0:00:04 > 0:00:12This programme contains some strong language and scenes which some viewers may find upsetting
0:00:12 > 0:00:1518th of October 2012.
0:00:16 > 0:00:21Across Britain, a hundred cameras are filming the NHS on a single day.
0:00:21 > 0:00:24'This change will be a disaster.'
0:00:26 > 0:00:31On this day, more than one and a half million of us will be treated.
0:00:31 > 0:00:34Three days ago you had a stroke.
0:00:34 > 0:00:371,500 of us will die.
0:00:37 > 0:00:402,000 will be born.
0:00:41 > 0:00:43WHISTLE BLOWS
0:00:43 > 0:00:47The NHS is the largest public healthcare system in the world.
0:00:48 > 0:00:52We want that to be in your voice all the time.
0:00:52 > 0:00:53Can I help you?
0:00:53 > 0:00:56- We rely on it...- Be really brave.
0:00:56 > 0:00:57..complain about it...
0:00:57 > 0:00:59And in the bin. That's because of you.
0:00:59 > 0:01:01..often we take it for granted.
0:01:01 > 0:01:03Lucas! Lucas!
0:01:03 > 0:01:06What we expect from the NHS is ever-increasing.
0:01:08 > 0:01:10But money to pay for it isn't.
0:01:12 > 0:01:15If we could see what this institution does in
0:01:15 > 0:01:17a single day...
0:01:18 > 0:01:21..what would it make us think?
0:01:21 > 0:01:25This entire series tells the story of one day...
0:01:25 > 0:01:26So why isn't she waking up?
0:01:26 > 0:01:29..100 cameras
0:01:29 > 0:01:33capturing the NHS as you've never seen it before.
0:01:33 > 0:01:35Baby born at five to three.
0:01:45 > 0:01:47- RADIO:- 'Good morning, everyone.
0:01:47 > 0:01:49'Thursday the 18th of October.'
0:01:55 > 0:01:57That's it. And again.
0:01:57 > 0:02:01WOMAN GROANS
0:02:06 > 0:02:09- Not wanting to wait no longer. - It's probably because they're busy.
0:02:09 > 0:02:12- It's not my fault they're so busy. - I appreciate that.
0:02:12 > 0:02:16All I've come here for is cos you're walking down here with a gown on.
0:02:16 > 0:02:18I just want to make sure you're all right to go home.
0:02:18 > 0:02:21I'm fine. Yeah, but I'm not waiting that long.
0:02:21 > 0:02:23- I've been waiting probably an hour. - An hour?
0:02:23 > 0:02:27- All you've been waiting is an hour? - All? All?
0:02:27 > 0:02:29Yeah, but it's an Accident and Emergency department.
0:02:29 > 0:02:32- It takes a while to process people. - It does indeed.
0:02:32 > 0:02:34But it's more of an accident,
0:02:34 > 0:02:37cos there's a lack of staff there that can help people.
0:02:37 > 0:02:38OK, can you tell me your name?
0:02:38 > 0:02:42- No.- What's your name?- Don't worry about me. Are you a police officer?
0:02:42 > 0:02:46No, no. I just want to make sure you're aware enough to make the decision to discharge yourself.
0:02:46 > 0:02:48- That's all.- I'm fine.
0:02:48 > 0:02:49- You're all right?- Yeah.
0:02:49 > 0:02:51OK, I can't stop you from leaving
0:02:51 > 0:02:53- if you're well enough to take yourself.- Good night.- OK.
0:02:59 > 0:03:03'My first priority was that he was safe to go home.
0:03:03 > 0:03:06'If he's safe to go home and he's got capacity,
0:03:06 > 0:03:09'I'm not going to persuade him to come back in,'
0:03:09 > 0:03:12but it's interesting that he dialled an ambulance,
0:03:12 > 0:03:15it's interesting that he came to A & E.
0:03:15 > 0:03:20'He's waited an hour and he's left. That's completely unreasonable.'
0:03:22 > 0:03:26One of my children does that when they are... How old was he? 19, 20?
0:03:26 > 0:03:30If they do that, I will absolutely hang, draw and quarter them.
0:03:30 > 0:03:34That's a waste of public resources an unacceptable way to behave,
0:03:34 > 0:03:37and not how I've brought up my children.
0:03:38 > 0:03:43Liz runs the Clinical Decision Unit, or CDU.
0:03:43 > 0:03:45Most large hospitals now have one.
0:03:45 > 0:03:47They help avoid unnecessary admissions and
0:03:47 > 0:03:50take pressure off A & E departments.
0:03:51 > 0:03:54It's almost like a big filter for the hospital.
0:03:54 > 0:03:57You come in here, we will decide whether you actually need
0:03:57 > 0:04:02a hospital bed or we'll filter you off home again to make sure that the
0:04:02 > 0:04:05only people that are in hospital are people that really need to be here.
0:04:05 > 0:04:07Well, I know she'll go home.
0:04:07 > 0:04:11I looked at her yesterday in A & E and we'll sit her out this morning.
0:04:11 > 0:04:14Is there anybody else that's obvious that we can sit out?
0:04:14 > 0:04:15- Here.- Oh, no.
0:04:15 > 0:04:18Not again! She hasn't got the police with her today?
0:04:18 > 0:04:21She has, but she's under 136.
0:04:21 > 0:04:24So, what did you take last night?
0:04:24 > 0:04:27Honestly, please, my love.
0:04:27 > 0:04:29I'm going to get one of the consultants to see you.
0:04:29 > 0:04:32- Is she on a section now?- We haven't sectioned her.- You haven't? Good.
0:04:32 > 0:04:34OK. I'm going to get the doctors to come and see you
0:04:34 > 0:04:37and you will be discharged this morning. All right?
0:04:39 > 0:04:42So, it doesn't look like she's actually taken an overdose
0:04:42 > 0:04:46of what she says she's taken. She's a very regular patient.
0:04:46 > 0:04:49The issue is, for us, is that anyone who's says they've taken
0:04:49 > 0:04:51an overdose, we have to take seriously.
0:04:51 > 0:04:54We have to do everything as if they're completely genuine
0:04:54 > 0:04:56and make sure she's safe.
0:04:56 > 0:05:00- MAN:- Does she just like to come into hospital?- Yeah.
0:05:01 > 0:05:04Liz's next patient is a 27-year-old who
0:05:04 > 0:05:09woke in the night with severe pain and came straight to A & E.
0:05:09 > 0:05:14Past two days I've had a pain underneath the chest.
0:05:15 > 0:05:17You've come to us with some chest pain, is that right?
0:05:17 > 0:05:20And kind of a bit of an irregular feeling,
0:05:20 > 0:05:22like your heartbeat's irregular.
0:05:22 > 0:05:25Everything's absolutely normal, but what we need to do is do this
0:05:25 > 0:05:30blood test, which will rule out any damage to your heart.
0:05:30 > 0:05:32We'll take you round the corner, but just bear with us.
0:05:32 > 0:05:34All right? OK. Fabulous.
0:05:36 > 0:05:40'It's incredibly unlikely that there is anything wrong with his heart.'
0:05:40 > 0:05:43It does happen, but very rare.
0:05:43 > 0:05:44Yeah, when you don't know what it is
0:05:44 > 0:05:48and it's around your heart area, you need to come and see a doctor.
0:05:48 > 0:05:50You can find anything on the internet.
0:05:50 > 0:05:53I've regularly got a brain tumour if I look on the internet.
0:05:53 > 0:05:55He kept me awake all night just to
0:05:55 > 0:05:58talk to him, to keep him calm a bit.
0:05:58 > 0:06:01- He was really scared.- I was, yeah. I was. I was definitely scared.
0:06:01 > 0:06:04He thought he was going to die and everything, he did.
0:06:05 > 0:06:08I don't think they know what it is, to be honest.
0:06:11 > 0:06:15LIZ: 'I don't think, as a society, we're very stoical any more.'
0:06:15 > 0:06:18The minute you feel slightly unwell, you don't go see your GP, you don't
0:06:18 > 0:06:21go and see your pharmacist, you come straight to the emergency department.
0:06:21 > 0:06:25But you can't have an NHS that picks up everything,
0:06:25 > 0:06:28otherwise it will cease to function.
0:06:31 > 0:06:35SIREN BLARES
0:06:37 > 0:06:40She definitely has got her teeth stuck in her throat.
0:06:43 > 0:06:46So remember how that's still a lot better
0:06:46 > 0:06:48- than before the first operation.- Yes.
0:06:48 > 0:06:51Come and sit down, Alice. Oh, right.
0:06:51 > 0:06:54OK, so I'm going to start at the beginning as usual.
0:06:54 > 0:06:56Your sex drive. What's that like?
0:06:59 > 0:07:04SIREN BLARES
0:07:06 > 0:07:10We've got a 20-year-old motorcyclist versus car.
0:07:13 > 0:07:16Do you remember everything that's happened?
0:07:16 > 0:07:19It's been a busy morning in Leeds A & E,
0:07:19 > 0:07:23when a 64-year-old man who's collapsed at work is rushed in.
0:07:23 > 0:07:27He's paralysed down one side and unable to speak.
0:07:27 > 0:07:31- Brian? Hello, there.- Hello.
0:07:31 > 0:07:34My name's Robin, I'm one of the nurses.
0:07:37 > 0:07:40It looks like he's probably had some kind of stroke or something
0:07:40 > 0:07:42that's gone on in his head,
0:07:42 > 0:07:45either a clot or some kind of bleed in his head.
0:07:45 > 0:07:46Brian...
0:07:48 > 0:07:50- Is it Brian?- Graham.
0:07:50 > 0:07:51Graham? I've been calling him Brian.
0:07:51 > 0:07:53I thought you said Graham.
0:07:53 > 0:07:56Can you lift this arm up for me?
0:07:58 > 0:08:01Can you lift this arm up? Graham?
0:08:01 > 0:08:04Can you lift your arm up in the air for me?
0:08:04 > 0:08:05GRAHAM MUMBLES
0:08:05 > 0:08:08He's unable to converse with us at this moment in time.
0:08:08 > 0:08:11He's got a dense right-sided weakness.
0:08:11 > 0:08:14He's confused and unable to actually physically tell us what's wrong.
0:08:14 > 0:08:19I know it's really scary. We just need to take some blood from you, OK?
0:08:19 > 0:08:23And then we're going to take you for a scan of your brain, OK?
0:08:23 > 0:08:26The words that he's using are just not making any sense at all.
0:08:26 > 0:08:30GRAHAM MUMBLES
0:08:31 > 0:08:33Say that again, Graham.
0:08:34 > 0:08:37Just ten minutes after arriving at hospital,
0:08:37 > 0:08:41Graham's brain is scanned to find out what caused his collapse.
0:08:43 > 0:08:46Oh, it's a big clot. Ooh.
0:08:46 > 0:08:50Right-side weakness. Look at that.
0:08:50 > 0:08:54You can see that is a high density. So that is a clot.
0:08:54 > 0:08:57Can we get somebody to ring the GP, get the GP history out of him
0:08:57 > 0:09:00and screen the results over.
0:09:00 > 0:09:02What I'm going to do is, I'm going to go from his groin,
0:09:02 > 0:09:06go up into his head on his left side, get into the vessel
0:09:06 > 0:09:09and then first see what the problem is and see
0:09:09 > 0:09:12whether I can take it out and then I'll go inside and I'll use
0:09:12 > 0:09:16the special stent, which you can actually pull the clot.
0:09:16 > 0:09:18So we're going to try and use those stents to pull the clot out.
0:09:18 > 0:09:21It's like a plumbing job - the drain is not going to open,
0:09:21 > 0:09:24so you have to suck it and take it out.
0:09:25 > 0:09:28There's a term that we use - time is brain.
0:09:28 > 0:09:31So the quicker we do stuff, the quicker we can get things done,
0:09:31 > 0:09:35the more brain and the more of the person can survive.
0:09:35 > 0:09:38OK. Now then, just look at my face. Look at me.
0:09:38 > 0:09:40With millions of brain cells dying every minute,
0:09:40 > 0:09:44Graham's given a clot-busting drug while the surgical team prepare.
0:09:44 > 0:09:48- Can you see my hand moving?- I've stopped all the other cases.
0:09:48 > 0:09:51He's going to be the top priority now.
0:09:51 > 0:09:53I've got an anaesthetist here with me now,
0:09:53 > 0:09:57so what we're going to do, the main idea is to put him to sleep very quickly.
0:09:57 > 0:09:59And then we're going to try and get this done.
0:09:59 > 0:10:02Hello? We're just going to pop this blood pressure cuff back on, OK?
0:10:02 > 0:10:05If we don't do it, basically the brain is starved of oxygen,
0:10:05 > 0:10:09so you've got to take the block, so the blood flow gets back
0:10:09 > 0:10:11and the oxygen gets back. That's what you're trying to do.
0:10:11 > 0:10:13You're getting oxygen back into the brain.
0:10:13 > 0:10:17You OK? I'm Dr Patankar, I'm the consultant, OK?
0:10:17 > 0:10:20What we're planning to do is, you're in this room here
0:10:20 > 0:10:23where we're going to try and remove the clot from your head.
0:10:23 > 0:10:26Everybody's used to this, OK? All right?
0:10:26 > 0:10:28You're in the right place at the right time
0:10:28 > 0:10:30and we'll get you better, OK?
0:10:30 > 0:10:33Right? See you soon, all right?
0:10:35 > 0:10:38Graham is one of around 400 people who will suffer
0:10:38 > 0:10:40a stroke in Britain today.
0:10:40 > 0:10:44Try and keep your eyes open for as long as you can.
0:10:44 > 0:10:46One in five will die.
0:10:46 > 0:10:48Around half of them will be left disabled.
0:10:50 > 0:10:52One, two, three.
0:11:04 > 0:11:06- RADIO:- 'Now this morning,
0:11:06 > 0:11:09'confusion about David Cameron's plan to make energy...'
0:11:09 > 0:11:12'..cheaper fuel deals.'
0:11:12 > 0:11:14BABY CRIES
0:11:16 > 0:11:19- Hello. How are you?- A bit nervous. - Are you?- Yeah.
0:11:19 > 0:11:22This is Sarah, my oldest daughter.
0:11:22 > 0:11:26She's had the gastric sleeve
0:11:26 > 0:11:31and she's lost 11 stone since 2010.
0:11:31 > 0:11:33Though it doesn't look like it.
0:11:33 > 0:11:36Oh, it does. It does. It does.
0:11:37 > 0:11:38All set.
0:11:40 > 0:11:4248-year-old Lynn weighs 20 stone.
0:11:42 > 0:11:45She's battled with her weight for years.
0:11:45 > 0:11:47The start of my new life.
0:11:49 > 0:11:53Later today, she'll become the third member of her family
0:11:53 > 0:11:54to have weight loss surgery.
0:11:54 > 0:11:58- How are you feeling? - Nerves, bit anxious.
0:12:00 > 0:12:02Just looking forward to the end result, really.
0:12:02 > 0:12:04You know, waiting for it to be over.
0:12:04 > 0:12:07I've had a comment on Facebook saying that people
0:12:07 > 0:12:10who are overweight are lazy, they should get off their backsides
0:12:10 > 0:12:15and lose weight normally and not cost the NHS money.
0:12:16 > 0:12:19They should save up and pay for it themselves.
0:12:19 > 0:12:22That upset me, actually, that comment, last night.
0:12:22 > 0:12:25I see that. Hasn't affected you this morning, though, has it?
0:12:25 > 0:12:30No, because it's something that I need for a better way of life.
0:12:30 > 0:12:33I mean, I've got to find something different to do at the weekends now,
0:12:33 > 0:12:36cos we used to go out for dinner.
0:12:36 > 0:12:39Obviously, I will be able to do that, but smaller portions.
0:12:39 > 0:12:43But for the while I won't be able to go to a restaurant.
0:12:43 > 0:12:46At the end of the day, they don't understand what people go through.
0:12:46 > 0:12:48Definitely not the easy option.
0:12:48 > 0:12:52- RADIO:- 'Psychological counselling around their eating habits
0:12:52 > 0:12:56'and nearly a fifth of patients were readmitted within six months...'
0:12:56 > 0:12:59'some needing further operations. The report was carried out by
0:12:59 > 0:13:04'the National Confidential Enquiry into Patient Outcome and Death.
0:13:04 > 0:13:06'Ian Martin is...'
0:13:06 > 0:13:10I quite like, basically, neck of femurs, in the older generation.
0:13:12 > 0:13:16Attending to them. OK.
0:13:16 > 0:13:20Purely because you're helping the older generation that don't normally call out for any sort of help.
0:13:20 > 0:13:22- Oh, I better get rid of this.- Yeah.
0:13:22 > 0:13:26We get a call now, we've got to go and you've got to get rid of that.
0:13:26 > 0:13:28That bin over there?
0:13:45 > 0:13:48I'm sure this gets longer, Doctor.
0:13:48 > 0:13:51Well, thank you for coming to the clinic today. How have you been?
0:13:51 > 0:13:52Not so good.
0:13:52 > 0:13:55I'm not sleeping at all, because the sleep apnoea's waking me up.
0:13:55 > 0:13:56My back's got more worse.
0:13:56 > 0:13:58Whereas I used to go out all the time,
0:13:58 > 0:14:01I only go out for an hour of a morning.
0:14:01 > 0:14:04You also went to see a cardiologist. What happened with that?
0:14:04 > 0:14:07He gave me a letter, recommending the gastric band.
0:14:07 > 0:14:12Your letter to them said I'd be on as much as £30,000 worth
0:14:12 > 0:14:15of medication and treatment a year,
0:14:15 > 0:14:16annually,
0:14:16 > 0:14:18if they don't do the operation.
0:14:18 > 0:14:20That's wasting a lot of money.
0:14:20 > 0:14:23I'll save them money, have your tablets back
0:14:23 > 0:14:24and give me the operation.
0:14:24 > 0:14:26I need something done now.
0:14:26 > 0:14:28The problem is, when we applied for it,
0:14:28 > 0:14:31they felt that you do not qualify
0:14:31 > 0:14:34what is called a comorbidity criteria.
0:14:34 > 0:14:37Comorbidity means other conditions accompanying weight problems.
0:14:37 > 0:14:40I've got everything they asked me to have except one.
0:14:40 > 0:14:42That was the diabetes.
0:14:42 > 0:14:45The problem that we have is where you are from, the West Midlands,
0:14:45 > 0:14:48has got one of the highest levels of obesity in Europe.
0:14:48 > 0:14:50So if they funded everybody who was eligible,
0:14:50 > 0:14:53then the NHS in the West Midlands would be bankrupt.
0:14:53 > 0:14:55So if I moved to Birmingham...
0:14:55 > 0:14:57No, you wouldn't. It's the West Midlands.
0:14:57 > 0:15:01- You have to move outside the West Midlands.- It's not fair.
0:15:11 > 0:15:14Lynn lives in the South East, Britain's slimmest region,
0:15:14 > 0:15:18which funds more weight loss surgery than anywhere in the country.
0:15:21 > 0:15:23How are you feeling?
0:15:25 > 0:15:26Shaky?
0:15:26 > 0:15:30In the NHS, the number of these weight loss operations has
0:15:30 > 0:15:33quadrupled in the last six years.
0:15:33 > 0:15:35The surgery costs £10,000.
0:15:35 > 0:15:38Obesity in this country has doubled in the last 20 years.
0:15:38 > 0:15:42That is an epidemic. You know, the messages are all very confused.
0:15:42 > 0:15:45Shops are open 24 hours a day, seven days a week.
0:15:45 > 0:15:48The Olympic Games was sponsored by McDonald's.
0:15:48 > 0:15:51So society is now organised in such a way
0:15:51 > 0:15:54that it's just making us all bigger.
0:15:54 > 0:15:56Morning, ladies.
0:15:56 > 0:16:00The cost of obesity to the NHS is about £4 billion a year.
0:16:00 > 0:16:03The cost of diabetes is £10 billion a year
0:16:03 > 0:16:05and that's related to obesity.
0:16:05 > 0:16:08So whilst surgery itself isn't cheap, after two to three years,
0:16:08 > 0:16:11we'll start saving money.
0:16:11 > 0:16:14- Is this your daughter?- My daughter. She had a gastric sleeve.
0:16:14 > 0:16:17- Did you?- I did.- Wow.
0:16:17 > 0:16:19No problems?
0:16:19 > 0:16:20SARAH LAUGHS
0:16:20 > 0:16:22Yeah.
0:16:22 > 0:16:24I had a blood vessel to my stomach burst,
0:16:24 > 0:16:26so I had to have emergency surgery.
0:16:26 > 0:16:29- Oh, no.- Yes. I very nearly died.
0:16:29 > 0:16:32I was doing the crossword, I dropped my pen and I thought,
0:16:32 > 0:16:35"I'm not going to call a nurse just to pick up a pen."
0:16:35 > 0:16:38So I bent down, I felt a little pop,
0:16:38 > 0:16:41"Oh, maybe it was just gas."
0:16:41 > 0:16:44And yes, my stomach burst.
0:16:44 > 0:16:45Gosh. That was traumatic.
0:16:45 > 0:16:49I hope it will be nice and straightforward today.
0:16:49 > 0:16:53It was that bad that they allowed my cousin
0:16:53 > 0:16:56and my husband at the time to come up to the top floor to say
0:16:56 > 0:17:00goodbye and they don't usually let family go up to the top floor.
0:17:00 > 0:17:03- MAN:- Is that one of the reasons that you're quite nervous?
0:17:03 > 0:17:04Yeah, I think...
0:17:04 > 0:17:07I mean, you hear stories about any operation, don't you,
0:17:07 > 0:17:12but there's always a bad one to go with a good one.
0:17:12 > 0:17:13- Bye.- Bye, see you later.
0:17:26 > 0:17:29- You've got pneumonia. - Yes, so they told me.- Good.
0:17:29 > 0:17:32- You're getting better. - Good, good.- OK.
0:17:32 > 0:17:34Because he knows that the doctor told me
0:17:34 > 0:17:35if I didn't get better I'd die.
0:17:35 > 0:17:36Well, that's...
0:17:36 > 0:17:41And I thought, "Well, at 89, who cares?"
0:17:41 > 0:17:44The October weather means Liz and the team in CDU
0:17:44 > 0:17:46are busy juggling beds.
0:17:46 > 0:17:51They've already seen 50 patients today, many of them elderly.
0:17:51 > 0:17:56I know, but to get you home, we need a relative.
0:17:58 > 0:17:59People are getting older
0:17:59 > 0:18:03and treatments are getting more sophisticated and we can make
0:18:03 > 0:18:08people live longer, but whether we should or not is another question.
0:18:08 > 0:18:11People are aware of it, but they're just not aware of how much it
0:18:11 > 0:18:16affects frontline services day in, day out, day in, day out.
0:18:18 > 0:18:23- Hello, Mrs Evans.- Hello.- This is the team looking after you today.
0:18:23 > 0:18:29- Over the last few weeks, have you felt more tired or breathless?- Yes.
0:18:29 > 0:18:32- Yes. Has that been gradually getting worse?- Yes.
0:18:32 > 0:18:35OK. I think you've had an operation
0:18:35 > 0:18:40- and a number of tests on the colon before, haven't you?- I'm not sure.
0:18:40 > 0:18:45- I don't think so. Breast cancer. - They had the breast cancer.
0:18:45 > 0:18:48- Yes, that was done.- Then there was the colon one as well.
0:18:48 > 0:18:50Nobody said a word about that.
0:18:50 > 0:18:52- Nobody said anything about that.- No.
0:18:52 > 0:18:55You have problems with your memory a little bit recently.
0:18:55 > 0:18:58At the moment, I can't remember anything twice.
0:18:58 > 0:19:02I think, because you got a bit anaemic, it might be worth us
0:19:02 > 0:19:05giving you a couple of pints of blood to top you up.
0:19:05 > 0:19:06Oh, not again.
0:19:06 > 0:19:09The honest truth is I don't think there's an awful lot more that
0:19:09 > 0:19:13I can do to slow it down.
0:19:13 > 0:19:17- The only thing I don't like here is no daylight.- No, I agree with you.
0:19:17 > 0:19:19This is totally the wrong room for you
0:19:19 > 0:19:21and we'll find you a room with some daylight.
0:19:21 > 0:19:24- Oh, please.- All right. - Yes, thank you.
0:19:24 > 0:19:27MAN: How long have you been poorly?
0:19:27 > 0:19:30I don't really know.
0:19:30 > 0:19:34Last Christmas it started, I think, or just before.
0:19:36 > 0:19:39And I went in because I thought I'd broken my hip
0:19:39 > 0:19:43and it was to do all this...
0:19:43 > 0:19:45I don't know what it is.
0:19:45 > 0:19:46I don't like it, anyway.
0:19:46 > 0:19:50I don't think anybody likes to be poorly, do they?
0:19:50 > 0:19:53No. Well, that's the pleasure of growing old.
0:19:53 > 0:19:55You can't have both.
0:19:55 > 0:19:59- That's Bernard, my husband. - Oh, I've got to sit down.
0:19:59 > 0:20:01- Yes, I know you have. - Before I fall down.
0:20:01 > 0:20:03Sorry to drag you out.
0:20:05 > 0:20:07I'm not quite sure why I'm in here.
0:20:07 > 0:20:13They're making a clinical decision about what's going to happen to you.
0:20:13 > 0:20:15What is going to happen to me?
0:20:15 > 0:20:20They're either going to put you in the ward, I suppose, or send you home.
0:20:20 > 0:20:22She's got this bowel cancer
0:20:22 > 0:20:28and we've got to face up to the fact that she is in a very bad
0:20:28 > 0:20:33position and we make the best of it while we can, what's left to us.
0:20:33 > 0:20:36When you get to my age,
0:20:36 > 0:20:40you appreciate the fact that you haven't got much longer to go.
0:20:41 > 0:20:45- What?- That you haven't got much longer to go.
0:20:45 > 0:20:49- You're going to pop your clogs sometime.- Of course we are.
0:21:08 > 0:21:11MONITORS BEEP
0:21:22 > 0:21:24OK, forward.
0:21:24 > 0:21:27She's trying to get an access into the groin,
0:21:27 > 0:21:29so she's going to get into the artery.
0:21:29 > 0:21:32And this is a little bit difficult, because he's big.
0:21:32 > 0:21:34It's going to be a little bit tricky.
0:21:34 > 0:21:35But she's good.
0:21:35 > 0:21:38She's got access now and everything we're going to do is from the groin.
0:21:38 > 0:21:40OK?
0:21:40 > 0:21:43Two hours ago, 64-year-old Graham was rushed to A & E with
0:21:43 > 0:21:44a clot in his brain.
0:21:44 > 0:21:46It's going to be a problem.
0:21:46 > 0:21:48The team need to remove the clot before Graham suffers
0:21:48 > 0:21:50permanent brain damage.
0:21:50 > 0:21:52OK, wire forward, please.
0:21:52 > 0:21:55Dr Patankar will try and remove the clot using a procedure he's
0:21:55 > 0:21:58only been performing for ten months.
0:21:58 > 0:22:02He's going to access Graham's brain through an artery in his groin.
0:22:02 > 0:22:06It's a risky operation that only a handful of hospitals perform.
0:22:06 > 0:22:10So now I have to find my way. It's like driving a car.
0:22:10 > 0:22:14You're trying to get your car parked in the vessel
0:22:14 > 0:22:16in the left side of the neck.
0:22:16 > 0:22:19So I'm going to try and see how his blood vessels are.
0:22:30 > 0:22:33OK? Lovely. Happy with that?
0:22:33 > 0:22:37The treatment has been there for a long time.
0:22:37 > 0:22:40Retrieving clots in other parts of the body had been going on.
0:22:40 > 0:22:41But for stroke, of late,
0:22:41 > 0:22:46it has been promoted in the last year a lot more.
0:22:47 > 0:22:50The main issue, what we've got to try and do is
0:22:50 > 0:22:53get blood flow back to that part of the brain
0:22:53 > 0:22:54that's not working,
0:22:54 > 0:22:56so the left hemisphere,
0:22:56 > 0:23:01which controls language and the power to the right side of the body.
0:23:01 > 0:23:04The critical thing is to try and get the clot out of the middle
0:23:04 > 0:23:08cerebral artery, which is providing bloods to that area of the brain.
0:23:08 > 0:23:10So that's what's happening at the moment.
0:23:10 > 0:23:12What's the success rate?
0:23:14 > 0:23:16Don't ask now.
0:23:16 > 0:23:18Life is full of surprises.
0:23:25 > 0:23:27Everybody ready?
0:23:27 > 0:23:29This is the clot here, huh, John?
0:23:29 > 0:23:30I'm actually through the clot.
0:23:30 > 0:23:34I can feel it, you know? It's not easy, because you can't see anything.
0:23:34 > 0:23:37Everything is blind, everything is in my head.
0:23:37 > 0:23:39Believe me, this is stressful.
0:23:39 > 0:23:40Come on, guys.
0:23:46 > 0:23:49OK. Oh, don't come back, baby.
0:23:51 > 0:23:52Bingo.
0:23:53 > 0:23:58- Ah! Succeeded. Lovely. - Excellent.- Brilliant.
0:23:58 > 0:24:02What's happened is, his brain needed perfusion, right?
0:24:02 > 0:24:05I have opened it now, so the perfusion is there
0:24:05 > 0:24:08and now we can go back in and try and take the clot out.
0:24:08 > 0:24:11Something has come. Let's clean that up.
0:24:11 > 0:24:13The final challenge is to pull
0:24:13 > 0:24:15the entire clot back through Graham's body.
0:24:15 > 0:24:18If at any point the clot breaks up,
0:24:18 > 0:24:20it could trigger another stroke.
0:24:24 > 0:24:26Lovely.
0:24:26 > 0:24:30There's clot everywhere. OK.
0:24:35 > 0:24:37Lovely. Oh, look at that.
0:24:37 > 0:24:39Brilliant, man.
0:24:39 > 0:24:43I'm so pleased. John, happy?
0:24:44 > 0:24:48- Yeah.- Yeah? Nice, isn't it?
0:24:48 > 0:24:50Yeah. It looks good.
0:24:51 > 0:24:54God, that was so much clot, wasn't it? Everywhere.
0:24:54 > 0:24:59The clot was just everywhere. Everything came out. Look at that.
0:25:02 > 0:25:05Four hours and £16,000 later,
0:25:05 > 0:25:08blood flow has been restored to Graham's brain.
0:25:08 > 0:25:11Money is an issue. I mean, these are expensive.
0:25:11 > 0:25:14How much money have I spent here? Quite a bit.
0:25:14 > 0:25:15But I think it's still worth it,
0:25:15 > 0:25:18for the man who has paid his taxes for his life.
0:25:18 > 0:25:20I would want it, wouldn't you?
0:25:20 > 0:25:22I pay taxes. I pay 50% tax.
0:25:22 > 0:25:26And I need to have this treatment if I get a stroke.
0:25:26 > 0:25:27No system is perfect,
0:25:27 > 0:25:31but the ability to do this sort of thing would not be available in
0:25:31 > 0:25:37other healthcare systems to anybody who just came in off the street.
0:25:37 > 0:25:39I don't know this gentleman, I've never met him,
0:25:39 > 0:25:42I don't know what his background is.
0:25:42 > 0:25:44And that just doesn't matter.
0:25:44 > 0:25:46We just get on and treat him.
0:25:46 > 0:25:50But the success of this operation is still unknown.
0:25:50 > 0:25:54It's not so much whether they survive these events or not,
0:25:54 > 0:25:57but most people have got a real fear of being left with
0:25:57 > 0:26:00severe neurological disability.
0:26:00 > 0:26:02Although it's very good we've got blood coming
0:26:02 > 0:26:06down the artery, what really matters is what's happened to the brain
0:26:06 > 0:26:13and we will not know that until the anaesthetic has been reversed and
0:26:13 > 0:26:14we actually wake him up
0:26:14 > 0:26:17and actually see what the residual problems will be.
0:26:24 > 0:26:27And just let it go. OK.
0:26:27 > 0:26:29So you're doing this four times.
0:26:29 > 0:26:33Slowly and gently, mindfully bringing your breath in...
0:26:34 > 0:26:35..and then breathing out.
0:26:37 > 0:26:39A breath in...
0:26:43 > 0:26:44OK, let's cover her up.
0:26:51 > 0:26:54Is there any next of kin on that phone yet?
0:26:54 > 0:26:57I can't find anybody on his phone either, but I presume we've
0:26:57 > 0:27:02looked on Portal, have we, to see if he's known anywhere?
0:27:03 > 0:27:09Liz and her team in CDU have now seen 67 patients today.
0:27:09 > 0:27:11So, what's your GP worried about?
0:27:11 > 0:27:15Well, he reckons it could be some sort of
0:27:15 > 0:27:18leakage in the valves in my heart.
0:27:18 > 0:27:21OK. What I'm going to do is have a quick press on your tummy, if that's all right?
0:27:23 > 0:27:26Yeah. She does have a murmur, Kate.
0:27:26 > 0:27:29We need to get you to be seen by the cardiologist,
0:27:29 > 0:27:30so the doctors who look after the heart.
0:27:30 > 0:27:34Pure fat, I know. I'm too fat.
0:27:34 > 0:27:37Is that why I've got this problem?
0:27:37 > 0:27:39No, I don't think so.
0:27:41 > 0:27:44Danny has been here for seven hours complaining of chest pain.
0:27:44 > 0:27:47Daisy, who's the doctor, is going to come and see you.
0:27:47 > 0:27:49She's just looking at the chest X-ray on the computer
0:27:49 > 0:27:51and then she'll be with you, OK?
0:27:51 > 0:27:52Do you know how long that's going to be?
0:27:52 > 0:27:54As long as it takes to look at a chest X-ray.
0:27:54 > 0:27:56So it shouldn't be too long.
0:27:56 > 0:28:01- I want to go.- That's awful.
0:28:01 > 0:28:03How long does it take to look at an X-ray?
0:28:03 > 0:28:06- Oh, there you go. It's done. - Oh, right.
0:28:06 > 0:28:07Should be done now, then.
0:28:07 > 0:28:10LIZ: A lot of the health campaigns in the past have said,
0:28:10 > 0:28:13"If you have chest pain, go to hospital."
0:28:13 > 0:28:14What they didn't say was
0:28:14 > 0:28:17if you have no risk factors and you're young,
0:28:17 > 0:28:20the likelihood of you needing to go to hospital are small.
0:28:20 > 0:28:22But that campaign was hugely successful
0:28:22 > 0:28:24and it's stuck in people's minds.
0:28:24 > 0:28:26The majority of them just need to go home and take a paracetamol
0:28:26 > 0:28:28and see if it settles.
0:28:29 > 0:28:31Hello. Right. Do you want to sit down for me?
0:28:31 > 0:28:34So the good news is that all your blood tests are back
0:28:34 > 0:28:35and they're absolutely fine.
0:28:35 > 0:28:40- Your chest X-ray looked completely fine as well.- So what is it, then?
0:28:40 > 0:28:42- What's a chest X-ray? - No, I mean what's this pain?
0:28:42 > 0:28:45Can I have a quick look at you? Examine you?
0:28:45 > 0:28:46- Would that be all right?- Yeah.
0:28:46 > 0:28:49If I press on there, is that painful?
0:28:49 > 0:28:52- Slightly here.- Slightly there. OK.
0:28:52 > 0:28:56Sometimes people can get a little bit of inflammation down there,
0:28:56 > 0:28:59which is something we call costochondritis,
0:28:59 > 0:29:01which is just a fancy word for saying a little bit of
0:29:01 > 0:29:06inflammation in the cartilage which joins the ribs to the breastbone.
0:29:06 > 0:29:08So is it just something that's going to pass?
0:29:08 > 0:29:09Yeah. Ibuprofen and paracetamol.
0:29:09 > 0:29:13- Good.- Thank you very much. - No worries.- Cheers.
0:29:16 > 0:29:21- MAN: How are you feeling now? - Relieved, mainly.
0:29:21 > 0:29:25Have you any idea how much
0:29:25 > 0:29:29that process that you've been through cost?
0:29:29 > 0:29:32I wouldn't have a clue, no.
0:29:32 > 0:29:36No idea how much it would cost for me to sit in the room, no.
0:29:38 > 0:29:41No. The thought didn't cross my mind.
0:29:41 > 0:29:44We take it for granted, don't we?
0:29:44 > 0:29:46Of course we do. All of us.
0:29:46 > 0:29:50We know they're here for us, no matter what.
0:29:50 > 0:29:54We expect them to be here for us, no matter what.
0:29:57 > 0:30:00And they are, which is really good.
0:30:08 > 0:30:10Is the wound still bleeding freely?
0:30:15 > 0:30:17- Ah-ah-ah.- Super.
0:30:25 > 0:30:29Hello, Lynne. You've brought all this in?
0:30:29 > 0:30:32That's my daughter, she's with me.
0:30:32 > 0:30:34- Yes.- She's had her sleeve done.- Yes.
0:30:34 > 0:30:38She is due to have it done next year. And that's my youngest one.
0:30:38 > 0:30:39Goodness me.
0:30:41 > 0:30:42So, let's go through it all.
0:30:42 > 0:30:45So this is the consent form for your operation.
0:30:45 > 0:30:48Like all surgery, there are risks, this is no different.
0:30:48 > 0:30:51The mortality risk with this operation is about one in 500.
0:30:51 > 0:30:54The risk of a problem is one in 100.
0:30:54 > 0:30:57They are all those risks, they are very low risks,
0:30:57 > 0:31:00but obviously I have to tell you all that and then you just sign there.
0:31:00 > 0:31:03- Signature to my new life.- That's it.
0:31:03 > 0:31:07Good for you. All right, we'll see you in a bit.
0:31:07 > 0:31:09See you in a bit. Bye.
0:31:10 > 0:31:12So, when did you have your operation?
0:31:12 > 0:31:16I had mine in May 2010, but I had the sleeve,
0:31:16 > 0:31:21- which is just one down from a bypass.- You look great.
0:31:21 > 0:31:25That's what I'm looking forward to - the confidence, you know?
0:31:25 > 0:31:26Get a life.
0:31:26 > 0:31:27'It's interesting, isn't it?'
0:31:27 > 0:31:32All of her daughters have obesity, one's had an operation,
0:31:32 > 0:31:37one's waiting for an operation. It does tend to cluster in families.
0:31:37 > 0:31:41That's not genetic so much, it's more an environmental issue.
0:31:41 > 0:31:46But there is still a huge amount of prejudice towards obesity
0:31:46 > 0:31:47and it's grossly unfair.
0:31:47 > 0:31:53If you see somebody who is obese, you just do not know what has led
0:31:53 > 0:31:56that person to that point in their life.
0:31:56 > 0:31:59And it's very unfair to judge people on those grounds.
0:31:59 > 0:32:03I had a very nasty comment made yesterday that the money
0:32:03 > 0:32:06should be spent on people that needed heart transplants.
0:32:06 > 0:32:11They judge you before they even know you. They don't know your story.
0:32:11 > 0:32:13Lucy hasn't got diabetes yet,
0:32:13 > 0:32:16but if she doesn't have this then she will have it.
0:32:16 > 0:32:19It wouldn't be just for diabetes, it would be numerous things,
0:32:19 > 0:32:21and I would be going to the NHS to solve those problems.
0:32:21 > 0:32:23And how much would that cost?
0:32:23 > 0:32:27At the end of the day, we're going to have the last laugh. Definitely.
0:32:27 > 0:32:30We'll have the last laugh. And we'll be happy.
0:32:30 > 0:32:31- And that's the main thing.- Yeah!
0:32:31 > 0:32:35Do you want to just pop that on for me? It does up at the back.
0:32:35 > 0:32:37And then we'll get you down to theatre shortly.
0:32:37 > 0:32:41I'll make sure I've got all your notes together. There we go.
0:32:41 > 0:32:45'Do you think this kind of operation is a waste of NHS resources?'
0:32:45 > 0:32:47Definitely not. Definitely not.
0:32:47 > 0:32:49Hi.
0:32:49 > 0:32:52'You see them a year, two years later,'
0:32:52 > 0:32:55they're not actually a drain on the NHS any more.
0:32:55 > 0:32:58They become an active member of the community
0:32:58 > 0:33:03and they're out there working and doing something with their lives.
0:33:03 > 0:33:05It's just giving them their life back.
0:33:05 > 0:33:08They're happy, and happy is the key word,
0:33:08 > 0:33:11because a lot of my patients aren't happy when they come in.
0:33:13 > 0:33:16- I'm getting really nervous now. - I'm sure you are.
0:33:32 > 0:33:34Now, you're going to start feeling
0:33:34 > 0:33:36like you've had a bottle or so of wine.
0:33:36 > 0:33:39- I know it's a bit early in the day. - Feel it now?
0:33:42 > 0:33:44We'll see you in a couple of hours.
0:33:54 > 0:33:56Out with the old and in with the new!
0:34:00 > 0:34:04I've done 600 of these before, and I'll hopefully do this one
0:34:04 > 0:34:08exactly as I have done the last 600. We don't like surprises.
0:34:08 > 0:34:12So you ate in the Park Tavern last night, did you?
0:34:12 > 0:34:16Richie was there, was he, and Louisa? So, mainly our team.
0:34:16 > 0:34:17And Joe, yeah, yeah.
0:34:17 > 0:34:20- Where was my invitation?- Eh? - Where was my invitation?!
0:34:24 > 0:34:27New surgical techniques over the last 10 years have reduced
0:34:27 > 0:34:31the cost of operations like Lynne's and improved recovery time.
0:34:34 > 0:34:37This is all done with keyhole surgery.
0:34:37 > 0:34:41This is our telescope, so these are the eyes for the operation,
0:34:41 > 0:34:46and it puts a picture up on the screen. We'll start off here.
0:34:46 > 0:34:50So everything that you see that's yellow is fat, fat, fat.
0:34:51 > 0:34:56Then we get onto muscle here, there is a muscle layer. Muscle layer.
0:34:57 > 0:35:03Muscle layer. OK, and that is into the abdominal cavity now.
0:35:06 > 0:35:09Here we go, so we are inside her abdomen.
0:35:09 > 0:35:15She's not got a great liver, look. Lots of little bits and bobs on it.
0:35:15 > 0:35:18Come down this side, Anna, if we could just take the port out,
0:35:18 > 0:35:19take the camera out.
0:35:21 > 0:35:23- Something weird. - There's something there.- Yep.
0:35:28 > 0:35:32Go back a little bit. OK, she has got a mass.
0:35:35 > 0:35:36What sort of mass is it?
0:35:40 > 0:35:43I'm not sure I'm going to carry on with her,
0:35:43 > 0:35:45- cos I think she's got a cancer. - She's got a mass.
0:35:47 > 0:35:49Look, she's got a big pelvic mass.
0:35:49 > 0:35:52- I wondered what was going on in her liver.- It did look like a mass.
0:35:58 > 0:36:03- She has got a tumour of some sort. I think it's ovarian.- Yeah.
0:36:03 > 0:36:06I think she's got an ovarian tumour.
0:36:06 > 0:36:08So I'm not going to do anything more for her.
0:36:08 > 0:36:11It would be wrong for me to plough on with an operation
0:36:11 > 0:36:16when there could be some other pathology that is significant.
0:36:17 > 0:36:20She wouldn't have known about it, we wouldn't have known about it.
0:36:20 > 0:36:23Very difficult to even feel it, to be honest with you.
0:36:23 > 0:36:29But, you know, that is entirely unusual, so that is a shock to us
0:36:29 > 0:36:34all, it will be a shock to her, poor love, when I tell her. It's tough.
0:36:35 > 0:36:39We'll see what it is. Bit upset by that, to be honest.
0:36:39 > 0:36:42Poor Lynne, you know? Anyway, let's find out what it is first.
0:36:42 > 0:36:44We can't speculate just yet.
0:36:46 > 0:36:49'That's the first time I've found what I think is a cancer'
0:36:49 > 0:36:52whilst doing an operation. She's only 48.
0:36:56 > 0:36:57Only 48.
0:37:04 > 0:37:06'Makes you think, it makes you reflect.'
0:37:06 > 0:37:10We are all subject to these problems. Let's wait and see.
0:37:10 > 0:37:15If that's a cancer, then she's got a battle on her hands.
0:37:18 > 0:37:21So I'm going to go speak to her daughter now.
0:37:32 > 0:37:35- Have you not got any pennies with you?- Have you got no money?
0:37:35 > 0:37:3910 months ago, neurosurgeon Sasha Burn operated on three-year-old
0:37:39 > 0:37:41Charlie to remove a tumour from his brain.
0:37:43 > 0:37:45Today, at her weekly clinic, she will tell his family
0:37:45 > 0:37:47if he's got the all clear.
0:37:47 > 0:37:49When Charlie's mum comes into clinic,
0:37:49 > 0:37:52all she's really going to want me to say is the scan looks fantastic
0:37:52 > 0:37:56and there's no changes, but in all likelihood, she may
0:37:56 > 0:37:59sense that there is some doubt in my voice or what have you,
0:37:59 > 0:38:03and will know straight away that there might be an issue, and
0:38:03 > 0:38:06so it's about me telling her openly and directly what we think, showing
0:38:06 > 0:38:12her the scan so she can see for herself, and she has an idea in her
0:38:12 > 0:38:16mind's eye as to what the problem is, and I'm not hiding anything from her.
0:38:16 > 0:38:19You know, it will introduce an element of concern
0:38:19 > 0:38:22and worry for her, but hopefully she'll be reassured that
0:38:22 > 0:38:25we are keeping a very close eye on Charlie.
0:38:25 > 0:38:28Look at that, is that aeroplane? How cool is that?
0:38:30 > 0:38:34OK, now, from the point of view of the scan that was done last week,
0:38:34 > 0:38:37- essentially, it looks very similar to the previous.- OK.
0:38:37 > 0:38:42But there is just a tiny subtle change in appearance.
0:38:42 > 0:38:45This is the one that was done in June.
0:38:45 > 0:38:50And this is the scan that is the one where it shows up more obviously.
0:38:50 > 0:38:53If you just look at that and look at that, you can just
0:38:53 > 0:38:58see that there is just, it looks just a little bit more substantial.
0:38:58 > 0:39:02The area that it's potentially going into,
0:39:02 > 0:39:05is that the motor neuron area, is it back into that a bit more?
0:39:05 > 0:39:07Slightly. Let's just see.
0:39:07 > 0:39:11If, on the next scan, it looks like there is a definite change
0:39:11 > 0:39:14at this point, then I would say first off we would offer more surgery.
0:39:14 > 0:39:17You would suggest surgery rather than chemo or anything?
0:39:17 > 0:39:20Let's just see what it looks like.
0:39:22 > 0:39:25The whole point is, we would want to be able to remove it without
0:39:25 > 0:39:27causing any damage to Charlie.
0:39:27 > 0:39:29That was the whole premise of the first surgery,
0:39:29 > 0:39:31and we want to do the same thing.
0:39:31 > 0:39:34It may be something, it may be nothing.
0:39:38 > 0:39:40'Whilst acknowledging what has happened,
0:39:40 > 0:39:43'for me it's been sort of a survival technique.'
0:39:43 > 0:39:47You couldn't continue to work for 25-30 years as a consultant
0:39:47 > 0:39:51in this job if you absorbed too deeply everything that goes on.
0:39:51 > 0:39:54- Thank you very much.- You're welcome. Take care now. Bye-bye.
0:39:58 > 0:40:00The number of times that you miss
0:40:00 > 0:40:05your child's first nativity play, or parents' evening,
0:40:05 > 0:40:09or sports day, or that dinner date that you had in the diary for ages -
0:40:09 > 0:40:11that is just life, and
0:40:11 > 0:40:14these other events are competing with a sick child, and they will
0:40:14 > 0:40:18never win, you will always stay with a sick child
0:40:18 > 0:40:19before you would go home.
0:40:19 > 0:40:23How are you, champion? Hiya, come in, take a seat.
0:40:23 > 0:40:28- Hi, come in, have a seat. - Come in, have a seat.- Hi, Kevin.
0:40:28 > 0:40:30- Welcome, welcome. - You're looking well, anyway.
0:40:30 > 0:40:32Are you feeling all right today?
0:40:32 > 0:40:36- So, how have things been? - Business as usual, really.
0:40:36 > 0:40:40Hey, Ben, how are you? You all right?
0:40:40 > 0:40:44Back in August, I saw you about the back pain, didn't I?
0:40:44 > 0:40:47- Yes, and I hadn't heard anything since.- Oh, dear!
0:40:53 > 0:40:56We've ordered some blood for you.
0:40:56 > 0:40:58Oh, no. Have I got to stay here?
0:40:58 > 0:41:00Well, we're going to move you to one of our medical wards upstairs
0:41:00 > 0:41:03- where there's a bit of natural light for you.- Oh, yes.
0:41:03 > 0:41:08- So that will be Ward 513.- Oh, yes, I don't know that one.- No, it's OK.
0:41:08 > 0:41:11- Is it lively up there? - Do you like a bit of lively?
0:41:11 > 0:41:14Well, I mean, it's dreary in here.
0:41:14 > 0:41:17It is, it's much more lively up there, and you've got natural
0:41:17 > 0:41:20- daylight as well, which will be good for you.- Thank you, thank you.
0:41:20 > 0:41:22Good luck. You're welcome.
0:41:25 > 0:41:28I don't like the sound of cancer at all.
0:41:30 > 0:41:35- What, the word, or what?- Anything about it, I just don't want to know.
0:41:35 > 0:41:41- What's the prognosis, do you know? - Well, I don't really ask.
0:41:41 > 0:41:42I just say, well,
0:41:42 > 0:41:45I'm not going to have... I don't want the operation.
0:41:45 > 0:41:49It's very, very serious and I'm a bit old for that.
0:41:50 > 0:41:52But there you are, it's no good complaining, is it?
0:41:52 > 0:41:54I've got to a good old age.
0:41:54 > 0:41:58- How old are you now? - 90. Don't mention it!
0:42:00 > 0:42:05- Is it frightening?- Frightening? Oh, yes, when I think about it.
0:42:05 > 0:42:08Well, I don't know why, you've got to die sometime.
0:42:10 > 0:42:13I don't particularly want to die a painful death -
0:42:13 > 0:42:16just to go to bye-byes. If I can.
0:42:18 > 0:42:20They're expecting you at one.
0:42:25 > 0:42:30'My friends have all said, "If it was me, I wouldn't be as brave as
0:42:30 > 0:42:34'"you," but I don't personally think it's about being brave.'
0:42:34 > 0:42:36I think if it was you, you haven't got a choice.
0:42:36 > 0:42:38What would you do otherwise?
0:42:39 > 0:42:42I don't know. I couldn't kill myself.
0:42:42 > 0:42:45You have to do it, it's not about being brave, I don't think.
0:42:47 > 0:42:5210 people under the age of 24 will be diagnosed with cancer today.
0:42:54 > 0:42:57- Do you not feel scared?- No.
0:42:57 > 0:43:00That's one thing I've never felt - scared.
0:43:00 > 0:43:07I'm scared of being sick, that's one thing. No, I've never felt scared.
0:43:09 > 0:43:14Yeah, that's weird, that is, isn't it? My mum is. God, speak to her.
0:43:14 > 0:43:16Bloody hell.
0:43:16 > 0:43:20Like many young people with cancer, Laura was misdiagnosed
0:43:20 > 0:43:23several times before her brain tumour was discovered.
0:43:25 > 0:43:29# Why, why, why, Delilah? #
0:43:31 > 0:43:34A year ago, 17-year-old Dean was told his headaches were just
0:43:34 > 0:43:36migraines.
0:43:36 > 0:43:40# ..Take any mo-o-o-o-ore. #
0:43:43 > 0:43:45All right, Dean?
0:43:47 > 0:43:52Better late than never, hey? Dean is a little star.
0:43:52 > 0:43:56- I love a bit of Tom Jones. Anything else?- Culture Club.- Oh!
0:43:58 > 0:44:02- So, I'm just accessing Dean's line. - My magic line.
0:44:02 > 0:44:05- Your magic line, yeah. - I've had this in 12 months now.
0:44:05 > 0:44:08It's doing well for 12 months, this line, isn't it?
0:44:08 > 0:44:11I'll be happy when it's over so I can start college.
0:44:11 > 0:44:14- That's all I'm hoping to do. - What are you doing at college?
0:44:14 > 0:44:17- Performing arts.- So, what does performing arts involve?
0:44:17 > 0:44:21- Acting, singing, dance. - Perfect for you, Dean!
0:44:21 > 0:44:25I was hoping to start last year in September,
0:44:25 > 0:44:27but I was diagnosed with the cancer
0:44:27 > 0:44:30so I had to go for the treatment, hold it back for another year.
0:44:32 > 0:44:34Was that a real blow?
0:44:34 > 0:44:38Yeah, and I'm just stuck here all the time, I've got nothing to do.
0:44:38 > 0:44:41It's quite isolating, being in on your own.
0:44:42 > 0:44:48It was a brain tumour I was diagnosed with back in August,
0:44:48 > 0:44:54and I had to undergo an operation that lasted 12 hours.
0:44:56 > 0:45:01As you can see, my face is not even.
0:45:01 > 0:45:03Half of my face went because of the operation.
0:45:05 > 0:45:06I used to be able to smile.
0:45:06 > 0:45:11But now if I smile...it's not the same as what it used to be.
0:45:11 > 0:45:14So that kind of works out quite difficult.
0:45:14 > 0:45:16But I always said I'd rather not be able to smile
0:45:16 > 0:45:20and still be alive than if I could smile and I'd be dead.
0:45:22 > 0:45:23And that's how I see it.
0:45:31 > 0:45:34My auntie is downstairs. I'm going to go and tell her and my sister.
0:45:34 > 0:45:36- Are you bringing them back up here?- Yeah.
0:45:36 > 0:45:39I'm going to tell them downstairs
0:45:39 > 0:45:41and then I'm going to bring them up, so we can wait for Mum
0:45:41 > 0:45:46and then we can all be there when they tell Mum what's going on.
0:45:46 > 0:45:49- Do you want to bring them up here and tell them?- Yeah.- Do that then.
0:45:49 > 0:45:51All right, thank you.
0:45:52 > 0:45:54SHE SIGHS
0:45:54 > 0:45:56Hello!
0:45:56 > 0:45:58Hello!
0:45:58 > 0:46:01- I'll take you up to where she is. - All right.
0:46:01 > 0:46:05- They're going to bring her up in a minute.- Yeah.
0:46:06 > 0:46:09- It didn't take long to get here, actually.- Did it not?
0:46:09 > 0:46:13- Couple of hours?- It was quite quick from when I spoke to you.- Yeah.
0:46:13 > 0:46:14It takes two hours.
0:46:14 > 0:46:17So...not too bad at all.
0:46:17 > 0:46:19And there was no traffic, so...
0:46:19 > 0:46:21Oh, that's all right, especially for that time of day.
0:46:21 > 0:46:24- I know.- So...- Is she back up yet?
0:46:24 > 0:46:27- No, they'll bring her up in a minute.- Right.
0:46:27 > 0:46:30How long was she in there for?
0:46:30 > 0:46:35Um, not... About... Just over an hour.
0:46:35 > 0:46:36Oh, right.
0:46:40 > 0:46:42- In here?- Yeah.
0:46:42 > 0:46:44- Her own little room.- Yeah. Want to sit down?
0:46:46 > 0:46:47She didn't have the op.
0:46:49 > 0:46:50Oh, no.
0:46:50 > 0:46:53- HER VOICE BREAKS: - When they opened her up...
0:46:56 > 0:47:00..they found a tumour filling the whole of her pelvis.
0:47:00 > 0:47:04SHE BREAKS DOWN SOBBING
0:47:04 > 0:47:05She'll be all right!
0:47:18 > 0:47:22What's the matter? What are you crying for?
0:47:26 > 0:47:27What's the matter?
0:47:27 > 0:47:29Have they done it?
0:47:29 > 0:47:31They haven't done it, have they?
0:47:41 > 0:47:44They will do it. They are going to do it.
0:47:44 > 0:47:47Mr Pring is going to come up and he's going to tell you
0:47:47 > 0:47:52you know, when they're going to be able to do it again, etc.
0:47:52 > 0:47:55- How did you know they didn't do it? - I had a feeling.
0:47:55 > 0:47:56Right.
0:47:59 > 0:48:03It's just not your day, pet. It's just not meant to be today.
0:48:05 > 0:48:07Mr Pring is still in theatre.
0:48:07 > 0:48:09He won't be able to speak to Lynn
0:48:09 > 0:48:11until he's finished today's operating list.
0:48:20 > 0:48:24Grahame's family is with him as he comes round after his surgery.
0:48:27 > 0:48:30Only now will they know how successful it's been.
0:48:31 > 0:48:34Can you lift your right arm up for me?
0:48:34 > 0:48:36No, your right arm. Your arm.
0:48:38 > 0:48:40You'd no movement in there at all.
0:48:41 > 0:48:43And can you lift this right leg at all?
0:48:43 > 0:48:48He couldn't move it at all earlier on. He couldn't move it at all, could he?
0:48:48 > 0:48:51'Me husband goes out at morning...'
0:48:51 > 0:48:54and you get a phone call saying he's collapsed
0:48:54 > 0:48:55and been taken to hospital.
0:48:58 > 0:49:03So you're just in a blur then. You just do what you have to do.
0:49:03 > 0:49:05Terrible.
0:49:06 > 0:49:08You don't think it's ever going to happen.
0:49:08 > 0:49:11'Well, obviously I'm delighted.
0:49:11 > 0:49:12'I'm interested in what happens to the patient.'
0:49:12 > 0:49:15It's nice to see all the blood come back down the artery.
0:49:15 > 0:49:18But in the end it's actually how the patient is.
0:49:18 > 0:49:21And OK, his speech is a little bit slurred still.
0:49:21 > 0:49:23That's to be expected.
0:49:23 > 0:49:28But to get all that movement back from about six hours ago,
0:49:28 > 0:49:32ten hours ago now in total, is really quite remarkable.
0:49:32 > 0:49:36You know, we would hope to get him back to work.
0:49:36 > 0:49:38It doesn't always go like that
0:49:38 > 0:49:42and that's why it's been a great pleasure to be around today.
0:49:42 > 0:49:44It makes it worth coming to work.
0:49:49 > 0:49:53You sometimes just have to push the boundaries a little bit,
0:49:53 > 0:49:55you know, and it's important that we're able to do that because
0:49:55 > 0:49:58that's how you get advances in medical care.
0:50:06 > 0:50:09- Hello! Hello, Mrs Evans.- Hello.
0:50:09 > 0:50:12Your bed's ready, so we'll get all your stuff packed up
0:50:12 > 0:50:15- and then we'll get you escorted up there.- Oh, good.- Is that all right?
0:50:15 > 0:50:16- Lovely.- All right then.
0:50:17 > 0:50:21In CDU, Jeanette is finally being moved upstairs to her room
0:50:21 > 0:50:23with a view.
0:50:23 > 0:50:27A few doors down, a hospital regular has just been readmitted -
0:50:27 > 0:50:2858-year-old Ken.
0:50:29 > 0:50:31What brought you into hospital?
0:50:31 > 0:50:34Well, me mates phoned the ambulance cos I was throwing up blood
0:50:34 > 0:50:36and everything.
0:50:36 > 0:50:39- You mentioned that you take heroin. Is that right?- Yeah, that's right.
0:50:39 > 0:50:41Heroin and crack cocaine.
0:50:41 > 0:50:43- And do you drink?- Yeah.
0:50:43 > 0:50:46OK, so that's the reason they referred you to us again,
0:50:46 > 0:50:49so we can make sure you're on whatever it is you need to
0:50:49 > 0:50:51be on to stay comfortable while you're here.
0:50:51 > 0:50:55- Yeah. - So how much would you do a day, Ken?
0:50:55 > 0:51:00Er...about 50 quid a day. Depends on how much money we've got.
0:51:01 > 0:51:05- OK, well...- It's an expensive habit, but you just don't get a lot.
0:51:05 > 0:51:06Yeah, OK.
0:51:06 > 0:51:11And in terms of, like, alcohol, how much would you drink a day, Ken?
0:51:11 > 0:51:14I'm on six cans of Skol Super a day.
0:51:14 > 0:51:16- Which is 10%.- Yes.
0:51:16 > 0:51:20A three-litre bottle of White Lightning.
0:51:20 > 0:51:24Plus waking up pouring meself a snakebite.
0:51:24 > 0:51:27All right, well, let's get your meds sorted out for tonight and then
0:51:27 > 0:51:29tomorrow we'll come back and review things, see how you are and
0:51:29 > 0:51:33we'll try and get some kind of plan in place for when they send you home.
0:51:33 > 0:51:36- OK.- All right? - Yeah, thank you.- Thank you.
0:51:37 > 0:51:40A friend of Ken's has turned up at reception
0:51:40 > 0:51:42hoping to pay him a visit.
0:51:43 > 0:51:45- Have you had a drink?- Only one...
0:51:45 > 0:51:47HIS SPEECH IS SLURRED
0:51:47 > 0:51:51I'm sure. Yeah, that's fine. You can write him a little note.
0:51:51 > 0:51:54That's fine, you can write him a little note
0:51:54 > 0:51:57and I'll take it to him, but I won't allow you to see him at the moment.
0:51:57 > 0:52:01He's not feeling very well and he just needs peace and quiet.
0:52:01 > 0:52:03I'll just be outside.
0:52:03 > 0:52:07- We'll try and get him out.- Thank you.
0:52:08 > 0:52:10Hello.
0:52:12 > 0:52:17- Kenneth?- Yeah.- Is that your friend? - Yeah.- I've not let him in.- I know...
0:52:17 > 0:52:19- He's quite drunk.- Yeah, yeah.
0:52:19 > 0:52:22I got him to write you a little note though, cos he's worried about you.
0:52:22 > 0:52:25- Yeah. - I've told him that you're very well.
0:52:25 > 0:52:28I'll go for a smoke, but I've got me coat anyway.
0:52:28 > 0:52:30- You won't have a drink out there, will you?- No, no.
0:52:30 > 0:52:34It would be very dangerous to have some alcohol now.
0:52:34 > 0:52:38Because we're giving you drugs that are supporting you being off the alcohol.
0:52:38 > 0:52:41Hold on, hold on, cos you've got a line that's attached to you.
0:52:41 > 0:52:44So you need to just wait a minute. Your friends can wait.
0:52:44 > 0:52:50You just need to wait for the nursing staff to make sure they're all sorted and get this out, right?
0:52:50 > 0:52:53Can you undo this...please?
0:52:53 > 0:52:57- You will come back, won't ya? - Yeah, course I will.
0:52:57 > 0:53:00- See you in a bit, Kenneth.- OK. - Take care, walk slowly.- I will.
0:53:00 > 0:53:02- How common is that kind of thing? - Very common.
0:53:03 > 0:53:06I'd say about...I don't know, maybe 25%, maybe,
0:53:06 > 0:53:09of our patients are similar.
0:53:09 > 0:53:11I can't really judge, but...
0:53:11 > 0:53:14It's hard when you get them in time and time again.
0:53:14 > 0:53:18That's when it becomes hard, because you give them all the right care and
0:53:18 > 0:53:22medication, treatment, yet they'll just go back out
0:53:22 > 0:53:24and drink again and, but...
0:53:24 > 0:53:28that's their way of life, in and out of hospital, I suppose.
0:53:28 > 0:53:30They've been used to it for years.
0:53:30 > 0:53:33It can be frustrating, Kenneth's lovely, so I don't mind.
0:53:35 > 0:53:36MAN GROANS
0:53:46 > 0:53:50Mr Pring has now finished his fourth weight-loss operation of the day
0:53:50 > 0:53:52and has been able to speak to Lynn.
0:53:55 > 0:53:59So I've just basically said, you know, that we need to do a scan.
0:53:59 > 0:54:03There's something going on in the pelvis. It's probably a tumour.
0:54:03 > 0:54:04We don't know what sort of tumour.
0:54:04 > 0:54:07But everyone in theatre was stunned, so you just don't expect it.
0:54:07 > 0:54:11So it leaves you with a bit of an empty feeling, I have to say.
0:54:12 > 0:54:15- LYNN:- 'Some people go through life and it runs smoothly
0:54:15 > 0:54:19'and they get what they want when they want how they want.'
0:54:19 > 0:54:23Our family's always had to fight all the way for everything that we've had.
0:54:26 > 0:54:28Another challenge to get over.
0:54:28 > 0:54:30WOMAN: You can do it.
0:54:30 > 0:54:33She's come in for one problem, we've uncovered another problem
0:54:33 > 0:54:36and then tomorrow, another day in the NHS,
0:54:36 > 0:54:38we'll set about sorting out her other problem.
0:54:38 > 0:54:42And she'll get the scans and the tests and the expert opinion.
0:54:43 > 0:54:48It's incredible that she's got this big care blanket around her
0:54:48 > 0:54:50that's going to look after her.
0:55:10 > 0:55:15- Mr Lawrence is outside with two intoxicated friends.- Oh, dear. OK.
0:55:15 > 0:55:18- Do you want me to bring him back in?- No, he's fine.
0:55:18 > 0:55:20He's assured me he's not going to have a drink,
0:55:20 > 0:55:23but he's had Chlordiazepoxide, so it will be dangerous if he has a drink.
0:55:23 > 0:55:26Now, where has he gone?
0:55:26 > 0:55:30It's the end of Liz's shift, but she's concerned about Ken.
0:55:30 > 0:55:32He's been missing since his visitor arrived.
0:55:34 > 0:55:36Where has he gone?
0:55:39 > 0:55:42I might get security to just have a little walk round,
0:55:42 > 0:55:44because if he's not obviously out here...
0:55:46 > 0:55:50I don't suppose anybody thinks
0:55:50 > 0:55:53when they come into nursing that that's what they'll spend a portion
0:55:53 > 0:55:57of their day doing, but it is the reality of what I spend my day doing.
0:55:57 > 0:55:58Night!
0:56:02 > 0:56:03NURSE: Thank you.
0:56:05 > 0:56:07- I'll be about tomorrow, yeah? - Right.
0:56:09 > 0:56:11Kenneth?
0:56:11 > 0:56:13Ken? Kenneth, back in now, mate.
0:56:13 > 0:56:15OK.
0:56:25 > 0:56:30They tried to get me off smoking, trying to get you off the heroin,
0:56:30 > 0:56:32they're trying to get you off the drink...
0:56:32 > 0:56:37If God meant them to have their way, you wouldn't do nothing, would ya?
0:56:38 > 0:56:42If they want to spend their money on drugs, then fair enough.
0:56:42 > 0:56:45It's their money, they're earning it. You know...
0:56:45 > 0:56:49But what about when you end up in hospital and they have to try
0:56:49 > 0:56:50and pick up the pieces?
0:56:50 > 0:56:52Well, yeah, that is a point.
0:56:52 > 0:56:55That is a very good point.
0:56:55 > 0:56:57OK, that, I can quite understand that.
0:57:00 > 0:57:03Ken, what's that in your pocket, mate?
0:57:03 > 0:57:05- Which?- Ken, what's that in your pocket?
0:57:07 > 0:57:10I didn't know that was there! That's from yesterday, that is!
0:57:10 > 0:57:13You can't have that in hospital, mate. I'll have to take that off you.
0:57:13 > 0:57:18- Do you want a blanket round you, mate?- No...- Sure? Sit down for me, please.
0:57:27 > 0:57:29Ken's chest problem needs monitoring
0:57:29 > 0:57:32so a space has been found for him on a ward upstairs.
0:57:32 > 0:57:35Freeing up a bed for another day in CDU.
0:58:31 > 0:58:34Subtitles by Red Bee Media Ltd