Episode 1 Keeping Britain Alive: The NHS in a Day


Episode 1

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This programme contains some strong language and scenes which some viewers may find upsetting

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18th of October 2012.

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Across Britain, a hundred cameras are filming the NHS on a single day.

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'This change will be a disaster.'

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On this day, more than one and a half million of us will be treated.

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Three days ago you had a stroke.

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1,500 of us will die.

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2,000 will be born.

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WHISTLE BLOWS

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The NHS is the largest public healthcare system in the world.

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We want that to be in your voice all the time.

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Can I help you?

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-We rely on it...

-Be really brave.

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..complain about it...

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And in the bin. That's because of you.

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..often we take it for granted.

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Lucas! Lucas!

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What we expect from the NHS is ever-increasing.

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But money to pay for it isn't.

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If we could see what this institution does in

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a single day...

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..what would it make us think?

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This entire series tells the story of one day...

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So why isn't she waking up?

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..100 cameras

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capturing the NHS as you've never seen it before.

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Baby born at five to three.

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-RADIO:

-'Good morning, everyone.

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'Thursday the 18th of October.'

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That's it. And again.

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WOMAN GROANS

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-Not wanting to wait no longer.

-It's probably because they're busy.

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-It's not my fault they're so busy.

-I appreciate that.

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All I've come here for is cos you're walking down here with a gown on.

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I just want to make sure you're all right to go home.

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I'm fine. Yeah, but I'm not waiting that long.

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-I've been waiting probably an hour.

-An hour?

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-All you've been waiting is an hour?

-All? All?

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Yeah, but it's an Accident and Emergency department.

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-It takes a while to process people.

-It does indeed.

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But it's more of an accident,

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cos there's a lack of staff there that can help people.

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OK, can you tell me your name?

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-No.

-What's your name?

-Don't worry about me. Are you a police officer?

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No, no. I just want to make sure you're aware enough to make the decision to discharge yourself.

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-That's all.

-I'm fine.

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-You're all right?

-Yeah.

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OK, I can't stop you from leaving

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-if you're well enough to take yourself.

-Good night.

-OK.

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'My first priority was that he was safe to go home.

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'If he's safe to go home and he's got capacity,

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'I'm not going to persuade him to come back in,'

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but it's interesting that he dialled an ambulance,

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it's interesting that he came to A & E.

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'He's waited an hour and he's left. That's completely unreasonable.'

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One of my children does that when they are... How old was he? 19, 20?

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If they do that, I will absolutely hang, draw and quarter them.

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That's a waste of public resources an unacceptable way to behave,

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and not how I've brought up my children.

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Liz runs the Clinical Decision Unit, or CDU.

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Most large hospitals now have one.

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They help avoid unnecessary admissions and

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take pressure off A & E departments.

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It's almost like a big filter for the hospital.

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You come in here, we will decide whether you actually need

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a hospital bed or we'll filter you off home again to make sure that the

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only people that are in hospital are people that really need to be here.

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Well, I know she'll go home.

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I looked at her yesterday in A & E and we'll sit her out this morning.

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Is there anybody else that's obvious that we can sit out?

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-Here.

-Oh, no.

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Not again! She hasn't got the police with her today?

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She has, but she's under 136.

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So, what did you take last night?

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Honestly, please, my love.

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I'm going to get one of the consultants to see you.

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-Is she on a section now?

-We haven't sectioned her.

-You haven't? Good.

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OK. I'm going to get the doctors to come and see you

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and you will be discharged this morning. All right?

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So, it doesn't look like she's actually taken an overdose

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of what she says she's taken. She's a very regular patient.

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The issue is, for us, is that anyone who's says they've taken

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an overdose, we have to take seriously.

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We have to do everything as if they're completely genuine

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and make sure she's safe.

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-MAN:

-Does she just like to come into hospital?

-Yeah.

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Liz's next patient is a 27-year-old who

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woke in the night with severe pain and came straight to A & E.

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Past two days I've had a pain underneath the chest.

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You've come to us with some chest pain, is that right?

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And kind of a bit of an irregular feeling,

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like your heartbeat's irregular.

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Everything's absolutely normal, but what we need to do is do this

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blood test, which will rule out any damage to your heart.

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We'll take you round the corner, but just bear with us.

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All right? OK. Fabulous.

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'It's incredibly unlikely that there is anything wrong with his heart.'

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It does happen, but very rare.

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Yeah, when you don't know what it is

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and it's around your heart area, you need to come and see a doctor.

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You can find anything on the internet.

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I've regularly got a brain tumour if I look on the internet.

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He kept me awake all night just to

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talk to him, to keep him calm a bit.

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-He was really scared.

-I was, yeah. I was. I was definitely scared.

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He thought he was going to die and everything, he did.

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I don't think they know what it is, to be honest.

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LIZ: 'I don't think, as a society, we're very stoical any more.'

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The minute you feel slightly unwell, you don't go see your GP, you don't

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go and see your pharmacist, you come straight to the emergency department.

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But you can't have an NHS that picks up everything,

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otherwise it will cease to function.

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SIREN BLARES

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She definitely has got her teeth stuck in her throat.

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So remember how that's still a lot better

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-than before the first operation.

-Yes.

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Come and sit down, Alice. Oh, right.

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OK, so I'm going to start at the beginning as usual.

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Your sex drive. What's that like?

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SIREN BLARES

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We've got a 20-year-old motorcyclist versus car.

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Do you remember everything that's happened?

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It's been a busy morning in Leeds A & E,

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when a 64-year-old man who's collapsed at work is rushed in.

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He's paralysed down one side and unable to speak.

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-Brian? Hello, there.

-Hello.

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My name's Robin, I'm one of the nurses.

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It looks like he's probably had some kind of stroke or something

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that's gone on in his head,

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either a clot or some kind of bleed in his head.

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Brian...

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-Is it Brian?

-Graham.

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Graham? I've been calling him Brian.

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I thought you said Graham.

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Can you lift this arm up for me?

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Can you lift this arm up? Graham?

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Can you lift your arm up in the air for me?

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GRAHAM MUMBLES

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He's unable to converse with us at this moment in time.

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He's got a dense right-sided weakness.

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He's confused and unable to actually physically tell us what's wrong.

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I know it's really scary. We just need to take some blood from you, OK?

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And then we're going to take you for a scan of your brain, OK?

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The words that he's using are just not making any sense at all.

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GRAHAM MUMBLES

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Say that again, Graham.

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Just ten minutes after arriving at hospital,

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Graham's brain is scanned to find out what caused his collapse.

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Oh, it's a big clot. Ooh.

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Right-side weakness. Look at that.

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You can see that is a high density. So that is a clot.

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Can we get somebody to ring the GP, get the GP history out of him

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and screen the results over.

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What I'm going to do is, I'm going to go from his groin,

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go up into his head on his left side, get into the vessel

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and then first see what the problem is and see

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whether I can take it out and then I'll go inside and I'll use

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the special stent, which you can actually pull the clot.

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So we're going to try and use those stents to pull the clot out.

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It's like a plumbing job - the drain is not going to open,

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so you have to suck it and take it out.

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There's a term that we use - time is brain.

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So the quicker we do stuff, the quicker we can get things done,

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the more brain and the more of the person can survive.

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OK. Now then, just look at my face. Look at me.

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With millions of brain cells dying every minute,

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Graham's given a clot-busting drug while the surgical team prepare.

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-Can you see my hand moving?

-I've stopped all the other cases.

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He's going to be the top priority now.

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I've got an anaesthetist here with me now,

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so what we're going to do, the main idea is to put him to sleep very quickly.

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And then we're going to try and get this done.

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Hello? We're just going to pop this blood pressure cuff back on, OK?

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If we don't do it, basically the brain is starved of oxygen,

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so you've got to take the block, so the blood flow gets back

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and the oxygen gets back. That's what you're trying to do.

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You're getting oxygen back into the brain.

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You OK? I'm Dr Patankar, I'm the consultant, OK?

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What we're planning to do is, you're in this room here

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where we're going to try and remove the clot from your head.

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Everybody's used to this, OK? All right?

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You're in the right place at the right time

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and we'll get you better, OK?

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Right? See you soon, all right?

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Graham is one of around 400 people who will suffer

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a stroke in Britain today.

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Try and keep your eyes open for as long as you can.

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One in five will die.

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Around half of them will be left disabled.

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One, two, three.

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-RADIO:

-'Now this morning,

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'confusion about David Cameron's plan to make energy...'

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'..cheaper fuel deals.'

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BABY CRIES

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-Hello. How are you?

-A bit nervous.

-Are you?

-Yeah.

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This is Sarah, my oldest daughter.

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She's had the gastric sleeve

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and she's lost 11 stone since 2010.

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Though it doesn't look like it.

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Oh, it does. It does. It does.

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All set.

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48-year-old Lynn weighs 20 stone.

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She's battled with her weight for years.

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The start of my new life.

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Later today, she'll become the third member of her family

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to have weight loss surgery.

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-How are you feeling?

-Nerves, bit anxious.

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Just looking forward to the end result, really.

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You know, waiting for it to be over.

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I've had a comment on Facebook saying that people

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who are overweight are lazy, they should get off their backsides

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and lose weight normally and not cost the NHS money.

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They should save up and pay for it themselves.

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That upset me, actually, that comment, last night.

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I see that. Hasn't affected you this morning, though, has it?

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No, because it's something that I need for a better way of life.

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I mean, I've got to find something different to do at the weekends now,

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cos we used to go out for dinner.

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Obviously, I will be able to do that, but smaller portions.

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But for the while I won't be able to go to a restaurant.

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At the end of the day, they don't understand what people go through.

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Definitely not the easy option.

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-RADIO:

-'Psychological counselling around their eating habits

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'and nearly a fifth of patients were readmitted within six months...'

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'some needing further operations. The report was carried out by

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'the National Confidential Enquiry into Patient Outcome and Death.

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'Ian Martin is...'

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I quite like, basically, neck of femurs, in the older generation.

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Attending to them. OK.

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Purely because you're helping the older generation that don't normally call out for any sort of help.

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-Oh, I better get rid of this.

-Yeah.

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We get a call now, we've got to go and you've got to get rid of that.

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That bin over there?

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I'm sure this gets longer, Doctor.

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Well, thank you for coming to the clinic today. How have you been?

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Not so good.

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I'm not sleeping at all, because the sleep apnoea's waking me up.

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My back's got more worse.

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Whereas I used to go out all the time,

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I only go out for an hour of a morning.

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You also went to see a cardiologist. What happened with that?

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He gave me a letter, recommending the gastric band.

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Your letter to them said I'd be on as much as £30,000 worth

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of medication and treatment a year,

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annually,

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if they don't do the operation.

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That's wasting a lot of money.

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I'll save them money, have your tablets back

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and give me the operation.

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I need something done now.

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The problem is, when we applied for it,

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they felt that you do not qualify

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what is called a comorbidity criteria.

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Comorbidity means other conditions accompanying weight problems.

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I've got everything they asked me to have except one.

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That was the diabetes.

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The problem that we have is where you are from, the West Midlands,

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has got one of the highest levels of obesity in Europe.

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So if they funded everybody who was eligible,

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then the NHS in the West Midlands would be bankrupt.

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So if I moved to Birmingham...

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No, you wouldn't. It's the West Midlands.

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-You have to move outside the West Midlands.

-It's not fair.

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Lynn lives in the South East, Britain's slimmest region,

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which funds more weight loss surgery than anywhere in the country.

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How are you feeling?

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Shaky?

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In the NHS, the number of these weight loss operations has

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quadrupled in the last six years.

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The surgery costs £10,000.

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Obesity in this country has doubled in the last 20 years.

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That is an epidemic. You know, the messages are all very confused.

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Shops are open 24 hours a day, seven days a week.

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The Olympic Games was sponsored by McDonald's.

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So society is now organised in such a way

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that it's just making us all bigger.

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Morning, ladies.

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The cost of obesity to the NHS is about £4 billion a year.

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The cost of diabetes is £10 billion a year

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and that's related to obesity.

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So whilst surgery itself isn't cheap, after two to three years,

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we'll start saving money.

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-Is this your daughter?

-My daughter. She had a gastric sleeve.

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-Did you?

-I did.

-Wow.

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No problems?

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SARAH LAUGHS

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Yeah.

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I had a blood vessel to my stomach burst,

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so I had to have emergency surgery.

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-Oh, no.

-Yes. I very nearly died.

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I was doing the crossword, I dropped my pen and I thought,

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"I'm not going to call a nurse just to pick up a pen."

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So I bent down, I felt a little pop,

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"Oh, maybe it was just gas."

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And yes, my stomach burst.

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Gosh. That was traumatic.

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I hope it will be nice and straightforward today.

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It was that bad that they allowed my cousin

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and my husband at the time to come up to the top floor to say

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goodbye and they don't usually let family go up to the top floor.

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-MAN:

-Is that one of the reasons that you're quite nervous?

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Yeah, I think...

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I mean, you hear stories about any operation, don't you,

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but there's always a bad one to go with a good one.

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-Bye.

-Bye, see you later.

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-You've got pneumonia.

-Yes, so they told me.

-Good.

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-You're getting better.

-Good, good.

-OK.

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Because he knows that the doctor told me

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if I didn't get better I'd die.

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Well, that's...

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And I thought, "Well, at 89, who cares?"

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The October weather means Liz and the team in CDU

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are busy juggling beds.

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They've already seen 50 patients today, many of them elderly.

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I know, but to get you home, we need a relative.

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People are getting older

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and treatments are getting more sophisticated and we can make

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people live longer, but whether we should or not is another question.

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People are aware of it, but they're just not aware of how much it

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affects frontline services day in, day out, day in, day out.

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-Hello, Mrs Evans.

-Hello.

-This is the team looking after you today.

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-Over the last few weeks, have you felt more tired or breathless?

-Yes.

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-Yes. Has that been gradually getting worse?

-Yes.

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OK. I think you've had an operation

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-and a number of tests on the colon before, haven't you?

-I'm not sure.

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-I don't think so. Breast cancer.

-They had the breast cancer.

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-Yes, that was done.

-Then there was the colon one as well.

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Nobody said a word about that.

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-Nobody said anything about that.

-No.

0:18:500:18:52

You have problems with your memory a little bit recently.

0:18:520:18:55

At the moment, I can't remember anything twice.

0:18:550:18:58

I think, because you got a bit anaemic, it might be worth us

0:18:580:19:02

giving you a couple of pints of blood to top you up.

0:19:020:19:05

Oh, not again.

0:19:050:19:06

The honest truth is I don't think there's an awful lot more that

0:19:060:19:09

I can do to slow it down.

0:19:090:19:13

-The only thing I don't like here is no daylight.

-No, I agree with you.

0:19:130:19:17

This is totally the wrong room for you

0:19:170:19:19

and we'll find you a room with some daylight.

0:19:190:19:21

-Oh, please.

-All right.

-Yes, thank you.

0:19:210:19:24

MAN: How long have you been poorly?

0:19:240:19:27

I don't really know.

0:19:270:19:30

Last Christmas it started, I think, or just before.

0:19:300:19:34

And I went in because I thought I'd broken my hip

0:19:360:19:39

and it was to do all this...

0:19:390:19:43

I don't know what it is.

0:19:430:19:45

I don't like it, anyway.

0:19:450:19:46

I don't think anybody likes to be poorly, do they?

0:19:460:19:50

No. Well, that's the pleasure of growing old.

0:19:500:19:53

You can't have both.

0:19:530:19:55

-That's Bernard, my husband.

-Oh, I've got to sit down.

0:19:550:19:59

-Yes, I know you have.

-Before I fall down.

0:19:590:20:01

Sorry to drag you out.

0:20:010:20:03

I'm not quite sure why I'm in here.

0:20:050:20:07

They're making a clinical decision about what's going to happen to you.

0:20:070:20:13

What is going to happen to me?

0:20:130:20:15

They're either going to put you in the ward, I suppose, or send you home.

0:20:150:20:20

She's got this bowel cancer

0:20:200:20:22

and we've got to face up to the fact that she is in a very bad

0:20:220:20:28

position and we make the best of it while we can, what's left to us.

0:20:280:20:33

When you get to my age,

0:20:330:20:36

you appreciate the fact that you haven't got much longer to go.

0:20:360:20:40

-What?

-That you haven't got much longer to go.

0:20:410:20:45

-You're going to pop your clogs sometime.

-Of course we are.

0:20:450:20:49

MONITORS BEEP

0:21:080:21:11

OK, forward.

0:21:220:21:24

She's trying to get an access into the groin,

0:21:240:21:27

so she's going to get into the artery.

0:21:270:21:29

And this is a little bit difficult, because he's big.

0:21:290:21:32

It's going to be a little bit tricky.

0:21:320:21:34

But she's good.

0:21:340:21:35

She's got access now and everything we're going to do is from the groin.

0:21:350:21:38

OK?

0:21:380:21:40

Two hours ago, 64-year-old Graham was rushed to A & E with

0:21:400:21:43

a clot in his brain.

0:21:430:21:44

It's going to be a problem.

0:21:440:21:46

The team need to remove the clot before Graham suffers

0:21:460:21:48

permanent brain damage.

0:21:480:21:50

OK, wire forward, please.

0:21:500:21:52

Dr Patankar will try and remove the clot using a procedure he's

0:21:520:21:55

only been performing for ten months.

0:21:550:21:58

He's going to access Graham's brain through an artery in his groin.

0:21:580:22:02

It's a risky operation that only a handful of hospitals perform.

0:22:020:22:06

So now I have to find my way. It's like driving a car.

0:22:060:22:10

You're trying to get your car parked in the vessel

0:22:100:22:14

in the left side of the neck.

0:22:140:22:16

So I'm going to try and see how his blood vessels are.

0:22:160:22:19

OK? Lovely. Happy with that?

0:22:300:22:33

The treatment has been there for a long time.

0:22:330:22:37

Retrieving clots in other parts of the body had been going on.

0:22:370:22:40

But for stroke, of late,

0:22:400:22:41

it has been promoted in the last year a lot more.

0:22:410:22:46

The main issue, what we've got to try and do is

0:22:470:22:50

get blood flow back to that part of the brain

0:22:500:22:53

that's not working,

0:22:530:22:54

so the left hemisphere,

0:22:540:22:56

which controls language and the power to the right side of the body.

0:22:560:23:01

The critical thing is to try and get the clot out of the middle

0:23:010:23:04

cerebral artery, which is providing bloods to that area of the brain.

0:23:040:23:08

So that's what's happening at the moment.

0:23:080:23:10

What's the success rate?

0:23:100:23:12

Don't ask now.

0:23:140:23:16

Life is full of surprises.

0:23:160:23:18

Everybody ready?

0:23:250:23:27

This is the clot here, huh, John?

0:23:270:23:29

I'm actually through the clot.

0:23:290:23:30

I can feel it, you know? It's not easy, because you can't see anything.

0:23:300:23:34

Everything is blind, everything is in my head.

0:23:340:23:37

Believe me, this is stressful.

0:23:370:23:39

Come on, guys.

0:23:390:23:40

OK. Oh, don't come back, baby.

0:23:460:23:49

Bingo.

0:23:510:23:52

-Ah! Succeeded. Lovely.

-Excellent.

-Brilliant.

0:23:530:23:58

What's happened is, his brain needed perfusion, right?

0:23:580:24:02

I have opened it now, so the perfusion is there

0:24:020:24:05

and now we can go back in and try and take the clot out.

0:24:050:24:08

Something has come. Let's clean that up.

0:24:080:24:11

The final challenge is to pull

0:24:110:24:13

the entire clot back through Graham's body.

0:24:130:24:15

If at any point the clot breaks up,

0:24:150:24:18

it could trigger another stroke.

0:24:180:24:20

Lovely.

0:24:240:24:26

There's clot everywhere. OK.

0:24:260:24:30

Lovely. Oh, look at that.

0:24:350:24:37

Brilliant, man.

0:24:370:24:39

I'm so pleased. John, happy?

0:24:390:24:43

-Yeah.

-Yeah? Nice, isn't it?

0:24:440:24:48

Yeah. It looks good.

0:24:480:24:50

God, that was so much clot, wasn't it? Everywhere.

0:24:510:24:54

The clot was just everywhere. Everything came out. Look at that.

0:24:540:24:59

Four hours and £16,000 later,

0:25:020:25:05

blood flow has been restored to Graham's brain.

0:25:050:25:08

Money is an issue. I mean, these are expensive.

0:25:080:25:11

How much money have I spent here? Quite a bit.

0:25:110:25:14

But I think it's still worth it,

0:25:140:25:15

for the man who has paid his taxes for his life.

0:25:150:25:18

I would want it, wouldn't you?

0:25:180:25:20

I pay taxes. I pay 50% tax.

0:25:200:25:22

And I need to have this treatment if I get a stroke.

0:25:220:25:26

No system is perfect,

0:25:260:25:27

but the ability to do this sort of thing would not be available in

0:25:270:25:31

other healthcare systems to anybody who just came in off the street.

0:25:310:25:37

I don't know this gentleman, I've never met him,

0:25:370:25:39

I don't know what his background is.

0:25:390:25:42

And that just doesn't matter.

0:25:420:25:44

We just get on and treat him.

0:25:440:25:46

But the success of this operation is still unknown.

0:25:460:25:50

It's not so much whether they survive these events or not,

0:25:500:25:54

but most people have got a real fear of being left with

0:25:540:25:57

severe neurological disability.

0:25:570:26:00

Although it's very good we've got blood coming

0:26:000:26:02

down the artery, what really matters is what's happened to the brain

0:26:020:26:06

and we will not know that until the anaesthetic has been reversed and

0:26:060:26:13

we actually wake him up

0:26:130:26:14

and actually see what the residual problems will be.

0:26:140:26:17

And just let it go. OK.

0:26:240:26:27

So you're doing this four times.

0:26:270:26:29

Slowly and gently, mindfully bringing your breath in...

0:26:290:26:33

..and then breathing out.

0:26:340:26:35

A breath in...

0:26:370:26:39

OK, let's cover her up.

0:26:430:26:44

Is there any next of kin on that phone yet?

0:26:510:26:54

I can't find anybody on his phone either, but I presume we've

0:26:540:26:57

looked on Portal, have we, to see if he's known anywhere?

0:26:570:27:02

Liz and her team in CDU have now seen 67 patients today.

0:27:030:27:09

So, what's your GP worried about?

0:27:090:27:11

Well, he reckons it could be some sort of

0:27:110:27:15

leakage in the valves in my heart.

0:27:150:27:18

OK. What I'm going to do is have a quick press on your tummy, if that's all right?

0:27:180:27:21

Yeah. She does have a murmur, Kate.

0:27:230:27:26

We need to get you to be seen by the cardiologist,

0:27:260:27:29

so the doctors who look after the heart.

0:27:290:27:30

Pure fat, I know. I'm too fat.

0:27:300:27:34

Is that why I've got this problem?

0:27:340:27:37

No, I don't think so.

0:27:370:27:39

Danny has been here for seven hours complaining of chest pain.

0:27:410:27:44

Daisy, who's the doctor, is going to come and see you.

0:27:440:27:47

She's just looking at the chest X-ray on the computer

0:27:470:27:49

and then she'll be with you, OK?

0:27:490:27:51

Do you know how long that's going to be?

0:27:510:27:52

As long as it takes to look at a chest X-ray.

0:27:520:27:54

So it shouldn't be too long.

0:27:540:27:56

-I want to go.

-That's awful.

0:27:560:28:01

How long does it take to look at an X-ray?

0:28:010:28:03

-Oh, there you go. It's done.

-Oh, right.

0:28:030:28:06

Should be done now, then.

0:28:060:28:07

LIZ: A lot of the health campaigns in the past have said,

0:28:070:28:10

"If you have chest pain, go to hospital."

0:28:100:28:13

What they didn't say was

0:28:130:28:14

if you have no risk factors and you're young,

0:28:140:28:17

the likelihood of you needing to go to hospital are small.

0:28:170:28:20

But that campaign was hugely successful

0:28:200:28:22

and it's stuck in people's minds.

0:28:220:28:24

The majority of them just need to go home and take a paracetamol

0:28:240:28:26

and see if it settles.

0:28:260:28:28

Hello. Right. Do you want to sit down for me?

0:28:290:28:31

So the good news is that all your blood tests are back

0:28:310:28:34

and they're absolutely fine.

0:28:340:28:35

-Your chest X-ray looked completely fine as well.

-So what is it, then?

0:28:350:28:40

-What's a chest X-ray?

-No, I mean what's this pain?

0:28:400:28:42

Can I have a quick look at you? Examine you?

0:28:420:28:45

-Would that be all right?

-Yeah.

0:28:450:28:46

If I press on there, is that painful?

0:28:460:28:49

-Slightly here.

-Slightly there. OK.

0:28:490:28:52

Sometimes people can get a little bit of inflammation down there,

0:28:520:28:56

which is something we call costochondritis,

0:28:560:28:59

which is just a fancy word for saying a little bit of

0:28:590:29:01

inflammation in the cartilage which joins the ribs to the breastbone.

0:29:010:29:06

So is it just something that's going to pass?

0:29:060:29:08

Yeah. Ibuprofen and paracetamol.

0:29:080:29:09

-Good.

-Thank you very much.

-No worries.

-Cheers.

0:29:090:29:13

-MAN: How are you feeling now?

-Relieved, mainly.

0:29:160:29:21

Have you any idea how much

0:29:210:29:25

that process that you've been through cost?

0:29:250:29:29

I wouldn't have a clue, no.

0:29:290:29:32

No idea how much it would cost for me to sit in the room, no.

0:29:320:29:36

No. The thought didn't cross my mind.

0:29:380:29:41

We take it for granted, don't we?

0:29:410:29:44

Of course we do. All of us.

0:29:440:29:46

We know they're here for us, no matter what.

0:29:460:29:50

We expect them to be here for us, no matter what.

0:29:500:29:54

And they are, which is really good.

0:29:570:30:00

Is the wound still bleeding freely?

0:30:080:30:10

-Ah-ah-ah.

-Super.

0:30:150:30:17

Hello, Lynne. You've brought all this in?

0:30:250:30:29

That's my daughter, she's with me.

0:30:290:30:32

-Yes.

-She's had her sleeve done.

-Yes.

0:30:320:30:34

She is due to have it done next year. And that's my youngest one.

0:30:340:30:38

Goodness me.

0:30:380:30:39

So, let's go through it all.

0:30:410:30:42

So this is the consent form for your operation.

0:30:420:30:45

Like all surgery, there are risks, this is no different.

0:30:450:30:48

The mortality risk with this operation is about one in 500.

0:30:480:30:51

The risk of a problem is one in 100.

0:30:510:30:54

They are all those risks, they are very low risks,

0:30:540:30:57

but obviously I have to tell you all that and then you just sign there.

0:30:570:31:00

-Signature to my new life.

-That's it.

0:31:000:31:03

Good for you. All right, we'll see you in a bit.

0:31:030:31:07

See you in a bit. Bye.

0:31:070:31:09

So, when did you have your operation?

0:31:100:31:12

I had mine in May 2010, but I had the sleeve,

0:31:120:31:16

-which is just one down from a bypass.

-You look great.

0:31:160:31:21

That's what I'm looking forward to - the confidence, you know?

0:31:210:31:25

Get a life.

0:31:250:31:26

'It's interesting, isn't it?'

0:31:260:31:27

All of her daughters have obesity, one's had an operation,

0:31:270:31:32

one's waiting for an operation. It does tend to cluster in families.

0:31:320:31:37

That's not genetic so much, it's more an environmental issue.

0:31:370:31:41

But there is still a huge amount of prejudice towards obesity

0:31:410:31:46

and it's grossly unfair.

0:31:460:31:47

If you see somebody who is obese, you just do not know what has led

0:31:470:31:53

that person to that point in their life.

0:31:530:31:56

And it's very unfair to judge people on those grounds.

0:31:560:31:59

I had a very nasty comment made yesterday that the money

0:31:590:32:03

should be spent on people that needed heart transplants.

0:32:030:32:06

They judge you before they even know you. They don't know your story.

0:32:060:32:11

Lucy hasn't got diabetes yet,

0:32:110:32:13

but if she doesn't have this then she will have it.

0:32:130:32:16

It wouldn't be just for diabetes, it would be numerous things,

0:32:160:32:19

and I would be going to the NHS to solve those problems.

0:32:190:32:21

And how much would that cost?

0:32:210:32:23

At the end of the day, we're going to have the last laugh. Definitely.

0:32:230:32:27

We'll have the last laugh. And we'll be happy.

0:32:270:32:30

-And that's the main thing.

-Yeah!

0:32:300:32:31

Do you want to just pop that on for me? It does up at the back.

0:32:310:32:35

And then we'll get you down to theatre shortly.

0:32:350:32:37

I'll make sure I've got all your notes together. There we go.

0:32:370:32:41

'Do you think this kind of operation is a waste of NHS resources?'

0:32:410:32:45

Definitely not. Definitely not.

0:32:450:32:47

Hi.

0:32:470:32:49

'You see them a year, two years later,'

0:32:490:32:52

they're not actually a drain on the NHS any more.

0:32:520:32:55

They become an active member of the community

0:32:550:32:58

and they're out there working and doing something with their lives.

0:32:580:33:03

It's just giving them their life back.

0:33:030:33:05

They're happy, and happy is the key word,

0:33:050:33:08

because a lot of my patients aren't happy when they come in.

0:33:080:33:11

-I'm getting really nervous now.

-I'm sure you are.

0:33:130:33:16

Now, you're going to start feeling

0:33:320:33:34

like you've had a bottle or so of wine.

0:33:340:33:36

-I know it's a bit early in the day.

-Feel it now?

0:33:360:33:39

We'll see you in a couple of hours.

0:33:420:33:44

Out with the old and in with the new!

0:33:540:33:56

I've done 600 of these before, and I'll hopefully do this one

0:34:000:34:04

exactly as I have done the last 600. We don't like surprises.

0:34:040:34:08

So you ate in the Park Tavern last night, did you?

0:34:080:34:12

Richie was there, was he, and Louisa? So, mainly our team.

0:34:120:34:16

And Joe, yeah, yeah.

0:34:160:34:17

-Where was my invitation?

-Eh?

-Where was my invitation?!

0:34:170:34:20

New surgical techniques over the last 10 years have reduced

0:34:240:34:27

the cost of operations like Lynne's and improved recovery time.

0:34:270:34:31

This is all done with keyhole surgery.

0:34:340:34:37

This is our telescope, so these are the eyes for the operation,

0:34:370:34:41

and it puts a picture up on the screen. We'll start off here.

0:34:410:34:46

So everything that you see that's yellow is fat, fat, fat.

0:34:460:34:50

Then we get onto muscle here, there is a muscle layer. Muscle layer.

0:34:510:34:56

Muscle layer. OK, and that is into the abdominal cavity now.

0:34:570:35:03

Here we go, so we are inside her abdomen.

0:35:060:35:09

She's not got a great liver, look. Lots of little bits and bobs on it.

0:35:090:35:15

Come down this side, Anna, if we could just take the port out,

0:35:150:35:18

take the camera out.

0:35:180:35:19

-Something weird.

-There's something there.

-Yep.

0:35:210:35:23

Go back a little bit. OK, she has got a mass.

0:35:280:35:32

What sort of mass is it?

0:35:350:35:36

I'm not sure I'm going to carry on with her,

0:35:400:35:43

-cos I think she's got a cancer.

-She's got a mass.

0:35:430:35:45

Look, she's got a big pelvic mass.

0:35:470:35:49

-I wondered what was going on in her liver.

-It did look like a mass.

0:35:490:35:52

-She has got a tumour of some sort. I think it's ovarian.

-Yeah.

0:35:580:36:03

I think she's got an ovarian tumour.

0:36:030:36:06

So I'm not going to do anything more for her.

0:36:060:36:08

It would be wrong for me to plough on with an operation

0:36:080:36:11

when there could be some other pathology that is significant.

0:36:110:36:16

She wouldn't have known about it, we wouldn't have known about it.

0:36:170:36:20

Very difficult to even feel it, to be honest with you.

0:36:200:36:23

But, you know, that is entirely unusual, so that is a shock to us

0:36:230:36:29

all, it will be a shock to her, poor love, when I tell her. It's tough.

0:36:290:36:34

We'll see what it is. Bit upset by that, to be honest.

0:36:350:36:39

Poor Lynne, you know? Anyway, let's find out what it is first.

0:36:390:36:42

We can't speculate just yet.

0:36:420:36:44

'That's the first time I've found what I think is a cancer'

0:36:460:36:49

whilst doing an operation. She's only 48.

0:36:490:36:52

Only 48.

0:36:560:36:57

'Makes you think, it makes you reflect.'

0:37:040:37:06

We are all subject to these problems. Let's wait and see.

0:37:060:37:10

If that's a cancer, then she's got a battle on her hands.

0:37:100:37:15

So I'm going to go speak to her daughter now.

0:37:180:37:21

-Have you not got any pennies with you?

-Have you got no money?

0:37:320:37:35

10 months ago, neurosurgeon Sasha Burn operated on three-year-old

0:37:350:37:39

Charlie to remove a tumour from his brain.

0:37:390:37:41

Today, at her weekly clinic, she will tell his family

0:37:430:37:45

if he's got the all clear.

0:37:450:37:47

When Charlie's mum comes into clinic,

0:37:470:37:49

all she's really going to want me to say is the scan looks fantastic

0:37:490:37:52

and there's no changes, but in all likelihood, she may

0:37:520:37:56

sense that there is some doubt in my voice or what have you,

0:37:560:37:59

and will know straight away that there might be an issue, and

0:37:590:38:03

so it's about me telling her openly and directly what we think, showing

0:38:030:38:06

her the scan so she can see for herself, and she has an idea in her

0:38:060:38:12

mind's eye as to what the problem is, and I'm not hiding anything from her.

0:38:120:38:16

You know, it will introduce an element of concern

0:38:160:38:19

and worry for her, but hopefully she'll be reassured that

0:38:190:38:22

we are keeping a very close eye on Charlie.

0:38:220:38:25

Look at that, is that aeroplane? How cool is that?

0:38:250:38:28

OK, now, from the point of view of the scan that was done last week,

0:38:300:38:34

-essentially, it looks very similar to the previous.

-OK.

0:38:340:38:37

But there is just a tiny subtle change in appearance.

0:38:370:38:42

This is the one that was done in June.

0:38:420:38:45

And this is the scan that is the one where it shows up more obviously.

0:38:450:38:50

If you just look at that and look at that, you can just

0:38:500:38:53

see that there is just, it looks just a little bit more substantial.

0:38:530:38:58

The area that it's potentially going into,

0:38:580:39:02

is that the motor neuron area, is it back into that a bit more?

0:39:020:39:05

Slightly. Let's just see.

0:39:050:39:07

If, on the next scan, it looks like there is a definite change

0:39:070:39:11

at this point, then I would say first off we would offer more surgery.

0:39:110:39:14

You would suggest surgery rather than chemo or anything?

0:39:140:39:17

Let's just see what it looks like.

0:39:170:39:20

The whole point is, we would want to be able to remove it without

0:39:220:39:25

causing any damage to Charlie.

0:39:250:39:27

That was the whole premise of the first surgery,

0:39:270:39:29

and we want to do the same thing.

0:39:290:39:31

It may be something, it may be nothing.

0:39:310:39:34

'Whilst acknowledging what has happened,

0:39:380:39:40

'for me it's been sort of a survival technique.'

0:39:400:39:43

You couldn't continue to work for 25-30 years as a consultant

0:39:430:39:47

in this job if you absorbed too deeply everything that goes on.

0:39:470:39:51

-Thank you very much.

-You're welcome. Take care now. Bye-bye.

0:39:510:39:54

The number of times that you miss

0:39:580:40:00

your child's first nativity play, or parents' evening,

0:40:000:40:05

or sports day, or that dinner date that you had in the diary for ages -

0:40:050:40:09

that is just life, and

0:40:090:40:11

these other events are competing with a sick child, and they will

0:40:110:40:14

never win, you will always stay with a sick child

0:40:140:40:18

before you would go home.

0:40:180:40:19

How are you, champion? Hiya, come in, take a seat.

0:40:190:40:23

-Hi, come in, have a seat.

-Come in, have a seat.

-Hi, Kevin.

0:40:230:40:28

-Welcome, welcome.

-You're looking well, anyway.

0:40:280:40:30

Are you feeling all right today?

0:40:300:40:32

-So, how have things been?

-Business as usual, really.

0:40:320:40:36

Hey, Ben, how are you? You all right?

0:40:360:40:40

Back in August, I saw you about the back pain, didn't I?

0:40:400:40:44

-Yes, and I hadn't heard anything since.

-Oh, dear!

0:40:440:40:47

We've ordered some blood for you.

0:40:530:40:56

Oh, no. Have I got to stay here?

0:40:560:40:58

Well, we're going to move you to one of our medical wards upstairs

0:40:580:41:00

-where there's a bit of natural light for you.

-Oh, yes.

0:41:000:41:03

-So that will be Ward 513.

-Oh, yes, I don't know that one.

-No, it's OK.

0:41:030:41:08

-Is it lively up there?

-Do you like a bit of lively?

0:41:080:41:11

Well, I mean, it's dreary in here.

0:41:110:41:14

It is, it's much more lively up there, and you've got natural

0:41:140:41:17

-daylight as well, which will be good for you.

-Thank you, thank you.

0:41:170:41:20

Good luck. You're welcome.

0:41:200:41:22

I don't like the sound of cancer at all.

0:41:250:41:28

-What, the word, or what?

-Anything about it, I just don't want to know.

0:41:300:41:35

-What's the prognosis, do you know?

-Well, I don't really ask.

0:41:350:41:41

I just say, well,

0:41:410:41:42

I'm not going to have... I don't want the operation.

0:41:420:41:45

It's very, very serious and I'm a bit old for that.

0:41:450:41:49

But there you are, it's no good complaining, is it?

0:41:500:41:52

I've got to a good old age.

0:41:520:41:54

-How old are you now?

-90. Don't mention it!

0:41:540:41:58

-Is it frightening?

-Frightening? Oh, yes, when I think about it.

0:42:000:42:05

Well, I don't know why, you've got to die sometime.

0:42:050:42:08

I don't particularly want to die a painful death -

0:42:100:42:13

just to go to bye-byes. If I can.

0:42:130:42:16

They're expecting you at one.

0:42:180:42:20

'My friends have all said, "If it was me, I wouldn't be as brave as

0:42:250:42:30

'"you," but I don't personally think it's about being brave.'

0:42:300:42:34

I think if it was you, you haven't got a choice.

0:42:340:42:36

What would you do otherwise?

0:42:360:42:38

I don't know. I couldn't kill myself.

0:42:390:42:42

You have to do it, it's not about being brave, I don't think.

0:42:420:42:45

10 people under the age of 24 will be diagnosed with cancer today.

0:42:470:42:52

-Do you not feel scared?

-No.

0:42:540:42:57

That's one thing I've never felt - scared.

0:42:570:43:00

I'm scared of being sick, that's one thing. No, I've never felt scared.

0:43:000:43:07

Yeah, that's weird, that is, isn't it? My mum is. God, speak to her.

0:43:090:43:14

Bloody hell.

0:43:140:43:16

Like many young people with cancer, Laura was misdiagnosed

0:43:160:43:20

several times before her brain tumour was discovered.

0:43:200:43:23

# Why, why, why, Delilah? #

0:43:250:43:29

A year ago, 17-year-old Dean was told his headaches were just

0:43:310:43:34

migraines.

0:43:340:43:36

# ..Take any mo-o-o-o-ore. #

0:43:360:43:40

All right, Dean?

0:43:430:43:45

Better late than never, hey? Dean is a little star.

0:43:470:43:52

-I love a bit of Tom Jones. Anything else?

-Culture Club.

-Oh!

0:43:520:43:56

-So, I'm just accessing Dean's line.

-My magic line.

0:43:580:44:02

-Your magic line, yeah.

-I've had this in 12 months now.

0:44:020:44:05

It's doing well for 12 months, this line, isn't it?

0:44:050:44:08

I'll be happy when it's over so I can start college.

0:44:080:44:11

-That's all I'm hoping to do.

-What are you doing at college?

0:44:110:44:14

-Performing arts.

-So, what does performing arts involve?

0:44:140:44:17

-Acting, singing, dance.

-Perfect for you, Dean!

0:44:170:44:21

I was hoping to start last year in September,

0:44:210:44:25

but I was diagnosed with the cancer

0:44:250:44:27

so I had to go for the treatment, hold it back for another year.

0:44:270:44:30

Was that a real blow?

0:44:320:44:34

Yeah, and I'm just stuck here all the time, I've got nothing to do.

0:44:340:44:38

It's quite isolating, being in on your own.

0:44:380:44:41

It was a brain tumour I was diagnosed with back in August,

0:44:420:44:48

and I had to undergo an operation that lasted 12 hours.

0:44:480:44:54

As you can see, my face is not even.

0:44:560:45:01

Half of my face went because of the operation.

0:45:010:45:03

I used to be able to smile.

0:45:050:45:06

But now if I smile...it's not the same as what it used to be.

0:45:060:45:11

So that kind of works out quite difficult.

0:45:110:45:14

But I always said I'd rather not be able to smile

0:45:140:45:16

and still be alive than if I could smile and I'd be dead.

0:45:160:45:20

And that's how I see it.

0:45:220:45:23

My auntie is downstairs. I'm going to go and tell her and my sister.

0:45:310:45:34

-Are you bringing them back up here?

-Yeah.

0:45:340:45:36

I'm going to tell them downstairs

0:45:360:45:39

and then I'm going to bring them up, so we can wait for Mum

0:45:390:45:41

and then we can all be there when they tell Mum what's going on.

0:45:410:45:46

-Do you want to bring them up here and tell them?

-Yeah.

-Do that then.

0:45:460:45:49

All right, thank you.

0:45:490:45:51

SHE SIGHS

0:45:520:45:54

Hello!

0:45:540:45:56

Hello!

0:45:560:45:58

-I'll take you up to where she is.

-All right.

0:45:580:46:01

-They're going to bring her up in a minute.

-Yeah.

0:46:010:46:05

-It didn't take long to get here, actually.

-Did it not?

0:46:060:46:09

-Couple of hours?

-It was quite quick from when I spoke to you.

-Yeah.

0:46:090:46:13

It takes two hours.

0:46:130:46:14

So...not too bad at all.

0:46:140:46:17

And there was no traffic, so...

0:46:170:46:19

Oh, that's all right, especially for that time of day.

0:46:190:46:21

-I know.

-So...

-Is she back up yet?

0:46:210:46:24

-No, they'll bring her up in a minute.

-Right.

0:46:240:46:27

How long was she in there for?

0:46:270:46:30

Um, not... About... Just over an hour.

0:46:300:46:35

Oh, right.

0:46:350:46:36

-In here?

-Yeah.

0:46:400:46:42

-Her own little room.

-Yeah. Want to sit down?

0:46:420:46:44

She didn't have the op.

0:46:460:46:47

Oh, no.

0:46:490:46:50

-HER VOICE BREAKS:

-When they opened her up...

0:46:500:46:53

..they found a tumour filling the whole of her pelvis.

0:46:560:47:00

SHE BREAKS DOWN SOBBING

0:47:000:47:04

She'll be all right!

0:47:040:47:05

What's the matter? What are you crying for?

0:47:180:47:22

What's the matter?

0:47:260:47:27

Have they done it?

0:47:270:47:29

They haven't done it, have they?

0:47:290:47:31

They will do it. They are going to do it.

0:47:410:47:44

Mr Pring is going to come up and he's going to tell you

0:47:440:47:47

you know, when they're going to be able to do it again, etc.

0:47:470:47:52

-How did you know they didn't do it?

-I had a feeling.

0:47:520:47:55

Right.

0:47:550:47:56

It's just not your day, pet. It's just not meant to be today.

0:47:590:48:03

Mr Pring is still in theatre.

0:48:050:48:07

He won't be able to speak to Lynn

0:48:070:48:09

until he's finished today's operating list.

0:48:090:48:11

Grahame's family is with him as he comes round after his surgery.

0:48:200:48:24

Only now will they know how successful it's been.

0:48:270:48:30

Can you lift your right arm up for me?

0:48:310:48:34

No, your right arm. Your arm.

0:48:340:48:36

You'd no movement in there at all.

0:48:380:48:40

And can you lift this right leg at all?

0:48:410:48:43

He couldn't move it at all earlier on. He couldn't move it at all, could he?

0:48:430:48:48

'Me husband goes out at morning...'

0:48:480:48:51

and you get a phone call saying he's collapsed

0:48:510:48:54

and been taken to hospital.

0:48:540:48:55

So you're just in a blur then. You just do what you have to do.

0:48:580:49:03

Terrible.

0:49:030:49:05

You don't think it's ever going to happen.

0:49:060:49:08

'Well, obviously I'm delighted.

0:49:080:49:11

'I'm interested in what happens to the patient.'

0:49:110:49:12

It's nice to see all the blood come back down the artery.

0:49:120:49:15

But in the end it's actually how the patient is.

0:49:150:49:18

And OK, his speech is a little bit slurred still.

0:49:180:49:21

That's to be expected.

0:49:210:49:23

But to get all that movement back from about six hours ago,

0:49:230:49:28

ten hours ago now in total, is really quite remarkable.

0:49:280:49:32

You know, we would hope to get him back to work.

0:49:320:49:36

It doesn't always go like that

0:49:360:49:38

and that's why it's been a great pleasure to be around today.

0:49:380:49:42

It makes it worth coming to work.

0:49:420:49:44

You sometimes just have to push the boundaries a little bit,

0:49:490:49:53

you know, and it's important that we're able to do that because

0:49:530:49:55

that's how you get advances in medical care.

0:49:550:49:58

-Hello! Hello, Mrs Evans.

-Hello.

0:50:060:50:09

Your bed's ready, so we'll get all your stuff packed up

0:50:090:50:12

-and then we'll get you escorted up there.

-Oh, good.

-Is that all right?

0:50:120:50:15

-Lovely.

-All right then.

0:50:150:50:16

In CDU, Jeanette is finally being moved upstairs to her room

0:50:170:50:21

with a view.

0:50:210:50:23

A few doors down, a hospital regular has just been readmitted -

0:50:230:50:27

58-year-old Ken.

0:50:270:50:28

What brought you into hospital?

0:50:290:50:31

Well, me mates phoned the ambulance cos I was throwing up blood

0:50:310:50:34

and everything.

0:50:340:50:36

-You mentioned that you take heroin. Is that right?

-Yeah, that's right.

0:50:360:50:39

Heroin and crack cocaine.

0:50:390:50:41

-And do you drink?

-Yeah.

0:50:410:50:43

OK, so that's the reason they referred you to us again,

0:50:430:50:46

so we can make sure you're on whatever it is you need to

0:50:460:50:49

be on to stay comfortable while you're here.

0:50:490:50:51

-Yeah.

-So how much would you do a day, Ken?

0:50:510:50:55

Er...about 50 quid a day. Depends on how much money we've got.

0:50:550:51:00

-OK, well...

-It's an expensive habit, but you just don't get a lot.

0:51:010:51:05

Yeah, OK.

0:51:050:51:06

And in terms of, like, alcohol, how much would you drink a day, Ken?

0:51:060:51:11

I'm on six cans of Skol Super a day.

0:51:110:51:14

-Which is 10%.

-Yes.

0:51:140:51:16

A three-litre bottle of White Lightning.

0:51:160:51:20

Plus waking up pouring meself a snakebite.

0:51:200:51:24

All right, well, let's get your meds sorted out for tonight and then

0:51:240:51:27

tomorrow we'll come back and review things, see how you are and

0:51:270:51:29

we'll try and get some kind of plan in place for when they send you home.

0:51:290:51:33

-OK.

-All right?

-Yeah, thank you.

-Thank you.

0:51:330:51:36

A friend of Ken's has turned up at reception

0:51:370:51:40

hoping to pay him a visit.

0:51:400:51:42

-Have you had a drink?

-Only one...

0:51:430:51:45

HIS SPEECH IS SLURRED

0:51:450:51:47

I'm sure. Yeah, that's fine. You can write him a little note.

0:51:470:51:51

That's fine, you can write him a little note

0:51:510:51:54

and I'll take it to him, but I won't allow you to see him at the moment.

0:51:540:51:57

He's not feeling very well and he just needs peace and quiet.

0:51:570:52:01

I'll just be outside.

0:52:010:52:03

-We'll try and get him out.

-Thank you.

0:52:030:52:07

Hello.

0:52:080:52:10

-Kenneth?

-Yeah.

-Is that your friend?

-Yeah.

-I've not let him in.

-I know...

0:52:120:52:17

-He's quite drunk.

-Yeah, yeah.

0:52:170:52:19

I got him to write you a little note though, cos he's worried about you.

0:52:190:52:22

-Yeah.

-I've told him that you're very well.

0:52:220:52:25

I'll go for a smoke, but I've got me coat anyway.

0:52:250:52:28

-You won't have a drink out there, will you?

-No, no.

0:52:280:52:30

It would be very dangerous to have some alcohol now.

0:52:300:52:34

Because we're giving you drugs that are supporting you being off the alcohol.

0:52:340:52:38

Hold on, hold on, cos you've got a line that's attached to you.

0:52:380:52:41

So you need to just wait a minute. Your friends can wait.

0:52:410:52:44

You just need to wait for the nursing staff to make sure they're all sorted and get this out, right?

0:52:440:52:50

Can you undo this...please?

0:52:500:52:53

-You will come back, won't ya?

-Yeah, course I will.

0:52:530:52:57

-See you in a bit, Kenneth.

-OK.

-Take care, walk slowly.

-I will.

0:52:570:53:00

-How common is that kind of thing?

-Very common.

0:53:000:53:02

I'd say about...I don't know, maybe 25%, maybe,

0:53:030:53:06

of our patients are similar.

0:53:060:53:09

I can't really judge, but...

0:53:090:53:11

It's hard when you get them in time and time again.

0:53:110:53:14

That's when it becomes hard, because you give them all the right care and

0:53:140:53:18

medication, treatment, yet they'll just go back out

0:53:180:53:22

and drink again and, but...

0:53:220:53:24

that's their way of life, in and out of hospital, I suppose.

0:53:240:53:28

They've been used to it for years.

0:53:280:53:30

It can be frustrating, Kenneth's lovely, so I don't mind.

0:53:300:53:33

MAN GROANS

0:53:350:53:36

Mr Pring has now finished his fourth weight-loss operation of the day

0:53:460:53:50

and has been able to speak to Lynn.

0:53:500:53:52

So I've just basically said, you know, that we need to do a scan.

0:53:550:53:59

There's something going on in the pelvis. It's probably a tumour.

0:53:590:54:03

We don't know what sort of tumour.

0:54:030:54:04

But everyone in theatre was stunned, so you just don't expect it.

0:54:040:54:07

So it leaves you with a bit of an empty feeling, I have to say.

0:54:070:54:11

-LYNN:

-'Some people go through life and it runs smoothly

0:54:120:54:15

'and they get what they want when they want how they want.'

0:54:150:54:19

Our family's always had to fight all the way for everything that we've had.

0:54:190:54:23

Another challenge to get over.

0:54:260:54:28

WOMAN: You can do it.

0:54:280:54:30

She's come in for one problem, we've uncovered another problem

0:54:300:54:33

and then tomorrow, another day in the NHS,

0:54:330:54:36

we'll set about sorting out her other problem.

0:54:360:54:38

And she'll get the scans and the tests and the expert opinion.

0:54:380:54:42

It's incredible that she's got this big care blanket around her

0:54:430:54:48

that's going to look after her.

0:54:480:54:50

-Mr Lawrence is outside with two intoxicated friends.

-Oh, dear. OK.

0:55:100:55:15

-Do you want me to bring him back in?

-No, he's fine.

0:55:150:55:18

He's assured me he's not going to have a drink,

0:55:180:55:20

but he's had Chlordiazepoxide, so it will be dangerous if he has a drink.

0:55:200:55:23

Now, where has he gone?

0:55:230:55:26

It's the end of Liz's shift, but she's concerned about Ken.

0:55:260:55:30

He's been missing since his visitor arrived.

0:55:300:55:32

Where has he gone?

0:55:340:55:36

I might get security to just have a little walk round,

0:55:390:55:42

because if he's not obviously out here...

0:55:420:55:44

I don't suppose anybody thinks

0:55:460:55:50

when they come into nursing that that's what they'll spend a portion

0:55:500:55:53

of their day doing, but it is the reality of what I spend my day doing.

0:55:530:55:57

Night!

0:55:570:55:58

NURSE: Thank you.

0:56:020:56:03

-I'll be about tomorrow, yeah?

-Right.

0:56:050:56:07

Kenneth?

0:56:090:56:11

Ken? Kenneth, back in now, mate.

0:56:110:56:13

OK.

0:56:130:56:15

They tried to get me off smoking, trying to get you off the heroin,

0:56:250:56:30

they're trying to get you off the drink...

0:56:300:56:32

If God meant them to have their way, you wouldn't do nothing, would ya?

0:56:320:56:37

If they want to spend their money on drugs, then fair enough.

0:56:380:56:42

It's their money, they're earning it. You know...

0:56:420:56:45

But what about when you end up in hospital and they have to try

0:56:450:56:49

and pick up the pieces?

0:56:490:56:50

Well, yeah, that is a point.

0:56:500:56:52

That is a very good point.

0:56:520:56:55

OK, that, I can quite understand that.

0:56:550:56:57

Ken, what's that in your pocket, mate?

0:57:000:57:03

-Which?

-Ken, what's that in your pocket?

0:57:030:57:05

I didn't know that was there! That's from yesterday, that is!

0:57:070:57:10

You can't have that in hospital, mate. I'll have to take that off you.

0:57:100:57:13

-Do you want a blanket round you, mate?

-No...

-Sure? Sit down for me, please.

0:57:130:57:18

Ken's chest problem needs monitoring

0:57:270:57:29

so a space has been found for him on a ward upstairs.

0:57:290:57:32

Freeing up a bed for another day in CDU.

0:57:320:57:35

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0:58:310:58:34

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