Episode 1 Junior Doctors: Blood, Sweat and Tears

-Start CPR.

-Adrenaline.

Look at that.

-Easy, sir, easy.

-When did this become this bad?

One hospital...

Can I have a stet, please?

..seven junior doctors...

-Showtime.

-I've got an emergency, so I need the crash team here.

-I'm excited.

-Little bit nervous.

..working on the front line of medicine...

-Do you want to have a chat?

-..with all its blood...

I love a gory, bloody wound.

-..sweat....

-Try not to worry.

-..and tears.

-Just feels like I'm surrounded by death at the moment.

The doctors of your future...

Can I ask what brought you in today?

I slipped on my wedding dress.

..facing life...

And then I got to hold the baby as well.

-Lion King moment.

-..and death.

Have they got what it takes?

'Dickie here on this Wednesday morning, April 5th.

'Look at that for a lovely start this morning...'

Junior doctors all over Britain

are getting ready to start their new placements.

'So whatever you're up to today on your Wednesday,

'if you're maybe starting a brand-new job,

-'good luck in your brand-new job today.'

-In the West Midlands,

23-year-old Anna will be one of the youngest junior doctors

at the hospital.

Let's hope I don't get asked anything too difficult today.

Her boyfriend, Frazer, a pilot, is on hand for a last-minute pep talk.

I'm nervous for stepping out on the ward for the first time.

-Really?

-Having to meet everyone and don't know what I'm going to face

-or anything.

-You'll pick it up after a couple of days, I'm sure.

Yeah.

I first thought about being a doctor

when I was younger and I used to watch all these silly shows

like Grey's Anatomy and you think, "Yeah, I wonder if I could do that."

Being a doctor, you know,

people's lives are literally in your hands sometimes and that's

a big thing for someone who's 23 to have to deal with.

I still feel like that shy medical student hiding in the background.

Frazer, I'm heading off now.

-Wish me luck.

-Good luck.

So this is one of my delicacies.

Protein superfood.

26-year-old first-year doctor Osama fuels up for the big day ahead.

-It's pretty rough.

-For the next four months,

Osama will be working in obs and gynae,

delivering babies and dealing with women's reproductive health.

The nerves just kicked in yesterday.

I don't know. I just have this thing

about touching other people's private parts that I just...

I don't know. It just... I'm squeamish with that kind of stuff.

Osama and Anna are joining over 100 other junior doctors

also working at New Cross Hospital in Wolverhampton.

Osama's first challenge is locating his new department.

Excuse me. Sorry to bother you. Do you know where building 14 is?

-Building 14?

-Yeah.

Any idea?

-A14?

-No, 14.

I was born in Baghdad,

then, unfortunately, war broke out, so we had to flee.

So we left as refugees.

We came to the UK.

My mum makes really good grilled chicken.

This is just for me. This is just breakfast.

It's a huge jump from being a medical student to being a doctor.

You know, like, every single little decision now that I make

potentially has an impact on people's lives.

In the future, I'd hope to be an experienced surgeon.

Oh, I think that's one of my colleagues.

Hey. How are you?

-Hi.

-We've got induction now this morning.

-Same.

-Yeah.

You've got induction all day, haven't you?

Yeah. Well, till two.

-Yeah.

-Excited?

-Yeah.

-I'll see you later, anyways.

Yeah. This is all so strange, isn't it?

So, this is where we're going to live for the next few months.

Let's do this.

Anna will be spending the next four months on the respiratory ward.

It's her first-ever medical placement,

and being new to the specialty

-means she will have to learn fast on the job.

-And you are...?

-I'm Anna.

-Nice to meet you.

Nice to meet you.

Feel a bit like a spare part at the moment, I think.

I'm not really sure what I'm meant to be doing.

Without my phone, I would be very lost.

A consultant said to me,

"Can we get refeeding bloods for tomorrow morning?"

Which I can't remember off the top of my head what they are.

Always good to be able to Google stuff when I'm not sure.

It's only Osama's second week,

and today he's getting the opportunity

to do a complicated procedure in obs and gynae.

So, hi. My name's Osama.

So, I understand you've come to hospital...

Um...

Is it for your belly being a bit swollen?

-Yes.

-How long has it been like this for?

-A few days.

-A few days, OK.

-A few days.

-Do you mind if I examine your tummy quickly?

-No, I don't mind.

-OK.

Would you be able to pop on the bed for me?

Is that OK? That's perfect.

OK. OK, so...

-Is there any pain in your tummy at all?

-No.

OK.

-Just feel large.

-Yeah, so it's very distended, isn't it?

-Yeah.

-So I think it seems like there's a lot of fluid in here.

What we need to do is first of all drain the fluid because it's causing

you a lot of discomfort, then your symptoms will start to improve.

Three attempts have been made unsuccessfully to drain the fluid,

so the pressure is on Osama to get it right this time.

Just bear with me while I prepare everything else.

Thanks. So, we've got a needle.

We need this. It's a difficult drain,

but hopefully we'll get it in, because it needs to go in

because otherwise the patient is going to keep suffering from it.

And she's got a massive belly.

Before he inserts the needle,

his patient, Miss Frances, has a request.

Can I go and spend a penny?

-Say again, sorry?

-Can I go and spend a penny and come back?

Yeah, yeah, not to worry. Yeah, yeah.

I wonder what spending a penny means.

Ah, so, apparently, in olden days,

um...

toilets had locks on, which you had to put coins in to access.

So I think this lady might...

She probably thought you needed to pay for the toilets in the ward.

That's why she was saying about spending a penny.

-Thank you.

-No worries.

-Not to worry.

-Back from her spending spree, Osama can make a start.

With ambitions to specialise in surgery,

this delicate procedure is a good opportunity

to get some hands-on practise.

It's like a musical instrument, isn't it?

It's over six months since Osama graduated,

and now he's in charge of a tricky procedure

that is usually performed by a senior doctor.

-Are you comfortable?

-Oh, doctor, I'm trying to be but it's scary.

Yeah, don't worry.

-It's scary.

-Don't worry.

-First,

he injects the anaesthetic to numb the area.

Doing really well. OK, that's perfect.

-And the next part is just to put the drain in.

-OK.

-OK?

Next, Osama inserts a long needle into the side of the stomach.

It's critical he hits the right spot or he could puncture a major organ.

It's going in now.

Now stay still for me.

Perfect. You've done really well.

Yeah.

Doctor, it's not me. It's you.

No, no, no. You did it, really,

because I didn't want to tell you, but it's a big needle, you know.

If you want to, I'll show you the size of it later.

-No!

-No, you don't want to see?

OK, so it's draining really well.

Fluid draining, it's a huge achievement for Osama.

Do you have any questions for me at all?

Well, I just want to be grateful to you.

No, not at all. This is my job.

So, it's draining really well, so, hopefully, when the fluid is off,

you can go back to your dancing.

That's the plan, eh?

That was really satisfying, actually.

So, we managed to get the drain in successfully.

Once the fluid's out, you'll start feeling better.

I'm happy that I managed to deliver on what the consultant

wanted me to do, but the most important thing

is how the patient is feeling,

and I think she's feeling really grateful, which is amazing.

And just knowing that, I'm-I'm buzzing.

For 24-year-old junior doctor Emeka,

getting ready for a shift is serious work.

I'm a sharp-dressing guy. I'm here for business.

But at the same time, I want to kind of stand out.

And there's an art to dressing to impress.

You want that fitted white shirt and then you want a strong tie,

some shined-up black shoes,

so I think that's what we're going to go with today.

Every day, I wake up and I'm so excited to be a doctor.

It's a situation where I've prepared my whole life for this,

and now I'm here. My family and I, we are all very close.

We're a tight-knit bunch.

My father is an obs and gynae ex-consultant.

My grandfather was also in the medical field back in Nigeria,

where I'm from. And that's where my grandfather is what you call an eze,

which is translated in my language into a king.

That puts me in line to be a prince.

I should be Prince Doctor Emeka, which... I prefer that title!

I think my friends would describe me as overconfident.

But I'm supercompetitive, that's one thing I'll say.

It is a scary thought,

when you think about some of the decisions you make can result

in someone losing their life,

but that's the reality of what you sign up for.

Emeka's spending the next four months in general surgery,

and his colleagues have some tips.

A piece of advice, never wear your good clothes on call

because I've had experiences

with body fluids onto my actual good clothes.

-Bile.

-Bile?

Yeah. Vomit.

Vomit?

Do I need to change into scrubs?

If you need to.

Yeah. The team seem to think that my dapper clothes

are going to have to take a hit today,

and they're trying to encourage me to wear scrubs.

Baby blue's just not really my thing.

If you have to go into theatre to help, you have to wear these.

I'm hoping that I can wear a couple of aprons and dodge all that,

but I have to get my hands dirty, you know, so...

It's going to be a task for me.

This is my favourite part of the hospital -

in the elevator.

I use it as an opportunity to get a full body checkup

in that ten seconds. Get myself ready.

Get myself ready, just like that.

On the respiratory ward,

23-year-old Anna has been tasked

with fitting a device called a cannula,

a procedure all junior doctors have to master.

It's her first attempt at getting a needle

into pensioner Ms Benfield's vein.

Oh, gosh. It's got a cover on it, so we're fine.

If she doesn't hit the right spot, she could cause severe bruising.

OK.

Sharp scratch.

-Let me know if it's painful.

-Ow.

Yeah.

-Whoa!

-Sorry.

Mm...

I might need to come out and try somewhere else.

Anna fails to find the vein, so tries the other hand.

You OK?

Right, I'll just flush this

just to make sure it's going through.

-It's flushing through nicely.

-Yeah, yeah.

There we go.

And then I'll leave you in peace now.

For first year Anna, it's a huge relief.

It was my first cannula on respiratory.

It was quite a difficult one because the poor patient

didn't have very good veins.

It wasn't as bad as I thought, though.

I managed it in the end, so that's good,

so I'll tick this off my list of jobs.

Well, she tried her best.

I can't complain.

It's hard when they're trainees and they have to keep prodding about,

it makes them a bit nervous, isn't it?

Like Anna, first year Emeka

is facing a needle challenge of his own.

They had a bit of trouble taking your blood, did they?

Yeah, I've got little veins.

-OK.

-But if you're good, you'll get it.

-If not...

-Well, we're about to find out.

Just call the vampire lady.

-The vampire lady?

-Yeah.

-Why?

-She'll get it.

-She'll get it?

-Yeah.

-The vampire lady?

-Yeah.

Who is she? She seems like my competition.

Where is she? I'll challenge her to a one-on-one vein contest.

I feel I'll get some...

They might have to call me the vampire man after this one.

No, he's already taken.

-He's taken?

-Yeah, that's one of your other understudies, I'm afraid.

Oh, right. OK, so I need to come up with a supercool, awesome nickname.

He's a good one.

They call me the man who never misses.

Don't make me laugh. It hurts.

-The one-shot man.

-The one-shot man.

I like that one.

Ah!

Almost done.

Almost done.

OK? It's all done.

-I haven't missed yet, so...

-You were spot on.

I'm the new guy. Tell them there's a new kid on the block.

When it comes to taking blood and doing cannulas,

I'm the guy they call.

I don't want to say I'm the best, but I'm the best.

On the respiratory ward, there is a problem with Ms Benfield.

I was looking for something in my handbag.

When I fetched it out, I thought,

"Oh! It's all blood there." I seen it had come out.

Anna must re-fit the cannula.

Time for needle number four.

Fingers crossed this time.

Ow!

Oh!

All right.

See, that's an awkward one, that position.

Ow!

Not doing well here, are we?

Struggling to find a vein, and worried about hurting the patient,

Anna decides to stop.

I'm going to see if one of my senior doctors can try.

-Yeah, OK.

-Yeah? I'm sure she'll be able to get it in somewhere.

There's a team of, like, nurse practitioners in the hospital

that can help with difficult cannulas

out of hours, so as it's coming up to five o'clock,

I think we're going to ask if they can help us with it.

Otherwise, I think we'll be there all night.

Best mates Emeka and Osama

are taking time out from the hospital and hitting the gym.

Oh, cool.

This is like a ward round pace.

Yeah, this is like surgical ward round pace.

Should we go for a medical ward round pace?

This is our job, usually, as a junior doctor,

just to run around chasing stuff.

-Do you want to get some weights?

-Yeah, let's do some weights.

You're the only guy on...

-On obs and gynae.

-Yeah. So do you have to, like,

get a chaperone for everything you do?

-Yeah, pretty much.

-Because pretty much you have to have a nurse.

No way do I go without a chaperone. I get asked to go to theatre, right?

The surgeon was like, "Osama," you know, "Come and join me in theatre."

I was like, "Cool."

Keyhole surgery and whatnot.

And then I go to the operating theatre

and I see the patient like lying in the...

-you know, the legs up, wide open.

-Yeah, yeah, yeah.

-Boom.

-And he goes,

"Osama, I want you to sit right in front of the vagina."

And my job for the whole four hours

was to sit there in front of the vagina, like, holding instruments.

-Yeah, yeah.

-I couldn't see the laparoscope.

I couldn't see anything. Just stood right in front of the vagina.

-Yeah.

-It was the most awkward...

Four hours! Can you imagine that?

-Ah, man!

-It was bad.

Osama has only ever assisted with minor surgeries,

but today, all that is going to change.

He's been given the chance to help with his first major operation.

He will be helping to remove a growth called a fibroid

from inside the patient's womb.

I'm really excited

because everything I studied in medical school

was kind of leading up to this moment where you get to scrub in

and actually see what the anatomy looks like

and you see what the pathology looks like.

We've studied fibroids extensively in medical school,

but now actually getting to see them and removing them

and seeing how the patient copes with the whole operation,

this is just something incredible.

One thing I hate about surgery is the footwear.

Crocs. Big mistake.

Osama is getting in some last-minute revision.

Just reading up on some anatomy before surgery.

Showtime.

This will be really useful in surgery,

because when the surgeon is going to grill me, ask me questions,

I'll just refer to this diagram!

Since med school, Osama has dreamt of becoming a surgeon,

and today it's an opportunity

to experience a procedure he's only ever read about.

This is the uterus.

-Yeah. Wow!

-The main uterus. And the rest is fibroid.

Osama's job is to hold open the incision

so the surgeon has a clear view.

One wrong move and there's a risk of puncturing the bowel.

-Wow...

-Can I have the curved clamp for me, please?

Cool! Oh, wow!

The surgeon, Mr Saeed,

carefully removes the growth from the patient's womb.

Is this considered a large fibroid or normal?

It is fairly large, yes.

Now we are in business, yes.

Is there usually this much oozing and bleeding?

We keep it draining.

I'm happy. What do you think?

-Yeah, it looks good.

-Do you want to come here and help?

Osama's been practising his stitching at home,

but now he's getting the chance to do it for real

for the very first time.

Here?

Oh, along here.

Happy that your instruments, swabs, sharps are all correct?

I am, thank you.

Yeah, oh, that was awesome. There was a lot of blood. I mean,

I was actually a squeamish person before - quite hard to believe -

but now, not any more. I feel like a hardened vampire.

It's just amazing getting experience with such an experienced surgeon.

This is the kind of thing we study in medical school,

and to see it in real life, and so big, as well,

and to actually feel it and take it out, was just awesome.

It also makes you feel really hungry. I'm really hungry right now.

On the respiratory ward, one of the patients has passed away,

and for the first time, 23-year-old Anna has to confirm a death.

So, do you know what you're looking for when you're trying to assess?

So, you'd look at pupil responses...

Yeah.

..feel the pulse, listen for breath sounds and heart sounds.

Do you listen all over the chest or just...?

-Just two places, yeah.

-OK. OK. I'll do that.

This will soon become a routine part of the job,

but it's a daunting task for any young doctor.

A little bit nervous, but...

..I'll just take my time with it.

Anna must make sure there is no trace of life

before signing the death certificate.

First, she checks for a heartbeat...

If you're still alive, you can still kind of have a weak pulse

in your hand, so it's better to feel in the neck,

cos that should always be there, really.

..and then double-checks.

Sometimes you're thrown in right at the deep end in medicine.

And it's quite an important job, really,

to make sure that someone is actually dead.

Sometimes you think, 'I can't believe they leave it to you,

'who's never actually done it before,'

but I'm glad that I've actually done one now and feel proud of myself.

Hello!

How was your day, Socks?

I saw a dead body today, Socks.

In Obs and Gynae, Osama checks up on mum-of-three Mrs Bowen,

following her surgery.

Hi, Suzanne, how you feeling? You're not in any pain, are you?

Um, no, it's being controlled.

-OK.

-It was a little bit painful when I first got out of bed.

Yeah. The fibroid was actually very big.

It was probably... Do you want me to show you how big it was...

-Yeah.

-..in terms of...? Essentially, it was probably this size.

-Yeah.

-I would compare it to pregnancy, to be honest,

that's how big the mass was. It's probably the biggest one I've seen.

-Wow!

-But I've got a very small career!

-Yes!

Seeing the patient after, doing well, recovering,

I can't describe what feeling it gives you.

That's what I love about surgery. They come in, have the operation,

then a few weeks later down the line,

their quality of life improves significantly.

This has been an invaluable experience. I'll never forget it.

It's 8pm, and while his mates are hitting the town, over at

the hospital, Emeka's 12-hour shift is just beginning.

He's facing one of the biggest challenges for any junior doctor,

-working nights.

-Can I just give you these?

-Yes.

-5002 has just bleeped, literally two minutes ago.

24-year-old Emeka is on call across five surgical wards

and is responsible for over 120 patients.

He has the added responsibility of carrying the crash bleep.

With this bad boy, you can never really predict what happens, so...

-..just going to have to wait and see.

-This means he could be called

for backup if any patients in the hospital go into cardiac arrest.

Let's crack on.

It's a quiet start to the shift.

I'm just sorting all the drug charts,

chasing up the bloods I need to on this ward.

There are a few things that was handed over.

HE YAWNS

Staying alert during the night shift

is a challenge for any junior doctor,

but Emeka has his own way of fighting fatigue.

There's a squat, and then there's a deep squat.

WOMAN LAUGHS

-Oh, my life!

-SHE LAUGHS

I think dancing keeps me going on these night shifts.

Sometimes when it's 4:30 and you're trying to keep awake,

just shake it, give a little salsa,

keep going. The nurses seem to like it,

seem to like the moves a little bit! So, yeah, it's a winner.

It's not long before Emeka's medical training is put to the test.

PAGER BLEEPS

Hello, hi, sorry.

A patient has gone into cardiac arrest on a nearby ward.

HE EXHALES

Does anyone who works here know what this man's premorbid state is?

Are you OK with compressions?

Are you OK there?

Emeka's job is to do CPR

to try and keep blood flowing around the body.

Second adrenaline.

Someone ready to take over from Emeka when he tires?

-Slow pulse.

-Is he making any respiratory effort?

Not really showing any signs?

Nothing, no. No sign of reaction at all.

-Yeah, I've lost the pulse.

-Lost the pulse.

Realistically, even if we find a potassium level,

we've been down for the best part of 20 minutes now.

And given that it's not reversible,

there's probably not going to be a huge amount we can do here,

and I think we probably don't restart compressions.

Does anyone disagree with that?

Everyone in agreement that we stop?

The team have done everything they can.

Do we know what kind of time we're expecting the family?

Yeah, they should be here soon.

-Thanks for your help.

-No worries.

It's tough for any junior doctor

to accept they can't save every patient.

One minute, you're having a good night, everything's going well,

you're completing all your jobs, even having a little shake-shake.

The next minute, you're trying to...

..clutch a man from the jaws of death.

I just really thought we could bring the patient back.

It's hard for any doctor to accept

they're going to lose their patients

or they can lose patients and not have any control over it.

Yeah. I don't like these, especially those kind of battles.

After an exhausting experience,

Emeka still has three hours left on shift.

HE EXHALES

Following a challenging first set of night shifts,

Emeka and Osama have a chance to unwind.

4, 5am there was an arrest on the ward above me, and I was like,

"This guy hadn't had oxygen for 30 minutes, we can't bring him back."

And it was just so sad. Mentally, it breaks you a little bit.

Yeah, bro, this is the thing. Do you think over time we'll start

getting used to that kind of scenario?

Because I struggle with it, as well, I'm not going to lie.

It is what it is. It's part of the job,

and we're going to have to deal with it, whether we like it or not.

Life's for living, that's what I say.

Tonight, let's dance, let's just have a good time.

Let's blow off steam, man. It's been a long week at work. Whoo!

The patient's there.

Swallow it, swallow it.

But I am confident.

Trust in me as a doctor.

I've just been told that the nurses are a bit worried

about 4-3, Gladys. She's 95.

The baby came out, and it's so fragile.

I'd like everyone to see childbirth.