Episode 5 Operation Ouch!

He's Dr Chris.

And he's Dr Xand.

And, yes, we're identical twins.

Do you know, your body does heaps of amazing things

every single day?

That is incredible.

And we're going to show you how.

Oh! You've cut him in half.

We've got incredible experiments...

-Huh...!

-BOTH:

-Wow!

And real-life medical emergencies.

There's a big chunk of my leg missing.

Ouch!

We'll be turning our bodies inside out...

Oh! Yuk!

To show you what you're made of.

You should see a doctor.

Better go find one.

HE CLEARS HIS THROAT

Dr Xand, mm?

HE SIGHS

-Coming up today on Operation...

-Ouch!

'We find out why Chris is having afternoon tea in the lab.'

That's delicious, tea is my absolute favourite thing.

'Our portable clinic is open for business.'

Can I have the next patient, please?

'And we take you to the front line with paramedics saving lives.'

We need to get there as quick as possible.

'But first...'

In the emergency department,

the team are ready for their first patient.

Let's meet him.

At the Royal Manchester Children's Hospital, Jack is in with his

mum and dad, but it's no ordinary day for him.

It's my birthday today and I'm nine.

Well, happy birthday, fella.

But what's brought you into hospital on your special day?

A sausage finger.

Ooh, I love sausages.

Not this kind, Xand.

Look away now if you're squeamish, because that's a photo of

Jack's finger on his mum's phone.

Eugh!

Not your ordinary sausage.

Let's find out how the birthday boy's digit got damaged.

It was an ordinary Saturday...

Hang on, Xand, I thought it was Jack's birthday.

Oh, yeah, it was the most special day of the year.

That's more like it.

Jack received some money for his birthday, and the plan was to

buy a special toy.

-A flying dinosaur, perhaps.

-Awesome!

So Jack hopped in the car and headed straight to the toy shop.

Sounds harmless. Where's this story going, Xand?

To the toy shop, Chris.

Whoa! Did you see that?

But when he arrived, Jack got out of the car, and in the excitement,

he closed the door on his finger!

Ouch! But what about Jack's birthday party, Mum?

We can't celebrate the birthday today, so we're going to have

to have another one when his finger's better.

Two birthdays. Result!

On hand to mend Jack's mitt is Dr Anne Markey.

Right, shall we have a look at this finger, then?

-Tell the lady what we call your finger.

-Sausage finger.

SHE LAUGHS He calls it sausage finger.

-He won't be having sausages for birthday tea, then?

-No.

That's Mum's dinner plans out the window.

You can say you've been fighting crocodiles.

'Crocodiles?'

There's well-known crocodiles in Manchester.

-I had no idea!

-She's just kidding, Xand.

Phew! But how is Dr Anne going to fix the damaged digit?

We'll take that nail off.

Underneath the nail where you can see the bruise, it's likely

that there's a laceration there, a cut in the nail bed.

So we'll put some stitches in.

We'll probably put the nail back on,

but it's not there to retake or re-grow, it's just there to protect.

All that will happen in operation tomorrow.

In the meantime, to stop any infection, Jack's having his

whole hand bandaged up.

-That's more like a sandwich.

-A sausage butty.

A sausage butty!

Hmm, I love a sausage butty too.

Well, that's the hard work done for today.

And then we'll let you go home for some special birthday tea.

Ooh, can we come?

We'll see you tomorrow.

We'll see you before your operation.

And now to our lab for some amazing body experiments.

-Eugh!

-Whoa!

Just don't try anything you see here at home.

Cup of tea, Chris?

-Ooh, I'd love a cup of tea. Is this for me?

-Yeah.

-Hmm.

Made it specially.

Hmm, that's delicious, tea is my absolute favourite thing.

Are you having one?

No, no, all for you.

'I'm purposely making Chris drink lots of tea.

'Shh, don't tell him, you'll find out the reason later.'

Now, today in the lab, we're going to be looking at the bit

of your body which holds your wee, or urine - your bladder.

Now, over here we've got a pig's bladder from the butcher's,

but it's almost exactly the same as a human one.

Your body needs liquid, and it takes it out of everything you eat

and drink, along with lots of nutrients.

-Drink up, Chris, don't let your tea go cold.

-Mmm!

But there's always a bit of waste liquid left over

that isn't needed, and that's sent to your bladder as wee.

'This is what happens when your bladder is full of wee.

'It can actually hold up to a litre of liquid.

'That's almost the same as two pints of milk.'

There we go.

If I use the torch, you can see just how full the bladder is.

And if you think of how small it was when we started,

it's pretty amazing.

In the wall of the bladder, there are lots of fibres,

and some of these fibres are muscle fibres.

That's right, you can actually see the muscle fibres all over

the wall of the bladder here, and what that means is that the bladder

can withstand the force of more and more tea, I mean wee, filling it up.

'As your bladder fills it stretches, and sensors in the muscle

'wall tell your brain you need to go to the loo.'

Right, now you're sure I can't get you another cup of tea?

I've got Earl Grey, lemon, herbal?

Absolutely not, my bladder is sending lots of signals to my brain

telling me to go to the toilet, and I do feel like I'm going to burst.

Perfect, that's exactly what I wanted.

Hang on a minute.

Have you been giving me all this tea for an experiment?

How can I put this?

Yes.

'I've been giving Chris lots of tea because I want to use his

'bladder to show you what happens when we empty it.

'I'm going to use an ultrasound so that we can see what Chris's

'bladder looks like now that it's full.'

Now, what you're looking at here,

these top layers are Chris's tummy muscles

and then below here, this big black blob, that's all of Chris's bladder.

It's full of clear liquid, which is urine.

Now the reason Chris needs to go so badly is because the sensors in

his bladder wall are detecting all the stretching, and this is known as

the micturition reflex, the point at

which you really, really have to go.

I think, pretty confidently,

I can say that I'm about to feel the micturition reflex.

All right, go ahead then.

What, here in the lab?

Just this once, on one occasion,

you're allowed to pee in the lab, Chris.

I think I'd better

cos I don't think I'm going to make it to the toilet.

'I'm going to hold the ultrasound scanner against my bladder

'While I'm weeing, so you can see it shrinking as I go to the loo.'

'OK, Chris, let your micturition reflex go.

'We can see on the ultrasound that Chris's bladder is shrinking,

'and that's because the muscle fibres are pressing on the bladder,

'forcing the wee out.'

God, that's great.

And you can't see his bladder anymore at all.

Completely empty. So how much did you go?

-Do you want to see?

-Yeah.

Wow, so how much is that?

-About a litre.

-That's quite a lot.

So, the amazing thing is that my bladder's gone from being

this size... to so small that we can hardly see it on the ultrasound.

'And it's those muscle fibres

'in the bladder that force all the urine out.

'But be warned, if you hold in

'your wee for too long, the muscles

'in the bladder can weaken,

'making it harder for it to empty itself.'

So, when the call of nature comes, it's absolutely vital that

you answer it.

You know, Chris, I really feel like a cup of tea.

I think it's your turn to make it.

Now, don't forget to warm the pot. And what I'd like... I feel

like Earl Grey, maybe jasmine. I think we've got some of that.

Now we're getting ouch and about with our mobile clinic.

Today, we're at a theme park to help solve your medical mysteries.

If you're anxious about an ailment,

or curious about a condition,

then the Ouchmobile is the place for you.

That is incredible.

Xand is preparing the clinic ready for his first patient.

And Chris is out in the park to answer your burning questions.

The clinic is now open for business.

Could I have the next patient, please?

First in is eight-year-old Grace, who's had an eyeful of her ailment.

So, Grace, what's brought you to the Ouchmobile today?

When I fall asleep and wake up, my eyes get all crusty and red.

Diagnosis, please, Doc.

Sounds like a case of...

"When I fall asleep

"and wake up my eyes get

"really crusty and red-itis."

'That's exactly what I'd say.'

What we can see is your eyelids are quite red and inflamed,

and you've got those little

crusty bits in your eyelashes.

So you've actually got a problem called blepharitis.

So it is a real "itis" in this case.

What can I do about it?

The first thing is getting a towel and just soaking your eyelids,

and that makes the crusts a bit easier to remove.

And then sometimes you do get these big flare-ups.

In that case, you need to go to the doctor, and they can either give you

some drops or they can give you some antibiotic pills as well.

The good news, though, is that it's not really serious.

Thank you, Dr Xand.

Away from the clinic, Chris is ouch and about in the park, solving

your medical mysteries.

Why doesn't hair grow back on scars?

That's because when you're born you've got a certain number

of hair follicles, and you can never grow any more hair follicles.

So if we cut your skin, when that bit of skin heals, you get

the scar, but there are no cells that produce hair there.

So you will always have a small bald bit.

Why is your funny bone

called your funny bone?

And why is it when you bang it,

does it tingle?

So, in fact, you're both asking the same question.

And the funny thing about your funny bone is it's not a bone,

it's a nerve.

And it's your ulna nerve, and it runs through a little groove

there, which you can feel, and when you bang the nerve,

you get that tingling going all the way down your arm.

That's what feels funny.

'Back at the Ouchmobile, there's a new case in the waiting room.'

Next patient, please.

'And it's seven-year-old Bobby, with a story about his skin.'

So, Bobby, why have you come to the Ouchmobile today?

I wanted to show you my leopard spot.

You've got a leopard spot?

Look at that. Diagnosis, please, Doc.

Sounds to me like a case of,

"I've got a leopard spot-itis."

Spot on.

Now, that is a real leopard spot,

and it's very interesting.

It's a birth mark, right, you've had it since you were born?

Most birth marks are dark in colour,

and this one is mostly light in colour,

so it's what we call hypopigmented.

It means it's got less ink in it, effectively.

So, what causes it?

In your skin, you've got cells

called melanocytes,

and they make your skin brown.

So when you've got a patch of very

pale skin, like you've got there,

it means it's got very few

melanocytes in it at all.

And that started when you were

just a tiny ball of cells,

inside your mum,

and since then, you've had that birth mark.

I don't think there's anything you need to worry about at all,

it's just a really cool-looking birthmark.

Job done for today. Clinic closed.

'Still to come...

'Chris goes on call with the UK'S emergency services.'

So, a call's just come in about an 83-year-old woman...

'We've got more first aid tips.'

Uh-oh, Xand's gone pale and unresponsive.

'And Chris has a rather unusual hospital appointment.'

It's like being inspected by a really nosy robot.

Time to head back to Accident and Emergency

to catch up with Jack and his sausage finger.

Ooh, I love sausages. Do you think he's got any ketchup?

Let's see him get fixed.

In Manchester, nine-year-old Jack is back in hospital, waiting for

an operation.

And he's brought along a new friend.

Now I don't have a sausage finger, I have Cyril.

Hello, Cyril.

Cyril is protecting Jack's cut finger,

and this is how it was damaged.

It was Jack's birthday, and he'd been given some money to buy

a gift at the toy shop.

When they arrived, Jack got out of the car, and in the excitement,

he closed the car door on his finger!

Ouch!

Jack's operation is just moments away, so Cyril's days are numbered.

Tell him, Dad.

You're going to lose Cyril, aren't you?

Never mind, Jack.

Jack's on his way to have his operation.

And there's no sign of nerves from our patient. In fact,

he's cracking jokes.

Knock, knock.

Who's there?

-Done up.

-Done up who?

Done a poo! Get it?

I think Cyril enjoyed that one too.

Time to prepare Jack for theatre.

To make sure he doesn't feel any of the procedure, the doctor

gives him some anaesthetic.

Dr Anne Markey

and Dr Adeyinka Molajo

are performing Jack's surgery.

First, they thoroughly clean Jack's hand.

The next step is to remove the nail, so they can stitch up the finger.

And remember, Jack can't feel a thing.

Forceps, please.

Before he can start to stitch,

Dr Adeyinka takes out any little bits of dirt and broken nail stuck

in the wound.

Next, he stitches the cut...

before gluing back on the nail.

And there's just enough time for a quick trim.

With the nail in place, a protective gauze is put around the tip

of Jack's finger to stop the bandage sticking to the wound.

Time to wrap that sausage finger back up.

Good. Thank you very much, ladies and gentlemen.

How was the op, Doc?

That went really well.

He's got another sausage finger for a couple of weeks till that

gets better.

On the recovery ward, Jack's wide awake.

So, how was your snooze?

I had, like, this dream when I was in an action figure movie.

An action figure movie? Cool.

But are you missing Cyril?

Since Cyril's gone, I have a new sausage finger.

He's forgotten Cyril already.

I know, and it looks like he's about to take that sausage finger home.

Bye, Jack!

Bye!

It's not only teams in hospitals that deal with medical emergencies.

All over the UK, there are teams of paramedics on stand by,

ready to help.

We're on call with the UK emergency services, showing you what

it's really like on the front line saving lives.

Paramedics use state-of-the-art vehicles, like this,

to respond to medical emergencies within minutes.

And today, I'm going with them to see

what it's like to be first on the scene.

On call with me is paramedic Jan Vann.

She can do 20 emergency call-outs in a day.

And a new case has come through.

So, a call's just come in about an 83-year-old woman

with one of her legs swollen.

So we need to get there as quick as possible.

Following a fall three days ago,

Doreen's leg has swollen up

and she's not been able to leave the house.

Her daughter is concerned something serious could be wrong.

Oh!

We need to see if this, that knee needs draining.

It's quite swollen, isn't it, in comparison to the other one?

'To have her leg properly looked at, she'll need to go to the hospital.'

5157, can I have amber back up, please, here?

I'll arrange for an ambulance to pick you up.

-I'll do your blood pressure...

-I have to do my hair

-and everything...

-You look gorgeous, Doreen.

-Oh, God.

-You look gorgeous.

Have you had any clots before?

No.

-No.

-Not as I know of.

One of the main things I think might be going on is

she might have a clot, which can happen in older people.

And in her legs, that doesn't cause her too much problem,

but it can be dangerous if it moves from the legs and goes to the lungs.

'With the ambulance on its way, we have time to do some important

'tests that will help the hospital when Doreen gets there.'

Doreen, this is a tracing of your heart.

You can see, it's nice and regular.

I'm glad something's right.

All the lines are the right way up, and the right height,

and they look fine.

This is Doreen.

Had a fall on Saturday, pain in her left knee with swelling,

left lower leg.

The ambulance crew have arrived, and Doreen's in great shape.

She's really cheery, but she has got this knee pain, so we need to

get her to hospital, fix the pain, and then she can come home again.

We've got what's called a Stryker chair to get Doreen

downstairs on, and it's a special designed chair that has

runners rather than wheels, so it can slide down the stairs.

What do you think of this, Doreen?

I've never seen one of these before. I might get one myself.

THEY LAUGH

Doreen's an amazing woman, but today her leg's a bit swollen, she can't

walk around as easily as normal, so she's going to get to hospital.

And luckily, when she needed help,

Jan and the amazing chair were here to give it.

With hundreds of rapid response crews in the UK, if you have

an accident, an emergency service like this won't be far away.

It's one of the things that helps keep your organs warm.

Wow! And talking of keeping warm...

The British weather, it's so hard to predict.

At the moment, the sun is shining and it's hot, hot, hot.

And I always like to be the first to break out the shorts and sun cream.

You've missed a bit.

But you never know how long the sunshine is going to last.

At any moment, the sun could go in.

Don't think so, Chris, it's actually quite a nice day.

And once the sun's gone in, it could start getting chilly

and that could be dangerous.

At any moment, it could bucket down with rain.

Well, actually, Chris, I did bring an umbrella for that very eventuality.

Arghh! Arghh. Brr...

And in this country, even on a day like today, it could hail.

Hail?

Arghh!

Which is why you should always pack an extra layer of dry clothes,

isn't it, Xand?

Xand?

Uh-oh, Xand's gone pale and unresponsive.

This looks like hypothermia.

What do this lot think?

B - wrap them in a blanket and call 999.

Emily's absolutely right.

Have a look at this.

Let's sit you down.

-Now how cold are you?

-I'm freezing.

-Are your lips blue?

-Yeah, blue lips.

-Are his lips blue?

-KIDS:

-Yes!

Yes, his lips are blue. Let's get you a blanket.

-Also...

-We can give him a hot drink.

And chocolate bar.

'Sometimes the person may even be confused.'

So, do you know who you are?

I'm Dr Chris.

Oh, dear, he's a bit confused, and he's not been able to warm himself

up, even with the blanket or with the tea.

I think we need more help.

Ring-ring, ring-ring.

Emergency services, what's the problem?

I thought you were hypothermic?

-I'm just doing the emergency services bit.

-Oh, I see, OK, OK.

It's Dr Chris here, I've got an emergency.

I want the ambulance, please.

-Oh, right, whereabouts are you?

-I'm at the 'Operation Ouch!' school.

-We'll get an ambulance to you straightaway.

-Thank you.

So, now we'll just look after you,

and if we can, take off his wet clothes and move him indoors.

'Who's up for treating someone with hypothermia?'

-KIDS:

-Me, me!

-'They're keen.'

'Now remember, we're showing you what to do in an emergency, but

'it's always best to find an adult.'

OK, so, what else do you need to do now?

-Get her some...some hot cocoa.

-Hot cocoa.

-And some chocolate.

-And chocolate bar, lovely.

Do you know where you are?

Library.

-In the library. We're not in the library, are we?

-No.

-What do we want to do?

-Call 999.

Yeah, I think we better do that.

So, if you think someone has hypothermia, you should warm

the person by wrapping a blanket or towel around them, and give

them warm drinks and high-energy food such as chocolate.

Xand, what are you doing? We've finished,

you don't have to stuff your face with chocolate,

you haven't got hypothermia anymore.

Oh, right, OK. Ooh, look at that dog over there.

A dog? I want to see this.

Now, just take the bandage, just take it.

Oh, this is ridiculous.

I thought medical robotics was the future,

but I can't even teach this one the basics.

Xand, this isn't a medical robot, it's a toy.

But would you like to see a real medical robot?

Would I?

Time for Investigation Ouch!

Hey, I told you not to sneak up on me like that.

Now, this is Gary.

Now, he may look big and tough but, in fact, he's a big softie.

Aren't you, Gary?

Here at the Royal Marsden Hospital in London, Gary treats people

by zapping tumour cells.

Bodies are made up of billions of cells,

but sometimes they can go wrong and forget to stop growing.

And that's what a tumour is,

a bunch of cells that have forgotten to stop growing.

And Gary has special powers that can help get rid of tumours.

Doctors use beams of energy called radiation to destroy bad

tumour cells.

Unfortunately, sometimes nice normal cells living close by can get

destroyed too.

And that's where Gary comes in.

He delivers a beam of radiation as thin as a pin that's so

precise it avoids the good cells and kills only the bad ones.

And here to explain more about

Gary's powers is Dr Nicholas Van As.

Nick, I recognise some of this.

We've got a spinal column and...and the hips.

But what is the pink lump with the blue lines?

So we call this picture a hedgehog, which is just a map, essentially,

showing us where each beam of radiation's going to come in.

So the blue lines represent one dose of radiation from the machine.

And the pink in the middle is the tumour that we're trying to

get rid of.

Instead of using maybe one or two beams of radiation,

we're using many hundreds of beams.

The whole aim is to try and do as much damage to the...the bad bit

and do as little damage as we can to the good bits.

Time to see Gary in action with me in the hot seat.

Here to assist is...

How long does a typical treatment take?

Most treatments take about 45 minutes to an hour.

Do people get bored or anxious? What's it like? Should I worry?

No, there's nothing to worry about, and you don't feel anything.

Gary won't be beaming any radiation at me, but you will get to

see some of his cool moves.

It's like being inspected by a really nosy robot.

'Using his laser eye to guide him,

'Gary's able to attack the tumour cells from many different angles.'

And every time he stops, that's when he'd deliver

a dose of radiation to a tumour right in the middle of my head.

'By zapping the tumour in this way, Gary gets the job done super fast.'

Historically, if we wanted to give enough dose to try and get rid of

this, we might have had to give it treatment every day for six weeks.

With this, because we can give these high doses very accurately,

we can do this treatment over three days.

And that makes Gary robo-tastic.

Patients can spend much less time in hospital

and more time doing the things they love.

This is one smart robot.

In Accident and Emergency, doctors and nurses need to act fact.

Especially when things like this happen.

In the waiting room is seven-year-old Sally,

who seems to have misplaced her pocket money.

I have swallowed a coin.

Go on.

And I don't know how to get it out.

Well, how did you get it in?

Well, Xand, what happened was Sally's mum gave Sally a £1 coin

for her pocket money.

-Ah, nice. Did she put it in her piggy bank?

-No.

-Did she buy 100 penny sweets with it?

-Nope.

Did she use it to hire a supermarket trolley?

No, Xand.

Sally decided to use the coin to play catch with.

She threw the coin higher and higher...

Wow, that is very high.

-I know, Xand.

-I'm not sure the Queen's enjoying the ride.

And when the coin finally came back down, Sally ran forward to

catch it...

but it missed her hands and went straight in her mouth.

-BOTH:

-Ouch!

Don't worry Sally, here's Dr Alan Greyson.

Let's see if he can help you

get a refund.

Since you swallowed the pound coin, how has your breathing been?

It's been OK.

Can I have a little listen to your chest? Is that all right?

You take some big breaths like you've been running.

Dr Alan needs to check that the coin isn't affecting Sally's

breathing because that could be dangerous.

When you swallow something like a nut, it goes down your throat,

into your oesophagus, or food pipe, and then into your stomach.

And Sally's coin may have done the same journey, but it could go

down her trachea, or wind pipe, and end up in her lungs, which

would cause her to choke.

That all sounds normal.

Good news, but Dr Alan needs to find out exactly where

in her body that coin is, so it's off to X-ray.

So, this is my camera.

I'm just going to see if we can see your coin.

Show me the money!

There it is. What do you think, Nurse Fay?

You definitely swallowed a coin.

The coin was in my belly.

And that means it's passed her wind pipe and there's no risk of

it ending up in her lungs.

So, it's back to Dr Alan to find out how to remove the coin.

It's going to come all the way through your tummy

and out into the toilet, probably in about two to three days' time.

Is something on your mind, Sally?

What if it fell in the toilet and it was very dirty?

What we usually say to people is

don't try and get it back out of the toilet.

Well, I've heard of spending a penny, but never a pound.

If I go to the toilet, the money will, like, appear in the toilet.

That's money down the drain.

Try keeping your pounds in your purse next time, Sally.

-BOTH:

-Bye!

Next time on Operation Ouch!

'We take a dip, all in the name of science.'

This is hot.

'We're ouch and about solving your medical mysteries.'

Can I see the next patient?

'And Xand faces a lie detector test.

'Is he telling the truth?'

I like to do ballet dancing.

OK.

We'll see you next time for more...

-BOTH:

-Operation Ouch!

In the emergency department, the team are ready for their...

-LAUGHING:

-first patient.

Have you been giving me all this tea for an experiment?

How can I put this?

Yes.

Arghh, arghh...

Brr...