0:00:02 > 0:00:05Shetland, the most remote part of the UK.
0:00:06 > 0:00:09Here, you're closer to the Arctic Circle than you are to London
0:00:09 > 0:00:12and nearer Norway than you are to Edinburgh.
0:00:13 > 0:00:16There are more puffins than people
0:00:16 > 0:00:18and more seals than supermarkets.
0:00:20 > 0:00:24But this wild landscape is also home to 23,000 islanders.
0:00:25 > 0:00:29They're so far from the mainland that when things go wrong...
0:00:29 > 0:00:32A&E, can I help you?
0:00:32 > 0:00:35From helicopter rescues and spinal injuries...
0:00:35 > 0:00:38We're all here to make sure that you're OK.
0:00:38 > 0:00:39..to serious medical mysteries...
0:00:39 > 0:00:43Can we get assistance in, please? Something's not right.
0:00:43 > 0:00:45..Shetland's island medics have to be ready
0:00:45 > 0:00:47for anything and everything.
0:00:47 > 0:00:50- What happened? - I got in a fight with a seagull.
0:00:50 > 0:00:52- This was sheep sheared, was it? - Yeah.
0:00:54 > 0:00:57It means the tight-knit team of medics, volunteers
0:00:57 > 0:01:00and emergency services have a special bond.
0:01:00 > 0:01:01This might tickle then.
0:01:03 > 0:01:06And they know just how to keep each other going...
0:01:06 > 0:01:08Wee treat for night shift.
0:01:08 > 0:01:11..so they're always ready for any island emergency.
0:01:21 > 0:01:25Today, an injured worker rushed in by helicopter from an oil rig...
0:01:25 > 0:01:30- I fell forward fast and I heard the crunch.- You heard a crunch? OK.
0:01:30 > 0:01:33..a Shetland solution to a Shetland problem...
0:01:34 > 0:01:37..and the team welcome an old friend into A&E.
0:01:37 > 0:01:38Oh, you!
0:01:44 > 0:01:46Shetland is made up of over 100 islands
0:01:46 > 0:01:50which form a tough landscape of peaty moorland,
0:01:50 > 0:01:52savage rocks and surging tides,
0:01:52 > 0:01:55where you're never more than three miles from the sea.
0:01:55 > 0:01:58And, while life for the islanders can be challenging,
0:01:58 > 0:02:00it's a place they've chosen to call home.
0:02:04 > 0:02:05Yay!
0:02:11 > 0:02:14However, this remote location means there are unique challenges
0:02:14 > 0:02:16for Shetland's 100 medics,
0:02:16 > 0:02:21and especially for the staff at the islands' hospital, the Gilbert Bain.
0:02:24 > 0:02:26We see anything and everything here
0:02:26 > 0:02:28and we have to kind of be able to deal with it.
0:02:28 > 0:02:32Unlike on the mainland, the team here are generalist medics,
0:02:32 > 0:02:35meaning they can go from care of the elderly in the morning
0:02:35 > 0:02:38to paediatrics in the afternoon...
0:02:40 > 0:02:42..and all ages in between.
0:02:42 > 0:02:44A day in A&E can be much more varied
0:02:44 > 0:02:46because anything can walk through the door.
0:02:49 > 0:02:50Ooh!
0:02:50 > 0:02:53After working throughout most of the UK,
0:02:53 > 0:02:55this place has a lot of appeal.
0:02:55 > 0:02:58There's no comparison, really. It's lovely.
0:03:08 > 0:03:11Right, guys. Bye-bye.
0:03:11 > 0:03:13It's the start of the day
0:03:13 > 0:03:17for senior A&E and surgical doctor Kushik Lalla.
0:03:17 > 0:03:21South African Dr Lalla met his wife, Shetlander Sarah,
0:03:21 > 0:03:23when he came to the islands to work.
0:03:25 > 0:03:30My commute takes roughly five to seven minutes.
0:03:30 > 0:03:33When I worked in London, it took me a two-hour train journey
0:03:33 > 0:03:35to get into work.
0:03:35 > 0:03:37When I first got here,
0:03:37 > 0:03:43I was amazed to see the community spirit here.
0:03:43 > 0:03:45Very little in terms of crime.
0:03:45 > 0:03:49People stay with their doors open all the time.
0:03:49 > 0:03:53Coming from South Africa, that, for me, was unheard of.
0:03:53 > 0:03:56When I first got here, I kept locking the door
0:03:56 > 0:03:57and Sarah would get angry with me.
0:04:00 > 0:04:02We've got a small hospital.
0:04:02 > 0:04:04We're very generalist in what we do,
0:04:04 > 0:04:07so we're able to see and deal with most things.
0:04:07 > 0:04:13Clinically, we see so many different things here
0:04:13 > 0:04:16that you wouldn't see down south.
0:04:16 > 0:04:20We can see anything, so it is interesting.
0:04:20 > 0:04:23The case mix is very, very interesting.
0:04:27 > 0:04:30Dr Lalla and the team at Gilbert Bain Hospital
0:04:30 > 0:04:33don't just treat the islands' inhabitants.
0:04:33 > 0:04:37If anyone falls sick or gets injured on a boat or oil platform
0:04:37 > 0:04:40between Iceland and Norway, it's likely they'll be airlifted
0:04:40 > 0:04:42to Lerwick for life-saving treatment.
0:04:45 > 0:04:48Bringing those in peril on the seas to safety is the job
0:04:48 > 0:04:50of the islands' two lifeboats
0:04:50 > 0:04:53and the flight crews who operate the coastguard's helicopters,
0:04:53 > 0:04:55which are standing by to save lives 24/7,
0:04:55 > 0:05:00and fly 160 search and rescue missions every year.
0:05:00 > 0:05:02We get pretty fierce weather up here.
0:05:02 > 0:05:06It is dangerous but, you know, you're trained well
0:05:06 > 0:05:09and you just sort of get on with it, really.
0:05:14 > 0:05:17Shetland's coastguard operations centre, based in Lerwick,
0:05:17 > 0:05:21have scrambled a helicopter to rescue an injured worker
0:05:21 > 0:05:23from the Ninian Central Platform,
0:05:23 > 0:05:26located far off Shetland's east coast, towards Norway.
0:05:26 > 0:05:31- How many miles is it from Shetland, Gary?- 110.
0:05:31 > 0:05:33We took a call from a platform.
0:05:33 > 0:05:35We've got an injured crewman on board.
0:05:35 > 0:05:38He's had a fall and needs to be taken off the platform urgently,
0:05:38 > 0:05:40so what we've done now, is we've tasked
0:05:40 > 0:05:43coastguard helicopter rescue 900 to go up to the platform
0:05:43 > 0:05:45and evacuate the casualty.
0:05:45 > 0:05:48Because it's an emergency, they've chosen,
0:05:48 > 0:05:49or at the moment they're saying
0:05:49 > 0:05:52that they're going to the Clickimin emergency landing site.
0:05:52 > 0:05:54There are three designated sites
0:05:54 > 0:05:57the coastguard can land a helicopter on Shetland.
0:05:57 > 0:06:00If the case isn't serious or the weather severe,
0:06:00 > 0:06:03they land in the very south, at Sumburgh Airport,
0:06:03 > 0:06:06about 25 minutes by ambulance to the hospital.
0:06:06 > 0:06:10If it's a more pressing matter, they fly to Tingwall Airport,
0:06:10 > 0:06:1215 minutes from A&E in Lerwick.
0:06:12 > 0:06:15But if it's a life or death situation, they can land
0:06:15 > 0:06:20on the playing fields across from the hospital by the Clickimin Loch.
0:06:20 > 0:06:24Waiting at the Clickimin landing site are the coastguard volunteers,
0:06:24 > 0:06:26trained members of the local community,
0:06:26 > 0:06:29who give up their free time to help in rescue situations.
0:06:29 > 0:06:33Shetland coastguard. This is Lerwick mobile. Do you have an ETA? Over.
0:06:33 > 0:06:37- RADIO:- The last ETA we had was 11.20 local. Over.
0:06:37 > 0:06:39Roger. That's understood.
0:06:39 > 0:06:42Coastguard volunteer Stuart secures the area.
0:06:42 > 0:06:44The first thing we do when we get here
0:06:44 > 0:06:46is make the ELS ready to receive.
0:06:46 > 0:06:51Because this is a combination of football pitches,
0:06:51 > 0:06:54we have to take all the goalposts and stuff to the side,
0:06:54 > 0:06:56make it ready, make it nice and safe.
0:06:56 > 0:06:59We need to be making sure that the public are safe as well,
0:06:59 > 0:07:02behind the fence, just because of the downdraught of the helicopter.
0:07:02 > 0:07:05Meanwhile, at the islands' ambulance HQ...
0:07:05 > 0:07:08- ALARM SOUNDS - That's probably break over, right?
0:07:08 > 0:07:12..the call comes in, and paramedics Chris and Dan head for the site.
0:07:15 > 0:07:17- AMBULANCE COMMS:- 999 mode activated.
0:07:20 > 0:07:22SIREN WAILS
0:07:22 > 0:07:28So, we're going down to the emergency landing site at Clickimin.
0:07:28 > 0:07:32The helicopter's taken a patient off an oil rig.
0:07:32 > 0:07:35SIREN WAILS
0:07:37 > 0:07:40They only use the landing site at Clickimin
0:07:40 > 0:07:44when it's seen as life-threatening or limb-threatening.
0:07:44 > 0:07:46Otherwise they would use one of the airports.
0:07:54 > 0:07:56That was good driving, mate!
0:07:58 > 0:08:03I'm just going to pop on a helmet and stuff, because there's a chance
0:08:03 > 0:08:08that there's debris that can fly up when the rotors are turning.
0:08:08 > 0:08:13Just to keep us safe and make sure that we don't get hurt,
0:08:13 > 0:08:16cos then we end up with two casualties rather than one.
0:08:19 > 0:08:21I'm standing here being filmed and I'm not even sure if this fits.
0:08:21 > 0:08:26- You've never worn it before, have you?- No. Well, never at a job.
0:08:32 > 0:08:35The handover from the coastguard medic is the first chance
0:08:35 > 0:08:37the team have to discover
0:08:37 > 0:08:39the extent of the injuries they'll be dealing with.
0:08:40 > 0:08:43All right, how's it going? What have we got?
0:08:43 > 0:08:47- Spinal injury. He ran into a pole. - OK.
0:08:47 > 0:08:51He hit his head, he fell. He heard a massive crunch.
0:08:51 > 0:08:56- All right, OK.- Yeah, really sore. Pain was ten out of ten, initially.
0:08:58 > 0:09:01The patient's possible spinal injuries mean
0:09:01 > 0:09:02the team must be extra careful
0:09:02 > 0:09:05when they move him from helicopter to ambulance.
0:09:11 > 0:09:13Spinal, so be careful with the back.
0:09:40 > 0:09:44- Brian, how are you getting on? - I've been better.
0:09:44 > 0:09:47Brian, a 48-year-old ultrasound engineer from Liverpool,
0:09:47 > 0:09:50fell and injured his neck on his rig.
0:09:50 > 0:09:53The coastguard medic was concerned he may have broken it.
0:09:53 > 0:09:56I was immobilised. To be honest with you,
0:09:56 > 0:10:00when I went over, my neck snapped back.
0:10:02 > 0:10:05I hit the floor and I couldn't move.
0:10:07 > 0:10:10In the Gilbert Bain, the A&E team have been alerted
0:10:10 > 0:10:13to the incoming emergency and are preparing for the patient's arrival.
0:10:15 > 0:10:19All we've been told is we've got a 48-year-old man
0:10:19 > 0:10:23who's fallen on a rig and he's got neck and back pain.
0:10:23 > 0:10:25That's all the information we've been given,
0:10:25 > 0:10:28so we'll just have to assume the worst until we're proved otherwise.
0:10:38 > 0:10:41Lean back onto the pillow. Can you lean back?
0:10:42 > 0:10:4771-year-old shepherd John, who tends his flock in Dunrossness,
0:10:47 > 0:10:51in the very southern tip of the Islands, has arrived in A&E.
0:10:51 > 0:10:54He's been unable to pass water and is in agony.
0:10:54 > 0:10:58- So, is it coming on for sheep shearing time, is it?- Yeah.
0:10:58 > 0:11:01- Knock knock.- Hello.- Hello, there.
0:11:01 > 0:11:04John, I hear we've got a problem with the waterworks.
0:11:04 > 0:11:06We're going to try and pop a new catheter in
0:11:06 > 0:11:09and, hopefully, that will clear everything out
0:11:09 > 0:11:11and make you feel a lot better.
0:11:11 > 0:11:13Treating John is Dr Helen Hare.
0:11:13 > 0:11:16She's one of the many locums who work on Shetland
0:11:16 > 0:11:18and came for a bit of a change.
0:11:18 > 0:11:20I like talking to people,
0:11:20 > 0:11:22I like fixing their problems
0:11:22 > 0:11:24and that's as true of medicine
0:11:24 > 0:11:26as it was when I worked in a gift shop
0:11:26 > 0:11:29and helped people find Christmas presents.
0:11:33 > 0:11:35You get very used to dealing with human bodies
0:11:35 > 0:11:38and one bit is the same as another, really.
0:11:40 > 0:11:42Break the seal for me. That would be grand.
0:11:42 > 0:11:44You get very used to doing catheters
0:11:44 > 0:11:48although, that said, it's been at least a year since I've done one,
0:11:48 > 0:11:50so it was a bit of a guddle today.
0:11:51 > 0:11:53- Sorry.- No.
0:11:53 > 0:11:55But definitely necessary.
0:11:55 > 0:11:58Putting a catheter into somebody with urinary retention
0:11:58 > 0:12:00is one of the nicest things you can do, as a doctor or a nurse.
0:12:00 > 0:12:02It makes a huge difference to them.
0:12:02 > 0:12:04Just relax. We'll just hold it a moment.
0:12:05 > 0:12:08- In or out?- Just breathe in and out.
0:12:08 > 0:12:10- Just keep breathing.- All right.
0:12:11 > 0:12:16You need to have a huge range of skills at your fingertips.
0:12:16 > 0:12:20Deep breaths, in and out. Good man. Well done.
0:12:20 > 0:12:23Doctors coming from elsewhere don't necessarily have that.
0:12:23 > 0:12:26They're used to being able to hand over to experts,
0:12:26 > 0:12:28so that's why it's been a while since I've done that.
0:12:28 > 0:12:30After 15 minutes...
0:12:35 > 0:12:37..finally some relief for John...
0:12:40 > 0:12:42..almost two litres-worth.
0:12:48 > 0:12:51There are very few places in Shetland you can stand
0:12:51 > 0:12:53and not see the sea.
0:12:54 > 0:12:57This means the pull of the ocean is strong
0:12:57 > 0:13:00and messing about on boats is an islander session.
0:13:01 > 0:13:04From the yachts, tall ships and fishing boats
0:13:04 > 0:13:06that fill Lerwick harbour
0:13:06 > 0:13:10to the traditional yoals that race on summer evenings
0:13:10 > 0:13:12and the canoes that explore the coastline,
0:13:12 > 0:13:16Shetlanders are on the water almost as much as they're off it.
0:13:18 > 0:13:22Keeping an eye on the 1,697 miles of coastline,
0:13:22 > 0:13:25from their base high on the cliffs above the capital,
0:13:25 > 0:13:30are the coastguard, and no job is too big or too small.
0:13:31 > 0:13:33Another call has come in to the ops room.
0:13:33 > 0:13:39We had a radio call from a 25-foot pleasure vessel.
0:13:39 > 0:13:42It's got something wrapped around its props.
0:13:42 > 0:13:44The skipper of a boat, taking tourists out to see
0:13:44 > 0:13:47some of Shetland's amazing wildlife, has radioed in,
0:13:47 > 0:13:49after they lost power.
0:13:49 > 0:13:53They're drifting in strong currents and need rescuing fast.
0:13:53 > 0:13:57So, what we've done is we've called the Lerwick lifeboat.
0:13:57 > 0:13:59Lerwick lifeboat are now on scene.
0:13:59 > 0:14:04Coastal rescue teams should be on the jetty, ready to tie them up.
0:14:04 > 0:14:06The lifeboat has been scrambled
0:14:06 > 0:14:09and is towing in the good ship Christine May and her crew.
0:14:10 > 0:14:14Shetland has two lifeboat stations - one on the east coast, in Lerwick,
0:14:14 > 0:14:17and one based in Aith, on the west of the Islands.
0:14:17 > 0:14:22Both are vital lifelines for a community so reliant on the sea.
0:14:24 > 0:14:26Coastguard Liam is with the rest of the team,
0:14:26 > 0:14:28ready to help when she nears the harbour.
0:14:28 > 0:14:31Basically, we've been tasked
0:14:31 > 0:14:33by the Shetland operations centre
0:14:33 > 0:14:35to come down here and meet the Lerwick lifeboat.
0:14:35 > 0:14:39They've been tasked to go to a boat with a failed propeller,
0:14:39 > 0:14:40so they're just going to take them in
0:14:40 > 0:14:44and we'll basically assist the lifeboat in any way that we can.
0:14:45 > 0:14:49The lifeboat gently guides the Christine May safely to harbour,
0:14:49 > 0:14:51where her passengers can finally disembark,
0:14:51 > 0:14:54aided by Liam and his team.
0:15:07 > 0:15:09Sonia, the skipper of the Christine May,
0:15:09 > 0:15:12had been taking visitors on a day trip.
0:15:12 > 0:15:15From Burravoe, on the northern island of Yell,
0:15:15 > 0:15:18they sailed to watch the sea birds on the Isle of Noss.
0:15:23 > 0:15:28In seconds, we went from being extremely happy
0:15:28 > 0:15:30and taking photographs and enjoying the scenery
0:15:30 > 0:15:34to having a slight amount of panic set in when we realised
0:15:34 > 0:15:38we were about 60 feet from rocks and we weren't able to use our engines.
0:15:38 > 0:15:42Rope got caught up in a propeller shaft.
0:15:42 > 0:15:47Every time we put the boat into gear, it wouldn't drive at all.
0:15:48 > 0:15:51The attitude of the guys is phenomenal
0:15:51 > 0:15:54and it's just instinctive to them.
0:15:54 > 0:15:57The importance of having such services,
0:15:57 > 0:16:00not only for the islands of Shetland,
0:16:00 > 0:16:03but with the location of where we are
0:16:03 > 0:16:07and who they can get to from here, it's of vital importance.
0:16:07 > 0:16:09And, of course, this being Shetland,
0:16:09 > 0:16:11it shouldn't be too surprising
0:16:11 > 0:16:14if you recognise the person towing you to safety.
0:16:14 > 0:16:17My cousin Garry is actually coxswain of the Lerwick lifeboat.
0:16:17 > 0:16:19It's not often you tow your cousin in!
0:16:19 > 0:16:22My grandad is Garry's granduncle.
0:16:22 > 0:16:26And I couldn't believe it was him, so it was pretty cool.
0:16:28 > 0:16:31You're not needing any bottles of water or anything like that?
0:16:31 > 0:16:34No, no, thank you. We've got water on board.
0:16:34 > 0:16:36I think I'm going to need something stronger
0:16:36 > 0:16:37by the time I get home tonight.
0:16:37 > 0:16:40OK. Well, we'll head back and leave you to it then.
0:16:40 > 0:16:43- That's good, thank you very much. - Perfect, no problem. Cheers.
0:16:44 > 0:16:47Happy customer again, yeah. That's good.
0:16:47 > 0:16:52At least we can do something to help, so everybody's happy.
0:16:52 > 0:16:55It was quite exciting, but we were a bit worried
0:16:55 > 0:16:58because we were very close to the rocks where the gannets were.
0:16:58 > 0:17:00It was quite an amazing sight,
0:17:00 > 0:17:03but we were a bit close to the rocks at that point.
0:17:03 > 0:17:07We were pleased to see the lifeboat, definitely.
0:17:07 > 0:17:10With skipper Sonia and her boat safely in harbour,
0:17:10 > 0:17:14Liam and the coastguard team can move onto their next job.
0:17:15 > 0:17:17But Sonia's going to have to work out
0:17:17 > 0:17:20how to get her boat moving again before she can go home.
0:17:30 > 0:17:34Brian, a 48-year-old ultrasound engineer, was airlifted to A&E,
0:17:34 > 0:17:38after falling and injuring his neck on an oil rig.
0:17:40 > 0:17:43Wonderful. I'm just going to take your shoes off.
0:17:43 > 0:17:45Brian was helicoptered off the rig
0:17:45 > 0:17:49and then transferred to the hospital by ambulance.
0:17:49 > 0:17:52He's now in the capable hands of nurse Kathy Duffus.
0:17:52 > 0:17:56- I fell.- Right.- And obviously I fell forward fast.
0:17:56 > 0:18:00- OK, and then your neck was pulled, was it?- Yeah.- Backwards, like that?
0:18:00 > 0:18:03- I heard the crunch. - You heard a crunch? OK.
0:18:04 > 0:18:08That crunch sets alarm bells ringing for the A&E team.
0:18:08 > 0:18:11Neck injuries are a worry at the best of times
0:18:11 > 0:18:14and Brian may well have injured his spine.
0:18:15 > 0:18:19After making Brian comfortable, Kathy wants to run some tests.
0:18:19 > 0:18:23As well as the neck injury, he has an alarmingly low heart rate,
0:18:23 > 0:18:26well below the normal range of 60 to 100 beats per minute.
0:18:26 > 0:18:30Right, what I'm going to do is a proper ECG,
0:18:30 > 0:18:34which is a trace on your heart, just because it's quite slow there.
0:18:34 > 0:18:39All you have to do is lie still, which you're doing anyway. So...
0:18:39 > 0:18:42These results will be sent
0:18:42 > 0:18:44to the senior A&E consultant for inspection.
0:18:44 > 0:18:46OK.
0:18:46 > 0:18:47In the meantime,
0:18:47 > 0:18:51Dr Mihir Trivedi is keen to hear more about this neck injury.
0:18:51 > 0:18:56- What happened?- I hit the floor and couldn't move.- Yeah.
0:18:56 > 0:18:59But it's in my left arm.
0:18:59 > 0:19:02It was... I'd say pins and needles,
0:19:02 > 0:19:05but it was like a burning pins and needles.
0:19:05 > 0:19:09- I couldn't...- OK, has anybody got a pen?- It was horrendous.
0:19:09 > 0:19:13But Dr Lalla, the senior A&E surgical doctor,
0:19:13 > 0:19:15is worried about Brian's ECG results.
0:19:15 > 0:19:20No, no, no, his heart rate is 33, so can we get assistance in, please?
0:19:20 > 0:19:23Heart rate of 33, Cameron. This is the guy that fell at the oil rig.
0:19:23 > 0:19:27- Hi, there.- Hi. - What's your name?- Brian.- Brian.
0:19:27 > 0:19:30Have you been started on any new medication or anything like that?
0:19:30 > 0:19:33- Nothing.- Nothing. How old are you?- 48.
0:19:33 > 0:19:35And you are otherwise generally fit and well?
0:19:35 > 0:19:38- Yeah, I keep myself very fit. - Right, OK.
0:19:38 > 0:19:40The reason we're getting a bit excited
0:19:40 > 0:19:44is your heart rate is going quite low.
0:19:44 > 0:19:46Something's not right.
0:19:46 > 0:19:49Dr Lalla is worried that Brian's low heart rate could be
0:19:49 > 0:19:53the cause of his fall and it could point to something very serious.
0:19:54 > 0:19:56Can we get the heavy-duty scissors, please?
0:19:56 > 0:20:00- Sorry, Brian, that's the end of your T-shirt.- That's OK.- Right.
0:20:00 > 0:20:04- Now, do you exercise a lot? - I do exercise, yeah.
0:20:04 > 0:20:08- A lot?- Um...yeah, I think so.
0:20:09 > 0:20:11He looks like a pretty fit guy.
0:20:13 > 0:20:20But his heart rate is very low, and it might explain why he fell.
0:20:21 > 0:20:25Because the heart rate is that low, it's not pumping enough blood
0:20:25 > 0:20:28to his brain and they tend to get almost like a faint.
0:20:28 > 0:20:33This is down to 38 times, which is very, very low.
0:20:33 > 0:20:37At this level, we sometimes want to start external massage
0:20:37 > 0:20:40because they can go into cardiac arrest.
0:20:40 > 0:20:45So, we've got some medication ready that can push his heart rate up.
0:20:45 > 0:20:47Get out some atropine as well.
0:20:47 > 0:20:50Don't give it but just get it ready, just get it out.
0:20:50 > 0:20:53But we're hanging fire with that just now.
0:20:55 > 0:20:57Brian, what we need to do in the interim,
0:20:57 > 0:21:01while they're humming and hawing about your heart tracing,
0:21:01 > 0:21:03what we're going to do in the interim,
0:21:03 > 0:21:05- is just have a look at your neck. - OK.
0:21:05 > 0:21:09- I don't want you to move your head. - OK.- OK. So, don't move.
0:21:09 > 0:21:11I'm going to have a feel at the back of your neck, OK?
0:21:11 > 0:21:15Right, you tell me if anything is sore. Any pain there?
0:21:16 > 0:21:19- Not painful.- No.
0:21:21 > 0:21:25- There?- That's getting sharper. - That's getting sore.
0:21:27 > 0:21:30- And lower down there?- Yeah.- That's where you're feeling it?- Yeah.
0:21:30 > 0:21:32Right, OK. Brian, unfortunately,
0:21:32 > 0:21:34you're going to be stuck on this collar
0:21:34 > 0:21:36for a little while longer.
0:21:36 > 0:21:39What's happening next is they're going to get
0:21:39 > 0:21:41a CT scan of his neck
0:21:41 > 0:21:45to see if there's any fractures or damage there.
0:21:45 > 0:21:48In the meantime, we'll keep him under close observation.
0:21:48 > 0:21:50Obviously, what we're concerned about is his heart rate
0:21:50 > 0:21:52cos it's quite low.
0:21:52 > 0:21:55So, it's a tense wait for Brian and the team in A&E,
0:21:55 > 0:21:57who will need the result of some scans
0:21:57 > 0:21:59before they can rule out serious neck injury
0:21:59 > 0:22:02and find out the cause of his extremely low heart rate.
0:22:11 > 0:22:13Skipper Sonia called the coastguard for assistance,
0:22:13 > 0:22:16when her boat, the Christine May, lost power,
0:22:16 > 0:22:18thanks to a rope caught in a propeller.
0:22:18 > 0:22:21Having been safely towed to Lerwick harbour,
0:22:21 > 0:22:22Sonia still has to find a way
0:22:22 > 0:22:25to untangle the rope and check for any damage.
0:22:27 > 0:22:29Lucky for her, the Lerwick locals aren't the type
0:22:29 > 0:22:32to stand by and watch a seafarer struggle.
0:22:32 > 0:22:34I just thought that a diver,
0:22:34 > 0:22:38going to go down here at Victoria Pier,
0:22:38 > 0:22:40for about ten minutes
0:22:40 > 0:22:43to, hopefully, remove the rope from my prop shaft.
0:22:43 > 0:22:46- RADIO:- That's no problem.
0:22:46 > 0:22:50Hopefully, it's in such a state that I can untangle it.
0:22:52 > 0:22:55The water around Shetland is cold - seriously cold.
0:22:56 > 0:23:00The only way to get down to inspect the damage to the propeller
0:23:00 > 0:23:03is for a diver to suit up and jump into the icy water.
0:23:07 > 0:23:10- For God's sake, don't turn it on. - No, it's all off.
0:23:12 > 0:23:18He's the knight in shining armour today, along with the lifeboat.
0:23:19 > 0:23:22More of a knight in shining neoprene, if you ask me.
0:23:23 > 0:23:25Hopefully, there's no damage done.
0:23:25 > 0:23:30That's what we're ultimately looking for, that it's just bound up
0:23:30 > 0:23:33but the shaft itself is actually OK.
0:23:33 > 0:23:36So, we'll find out, with him, if all is all right.
0:23:41 > 0:23:43He should be able to see it no problem at all
0:23:43 > 0:23:46and see if there's anything come loose or bent.
0:23:46 > 0:23:48It'll be pretty obvious.
0:23:48 > 0:23:50So, fingers crossed.
0:24:03 > 0:24:04That'll be the rudder problem.
0:24:06 > 0:24:11- Does the shaft look OK to you, the shaft itself?- It looks all right.
0:24:11 > 0:24:13- It looks OK?- It was wrapped round the rudder is well.
0:24:13 > 0:24:16I'm no expert on props, but it didn't look...
0:24:16 > 0:24:19A lot of the rope was quite loose around it,
0:24:19 > 0:24:22- it was just wrapped around like that.- It wasn't tight?
0:24:22 > 0:24:23No, that's really good.
0:24:23 > 0:24:25I did find that I didn't have steering,
0:24:25 > 0:24:27so that would, obviously, make sense,
0:24:27 > 0:24:30- why it's around the rudder as well. - Yeah.
0:24:30 > 0:24:34No, I really can't thank you enough. That's fantastic.
0:24:34 > 0:24:35I hope this never happens again.
0:24:35 > 0:24:37Well, if it does, you know where I am.
0:24:40 > 0:24:45Thank you. One boat, ready for going home. A good result.
0:24:54 > 0:24:57When it comes to getting casualties to Accident & Emergency,
0:24:57 > 0:25:01the job more often than not falls to Shetland's team of paramedics
0:25:01 > 0:25:04and ambulance technicians, who staff the two ambulances
0:25:04 > 0:25:08which are on call 24 hours a day, 7 days a week.
0:25:08 > 0:25:10SIREN WAILS
0:25:12 > 0:25:15It's a pressurised job and can really take it out of you.
0:25:16 > 0:25:18SHE MOUTHS
0:25:18 > 0:25:21But it's one the team love.
0:25:21 > 0:25:24We get to know the patients because of the small community
0:25:24 > 0:25:28and we get to know friends and family of the patients.
0:25:29 > 0:25:31ALARM SOUNDS
0:25:32 > 0:25:35Chris and Emma have had a call.
0:25:37 > 0:25:39Have you got the keys?
0:25:47 > 0:25:51Burgh Road. Do you think that's a right turn or a left turn?
0:25:51 > 0:25:54- I really don't know. - EMMA LAUGHS
0:25:57 > 0:26:00Number 25. Right.
0:26:00 > 0:26:02Where is this house?
0:26:02 > 0:26:05Chris, what way do I go, right or left?
0:26:05 > 0:26:09- I'd go that way, just have a look. - Number two is down there.
0:26:09 > 0:26:1215... Chris, you sent me the wrong way!
0:26:17 > 0:26:19Right, 25. Oh, here we go.
0:26:21 > 0:26:24They've probably just watched us go the wrong way.
0:26:27 > 0:26:31- Hello.- Hello.- Now, then. - What's happened to you today?
0:26:31 > 0:26:34I think I've had a slight stroke on this side.
0:26:34 > 0:26:35And what makes you say that?
0:26:37 > 0:26:39- Because it's not working properly. - OK.
0:26:39 > 0:26:4579-year-old Anna called 999 when she lost sensation in her right hand.
0:26:45 > 0:26:47And when did this start, would you say?
0:26:47 > 0:26:50- Three o'clock this morning. - Three o'clock this morning.
0:26:50 > 0:26:51She's worried she's had a stroke.
0:26:51 > 0:26:55She suffered one a few weeks ago, while at a friend's house,
0:26:55 > 0:26:57and recognises the symptoms.
0:26:57 > 0:26:59Little wonder Chris doesn't want to leave her alone
0:26:59 > 0:27:03and is keen to get her into hospital as soon as possible.
0:27:03 > 0:27:06I think what we'll do then is we'll take you to hospital
0:27:06 > 0:27:10and we'll get this arm looked at. What do you think?
0:27:10 > 0:27:14- You're not convinced, are you? - I am not staying in that place.
0:27:14 > 0:27:16I worked in it for 40-odd years!
0:27:16 > 0:27:18EMMA AND CHRIS LAUGH
0:27:18 > 0:27:20Anna is a retired nurse
0:27:20 > 0:27:24and four decades at the Gilbert Bain was more than enough for her.
0:27:26 > 0:27:29But, with a bit of gentle persuasion, they coax her out.
0:27:29 > 0:27:33Come on then. Into the ambulance.
0:27:33 > 0:27:35- Are you ready, Chris? - Yeah, whenever you are.
0:27:41 > 0:27:45Fortunately, the route back to base is fresh in Emma's mind.
0:27:51 > 0:27:54- Are you being shy? - Are you camera shy?
0:27:54 > 0:27:56No, I'm not camera shy.
0:27:56 > 0:28:00Returning under duress to her old place of work,
0:28:00 > 0:28:02Anna spies a familiar face.
0:28:02 > 0:28:04Oh, you!
0:28:04 > 0:28:06THEY LAUGH
0:28:06 > 0:28:08She said that old fish is going to be here.
0:28:08 > 0:28:10How are you doing?
0:28:10 > 0:28:13- All the better for seeing you. - Me, too.
0:28:13 > 0:28:15Strokes are the result
0:28:15 > 0:28:18of a restricted flow of blood to the brain
0:28:18 > 0:28:22and can result in permanent damage or even death but, in many cases,
0:28:22 > 0:28:25prompt medical attention can make all the difference.
0:28:25 > 0:28:27She's quite an upbeat person.
0:28:27 > 0:28:31She's in now and again, but she's usually quite good.
0:28:31 > 0:28:35- I worked in hospitals all my life. - Did you work at this hospital then?
0:28:35 > 0:28:38Yeah, I did, mainly nights.
0:28:40 > 0:28:44- So, you must know a lot of the staff still, do you?- Yes, mm-hmm.
0:28:44 > 0:28:48- Are they still familiar?- Some of them are. If you go to A&E...
0:28:49 > 0:28:54..that's where I see a lot of old staff.
0:28:54 > 0:28:57While Anna gets comfy, the nurses she knows so well
0:28:57 > 0:29:00prepare for the CT scan they hope will get some answers
0:29:00 > 0:29:03as to the severity of her suspected stroke.
0:29:15 > 0:29:16On Shetland,
0:29:16 > 0:29:19knowing the people treating you is far from uncommon,
0:29:19 > 0:29:22which is certainly the case for our next patient.
0:29:22 > 0:29:24- Are you married to Miriam, by any chance?- I am.
0:29:24 > 0:29:28- I know Miriam through toddlers. - Very good.
0:29:28 > 0:29:30- Very cute bairns.- Thank you.
0:29:30 > 0:29:33So, I'm doing a kitchen renovation, working on the extractor fan,
0:29:33 > 0:29:36and I wasn't happy with how it was lining up.
0:29:37 > 0:29:40So, I tried to get the stainless steel shroud off the top of it
0:29:40 > 0:29:44but it wouldn't come, and it wouldn't come, and then it did come.
0:29:46 > 0:29:48And it got me, too.
0:29:48 > 0:29:51Danny should be more careful of his own strength,
0:29:51 > 0:29:54especially since, besides his work as a labourer,
0:29:54 > 0:29:56he has an unusual hobby.
0:29:58 > 0:30:01In my free time, I'm a strongman and I've just come back
0:30:01 > 0:30:04from Europe's Strongest Man, where I placed fifth.
0:30:05 > 0:30:08He certainly got the better of that extractor fan!
0:30:08 > 0:30:09Or did he?
0:30:09 > 0:30:11There was a lot of blood,
0:30:11 > 0:30:15so I actually went to the van to try and superglue it up myself
0:30:15 > 0:30:16but, when I had a look in the mirror,
0:30:16 > 0:30:18I thought I'd better come in.
0:30:18 > 0:30:21Well, I went to the van to superglue it.
0:30:21 > 0:30:25When I looked in the mirror, there was just a big chunk hanging off,
0:30:25 > 0:30:27so I thought I'd better come in.
0:30:27 > 0:30:31I think maybe just a dab of glue on there might be the best thing.
0:30:31 > 0:30:35But first of all, it'll need a good clean.
0:30:35 > 0:30:38- If it's very sore just let me know. - That is pretty sore.- Sorry.
0:30:38 > 0:30:40It's all right. Just go for it.
0:30:40 > 0:30:43- Sorry, it might be a bit stingy. - Mm-hmm.
0:30:43 > 0:30:45He may be able to lift a third of a tonne,
0:30:45 > 0:30:48but he's still got his sensitive side...
0:30:48 > 0:30:49- OK, coping?- Yeah.
0:30:49 > 0:30:52Eleanor, could I get you to go and ask the nurses
0:30:52 > 0:30:56if I can get one of the things of glue? Is that OK?
0:30:56 > 0:30:58..even if it's just on his nose.
0:30:58 > 0:31:02It could be a bit awkward. It's not really the easiest place.
0:31:02 > 0:31:03You'll just have to not poke at it.
0:31:03 > 0:31:06It doesn't look like it's gone too, too far.
0:31:07 > 0:31:10They may be surrounded by millions of pounds of equipment,
0:31:10 > 0:31:13but sometimes the simplest solutions are the best.
0:31:14 > 0:31:19- OK. It might be a bit stingy. - Sneezy.- Sorry.
0:31:19 > 0:31:21OK, I think that's the best
0:31:21 > 0:31:24that we're going to manage with you, given its location.
0:31:24 > 0:31:28- The difficult bit is going to be no touching it.- Yeah.
0:31:28 > 0:31:29I don't think it's too serious.
0:31:29 > 0:31:32It's just an awkward place to get into,
0:31:32 > 0:31:36so just a dab of superglue, which I had in the van anyway.
0:31:36 > 0:31:40But it's clean. That's the main thing, so back to work.
0:31:40 > 0:31:43SEAGULLS CRY
0:31:49 > 0:31:51Brian was airlifted off an oil rig
0:31:51 > 0:31:54after he slipped and banged his head.
0:31:54 > 0:31:56Dr Lalla and his team have two concerns.
0:31:56 > 0:32:00One is that Brian heard a loud crack from his neck when he fell,
0:32:00 > 0:32:02which could mean a broken neck.
0:32:02 > 0:32:05The other is Brian's heart rate is very low,
0:32:05 > 0:32:08which could be extremely serious.
0:32:08 > 0:32:09While he waits for his test results,
0:32:09 > 0:32:13Brian is enjoying the benefits of Gilbert Bain's nursing hospitality.
0:32:13 > 0:32:19Are you feeling OK? Brian, are you feeling OK? Yeah?
0:32:19 > 0:32:21But there's a limit, even to Kathy's patience.
0:32:21 > 0:32:23I haven't been to the Shetlands properly,
0:32:23 > 0:32:25- so I thought I'd pay you a visit. - Where had you not been?
0:32:25 > 0:32:29- I haven't been here. - What's it called?- The Shetlands.
0:32:29 > 0:32:30- KATHY GASPS - No?
0:32:30 > 0:32:33- Shetland.- Shetland.- Shetland. - Ah, right.
0:32:33 > 0:32:37- If you say the Shetlands, it's like nails down a blackboard.- Ah, OK.
0:32:37 > 0:32:39So, it's obvious you've never been here before.
0:32:39 > 0:32:41You learn something new every day, don't you?
0:32:41 > 0:32:43A lot of folk call it that but...
0:32:43 > 0:32:45Any other questions?
0:32:45 > 0:32:47- It's just the heart thing, isn't it?- Yeah.
0:32:47 > 0:32:49Well, actually, to be honest with you...
0:32:51 > 0:32:54- ..I feel I have all the answers. I'm in good hands.- Yeah.
0:32:54 > 0:32:56They're going to speak to a cardiologist.
0:32:56 > 0:32:58- Nurses are fantastic anyway, aren't they?- Yeah.
0:32:58 > 0:33:00- My mum was a nurse. - Well, there you go.
0:33:01 > 0:33:05- Yeah.- Underpaid and overworked. - Yeah!
0:33:05 > 0:33:09You should be on the highest pay scale, you really should.
0:33:09 > 0:33:11- You do an amazing job.- Thank you.
0:33:11 > 0:33:14Do you fancy running for Parliament or anything like that?
0:33:14 > 0:33:20Well, I run and I raise money, after my mum went, for the Macmillans.
0:33:20 > 0:33:22Oh, very good, yeah. They're excellent.
0:33:22 > 0:33:25- Yeah, I get thousands every year. - Good for you.
0:33:25 > 0:33:27Is that marathons and things?
0:33:27 > 0:33:31- Yeah, I do silly Tough Mudders. - So, you do that every year?
0:33:31 > 0:33:34- I do a few, yeah. - A few every year?- Yeah.
0:33:34 > 0:33:36- OK.- I've just done the European one.
0:33:36 > 0:33:40- That was eight hours through the night.- Right.- That wasn't too bad.
0:33:40 > 0:33:42Kathy may have just had an idea
0:33:42 > 0:33:45about what's causing Brian's low heart rate.
0:33:45 > 0:33:47He's telling me that he does several Tough Mudders a year.
0:33:47 > 0:33:50Would that go some way to explain his heart rate though,
0:33:50 > 0:33:52cos that sounds like pretty superfit to me?
0:33:52 > 0:33:56- There's 10.4 miles, there's 20 obstacles and a lot of mud.- Yeah.
0:33:56 > 0:34:00Right OK, CT is ready, so we'll take him around over there.
0:34:00 > 0:34:02One, two, three, roll.
0:34:05 > 0:34:08OK, one, two, three, back.
0:34:10 > 0:34:14- He does multiple Tough Mudders a year.- Yes?- Tough Mudders.
0:34:14 > 0:34:15Several times a year.
0:34:15 > 0:34:18It's like a ten-and-a-half mile course with 20 obstacles in it
0:34:18 > 0:34:20but it takes quite a bit of fitness to do.
0:34:20 > 0:34:23- He does that multiple times a year. - So, you ARE pretty fit.
0:34:23 > 0:34:26- Yes, he is.- BRIAN:- What do you want me to do?- Nothing.
0:34:26 > 0:34:30We want you just to lie still and look pretty. We'll do everything.
0:34:33 > 0:34:36Oh, I'm roasting. Is my face red?
0:34:37 > 0:34:41While it may be well equipped, the Gilbert Bain's remote location
0:34:41 > 0:34:45means specialist medics are in short supply.
0:34:45 > 0:34:47Luckily, they're able to send scan results
0:34:47 > 0:34:50to the specialists in Aberdeen for advice,
0:34:50 > 0:34:54saving the cost of an air ambulance evacuation to the mainland.
0:34:54 > 0:34:56I hope it's normal, for him.
0:34:57 > 0:35:01- We're all done, Brian, you'll be glad to hear.- OK, let's go.
0:35:03 > 0:35:05And while Dr Lalla pores over the CAT scan,
0:35:05 > 0:35:08he also requests an ultrasound to check Brian's heart.
0:35:10 > 0:35:12We're looking at his neck at the moment
0:35:12 > 0:35:14to see if there's any breaks over there.
0:35:14 > 0:35:16It's very unlikely that that's going be the case,
0:35:16 > 0:35:18but we need to make sure
0:35:18 > 0:35:21before we can get him up and moving a little bit.
0:35:21 > 0:35:24Dr Lalla seems confident, but the tests have been sent
0:35:24 > 0:35:28to the orthopaedic experts in Aberdeen for confirmation.
0:35:28 > 0:35:30The team will need to wait for this,
0:35:30 > 0:35:33along with the results of the ultrasound on Brian's heart,
0:35:33 > 0:35:36before they can settle on a final diagnosis.
0:35:42 > 0:35:45Just keep focusing on him, OK, and ignore the light.
0:35:45 > 0:35:47I'm just going to shine the light for each side, OK?
0:35:47 > 0:35:52Anna, a 79-year-old Shetland native and former nurse at Gilbert Bain,
0:35:52 > 0:35:56came into hospital earlier this morning, after a suspected stroke.
0:35:56 > 0:35:59I'm getting Anna ready to go for a CT scan,
0:35:59 > 0:36:02take her through, get a quick scan.
0:36:02 > 0:36:06That scan has to go to Aberdeen for the radiologists to report.
0:36:06 > 0:36:08They then send that back to us
0:36:08 > 0:36:12and then we'll get our doctor and consultant to review it
0:36:12 > 0:36:14and see what they're wanting to do from there.
0:36:14 > 0:36:17But Anna isn't really in the mood to hang about
0:36:17 > 0:36:20waiting for the specialists in Aberdeen.
0:36:20 > 0:36:24They said I would go home at two and it's now quarter past.
0:36:24 > 0:36:28She may be in a hurry to get home but, as a former nurse,
0:36:28 > 0:36:32she knows it doesn't do to rush the NHS.
0:36:32 > 0:36:36Can I pop this on your arm? OK, I'll be back in a minute, OK?
0:36:36 > 0:36:41The CT scan will show if Anna, as suspected, has had a stroke
0:36:41 > 0:36:43and the extent of any damage.
0:36:43 > 0:36:45The doctors in Aberdeen can then determine
0:36:45 > 0:36:47the best course of treatment
0:36:47 > 0:36:50and, ultimately, if Anna will get home tonight.
0:36:52 > 0:36:54There's no formal report back from Aberdeen yet,
0:36:54 > 0:36:58so the doctor's waiting for that and blood results to come back
0:36:58 > 0:37:00and, once we've got them, they can decide
0:37:00 > 0:37:03whether she's going to be admitted to the ward
0:37:03 > 0:37:06or if she would be safe to go home. She's OK in herself.
0:37:06 > 0:37:10She's quite keen to go home, but they usually are.
0:37:10 > 0:37:13She's in good humour as well, which always helps.
0:37:13 > 0:37:16Has the doctor told you she's going to admit you up to the ward tonight?
0:37:16 > 0:37:21- Why?- Usually, they just want to keep an eye on you.
0:37:21 > 0:37:23They're not keen to let you go.
0:37:23 > 0:37:26Let me just go and see if she's in the office, OK,
0:37:26 > 0:37:29and then we can get you upstairs and get your tea ready.
0:37:29 > 0:37:34- I would like some duck in plum sauce.- I'll put in a request, OK.
0:37:34 > 0:37:36SHE LAUGHS
0:37:36 > 0:37:40Dr Catherine Hawco is here to officially break the news to Anna.
0:37:40 > 0:37:44The reason we want to keep you in is because you live by yourself
0:37:44 > 0:37:47- and I know, if you've got weakness here...- Yeah, I know.
0:37:47 > 0:37:50..then I worry that you might struggle a little bit
0:37:50 > 0:37:52and you don't look very steady on your feet.
0:37:52 > 0:37:55- No, when I came off the bed... - I know.- ..I fell.
0:37:55 > 0:37:59I wouldn't like you to go home and fall and smack your head.
0:38:00 > 0:38:03- And I know you don't want to be here...- I might damage the monitor.
0:38:03 > 0:38:05Well, exactly.
0:38:05 > 0:38:06We've decided...
0:38:08 > 0:38:12- What have you decided? - LAUGHTER
0:38:12 > 0:38:16- We want duck in plum sauce.- Wow!
0:38:16 > 0:38:20I don't know if we can quite promise duck in plum sauce.
0:38:20 > 0:38:24- Oh, it's no use. We'll have to go. - With the pancakes.
0:38:24 > 0:38:28- But I still think you should bunk with us for tonight.- OK.
0:38:30 > 0:38:33It may not be home but, with views like this,
0:38:33 > 0:38:36there are worse places to spend the night.
0:38:36 > 0:38:39And, come the morning, Anna should have the results of her tests.
0:38:41 > 0:38:43Do you want to come out here?
0:38:43 > 0:38:45- No.- Not really, OK. You just want to go home.
0:38:45 > 0:38:49- I haven't been out since I came in, so...- I know.
0:38:49 > 0:38:53Right, Anna, I'm going to go and tell Leah what's been happening, OK?
0:38:53 > 0:38:57- Where's Leah?- This is Leah here. - Oh, this is Leah.- Yeah.
0:38:57 > 0:38:59She's going to be looking after you tonight.
0:38:59 > 0:39:02At long last, it's time for dinner
0:39:02 > 0:39:05and - spoiler alert - it wasn't duck in plum sauce.
0:39:07 > 0:39:09- Do you want some? - LEAH LAUGHS
0:39:09 > 0:39:11It does look good.
0:39:21 > 0:39:24Hello. You OK?
0:39:24 > 0:39:26Brian, who was airlifted off the oil rig,
0:39:26 > 0:39:29is waiting for the results of the CT scan on his neck
0:39:29 > 0:39:33and ultrasound on his heart and, while he waits,
0:39:33 > 0:39:36he's continuing to charm the nursing staff.
0:39:36 > 0:39:39My friend hates dogs and I can't understand how.
0:39:39 > 0:39:42- We had a lab for 15 years. - Labs are great, aren't they?
0:39:42 > 0:39:46They're so lovely. They become part of the family.
0:39:46 > 0:39:50- I used to see Floyd II when he went. - Floyd II!
0:39:50 > 0:39:52But I'd see him.
0:39:52 > 0:39:55I'd come in the house and I'd see him walk past the door,
0:39:55 > 0:39:58- after he was gone.- Uh-huh. - I'd see him walk past the doorway.
0:39:58 > 0:40:02I know that's only imagination, it's only in your head.
0:40:02 > 0:40:04- Yeah, yeah, yeah.- I'm not on about ghosties or anything.
0:40:04 > 0:40:07No, I believe in that kind of thing, though.
0:40:07 > 0:40:09Right, so good news.
0:40:09 > 0:40:12- It looks like you're just very fit. - Yeah. That's brilliant.
0:40:12 > 0:40:13Yes.
0:40:13 > 0:40:16They're good. We're happy, We're all happy.
0:40:16 > 0:40:19Um...
0:40:19 > 0:40:20He doesn't need to go to the surgical ward.
0:40:20 > 0:40:22He doesn't need to go to the medical ward
0:40:22 > 0:40:25because I think he's just a pretty fit guy.
0:40:25 > 0:40:27Yeah, so there's no damage?
0:40:27 > 0:40:30No, there's nothing that they can see.
0:40:30 > 0:40:32There was one area... Remember I was saying
0:40:32 > 0:40:34the one area in the spine that looks a bit abnormal?
0:40:34 > 0:40:36That, they think, is just congenital,
0:40:36 > 0:40:37that you were born with that.
0:40:37 > 0:40:41So, apart from being born wrong, everything else is OK.
0:40:41 > 0:40:43DR LALLA LAUGHS
0:40:43 > 0:40:45So, what we're going to do just now,
0:40:45 > 0:40:48is get the collar off and that will make you feel a little better.
0:40:50 > 0:40:53- Oh.- OK.- Oh, yeah.
0:40:53 > 0:40:57- Is that better? Is that easier? Yeah?- Yeah.
0:40:58 > 0:41:00Yeah, look at that!
0:41:00 > 0:41:03Heart rate has come back into your normal range again.
0:41:03 > 0:41:06We'll make arrangements to get you into one of the hotels
0:41:06 > 0:41:08and look at arranging flights and things like that
0:41:08 > 0:41:11- for you back home again. - That would be fantastic.
0:41:11 > 0:41:13My dog will be made up to see me...
0:41:13 > 0:41:16- and maybe my wife.- Maybe your wife!
0:41:18 > 0:41:23Just a bit stiff, but a lot better than I was earlier, definitely.
0:41:23 > 0:41:27All the nurses have been fantastic. Kathy is a star and so is Jenny.
0:41:29 > 0:41:30It all came out in the wash
0:41:30 > 0:41:34that he does a Tough Mudder once every two months.
0:41:34 > 0:41:37THEY LAUGH
0:41:37 > 0:41:40Kathy is doing the next one with us anyway.
0:41:40 > 0:41:43- Yeah, that will be fine.- And, um... Ow, ow.
0:41:46 > 0:41:50And so, bruised but not beaten, Brian's time on Shetland -
0:41:50 > 0:41:54and that is Shetland, Brian - comes to an end.
0:41:57 > 0:41:59- All the best.- Thank you very much. - We'll sort you out.
0:41:59 > 0:42:01- Thank you very much. Take care. - No worries.- Take care.
0:42:01 > 0:42:04- Bye-bye.- All the best.
0:42:07 > 0:42:10But, for nurse Kathy, it's straight back to work,
0:42:10 > 0:42:12tending to the rest of the population
0:42:12 > 0:42:14of this unique set of islands.
0:42:14 > 0:42:17So, have you come from South Africa straight here?
0:42:17 > 0:42:19No, I worked throughout the UK.
0:42:19 > 0:42:23I worked over here and I liked it and that's how I ended up over here.
0:42:23 > 0:42:29- It's hard work. Nowhere else in the UK, I think, works like this.- Sorry?
0:42:29 > 0:42:32Nowhere else in the UK works like this. I don't think...
0:42:32 > 0:42:35I can't think of any place.
0:42:37 > 0:42:41The team in A&E at Gilbert Bain are a close-knit bunch.
0:42:41 > 0:42:43Ooh, a little bit of cream on the side.
0:42:43 > 0:42:46And, like the tides that surround the islands,
0:42:46 > 0:42:49there's definite ebb and flow to their workload.
0:42:49 > 0:42:53Sometimes they're rushed off their feet and sometimes they're not.
0:42:54 > 0:42:56This might tickle then.
0:42:56 > 0:43:00But, whatever happens, they get each other through.
0:43:06 > 0:43:10Anna's home, having made a good recovery from her stroke,
0:43:10 > 0:43:13and is regularly enjoying her duck in plum sauce.
0:43:13 > 0:43:17John was back out with his sheep a few days after coming into hospital.
0:43:17 > 0:43:20Unfortunately, Brian's neck has continued to give him problems
0:43:20 > 0:43:22but, with the help of some physio and some rest,
0:43:22 > 0:43:26he's confident he'll be back raising money for charity in the New Year.