"Where's the Art in Heartache" is the 613th episode of Casualty and the 23rd episode of the 22nd series.
Maggie's daughter begins her contractions, Jeff is injured in a pub brawl making Greg consider whether he should resign after Dixie calls him a liability. While vandalising the underside of a bridge, the man slips and is left dangling down from the bridge. Greg is first on the scene. The rope snaps and he falls onto the road causing a car pile up. As Greg checks out the damage he finds that his patient from last week, Ruby, was involved in the crash. Chloe, the mother, has been impaled through the stomach and is trapped in the car. A chemical from a van begins to spread across the scene causing the fire brigade to tell the paramedics to retreat. Chloe passes away and Greg tells Ruby that her mother is just sleeping. Back in the hospital Ruth is treating the graffiti artist in cubicles while Adam treats Ruby, After Adam requests a blood gas for Ruby, Kelsey tells him that seen as she is on an agency shift she can not do them much to Adams disgust. Kelsey asks Adam to step outside where she tells him that she is not impressed with his attitude. Tess is forced to close the department as they can not cope with all the patients, even though Dixie and Jeff are literally minutes away they are forced to divert to St James, an extra 10 minutes away. It then transpires that the chemical was Carbon tetrachloride, Ruby dies after Adam, Kelsey and Zoe try desperately to resuscitate her for 30 minutes. Tess shouts at Abs blaming the work-to-rule in causing the death of the elderly man ,that Dixie had in the ambulance, and Ruby . The department gather outside to see themselves in graffiti as the graffiti artist from earlier made them a tribute.