0:00:03 > 0:00:07This programme contains scenes which some viewers may find upsetting.
0:00:12 > 0:00:1418th of October 2012.
0:00:16 > 0:00:21Across Britain, 100 cameras are filming the NHS on a single day.
0:00:21 > 0:00:26THROUGH MEGAPHONE: This change will be a disaster.
0:00:26 > 0:00:29On this day, more than 1.5 million of us will be treated.
0:00:31 > 0:00:34Three days ago you had a stroke.
0:00:34 > 0:00:361,500 of us will die.
0:00:37 > 0:00:392,000 will be born.
0:00:41 > 0:00:43ALARM SOUNDS
0:00:43 > 0:00:48The NHS is the largest public healthcare system in the world.
0:00:48 > 0:00:52We want that to be in your voice... WITH LIGHTER PITCH: ..all the time.
0:00:52 > 0:00:54Hello, we're going to help you.
0:00:54 > 0:00:56- 'We rely on it.'- Be really brave.
0:00:56 > 0:00:59- 'Complain about it.'- In the bin. That's because of you.
0:00:59 > 0:01:04- 'Often we take it for granted.' - Lucas. Lucas!
0:01:04 > 0:01:08What we expect from the NHS is ever increasing.
0:01:08 > 0:01:10The money to pay for it isn't.
0:01:12 > 0:01:18If we could see what this institution does in a single day,
0:01:18 > 0:01:21what would it make us think?
0:01:21 > 0:01:24This entire series tells the story of one day.
0:01:25 > 0:01:27So why isn't she waking up?
0:01:27 > 0:01:30100 cameras,
0:01:30 > 0:01:34capturing the NHS as you've never seen it before.
0:01:34 > 0:01:35Baby born at five to three.
0:01:48 > 0:01:50RADIO: Eight o'clock, Thursday the 18th of October...
0:01:50 > 0:01:54..to allow my hand to go inside your tummy.
0:02:08 > 0:02:11I just love this drive to work in the mornings.
0:02:13 > 0:02:17And you never quite know what you're going to see.
0:02:17 > 0:02:18There's a deer.
0:02:18 > 0:02:21Look, two, three. There they go.
0:02:23 > 0:02:25They come right up to the road.
0:02:25 > 0:02:29There's another one, look, big deer, straight ahead.
0:02:31 > 0:02:33Chris Abell is a GP on a remote island
0:02:33 > 0:02:35off the west coast of Scotland.
0:02:36 > 0:02:40He's one of three doctors responsible for 3,500 islanders.
0:02:42 > 0:02:46Here on Islay it's slightly different from other places as a GP,
0:02:46 > 0:02:50because we're the only doctors here and the nearest hospital is...
0:02:50 > 0:02:54nearest big hospital is Glasgow. Which is a plane flight away.
0:02:54 > 0:02:58So any serious illnesses, accidents,
0:02:58 > 0:03:02we will see, which is unusual for GPs.
0:03:02 > 0:03:05It's one of the things that makes me slightly anxious
0:03:05 > 0:03:08when I'm going into work, thinking about what might happen.
0:03:23 > 0:03:26At the UK's largest dedicated brain hospital,
0:03:26 > 0:03:31lead surgeon Andrew McEvoy has just one patient on his list this morning.
0:03:32 > 0:03:36So, the operation that we're doing today is on a patient of ours
0:03:36 > 0:03:38called Darrell Gittings.
0:03:38 > 0:03:44He's a man probably in his mid-40s who unfortunately in 2008
0:03:44 > 0:03:47had a brain tumour diagnosed.
0:03:50 > 0:03:54Erm, an operation was done to remove some of the volume of that tumour
0:03:54 > 0:03:58but unfortunately the tumour has come back.
0:03:58 > 0:04:02For Darrell this is going to be one of the most important days of his life.
0:04:05 > 0:04:08Nine o'clock, and by God, would I love a cup of tea right now.
0:04:08 > 0:04:12Gagging for a cuppa, but I'm not allowed.
0:04:12 > 0:04:17Yeah, good roast pork dinner. And a pint of real ale.
0:04:18 > 0:04:22Previous operations elsewhere, one of which cost Darrell his leg after
0:04:22 > 0:04:26a post-operative blood clot, have reduced but not removed the tumour.
0:04:26 > 0:04:31So, to simplify it for people who aren't educated to tumours,
0:04:31 > 0:04:34mine is known as an astrocytoma, so if I was to give somebody
0:04:34 > 0:04:40a really easy lesson, think of astro, the star.
0:04:40 > 0:04:45So think of a round tumour, but then add, like, spider legs to it,
0:04:45 > 0:04:47and that's what goes off into the brain
0:04:47 > 0:04:49and makes it difficult to treat.
0:04:49 > 0:04:53When Darrell started developing new symptoms, his local health authority
0:04:53 > 0:04:58in Wales supported a referral for specialist treatment in London.
0:04:58 > 0:05:00So, this is Darrell's latest scan.
0:05:00 > 0:05:04And you can see immediately that there is a huge
0:05:04 > 0:05:06difference between this side and this side.
0:05:06 > 0:05:09And this is the area where he'd normally speak from,
0:05:09 > 0:05:15and you can see that there is a huge big solid mass of tumour,
0:05:15 > 0:05:17I think probably with a little cyst.
0:05:17 > 0:05:21What has been put to Darrell and what is the truth
0:05:21 > 0:05:23is that if we do nothing here
0:05:23 > 0:05:27that this tumour is going to result in him losing his speech.
0:05:29 > 0:05:32Darrell's fully aware this is not a curable situation, erm,
0:05:32 > 0:05:37that at some point in his life this tumour is going to get him.
0:05:37 > 0:05:40And what we're trying to do is give him more time
0:05:40 > 0:05:43and improve his quality of life.
0:05:43 > 0:05:44I want them to take...
0:05:44 > 0:05:47I'd like them to take 100% of the tumour but they can't
0:05:47 > 0:05:50because of the spidering off of the tumour.
0:05:50 > 0:05:54But if they can remove 80% to 90%, that will be wonderful.
0:05:54 > 0:05:56That will be better than winning the Lottery to me,
0:05:56 > 0:05:59better than anything else.
0:05:59 > 0:06:01- Ha, ha, ha!- Ha, ha, ha.
0:06:03 > 0:06:04Just there?
0:06:04 > 0:06:06SHE SIGHS
0:06:06 > 0:06:08Morning in the mortuary. Love it.
0:06:16 > 0:06:19If you'd just...just relax for me.
0:06:19 > 0:06:22I'm just going to press on your rib cage, all right?
0:06:22 > 0:06:27On Islay, Dr Abell has a much smaller list of patients than most GPs.
0:06:27 > 0:06:29You again?
0:06:29 > 0:06:31- Yeah, it's me again! - THEY LAUGH
0:06:31 > 0:06:33Come down.
0:06:33 > 0:06:38'One of the things that I think is just terribly important in general practice'
0:06:38 > 0:06:42is...personal knowledge of patients.
0:06:42 > 0:06:44'And...continuity.'
0:06:44 > 0:06:48There's a sort of an element of, "Oh, how nice, it's somebody I know."
0:06:48 > 0:06:54And it just makes the whole process more personal and...better.
0:06:54 > 0:06:57Mrs McPhee, was I meant to be doing a flu jab?
0:06:59 > 0:07:02Although emergencies are rare, this small island has its own
0:07:02 > 0:07:06ten-bed hospital with a fully equipped A&E department.
0:07:06 > 0:07:10Today, Dr Abell is the only doctor on call for emergencies.
0:07:10 > 0:07:15It's not that it's always dreadfully busy. Sometimes it's not busy at all.
0:07:15 > 0:07:19But sometimes it is. But it's still... You have to be there.
0:07:19 > 0:07:23You have to be ready and you have to be available.
0:07:24 > 0:07:26Bizarre.
0:07:27 > 0:07:31An hour into his morning surgery, an emergency case comes in.
0:07:32 > 0:07:35Oh, I've just had to go down to A&E.
0:07:35 > 0:07:39A patient who has been brought up possibly having swallowed
0:07:39 > 0:07:41her bottom set of dentures.
0:07:41 > 0:07:44A carer has brought in one of her more vulnerable patients...
0:07:44 > 0:07:48- Can I come in?- ..'convinced she's swallowed her false teeth.'
0:07:48 > 0:07:51But an X-ray proves inconclusive.
0:07:51 > 0:07:53I actually think that it's probably a case of
0:07:53 > 0:07:57what they're meant to have swallowed has actually been lost rather than
0:07:57 > 0:07:58gone down their throat.
0:07:58 > 0:08:01But it's extremely difficult to tell, and it's one of those odd things
0:08:01 > 0:08:06that comes up when you're covering A&E as well as doing your surgery.
0:08:06 > 0:08:08The patient's carer is still worried.
0:08:08 > 0:08:12It's just, where are the teeth? She never takes them out once they're in.
0:08:12 > 0:08:15I think it would be really helpful if you could have a good look for them.
0:08:15 > 0:08:17I will. That's the first thing I'm doing now.
0:08:19 > 0:08:22Dr Abell promises to re-examine the patient at home in a few hours.
0:08:22 > 0:08:24Mr Stuart, please.
0:08:24 > 0:08:26- Did you have a busy morning out there?- Very busy.
0:08:26 > 0:08:30I'm sorry I'm late, I've just had to be sorting somebody out in A&E.
0:08:30 > 0:08:33- No, that's all right, that's grand. - In you come.- Cheers.
0:08:47 > 0:08:51- So are you going to be called any minute now?- Yeah, any minute.
0:08:51 > 0:08:54For the trolley or whatever you want to call it.
0:08:54 > 0:08:59The chair, trolley, whatever. Running a bit late, and, er...
0:08:59 > 0:09:01Yeah, get on with it.
0:09:02 > 0:09:05Darrell's three sons are waiting at home in Wales.
0:09:05 > 0:09:09But his wife is spending the day in a hotel nearby.
0:09:09 > 0:09:11We tend not to see each other on the day
0:09:11 > 0:09:14because we upset each other too much.
0:09:14 > 0:09:20And I want him to be going into surgery with a positive outlook
0:09:20 > 0:09:25and not with just me... blubbering before he goes in.
0:09:25 > 0:09:30He needs to be positive and knowing that I'm being positive as well.
0:09:30 > 0:09:34But if we saw each other this morning then, you know,
0:09:34 > 0:09:37he'd only get upset and I get upset and...
0:09:37 > 0:09:39It's...
0:09:39 > 0:09:46To us, it feels unlucky. To be seen... You know, to see each other.
0:09:46 > 0:09:48It's like your wedding day.
0:09:50 > 0:09:54That you don't see each other first thing before you get married.
0:09:54 > 0:10:00I don't want to see him until he's out of that theatre and that he's awake and he's well.
0:10:09 > 0:10:12It's a high-risk procedure, this,
0:10:12 > 0:10:17you know, and we're obviously very concerned about the damage that we could cause here.
0:10:17 > 0:10:22My biggest fear here is that he comes off the operating table
0:10:22 > 0:10:25much worse than he goes on to the operating table.
0:10:27 > 0:10:30To minimise the risk to Darrell's speech,
0:10:30 > 0:10:33he'll need to be monitored during the operation.
0:10:33 > 0:10:36Unfortunately for Darrell, this means he'll be woken up
0:10:36 > 0:10:39and asked to talk while the surgery continues.
0:10:42 > 0:10:44You make a decision.
0:10:44 > 0:10:47You lie down and die or you stand up and fight, and you fight like hell.
0:10:47 > 0:10:50Well, I've chosen to fight. I can't stop fighting.
0:10:50 > 0:10:54I fight because I love my family, let alone I love myself
0:10:54 > 0:10:56because I'm vain! And that's true!
0:10:56 > 0:10:58And I love what I do in my life personally.
0:10:58 > 0:11:02It's what I love to do with my family and I want to see them develop.
0:11:04 > 0:11:08Darrell will be anaesthetised to allow surgeons to open up his skull.
0:11:08 > 0:11:10Open your eyes for me.
0:11:10 > 0:11:13Once his brain is exposed, he'll be woken.
0:11:13 > 0:11:15The reason for doing him awake
0:11:15 > 0:11:18is that when we start taking out the brain tumour, we'll test him
0:11:18 > 0:11:21throughout so that we can make sure we're not damaging as we go.
0:11:23 > 0:11:26- OK, we're all ready. - Ready? One, two, three.
0:11:26 > 0:11:27There you go.
0:11:29 > 0:11:32I think it's going to end up being a struggle.
0:11:39 > 0:11:41He-llo.
0:11:52 > 0:11:56- Very busy, isn't it?- Always is.- Yep.
0:11:56 > 0:11:58# BHBN Hospital Radio! #
0:11:58 > 0:12:04- Would you like a song on the radio tonight?- Hotel California.- By?
0:12:04 > 0:12:07- Eagles.- Eagles, of course it is.- The extended version.
0:12:07 > 0:12:11- The extended version.- Dedicated to my wife, Lisa Jones.- Lisa.
0:12:11 > 0:12:14- Thank you very much, thank you. - Lisa Jones.
0:12:14 > 0:12:16Get well soon, Lisa, from everybody at BHBN.
0:12:16 > 0:12:19We're getting requests that are going to be broadcast
0:12:19 > 0:12:22this evening on BHBN Hospital Radio.
0:12:22 > 0:12:24It's a vital part of being in a hospital.
0:12:24 > 0:12:27- Hospital radio is important. - I agree, totally. Well said.
0:12:29 > 0:12:30Hello!
0:12:30 > 0:12:32My name is Ciaran and this is Olly
0:12:32 > 0:12:36and we're from BHBN Hospital Radio.
0:12:36 > 0:12:38Would you like a song?
0:12:38 > 0:12:42Or would you like us to choose you one? Bob Marley?
0:12:42 > 0:12:45- Hmm.- Get well soon from everybody at BHBN.
0:12:45 > 0:12:47How many do you think we have?
0:12:47 > 0:12:52- 11?- 12.- That's perfect. That's absolutely perfect.
0:12:55 > 0:12:58That is absolutely perfect, that's really good.
0:12:58 > 0:13:02AMBULANCE SIREN
0:13:08 > 0:13:12This guy. Yeah, oh yeah, she's a post-op.
0:13:12 > 0:13:16INAUDIBLE MUTTERING
0:13:18 > 0:13:2258-year-old Laura was admitted to intensive care three days ago
0:13:22 > 0:13:25after she collapsed from a brain haemorrhage.
0:13:25 > 0:13:30Her husband Pat has been by her bedside ever since.
0:13:32 > 0:13:37Laura was being interviewed for a... for a job,
0:13:37 > 0:13:41and during the interview she lost feeling in her left leg
0:13:41 > 0:13:47and they phoned first-aiders and they came and recommended an ambulance.
0:13:48 > 0:13:53And they assessed her very quickly, and sent her down here for surgery.
0:13:55 > 0:13:59And so they, erm, they operated to relieve the pressure on the brain
0:13:59 > 0:14:02and remove the blood, and, erm, she's been...
0:14:02 > 0:14:05she's been recovering ever since. So, to now.
0:14:06 > 0:14:10Since her operation, Laura has been in an induced coma.
0:14:12 > 0:14:15This morning, doctors will stop her sedatives
0:14:15 > 0:14:18to see if she'll wake up of her own accord.
0:14:18 > 0:14:23We have no concept at this moment in time how much of a...
0:14:23 > 0:14:26of a more general hit
0:14:26 > 0:14:28her brain encountered during this haemorrhage.
0:14:28 > 0:14:33For example we've no idea what she will be like from a cognitive
0:14:33 > 0:14:40point of view, erm, or...or even to what degree she'll wake up.
0:14:40 > 0:14:45Around half of people with a haemorrhage like this will suffer brain damage.
0:14:45 > 0:14:48One in five will die from their injuries.
0:14:49 > 0:14:52The issue about brain injuries is that actually
0:14:52 > 0:14:55it can strike at any time, anybody.
0:14:55 > 0:14:59On the whole, brain injury is something that
0:14:59 > 0:15:05comes up to anybody when they're probably least expecting it.
0:15:05 > 0:15:08They're just doing what they do every day
0:15:08 > 0:15:12and suddenly their life and that of their family changes.
0:15:12 > 0:15:15They've stopped all the drugs completely now
0:15:15 > 0:15:20so it's just a question of waiting for her to eventually come round.
0:15:20 > 0:15:22Laura likes to have a good sleep
0:15:22 > 0:15:25so it'll probably take slightly longer for her.
0:15:28 > 0:15:30Hello? Hello!
0:15:33 > 0:15:36No answer. I'm on my own.
0:15:36 > 0:15:37Help!
0:15:37 > 0:15:39Help!
0:15:39 > 0:15:40Is he breathing?
0:15:44 > 0:15:45One,
0:15:45 > 0:15:47two,
0:15:47 > 0:15:48three.
0:15:49 > 0:15:52Yes, he is definitely breathing.
0:15:52 > 0:15:55If someone on Islay needs intensive care,
0:15:55 > 0:15:57they have to be airlifted to the mainland.
0:15:57 > 0:16:00Unconscious people, just check whether they're breathing or not.
0:16:00 > 0:16:04So Dr Abell wants the islanders to be as self-sufficient as possible.
0:16:06 > 0:16:10What we're doing is we're... This is Portnahaven
0:16:10 > 0:16:15right at the very end of the island, a long way from any medical care.
0:16:15 > 0:16:19We've got a defibrillator and it's kept down in the village.
0:16:19 > 0:16:23I've taken this opportunity to come down and just go through
0:16:23 > 0:16:26some basic life support and use of the defibrillator with the group.
0:16:29 > 0:16:34# Ah, ah, ah, ah, stayin' alive, stayin' alive... #
0:16:34 > 0:16:36OK, and about that speed.
0:16:36 > 0:16:39- Help!- Help! Go for it.
0:16:39 > 0:16:41Help! Help!
0:16:41 > 0:16:44Hello? OK, yes, the ambulance is on the way.
0:16:47 > 0:16:51Use your weight. That's very good. Excellent.
0:16:53 > 0:16:56In England, somebody has a heart attack, 999,
0:16:56 > 0:17:00be in the hospital within a very short space of time.
0:17:00 > 0:17:06Here, somebody has a heart attack, it's going to be three, four, five, six hours.
0:17:06 > 0:17:09And if it's really bad weather and the plane can't fly,
0:17:09 > 0:17:12and in the winter that definitely happens,
0:17:12 > 0:17:15it might be 10, 12 hours or more.
0:17:15 > 0:17:18It is genuinely frightening.
0:17:18 > 0:17:19OK?
0:17:21 > 0:17:25He's really hairy. Do you just want to hold that, Maureen?
0:17:25 > 0:17:27I've got two pads...
0:17:27 > 0:17:30MACHINE: Apply pads to patient's bare chest.
0:17:30 > 0:17:33Put that on the chest that way. OK.
0:17:35 > 0:17:38MACHINE: 'Plug in pad connector next to flashing light.'
0:17:41 > 0:17:43'Analysing heart rhythm.
0:17:43 > 0:17:46'Do not touch the patient.
0:17:46 > 0:17:48'Analysing heart rhythm.
0:17:48 > 0:17:50'No shock advised.'
0:17:58 > 0:18:02Dr Abell still has home visits to make.
0:18:02 > 0:18:05He's going to re-examine the woman with the missing false teeth.
0:18:11 > 0:18:13What's happening?
0:18:13 > 0:18:19Well, it's not solved the problem but at least I'm sure of the diagnosis now.
0:18:19 > 0:18:23- Which is?- She definitely has got her teeth stuck in her throat...
0:18:24 > 0:18:27..and they won't come out.
0:18:27 > 0:18:33So, I think it's so obvious that she's got to have something done about it.
0:18:35 > 0:18:37With an unusual case like this,
0:18:37 > 0:18:42Dr Abell has to refer the patient to a specialist on the mainland.
0:18:42 > 0:18:44Hello?
0:18:44 > 0:18:48Hello, I'm Dr Abell. Who am I speaking to, please?
0:18:48 > 0:18:51I have a patient on the island of Islay.
0:18:51 > 0:18:54She has swallowed her dentures,
0:18:54 > 0:18:58and I've actually gently slid my finger into her throat,
0:18:58 > 0:19:02and she definitely has got her dentures stuck right at the back.
0:19:04 > 0:19:09No, it's a full, full set of plastic lower dentures.
0:19:09 > 0:19:11I can't take them out here,
0:19:11 > 0:19:15so she'll have to be sent to Glasgow to have that done.
0:19:16 > 0:19:19A fleet of four air ambulances covers the whole of Scotland.
0:19:19 > 0:19:24The planes cost £1,500 an hour to run and operate a strict priority system.
0:19:25 > 0:19:29Until the plane arrives, Dr Abell will keep the patient in hospital.
0:19:29 > 0:19:31How serious do you think this is?
0:19:35 > 0:19:37Well, it's not blue lights and ambulance serious
0:19:37 > 0:19:41in the sense that the patient is fine,
0:19:41 > 0:19:44she can breathe OK and she's not uncomfortable,
0:19:44 > 0:19:48but potentially, erm, if she vomits
0:19:48 > 0:19:52or if she starts inhaling...erm,
0:19:52 > 0:19:55sputum and things, yeah, it can be serious.
0:20:11 > 0:20:13This is obviously the brain here.
0:20:13 > 0:20:16You can see the area where this tumour is starting
0:20:16 > 0:20:18on the surface, it's all here.
0:20:18 > 0:20:22I think almost certainly that's going to end up being part of the tumour there.
0:20:22 > 0:20:25You see here where it's come out through the membrane of the brain.
0:20:25 > 0:20:29What we're going to do now is we're going to start doing the operation.
0:20:29 > 0:20:31You can wake him up, mate. Thank you.
0:20:31 > 0:20:34Darrell? Darrell?
0:20:34 > 0:20:35- Darrell?- Darrell?
0:20:35 > 0:20:40Darrell, hello. Can you open your eyes for us?
0:20:40 > 0:20:43- Darrell?- Darrell?
0:20:43 > 0:20:46- Darrell, can you open your eyes for me?- That's it.
0:20:54 > 0:20:57You're going to do some tests for us. So, what's the man doing?
0:20:57 > 0:20:59He's holding a mug.
0:20:59 > 0:21:02- But what's he doing?- He's having a mug of coffee.- OK, good.
0:21:02 > 0:21:03Let's go to the next one.
0:21:05 > 0:21:06Left-hand drive.
0:21:08 > 0:21:11Although local anaesthetic means that Darrell can't feel any pain,
0:21:11 > 0:21:15he is now fully conscious and the team are monitoring his speech.
0:21:17 > 0:21:20What's the lion doing? Try to describe it to me.
0:21:20 > 0:21:22He's hiding, he's just sitting in the hole.
0:21:23 > 0:21:28I've got this little electrode and we're going to place this onto the surface of the brain
0:21:28 > 0:21:29and it will disrupt the function
0:21:29 > 0:21:33so what we don't want to see is that he stops speaking when we touch the brain.
0:21:33 > 0:21:35All right?
0:21:36 > 0:21:38Good, just sing out when you want some more.
0:21:38 > 0:21:42Here, is the sort of motor speechy areas.
0:21:42 > 0:21:46- Language function is usually all down here.- OK.
0:21:46 > 0:21:49And here would be memory and verbal memory,
0:21:49 > 0:21:51things like your memory of words, of names, written information.
0:21:51 > 0:21:54All those sort of functions are around here.
0:21:54 > 0:21:57- At least you're talking at the moment, and that's good. - I'm perfect!
0:21:57 > 0:22:00That's what we want to hear, Darrell!
0:22:00 > 0:22:04- 100%, as if I've never had surgery. - Yep, I know.
0:22:04 > 0:22:08I can't say it, I really have been glad to be here.
0:22:08 > 0:22:12Pity that I'm here because of the tumour, but there you go.
0:22:14 > 0:22:16How much do you think you can get out?
0:22:16 > 0:22:19I don't know, we'll just have to see. We're doing a really good job
0:22:19 > 0:22:22but I've still got a big lump of tumour here that I'd like to remove.
0:22:22 > 0:22:24It's abnormal here.
0:22:24 > 0:22:26This abnormal tissue, the tumour,
0:22:26 > 0:22:30and that's what I'm going to take out now.
0:22:30 > 0:22:32As long as Darrell is still speaking,
0:22:32 > 0:22:36Andrew knows he can continue removing parts of the tumour.
0:22:36 > 0:22:37The more he takes out,
0:22:37 > 0:22:40the closer he gets to the healthy parts of Darrell's brain.
0:22:40 > 0:22:42Are you still awake, Darrell?
0:22:42 > 0:22:44Yeah, just. I...oh.
0:22:44 > 0:22:46I really want you awake, mate,
0:22:46 > 0:22:49because I'm doing the really tricky bit at the moment so you keep going.
0:22:49 > 0:22:54- OK.- We're doing a fantastic job here. You just keep going, yeah?
0:22:54 > 0:22:56We've got loads of it coming out.
0:22:56 > 0:23:01You can see an enormous amount of tumour that we've removed here already.
0:23:01 > 0:23:02It's a huge amount of tumour.
0:23:02 > 0:23:04What's the dog doing?
0:23:04 > 0:23:06It's holding something in its mouth.
0:23:06 > 0:23:08Darrell is still talking brilliantly
0:23:08 > 0:23:11so as long as he's still talking, I'm going to take more and more out.
0:23:11 > 0:23:14It's gone a bit wishy-washy there.
0:23:14 > 0:23:16Yeah, I've gone funny all of a sudden.
0:23:16 > 0:23:19That's me pouring some water in, mate, you're just feeling it.
0:23:19 > 0:23:23- Oh, it makes me...I'm all over the shop now.- Are you all right?
0:23:23 > 0:23:26- Yeah, I'm just wondering, my head is spinning.- Yes, that was just me.
0:23:26 > 0:23:29- What have you done then, Andrew? - We've put a bit of water in there
0:23:29 > 0:23:32- and it made you feel a bit funny because it stimulated it. - Oh, right.
0:23:32 > 0:23:34You're doing great here.
0:23:34 > 0:23:38I think I'm doing all right, better than I expected.
0:23:38 > 0:23:39Good.
0:23:39 > 0:23:40How much have you got out, Andrew?
0:23:40 > 0:23:45Oh, I think, I don't know, mate, but a lot. 70, 80% at least.
0:23:45 > 0:23:48OK. OK.
0:23:48 > 0:23:49A lot.
0:23:55 > 0:23:57- What did you say you needed to look for?- All right, Bob.
0:23:57 > 0:23:58Just stay with us.
0:23:58 > 0:24:02It's getting worse. The pain is getting worse, doctor.
0:24:04 > 0:24:05Not me being heavy-handed.
0:24:15 > 0:24:18We're always in the bowels of any hospital. We're always tucked away.
0:24:18 > 0:24:20The mortuary is always pretty much well hidden.
0:24:20 > 0:24:23Obviously people don't come to hospital to die.
0:24:23 > 0:24:26Essentially they come here to get better, so they don't like to
0:24:26 > 0:24:27earmark where we actually are,
0:24:27 > 0:24:29hence the private kind of thing.
0:24:29 > 0:24:32It causes a lot of problems when people are trying to find us,
0:24:32 > 0:24:35but yeah, just the fundamental reason that mortuaries shouldn't
0:24:35 > 0:24:38really exist, but obviously they do because sadly people do pass away
0:24:38 > 0:24:41and us mortuary folk do exist.
0:24:41 > 0:24:46Over 50% of all deaths in Britain take place in an NHS hospital.
0:24:46 > 0:24:51At St Thomas's mortuary, they get around five new arrivals a day.
0:24:51 > 0:24:54Erm, we get left with various removal forms of various descriptions,
0:24:54 > 0:24:57lets us know which patients have come in overnight
0:24:57 > 0:25:01and the kind of routine is to check them, weigh them, measure them,
0:25:01 > 0:25:04either for post-mortem information or potential post-mortem
0:25:04 > 0:25:06information, or even coffin size,
0:25:06 > 0:25:09which we might get a call from the funeral directors eventually for.
0:25:09 > 0:25:11And to make sure they are the correct people.
0:25:14 > 0:25:19Erm, she just had a bit of, erm, a bit of fluid on her face, just where
0:25:19 > 0:25:23possibly she's obviously laying down and it poured out of her mouth a bit.
0:25:23 > 0:25:26So rather than keep them saturated in their own fluids,
0:25:26 > 0:25:29we like to keep them nice and clean and give them a wipe.
0:25:29 > 0:25:31This is our fridge room.
0:25:31 > 0:25:35So we have designated fridge areas for all of our different patients.
0:25:35 > 0:25:39For everything from a gestational foetus that might come from gynaecology or A&E
0:25:39 > 0:25:43or the hospital birth centre, right up to your kind of 110-year-old,
0:25:43 > 0:25:47and also high-risk patients, ie. those carrying an infection.
0:25:47 > 0:25:52This is our one bariatric unit for the larger patients.
0:25:52 > 0:25:55These here are our designated high-risk fridges,
0:25:55 > 0:25:59and also we've kind of designated these as our decomp fridges as well
0:25:59 > 0:26:01so we like to keep the maggots all kind of isolated away.
0:26:01 > 0:26:06A lot of people think, why would you have to keep everyone isolated?
0:26:06 > 0:26:07There's not a law about it.
0:26:07 > 0:26:10It's maybe a recommendation, but there's no actual legislation
0:26:10 > 0:26:13to say that a baby can't be in the same fridge as an adult
0:26:13 > 0:26:16by any means, but it's just a kind of ethos that we've got here at Tommy's.
0:26:16 > 0:26:18Tuck you back in, mate.
0:26:29 > 0:26:32Are you going to draw us some pictures to put on our wall?
0:26:32 > 0:26:33Some flower pictures?
0:26:38 > 0:26:41You have to start breathing on your own soon.
0:26:41 > 0:26:43They're needing an air cut.
0:26:43 > 0:26:48- I'm Pat.- Hi, I'm Mirabelle, I'm looking after your wife.
0:26:48 > 0:26:51OK, yes, that's my wife, that's right.
0:26:51 > 0:26:54- Hi, Mirabelle, how are we doing? - Erm...
0:26:54 > 0:26:56Laura's sedatives have now worn off
0:26:56 > 0:27:00and nurses are going to try and wake her up.
0:27:00 > 0:27:03I'm just staring at eyes and the first thing I expect to see,
0:27:03 > 0:27:06do you know when people are asleep and they do the rapid eye movement thing?
0:27:06 > 0:27:11- I'm just waiting to see that.- Hello, Laura. Open your eyes, Laura.
0:27:11 > 0:27:14Hello? Laura, come on, open your eyes.
0:27:16 > 0:27:18Laura, open your eyes.
0:27:21 > 0:27:22Angel.
0:27:23 > 0:27:24Start waking up now?
0:27:24 > 0:27:30They've stopped all the drugs so it's just you and the machine.
0:27:32 > 0:27:34So you've just got to start coming up.
0:27:37 > 0:27:42We're just waiting for you to open your eyes. Come on, open your eyes.
0:27:42 > 0:27:44Laura, open your eyes, Laura.
0:27:44 > 0:27:47Can you open your eyes for me?
0:27:47 > 0:27:50- Please?- Laura?
0:27:50 > 0:27:53Can you hear me? Can you wiggle your toes for me? Or move your fingers?
0:27:58 > 0:28:02Try and move your toes, love. Just wiggle them a little bit.
0:28:07 > 0:28:09Come on.
0:28:21 > 0:28:23So why isn't she waking up?
0:28:28 > 0:28:32So, so what I wanted to talk to you about today is just to check
0:28:32 > 0:28:37that you understand that the sedation has now worn off
0:28:37 > 0:28:41so, so, how you see Laura is how she is.
0:28:41 > 0:28:44So how she is at the moment is
0:28:44 > 0:28:50- because of the brain haemorrhage, not because of any drugs, yes?- OK.
0:28:50 > 0:28:55I suppose there are no clear sort of timeframes of saying
0:28:55 > 0:28:59we've now got to the gloomy stage?
0:28:59 > 0:29:05No, I think that depends entirely on what progress she makes.
0:29:05 > 0:29:10I mean this is very early days yet, but it means that, you know,
0:29:10 > 0:29:15we can't give you any firm idea at the moment about
0:29:15 > 0:29:20how she's going to progress over the next few days and where she might end up.
0:29:20 > 0:29:22Right, OK. Thank you.
0:29:22 > 0:29:24That's a lot to take in.
0:29:24 > 0:29:27Is there anything you want to ask me or anything that's not clear?
0:29:27 > 0:29:33No, I have taken in so much over the last three days, and, and...
0:29:33 > 0:29:36and people have given me lots of information, which I'm
0:29:36 > 0:29:42grateful for because just not knowing what's going on just makes it worse.
0:29:47 > 0:29:52The information they want - that is will she be back to normal,
0:29:52 > 0:29:56and when - is information we can't give them at this time,
0:29:56 > 0:29:59but it's very common in the early phases after an acute brain
0:29:59 > 0:30:04injury that patients do remain unconscious for some time.
0:30:04 > 0:30:09That doesn't mean to say that that will be the ultimate outcome.
0:30:11 > 0:30:16My expectation today, you know, and probably very silly,
0:30:16 > 0:30:21but I was expecting to come in and, erm, and, er,
0:30:21 > 0:30:27and for them to start stimulating her and that she'd wake up.
0:30:27 > 0:30:30And I knew she wouldn't wake up with, you know, eyes wide open
0:30:30 > 0:30:33but there would be some sort of response,
0:30:33 > 0:30:38and that she would maybe understand that we were there and react to that.
0:30:40 > 0:30:44So that was... That was kind of disappointing.
0:30:44 > 0:30:48I'm not sure that's the right word but it was disappointing that that didn't happen.
0:30:48 > 0:30:50In fact it was worse than disappointing.
0:30:54 > 0:30:55Ooh!
0:30:55 > 0:30:57- Adele?- Adele.- Love Adele.
0:30:58 > 0:31:00Do you know where this patient's gone?
0:31:04 > 0:31:08Imagine what it would be like if you had funeral directors turning up on a ward!
0:31:08 > 0:31:13With obviously a trolley for deceased people and in their regalia,
0:31:13 > 0:31:16it wouldn't be very nice for the patients who were still alive.
0:31:16 > 0:31:19Well done, boys.
0:31:19 > 0:31:21Don't trip over on the way out.
0:31:24 > 0:31:26Take it easy, gents.
0:31:28 > 0:31:29Right, let's get you dry now.
0:31:31 > 0:31:33As well as storing the bodies,
0:31:33 > 0:31:36the mortuary assistants also prepare them for the relatives' room.
0:31:36 > 0:31:39We try and clean them up as best we can, no matter what state they're in.
0:31:39 > 0:31:42Again, people who, say, jump off buildings from a great height
0:31:42 > 0:31:44or people who get squished by lorries or cars and stuff like that,
0:31:44 > 0:31:47they might come in in bits, or people who jump in front of trains.
0:31:47 > 0:31:50If they're reconstructable, we'll reconstruct them.
0:31:50 > 0:31:53It might take us five hours but we'll do it, just because, I mean,
0:31:53 > 0:31:56it would bother us. I don't think any of us would sleep well
0:31:56 > 0:31:58if we knew that we'd just left the person in bits in the fridge.
0:32:03 > 0:32:05We have this kind of conflict with doctors sometimes.
0:32:05 > 0:32:08They come in, ringing on the door and kind of go, "Hello, I'm a doctor."
0:32:08 > 0:32:12"That's lovely, what do you want?" "I've come to see a body." I'm like, "Will mine do?"
0:32:12 > 0:32:16What do you mean by that? Oh, do you mean you've come to see a patient?
0:32:16 > 0:32:18They go, "They're not patients, they're dead." I'm like,
0:32:18 > 0:32:21"No, until they leave this hospital, they're deceased patients."
0:32:21 > 0:32:24They might be a different classification but they're our patients
0:32:24 > 0:32:26and that's how we see them and that's how we look after them.
0:32:26 > 0:32:29So, but yeah, I can take you through now to where the body -
0:32:29 > 0:32:32or the patient - would normally reside.
0:32:32 > 0:32:35Obviously this is the only area that the families would come into.
0:32:35 > 0:32:38As you can see, it's quite a nice kind of calming environment.
0:32:38 > 0:32:43If we get a viewing, the patient will be taken out of the fridge by us, the APTs.
0:32:43 > 0:32:45Get put on the trolley, have a nice duvet put over them
0:32:45 > 0:32:47so they look like they're tucked up in bed asleep.
0:32:47 > 0:32:50Obviously we've cleaned them up and they're looking presentable.
0:32:50 > 0:32:53Any tubes or lines, we'll cut those off at the level where they are
0:32:53 > 0:32:56and poke those down so it's not quite as they looked in intensive care
0:32:56 > 0:33:00and stuff like that, but it can get extremely, extremely emotional in here.
0:33:00 > 0:33:02You can often have fainters, kind of like hysteria.
0:33:02 > 0:33:06Sometimes they want to have a party. I've had it before with different cultures,
0:33:06 > 0:33:10especially with our catchment area where we are, certain cultures demand
0:33:10 > 0:33:13that you have to have a drink so we've had schnapps offered to us in here before.
0:33:13 > 0:33:16We're like, "We really, really can't. We're kind of on duty."
0:33:16 > 0:33:19"You must, you'll insult us if you don't!" So you get the boss on the phone.
0:33:19 > 0:33:23"Can I have a shot of schnapps?" "No, you can't." "OK then, sorry!"
0:33:29 > 0:33:31I have to take some antidepressants the doctor gave me
0:33:31 > 0:33:34because I had an overactive bladder, and it works.
0:33:34 > 0:33:36- HE SNEEZES - You're all right!
0:33:39 > 0:33:40No, you're all right.
0:33:57 > 0:34:00- You'll be all right.- You'll be fine.
0:34:00 > 0:34:04I've told you, if you don't have yours done, I'll have mine done!
0:34:04 > 0:34:07Around 80% of all surgery today will be carried out
0:34:07 > 0:34:10on people over the age of 75.
0:34:10 > 0:34:14- You're all right?- Yes. Fine.
0:34:14 > 0:34:16Well, get up and let me sit down!
0:34:16 > 0:34:18John is 85.
0:34:18 > 0:34:22Today he's having one of the most common operations performed on the NHS.
0:34:22 > 0:34:24OK?
0:34:24 > 0:34:26Off we go.
0:34:28 > 0:34:32My name's Lindsay. Do you know why you're here today?
0:34:32 > 0:34:34Yeah, a cataract.
0:34:34 > 0:34:37I'm virtually blind now, you know.
0:34:37 > 0:34:39My right eye is the worst.
0:34:41 > 0:34:45Gradually, over the last 12 months, his eyes have just...
0:34:45 > 0:34:49His right eye and his other one, well, both of them, they've just gone.
0:34:49 > 0:34:52Everywhere's blurred.
0:34:52 > 0:34:54He thought at first it was the television that was, er...
0:34:54 > 0:34:57- HE LAUGHS Didn't you?- Yeah!
0:34:57 > 0:34:59He thought it was the television that had gone.
0:34:59 > 0:35:02The television's going blurred, we'll have to do something about it.
0:35:02 > 0:35:06We bought a bigger television. You know.
0:35:06 > 0:35:09Always something going wrong, especially with me, you know.
0:35:11 > 0:35:13This is the latest.
0:35:13 > 0:35:16Everything else has been done.
0:35:16 > 0:35:18Do you know what the operation entails?
0:35:18 > 0:35:22Yes, they just slit the eye and take the sac out,
0:35:22 > 0:35:28- whatever it is, and put the lens in. - We watched it on the television.
0:35:28 > 0:35:32- Didn't we?- Yes. - He likes watching things like that.
0:35:32 > 0:35:36Nearly every operation I've had, I've been in some pain after it,
0:35:36 > 0:35:40you know, but I believe this one is pretty painless.
0:35:41 > 0:35:46- It doesn't matter if you're going to get your sight back, does it?- Oh, no.
0:35:46 > 0:35:47Put up with that.
0:36:00 > 0:36:03Are you worried at all about the operation?
0:36:03 > 0:36:06- No.- Not worried?- No.
0:36:06 > 0:36:07No.
0:36:11 > 0:36:13He's strong!
0:36:13 > 0:36:16You know, and he never gives in for anything.
0:36:17 > 0:36:21So, er, I don't worry. I mean what's the point?
0:36:22 > 0:36:27You die if you worry, you die if you don't, so why worry at all?
0:36:29 > 0:36:32OK, put your chin on the chin rest there.
0:36:32 > 0:36:33You OK like that?
0:36:35 > 0:36:38Do you want me to explain to you what the procedure involves
0:36:38 > 0:36:40and go through it or are you happy with...
0:36:40 > 0:36:45- As long as you're not going to chop my head off.- Definitely not!
0:36:47 > 0:36:51Demand for cataract surgery has grown with an ageing population,
0:36:51 > 0:36:56but with NHS cuts, many hospitals have reduced the number they carry out.
0:36:56 > 0:37:00They don't have to be perfect, but as long as he can read
0:37:00 > 0:37:04and watch the television, things like that.
0:37:04 > 0:37:10You know, because he loves to watch the television. All the quizzes.
0:37:10 > 0:37:12Because you see, when you can't see very well,
0:37:12 > 0:37:17those sort of things where you've got to think, keep your brain working.
0:37:31 > 0:37:35I think we've done enough, but we've gone up to about what...
0:37:37 > 0:37:41- How long have you been married for? - 60 years.- 60 years married?
0:37:41 > 0:37:46We got a card off the Queen, er, with a photograph
0:37:46 > 0:37:49and many happy, er, anniversaries and things.
0:37:50 > 0:37:53A lovely card. My daughter arranged that.
0:37:54 > 0:37:58She got on the Internet and straight through to the Palace.
0:37:58 > 0:38:03You don't deal with the Queen, I don't think, but she signs the thing.
0:38:03 > 0:38:08You know, printed sign, but it's a lovely card which we'll keep.
0:38:08 > 0:38:13- That's very sweet.- I keep a lot of things from royalty. I like royalty.
0:38:13 > 0:38:16I feel sorry for the Queen, actually!
0:38:16 > 0:38:19Because I've had no trouble with my children.
0:38:25 > 0:38:29Dr Abell has the hospital in Glasgow on standby to treat the patient
0:38:29 > 0:38:34who swallowed her false teeth, but there's no sign of a plane yet.
0:38:34 > 0:38:37I really want to wait for this phone call to come through.
0:38:41 > 0:38:45There's another patient in the hospital, who Dr Abell is keeping an eye on today.
0:38:48 > 0:38:51- Barbara is 84 and has lung cancer. - Can I sit here?- Mm.
0:38:54 > 0:38:56How are you doing?
0:38:56 > 0:39:00- Not as well as I would like to do. - Ah.
0:39:00 > 0:39:06Barbara's situation is a situation that really touches me
0:39:06 > 0:39:11personally because she is in the last few months of her life.
0:39:11 > 0:39:18Er, she lives alone in quite a remote place, where she'd like to be,
0:39:18 > 0:39:22but you can see just by looking at her how breathless she is
0:39:22 > 0:39:25and how much difficulty she has coping there.
0:39:25 > 0:39:29Are you wanting to go home, Barbara?
0:39:29 > 0:39:33I don't know, really. And it's no use me...erm...
0:39:36 > 0:39:41..kidding myself that I'm going to walk in to my front door.
0:39:41 > 0:39:45- "Hello, I'm here." I'm not.- No.
0:39:45 > 0:39:50- I'm not. So I will need help.- Yes.
0:39:50 > 0:39:55If you are not well enough to go home, you don't have to go,
0:39:55 > 0:39:59and if you go home and you can't manage,
0:39:59 > 0:40:01of course we can bring you back in again.
0:40:01 > 0:40:06- Oh, I will try, believe me.- But if it doesn't go well, don't worry.
0:40:09 > 0:40:11No, I won't.
0:40:11 > 0:40:17And I'm not in a position to worry because it will achieve nothing,
0:40:17 > 0:40:21- will it?- Worry rarely does, does it?
0:40:21 > 0:40:26No, it's a hiding to nowhere and nothing, you know.
0:40:26 > 0:40:32And I'm shut up in here, and I'm happy, I'm not resentful, not angry.
0:40:32 > 0:40:38I'm not...nothing. I've become like an amoeba.
0:40:40 > 0:40:43Yes, of course we're treating her but it depends what you mean
0:40:43 > 0:40:50by treating her. She'll get, here, really personal attention.
0:40:50 > 0:40:55We will look after her, we will not be sending her away
0:40:55 > 0:41:00to some remote hospital, where strangers will look after her.
0:41:00 > 0:41:05What Barbara needs is love and respect, really.
0:41:05 > 0:41:06She doesn't need anything else.
0:41:14 > 0:41:17Yes, one of the things about being a doctor is you...
0:41:17 > 0:41:21You're always running up against death, one way or another.
0:41:26 > 0:41:29Well, it's just been a very busy day today.
0:41:29 > 0:41:30It's, er...
0:41:32 > 0:41:35..keep going without a pause, really.
0:41:41 > 0:41:45And the opportunity just to sit down here for a minute or two
0:41:45 > 0:41:48and eat a sandwich is very good.
0:41:51 > 0:41:54The role of the doctor I feel is less important,
0:41:54 > 0:41:57less technological than I used to think of it as.
0:41:57 > 0:42:01Now I think that my role is actually more helping people,
0:42:01 > 0:42:06and sometimes that help is about absolutely spotting the right diagnosis,
0:42:06 > 0:42:11absolutely doing the right thing, absolutely getting the technology right.
0:42:11 > 0:42:14Sometimes it's just to help people cope
0:42:14 > 0:42:18with the vicissitudes of their life. There's nothing you can do...
0:42:18 > 0:42:21There's nothing you can do to stop people suffering...
0:42:24 > 0:42:27..degenerative problems, there's nothing you can do to stop people getting old,
0:42:27 > 0:42:30there's nothing you can do to stop people having the social
0:42:30 > 0:42:32and psychological problems that they have.
0:42:32 > 0:42:35I'm never going to be able to cure those things,
0:42:35 > 0:42:40but there are some things that I can do just to be helpful.
0:42:51 > 0:42:55After six hours on the operating table, Darrell's surgery is over.
0:42:55 > 0:42:57Can I have a cup of tea?
0:42:57 > 0:43:00And his speech is completely intact.
0:43:00 > 0:43:02For me as the surgeon,
0:43:02 > 0:43:05I'm just very happy that we've managed to achieve
0:43:05 > 0:43:06what we needed to do.
0:43:06 > 0:43:10- Will I get any painkillers for the head at all?- Yes.
0:43:10 > 0:43:15He's got a very serious condition that he didn't want, and no-one would
0:43:15 > 0:43:20wish on him, but I do think that we've been able to give him a better
0:43:20 > 0:43:24outcome than he might otherwise have had in many other places.
0:43:24 > 0:43:28- How are you feeling?- Better than expected.
0:43:28 > 0:43:33Yeah, I'm happy. Very, very happy.
0:43:33 > 0:43:35- Are you OK?- Yes.- Everything works?
0:43:35 > 0:43:38Can you wiggle your fingers for me? Wiggle your toes.
0:43:38 > 0:43:41On the left hand as well.
0:43:41 > 0:43:47I'm in London, it's the 18th of October, I've had full surgery with Andrew.
0:43:47 > 0:43:50Very good. That's good.
0:43:51 > 0:43:53Er, now I want to see Jill.
0:43:56 > 0:44:00And just...have a hug.
0:44:03 > 0:44:04I'm alive.
0:44:09 > 0:44:11I'm emotion, as we speak.
0:44:14 > 0:44:18I'm breathing deep.
0:44:18 > 0:44:21I survived because I love my family.
0:44:27 > 0:44:30Oh, and he's awake.
0:44:30 > 0:44:34- Hello!- Hello!- Oh!- All right?
0:44:35 > 0:44:38Are you going to get a cup of tea?
0:44:38 > 0:44:42He said Andrew's taken a massive amount.
0:44:42 > 0:44:47- Good.- Which is great stuff. And I mean a lot.
0:44:47 > 0:44:50It's good that I got what I wanted, it's waking up.
0:44:51 > 0:44:58# By your bedside all day every day, BHBN hospital radio! #
0:44:59 > 0:45:03It's Olly and Ciaran for the next hour and it's our pleasure
0:45:03 > 0:45:07and even a delight to play you the songs you guys have chosen.
0:45:07 > 0:45:10This evening we've got requests for Stevie Wonder, Neil Diamond,
0:45:10 > 0:45:12the Eagles, to name but a few.
0:45:12 > 0:45:15This evening we're going to start with Eagles, Hotel California,
0:45:15 > 0:45:17and, Scott, this is just for you.
0:45:17 > 0:45:18Enjoy.
0:45:26 > 0:45:28- I haven't got names.- Pardon?
0:45:28 > 0:45:31- I haven't got names on there, who they're for.- Oh, who they're for!
0:45:31 > 0:45:34Yeah. Have you got them on here? Quickly, quickly.
0:45:34 > 0:45:36Come on, quickly.
0:45:40 > 0:45:43When you're in hospital, you don't know when you're going to be home.
0:45:43 > 0:45:47You don't know, there may be complications, God willing there isn't,
0:45:47 > 0:45:49but you just don't know, and I think that's a lot of the thing.
0:45:49 > 0:45:52People just, when they're in hospital, they just want to know
0:45:52 > 0:45:55when they're going home, so it's a lonely place.
0:45:55 > 0:45:57Even with people around you, it can be a very lonely place
0:45:57 > 0:46:00and I think this brings a bit of warmth to people.
0:46:00 > 0:46:03We spoke earlier about, you know, music being a healer, I believe that,
0:46:03 > 0:46:05and I think that's part of what it does.
0:46:05 > 0:46:08It's something to distract people when they are ill.
0:46:08 > 0:46:12When they get their requests and their name read out, I think it's massively important.
0:46:13 > 0:46:16# Welcome to the Hotel California
0:46:19 > 0:46:21# Such a lovely place
0:46:21 > 0:46:22# Such a lovely place
0:46:22 > 0:46:24# Such a lovely place... #
0:46:36 > 0:46:41- Are you all right?- Yeah. - OK, give me a kiss.
0:46:43 > 0:46:47- You were worried just a little bit, weren't you?- Just a bit.
0:46:47 > 0:46:51I don't like to show it, though. You see, you know.
0:46:51 > 0:46:55It's all right. You just stand there, I've got to take your hat off.
0:46:59 > 0:47:02He's been a very, very good patient. It's gone very well
0:47:02 > 0:47:06so hopefully you'll find tomorrow that there's a big difference.
0:47:06 > 0:47:07Thank you very much!
0:47:10 > 0:47:16The NHS, I think it's marvellous. We saw it start.
0:47:16 > 0:47:20Prior to that, there used to be the doctor man came round
0:47:20 > 0:47:24on a Friday night, and most people paid sixpence a week,
0:47:24 > 0:47:26which was a lot of money then.
0:47:26 > 0:47:31But today there isn't anywhere in the world where you could get the treatment.
0:47:31 > 0:47:35I mean, think about it, in Manchester we've got every hospital you can think of
0:47:35 > 0:47:38to treat everything wrong with you.
0:47:38 > 0:47:41Eyes, nose, everything.
0:47:41 > 0:47:43I've never seen him look as happy!
0:47:43 > 0:47:47I'll make him something nice for his tea.
0:47:47 > 0:47:49Chips!
0:47:49 > 0:47:51- RADIO:- Welcome to drive time.
0:47:56 > 0:47:58Good, I'm just going to quickly check...
0:48:17 > 0:48:19You've got to start waking up.
0:48:19 > 0:48:23It's been six hours since nurses started trying to wake up Laura.
0:48:23 > 0:48:25There's been no response.
0:48:25 > 0:48:27Come on, darling. Start waking up.
0:48:29 > 0:48:32Come on, babe. Eh?
0:48:34 > 0:48:37Flicker your eyes. Flicker your eyes.
0:48:43 > 0:48:47Anything, any sort of movement will do me for now.
0:48:49 > 0:48:52I just want it, I just want it to happen quickly. I just want it to...
0:48:55 > 0:48:56I just want her to be awake.
0:48:56 > 0:49:01Just so we can know what's going on and...and get on with it.
0:49:07 > 0:49:10Try and open your eyes, love.
0:49:10 > 0:49:12Just a little bit.
0:49:13 > 0:49:16Just to let me know, even just for a second.
0:49:19 > 0:49:24We've been married 34 years, and she's the brains of the outfit
0:49:24 > 0:49:25and I'm the doer.
0:49:27 > 0:49:30You know, we make joint decisions
0:49:30 > 0:49:34but it's, you know, whatever she decides basically is fine by me
0:49:34 > 0:49:38because she's always, she always kinds of gets it right, you know?
0:49:41 > 0:49:45That's what I carry around with me. Not that I need to, but...
0:49:47 > 0:49:49That's just there.
0:49:51 > 0:49:54Maybe tomorrow you'll see something a little bit different.
0:49:54 > 0:49:55Yeah, that would be good.
0:49:55 > 0:49:59You're having long days, but she's going to need you much more
0:49:59 > 0:50:03when she's a bit more awake so think of yourself in all of this.
0:50:03 > 0:50:05- Will do.- You're going to go home tonight, aren't you?
0:50:05 > 0:50:08- Oh, yes.- OK.- I'm used to long days, so...- You are, OK,
0:50:08 > 0:50:12but just sort of think of yourself because it's exhausting and
0:50:12 > 0:50:16although we're here to look after her, we need to look after you as well.
0:50:16 > 0:50:19After a brain injury, there's a whole spectrum of outcome
0:50:19 > 0:50:26from getting back pretty much to how you were before at one end of the spectrum.
0:50:26 > 0:50:30The other end of the spectrum is always considered to be death.
0:50:30 > 0:50:35Many patients and their families actually might not perceive
0:50:35 > 0:50:39that death IS the worst outcome, that actually surviving with
0:50:39 > 0:50:43a terrible neurological injury, in a coma for the rest of one's
0:50:43 > 0:50:47life, is in some people's minds potentially worse than dying.
0:50:50 > 0:50:56It costs £1,600 a day to look after a patient in neuro intensive care.
0:50:56 > 0:50:59Laura will remain here for as long as it takes for her to improve.
0:50:59 > 0:51:03For her husband, Pat, there's nothing he can do but wait.
0:51:05 > 0:51:09I suppose the worst is not knowing, erm...
0:51:11 > 0:51:13..how it's going to turn out.
0:51:16 > 0:51:17Erm...
0:51:19 > 0:51:25And, and, and...knowing that there are no easy answers.
0:51:25 > 0:51:27I can't just go to somebody and say,
0:51:27 > 0:51:29"How long is this going to take to fix?"
0:51:29 > 0:51:34But I suppose it'll take time for, for...
0:51:34 > 0:51:41the real reality to kick in and, er, and for me to accept it.
0:51:42 > 0:51:47I mean I accept it at one level, but this doesn't happen to Laura.
0:51:47 > 0:51:49This doesn't happen to fit young women.
0:51:52 > 0:51:54Er, but clearly it does.
0:51:54 > 0:51:58And what will the future be? You know, that's the other big thing.
0:51:58 > 0:52:00What's the future going to be? What's it going to be like?
0:52:00 > 0:52:04Are we all going to go back to normal, or, you know,
0:52:04 > 0:52:07just completely different?
0:52:07 > 0:52:09So, it's, erm,
0:52:09 > 0:52:13strange, difficult, all those things.
0:52:15 > 0:52:17Scary. Very, very scary.
0:52:37 > 0:52:40Darrell will be in hospital for several days.
0:52:41 > 0:52:43In another part of the building,
0:52:43 > 0:52:47pathologists are analysing a sample of his tumour.
0:52:47 > 0:52:49They're doing preliminary checks
0:52:49 > 0:52:52to see if the grade or the malignancy has increased.
0:52:55 > 0:52:59The vessels are suspicious, and I think the cellularity
0:52:59 > 0:53:02is very high and it's possible that we're having at least a grade three.
0:53:04 > 0:53:06It probably is more likely to be a four.
0:53:07 > 0:53:12For the patient that means first of all the tumour has become more malignant as it recurred,
0:53:12 > 0:53:19and it also will unfortunately indicate or mean that the tumour, er, comes...
0:53:19 > 0:53:23After this operation, it will come back even earlier.
0:53:23 > 0:53:27So the majority of the people that have a grade four of this diagnosis
0:53:27 > 0:53:32have a life expectancy of several months rather than several years.
0:53:36 > 0:53:38It's going to be devastating news for him
0:53:38 > 0:53:43and his family but I think you have to appreciate your place in the disease.
0:53:43 > 0:53:45We can only do what we can to help people
0:53:45 > 0:53:50and that's what we've tried to do today, but we can't play God.
0:53:50 > 0:53:53We can't cure this tumour, he knows that.
0:53:53 > 0:53:57He knew even when it was a low-grade tumour that it couldn't be cured.
0:53:57 > 0:54:00There will be treatments that will be offered, and he'll be given,
0:54:00 > 0:54:03I'm sure, a very aggressive chemotherapy,
0:54:03 > 0:54:06but at the end of the day we know that for the vast majority of people,
0:54:06 > 0:54:09they don't respond fully to the chemotherapy for high-grade brain tumours
0:54:09 > 0:54:12and eventually, unfortunately, they succumb to their tumours.
0:54:14 > 0:54:19Doctors will verify the test results before sharing the news with Darrell in a few days' time.
0:54:23 > 0:54:26AMBULANCE SIREN
0:54:26 > 0:54:29Have you taken any tablets tonight?
0:54:29 > 0:54:32No. No...
0:54:36 > 0:54:41There's no toilet on here, OK? If you're that desperate to go, go.
0:54:48 > 0:54:51Because we're on call, I've got my own pillow.
0:54:51 > 0:54:55When he's on duty, Dr Abell stays overnight in the hospital.
0:55:03 > 0:55:06I have my own little tuck box.
0:55:06 > 0:55:08But he won't go to bed until the plane has picked up
0:55:08 > 0:55:11the patient who swallowed her false teeth.
0:55:11 > 0:55:12Hiya. Chris Abell speaking.
0:55:15 > 0:55:16Oh, hiya.
0:55:19 > 0:55:23Have you got any ideas at all about when it might be?
0:55:23 > 0:55:25OK. OK.
0:55:27 > 0:55:31OK, good, so the aircraft in about two hours, hopefully.
0:55:35 > 0:55:39His other patient, Barbara, is finding it difficult to sleep.
0:55:42 > 0:55:46She knows that no more treatment can be given, she's had radiotherapy.
0:55:46 > 0:55:49She knows that things are going to get worse and I'm absolutely sure
0:55:49 > 0:55:53that she knows what is happening, but we don't have to discuss it.
0:55:53 > 0:55:57If I switch the light off, do you think you might just have a bit of a doze?
0:56:02 > 0:56:04That's a bit better.
0:56:10 > 0:56:16One of the things that's changed is that ever so many people end up
0:56:16 > 0:56:21falling into sort of the clutches of technology at the end of their lives.
0:56:21 > 0:56:23Something happens to them
0:56:23 > 0:56:26and the emergency response is admit them to hospital because, you know,
0:56:26 > 0:56:30the traditional view is that doctors are in a fight against death,
0:56:30 > 0:56:35that you have to sort of ward off the evil death with everything you can.
0:56:35 > 0:56:39But, when death is coming, when it's inevitable,
0:56:39 > 0:56:45if you can actually help a person and a family achieve a good death,
0:56:45 > 0:56:46you've done a wonderful thing.
0:56:46 > 0:56:48Supper.
0:56:51 > 0:56:55I think that there's... a lot of people...
0:56:59 > 0:57:01..fear death.
0:57:03 > 0:57:07I don't fear death at all. I, I just don't.
0:57:07 > 0:57:12The idea for me of death is, "Good, I can go to sleep."
0:57:57 > 0:57:59Subtitles by Red Bee Media Ltd
0:58:09 > 0:58:12To order your free copy of the Open University's booklet,
0:58:12 > 0:58:16"working to save lives", which accompanies this series, call:
0:58:19 > 0:58:22Or go to...
0:58:22 > 0:58:24..and follow the links to the OU.