Tonight’s Casualty picks up the thread that sent shockwaves through fans last week: the possibility that Dr. Matty Linlaker could actually be Dylan Keogh’s son after a brief university romance decades ago.

For a man who has mastered the art of emotional detachment, Dylan is suddenly rattled — and it shows.

Dylan’s mind isn’t on the medicine

Still reeling from the revelation, Dylan’s focus in the ED collapses. He botches a basic procedure, forcing Jodie to step in and quietly cover for him. The mistake doesn’t go unnoticed.

Stevie Nash watches him with growing concern — and eventually corners him. Dylan admits the truth he can’t shake: if Matty is his son, nothing else matters right now.

Stevie offers what seems like the most obvious solution: call Sarah, the woman Dylan had the fling with. But the moment her name is mentioned, Dylan shuts down. Too many years. Too much unfinished business. Too much risk.

A desperate plan — and an ethical nightmare

Instead of talking, Dylan decides to act — and what he does next is one of the boldest and most ethically questionable moves the character has ever made.

When Matty self-tests after exposure to a Strep A case, Dylan watches him discard the used swab, still covered in his DNA. The rest of the department moves on. Dylan doesn’t.

In a moment that feels equal parts desperate and calculated, Dylan retrieves the swab from the bin when no one is looking. Later, at home or in a quiet corner of the hospital, he collects his own DNA sample — ready to send both away for testing.

It’s a staggering breach of medical ethics, privacy, and trust. But for Dylan, all those boundaries dissolve under one overpowering fear:
What if he’s been a father all this time without knowing?

The emotional stakes are enormous

This storyline isn’t about legalities — it’s about identity. For Dylan, a confirmed paternity test could mean:

• A son he never raised

• Decades of lost time

• A relationship built on silence

• And a future he can’t predict

For Matty, the fallout could be even more complicated, especially if he learns the truth after Dylan has already obtained his DNA without consent.

What happens next?

The questions hanging over tonight’s episode are heavy:

• Will the test confirm Dylan’s suspicions?

• How will he explain what he’s done if the result is positive?

• How will Matty react if he discovers the truth by accident?

• And what happens if the results come back negative — after Dylan has crossed a line he can’t uncross?

There is also the quiet possibility that someone — Stevie, Jodie, or even Matty — may catch Dylan in the act, adding another layer of tension to the ED.

For a character who has always prided himself on control, tonight’s episode exposes just how far Dylan Keogh will go when that control shatters.

And for Holby City… nothing is more dangerous than Dylan acting on instinct instead of reason.