:00:20. > :00:26.Good morning, thank you for coming. OK, let's go please. Papworth, and
:00:27. > :00:33.a major heart operation is underway. For the patient the outcome is
:00:33. > :00:37.crucial. It really will make the difference between life and death.
:00:37. > :00:40.We are now going to stop the heart so we can open it up and have a
:00:40. > :00:42.look inside and this guy's circulation depends on what is
:00:42. > :00:45.going on down there. This is what the Cambridgeshire Hospital does.
:00:45. > :00:55.Every year thousands of people' lives are saved or transformed by
:00:55. > :01:00.
:01:00. > :01:09.open-heart surgery and transplants. You will see the heart has no
:01:09. > :01:12.output. Lungs have stopped and we are going to do the operation.
:01:12. > :01:18.today is more than just another extraordinary day at an
:01:18. > :01:21.extraordinary hospital. After a career spanning 40 years this is
:01:21. > :01:24.the last time one of its most accomplished surgeons will ever
:01:24. > :01:27.perform an operation. His name is John Wallwork and he's probably
:01:27. > :01:30.done more to put Papworth's name on the map than almost any other
:01:30. > :01:33.surgeon in its history. Over the past year we've been given
:01:33. > :01:37.exclusive access to the life of a man affectionately known at the
:01:37. > :01:42.hospital as 'God'. Heart transplantation has always
:01:42. > :01:44.fascinated John Wallwork. To think about what the heart does, it beats
:01:44. > :01:48.something like 30-40 million times a year that's for one year.Then
:01:48. > :01:58.you've got to work that out for how many over your lifetime and to be
:01:58. > :01:59.
:01:59. > :02:02.able to replace that was pretty exciting. And back in the 1970s for
:02:02. > :02:05.a young ambitious doctor wanting to specialise in cardiac surgery, the
:02:05. > :02:10.place to be was Stanford in California - at that time the
:02:10. > :02:13.world's leading transplant hospital. The world's first heart/lung
:02:13. > :02:17.transplant took place in Stanford with Bruce Reitz and I was the
:02:17. > :02:24.chief resident at the time. So basically the team was him, me and
:02:24. > :02:27.obviously all the other people around. It was a very exciting time.
:02:27. > :02:35.I set up the first donor for that operation and looked after the
:02:35. > :02:38.patients afterwards. At that time the UK was lagging behind - but not
:02:39. > :02:43.far. In 1979 Keith Castle became the first person in Britain to have
:02:43. > :02:53.a successful heart transplant. The operation was carried out by Sir
:02:53. > :02:59.Terence English at Papworth. And now he wanted to build a world-
:02:59. > :03:05.class team. As someone who had spent a year carrying out
:03:05. > :03:09.transplants in the United States, he was a good choice. The at my
:03:09. > :03:14.interview I was asked what my experience of heart transplantation
:03:14. > :03:20.was. I said my first experience was better than your national
:03:20. > :03:24.experience. Three years later, Brenda Barber became the first
:03:24. > :03:31.person in Europe to successfully undergo a heart and lung transplant,
:03:31. > :03:36.carried out at Papworth Hospital. remember it very well. We had to
:03:36. > :03:42.bring the donor down from the Midlands and do the operation here.
:03:42. > :03:46.Two operating rooms and spends a fair amount of the evening and into
:03:46. > :03:54.the night doing it. There was so many things we did not know. We
:03:54. > :04:00.have no way of properly measuring drug levels. We did not know about
:04:00. > :04:04.the rejection of the lung. Celia was one of the nurses who took part
:04:04. > :04:10.in a ground-breaking operation. When you work in cardiothoracic,
:04:10. > :04:18.anything to do with the heart and lung, his major anyway. But to take
:04:18. > :04:26.out a false set of lungs and a heart, the patient dependent on the
:04:26. > :04:31.machine, was ground-breaking. we did not have any back-ups if
:04:31. > :04:36.things did not work. It was stressful doing kidneys and livers,
:04:36. > :04:41.because it just goes pink. There is always an excitement when the heart
:04:41. > :04:44.of beats and the circulation has taken over and they come off bypass.
:04:44. > :04:51.Following her transplant, Brendan Barber was able to return to an
:04:51. > :04:57.active life. I was the first one at Papworth Hospital to be done and in
:04:57. > :05:02.Britain. I wasn't scared. I only had a fifty-fifty chance and they
:05:02. > :05:06.knew I was dying. I did not have anything to lose.
:05:06. > :05:09.She lived 11 years following the transplant, and most of those
:05:10. > :05:14.extremely well. She saw her daughter grow up. It is a great
:05:14. > :05:23.pleasure. I think I realised personally when the patient went
:05:23. > :05:28.home we were part of something special and it wasn't A1 we help
:05:28. > :05:33.change the quality of life. Harold is one of those whose lives have
:05:33. > :05:36.been transformed following the first transplant. Born with a
:05:36. > :05:46.condition that left toe with a hole in the heart and damaged lungs, she
:05:46. > :05:48.
:05:48. > :05:55.was expected to die young. Young was up to seven. They just kept
:05:55. > :06:01.moving the goalposts. But the outpost was 30. How are you feeling
:06:01. > :06:08.today? I am all right. Or we will put the nose pegs on and start with
:06:08. > :06:12.normal breathing. Take a big breath in and then blow out as hard and as
:06:12. > :06:18.fast as you can. Like all of its patients, she comes back to
:06:18. > :06:26.Papworth hospital for regular check-ups. Low as fast as you can.
:06:26. > :06:30.Keep it going. Carol had co- operation in 1987, three years
:06:30. > :06:34.after Brendan Barber. I can remember him saying, we would like
:06:35. > :06:40.to offer you, if we do the operation we would hope to of the
:06:40. > :06:48.you four healthy years. That sounded great. I will have one of
:06:48. > :06:55.them. We will do that again. Brenda Barber, the first person, she was
:06:55. > :07:00.in having tests. And I can remember saying, I don't know who that is,
:07:00. > :07:06.assuming it was a member of the staff. And they said, she has had
:07:06. > :07:12.one! It was brilliant. You could ask a real person that was walking
:07:12. > :07:20.around who had had a transplant are, how they were. She was normal. It
:07:20. > :07:26.was great! I went through a silly season post transplant. Having
:07:26. > :07:31.never being allowed out to play or to any sport. I did horse riding,
:07:31. > :07:37.Badminton, circuit training, I learnt to swim. There was almost
:07:37. > :07:43.nothing I didn't have a go at. A hospital have invited me back and
:07:43. > :07:48.we met Princess Diana and I chatted to her for quite a long time. I
:07:48. > :07:55.felt sorry for her. I think it was meant to be the other way around,
:07:56. > :08:02.but she was quite shy. All of your tests are done. We have the same
:08:02. > :08:08.results as last time and your lung function is above 100%. When you
:08:08. > :08:14.start something you are interested in getting people to survive a year.
:08:14. > :08:18.And all of those milestones. Then most people survived by five years.
:08:18. > :08:23.The lungs are particularly difficult for a transplant because
:08:23. > :08:30.they are prone to infection. All the other organs are neatly inside,
:08:30. > :08:36.the lungs are a challenge. 24 years after her operation, Carol is
:08:36. > :08:44.another longer surviving double transplant patient. I work on the
:08:44. > :08:50.basis that I am alive today, I was a live yesterday, and I will let
:08:50. > :08:55.you know about tomorrow when it happens. When I saw you were
:08:55. > :09:00.getting breathless... After more than 3,000 operations, John is
:09:00. > :09:05.talking things through with his last patient, Colin who needs open-
:09:05. > :09:10.heart surgery. How have you been since I saw you? It has got
:09:10. > :09:15.progressively worse. Transplants might make the headlines, but
:09:15. > :09:19.Papworth hospital carries Alps routine operations such as valve
:09:19. > :09:23.replacements, more than any other hospital in the country. Around
:09:24. > :09:30.2000 a year. When your valve is very narrow, you get breathless
:09:30. > :09:38.quickly. You haven't had symptoms for a while because your heart has
:09:38. > :09:42.been trying to push blood through a tiny hole. We will fix that for you
:09:42. > :09:49.tomorrow. We said we will replace your bath, there are lots of things
:09:49. > :09:54.we can do to hearts that Lee Cook not do. We repair some of them, if
:09:54. > :09:57.we don't do this you will be in trouble. We can do things to the
:09:57. > :10:03.heart to make it work better without needing a transplant. And
:10:03. > :10:11.there will be more efficient mechanical devices.
:10:11. > :10:16.We will give you an anaesthetic if you are and nice person! I hope so.
:10:16. > :10:21.In 1986, 35-year-old Davina Thompson was so ill she needed a
:10:21. > :10:24.new heart, lungs and liver. A triple transplant had never been
:10:24. > :10:30.attempted anywhere in the world, but John was convinced he could do
:10:30. > :10:35.it. I think progress in medicine and surgery has to have people who
:10:35. > :10:40.will pioneer it. You cannot just sit on your backside and wait for
:10:40. > :10:46.other people to make developments. You have to do it in a responsible
:10:46. > :10:56.way. We had a patient whose lungs had been destroyed because of liver
:10:56. > :11:02.disease. People with cystic fibrosis are usually young people.
:11:02. > :11:06.But they are very ill because of their illness. I suppose you have
:11:06. > :11:11.to argue, because we were stretching the boundaries of
:11:11. > :11:17.transplantation, we have the patience and we think we can do
:11:17. > :11:22.this. It meant two surgical teams working side-by-side. John leading
:11:22. > :11:30.a heart and lung transplant, while another surgeon transplanted the
:11:30. > :11:35.liver. We worked out how to do this. The first time it we did it, which
:11:35. > :11:39.we did not do the second time, we put them in separately. They
:11:39. > :11:46.connect at the bottom end. So the second time we put them in
:11:46. > :11:52.connected together to save one junction. It was how many people
:11:52. > :12:00.were in just for that one person. You see those people working as a
:12:00. > :12:04.team, and we did work as a team. It was very special. By the time
:12:04. > :12:09.Davina Thomson left hospital, the press was gathering. The operation
:12:09. > :12:13.had taken nearly eight hours and involved a team of around 20 beagle.
:12:13. > :12:23.John had attempted something that had never succeeded before and it
:12:23. > :12:24.
:12:24. > :12:29.had paid off. It is like being reborn again. His I cannot describe
:12:29. > :12:36.how much difference it has made to me. One of the most exciting sites
:12:36. > :12:41.in surgery, what you don't see is looking at an empty chest. A person
:12:41. > :12:46.who is alive with no heart and lungs. And then the next day that
:12:46. > :12:53.person can talk to you. It is an interesting experience. When you
:12:53. > :13:00.get an empty chest and no liver, it is a very big and empty person. It
:13:00. > :13:05.is quite interesting site. I remember being on the Tube after
:13:05. > :13:10.doing the heart, lung and liver transplant. And I looked round the
:13:10. > :13:13.Tube and said to myself, I have seen something you never have. It
:13:13. > :13:17.is in my Guinness Book of Records. Of all the publications I have come
:13:17. > :13:22.of the one my children look at is the Guinness Book of Records.
:13:22. > :13:26.Guinness Book of Records a lot, Papworth Hospital was on the map as
:13:26. > :13:36.a walled leading cent of the transplantation. For the next few
:13:36. > :13:36.
:13:36. > :13:44.decades, his feet would hardly touch the ground. When it first
:13:44. > :13:50.started a lot of us were on call all of the time. It was exciting. I
:13:50. > :13:56.don't think anybody moaned about it. If anybody did, if the kitchen is
:13:56. > :14:06.too hot and then you leave. There was a time when we were doing about
:14:06. > :14:09.
:14:09. > :14:18.100 transplants a year. You would be automatically wide awake. When
:14:18. > :14:23.the kids started getting phone calls, I ended up getting two lines.
:14:23. > :14:27.You don't know when it is going to happen, Christmas Eve, New Year's
:14:27. > :14:32.Day or 6:00pm a night on your white's birthday. So we deal with
:14:32. > :14:39.it. I have called the ambulance service and they are mobilising a
:14:39. > :14:42.crew to come and pick you up. its peak in the 80s and 90s, up to
:14:42. > :14:49.400 Heart, Lung and combined heart, lung transplants took place in the
:14:49. > :14:54.UK each year. Improved car design and road safety has seen the number
:14:54. > :15:01.of available donor organs for. In the last year there have been fewer
:15:01. > :15:05.than 100 transplants in Britain. Both carried out at Papworth will
:15:05. > :15:10.stop transplantation is a rare thing. Though never be enough donor
:15:10. > :15:14.organs to go around with people with heart failure and lung failure
:15:14. > :15:18.who need them. We have a very scarce resource and we need to use
:15:18. > :15:23.it as wisely as possible. She gets a hard because she is the right
:15:23. > :15:30.blood group and the right size. Do you transplants somebody who is
:15:30. > :15:36.actually dying with a very low risk of surviving? Body transplant into
:15:36. > :15:46.someone who is stable but you know it is going to get worse? It is a
:15:46. > :15:47.
:15:48. > :15:51.difficult area how you choose. It is a mods form of medical therapy,
:15:51. > :15:55.in order for someone to live, somebody has to die. We sometimes
:15:55. > :16:05.forget when people say they are calling for an organ to come
:16:05. > :16:05.
:16:05. > :16:13.forward, they are saying, we want someone else to die. Combined a
:16:13. > :16:19.number of transplant years, his 29. John is being reunited with two of
:16:19. > :16:29.his former transplant patients, Sandy Law and Peter Harte, the
:16:29. > :16:30.
:16:30. > :16:37.longest surviving heart transplant patient in Britain. You were very
:16:37. > :16:45.ill. I can remember the first thing when I woke up, I have warm feet
:16:45. > :16:49.for the first time ever. I could feel my toes. It was incredible.
:16:50. > :16:54.went for 15 years with no trouble at all after the transplant. What
:16:54. > :16:59.has it meant the you the 29 years to have a heart transplant? It was
:16:59. > :17:04.the end of the road for made. was either that or nothing. I had
:17:04. > :17:10.been told I wouldn't survive until Christmas. It was fantastic fining
:17:10. > :17:14.out it wouldn't take half-an-hour to take a five-minute trip to the
:17:14. > :17:24.bus. I could do it in five minutes, I could run with the dogs, I could
:17:24. > :17:27.
:17:27. > :17:29.go shopping, it was incredible. It It made every difference. My
:17:29. > :17:39.children have all grown up, I've got grand children, great
:17:39. > :17:41.
:17:41. > :17:45.grandchildren. I'd have missed all them. Six years ago, Sandy's heart
:17:45. > :17:49.began to fail. She became one of the very few people and the world
:17:49. > :17:59.to receive a second replacement heart. She and Peter have strong
:17:59. > :18:02.
:18:03. > :18:08.views about organ donation. And so glad I have never been in the
:18:08. > :18:13.position of being denied a transplant, because I know there
:18:13. > :18:20.are a lot of people who have died waiting for an organ. It should be
:18:20. > :18:27.compulsory unless you decide not to donate beforehand. Thousands are
:18:27. > :18:30.dying every year, young people. It is not right. The transplant
:18:30. > :18:35.community of divided on this, because whichever way you look at
:18:35. > :18:39.it, even with presumed consent, people are not going to go round
:18:39. > :18:43.saying that they have the right to take the organ without discussion.
:18:43. > :18:48.I do not mind the system, as long as the public except that for most
:18:48. > :18:54.of them, it is a gift and for most of the patients who are sick, it is
:18:55. > :18:58.a gift that they need. John retires from operating today, but what goes
:18:58. > :19:02.through the mind of a surgeon as he prepares to undertake open heart
:19:03. > :19:06.surgery? I am always very interested in watching Formula One
:19:06. > :19:13.drivers. I would have thought that they should be sitting there for
:19:13. > :19:18.hours in their cars, but then suddenly they are in the zone. The
:19:18. > :19:23.same happens with surgery. As soon as you're in the operating room, it
:19:23. > :19:29.starts and you're completely focused. One of the things we learn
:19:29. > :19:33.in surgery is how to deal with patients without hurting yourself.
:19:33. > :19:39.It is similar to the way that people are taught when they go into
:19:39. > :19:44.areas of deprivation and starvation, the thing you have to remember is
:19:44. > :19:48.not to give away your emotions. You can have empathy and sympathise and
:19:48. > :19:52.sometimes you feel hurt. Sometimes you feel hurt for them and
:19:52. > :19:59.sometimes for yourself. Especially if you think you could have done
:19:59. > :20:04.things better. But his is important to learn how to have compassion,
:20:04. > :20:12.but not lose your own emotions, because you can get seriously burnt.
:20:12. > :20:18.If you get too involved emotionally, you can make bad decisions. There
:20:18. > :20:24.is a time to leave, there is always that business would people hang on
:20:24. > :20:28.for too long or they believe they are indispensable. I learned early
:20:28. > :20:36.on that time not indispensable. That means you have to make sure
:20:36. > :20:41.that you live as healthily as you can. By stepping down, I allowed
:20:41. > :20:47.that service to get a younger person in, someone who could grow.
:20:47. > :20:53.I so of patience yesterday, and he has got a tight valve. We're going
:20:53. > :20:59.to take it out and put a new one in. We will do that by stopping his
:20:59. > :21:09.heart on the heart and lung machine. My assistants have opened the chest
:21:09. > :21:10.
:21:10. > :21:16.and put the pipes in. We do two operations in each room every day.
:21:16. > :21:24.These gloves never fit. My fingers are too short. It has been like
:21:24. > :21:28.that for 30 years. Even if he is not in the operation
:21:28. > :21:38.theatre, he knows what is going on. We have never cottoned on to that -
:21:38. > :21:39.
:21:39. > :21:48.- how he does it. If something is going wrong, he appears in the
:21:48. > :21:54.doorway. He has a A6 sense of what is going on. He is fast, but
:21:54. > :21:58.accurate. He is amazing. Of course, he likes to tell us that he makes
:21:58. > :22:04.very good pastry. He has very cold hands, which you probably need on
:22:04. > :22:10.an operating theatre. That is the end of the operation. We're nearly
:22:10. > :22:20.there, folks. You can see the heart beating again, which is nice.
:22:20. > :22:25.
:22:25. > :22:30.That's all, folks. Thank you. Goodbye. That is my final day.
:22:30. > :22:35.Coffee. Enjoy it. Come back in to see it. By Emily coming back in one
:22:35. > :22:40.it is my operation. Thank you, darling. -- I am only coming back
:22:40. > :22:44.in when it is my operation. It was difficult to get the new valve in
:22:44. > :22:54.but we expected that. His heart is working OK and he is off the bypass.
:22:54. > :22:57.
:22:57. > :23:02.It looks good. I have been thinking about finishing for a while. It is
:23:02. > :23:05.not as though I have been dragged out of the theatre screaming. I
:23:06. > :23:14.have known it was going to be happening, so why do not feel any
:23:15. > :23:19.concern about that. Roger, is this guy asleep? I hope that the system
:23:19. > :23:24.will continue to work on. Hopefully, we will learn something so that
:23:24. > :23:31.when I have a heart operation, they will do it properly. He made the
:23:31. > :23:36.cake? Wow. As John prepares to leave, his legacy continues. -- who
:23:36. > :23:40.made the cake. Artificial heart by a knowledge -- technology was
:23:40. > :23:44.pioneers here. Today, artificial hearts are smaller and keep people
:23:44. > :23:48.alive while they wait for donors. You operations mean that damaged
:23:48. > :23:55.organs that would have once required transplantation can now be
:23:55. > :24:00.saved. -- transplantation. But it is not enough. The people die every
:24:00. > :24:07.day waiting for an organ transplant. John feels that the use of animal
:24:07. > :24:11.organs is the best way forward. You would get an organ that was
:24:11. > :24:17.already working, you know what it can do. We got to the stage where
:24:17. > :24:23.we could transplant other animals with pig organs. And we did that
:24:23. > :24:28.successfully. At the same time as running the transplant service,
:24:28. > :24:33.John teamed up with David White, to set up a biotech company to try and
:24:33. > :24:36.push forward the frontiers of science. It was controversial but
:24:36. > :24:43.John was convinced it could save more of his patients. I regret we
:24:43. > :24:49.did not get xenotransplantation through. I think there became a
:24:49. > :24:54.stage were there was nothing I could do against -- various powers
:24:54. > :24:57.around, other than the unbelievably brave -- other than be unbelievably
:24:57. > :25:02.brave and do something inappropriate. In a different era,
:25:02. > :25:08.we could have got that opportunity but we did not for a variety of it
:25:08. > :25:12.-- a variety of reasons. I regret that I lost control of the Science
:25:12. > :25:18.Of Zeno transplantation. To mark an extraordinary career. --
:25:18. > :25:23.xenotransplantation. Scientists have come to Cambridge to pay
:25:23. > :25:26.tribute to John's work during his time here. Among best scientists,
:25:26. > :25:36.Terence English, who operate alongside John during that first
:25:36. > :25:41.
:25:41. > :25:46.transplant. There is a lot of energy there, he is not constrained
:25:46. > :25:49.by accepted rules. He is very stimulating to work with.
:25:49. > :25:53.legacy has extended beyond national boundaries because he has trained
:25:53. > :25:59.people from all over Europe and other countries, particularly from
:25:59. > :26:07.Australia. He has single-handedly been responsible for the legacy of
:26:07. > :26:15.heart and lung transplantation, through training and experience.
:26:15. > :26:25.John's last-ever patient,: Deadman is a transformed man. -- Colin. He
:26:25. > :26:27.
:26:27. > :26:30.is able to return to his passion. The changes are unbelievable. I can
:26:30. > :26:37.walk quite a distance and keep up with most people without getting
:26:37. > :26:45.out of breath. As time goes on, that will get better. It is already
:26:45. > :26:48.been down to the Professor. Isn't it clever but I remember this?
:26:48. > :26:54.may have stopped operating but now he has a new goal. He is working on
:26:54. > :26:57.a project with Cambridge University to help build a �40 million
:26:57. > :27:03.research institute which will see Papworth's world-class reputation
:27:03. > :27:07.continue into the future. We cannot just sit there and say we did this
:27:07. > :27:12.in the past so therefore we are good, we have to look to the future.
:27:12. > :27:17.How old is that think? This machine is 12 months old. There has to be a
:27:17. > :27:22.dichotomy between laps science and medical science. The mantra has
:27:22. > :27:27.been bench to bed side. I think we can do that better when we are
:27:27. > :27:31.within the same physical environment. We have our research
:27:31. > :27:37.institute and scientists and the collisions, and then mix of people
:27:37. > :27:41.between in the same place, so that they can be with each other. Who
:27:41. > :27:46.knows what they're going to find to do and what clever ways they will
:27:46. > :27:53.be able to treat people with heart failure. Who knows whether somebody
:27:54. > :27:57.will manage to get rid of heart failure and lung failure. A a a or
:27:57. > :28:03.pie have left the place with the ability to wonder. I hope by leave
:28:04. > :28:10.it with the ability to contemplate new things and to be brave. -- I