Doctors All Over the Workplace

Are you bonkers about biology and crazy about chemistry?

Have you got a hankering for helping people who are ill?

And in a full-on emergency, are you up to saving someone's life?

Then a career as a doctor or medic could be for you.

Today, we will really get your blood pumping.

Our two rookies are determined doctors in the making.

We'll get their hearts racing at a GP practice

and one of the UK's biggest children's hospitals.

They'll even try their hand at surgery

when we go All Over The Workplace!

Now, I'm pretty sure I know my way around medicine.

After all, I've seen loads of TV doctor dramas.

There's loads of urgent running down corridors with trolleys.

And loads of bossing people about with big words.

You! Cross match two units of O neg. Stats!

And lots of looking concerned and nodding.

But when our rookies find out what being a doctor is really like,

will they still want to be life-savers?

Or will they end up losing their PATIENTS?

Ha-ha! Patience! Patients! Ha-ha!

My name's Lubna. I am 12 years old.

Recently there has been an earthquake in Pakistan

and Afghanistan.

I want to be that daring doctor to go and help their injuries

and I want to go and help Palestine, Syria, Israel and et cetera.

Hi, I'm Rayaan and I'm 12 years old and I want to be a heart surgeon.

The reason why I want to be a heart surgeon is because,

when my grandad had a heart operation,

I really feel that it's something that's really serious, and to

save somebody's life like that, I think I'd really love to do it.

The rookies have travelled from their home towns to join

Alex in Newcastle.

So, Rayaan and Lubna, you both want to be doctors?

-Yes.

-That's quite a tough profession, I would say.

What do you think might be tough about it, Rayaan?

Well, definitely dealing with tragedies is something very big.

OK, well, that's the negative side.

What do you think you could bring to that job?

Well, I'm good with kids,

so I think I can make them calm and tell them that everything's

going to be all right and there's nothing to worry about.

A good bedside manner. Very important, yes.

So, what about you, Rayaan?

-Well, I want to be a surgeon.

-Yeah.

So, to be a surgeon, you have to have a steady hand. I like painting.

So, when you paint, you have to have a steady hand.

Well, that's what you think about your skills.

But here's what your parents have got to say.

The bits that Rayaan may potentially find challenging

is the gory side of it, and seeing blood.

When she sees blood, it's not like she's screaming or crying,

"Oh, Mum, I've seen something."

She's not that kind of a person.

Rayaan? You don't like blood!

-Yeah...

-You want to be a surgeon!

You're going to see blood when you're a surgeon, you know.

I know, but the only thing is, I don't like to cut the skin.

"I'm a great surgeon. I just don't like cutting people up."

I mean, what are you going to do about that?

-That's not a very good surgeon, is it?

-I know, I know.

See if there was a child right there and they was, like,

they're bleeding or something

and no-one's doing anything about it, then I'll be there to help them.

OK, all right. I'll bear that in mind.

OK, well, let's see how you get on with your first task. Come with me.

Let's go.

So, have you any idea what we're going to be doing next?

Nope, no idea.

We're going to see the GP.

Hope we can get an appointment!

"GP" means General Practitioner.

Basically another term for "doctor".

The GP would usually be a patient's first port of call

if they notice something wrong.

Dr Natalie Crowe has been a GP for 20 years,

and she is also responsible for training junior doctors.

So she should be a great mentor for Lubna and Rayaan.

Have you got three top tips that you can give us about being a GP?

Well, my first top tip would have to be that you have to be able

to listen really well to people and make them feel at ease,

so they don't mind talking to you.

My second top tip would be that you need to

think about the person as a whole person, not just about why

they're poorly, but how that affects their everyday life.

And my third top tip would be that you have to be able to work

under pressure and you have to be able to work quite quickly

and make quick decisions.

Dr Natalie's top tips are...

You've got to pay attention as a medic.

Improving the everyday life of the patient is the aim.

You've got to keep your cool in those time-critical moments.

Well, I think it's about time we saw some patients. OK?

So what I'd like you to do is

to find out a little bit about his history.

Dr Natalie wants Rayaan and Lubna to investigate the patient's medical

background and find out about any medication he might be taking.

Remember her top tip, treating the patient as a whole?

This is exactly what she means.

I've got a history of high blood pressure.

And it is controlled by medication.

OK, so what do you think we should do with Mr Barnes?

-Take his blood pressure.

-That sounds like a very good idea.

Lubna, do you want to see if you can help me fit this on Mr Barnes?

So we need to put this on his arm,

so you need to wrap this round so that this bit is

just above the crease of his elbow, so you start pumping. That's it.

Press a bit harder. Very good. Can you see what's happening here?

-Yeah.

-So, can you put that in your ears?

-OK.

So if you can tell me when you hear some sounds starting.

-Now.

-Excellent.

And then when they disappear. Yeah?

-Disappeared.

-Fantastic. So, you've checked his blood pressure.

-Thank you.

-Were they round about here, at 140?

-Yeah.

-And then when they disappeared...

It was round about, yeah...

-About 70.

-Yeah.

-Excellent. So your blood pressure is 140/70.

-Thank you, thank you.

-That was really good.

So, I think, if we have a listen to his heart,

-would you like to have a go at that?

-OK.

OK, so I'll put the stethoscope on Mr Barnes' chest

and you can tell me what you can hear, OK?

-Is that all right?

-Cool, cool.

-Lovely. Just put it down there.

-His heart beating.

-Good. That's a good sign!

-I'm alive!

It's doing beat, beat-beat. Beat, beat-beat, like that.

-So it's going a regular rhythm, so well done!

-Good!

-That sounds fantastic, excellent job. Good. Thank you.

-Thank you.

In the 1890s, Victor Horsley was the first surgeon

anywhere in the world to work in a hospital as a brain surgeon

at the age of just 29.

South African cardiac surgeon Christiaan Barnard

performed the world's first successful heart transplant in 1967.

That's less than 50 years ago.

Wilson Greatbatch invented the heart pacemaker accidentally

when he was trying to record the sound of a heart beating.

Pacemakers now improve the lives of thousands of people and,

in some cases, save lives.

I've got another patient for you to see, but this time

I want you to see if you can see the patient on your own, without me.

Wow!

-Hi.

-Hi, there.

-Hiya.

-How are you?

-I'm good, thank you.

-I'm Rayaan.

-Nice to meet you.

I'm Lubna.

Ah, nice to meet you.

Alex and Dr Natalie will be next door, assessing how Lubna

and Rayaan are doing in their first consultation.

This hidden camera set-up is also used when training real GPs.

Let's see how they get on.

For the past few days she's just felt sort of quite hot to touch,

and she's been a bit sniffly.

That was good, finding out when it started and how long it's been.

I liked the way they introduced themselves at the beginning.

That was very good.

Does she take any medication?

I've given her some infant paracetamol

and that did seem to help bring her temperature down a little bit,

made her feel a little bit more comparable.

Really sensitive questions.

So I've got, which I've seen,

-a temperature which I can put under her armpit...

-OK.

..to check what temperature she's at. Is that OK if we do that?

-No, that should be fine.

-Yeah? Put that part under.

OK, we'll pop in.

That's quite good. They're giving it to the mother to do.

-That's very clever.

-Sensitive.

-Very clever, yeah.

What I'm thinking that it could be is either an infection,

a virus or a bug.

I'm wondering whether he's already been to medical school, this one!

35.5, so a reasonable temperature for a body.

We could, well, the doctors, would give medicine.

-If it gets worse then I would come back in.

-Yeah, after a few days,

just check her temperature, so, then, you know

-if it's going up and down.

-Yeah.

We actually call that safety-netting when we explain to patients that,

-if things don't improve, they need to come back and see us.

-Yeah, true.

It was nice meeting you. Thank you very much.

-Thank you, that was really helpful.

-You're welcome.

-Bye-bye.

I was pretty nervous to be meeting somebody, a real patient.

I was nervous and also excited,

because I wanted to identify what was wrong with the baby.

It was really good today, because it gave me

a short experience of what will happen during medical school.

Lubna, I thought you did really well today. I was really impressed.

I think maybe you need a bit more practice at some of the practical

tasks that we did, but I thought you were excellent, so well done.

Rayaan, I thought you did really well today.

You showed that you are a really good listener

and you were really confident and enthusiastic.

I think, once you've done some proper doctor training

at medical school, I think you'll make a fantastic doctor.

Medicine, in general, whether you want to be a doctor or

a nurse or you work in health care in lots of different ways,

medicine's a pretty good way of having that kind of fun combination

of meeting lots of people, lots of cool equipment, lots

of hi-tech stuff, and also something that seems a bit worthwhile.

If you like to take scientific thinking and reasoning

and apply it to solving human problems,

problems of human biology,

and you enjoy talking to people and solving those problems,

then being a doctor is the job for you.

OK, have you got any idea what you are going to be doing next?

-No!

-OK, when someone comes to a GP's surgery and what's wrong with them

is quite serious, they get referred up to the hospital.

So that's where we're going now, to find out what hospital doctors do.

-Awesome!

-Let's go.

Great North Children's Hospital is

one of the largest children's hospitals outside of London.

It was built just five years ago

and was designed to look as little like a hospital as possible.

Before our rookies go any further, they need to look the part.

So we surprised them with their very own uniforms.

That's amazing.

I told you, ah, look!

-I've got my own card and everything.

-Ah!

-It's amazing!

Meet Dr Rayaan and Dr Lubna.

They're reporting for duty at the Children's Intensive Care Unit,

where children who are critically ill or in an unstable

condition are treated.

Mentoring Rayaan and Lubna here is Dr Iain Johnstone,

an intensive care paediatrician.

But he previously worked as a lifeguard

before going to medical school.

He looks after very ill children in the intensive care unit, or ICU.

Put your head through there.

Hygiene is important everywhere in a hospital,

-but in an ICU, it's particularly important.

-One scoop...

Lubna and Rayaan are sanitising their hands before going on duty.

This is one of our typical babies. This is Miles, OK?

And he's only a few weeks old, and he's come in with a chest infection.

Now, do you think he's awake or asleep?

-Asleep.

-Yeah, he looks very asleep, doesn't he?

That's intensive care, you see.

The reason we have to keep him asleep is because

he's on a breathing machine that helps him breathe.

You have a plastic tube going down your nose into your throat.

And that's not very nice.

So if it was you or me, the first thing you'd do is pull the tube out.

So that's why babies and children in intensive care are kept asleep.

He's got these things called ECG dots or heart tracings.

And if you look here, that's the heart tracing,

that green line at the top.

-And it tells you how many beats per minute, which is...

-137.

Now, if that was me, I'd probably just run up a flight of stairs.

But if I was as old as Miles, that'd be absolutely normal, OK?

So, if you look at this leg, what do you think that's for?

Is it for the blood pressure, to measure it?

It is. That's to measure the blood pressure, yes. There it is.

That's OK. So the blood pressure's all right.

Now, do you think babies should be warm or cold?

-Warm.

-Yeah.

So, sometimes, he feels really cold down here,

and as you move your fingers up, it gets warmer.

And that means that the heart is struggling to get its blood

right to the edges and that's why your hands and feet go cold.

So why don't you put the back of your fingers on here

-and just feel up his leg?

-OK.

The same.

-What do you think, Lubna?

-It's the same.

Yeah, I think it's the same, as well.

So that's good. I think that's healthy.

OK, so after I've done that, that's a general look, I'm going

to listen to the chest. So that means a new bit of equipment.

It's a stethoscope. But, because it's intensive care,

each patient has their own stethoscope at the bed space.

Now, do you want to have a go?

-OK.

-Put them in that way round.

So we just place it gently here.

AMPLIFIED BREATHING

OK?

Lubna, do you want to do the same?

He's put his arms up obligingly for you there.

LUBNA CHUCKLES

Oh, yeah, you can hear it.

What did you think of this chest?

Any crackly noises or musical noises?

-No, it sounded quite healthy.

-I agree. I think it did.

It sounded all right, didn't it?

There wasn't any of what I would call added sounds. Very good.

Another thing you can do is listen to the baby's tummy

and you can hear gurgling sounds.

You know when you're really hungry and your tummy gurgles?

Just have a little listen.

GURGLING

Yep?

Yeah, you can hear that.

So we've assessed Miles,

we know he's on the breathing machine,

we know that his skin's nice and warm,

we know that his lungs actually sound reasonably healthy,

so I don't really want to change anything at the moment.

I think we'll keep doing what we're doing

and then we'll come back in a couple of hours and reassess.

OK.

OK, guys, one of the things we often do,

one of the tests we usually do is a chest X-ray.

So this is the X-ray of Miles, the baby we've just been looking at.

Before I start, can you tell me anything that's on there?

Do you know any of the parts?

-The ribs.

-Those lines are the ribs.

-Spine.

-There's the spine. Excellent.

How do I know that the stomach's there, though?

-Because there's a line going down.

-Yes, very good.

It's a tube that's put in by us,

so that we can put feed and medicines

down when the baby's asleep, so it

goes from the nose all the way down the gullet and into the stomach.

Now, can you see any other parts on this X-ray

that aren't normal parts of the body?

-It's a spring.

-It's a spring.

Perhaps that's why his arm kept going up!

Boing, boing!

No, that's on the outside,

so that's on the other end of the breathing tube there.

So what you can't see is his head.

So it goes into his nose and down into his windpipe.

And what do you think those darker shapes might be?

-Are they the lungs?

-They are the lungs, yes.

So, what do you think that makes that white shape in the middle?

-The heart.

-The heart, absolutely. It's the heart.

Now, what colour is that?

-Black.

-It's very black, isn't it? Because that's just air.

Why don't the lungs look quite as dark as the air outside,

if they're just full of air?

-Because of his chest infection.

-It could be an infection, couldn't it?

So that's why it looks a little bit white and fluffy.

So that's probably abnormal.

The good news is that baby Miles is out of intensive care

and is well on the road to recovery.

The rookies don't know it,

but a simulated emergency is about to happen.

Doctors actually go through this kind of training to make sure

they're alert and efficient at all times.

How will the rookies do?

Wednesday night, you'll be on duty... Oh!

It's an emergency. Come on.

-Come on, come on!

-Let's go!

Come on, run.

Come on, come on, come on.

The baby was working really hard, so I gave him a suction.

He started dropping his sats.

I put his oxygen right up but he's still working really hard.

This is a simulation of CPR, a technique that's used

if someone's not breathing properly or even if their heart has stopped.

Oh, dear, look. See that big yellow number there?

That's the oxygen level. What does it say it should be?

-100.

-100. And what is it?

-It's 69.

-Oh, he's looking a bit blue round the lips.

So we better put some extra oxygen on.

Right, Lubna, take your left hand. Hold that mask on the baby's face.

Squeeze that, let it fill up with oxygen.

Lubna is using an oxygen mask to assist the patient's breathing.

Look at the heart rate. Remember it was really fast in baby.

That's a bit low, isn't it?

If that goes below 60, let me know,

because I'll have to start doing chest compressions.

-It's gone down.

-What is it now?

-56.

-Really?

All right, OK, can you feel the edge of the breastbone is just there?

Use these two fingers.

Four, five, six, seven, eight, nine, ten.

Get those two fingers. These two.

Rayaan is giving chest compressions,

keeping blood and oxygen circulating around the body.

This technique needs specialist training

and is only carried out in an emergency.

Keep going, keep going.

-It's coming up. Good. Right. Rayaan, pull that mask on.

-Yep.

So you've got two hands now

so I want you to let a little bit of air out of that hole at the back.

That's it. Oh, very good. So the numbers are all better.

Let's just have a quick look.

It will still need some oxygen, I think. He looks nice and pink now.

He's breathing. What do you think, Rachel?

Shall we just see how he goes, like that? Just needed a bit of oxygen.

-Well done, guys.

-Thank you. Great.

Well done, guys. A life saved! Emergency response team, excellent!

Oh, I think I need to go and lie down.

LUBNA LAUGHS

Being in intensive care drew me back, but it also inspired me

to see how many tools we have today just to make people better.

It was mind-blowing, because at first I didn't even know what to do

or how to do it, but then, after the whole experience, it was amazing.

Rayaan, what a performance. First time you've examined a patient

and you could tell the temperature of his skin,

you could tell me all about how healthy that felt on the baby.

Really impressed. Lubna, I thought you were excellent.

At the emergency resuscitation,

you delivered oxygen to that baby with great skill.

For someone who's never done it before, that was highly impressive.

So, with GP and intensive care experience under their belts,

it's time to head to London for their next assignment.

Any idea what you're going to be doing next?

Well, we are outside a hospital.

Yes, but this time, you're going to be doing surgery.

You're going to be working on the same surgical models that

-doctors train on.

-Wow!

-Amazing.

So if you do feel a bit squeamish, maybe this bit isn't for you.

So what's a good name for a surgeon?

Backbone? Thighbone?

Kneebone?

Yes, Kneebone!

Rayaan and Lubna's next mentor is actually called

Professor Roger Kneebone.

He works at the Imperial College Centre

for Engagement and Surgical Science.

He simulates operations

and real-life procedures to train budding doctors and surgeons.

The rookies are getting dressed in their sterile surgical gear

because Dr Kneebone and his team are about to put them through their

paces, as they try keyhole surgery in a simulated training exercise.

In this operation, the patient is played by an actor.

This is exactly how real surgeons train.

We are going to introduce ourselves first of all to Sarah,

who's simulating a patient who is having a heart attack.

-Hi, Sarah. I'm Lubna.

-Hi there, I'm Rayaan.

Have you done a lot of these operations?

No, but we've got a specialist

that can talk us through what we're doing.

-I thought you looked a wee bit young.

-We are young.

-Yes.

OK, so this is the screen we should be operating on.

You can see Sarah's heart beating faintly on the screen,

and that's the X-ray which helps you guide your wires through the artery.

The first thing is to unblock the blockage.

And they do that by putting a wire up into the blockage

and then blowing up a tiny balloon inside that stretches

the blockage and allows blood to go through.

The device is guided along the artery to where the blockage is.

The balloon is then inflated and that expands a mesh tube,

or stent, which keeps the artery open.

So, Lubna, if you help me guide the catheter into the artery.

Keep looking at the screen

because you have to be able to see what's happening.

You have to be able to feel what your hands are doing.

Rayaan, if I can get you just to inject some dye, this is a dye

-that helps us look at the artery while we're taking the X-rays.

-OK.

-There you go.

-Oh, wow, I see.

Am I looking all right? Is it looking good?

It's looking fine, actually, now.

-Soon the operation should be over.

-Yes.

They're working as a team.

Are they doing it with enough

sort of precision?

They're doing it really, really well.

Put your wire forward just a little bit.

-In?

-Yeah.

You're making tiny little movements, tiny little movement in and out

to get it in exactly the right place,

because it's critical to get it exactly right.

So the stent is just across where that narrowing is, so if you can see

that grid-like system, so that's where your stent is.

And what we have to do is inflate the balloon with the stent

to now keep that artery open.

And that actually goes up to very high pressures.

The stent looks like it's gone up very nicely.

What we can do is, we can bring down the balloon,

so you release the balloon by just pressing that yellow button.

Perfect.

So you can tell Sarah that you've now got her artery open

and that she will be fine.

OK. Well, Sarah, good news. Your artery is now open.

So the repair's done?

-Yeah.

-Thanks very much.

-You're back to normal.

I thought they did that brilliantly because they were making her

feel, I think, that everything was in control and that they knew

what they were doing and it was going to be OK.

We've all got 100 billion cells inside our brain, all of us.

And if you're prepared to learn and work and study, you can

become a doctor.

Secondly, I think

it's very important to want to know new things.

So I think to be inquisitive is very important,

because what you're trying to do is discover why somebody's ill.

Third thing is just really interest and focus.

I think one of the great top tips in any aspect of life, whatever

you want to do, is to really focus on what your ambition is.

Lubna and Rayaan have faced a steep learning curve so far.

They're about to face their biggest challenge yet -

to operate on a totally realistic model.

This is cutting-edge technology.

What you see here is not an actual patient on the table,

but everything else is very real.

These are people who have actually been trained to do what they're

going to do today, and you're going to join them

to look after this patient, who's been seriously injured,

and you're going to come and help with the operation.

Remember, this isn't a human patient,

it's an incredibly realistic model, as used by surgeons to train.

OK, so we need to be quite quick about this,

because he's fairly unstable, this chap.

So if you take that retractor,

just hold that and give us a nice, good view.

If you can get your hand in here and just see

if you can see where the bleeding's coming from.

What you want to do is look through all these bits of bowel to see

if you can see where the blood's coming out.

Oh, I saw something that was bleeding, that bit.

So what's Lubna doing now?

She's looking to see if there's any bleeding,

and there is some bleeding. Look.

Oh, quick, we're losing quite a lot of blood, actually.

Can you just try and clip that tube?

See that blood coming out? What she's going to try and do

is use the tip of those to stop that bleeding.

-She's got control of the bleeding. That's very good.

-Yeah.

-OK, what do you think? Do you think that's got it?

-Yeah.

Can you see any more blood coming out of that blood vessel?

-No.

-OK, well done.

-Can I please have a tie?

-Of course you can.

Right, now what you want to do

is tie a nice tight knot.

She's tried to put that round the end of the clip.

And tying a knot like that is not easy,

so she's making a very good attempt at it.

It's a bit fiddly, isn't it?

Oh, dear.

-Oh, no, it's coming loose.

-There we go,

that's got a bit tighter.

So how's the patient doing?

The blood pressure is stabilised,

so I'm hoping you've found the bleeder and stopped the bleeding.

I'll take the retractor.

You take the pair of scissors

and cut that a little bit away from the knot so that it stays...

Well done.

-Good.

-How will they know if they've found all the bleeds?

They go through everything and have another look.

Then at the same time, they keep an eye on

everything else that's going on in the operating theatre,

as well as what they were doing with their hands.

The big test is when we take this off.

If you can take the clip off like you did before...

That's it. Good.

So do you know what you can see in here?

So you can see the intestines.

Exactly. What else can you see up here?

We've got the guts here, which is the stomach.

-Yeah, that's right.

-And then here we have the liver.

-Very good.

-And you can see the difference, can't you?

-Yeah.

-OK, that's great. You guys are happy. Sharon, are you happy?

-Yep.

-Justine?

-Yeah, everything's OK. I'm happy.

That's brilliant. We can start closing him up.

Good job, everyone, that was awesome. Well done.

Very professional, I was impressed.

They worked closely with everyone and even when there was bleeding,

they didn't let it knock them off course, they were very calm.

At the age of 12, to be able to do surgery

was something extraordinarily brilliant.

It was exciting, but also it was a bit nerve-racking

because I didn't want to do anything wrong.

It was a bit weird seeing all that blood

because I actually have a fear of blood.

Lubna, you were great.

You were aware of what was going on around you

and at the same time doing the delicate things surgeons need to do.

Well done.

Rayaan, you have a real aptitude for using your hands,

for doing delicate things under pressure

but you were also aware of the other things happening

in the operating theatre,

and I thought that was really great, so well done.

The wannabe doctors have been tested to extremes,

assessing patients at the GP surgery,

learning about the daily running of a hospital,

and receiving training in both CPR and simulated surgery.

I think you'd both make fantastic doctors

and especially fantastic GPs,

so carry on working hard and being enthusiastic,

and you'll go far.

From what I've seen today I think both of you would make

excellent doctors in the future and I hope you go on to do so.

I think you've definitely got what it takes to become doctors

and work in the operating theatre. Well done.

Now, at the beginning of this whole process, Rayaan,

you were frightened of blood. Are you still frightened?

After the experience of being able to operate on a model,

I've realised that the blood isn't that important.

So I think yes, I have overcome my fear of blood.

That's great news. And Lubna, you were frightened of

dealing with children in pain. How do you feel about that now?

Do you know what? I need to overcome this fear

and I'm all right with it.

So do you still want to work with children,

or do you want to be a GP or maybe a surgeon?

I think I'm going to stick to working with children.

Brilliant. What about you, Rayaan? You wanted to be a heart surgeon

at the beginning of this - are you still as keen?

I'm definitely as keen and I really want to be a heart surgeon.

Congratulations.

-You've been brilliant.

-Whoo!

Well, I think Rayaan and Lubna are definitely doctors of the future.

I wouldn't be surprised to see them in the medical profession

in just a few years' time. Well, that just about wraps it up from me,

and...hang on a minute! What are you doing? Hey, you two!

Get off! I can't...!

What are you doing?!

-Bye!

-Bye!