Tremendous Tears Operation Ouch!

He's Doctor Chris.

He's Doctor Xand.

Yes, he's still got his beard.

And we're still identical twins.

Your body's amazing.

And we're going to show you why.

I've got something stuck in my ear.

We're head-to-head in Operation Takeover.

SIRENS WAIL

Ouch And About hits the wards.

What kind of ambulance did you get?

I didn't get an ambulance, I got a helicopter.

There's more first aid tips.

We do need to get Xand to hospital.

We catch up with our new Ouch patients.

Hello!

And our lab experiments will

blow...your...mind!

That is an amazing view.

Are you ready to join us?

PPRRRRFFFFT!

-Was that you?

-No.

Coming up today on...

Operation Ouch!

There are tears of pain.

Ah!

I give some advice.

HE BURPS

And we're all at sea.

-That is amazing. BOTH:

-Man overboard, starboard side!

But first....

The team in the emergency department can fix just about anything.

Which is just as well! Check out this next case.

Right, Xand, let's go.

Over in Sheffield accident and emergency department,

12-year-old Callum has arrived with Mum, sister Jodie,

a busted lip and a grazed shoulder.

Ooh! How did that happen?

Callum went to an outdoor skate park on his scooter.

Whoa! Look at that guy's moves!

I know. Callum couldn't wait to join in.

Hold your horses, mister!

Callum can't join in, he doesn't have a helmet on.

I know, Xand. But he went on in anyway.

Er...rewind!

What about knee and elbow pads as well?

I know, Xand. He didn't have any.

Oh, no! I can't watch!

Callum embarked on his best move ever!

But it went totally wrong, he crash-landed onto his mouth,

slid along the ground, scraping his body.

Ouch! Ooh, poor guy can't even speak at the moment.

Luckily, Dr Caroline Kendrick

is ready to see you, Callum.

As Callum landed with force,

Dr Caroline checks that

he doesn't have any hidden internal injuries.

It looks as though these are all just very,

what we say, superficial grazes.

So, with his body in one piece,

there's just one last place to check.

Right, need to see what's under here.

All right? OK.

You've got a cut on the inside of your lip

and around the teeth, OK, it looks as though

you've given them a good push back. OK.

Callum's front teeth are totally bent out of position,

so he needs to see a specialist.

Find out what the docs have got in store later.

Did you know your eyes are made up of over 4 million working parts?

Wow!

And now to our lab.

It's time for some big body experiments.

Some of them gory!

This is not for the squeamish.

Some extreme!

It's freezing!

We're ready, are you?

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

Xand, what are you doing?

Oh, Chris, I'm blinking.

Did you know that you blink 15 times every minute?

And so if you take sleep time into account,

that's 16 hours of waking time, and that means that we blink...

14,400 blinks every day!

And if each blink lasts about a third of a second,

that means I have my eyes closed for an hour and 20 minutes every day.

Right, and your point is?

Well, I thought if I could get all my blinking out of the way

early in the morning, then I wouldn't miss anything later on.

Well, Xand, it's an interesting idea, but it's never going to work,

because blinking is controlled by a reflex.

HE SOBS

Chris! I really thought I was onto something there.

Wait, Xand, you are.

-You are a genius.

-Oh, am I?

-Yes!

You cried and your eyes produced tears,

which is exactly what today's lab is all about.

Tears are a bit like the saliva in your mouth, they have loads of jobs.

Making your eyes sparkle!

That's not an important one.

Well, it is to me. But to show you where they come from,

we need to take a closer look at the human eye.

Absolutely, Xand, which is why I need you to come and sit over here.

I'm going to use this slit lamp to get a super detailed view.

Lights down.

And now we can see on the screen Xand's eye.

Tears are produced in the lacrimal gland beneath your top eyelid.

It's like a slow dripping tap that constantly releases tears

onto the outer surface of the eyeball.

Whenever you blink, they spread across the surface of the eye.

And I can show you...

where they end up.

Because obviously tears don't flow down your cheek all day.

In the corner of your eye, you can see that little hole...

it's called the puncta lacrimalis.

And so tears flow across your eye, into that hole

and into your nose, a bit like the plughole in a bath

and that's why your nose runs when you cry.

Now, the tears that Xand's making at the moment are called basal tears

and they protect the eye.

They contain antibodies

and they lubricate it.

And when they run into the nose, you swallow them and recycle them.

But not all tears are created equal.

And we are going to try and prove it.

-Are we? How?

-By turning your tears, Xand, into crystals.

Crystals? In my eye?

That's going to hurt!

No, Xand, not in your eyes, in our lab!

Your eyes actually make different types of tears

depending on why you cry.

And I want to see if we can prove it.

Are you ready, Xand?

-No!

-Good.

Now what we need you to do is to produce some tears.

I will then collect them using a little syringe.

So what kind of things make you cry?

Well, I suppose a really sad movie.

Brilliant. Sad tears.

HE SOBS

Success! Now what about tears from chopping onions?

And let's try some wind-in-your-face

while-you're-riding-your-bike kind of tears.

Now, there's one more type of tears I had mind.

Tears of pain.

So I'm getting Xand's eyebrows threaded.

Ow, ow, ow, ow!

Hold on, stop! Stop! I can see a tear.

Great. Now all we have to do is wait for the tears to dry

and turn into crystals.

Right, come on, Xand. Time to look at the results.

First up, it's the onion tears.

So these are your dried tears from when you chopped onions.

Wow! Crystals from my eyes!

These are actually reflex tears

and they're full of antibodies and enzymes

which is what you can see here as having dried on the dish.

And those are produced to soothe the eyes

when they're exposed to an irritant.

That's why your eyes cry when you chop onions.

Next up, it's the wind tears.

Wow! That looks very different to the onion tears.

These are also reflex tears, but they look different

because the body has responded to the wind differently to the onions

by making a different combination of salts, antibodies,

and enzymes in response to a different irritant.

What about my sad tears?

Wow! They look different again,

they've got very beautiful crystals, amazing!

Now, these are emotional tears, they're a different kind of tear.

They're produced in response to stress

and they contain a high level of a natural painkiller

called leucine enkephalin.

Now time for the final tears.

Xand's pain tears.

Look at that! These are also emotional tears,

but they look different again

because they also have a different combination of salt, enzymes,

and antibodies in them.

So in these four samples,

we've got two different kinds of tears,

reflex tears and emotional tears,

but all of them actually look different.

Which just goes to show

how incredibly fine-tuned your tears really are.

So, we've shown that your tears flow over your eyes

and are drained through a hole into your nose!

And we've shown you not all your tears are the same,

they're made up of different chemicals

to protect your eyes in different ways.

HE SNORES Hmmm.

I wonder if Chris's pain tears are the same as mine?

Ooh! That's a nice big nose hair!

Maybe I'll get it for him!

He'll be thankful.

Ow! Who did that?

Xand!

We're both Ouch And About.

I'm hitting the wards with my Ouch bleeper.

That can be really serious.

And I'm hitting the streets to answer your medical mysteries.

Awesome!

Chris has had his first call.

It's from Grace who's had a heart operation.

Hold on a second, Grace!

There you are! I got your bleep, what's the question?

What is my pacemaker for?

What's the diagnosis, Doc?

So it sounds to me like you have a case of

"I want to know what my pacemaker is for-itis."

We need your finger on the pulse for this one.

You've had recent heart surgery, is that true?

-Yes.

-Can you show us the little scar that you've got?

And the pacemaker in your heart is damaged, isn't it?

-Yeah.

-It's called a pacemaker

because it makes the pace of the heart,

it's what sends an electrical signal, a bit like a clock,

telling the heart when to beat.

Cos your heart's lost its natural pacemaker,

you've been fitted with an external pulse generator.

So this sends an electrical pulse

through these four blue wires and these go inside Grace's body,

inside her heart and they send an electrical signal

telling it when to beat.

It's pretty cool, isn't it?

This isn't very convenient, so what some very clever engineers have done

is shrunk this down to something even smaller than my bleeper.

So the doctors will do another operation

to put a tiny version under Grace's skin.

Just about here, at the front of her shoulder.

I think you have earned a sticker.

There we go. It was a pleasure answering your questions.

-I'll see you soon, OK? Bye!

-Bye!

Meanwhile, I'm out on the street

and picking up the pace to answer your questions.

-Dr Xand!

-Hello.

The reason that fizzy drinks are bad for you is because

a lot of them contain a lot of sugar.

And fizzy drinks don't make you full.

So if you drink a fizzy drink, you get loads of sugar,

loads of calories, but you still feel hungry

and then you'll go and eat a big load of fish and chips

and that can make you put on weight.

That isn't healthy.

But there are fizzy drinks that don't have sugar in

and those are fine. And the good thing about fizzy drinks

is they really make you burp.

HE BURPS

Will, can you burp that well?

Yes!

HE ROARS OUT A HUGE BURP Aaaargh!

What a roaring success!

THAT deserves a sticker.

Back in hospital I've got another call.

All right, where is he? It's from James,

who's had a kidney operation.

James, I got here as quick as I could.

-Apparently you've got a question for me.

-Why did my kidney get blocked?

Why did your kidney get blocked?

That is a tough question.

Did the doctors use any words that might give me a clue?

They said I had a stricture.

What's the diagnosis, Doc?

So it sounds to me, James, that you have a case of

"I want to know why my kidneys got blocked

"and then the doctors said that

"I had a stricture-itis."

It's a tongue twister!

You had a thing called a ureteropelvic stricture.

-Can you say that?

-No.

I mean, nor could I, really.

So James, you've got two kidneys.

They're at your back, either side and out of those kidneys come tubes

called ureters that drain urine

from the kidneys into the bladder.

When the bladder's full, that's when you need to go for a wee.

But on your left side, that tube got blocked

because it had a thing called a stricture

which is a tightening in the tube

that drains the urine from the bladder.

When that got blocked, your kidneys swelled up

and was really, really painful. So what did the doctors do?

-Operation.

-They gave you an operation.

So the doctors put a tube inside the ureter to keep it open

and that little tube's called a stent.

And now the urine can drain freely from the ureter into the bladder

-and you're not in pain any more, are you?

-Nope.

-You're all better.

So James, would you like a sticker?

-Yes.

-There you go.

-Great to see you, bye!

-Bye!

Job done for today, clinic closed.

Back in the emergency department,

Callum is seeing a specialist to fix his teeth.

Let's find out how they do it!

TEETH CHATTER

Earlier, Callum came in to the emergency department

with a cut lip and bent front teeth.

Now, that's what you call a tooth ache!

Callum was at the skate park.

But he's not got a helmet or pads on.

Nope. But he was doing his best-ever move and it all went wrong.

Ouch!

Callum's front teeth are so skewiff

that he's been referred to a teeth and jaw specialist.

Meet Dr Shinal Desai.

She's got the know-how about gnashers.

Dr Shinal starts by totally numbing the whole area

so he can't feel any pain.

I'm going to put the jelly onto your gums here, OK?

The jelly is an anaesthetic gel.

And this is what we doctors call the Dracula look!

Mwah-ha-ha-ha!

Jodie finds it funny too!

Once the gel has numbed Callum's gums,

Dr Shinal can give him an injection with a stronger anaesthetic.

Unfortunately, this makes Callum's lip swell even more.

How do you think your lip looks?

-Big.

-Big?

I'm not sure that quite covers it.

-Massive.

-Yes, massive, that's more like it.

Now everything's numb, Dr Shinal can get to work.

Callum has two stitches in his lip.

Those two front teeth are pulled into line.

I think that looks much better.

And a temporary brace fitted for extra support.

Dr Shinal cuts a metal splint to size

and will attach it to the teeth with glue.

Do I have a volunteer to help me to do the light?

-I'll do it.

-Callum's sister Jodie shines a blue light

which activates the glue and sets it.

Almost done, a little bit more on this side.

All done. Good work, Jodie!

What do you think, Callum?

-My lip's big.

-Don't worry, it'll heal in no time.

Bye!

Still to come...

Xand's got a new friend.

I like a bit of a dance at the end of the day.

And Rose and Bob are in A&E.

My name is Bob.

But first...

Amazing people do lots of important jobs inside and outside hospitals

that help to keep you safe.

But what will happen when we have a go?

I feel a bit silly.

This is Operation Takeover.

Can you guess who today's heroes are?

Well, I'll give you a clue.

They often use one of these.

-Are they professional hula-hoopers?

-Erm, no!

Did you guess it? We are about to take over the job of today's hero,

lifeboat crew member Keith.

Keith is the boss on board the Southport lifeboat.

He's one of 40,000 specially trained volunteers in the UK

-who save anyone in trouble at sea.

-Let's go, Keith!

Whoooo!

This is not an easy job, but there are a few perks.

I'm about three feet away from a dolphin.

Look at that. Wow!

That is amazing.

Unlike dolphins, humans aren't always great in water.

Keith, what kind of medical emergencies

do you get out here, then?

Boating accidents, where the boats are sinking and capsizing,

so it's hypothermia if anybody has fallen in.

Hypothermia is a dangerous condition

where someone's body temperature drops too low.

It's a huge problem if someone's stuck in cold water.

We get them on board, as quickly as we can,

we will try to prevent the condition worsening

and then our main aim is to get them emergency help

as quickly as possible.

To get ready for our challenge,

we need some training on how to save a person in the water.

The exercise starts with a dummy going overboard.

-This bit doesn't feel very doctor-ish, does it?

-No.

From the moment someone is spotted in the water...

-BOTH:

-Man overboard, starboard side!

..every crew member points to the casualty.

So the idea is that we point so that we don't lose the casualty position.

I have to say, I have just lost it, hang on. Where is he? There, OK.

Concentrate, Xand.

Keith then expertly manoeuvres the lifeboat

so the casualty can be pulled on board, ready to treat any injury.

Hello, can you hear me? It's the lifeboat.

Finally, it's time to head back to shore.

Hang on a minute!

Where's Xand?

Man overboard!

This is very embarrassing.

You have to hold on. As you can tell,

it's very easy to have an accident at sea.

Sorry!

The lifeboat crew have an absolutely vital job.

It's time for us to head back to shore

and take over as lifeboat crew.

What's our challenge?

Mini Xand is going to be marooned in his boat

over the other side of the pond.

What?! Mini Xand is marooned?

Chris, what will we do?

We're going to use our training, Xand.

We will launch the lifeboat,

navigate through the treacherous waters,

pass between the buoy and the jagged rocks

-and finally safely manoeuvre the lifeboat next to mini Xand.

-Phew!

We are going to judge you on three things.

We are going to have the safety of your boat and crew,

the speed and the safety of the casualty.

Chris, you're up first.

I'm using a rigid inflatable boat,

it's the Halmatic Artic 24.

I just call mine Donna.

Are you ready, Chris?

-Ready.

-Three, two, one, go.

It's a good launch.

-Good speed.

-Oh, excellent navigation through the dangerous waters.

Nicely done. Old Mini Xand probably doesn't even have a boating licence,

you know? He hasn't been maintaining that boat.

He's exactly like Xand.

-Cheeky!

-Right, he's approaching the casualty now.

OK, slow down, slow down now.

Slow down! Slo-o-o-o-ow!

A bit of damage to the propellers, there, I think.

At least I could...administer first aid

while perhaps someone else comes and rescues me.

Let's see if you can do any better, Xand.

Three, two, one, go.

OK.

Good launch, quickly away.

-Come on!

-Seems a little bit slower perhaps approaching the buoy.

Where are you going, Xand?

Oh, hang on, hang on.

Come back! Watch out for those rocks.

Here we go now. I'm on track.

Don't worry, Mini Xand.

I'm coming to get you!

Not any time soon, by the looks of it.

Good direction for the approach,

let's see how he manages the casualty.

I'm almost there.

-You've hit him!

-Oops.

-And again.

-Rescued!

Yes!

It was only a bump.

I think I've got this one in the bag.

You need to think again.

Keith, what's the verdict?

Safety of the crew, Chris was slightly ahead there.

Xand clipped the rocks on the far side.

In the entire pond, there is only one rock.

Secondly, safety of the casualty.

Xand, you hit Mini Xand.

Well, I must've been quicker than you, Chris.

Xand, unfortunately you were slower.

So, I have to give it to Chris.

Yes!

In your face.

Well, I may have won, Xand, but what we've mainly seen today

is just how important and difficult the work of the lifeboat really is.

And I think it's definitely best left to the professionals.

Keith, we're going to give you our hats back

and you will definitely want these little boats

because Mini Xand has planned his summer holiday next year

in Southport. You might have to rescue him again.

Right, I'm going to go and buy him some sunscreen.

Xand, what are you doing?

I'm putting my facial muscles to the test

by pulling as many facial expressions as possible.

Well, you want to be careful. You know what they say, Xand,

if the wind changes, you could be stuck like that.

That, Chris, is just an old-fashioned expression.

Time for Investigation Ouch.

You don't just communicate with the people around you by talking.

The majority of your feelings are revealed by your facial expressions.

When you experience any emotion,

it is involuntarily expressed on your face

by changes in your 43 different facial muscles.

Unbelievably, the human face

can make over 10,000 expressions!

We learn to read different facial expressions

as early as when we're babies and if you look at these cards,

it's easy to tell whether the person is happy,

sad, surprised,

angry or...

Whoops. Didn't mean to include that one.

-Thanks, Xand.

-For the majority of people,

working out how a person is feeling is second nature.

See how quick this lot are.

What do you think this man is feeling?

-Happy.

-Happy.

I think happy.

Spot-on, everyone.

-What about this person?

-Sad.

-Sad.

-Sad.

Oh, they're brilliant at this.

However, not everyone can suss out emotions this easily.

Autism Spectrum Disorder or autism for short

is a condition where people find it hard to communicate

and one of the reasons why is that they can't understand

different facial expressions.

So, how does it feel when you have difficulty understanding

other people's facial expressions?

Well, to put it to the test,

I've jumbled up my face to make a very odd expression.

Let's see what happens.

Erm...

Confused or angry.

Upset?

-Weird.

-Weird?

Everyone was unable to work out what the expression meant

and it left them feeling confused and frustrated.

This is how people on the autism spectrum can feel a lot of the time.

Fortunately, there's someone who might be able to help.

Meet Zeno, he's a humanoid robot

with a computer for a brain,

but he's capable of pulling a range of facial expressions.

We've come to a school which specialises

in helping children with autism.

Meet Dr Alyssa from the UCL Institute of Education.

She is working on the DE-ENIGMA autism project

and she is Zeno's BFF.

We've been using Zeno with children with autism

to help them start to learn about different facial expressions.

And what facial expressions can Zeno pull?

First one is his...

happy face. He can also do a good sad face.

And he can be angry.

And he can be scared.

Having a good understanding of the happy, sad, angry and scared,

that's a really important tool for successful social interaction

with other people in everyday life.

Ta-dah!

In working with the robot, children with autism like Kyren,

Harry and Maxi can learn to understand different looks...

-It's angry.

-Sad face.

..without the awkwardness of practising with a real person.

Happy face.

Unlike a human, Zeno doesn't get offended if you get it wrong.

Yeah!

And he doesn't mind doing the same look over and over.

Practice makes perfect.

Don't cry.

And it's not all about recognising Zeno's expressions.

These guys are learning to pull the faces themselves.

Can you show me your scared face?

Over time, this will help them know what to do

when they're around people in daily life.

The kids just really light up when they see Zeno,

he's just kind of nice to be around.

And he loves a party.

What a dance. I like a bit of a dance at the end of the day!

It's time to head back to the emergency department.

HE SNORES

Aaaaargh!

Let's see who's turned up this time.

Over in accident and emergency,

12-year-old Rose has come in with her mum and dad.

That's a big old bandage on that hand, Rose,

what have you been up to?

I was chopping cardboard with a craft knife

and I chopped my hand instead.

That's no laughing matter!

How did it happen?

Rose was in her craft room at home cutting cardboard.

-What was she making?

-She hadn't decided.

She could make cardboard cut-outs of us.

-Hi, Xand!

-Hi, Chris!

Hi, Rose! Uh-oh, Chris, she's cutting towards her hand.

-I can't watch!

-Always have a grown-up with you

when you're using a dangerous tool.

Yes, Chris, but Rose was on her own

and her knife accidentally slipped,

she cut her hand.

Ouch!

Nope, I'm good.

I can feel my thumb.

Well, that's a good start.

Getting to grips with that painful paw is Dr Tom Smart.

Let's have a look at it, shall we?

So, the cut looks clean and not particularly deep.

Probably put some steri strips on and some glue

and just pop that back together.

It looks really funny when I bend my thumb.

-My name is Bob.

-Nice to meet you, Bob.

-You all right?

-"I've had better days, Rose!"

Shhh!

Here comes clinical support worker Emma Arnold to mend Bob.

I'm going to clean your hand first.

Bob is saying "I'm clean enough," but Bob is not always right.

He's going to get treated with steri strips.

-I'm going to miss Bob.

-Don't worry, Bob,

we'll make sure Rose doesn't ever forget you.

I'll always remember Bob.

In five days, Bob will have healed.

So, Rose, have you learned any lessons?

Learned to say goodbye to Bob

and Bob needs to say bye to me because he's not coming back.

BOTH: Bye, Bob! Bye, Rose!

Next time on Operation Ouch!...

Yippee! I take the plunge.

We say goodbye to our Ouch patients.

Bye, everyone.

And some of our old favourites are back!

BOTH: Back to Earth!

So we'll see you next time for more Operation Ouch!

Oh, no, have we missed the end?

Thought so.

Ow!

HE LAUGHS AND SHRIEKS

Ow, ow, ow.

Mercy. How much more threading do we need?

Let's do the beard now.