0:00:02 > 0:00:05Shetland - the most remote part of the UK.
0:00:06 > 0:00:09Here, you are closer to the Arctic Circle than you are to London,
0:00:09 > 0:00:11and nearer Norway than you are to Edinburgh.
0:00:13 > 0:00:15There are more puffins than people,
0:00:15 > 0:00:19and more seals than supermarkets.
0:00:20 > 0:00:24But this wild landscape is also home to 23,000 islanders.
0:00:26 > 0:00:29They are so far from the mainland that when things go wrong...
0:00:29 > 0:00:31A&E, can I help you?
0:00:32 > 0:00:35From helicopter rescues and spinal injuries...
0:00:35 > 0:00:37We're all here to make sure that you're OK.
0:00:37 > 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 > 0:00:44..Shetland's island medics
0:00:44 > 0:00:47have to be ready for anything and everything.
0:00:47 > 0:00:50- What happened?- Got in a fight with a seagull.
0:00:50 > 0:00:53- This was sheep shears, was it? - Yeah.
0:00:53 > 0:00:54SIREN WAILS
0:00:54 > 0:00:56It means the tight-knit team of medics,
0:00:56 > 0:01:00volunteers and emergency services have a special bond.
0:01:00 > 0:01:02This might tickle, then.
0:01:03 > 0:01:05And they know just how to keep each other going...
0:01:05 > 0:01:08A wee treat for night shift.
0:01:08 > 0:01:11..so they're always ready for any island emergency.
0:01:20 > 0:01:23Today, a midwife tours the islands
0:01:23 > 0:01:25to meet the newest batch of Shetlanders...
0:01:25 > 0:01:28Yeah. You're not going to pee on me, OK?
0:01:28 > 0:01:32..a man is rushed from a rig with a suspected heart attack...
0:01:35 > 0:01:37..and the most Shetland injury imaginable.
0:01:37 > 0:01:39I fell off a Shetland pony.
0:01:49 > 0:01:51Unlike hospitals on the mainland,
0:01:51 > 0:01:55the Gilbert Bain Hospital is busiest in summer when tourists flock to the
0:01:55 > 0:01:57islands in their droves.
0:01:57 > 0:02:01In winter, however, the pace of life slows as the nights draw in.
0:02:01 > 0:02:04It can be dark for 18 hours or more,
0:02:04 > 0:02:07and long, cold nights mean just one thing.
0:02:07 > 0:02:09BABY CRIES
0:02:09 > 0:02:10Babies.
0:02:10 > 0:02:12Lots of 'em.
0:02:12 > 0:02:15Shetland has the highest birth rate in Scotland and last year,
0:02:15 > 0:02:20Gilbert Bain's maternity unit handled 278 pregnancies.
0:02:22 > 0:02:25It is staffed by a merry band of midwives who meet the needs of the
0:02:25 > 0:02:29archipelago's new and expectant mothers.
0:02:29 > 0:02:31At the hospital, head midwife
0:02:31 > 0:02:34Elaine McCover has been called in to check on an anxious
0:02:34 > 0:02:37soon-to-be first-time mum.
0:02:37 > 0:02:40So we are doing your scan today because you haven't felt baby moving
0:02:40 > 0:02:43- quite as much.- Yeah. It's happened twice.- OK.
0:02:43 > 0:02:47Caitlin from Lerwick is eight months pregnant and hasn't felt her baby
0:02:47 > 0:02:49move for some time.
0:02:49 > 0:02:50Yeah, just lie yourself back.
0:02:50 > 0:02:52What we're going to do...
0:02:52 > 0:02:54In order to see the scan pictures clearly,
0:02:54 > 0:02:56Elaine turns down the lights.
0:02:56 > 0:03:00This is Caitlin and her partner Robbie's first baby, and they are
0:03:00 > 0:03:04understandably worried about what lack of movement might mean.
0:03:04 > 0:03:07Elaine does her best to reassure Caitlin.
0:03:07 > 0:03:09I'm just going to pop some lovely gel on your tummy.
0:03:12 > 0:03:14As Elaine attempts to find a good image of the baby,
0:03:14 > 0:03:16it's a tense moment.
0:03:23 > 0:03:25So, obviously, with baby getting that wee bit bigger,
0:03:25 > 0:03:28we're maybe not going to see quite as much.
0:03:28 > 0:03:30But there is your baby's lovely wee face.
0:03:30 > 0:03:33Look at that. You can see its lips.
0:03:33 > 0:03:36So we will get a wee quick photo done first.
0:03:36 > 0:03:37I've seen baby's heart beating away,
0:03:37 > 0:03:41so I have got baby's heart beating away in there quite happily.
0:03:41 > 0:03:44With a clear view of the baby's heart beating well,
0:03:44 > 0:03:46everyone can relax.
0:03:47 > 0:03:49It's looking quite cramped, your baby, now, isn't it?
0:03:49 > 0:03:52It's running out of room, isn't it?
0:03:52 > 0:03:55To be sure the baby is growing at the right pace,
0:03:55 > 0:03:58Elaine takes a range of measurements from head to thigh,
0:03:58 > 0:04:01and also checks the blood flow from the placenta.
0:04:01 > 0:04:04Right, and now we will get the wee tummy measurement.
0:04:04 > 0:04:07It's all looking absolutely fine so far.
0:04:07 > 0:04:08Yeah.
0:04:08 > 0:04:10Still looking a little stunned,
0:04:10 > 0:04:13dad-to-be Robbie moves in for a closer look.
0:04:13 > 0:04:16You can see it quite clearly on that one. There you go.
0:04:19 > 0:04:21It's a nice amount of fluid all round about your baby,
0:04:21 > 0:04:24and because you have been having those episodes of less movement,
0:04:24 > 0:04:27we will just have a wee check of the blood flow
0:04:27 > 0:04:29- from the placenta through the cord, if that's OK?- Yeah.
0:04:29 > 0:04:31We are going to need your baby to stay still.
0:04:31 > 0:04:35- HEART BEAT ECHOES - There we go. Absolutely fine.
0:04:35 > 0:04:38So what we are looking at, it's not this kind of top peak,
0:04:38 > 0:04:40we are looking at this bottom bit there,
0:04:40 > 0:04:42something called the end diastolic flow,
0:04:42 > 0:04:45and it just reassures us that your placenta is working normally.
0:04:45 > 0:04:48- OK.- Your baby today is 5lb 2oz.
0:04:48 > 0:04:51Oh, my goodness! Last time we were in here, what was it? 4lb 5oz.
0:04:51 > 0:04:54- Yeah. It's fairly grown. - Yeah, it has.
0:04:54 > 0:04:56It is amazing.
0:04:56 > 0:04:59I feel a bit silly coming in, and the baby starts moving
0:04:59 > 0:05:01and then you are like, oh, you know.
0:05:01 > 0:05:05See in reality, though, we would far, far rather that you came in
0:05:05 > 0:05:08- and we quickly reassured you that everything was fine...- Yeah.
0:05:08 > 0:05:12..than you sat at home worried about it or waited too long.
0:05:12 > 0:05:14With the future parents reassured,
0:05:14 > 0:05:17all that's left to do is offer a scan picture of the healthy baby.
0:05:20 > 0:05:22- There you go.- Thank you.
0:05:23 > 0:05:25Caitlin's scan today was absolutely fine.
0:05:25 > 0:05:27It shows the baby is really well grown.
0:05:27 > 0:05:29There is a normal amount of fluid
0:05:29 > 0:05:32and that blood flow through the cord is absolutely fine.
0:05:32 > 0:05:34It is also about being able to provide a bit of reassurance,
0:05:34 > 0:05:37but also let her know that if she has another episode, that she needs
0:05:37 > 0:05:39to come back and see us again.
0:05:39 > 0:05:41Yeah, it's exciting!
0:05:42 > 0:05:44Thank you very much. OK, have a nice day.
0:05:44 > 0:05:45Cheerio, Caitlin. Bye-bye.
0:05:59 > 0:06:02The maternity unit is one of the few specialised units
0:06:02 > 0:06:04at the Gilbert Bain Hospital.
0:06:04 > 0:06:08Here, a team of 13 midwives and three doctors help bring the next
0:06:08 > 0:06:11generation of Shetlanders into the world.
0:06:11 > 0:06:15It's a job that takes them to every inhabited corner of these islands.
0:06:15 > 0:06:18For many, it's a calling.
0:06:18 > 0:06:22And today, 26-year-old Hannah, a recent arrival on Shetland,
0:06:22 > 0:06:26is doing the rounds to check on the island's newest bundles of joy.
0:06:26 > 0:06:28I'll hopefully not get too lost...
0:06:28 > 0:06:30..today.
0:06:34 > 0:06:39I trained as a midwife in Aberdeen, and one part of the
0:06:39 > 0:06:43training is to do placements in the community,
0:06:43 > 0:06:46and I was put to Shetland.
0:06:46 > 0:06:48And I really, really loved it up here.
0:06:48 > 0:06:52So when the job came up for Shetland,
0:06:52 > 0:06:55I immediately applied and I felt like it
0:06:55 > 0:06:59was coming home to who I was as a midwife,
0:06:59 > 0:07:00and who I am as a person,
0:07:00 > 0:07:05that I really, really enjoyed being with women throughout the journey of
0:07:05 > 0:07:07being pregnant and having a baby.
0:07:09 > 0:07:12I love puffins, so it was the best place to come.
0:07:14 > 0:07:19Today, Hannah is off to visit new mum Louise and her baby boy Wilhem,
0:07:19 > 0:07:2112 miles from Lerwick, in Sandwick.
0:07:24 > 0:07:26Sounds simple enough,
0:07:26 > 0:07:29but for an island newbie, Shetland can be a little tricky to navigate.
0:07:31 > 0:07:35There is no street names, there is no house names or house numbers.
0:07:35 > 0:07:37You've just got to follow their directions,
0:07:37 > 0:07:39like, "Go up this lane.
0:07:40 > 0:07:45"Go past the big bush and find, like, a yellow house."
0:07:45 > 0:07:49And you've just got to hope that you are in the right yellow house.
0:07:52 > 0:07:55I bet you it's that house next door to the Cabin Museum.
0:08:00 > 0:08:02Hello!
0:08:05 > 0:08:06Hello!
0:08:09 > 0:08:12Hello. How are you?
0:08:12 > 0:08:14I'm at the wrong house, aren't I?
0:08:15 > 0:08:18Right, we'll go find our house.
0:08:18 > 0:08:19All right. Sorry about that.
0:08:19 > 0:08:21That was funny.
0:08:24 > 0:08:26Those were the instructions.
0:08:26 > 0:08:29Undeterred, she's back on the road.
0:08:31 > 0:08:34And this time, she's got the right house.
0:08:34 > 0:08:35Hiya. How are you doing?
0:08:35 > 0:08:37I'm fine. He's a lovely baby.
0:08:37 > 0:08:40I haven't seen them yet. I am excited to see them.
0:08:43 > 0:08:45- How are you doing? - Good, really well.
0:08:45 > 0:08:47- Congratulations.- Thank you.
0:08:47 > 0:08:49- Happy one-week birthday!- Yeah.
0:08:49 > 0:08:51I cannot believe he's a week already.
0:08:56 > 0:08:58- He's still a little jaundiced, I would say.- Yeah.
0:08:58 > 0:09:01But over the next couple of days, it will hopefully go.
0:09:01 > 0:09:03You've got lots of nice windows,
0:09:03 > 0:09:05so try and keep him close to the windows.
0:09:05 > 0:09:08- OK.- Light helps it go away.
0:09:08 > 0:09:10Oh!
0:09:10 > 0:09:12What a face.
0:09:12 > 0:09:15It's amazing how many faces they pull, isn't it?
0:09:15 > 0:09:17Has he done a smile yet?
0:09:17 > 0:09:19Well, we think he has.
0:09:19 > 0:09:22But I think it's just wind.
0:09:22 > 0:09:25- Or happy about being fed.- Yeah.
0:09:25 > 0:09:28You seem like you are doing really, really well.
0:09:28 > 0:09:31Yeah, it feels quite natural.
0:09:31 > 0:09:32It feels...
0:09:34 > 0:09:36It feels good.
0:09:37 > 0:09:40Righty-o. I'm off now.
0:09:40 > 0:09:43While Hannah may be living the dream,
0:09:43 > 0:09:46pursuing it rarely comes without a cost.
0:09:46 > 0:09:49In this case, it meant leaving her friends and family behind.
0:09:49 > 0:09:51I have been quite homesick.
0:09:51 > 0:09:54It's been quite tough because, obviously,
0:09:54 > 0:09:57it's a very community-orientated place,
0:09:57 > 0:10:01everyone knows everyone, so you're kind of the outsider.
0:10:01 > 0:10:04But once you get to know people, they are very, very friendly.
0:10:04 > 0:10:07But if there's one thing guaranteed to get you into a Shetlander's good
0:10:07 > 0:10:11books, it's a trip to one of the islands' favourite institutions.
0:10:11 > 0:10:13Near East Burrafirth,
0:10:13 > 0:10:16on a single-track road between Voe and Aith,
0:10:16 > 0:10:19it's patisserie par excellence, Da Cake Cupboard.
0:10:21 > 0:10:22Oh!
0:10:24 > 0:10:25Oh!
0:10:25 > 0:10:27Cake.
0:10:29 > 0:10:30Lemon cake.
0:10:30 > 0:10:32And some Tiffin.
0:10:32 > 0:10:35I'll get some for a treat for everyone in the ward.
0:10:35 > 0:10:38So you write down what you've taken
0:10:38 > 0:10:40and just leave some money.
0:10:45 > 0:10:46Looks like Hannah's getting
0:10:46 > 0:10:48the hang of Shetland life pretty quickly.
0:10:59 > 0:11:01As the only hospital on Shetland,
0:11:01 > 0:11:04the Gilbert Bain is the destination for any islanders unlucky enough
0:11:04 > 0:11:07to need emergency care at any time of day or night.
0:11:09 > 0:11:12But it doesn't just open its doors to island residents.
0:11:12 > 0:11:16Anyone who has taken ill or injured on one of the many fishing boats,
0:11:16 > 0:11:20cargo vessels or oil rigs within 100 miles of the island
0:11:20 > 0:11:23is likely to be airlifted to Shetland for treatment,
0:11:23 > 0:11:25meaning that the quiet of a night shift could be shattered
0:11:25 > 0:11:27at any moment.
0:11:33 > 0:11:35At Tingwall Airport, a helicopter is flying in
0:11:35 > 0:11:39with an oil rig worker with a suspected heart attack.
0:11:40 > 0:11:44We have just got a notification to say we are getting a medevac from an
0:11:44 > 0:11:48offshore oil rig with a man with chest pain.
0:11:48 > 0:11:51So you're immediately thinking it's something cardiac,
0:11:51 > 0:11:54so we'll just do what we'd usually do for anybody that comes in with
0:11:54 > 0:11:58chest pain - get ECGs and observation, bloods,
0:11:58 > 0:12:01get the doctor to see them, and then take it from what we find.
0:12:01 > 0:12:05Shetland's isolated North Sea location means the Gilbert Bain
0:12:05 > 0:12:07is well prepared for cases like this.
0:12:08 > 0:12:13Once or twice a week, we might get a medevac because we are the closest
0:12:13 > 0:12:15area to the offshore.
0:12:15 > 0:12:17So we do get a lot of offshore.
0:12:20 > 0:12:23With over 20 oil and gas rigs off the coast of Shetland,
0:12:23 > 0:12:26the emergency services provided by the island are a lifeline for
0:12:26 > 0:12:28thousands of workers.
0:12:30 > 0:12:34It is essential that patients are transferred to the resus unit at
0:12:34 > 0:12:37Gilbert Bain as quickly and efficiently as possible.
0:12:37 > 0:12:40Usually they are possibly 100 miles away.
0:12:40 > 0:12:43Coming in a boat, it would take the best part of a day or two
0:12:43 > 0:12:45to get them ashore,
0:12:45 > 0:12:48so the coastguard helicopter is the only way.
0:12:48 > 0:12:51With the patient safely transferred into the ambulance,
0:12:51 > 0:12:54it won't be long before he arrives at Gilbert Bain to be assessed.
0:12:54 > 0:12:57That's the thing with A&E, you never know what is going to come in
0:12:57 > 0:13:02through the door, and sometimes folk will come in and appear well,
0:13:02 > 0:13:06but can deteriorate quite quickly. Night shift is a bit more daunting.
0:13:06 > 0:13:10And you know you've not got people immediately on hand to shout for.
0:13:10 > 0:13:13So... But we try. We get there.
0:13:21 > 0:13:24The casualty, Donald from Peterhead, near Aberdeen,
0:13:24 > 0:13:26is brought into resus.
0:13:26 > 0:13:29Nurses Dawn and Lauren are on hand to admit him and begin
0:13:29 > 0:13:30their assessment.
0:13:32 > 0:13:34What has been happening?
0:13:35 > 0:13:39I've just got a sharp pain sitting on my chest.
0:13:39 > 0:13:41- OK. What time was that? - About half three.
0:13:41 > 0:13:42- Half three today?- Yeah.
0:13:42 > 0:13:44I didn't think anything about it at the time.
0:13:44 > 0:13:47I'm just going to pop the blood pressure cuff on.
0:13:47 > 0:13:51Then about...just after four, the same again
0:13:51 > 0:13:53but a lot stronger.
0:13:53 > 0:13:56Sorry. I'm just going to pop this on a finger, as well.
0:13:56 > 0:13:58I went to my bed really early because I felt tired.
0:13:58 > 0:14:00And, er...
0:14:03 > 0:14:05For about 45 minutes, it was just constant.
0:14:08 > 0:14:11Donald has no history of heart problems,
0:14:11 > 0:14:13but with his chest pains beginning nine hours ago,
0:14:13 > 0:14:17the team take blood samples and an ECG to try and rule out
0:14:17 > 0:14:18a heart attack.
0:14:20 > 0:14:22While they await the test results,
0:14:22 > 0:14:25the on-duty junior doctor looks for other clues as to what might be
0:14:25 > 0:14:28causing Donald's symptoms.
0:14:28 > 0:14:29Has the pain...
0:14:29 > 0:14:31You'll need to press it again, it's saying it's loose.
0:14:31 > 0:14:33Half past three.
0:14:33 > 0:14:35- It's still there?- Yeah.
0:14:35 > 0:14:37And can you point to where it is?
0:14:37 > 0:14:39It's just in here.
0:14:39 > 0:14:41And is that where it's been all day?
0:14:41 > 0:14:43- Yeah.- What did it feel like?
0:14:43 > 0:14:47Just sort of gradually came up and felt like it was just being
0:14:47 > 0:14:49- pushed, you know?- OK.
0:14:49 > 0:14:50Like a vice-type thing.
0:14:50 > 0:14:56Sure. And at any point did it suddenly start, or get worse?
0:14:56 > 0:15:00- It seemed to get worse if I lay on any side.- OK.
0:15:00 > 0:15:04Because I tried to turn, thinking I was just uncomfortable, you know.
0:15:04 > 0:15:07From what you're telling me, this kind of tight feeling,
0:15:07 > 0:15:11when people say that, we get worried about people's hearts.
0:15:11 > 0:15:13Yeah.
0:15:13 > 0:15:15With Donald's ECG readings looking normal,
0:15:15 > 0:15:18his chest pain is proving difficult to diagnose.
0:15:20 > 0:15:24We're just doing bloods.
0:15:24 > 0:15:28And we have done an ECG, so the doctor has had a look at them.
0:15:28 > 0:15:30We have our cardiac pathway that we follow
0:15:30 > 0:15:34if anybody presents with chest pain.
0:15:36 > 0:15:39So we are just working with that at the moment.
0:15:41 > 0:15:43Here we go.
0:15:48 > 0:15:50Looks OK.
0:15:51 > 0:15:54With Donald stable and the condition under control,
0:15:54 > 0:15:57the decision is made to move him to the medical ward,
0:15:57 > 0:16:00where he will continue to be assessed.
0:16:00 > 0:16:02But with blood tests still pending,
0:16:02 > 0:16:05they won't know until morning exactly what the problem is.
0:16:17 > 0:16:21To cope with a variety of ailments that come through the sliding doors
0:16:21 > 0:16:24at the Gilbert Bain, its small medical staff need
0:16:24 > 0:16:26a broad skill set.
0:16:26 > 0:16:29To this end, senior A&E surgical doctor Kushik Lalla
0:16:29 > 0:16:33runs a weekly minor operations clinic.
0:16:33 > 0:16:36Here, he not only sees anyone in need of day surgery,
0:16:36 > 0:16:39but he also uses it to teach other doctors new skills.
0:16:39 > 0:16:42- You've looked through all of these? - Yes, I was peeking.- That's fine.
0:16:44 > 0:16:47Today, Dr Lalla is going to show GP Judith Pinnick,
0:16:47 > 0:16:50how to perform a typical minor operation,
0:16:50 > 0:16:53the idea being that she will then be able to carry out this procedure at
0:16:53 > 0:16:57her own surgery, alleviating some of the strain on the hospital clinic.
0:17:00 > 0:17:01Mrs Anderson. Hi there.
0:17:01 > 0:17:05Right, we got a letter from your GP asking us to see you with regards to
0:17:05 > 0:17:08- a number of cysts, is it, sebaceous cysts?- Yeah.
0:17:08 > 0:17:11- Have you had that for a while? - I've had them before.
0:17:11 > 0:17:17And this is probably about the fifth or sixth time that I've had to have
0:17:17 > 0:17:21- some removed.- Unfortunately, this will not be your last time, either.
0:17:21 > 0:17:23- Probably not.- No.
0:17:23 > 0:17:25Is there anyone else in your family that has them?
0:17:25 > 0:17:27My mother has them.
0:17:27 > 0:17:30Sebaceous cysts are common cysts of the skin
0:17:30 > 0:17:35that, although noncancerous, can recur and are often hereditary.
0:17:35 > 0:17:38A quick look at this area.
0:17:38 > 0:17:41So it is one very easily...
0:17:42 > 0:17:44That's one there.
0:17:44 > 0:17:46That's fine.
0:17:46 > 0:17:49The cysts are slow growing but can become uncomfortable if
0:17:49 > 0:17:51they go unchecked.
0:17:51 > 0:17:54Which one is the most troublesome? The one at the back?
0:17:54 > 0:17:55The one at the back, yes.
0:17:55 > 0:17:57By removing them surgically,
0:17:57 > 0:18:00it's hoped they will be less likely to return.
0:18:00 > 0:18:04OK. We will go ahead and get those removed for you today.
0:18:04 > 0:18:05- OK.- Yeah.
0:18:19 > 0:18:21Jennifer.
0:18:21 > 0:18:23Hello! How are you doing?
0:18:23 > 0:18:26Midwife Emma is meeting Jennifer from Quendale,
0:18:26 > 0:18:28in the south of Shetland's mainland,
0:18:28 > 0:18:31whose first baby is now ten days overdue.
0:18:33 > 0:18:35So any signs of this baby coming?
0:18:35 > 0:18:40- No.- No. Any signs of anything? - I can feel it just stretching.
0:18:40 > 0:18:42Just wriggling around.
0:18:42 > 0:18:46That's it. And it's so important at this stage that you keep a really
0:18:46 > 0:18:48close eye on baby's movements,
0:18:48 > 0:18:52because our best way of knowing how baby is is through its movements.
0:18:52 > 0:18:55Overdue births are not uncommon.
0:18:55 > 0:18:59In fact, fewer than one in 20 babies are born on their due date.
0:18:59 > 0:19:00But here on Shetland, a missed
0:19:00 > 0:19:03due date calls for a bit of extra caution.
0:19:03 > 0:19:08You are now ten days past your due date,
0:19:08 > 0:19:13and what we now need to do is just assess you for induction of labour.
0:19:13 > 0:19:17Oh, what a beautiful bump you've got.
0:19:17 > 0:19:18It's lovely.
0:19:18 > 0:19:24We've got this lady, she is now ten days past her due date.
0:19:24 > 0:19:28This is where we do an examination. Where do you feel your kicks?
0:19:28 > 0:19:30- Just about here.- Around there.
0:19:30 > 0:19:34And what it does is, it gives us a score that tells us how likely women
0:19:34 > 0:19:36are to go into labour.
0:19:36 > 0:19:38We will go and examine her and we
0:19:38 > 0:19:41will work out what her Bishop score is.
0:19:41 > 0:19:45A Bishop score of less than five in women having their first baby may
0:19:45 > 0:19:48indicate that the induction process will take longer
0:19:48 > 0:19:51and require more intervention.
0:19:51 > 0:19:54As there is no epidural service on the island,
0:19:54 > 0:19:57women are transferred to an obstetric unit in Aberdeen to
0:19:57 > 0:20:00increase their chances of a natural birth.
0:20:00 > 0:20:03It's always slightly different in Shetland
0:20:03 > 0:20:07because we are remote and rural, so to stay in Shetland,
0:20:07 > 0:20:11she needs to have a Bishop score of five and above.
0:20:11 > 0:20:14I would say that, basically,
0:20:14 > 0:20:16the kind of top of the baby's head is into the pelvis.
0:20:16 > 0:20:19It's definitely fixed in the pelvis,
0:20:19 > 0:20:22it's not bobbing away or anything like that.
0:20:22 > 0:20:24And sometimes, particularly with
0:20:24 > 0:20:27first babies, it just takes, you know,
0:20:27 > 0:20:30the contractions to actually physically push the baby's head
0:20:30 > 0:20:32down into the pelvis.
0:20:32 > 0:20:35Jennifer's Bishop score is two,
0:20:35 > 0:20:38meaning she will have to travel to the mainland to give birth
0:20:38 > 0:20:39under specialist supervision.
0:20:39 > 0:20:42Yeah, hi, it's Dr Murphy up in Shetland.
0:20:42 > 0:20:45Hi, I just wondered if I can arrange for a lady to come down to you
0:20:45 > 0:20:50- for induction?- Knock-knock. I've got Dr Murphy.
0:20:50 > 0:20:52I've spoken to the ward in Aberdeen,
0:20:52 > 0:20:54they've got a slot for induction tomorrow.
0:20:54 > 0:20:57We've arranged for you to go on the first flight.
0:20:57 > 0:20:59You will be going to Westburn Ward.
0:20:59 > 0:21:02I will sign a fit-to-travel for you,
0:21:02 > 0:21:06and the next time we see you will be with a lovely baby at home,
0:21:06 > 0:21:08because that's what we like.
0:21:20 > 0:21:24Whilst some patients have to be transferred to the mainland for
0:21:24 > 0:21:27treatment, the staff at Gilbert Bain try to do as much as they possibly
0:21:27 > 0:21:31can right here on Shetland, and at the hospital's outpatient clinic,
0:21:31 > 0:21:36senior A&E and surgical doctor Kushik Lalla is training local GP
0:21:36 > 0:21:39Dr Pinnick to remove sebaceous cysts from a patient's scalp.
0:21:39 > 0:21:41A sharp scratch coming up now.
0:21:44 > 0:21:46Sorry.
0:21:46 > 0:21:48And it will sting.
0:21:48 > 0:21:51It's Mrs Anderson's sixth time having this surgery and
0:21:51 > 0:21:54with a local anaesthetic administered,
0:21:54 > 0:21:55she is taking it all quite calmly.
0:21:57 > 0:21:59Right, so, if you look, Judith,
0:21:59 > 0:22:03what I've done is just made a single incision overlying the top.
0:22:05 > 0:22:07A veteran of this procedure,
0:22:07 > 0:22:10Dr Lalla is demonstrating how it's done to GP Dr Pinnick,
0:22:10 > 0:22:12who has never removed a cyst.
0:22:12 > 0:22:15And I'm not taking it too deep.
0:22:15 > 0:22:18I will start from this edge down here,
0:22:18 > 0:22:23rather than directly overlying the cyst, and just try and gently...
0:22:23 > 0:22:25- It's OK?- Hm-mm.
0:22:25 > 0:22:27Just open that up.
0:22:32 > 0:22:34- I've got your head in a vice-like grip.- It's OK.
0:22:41 > 0:22:42- Are you OK?- Yep.
0:22:48 > 0:22:51- OK?- If a cyst is removed in one piece,
0:22:51 > 0:22:54there is a good chance it won't reappear in the same place.
0:22:54 > 0:22:57Right, so a couple of stitches in there now.
0:22:57 > 0:23:00And that's the first one done.
0:23:00 > 0:23:02Did you manage that?
0:23:02 > 0:23:03- It was fine.- Good.
0:23:04 > 0:23:06She's so lying!
0:23:06 > 0:23:07With one of the cysts removed,
0:23:07 > 0:23:11Dr Lalla sews up the incision and hands over to Dr Pinnick...
0:23:13 > 0:23:15..a newbie to this procedure.
0:23:15 > 0:23:17Good. Don't go deep.
0:23:20 > 0:23:23Yeah, that's good. Now that's fine.
0:23:24 > 0:23:29What you do now is use the edge of the blade, rather than the tip.
0:23:29 > 0:23:32Just use the edge. Use the edge of the blade.
0:23:32 > 0:23:36If Dr Pinnick can master this and other minor surgeries,
0:23:36 > 0:23:40she'll relieve pressure on this clinic by running her own service.
0:23:40 > 0:23:43Yeah, that's the cyst coming up there.
0:23:43 > 0:23:45- You see it?- Mm-hm.
0:23:52 > 0:23:55Your assistant is not doing a good enough job!
0:23:58 > 0:24:01I'll do the swabbing for you. If you just...
0:24:03 > 0:24:06That's it. That's it. That's it.
0:24:06 > 0:24:10Another offending cyst gone, and now it's just a few final stitches.
0:24:14 > 0:24:18Good. I can see, even in your hand movements, Judith,
0:24:18 > 0:24:22you are getting more confident, more familiar.
0:24:23 > 0:24:28- Yeah, I think it takes practice. - Yeah. Everything takes practice!
0:24:28 > 0:24:29Procedure complete.
0:24:29 > 0:24:33With one relieved patient and one doctor more confident at handling a
0:24:33 > 0:24:36new procedure, it's a good result for Dr Lalla.
0:24:36 > 0:24:38- OK. Thank you very much.- OK.
0:24:38 > 0:24:41- That's no bother.- See you later.
0:24:51 > 0:24:54The morning after being medevac'd to Gilbert Bain from an
0:24:54 > 0:24:58oil rig, 54-year-old Donald's chest pains have subsided,
0:24:58 > 0:25:00but before discharging him,
0:25:00 > 0:25:03the team want to take an X-ray in the hope of being able to diagnose
0:25:03 > 0:25:06last night's pain.
0:25:10 > 0:25:13- Are you OK to stand for the X-ray?- Yeah.- Right.
0:25:13 > 0:25:17Unlike many X-rays which are carried out lying down...
0:25:17 > 0:25:19So if I get you to stand just here...
0:25:19 > 0:25:22..the chest X-ray gives a clearer image of the lungs
0:25:22 > 0:25:25if the subject is standing.
0:25:25 > 0:25:27So you're just right up against the board.
0:25:29 > 0:25:33The team in A&E have already carried out ECGs and blood tests to
0:25:33 > 0:25:36see if Donald's chest pains are being caused by his heart.
0:25:38 > 0:25:41These X-rays will show if his pain is actually the result of a problem
0:25:41 > 0:25:43with his lungs.
0:25:44 > 0:25:48So, if you take a nice deep breath in, please.
0:25:48 > 0:25:50And hold.
0:25:50 > 0:25:51Breathe normally.
0:25:53 > 0:25:55- Excellent.- OK, that's all done.
0:26:00 > 0:26:01All the best.
0:26:01 > 0:26:03- Thanks.- Thank you.
0:26:06 > 0:26:08Having taken over from the night shift,
0:26:08 > 0:26:12Dr Catherine Hawco has gone over Donald's notes and X-rays.
0:26:13 > 0:26:16He has not had any more chest pain, he's not had any more
0:26:16 > 0:26:19episodes where he's felt unwell at all.
0:26:19 > 0:26:20His blood pressure has been OK.
0:26:20 > 0:26:23That was one of the things I think that they were worrying overnight,
0:26:23 > 0:26:26is that he had a difference in blood pressure in both his arms.
0:26:26 > 0:26:30That's now non significant, really.
0:26:30 > 0:26:33There's not any big change between them.
0:26:33 > 0:26:34We've repeated his ECGs,
0:26:34 > 0:26:37which is a tracing of his heart, and they are totally normal.
0:26:37 > 0:26:40They don't show any signs of any heart attacks or problems with his
0:26:40 > 0:26:42heart. We also checked a blood test
0:26:42 > 0:26:46to check for any damage to his heart muscle, which came back normal.
0:26:46 > 0:26:49And he has just had an X-ray of his chest, just to make sure there's
0:26:49 > 0:26:52nothing going on in his lungs that could be causing this pain.
0:26:52 > 0:26:53That has come back normal as well.
0:26:53 > 0:26:57But it might be that it was just a bit of muscular pain that he was
0:26:57 > 0:27:00experiencing. That's really common and sometimes people worry
0:27:00 > 0:27:01about that when it's their chest.
0:27:01 > 0:27:04Because it's your chest and it was painful and that,
0:27:04 > 0:27:08it's the first thing that comes into your head, no matter who you are.
0:27:08 > 0:27:11So it was just a case of eliminating things.
0:27:11 > 0:27:14And this is the best place to be.
0:27:14 > 0:27:16He is being discharged today,
0:27:16 > 0:27:20just with some kind of pain spray if it comes back.
0:27:20 > 0:27:24- But hopefully it won't. - Home tomorrow. See my own doctor.
0:27:24 > 0:27:28Got to go through some tests for angina.
0:27:28 > 0:27:32Do some physical tests for fatigue, and that.
0:27:32 > 0:27:36And take it from there. I've had two hours' sleep.
0:27:37 > 0:27:41So... I'll probably sleep well tonight.
0:27:51 > 0:27:53In hospitals across the British Isles,
0:27:53 > 0:27:56there are dedicated paediatric departments that treat the nation's
0:27:56 > 0:27:58sick and injured children.
0:27:58 > 0:28:01Due to its size and Shetland's small population,
0:28:01 > 0:28:04the Gilbert Bain has to do without.
0:28:04 > 0:28:07Instead, each and every one of their team must be ready
0:28:07 > 0:28:10to roll up their sleeves and treat any sick kids who are brought in.
0:28:15 > 0:28:17Did anybody see what happened?
0:28:17 > 0:28:18Did you?
0:28:18 > 0:28:20Yeah? What, did she...
0:28:20 > 0:28:24- Did she land?- She pulled his hand and he came back.
0:28:24 > 0:28:28Accident-prone three-year-old Darina from Nesting has been brought into
0:28:28 > 0:28:31A&E for the second time in a week.
0:28:34 > 0:28:37Did somebody land on top of her?
0:28:37 > 0:28:40- No, he was pulling her around. - Oh, he was pulling her around.
0:28:40 > 0:28:43- Yeah.- And has she fallen and maybe got a pull...
0:28:43 > 0:28:46- Yes.- Pulled her arm.- Yes.
0:28:46 > 0:28:49The little child, she was in a week ago,
0:28:49 > 0:28:53playing on trampoline and had a pulled elbow,
0:28:53 > 0:28:57which is a dislocated elbow, which was reduced in the department.
0:28:59 > 0:29:01She's been playing
0:29:01 > 0:29:05with her friends, and somebody's had a hold of her arm,
0:29:05 > 0:29:08pulled her arm again, so her elbow, I think,
0:29:08 > 0:29:12has probably dislocated again.
0:29:12 > 0:29:16And it happens and it happens a lot.
0:29:16 > 0:29:19- Yeah?- Yeah. With this-age children, it does happen a lot.
0:29:19 > 0:29:22It certainly seems to happen to Darina a lot.
0:29:22 > 0:29:25Just games. Just games.
0:29:25 > 0:29:27- Yeah.- Jumping on the trampoline.
0:29:27 > 0:29:31Yeah. You know, it's kids...just...
0:29:31 > 0:29:33While brother and sister play together,
0:29:33 > 0:29:36nurse Amanda Brown gets that all-important
0:29:36 > 0:29:39- pain relief sorted out. - Is she good at taking medicine?
0:29:39 > 0:29:41This for the pain.
0:29:41 > 0:29:42Do you want to give it to her?
0:29:42 > 0:29:44Yum-yum.
0:29:45 > 0:29:47Oh, you're so clever.
0:29:47 > 0:29:50Now, that will help with the pain.
0:29:50 > 0:29:52Tasked with relocating Darina's
0:29:52 > 0:29:54elbow is third-year junior doctor Aideen Carroll.
0:29:54 > 0:29:58The only problem is, this will be the first time she's done this
0:29:58 > 0:30:02procedure, so she's called on consultant surgeon Gordon McFarlane
0:30:02 > 0:30:04to cast an eye over proceedings.
0:30:04 > 0:30:08- Morning.- A lot of our junior doctors are going to be GPs.
0:30:09 > 0:30:13Particularly, they may be GPs in rural areas.
0:30:13 > 0:30:19- Mm.- So if they can do this themselves, without having to send a
0:30:19 > 0:30:25child miles and miles to a bigger centre, then that's really valuable.
0:30:25 > 0:30:27And that's what we try and encourage here.
0:30:27 > 0:30:31- Hey there.- Hi.- Hi. I'm Mr McFarlane. - Hello.- One of the surgeons.
0:30:33 > 0:30:34So this is Darina.
0:30:34 > 0:30:39- Hi.- We talked about trying to reduce the elbow.
0:30:39 > 0:30:43OK? So we're just going to do that now. Is that all right?
0:30:43 > 0:30:45OK. OK.
0:30:45 > 0:30:47Just hold on to Darina.
0:30:47 > 0:30:48OK, you're doing really well.
0:30:48 > 0:30:52The doctor needs to push the elbow back into the socket.
0:30:52 > 0:30:55So at the moment...
0:30:55 > 0:30:57Mm-hm. Yeah. That's right.
0:30:57 > 0:30:59I know.
0:30:59 > 0:31:01- I heard it, yeah.- Oh, did you feel it click?
0:31:01 > 0:31:03Well, there you are. Job done.
0:31:03 > 0:31:05- I think that's it.- That's what you need.
0:31:05 > 0:31:07A nice click. That's exactly what you need.
0:31:07 > 0:31:09Fantastic. Oh.
0:31:09 > 0:31:11Better?
0:31:11 > 0:31:14- Not convinced.- Not sure.
0:31:14 > 0:31:17That's great. Well, just give her something to play with and see if
0:31:17 > 0:31:20she's using it and... If she's happy, she can go home.
0:31:20 > 0:31:22Yeah. Pop into the waiting room, play with lots of toys.
0:31:22 > 0:31:26- Yeah.- And see if she'll use the arm. - OK, thank you very much.
0:31:26 > 0:31:29OK. There you go.
0:31:31 > 0:31:37The doctor knew what to do, and just needed a little bit of presence,
0:31:37 > 0:31:39maybe, to give her some confidence.
0:31:39 > 0:31:43More than happy to use her elbow again, Darina can head home.
0:31:44 > 0:31:49Hopefully, it'll be some time before she's back in A&E.
0:31:49 > 0:31:54- Bye, thank you.- All right, bye.
0:31:58 > 0:32:00However, like most A&E departments,
0:32:00 > 0:32:04it's never too long before they're greeting another youngster who's
0:32:04 > 0:32:06come unstuck due to misadventure.
0:32:06 > 0:32:10Today, it's the turn of six-year-old Daniel, whose mum Sarah
0:32:10 > 0:32:12has brought him in from Voe.
0:32:14 > 0:32:18Here we go. He ran into a wooden banister.
0:32:18 > 0:32:21The stairs, it kind of points out a little bit and he's just ran round
0:32:21 > 0:32:24- the corner from the kitchen. - All right, OK.- Ow.
0:32:24 > 0:32:27Oh, it's going to be painful coming off, sweetheart.
0:32:27 > 0:32:30- We had this from... - Why don't you tell me your name, eh?
0:32:30 > 0:32:31- Daniel.- Eh?
0:32:33 > 0:32:36It's quite a big split. Sorry.
0:32:36 > 0:32:38You've been running wild at home, have you?
0:32:41 > 0:32:43Tell them what happened, Daniel.
0:32:43 > 0:32:50I ran out the kitchen with something and I...
0:32:50 > 0:32:56My head...got caught on the banister, then it started bleeding.
0:32:56 > 0:32:59- Aw.- I just have to go slowly now. - Go slowly.
0:33:00 > 0:33:02To make matters worse,
0:33:02 > 0:33:05his injuries were sustained in the execution of a robbery.
0:33:05 > 0:33:08They took some straws out of the kitchen,
0:33:08 > 0:33:11they've got milkshake little balls in them.
0:33:11 > 0:33:15- Yeah, and...- So you drink the milk and the milk goes the flavour of the
0:33:15 > 0:33:17straw. So they were sneaking.
0:33:17 > 0:33:20- And when...- So they were thinking they were getting away with
0:33:20 > 0:33:23something, so they've all ran out the kitchen at full speed.
0:33:23 > 0:33:25The banister stopped you, didn't it?
0:33:27 > 0:33:30After any head injury, but particularly with children,
0:33:30 > 0:33:34it's important to check for any signs of concussion.
0:33:34 > 0:33:40We've had kids with head injuries and it's vitally important for us to
0:33:40 > 0:33:42be able to deal with these things locally.
0:33:42 > 0:33:46Squeeze my fingers as hard as you can.
0:33:46 > 0:33:49Because very often the weather turns bad
0:33:49 > 0:33:51and we can't get them out in time.
0:33:51 > 0:33:54Harder. Oh, well done.
0:33:54 > 0:33:57Now, can you push my hand away?
0:33:57 > 0:34:00I'll not do two hands because you're only little.
0:34:00 > 0:34:02Can you push my hand away?
0:34:02 > 0:34:04Oh, well done. What a strong boy.
0:34:04 > 0:34:06Push this one away?
0:34:06 > 0:34:08Thank you.
0:34:08 > 0:34:11With Daniel showing no signs of concussion,
0:34:11 > 0:34:15it's time for the doctor to deal with his cut head.
0:34:15 > 0:34:18Did you feel dizzy, or anything?
0:34:18 > 0:34:19Yeah? Aw.
0:34:19 > 0:34:22And has he been sick at all?
0:34:22 > 0:34:24OK, that's fine.
0:34:24 > 0:34:25Whoops. All right.
0:34:25 > 0:34:28All right, let me have a quick look here.
0:34:28 > 0:34:30That's good. OK.
0:34:30 > 0:34:32I think we'll maybe put a little bit of glue on there.
0:34:32 > 0:34:34No? You don't want glue?
0:34:34 > 0:34:36No? It's not that bad, honestly.
0:34:36 > 0:34:39It'd hurt more to have this done.
0:34:39 > 0:34:41OK? It's not going to hurt that much.
0:34:41 > 0:34:44There's no needles. OK? No needles at all.
0:34:44 > 0:34:46OK, no sticky bits.
0:34:46 > 0:34:49Just a tiny bit of glue over the top.
0:34:49 > 0:34:51And then it's finished, OK?
0:34:51 > 0:34:53Do you think you can be brave enough for that?
0:34:53 > 0:34:55- Good stuff. All right. - Well done, Daniel.
0:34:57 > 0:34:59- You all right, darling?- Mm-hm.
0:34:59 > 0:35:02- It sore?- No.- You're so brave. - No, he's doing fine.
0:35:02 > 0:35:05Oh, you're very good boy, aren't you?
0:35:05 > 0:35:07There you go.
0:35:07 > 0:35:10That's it. We're just letting it dry, OK?
0:35:10 > 0:35:12That's all.
0:35:13 > 0:35:15That's as bad as it gets, OK?
0:35:15 > 0:35:18He's been with us for quite some time
0:35:18 > 0:35:20and his, you know, behaviour hasn't deteriorated,
0:35:20 > 0:35:23he hasn't become more sleepy in the meantime,
0:35:23 > 0:35:26so that's all very reassuring. He's been with us for an hour-and-a-half
0:35:26 > 0:35:28and so, in that time,
0:35:28 > 0:35:31he's not showing any signs of any serious concussion.
0:35:31 > 0:35:34So that's very good stuff, and all his eye movements,
0:35:34 > 0:35:37how he's been playing and interacting, it's been great.
0:35:37 > 0:35:40- OK. - Yeah.- That's good to know.- Yeah.
0:35:40 > 0:35:43Skin glue is administered when wounds are deemed too small or minor
0:35:43 > 0:35:47to go through the discomfort of stitches or staples.
0:35:47 > 0:35:51And now that Daniel's patched up, it's time to head home,
0:35:51 > 0:35:54where he will take things much slower. Or so he says.
0:35:54 > 0:35:58Thank you very much, Doctor. Will you say thank you, Daniel?
0:35:58 > 0:36:01- All right.- Thank you.- Bye. - Thank you.
0:36:11 > 0:36:15Shetland's most famous inhabitants are undoubtedly the Shetland ponies.
0:36:17 > 0:36:19These hardy horses have been roaming
0:36:19 > 0:36:21the islands for at least 4,000 years.
0:36:24 > 0:36:27While in the past they were used in farming and coal-mining,
0:36:27 > 0:36:30today Shetland's diminutive stalwarts are often
0:36:30 > 0:36:32ridden by local children.
0:36:33 > 0:36:37One of those pony enthusiasts, who competes in shows all over Scotland,
0:36:37 > 0:36:40is Emily from Bigton in the south of Shetland.
0:36:40 > 0:36:43She's had to pay a visit to Gilbert Bain A&E.
0:36:43 > 0:36:44I fell off my horse.
0:36:44 > 0:36:48It was a Shetland pony and I was cantering
0:36:48 > 0:36:52and then he put his head down and I fell off.
0:36:52 > 0:36:56Even though the average pony stands at just 42 inches tall,
0:36:56 > 0:36:59taking a tumble from one can be a bruising affair.
0:37:00 > 0:37:03You were practising for the show, weren't you?
0:37:03 > 0:37:07The doctor said that he thinks it might be a fracture.
0:37:07 > 0:37:11That's your collarbone, it's up here. Yeah.
0:37:13 > 0:37:16It will be a while before you're on a horse again.
0:37:16 > 0:37:19With Emily's hopes of competing in a local show looking slim,
0:37:19 > 0:37:23it's up to nurse Emma to make her as comfortable as possible.
0:37:23 > 0:37:26So we'll just pop this on and see if it's any comfier.
0:37:26 > 0:37:29Could you stand up for me, darling?
0:37:29 > 0:37:33Right, and you slip that through there.
0:37:33 > 0:37:36Now, this is kind of stretchy, this material. Have you got him?
0:37:36 > 0:37:39- Mm-hm.- So, erm...
0:37:39 > 0:37:43it might kind of loosen off a bit and, if that happens,
0:37:43 > 0:37:46you can just tighten him up.
0:37:46 > 0:37:48If you just kind of make sure it's...
0:37:48 > 0:37:52there. And it'll take the weight across your back rather than on your
0:37:52 > 0:37:55neck. Have you got your full weight on that?
0:37:55 > 0:37:57Cos I can make it a bit tighter if you want. Does that feel OK?
0:37:57 > 0:37:59What we'll do is keep you in that,
0:37:59 > 0:38:02give you some painkillers and then we'll get you back tomorrow.
0:38:02 > 0:38:05If the pain is too sore at home,
0:38:05 > 0:38:08then you can come back and we could see about getting
0:38:08 > 0:38:11some more pain relief. Usually, once it's in the sling,
0:38:11 > 0:38:14paracetamol and brufen, you should be all right.
0:38:14 > 0:38:18OK? And is the horse forgiven?
0:38:19 > 0:38:23- Always!- Thank you.- No bother.
0:38:25 > 0:38:2624 hours later,
0:38:26 > 0:38:30the silent cowgirl returns to find out when exactly she can get back on
0:38:30 > 0:38:32her pony.
0:38:32 > 0:38:34So you have broken your clavicle,
0:38:34 > 0:38:37that's your collarbone, just sits here.
0:38:37 > 0:38:40I don't think that's surprising, because we can feel that it's
0:38:40 > 0:38:43- broken, pretty much, can't you?- And what about going back on the horse?
0:38:43 > 0:38:44How long is that going to take?
0:38:44 > 0:38:47It will be at least six to eight weeks
0:38:47 > 0:38:49before you have a full range of movement.
0:38:49 > 0:38:52- That's all she is worried about. - I know.
0:38:52 > 0:38:54Thank you very much.
0:38:54 > 0:38:56You'll be back on your pony before you know it.
0:38:56 > 0:39:00She may play her cards close to her chest, but you wouldn't want to bet
0:39:00 > 0:39:02against her being back in the saddle before long.
0:39:15 > 0:39:18Anna the midwife is back out on her rounds,
0:39:18 > 0:39:22and on her list today is Jennifer in Quendale, 22 miles south of Lerwick.
0:39:23 > 0:39:26Jennifer was flown to Aberdeen just over a week ago
0:39:26 > 0:39:29to have her overdue baby induced.
0:39:29 > 0:39:33In the end, her baby was delivered by C-section and, like most babies,
0:39:33 > 0:39:36began to lose weight in the days that followed.
0:39:36 > 0:39:40Today, we are going to see how she's getting on with feeding and we're
0:39:40 > 0:39:45going to weigh the baby because the last time the baby was weighed,
0:39:45 > 0:39:49she had lost over 9% of her body weight,
0:39:49 > 0:39:53so we're hoping today that she's started to put on some weight.
0:39:56 > 0:39:58Hello.
0:39:58 > 0:40:02We found it. We were like, "I hope we don't get lost."
0:40:02 > 0:40:05- Do you want me to take my shoes off or...?- No, you're OK.
0:40:10 > 0:40:14- How is she doing? - Oh, she's doing amazing.
0:40:16 > 0:40:19I like your little tufts this morning.
0:40:19 > 0:40:23And is she waking up for feeds herself, are you waking her up?
0:40:23 > 0:40:26Yeah, last night, then I just let her wake herself up.
0:40:26 > 0:40:29Mm-hm. Oh!
0:40:29 > 0:40:31I know, I'm sorry.
0:40:31 > 0:40:35I know! These mean midwives just come and see you and torture you.
0:40:38 > 0:40:40Yeah. You're not going to pee on me, OK?
0:40:40 > 0:40:45Yes, so this is going to be a bit chilly. 3-0-8-0.
0:40:46 > 0:40:49So she's doing brilliantly, and you are as well, obviously,
0:40:49 > 0:40:52with the feeding. Well done.
0:40:53 > 0:40:55After all that torture, eh?
0:40:55 > 0:40:58After a few teething troubles,
0:40:58 > 0:41:00Jennifer and the baby are settling in nicely.
0:41:00 > 0:41:04In fact, baby seems to have just one thing on her mind.
0:41:04 > 0:41:09And you can tell that she's thinking about milk at all times.
0:41:09 > 0:41:12- Dreaming about it just now! - A one-track mind.
0:41:12 > 0:41:14Yeah.
0:41:29 > 0:41:32On Shetland, it takes more than a broken clavicle
0:41:32 > 0:41:36to keep a good girl down, and six weeks after her fall,
0:41:36 > 0:41:39Emily is keen to show she's no one-trick pony.
0:41:41 > 0:41:45We're just going to go for a ride up on the road.
0:41:47 > 0:41:52It was meant to be six weeks but I think I started riding in,
0:41:52 > 0:41:53like, five weeks.
0:41:53 > 0:41:57She may have had five weeks off riding, but nothing comes
0:41:57 > 0:42:00between a Shetland girl and her Shetland pony.
0:42:00 > 0:42:02She's been here nearly every single day since she did it
0:42:02 > 0:42:05and she's never looked back, it's not put her off at all.
0:42:32 > 0:42:36Caitlin went into labour and eventually gave birth to a baby boy,
0:42:36 > 0:42:41Leo, by emergency C-section, weighing in at a whopping 9lb 1oz.
0:42:41 > 0:42:46Both are doing well. Leo's sleeping through the night, and smiling.
0:42:46 > 0:42:50Dr Pinnick is still shadowing Dr Lalla's clinics,
0:42:50 > 0:42:52getting more experience in minor operations,
0:42:52 > 0:42:55and hopes to be running clinics of her own very soon.
0:42:55 > 0:42:59And Darina was back on her trampoline in no time.