0:00:12 > 0:00:13MAN SCREAMS
0:00:13 > 0:00:1618th October, 2012.
0:00:16 > 0:00:21Across Britain, 100 cameras are filming the NHS on a single day.
0:00:21 > 0:00:24MAN VIA LOUDSPEAKER: This change will be a disaster.
0:00:24 > 0:00:26CHEERING
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 > 0:00:402,000 will be born.
0:00:41 > 0:00:43WHISTLE BLOWS
0:00:43 > 0:00:47The NHS is the largest public healthcare system in the world.
0:00:49 > 0:00:52We want that to be in your voice all the time.
0:00:52 > 0:00:53Hi, we're going to help you.
0:00:53 > 0:00:55We rely on it...
0:00:55 > 0:00:57- Be really brave. - ..complain about it...
0:00:57 > 0:00:59In the bin. That's because of you.
0:00:59 > 0:01:01..often, we take it for granted.
0:01:01 > 0:01:03Lucas, Lucas!
0:01:03 > 0:01:06What we expect from the NHS is ever-increasing.
0:01:08 > 0:01:10The money to pay for it isn't.
0:01:12 > 0:01:16If we could see what this institution does in a single day...
0:01:18 > 0:01:21..what would it make us think?
0:01:21 > 0:01:25This entire series tells the story of one day.
0:01:25 > 0:01:27So, why isn't she waking up?
0:01:27 > 0:01:29100 cameras...
0:01:29 > 0:01:33capturing the NHS, as you've never seen it before.
0:01:33 > 0:01:35Baby born at 2.55.
0:01:45 > 0:01:48RADIO: Good morning, everyone!
0:01:48 > 0:01:50- RADIO:- This day, 18th October. It's...
0:01:52 > 0:01:53BABY CRIES
0:01:53 > 0:01:57- Good morning.- Morning. - Morning, Collette. Any drama?
0:01:57 > 0:02:00- RADIO:- ..West Yorkshire, overturned lorry at...
0:02:00 > 0:02:03- Could you come and see a patient? - Yeah, of course.
0:02:03 > 0:02:05- PATIENT:- Oh, the pain's getting worse, Doctor.
0:02:05 > 0:02:08Dial 2222 for me, please. Is it...? What medication is he on?
0:02:09 > 0:02:11All right, there's no...
0:02:24 > 0:02:27PATIENT GROANS
0:02:27 > 0:02:28What happened, Doctor?
0:02:28 > 0:02:31Oh, what's going on?
0:02:31 > 0:02:33Oh-h!
0:02:33 > 0:02:35You've had a bit of a heart attack again, it looks like.
0:02:35 > 0:02:37A bit of a what?
0:02:37 > 0:02:39Manchester Royal Infirmary -
0:02:39 > 0:02:42final-year medical students role-play heart attack scenarios.
0:02:42 > 0:02:45Not another one! Oh-h!
0:02:45 > 0:02:48The patient is Bob, a £33,000 dummy.
0:02:48 > 0:02:50OK, guys, we'll stop there.
0:02:50 > 0:02:52Thank you so much.
0:02:52 > 0:02:53You saved my life!
0:02:54 > 0:02:56Bob's alive.
0:02:56 > 0:02:59Bob lives again! Right, marvellous. Let's go round the other side and...
0:02:59 > 0:03:03Around 282 people will have heart attacks in Britain today.
0:03:05 > 0:03:07200 will die.
0:03:18 > 0:03:21Dr Ordoubadi is a heart specialist.
0:03:21 > 0:03:24He's about to start one of his regular 24-hour shifts.
0:03:24 > 0:03:26Hi, guys!
0:03:26 > 0:03:30- Oh, hi!- Yeah, you've got a heart attack case?
0:03:30 > 0:03:32Just waiting for the ECG.
0:03:32 > 0:03:37He's got previous bypass, extensive cardiac history.
0:03:37 > 0:03:39AMBULANCE SIRENS BLARE
0:03:39 > 0:03:42Dr Ordoubadi heads up the cardiac cath lab,
0:03:42 > 0:03:45a specialist unit that deals with emergency heart problems
0:03:45 > 0:03:47from across Greater Manchester.
0:03:50 > 0:03:55A 77-year-old man has been rushed in by ambulance, after collapsing at home.
0:03:55 > 0:04:01- Hello. You've had a bypass operation, when?- 1997.- 1997.
0:04:01 > 0:04:05- Had you had previous heart attacks? - Yes, the first one was in '92.
0:04:05 > 0:04:07MACHINE BEEPS
0:04:09 > 0:04:13- Sorry.- It's all right, don't worry. - We won't be able to...
0:04:15 > 0:04:20I had a stent fitted and it was during the stent-fitting that I had a heart attack.
0:04:20 > 0:04:23- Do you still have the chest pain? - Yes.
0:04:23 > 0:04:26- It looks as though you might be having a heart attack.- Oh!
0:04:28 > 0:04:30The cath lab aims to treat all patients within an hour
0:04:30 > 0:04:34of their heart attack. The sooner Clifford gets treated,
0:04:34 > 0:04:37the better the chances that doctors can prevent long-term damage.
0:04:37 > 0:04:40If there's a blockage, we'll try to unblock it.
0:04:40 > 0:04:42The longer that artery remains blocked,
0:04:42 > 0:04:44the more muscle that actually dies,
0:04:44 > 0:04:48so we need to unblock that as soon as possible, to save more heart muscle.
0:04:48 > 0:04:50Are we ready?
0:04:50 > 0:04:54That's why we want to get him in as soon as possible,
0:04:54 > 0:04:58because the best way to unblock the artery is by putting
0:04:58 > 0:05:00the wire down and doing angioplasty.
0:05:00 > 0:05:04'And the sooner we get him on the table,
0:05:04 > 0:05:07'the sooner we know where the blockage is and the sooner we can open it up.'
0:05:09 > 0:05:11What a pain.
0:05:11 > 0:05:14Damp, clammy...
0:05:14 > 0:05:15Not very nice, no.
0:05:19 > 0:05:21Access time now.
0:05:21 > 0:05:23OK, all set.
0:05:23 > 0:05:25OK, can I have the camera in, please?
0:05:27 > 0:05:30Dr Ordoubadi guides a tiny catheter from Clifford's groin,
0:05:30 > 0:05:34so the artery is feeding the heart, in an attempt to free the blockage.
0:05:34 > 0:05:36It's, kind of, like fishing...
0:05:36 > 0:05:38Fishing, fishing, fishing.
0:05:41 > 0:05:44So, in a minute, you're going to get this hot flush. Ready?
0:05:44 > 0:05:46Stop breathing, sir.
0:05:48 > 0:05:49Make it start.
0:05:51 > 0:05:54Clifford has had 20 years of heart problems,
0:05:54 > 0:05:59but it's only in the last five that this technique has been available.
0:05:59 > 0:06:01This artery is very degenerative.
0:06:01 > 0:06:04It's, kind of, got massive amounts of clots in it.
0:06:04 > 0:06:07It's just full of clots, full of clots.
0:06:07 > 0:06:09Below it, haemorrhaging.
0:06:09 > 0:06:11We found the problem.
0:06:11 > 0:06:15Where they put the stent in, inside your chest,
0:06:15 > 0:06:17- that's blocked off.- Ah-ha.- Mm.
0:06:19 > 0:06:22Outside the operating room, the cath lab is starting to fill up.
0:06:24 > 0:06:27As well as six patients booked in for pre-planned treatments,
0:06:27 > 0:06:30there are more emergency cases coming in.
0:06:32 > 0:06:34PHONE RINGS
0:06:34 > 0:06:36Hello, primary PCI, Justine speaking.
0:06:36 > 0:06:39OK, where is he coming from?
0:06:39 > 0:06:41Just blue-light him straight over, don't worry.
0:06:45 > 0:06:47- RADIO:- Both directions between the M6...
0:06:50 > 0:06:52- Put an arrow there, if that's all right?- Yeah!
0:06:52 > 0:06:55I'd love to go on Bake Off.
0:06:55 > 0:06:57HENS CLUCK
0:07:14 > 0:07:15GEESE SQUAWK
0:07:15 > 0:07:17Morning, Basil.
0:07:17 > 0:07:19Morning, Paddy.
0:07:19 > 0:07:22Sit!
0:07:22 > 0:07:23Morning, Mother.
0:07:29 > 0:07:3425-year-old Ciaran has an extremely rare genetic disorder called Prader-Willi.
0:07:34 > 0:07:35He just licked my ear!
0:07:37 > 0:07:41The rabbit's just licked my ear.
0:07:41 > 0:07:42Pardon!
0:07:42 > 0:07:44Are you all right?
0:07:48 > 0:07:51He's a bit irregular.
0:07:51 > 0:07:55Mostly, that's what I hold, is the wee bunny rabbits.
0:07:55 > 0:08:00That's all you do, put them towards your heart and hold them tightly,
0:08:00 > 0:08:01but not too tight.
0:08:01 > 0:08:06One of the main symptoms of the condition is an insatiable hunger,
0:08:06 > 0:08:10for which there is no effective treatment beyond careful supervision around food.
0:08:10 > 0:08:11GOOSE SQUAWKS
0:08:11 > 0:08:16I am throwing this to Basil, the goose.
0:08:16 > 0:08:18SQUAWKING CONTINUES
0:08:18 > 0:08:22- My, he loves the tomatoes! Aye, doesn't he?- Yeah.- Yeah.
0:08:22 > 0:08:24Since leaving home at 18, Ciaran,
0:08:24 > 0:08:27who also suffers learning difficulties, has been
0:08:27 > 0:08:31in and out of community placements and secure institutions.
0:08:31 > 0:08:33For the last three weeks,
0:08:33 > 0:08:37the NHS have been helping to fund a place in supported accommodation.
0:08:37 > 0:08:41- DIRECTOR:- So this is your palace, then?- Yes, this is my palace.
0:08:44 > 0:08:47My palace.
0:08:47 > 0:08:52At Kilcreggan, Ciaran has his own house, but for his own safety,
0:08:52 > 0:08:56his access to food is carefully controlled.
0:08:56 > 0:09:02It's thought that as many as one in 35 people with Prader-Willi die as a result of overeating.
0:09:02 > 0:09:07Does it frustrate you having the fridge locked and everything locked up?
0:09:07 > 0:09:11It does, yeah. It doesn't feel like a normal person.
0:09:11 > 0:09:14Like, yourself, your fridge is not locked.
0:09:14 > 0:09:18If they didn't lock your fridges, would you eat the stuff in it?
0:09:18 > 0:09:24No, I won't, but other Prader-Willis would eat themselves to death.
0:09:24 > 0:09:27Overeat, overeat, you put on a lot of weight,
0:09:27 > 0:09:31and then the wee heart stops and that will be the end of them - dead.
0:09:31 > 0:09:34I'm still alive...
0:09:34 > 0:09:38because I just watch what I eat, sometimes.
0:09:38 > 0:09:40KNOCK ON DOOR
0:09:42 > 0:09:45- Hi, Ciaran, how are you doing? - Hello, Damian.
0:09:45 > 0:09:47Damian is the manager of the home.
0:09:47 > 0:09:52He knows that today, like every day, he'll need to watch Ciaran closely.
0:09:52 > 0:09:55Ciaran is going to be a difficult proposition.
0:09:55 > 0:09:58He feels hungry all the time.
0:09:58 > 0:10:02That urge to quench that hunger is on him all the time,
0:10:02 > 0:10:03irrespective of how much he eats.
0:10:03 > 0:10:06To complicate it further, he has diabetes.
0:10:06 > 0:10:09When you factor in his constant desire to have food
0:10:09 > 0:10:13and how he can manage to manipulate situations
0:10:13 > 0:10:17and get food in other ways that you are not aware of,
0:10:17 > 0:10:20it makes it an extremely difficult condition to work with.
0:10:20 > 0:10:24Can you sometimes be manipulative to get food?
0:10:24 > 0:10:28Mmmm, if I was hungry, yes.
0:10:29 > 0:10:33- Are we nearly ready to rock? - Yes.- Yes, you done?
0:10:33 > 0:10:36'An hour delay on the train's northern route.'
0:10:43 > 0:10:47Um, I was close to pigeons a few weeks ago.
0:10:47 > 0:10:50- But not regularly close to pigeons?- No.
0:11:00 > 0:11:03- He is such a happy boy. - What time are you taking him in?
0:11:03 > 0:11:06- I'm not too sure. - Has he not said yet?- No.
0:11:06 > 0:11:09Tell me about Kyran's heart operation today.
0:11:09 > 0:11:12They are going to be opening him up from the chest
0:11:12 > 0:11:16and then they are going to be fixing his aortic artery.
0:11:16 > 0:11:18It's not a small operation.
0:11:18 > 0:11:21There's nothing you can do about it though, is there? He has to have it.
0:11:21 > 0:11:23Oh, dear.
0:11:23 > 0:11:25Baby Kyran is six months old.
0:11:25 > 0:11:29He was born with an abnormally small main artery to the heart
0:11:29 > 0:11:32and, at ten-days-old, had his first open heart surgery.
0:11:33 > 0:11:36Today is his second operation and, if all goes well,
0:11:36 > 0:11:38it should be his last.
0:11:38 > 0:11:41We need to stop the heart to go in and do this operation.
0:11:41 > 0:11:44This is a complex procedure.
0:11:44 > 0:11:47We need to put him on a heart-lung machine which takes
0:11:47 > 0:11:50all of the blood, mixes with oxygen and pumps back into the body.
0:11:50 > 0:11:53Getting into the chest a second time is always a difficult problem.
0:11:53 > 0:11:56There's a bit of risk involved with this operation,
0:11:56 > 0:11:58but I'm quite confident and optimistic that Kyran
0:11:58 > 0:12:00- will do very well.- Yes.
0:12:04 > 0:12:07Parents Michael and Gemma separated before Kyran was born,
0:12:07 > 0:12:10but attend all his medical appointments together.
0:12:13 > 0:12:17What's that big smile, mate? Look at that big, lovely smile!
0:12:18 > 0:12:19Here you go.
0:12:19 > 0:12:23Is that better, eh, mate? It's cold on them corridors.
0:12:29 > 0:12:31You don't have a clue, do you?
0:12:31 > 0:12:33He's so happy.
0:12:33 > 0:12:36- I know.- It's the best way.- I know.
0:12:37 > 0:12:39Is that nice?
0:12:41 > 0:12:44Hello, gorgeous. He's gorgeous, isn't he?
0:12:44 > 0:12:47- Is he always this well behaved?- Yeah.
0:12:54 > 0:12:56BABY WHIMPERS
0:12:56 > 0:12:57I'm sorry, sweetie. Oh, dear.
0:13:00 > 0:13:01BABY CRIES
0:13:01 > 0:13:04- Oh, sorry. Oh!- OK, sh, sh, sh.
0:13:09 > 0:13:12That's it now. Big kiss and we'll look after him for you, OK?
0:13:12 > 0:13:15Did you see his eyes!
0:13:15 > 0:13:16Bye now.
0:13:16 > 0:13:18Did you see his eyes?
0:13:18 > 0:13:21His eyes were just like, up like that.
0:13:22 > 0:13:25I'm just a bit shocked because he...
0:13:25 > 0:13:27He still had his eyes open as he was falling asleep,
0:13:27 > 0:13:30so his eyes were like, going up.
0:13:30 > 0:13:34The operation to repair Kyran's heart is expected to take 4.5 hours.
0:13:39 > 0:13:41I'll try and get some sleep.
0:13:41 > 0:13:43I wouldn't be able to go to sleep.
0:13:52 > 0:13:55See the dots? Those dots are all clots.
0:13:55 > 0:13:56It doesn't look that big,
0:13:56 > 0:14:00but you only need that much to cause a complete blockage.
0:14:00 > 0:14:04In the cath lab, Dr Ordoubadi has been working for over an hour
0:14:04 > 0:14:06on Clifford's blocked arteries.
0:14:06 > 0:14:09We have done a bit of fishing, we're going to do more fishing.
0:14:09 > 0:14:12- What does the ECG doing? - 'It's on slow motion.'
0:14:12 > 0:14:15- Thank you very much. - What does that mean?
0:14:15 > 0:14:17That means that what we were doing is working.
0:14:17 > 0:14:19Simple as that.
0:14:23 > 0:14:25Yes.
0:14:28 > 0:14:30Yes.
0:14:32 > 0:14:33Come in.
0:14:36 > 0:14:39You can see the white bit is the clot,
0:14:39 > 0:14:41we have actually managed to catch the clot.
0:14:43 > 0:14:45Taking everything out...
0:14:45 > 0:14:49This is the moment of truth. Let's get rid of this clot.
0:14:50 > 0:14:52So this is it.
0:14:54 > 0:14:56Open it up, that red bit at the bottom
0:14:56 > 0:14:59is all of the clot that we captured.
0:14:59 > 0:15:01That is what I found here.
0:15:06 > 0:15:08OK, good. So, I think our job is done.
0:15:08 > 0:15:10Clifford's procedure has been a success.
0:15:10 > 0:15:13He'll be taken to recovery
0:15:13 > 0:15:17while Dr Ordoubadi moves straight on to his next heart-attack patient.
0:15:17 > 0:15:20You've got to treat her condition, so we just put it on, anyway.
0:15:20 > 0:15:22The other one is already coming, isn't it?
0:15:22 > 0:15:25It's coming from Hull, but I think that would be more suited to Bernard.
0:15:25 > 0:15:28- Tell me what to do, I'll do it.- Dance!
0:15:30 > 0:15:33What would we do without the NHS, eh?
0:15:33 > 0:15:35Hmm?
0:15:52 > 0:15:54- What was the question? - Show them what they get in a pack.
0:15:54 > 0:15:57I could rip open the pack!
0:15:57 > 0:15:58Are we allowed to rip it open?
0:15:58 > 0:16:00There is a science behind what's in the pack.
0:16:00 > 0:16:01Absolutely...
0:16:01 > 0:16:04What we came across in the evidence is that,
0:16:04 > 0:16:07if you quit for 28 days, you're actually five times more likely to quit
0:16:07 > 0:16:10for good and so that is what we focused on with this campaign,
0:16:10 > 0:16:12so it is a start to stopping, as it were.
0:16:12 > 0:16:15At one point on Monday, 1 October when we launched,
0:16:15 > 0:16:18we had 50 tweets a minute.
0:16:20 > 0:16:23One, two, three, four, five. Yeah?
0:16:23 > 0:16:2810, 11, 12, 13, 14, 15, 16.
0:16:36 > 0:16:39So I would be lying to you if I said that I'm not nervous
0:16:39 > 0:16:42or I'm not anxious or anything like that.
0:16:45 > 0:16:47Most of the cases, when they are straightforward,
0:16:47 > 0:16:51we don't think twice about it, but today's case, Kyran,
0:16:51 > 0:16:55being a second operation, there is a certain element of risk.
0:17:08 > 0:17:10- Testing the saw.- Testing.
0:17:12 > 0:17:15This is where things can go wrong while opening the breastbone
0:17:15 > 0:17:17we can straight enter into the heart,
0:17:17 > 0:17:21so we make sure that everybody's available in the theatre.
0:17:21 > 0:17:24We have the perfusionist and the heart-lung machine ready
0:17:24 > 0:17:26and set up, in case if we need to go on bypass.
0:17:26 > 0:17:28Gently.
0:17:28 > 0:17:29Are you OK?
0:17:29 > 0:17:31Is everybody all right?
0:17:31 > 0:17:34SAW WHIRRS
0:17:45 > 0:17:49It's always in my mind, what they think they might be doing
0:17:49 > 0:17:53and... I have visions in my head and...
0:17:55 > 0:17:57I just don't think about it.
0:17:57 > 0:18:02I don't know how you can do that. How can you not think about it?
0:18:05 > 0:18:07It's mine now.
0:18:10 > 0:18:14Hello, mate. What's been happening?
0:18:15 > 0:18:17That's good news, Dad.
0:18:23 > 0:18:26Look at the camera. Smile for the camera.
0:18:26 > 0:18:29I know you haven't done your hair yet, but, hey!
0:18:29 > 0:18:33You're still beautiful, you get me?
0:18:33 > 0:18:35A true teenager.
0:18:35 > 0:18:38Genieva was diagnosed with early stage kidney failure.
0:18:38 > 0:18:40That's my girl.
0:18:42 > 0:18:43Oh, it tastes nasty.
0:18:43 > 0:18:45Yeah, but you know it's not about the taste,
0:18:45 > 0:18:48it's about what it's going to do for your body.
0:18:48 > 0:18:49All right there?
0:18:49 > 0:18:51- Are you Genieva's sister?- Yes.
0:18:51 > 0:18:54Give her a kiss, then.
0:18:54 > 0:18:55Do you love her?
0:18:55 > 0:18:57Oh, cuddle time.
0:19:08 > 0:19:12The Yorkshire air ambulance is one of 35 helicopters on stand-by
0:19:12 > 0:19:14today across the UK.
0:19:14 > 0:19:17'Ambulance, tell me exactly what's happened?'
0:19:17 > 0:19:21'I've had a mechanic doing some work and I think he's had a heart attack.'
0:19:24 > 0:19:26A call has come from a farm outside Ripon.
0:19:26 > 0:19:28'OK, I'm organising help for you now.
0:19:28 > 0:19:31'Stay on the line and I'll tell you how to do resuscitation.
0:19:31 > 0:19:33- 'Listen carefully.'- Yes.
0:19:33 > 0:19:36'Pump the chest hard and fast at least twice a second.
0:19:36 > 0:19:40'We're going to do this 600 times or until help can take over.'
0:19:40 > 0:19:43Paramedics have been dispatched by road.
0:19:43 > 0:19:46The helicopter has been scrambled to get the 80-year-old mechanic
0:19:46 > 0:19:49to hospital as fast as possible.
0:19:49 > 0:19:53- 'Is that the right pace? - Yep. Keep going for me.'
0:19:53 > 0:19:56'11, 12, 13, 14, 15...
0:19:56 > 0:19:58'..55, 56, 57, 58, 59...
0:19:58 > 0:20:02'..90, 91, 92, 93...
0:20:02 > 0:20:03'96, 97, 98, 99...'
0:20:03 > 0:20:06'Don't give up, this will keep him going
0:20:06 > 0:20:09'until the ambulance gets there.'
0:20:09 > 0:20:11'98, 99, 100. I think the ambulance is here.'
0:20:11 > 0:20:14'OK, keep going for me until they're ready to take over.'
0:20:14 > 0:20:18'I don't how long he was down. I literally...'
0:20:19 > 0:20:23Paramedics are on the scene, trying to resuscitate the mechanic.
0:20:23 > 0:20:27It's now 15 minutes since the 999 call was made.
0:20:28 > 0:20:31Found collapsed, was blue, I got here CPR was in progress
0:20:31 > 0:20:34when I got here. Arrest could have happened at any time.
0:20:34 > 0:20:36He has got a bit of a cut on his head.
0:20:36 > 0:20:38OK. Just stop.
0:20:43 > 0:20:46Carry on. Tell me if you want to swap.
0:20:49 > 0:20:52See if you can gather any information off the other guy,
0:20:52 > 0:20:54- age and that type of thing. - Yes, sure.- Cheers.
0:20:54 > 0:20:56Is it a relative or...?
0:20:56 > 0:21:01No, he's a friend from the village. He does a bit of mechanicing.
0:21:01 > 0:21:05He could be hypothermic. It's unlikely.
0:21:05 > 0:21:08At the moment, he's not responding to anything we're doing.
0:21:08 > 0:21:11- No, I didn't like the look of him when I found him.- Yes.
0:21:11 > 0:21:13Probably not going to be here.
0:21:13 > 0:21:16He's not got any bruising where he's fallen or anything like that?
0:21:16 > 0:21:20No. There is one cut here. He could've clouted it on the way.
0:21:20 > 0:21:24He was saying to the chap it was a bit of a bugger as a job,
0:21:24 > 0:21:28when he was doing this vehicle, so he could've got himself worked up.
0:21:28 > 0:21:29Liz Shade.
0:21:29 > 0:21:32- She's going to be absolutely mortified.- Of course she is.
0:21:32 > 0:21:35Why don't you hang fire a minute and let's see what happens.
0:21:35 > 0:21:36Let's see if...
0:21:36 > 0:21:39Yes, I don't want to hide it from her either, do you know what I mean?
0:21:39 > 0:21:43I didn't know whether to call her first or the ambulance, but it was ambulance.
0:21:43 > 0:21:45Yes, yes.
0:21:48 > 0:21:50Pupils are fixed and dilated.
0:21:51 > 0:21:53All right,
0:21:53 > 0:21:55I think we're going to get to the point of calling this.
0:21:55 > 0:21:57Is everybody happy that we call this?
0:21:57 > 0:22:00All right, we've done ALS, we've done BLS.
0:22:00 > 0:22:02- All his reversible causes. - All his reversible causes.
0:22:02 > 0:22:05Maintained asystole throughout.
0:22:05 > 0:22:07- Right, stop here then, yes?- Yes.
0:22:09 > 0:22:11Tell this gentleman.
0:22:17 > 0:22:21Yes, as we suspected, we've given him all the drugs we can
0:22:21 > 0:22:22so far and, there's nothing.
0:22:24 > 0:22:26I think Mark's just gone to...
0:22:28 > 0:22:31I mean, great stuff for doing what you did.
0:22:31 > 0:22:33I mean, certain cardiac events, certain things,
0:22:33 > 0:22:35there's just no coming back from.
0:22:44 > 0:22:47- Right, I better go up and see Liz then, hadn't I?- OK.
0:22:48 > 0:22:51Husband, father and grandfather
0:22:51 > 0:22:54Jim Shade had no previous history of heart trouble.
0:23:00 > 0:23:03We cut here. Press it and cut there.
0:23:03 > 0:23:05Just leave it there.
0:23:06 > 0:23:09Having reached baby Kyran's heart,
0:23:09 > 0:23:11surgeon Ram is ready to cut into the artery.
0:23:11 > 0:23:16Kyran's heart problems, this part of the aorta was quite small
0:23:16 > 0:23:19when he was born, so, initial operation,
0:23:19 > 0:23:23we made this bigger and now he came back with narrowing in here,
0:23:23 > 0:23:26right in the root of this great vessel,
0:23:26 > 0:23:29so we had to enlarge that wall,
0:23:29 > 0:23:32make it bigger, as well as this part of the great artery.
0:23:32 > 0:23:36To widen the valve, Ram has to painstakingly stitch
0:23:36 > 0:23:39a six-millimetre skin graft into the artery,
0:23:39 > 0:23:41but he can't operate with the heart beating.
0:23:41 > 0:23:43- Are you happy?- Yes.
0:23:43 > 0:23:46- On bypass please.- OK.
0:23:48 > 0:23:51The bypass machine will take on the job of the heart.
0:23:56 > 0:23:59So now, the heart-lung machine is taking over the circulation
0:23:59 > 0:24:01and the heart will become empty now.
0:24:10 > 0:24:13- We are about to stop the heart. - We are about to stop the heart.
0:24:38 > 0:24:40It has actually stopped.
0:24:40 > 0:24:42If you see the ECG monitoring line there,
0:24:42 > 0:24:45which has completely gone flat.
0:24:45 > 0:24:47The white at the top and the heart rate is zero.
0:24:53 > 0:24:57Gemma first found out there was a serious problem with Kyran's heart
0:24:57 > 0:24:59during a routine pregnancy scan.
0:24:59 > 0:25:03Doctors couldn't tell whether the defect was treatable
0:25:03 > 0:25:06and weren't able to give a clear prognosis until he was born.
0:25:06 > 0:25:11I was 32 weeks pregnant and they actually said to me
0:25:11 > 0:25:13that I could actually terminate my pregnancy then.
0:25:13 > 0:25:18For someone to say that you could terminate your baby at 32 weeks
0:25:18 > 0:25:21is, it's very hard to take.
0:25:21 > 0:25:23I couldn't.
0:25:23 > 0:25:25I know they have to give you that opportunity
0:25:25 > 0:25:27to have a termination but...
0:25:27 > 0:25:29No, I couldn't.
0:25:30 > 0:25:34Because of all the stress, me and Michael have split up.
0:25:34 > 0:25:38Michael couldn't take it, so he went to live with his mum.
0:25:40 > 0:25:42I think he just wanted to be on his own.
0:25:45 > 0:25:50For Michael not being there, it was a lot harder to...
0:25:52 > 0:25:56Because I was, I just got all of that information about Kyran
0:25:56 > 0:26:00and all I wanted to do was just cuddle up to Michael,
0:26:00 > 0:26:04you know, like you do, and he weren't there.
0:26:06 > 0:26:10You're too busy worrying to think about each other. It's quite...
0:26:11 > 0:26:13It very difficult.
0:26:17 > 0:26:18He'll be all right.
0:26:20 > 0:26:22Genieva, roll your window.
0:26:22 > 0:26:24Thank you.
0:26:24 > 0:26:26Where are you going, Genieva?
0:26:26 > 0:26:29- Look in the camera, please. Where are you going?- Hospital.
0:26:29 > 0:26:30Which hospital?
0:26:30 > 0:26:32Evelina.
0:26:32 > 0:26:34Guys Children's Hospital.
0:26:34 > 0:26:38- How do you feel about going there? - OK.
0:26:38 > 0:26:39You feel OK?
0:26:39 > 0:26:40Cheese, Mum!
0:26:40 > 0:26:43- Why do you have to go there? - To have dialysis.
0:26:43 > 0:26:46- Look into the camera, please. - Cheese!
0:26:46 > 0:26:49- To have dialysis. - Three times a week.- Yes.
0:26:49 > 0:26:50Cheese!
0:26:50 > 0:26:54'A very important date in the calendar of Welsh music today...'
0:26:55 > 0:26:59My friend, Louisa, the blonde.
0:27:01 > 0:27:03Very good. What lovely teeth.
0:27:16 > 0:27:18Stigmatise the cigarette, rather than the smoker.
0:27:18 > 0:27:22We want the smokers to feel we are on their side.
0:27:22 > 0:27:26OK, let me show you again. This is our dominant image.
0:27:26 > 0:27:31It's a cigarette with a fleshy, red, cancerous tumour.
0:27:34 > 0:27:37Oh, I could never be a heroin addict!
0:27:37 > 0:27:40'We are talking about the cost of celebrity gone wrong.
0:27:40 > 0:27:43'Plebgate, it's not going away, you know.
0:27:43 > 0:27:47'Gary Barlow is off on a solo tour. Would you pay to see him
0:27:47 > 0:27:49'without the rest of the Take That lads?
0:27:49 > 0:27:52Under the watchful eye of Kilcreggan care home staff,
0:27:52 > 0:27:56Ciaran is making his favourite egg and onion sandwiches for lunch.
0:27:56 > 0:27:58Ciaran does like onions,
0:27:58 > 0:28:00absolutely no problem to him.
0:28:00 > 0:28:04Eats them like apples. It's an acquired taste, that's for certain.
0:28:04 > 0:28:08There is no medication to ease Ciaran's constant urge to eat.
0:28:08 > 0:28:12All staff can do is make sure he maintains a healthy lifestyle
0:28:12 > 0:28:14with exercise and strict meal rotas.
0:28:14 > 0:28:17You go swimming today, yes?
0:28:17 > 0:28:18No. Go on Sunday.
0:28:18 > 0:28:22- It's under swimming.- Zumba.
0:28:22 > 0:28:24Zumba.
0:28:24 > 0:28:27- Zumba.- Zumba today.- Yes.
0:28:27 > 0:28:32- OK.- I know what my days, I know my schedule, blah blah blah.
0:28:36 > 0:28:39That's what I'm looking for.
0:28:40 > 0:28:42You don't have soup today.
0:28:42 > 0:28:44Yes, I have soup with my sandwich.
0:28:44 > 0:28:46It's all right.
0:28:57 > 0:28:58Go on, make a big fuss of it.
0:28:58 > 0:29:01Go on! Make a big fuss of it! Go on!
0:29:01 > 0:29:04- Make a big fucking fuss of it! - I just want to...
0:29:04 > 0:29:06Go on, make a big fuss of it, go on.
0:29:06 > 0:29:09- I just want to talk to him. - Go on, make a big fuss of it.
0:29:09 > 0:29:14You see that there. I can crumple it up. I can put it in the bin.
0:29:14 > 0:29:17- That's because of you. - No, I just explained to you.
0:29:17 > 0:29:19I've put it in the bin.
0:29:19 > 0:29:23- You can read. Today... - Fuck away off! Fuck away off!
0:29:23 > 0:29:25Calm down, Ciaran.
0:29:25 > 0:29:27I'm going to see him.
0:29:27 > 0:29:30I'm not staying in this fucking Kilcreggan.
0:29:30 > 0:29:32I'm telling you, I'm telling my mother.
0:29:32 > 0:29:33Calm down, calm down.
0:29:33 > 0:29:36Fuck away off. Fuck away off!
0:29:36 > 0:29:39You are driving me in-fucking-sane, man.
0:29:39 > 0:29:42He's over limit on his food budget,
0:29:42 > 0:29:45because the soup is tomorrow's lunch.
0:29:45 > 0:29:48Being in this place makes me so popping mad sometimes.
0:29:48 > 0:29:50Ciaran, did you read this?
0:29:50 > 0:29:52Get the saucepan out of his hands.
0:29:52 > 0:29:54I'm sure you read that, Ciaran.
0:29:54 > 0:29:56I always have a soup along with my sandwich.
0:29:56 > 0:29:59So is the thing for you and me to do
0:29:59 > 0:30:01- to have a conversation with Sandra later on?- Yes.
0:30:01 > 0:30:03OK, that's the thing we'll do then.
0:30:06 > 0:30:09Mealtimes will, nine times out of ten, will be challenging.
0:30:09 > 0:30:12What he was after, was he'd seen the cup-a-soups sitting there
0:30:12 > 0:30:13and that's what he wanted.
0:30:13 > 0:30:16That was part of his menu yesterday and part of his menu tomorrow
0:30:16 > 0:30:19and he knows his menu, you can be absolutely sure of it,
0:30:19 > 0:30:24but that was an opportunity that he'd seen to get something extra.
0:30:27 > 0:30:29Anybody else, it's not a problem,
0:30:29 > 0:30:31but, you know, he's limited to an amount of calories.
0:30:31 > 0:30:36His metabolism burns off food a lot slower than we do
0:30:36 > 0:30:38and that's where the real risk is.
0:30:38 > 0:30:41It seems like such a simple thing to turn around and say,
0:30:41 > 0:30:42"Yeah, go ahead and have that,"
0:30:42 > 0:30:45and the next time, "Go ahead and have that."
0:30:45 > 0:30:48Then you come back four weeks later and allow him to have all that
0:30:48 > 0:30:51and you're looking at a stone weight on as fast as that.
0:30:51 > 0:30:53And that continues to multiply
0:30:53 > 0:30:56and that's where the real danger in his health comes to.
0:31:15 > 0:31:1754 minutes, coming up to an hour now.
0:31:24 > 0:31:28OK, now let me assess that other side once again to see...
0:31:28 > 0:31:29No, stop.
0:31:31 > 0:31:34He is given? OK, we will try and do our best to...
0:31:34 > 0:31:38Ram has successfully sewn the tiny graft into baby Kyran's heart valve.
0:31:40 > 0:31:43But in doing so, he has discovered another problem.
0:31:43 > 0:31:47These are called the leaflets of the valve, they are supposed to be
0:31:47 > 0:31:52very thin, but in Kyran's case they are a bit thicker now.
0:31:52 > 0:31:56What looks like instead of having three leaflets out of three doors,
0:31:56 > 0:31:59- surprisingly he has got only two doors.- Did you know that?
0:31:59 > 0:32:02Sometimes with the scans you can't exactly see,
0:32:02 > 0:32:07but what we know is that it will cause problems to him
0:32:07 > 0:32:10later on because it's not a normal valve.
0:32:12 > 0:32:15The newly discovered defect means Kyran may well have to undergo
0:32:15 > 0:32:17more open heart surgery.
0:32:18 > 0:32:23What we need to do now is to expel all the air.
0:32:23 > 0:32:26If air travels to the brain, it causes brain damage.
0:32:26 > 0:32:28Is the vent sucking OK?
0:32:31 > 0:32:34OK, clamp off, lungs off, please.
0:32:42 > 0:32:46The heart has started beating happily which is a good sign.
0:32:46 > 0:32:48You can see the ECG has returned.
0:32:48 > 0:32:50The heart is contracting,
0:32:50 > 0:32:53so now we are ready to take Kyran off the heart-lung machine.
0:32:53 > 0:32:54- Are you happy?- Happy.
0:32:54 > 0:32:59Are you ventilating a bit? Come off bypass, please. Go on.
0:33:01 > 0:33:04- A little bit of volume, please.- OK.
0:33:04 > 0:33:07Ram can only be sure this operation has worked
0:33:07 > 0:33:09when the heart is beating independently
0:33:09 > 0:33:13and the scan shows the artery is working.
0:33:24 > 0:33:26I am happy.
0:33:26 > 0:33:27With the scan we have done
0:33:27 > 0:33:30and with the result, we are sure that the operation is a success.
0:33:37 > 0:33:40- Hello.- Hello.- Everything went fine.
0:33:40 > 0:33:43- We did what we planned to do.- Yes.
0:33:43 > 0:33:48There were a couple of things that we hadn't been expecting.
0:33:48 > 0:33:51Normally in every person the valves should contain three doors,
0:33:51 > 0:33:54open and closed. Normal people.
0:33:54 > 0:33:57So what Kyran has got is he has got only two doors
0:33:57 > 0:33:59and the two doors are not equal.
0:33:59 > 0:34:03So the problem now is that since his valve is not normal,
0:34:03 > 0:34:05- it might require another operation later on.- OK.
0:34:05 > 0:34:08- He hopefully won't need another one after that.- Hopefully not.
0:34:08 > 0:34:10- Hopefully not.- So... - Everything went well.
0:34:10 > 0:34:12We'll give him some more time
0:34:12 > 0:34:14so that he'll settle and then wake up properly.
0:34:14 > 0:34:16Yay!
0:34:16 > 0:34:21- I'm going to cry. I am just so happy.- Yes, he is fine.- Good.
0:34:21 > 0:34:25Thank you very much. Yes. I'm just so happy.
0:34:25 > 0:34:28Everything were good, everything were successful, yes.
0:34:28 > 0:34:31I'm just so happy. Yes.
0:34:42 > 0:34:43At the cath lab,
0:34:43 > 0:34:4773-year-old Noel has come in to have his arteries examined.
0:34:49 > 0:34:52I seem to be, you know,
0:34:52 > 0:34:57if I'm walking any distance, I seem to get breathless very easily.
0:34:57 > 0:35:00And I get tired very, very easily.
0:35:00 > 0:35:05So they just want to sort of check to see basically
0:35:05 > 0:35:08what's causing this problem.
0:35:08 > 0:35:11- What do you think it might be? - Who knows?
0:35:13 > 0:35:15Just have to wait and see.
0:35:17 > 0:35:20Bit of pushing in the arm now, sir, a bit of pushing in the arm.
0:35:29 > 0:35:30- Right, sir, we're done.- Lovely.
0:35:30 > 0:35:32We're going to take this tube out of your arm now,
0:35:32 > 0:35:34if you just hold onto this, sir.
0:35:34 > 0:35:36- We are done.- Glad it's over.
0:35:37 > 0:35:40- Right, so I'm just going to... - Pretty boring just lying here.
0:35:40 > 0:35:43All I'm thinking now is a nice cup of coffee.
0:35:49 > 0:35:54And a cigarette. I shouldn't say that, should I?
0:35:54 > 0:35:57Your arteries, although there are certain blockages here and there,
0:35:57 > 0:36:00they're not severe enough to require any intervention,
0:36:00 > 0:36:02be it stents or bypass surgery or anything like that.
0:36:02 > 0:36:05The other thing to say is that the pumping function of your heart
0:36:05 > 0:36:06is actually not bad.
0:36:06 > 0:36:13So why does my body feel as if it's out of oxygen after about 100 metres?
0:36:13 > 0:36:16- You know, remember you are a smoker, aren't you?- Yes.
0:36:16 > 0:36:20So it's not necessarily your heart that's to blame for all of this.
0:36:20 > 0:36:23He does have clinical signs of smoking-related lung disease
0:36:23 > 0:36:26and he's promised he's going to stop, gradually.
0:36:26 > 0:36:28- Yes, the willpower is what you need now.- Yes, I do.
0:36:28 > 0:36:30Say to yourself, "Look, it's not too bad,
0:36:30 > 0:36:33- "I've been given reasonably good news..."- Right.
0:36:33 > 0:36:36- "..let's consolidate that and build on it."- Yes.- OK?
0:36:36 > 0:36:38- See you later on on the ward, then. - Yes.
0:36:38 > 0:36:40Smoking is a big part of his problem
0:36:40 > 0:36:42and his main problem is breathlessness.
0:36:42 > 0:36:45A proportion of his breathlessness will be down to his lungs
0:36:45 > 0:36:48because when I did examine them, he does have wheezy lungs,
0:36:48 > 0:36:50he's got expanded lungs and it's probably all smoking-related
0:36:50 > 0:36:53so a lot of his breathlessness will be down to smoking.
0:36:53 > 0:36:56Does it frustrate you that people carry on smoking after you see them?
0:36:56 > 0:37:01It can be, but you know, you do your best to improve their health
0:37:01 > 0:37:03and as frustrating as it may be, there is nothing I can do
0:37:03 > 0:37:06to force him to stop. All we can do is just keep advising.
0:37:06 > 0:37:12It's good news but I still haven't got sort of... How can I put it?
0:37:12 > 0:37:18..something that I can do which actually can give me an improvement.
0:37:18 > 0:37:22- If you understand me.- They said if you cut down on smoking...
0:37:22 > 0:37:24Yes, yes, yes. Well, I'm on ten.
0:37:26 > 0:37:28Ten a day.
0:37:30 > 0:37:33Instinctively I feel that that's not the problem.
0:37:33 > 0:37:35Oh, well.
0:37:47 > 0:37:49- How are you feeling?- Anxious.
0:37:49 > 0:37:53- Nervous?- Yes.- Excited? - Excited, nervous.- Can't wait?
0:37:53 > 0:37:57- How old are you?- Me, I'm 39 now,
0:37:57 > 0:37:59I had a heart attack when I was 37.
0:37:59 > 0:38:05And since I've had my bypass I've been back here 44 times
0:38:05 > 0:38:08- with the same problem. - That's crazy, isn't it?- Yes.
0:38:08 > 0:38:12I used to think it was down to being a little bit overweight,
0:38:12 > 0:38:15but the time when I had my last heart attack,
0:38:15 > 0:38:18there was a person in there who was on my ward, in my cubicle,
0:38:18 > 0:38:22and by looking at him you could see that he was really fit,
0:38:22 > 0:38:25he goes to the gym and everything and he had a bypass
0:38:25 > 0:38:27so it could happen to anybody, really.
0:38:33 > 0:38:35Right hand, quickly, quickly.
0:38:36 > 0:38:39HE RETCHES
0:38:39 > 0:38:42This is the hand that I used to use.
0:38:46 > 0:38:50I had a stupid idea this, three months ago, I said,
0:38:50 > 0:38:55for my 77th birthday, which was last week, to celebrate it...
0:38:56 > 0:38:59..in Croatia. Dear! Did we?
0:38:59 > 0:39:02Any heart problems prior to last week?
0:39:02 > 0:39:06- I have had a heart attack when... - July, 1996.
0:39:06 > 0:39:09David and Josie have been married for 53 years.
0:39:09 > 0:39:14On holiday in Croatia last week, David was rushed into hospital.
0:39:14 > 0:39:17He spent three days on a coronary care ward in Dubrovnik
0:39:17 > 0:39:19where he was diagnosed with a heart murmur.
0:39:19 > 0:39:23He flew home, but today his symptoms have returned.
0:39:24 > 0:39:26At least they all speak English, don't they?
0:39:26 > 0:39:29David can communicate with people and you couldn't there,
0:39:29 > 0:39:32and they were lovely, but it was very hard work, wasn't it?
0:39:32 > 0:39:34Oh, yes, wonderful, wonderful doctor.
0:39:34 > 0:39:36It was very traumatic for me in Dubrovnik.
0:39:36 > 0:39:38They put him in a place like this,
0:39:38 > 0:39:42"Well, we will keep him in. You go, we will keep him in."
0:39:42 > 0:39:44I thought, "Oh, thanks."
0:39:44 > 0:39:46So at twenty to four in the morning,
0:39:46 > 0:39:52I was left in a very, very dark corridor with just little...
0:39:52 > 0:39:56Nothing like these, nothing at all like that, just little lamps.
0:39:57 > 0:39:59So how do you get out of there? You know?
0:39:59 > 0:40:02"How do I get out of there?"
0:40:02 > 0:40:04I thought "Well, I think I've done the easy bit,
0:40:04 > 0:40:07"the easy bit is I've got David looked after,
0:40:07 > 0:40:09"I could do with someone to look after me,"
0:40:09 > 0:40:15because, you see, all the signs are in Croat. You just...
0:40:15 > 0:40:19It's not something that I would recommend to anybody,
0:40:19 > 0:40:22but we got through it.
0:40:22 > 0:40:26Anyway, I found my way out with the help of a...gorgeous man.
0:40:28 > 0:40:32Clogs and all. White clogs and everything on. You know?
0:40:34 > 0:40:36We did want to come home, yes.
0:40:36 > 0:40:42David more than me, because the food was, it was fed in steel bowls.
0:40:42 > 0:40:45You know, like you give dogs.
0:40:45 > 0:40:50It was, well, I don't know if it was soup or Ready Brek.
0:40:50 > 0:40:53I don't know what it was. It was indescribable.
0:40:53 > 0:40:55The food was terrible.
0:40:55 > 0:40:57He said, "Look at my lunch!"
0:41:05 > 0:41:08But he's not right, my David, you know, he's not right.
0:41:08 > 0:41:11They'll get him right, hopefully.
0:41:32 > 0:41:36Kyran is back from theatre and he is stable,
0:41:36 > 0:41:38but since he's come onto the unit he has started bleeding
0:41:38 > 0:41:40more and more.
0:41:40 > 0:41:46We are on top of it, but his body is fighting us so we need to keep him...
0:41:48 > 0:41:51There's been an unexpected complication.
0:41:51 > 0:41:54Kyran's suddenly losing a lot of blood.
0:42:00 > 0:42:03I can see his heart beating.
0:42:03 > 0:42:06Yes, because it's beating so hard, so fast, the heart.
0:42:06 > 0:42:09- He's not going into cardiac arrest or anything?- No, as long as we...
0:42:09 > 0:42:14Ram is going to reopen Kyran's chest to find out why he's bleeding so heavily.
0:42:14 > 0:42:16If he is bleeding excessively...
0:42:16 > 0:42:19When he initially came in here, it wasn't much,
0:42:19 > 0:42:21he was extubated, everything was good, we thought.
0:42:21 > 0:42:24But then he suddenly started bleeding.
0:42:24 > 0:42:28We interfered with the clotting mechanism of the blood, so
0:42:28 > 0:42:31we keep it very thin and sometimes it doesn't thicken very well.
0:42:31 > 0:42:34It is always safer to have a look.
0:42:34 > 0:42:36Hopefully we can fix it.
0:42:37 > 0:42:39Will someone ring us?
0:42:39 > 0:42:41Can I give him a quick kiss?
0:42:49 > 0:42:54Ram needs to operate immediately and so closes the intensive care ward.
0:42:55 > 0:42:58I thought that were it, I thought he were going to be fine and then...
0:43:00 > 0:43:02Everything's changed.
0:43:03 > 0:43:06I'm confident in everything what they're doing, but it's...
0:43:06 > 0:43:09At the end of the day, it's still my baby and there's still,
0:43:09 > 0:43:12something, you know, serious happening.
0:43:25 > 0:43:28He's got an emergency on and there's one treat and return.
0:43:28 > 0:43:31- And there's another one going in. - There's another one after this one.
0:43:31 > 0:43:34It looks like we going to be busy already, so...
0:43:34 > 0:43:36I know, that's why I want to create as much capacity.
0:43:36 > 0:43:40The cath lab is having a run of emergency cases.
0:43:40 > 0:43:43When you say extensive, have you got a measurement?
0:43:43 > 0:43:46OK, all done! Good news.
0:43:46 > 0:43:48- One in, one out.- One in, one out.
0:43:48 > 0:43:51ETA, when, sorry?
0:43:51 > 0:43:53Ten minutes, OK. Thank you very much.
0:43:54 > 0:43:57There is a shortage of beds and procedure rooms.
0:43:57 > 0:44:02Five minutes, thank you. All right, thanks, love. Bye. Five minutes.
0:44:02 > 0:44:06With another emergency case about to arrive, the team have to make
0:44:06 > 0:44:09a difficult decision about a female patient from another hospital,
0:44:09 > 0:44:12who's been waiting for her planned operation.
0:44:14 > 0:44:17She won't have a bed to go into because they're all male beds.
0:44:17 > 0:44:20I'm not arguing who should be done, but there is still two to do.
0:44:20 > 0:44:22Don't you agree with that, though?
0:44:22 > 0:44:23Don't you think that's a wise decision?
0:44:23 > 0:44:25If we can't do it, we can't do it.
0:44:27 > 0:44:30- We're just moving, so there should be a bed.- Right, lovely.
0:44:30 > 0:44:31She's crying.
0:44:32 > 0:44:33She's not happy.
0:44:33 > 0:44:36It's quite sad really, because she's been waiting for a few days.
0:44:36 > 0:44:39She's got a complex case and you want to do her procedure
0:44:39 > 0:44:42but you can't right now, because we've got an emergency coming in.
0:44:42 > 0:44:45If it's up to you, you'd stick around after five o'clock
0:44:45 > 0:44:47and do it at six or seven, but it's not up to you
0:44:47 > 0:44:50and we've got nowhere to put her after we do her procedure.
0:44:50 > 0:44:54The latest emergency patient is 74-year-old Rita.
0:44:58 > 0:44:59When did the chest pain start?
0:44:59 > 0:45:02I've had an aching chest all week.
0:45:02 > 0:45:07- Have you got chest pain now? - Yes.- ECG, please.
0:45:09 > 0:45:11The ECG shows you're having a heart attack.
0:45:11 > 0:45:15In that case we're going to take you straight to the lab
0:45:15 > 0:45:18to unblock the artery to stop the heart attack.
0:45:18 > 0:45:20- Is that OK?- Yes.- Let's go.
0:45:35 > 0:45:37What's happened to the ECG?
0:45:37 > 0:45:39INAUDIBLE SPEECH
0:45:39 > 0:45:44Right, OK, so that means that we need to be acting more quickly.
0:45:44 > 0:45:48- If you hear extensive ST changes... - It sounds bad.- It sounds bad, yeah.
0:45:53 > 0:45:56I've just walked into the dialysis room.
0:45:56 > 0:46:00This is the machine that Genieva's going to be plugged into.
0:46:00 > 0:46:05My precious baby will not be on dialysis for ever,
0:46:05 > 0:46:08because there's nothing God cannot do, amen.
0:46:10 > 0:46:12Some saline.
0:46:12 > 0:46:16When you found out I was sick, like, how did you feel?
0:46:16 > 0:46:20When I found out you were sick I was heartbroken,
0:46:20 > 0:46:25because...this was the last thing I expected to hear.
0:46:28 > 0:46:31'See how it is out there on the water...'
0:46:37 > 0:46:39THEY GIGGLE
0:46:44 > 0:46:48- How are you feeling over there? - All right.- OK. Any chest pain?
0:46:48 > 0:46:51- How is the chest pain? - It's got a lot easier.
0:46:51 > 0:46:56We can see why, because we managed to open the artery for you. It's open.
0:46:56 > 0:46:59So you're getting blood back to your heart, which is good news.
0:46:59 > 0:47:02That is the artery now.
0:47:02 > 0:47:07That's what it was before. And here, the blood flow stops completely.
0:47:07 > 0:47:08The edge of the heart is there,
0:47:08 > 0:47:11so that portion of the heart is not getting any blood here.
0:47:11 > 0:47:15And now, we put a stent here
0:47:15 > 0:47:18and now we know that the blood flow is going back to where it should be.
0:47:18 > 0:47:20Good.
0:47:20 > 0:47:21- Are you a smoker?- Yes.
0:47:21 > 0:47:24One artery was fully blocked today.
0:47:24 > 0:47:27The tablets that you're going to be on are very important to protect you,
0:47:27 > 0:47:29but stopping smoking is absolutely vital here.
0:47:29 > 0:47:32I only smoke about five a day.
0:47:32 > 0:47:35My husband smokes three times as much.
0:47:35 > 0:47:41Mind you, I hope he doesn't end up with the same thing.
0:47:41 > 0:47:45- I never buy them. I won't buy them. - You just smoke his?
0:47:45 > 0:47:47I just smoke his!
0:47:50 > 0:47:52Rita has no history of heart problems.
0:47:55 > 0:47:58Well, we'd just had a cup of coffee and...
0:48:01 > 0:48:05Rita said that she had pains here. She said, "It's like indigestion."
0:48:05 > 0:48:07And it gradually got worse,
0:48:07 > 0:48:11and I said, "This is more than indigestion."
0:48:11 > 0:48:14And she was grey, her face was grey,
0:48:14 > 0:48:17and her hands were clammy and then she started to vomit.
0:48:17 > 0:48:20I said, "This is more than indigestion, this,
0:48:20 > 0:48:21"let me get an ambulance."
0:48:21 > 0:48:23She wouldn't let me get an ambulance at first.
0:48:23 > 0:48:25- She wouldn't let you get one? - No.- Why not?- Not at first.
0:48:25 > 0:48:28Well, she doesn't like the fuss and things like that.
0:48:28 > 0:48:34But she didn't tell me that she'd had this ache all week. Did you?
0:48:34 > 0:48:36- No.- Naughty girl.
0:48:36 > 0:48:37Well, now I'm worried.
0:48:37 > 0:48:40If I do have a smoke, it's not going to be in her vicinity.
0:48:40 > 0:48:43- It's going to be outside. Away from her.- Oh, no...
0:48:43 > 0:48:46It will be, it will be. You watch.
0:48:46 > 0:48:50I've always smoked, a good many years, you know.
0:48:50 > 0:48:54- I enjoy a cigarette.- Have you ever had any problems with your heart?
0:48:54 > 0:48:56Touch wood, no.
0:49:07 > 0:49:08HE COUGHS
0:49:08 > 0:49:10Do you like smoking?
0:49:10 > 0:49:12I do, yes.
0:49:12 > 0:49:14Because I like working...
0:49:14 > 0:49:20I like something working to do with my hands. I don't like...
0:49:20 > 0:49:25I don't like my hands just lying flat.
0:49:25 > 0:49:28Just the way I go.
0:49:28 > 0:49:31That's what I do during the day - smoke.
0:49:31 > 0:49:35During the night - smoke.
0:49:35 > 0:49:39That's just one of my leisures.
0:49:39 > 0:49:41Keeps you calm.
0:49:43 > 0:49:47Does smoking take your mind off the food?
0:49:47 > 0:49:49Erm, not really.
0:49:52 > 0:49:53What happened, James?
0:49:53 > 0:49:55Stabbed.
0:49:55 > 0:49:58I'm looking to retire. I feel cheated at the moment
0:49:58 > 0:50:01because the government's upped the retirement age,
0:50:01 > 0:50:04so I've got to stay on an extra two years, so I feel very cheated.
0:50:06 > 0:50:09'..Chelsea defender says he wanted to apologise to everyone...'
0:50:11 > 0:50:14That's us leaving now after a long day at dialysis.
0:50:14 > 0:50:17She's so tired and fed up.
0:50:17 > 0:50:22Her room is damp, so we are all sleeping in one bedroom.
0:50:22 > 0:50:25It's ridiculous, really.
0:50:25 > 0:50:28But I love her courage, I love her strength.
0:50:28 > 0:50:32If her dad was alive, I'm sure he'd be proud of her,
0:50:32 > 0:50:35she's a beautiful daughter.
0:50:35 > 0:50:36My beautiful Genieva.
0:50:46 > 0:50:51- Hello.- Hello.- How's things?- Not too bad.- Hello, how are you?- All right.
0:50:51 > 0:50:55You're looking very smart.
0:50:55 > 0:50:58So what's your plans the rest of the day, Ciaran?
0:50:58 > 0:51:00Well, I don't know.
0:51:00 > 0:51:03Since Ciaran moved in to the Kilcreggan Care Home
0:51:03 > 0:51:04three weeks ago,
0:51:04 > 0:51:06his mum, Angela, has been coming to check on him
0:51:06 > 0:51:08as often as she can.
0:51:08 > 0:51:10- We talk about it quite a lot, don't we, Ciaran?- Yeah.
0:51:10 > 0:51:12Yeah, just to make sure
0:51:12 > 0:51:15you're on the same wavelength as everybody else, aren't we?
0:51:15 > 0:51:17And that you've got the correct food and stuff,
0:51:17 > 0:51:24that you're making the right choices to keep yourself alive, isn't it?
0:51:24 > 0:51:28Because we wouldn't want anything less for you, would we? No.
0:51:28 > 0:51:31We wouldn't. We wouldn't want anything less.
0:51:33 > 0:51:35Have to be careful.
0:51:35 > 0:51:37- What have you found? - No, it's just sugar-free.
0:51:37 > 0:51:39We were just checking to make sure it was the right stuff
0:51:39 > 0:51:42that he should be drinking. But it is.
0:51:42 > 0:51:44I'm not buying any stupid stuff.
0:51:44 > 0:51:48No, I know you wouldn't buy stupid stuff, I'm just saying.
0:51:48 > 0:51:50'If Ciaran wants food, he's going to get it anywhere.
0:51:50 > 0:51:52At home we call Ciaran Houdini,
0:51:52 > 0:51:54because he was able...
0:51:54 > 0:51:56We were convinced he floated about the house,
0:51:56 > 0:51:57because we never heard him.
0:51:57 > 0:52:00You wouldn't know until the wrappers
0:52:00 > 0:52:02or the bottles or whatever were sitting.
0:52:02 > 0:52:04He was able to get tins of beans and things, even, out.
0:52:04 > 0:52:07I lifted it out of his bedroom one time.
0:52:07 > 0:52:11The food part of it is quite extreme with Ciaran.
0:52:11 > 0:52:15This is my bathroom, my shower and that.
0:52:15 > 0:52:19And my Home Changing Room sign.
0:52:19 > 0:52:23'Independence to Ciaran is very much top of the agenda.
0:52:23 > 0:52:27'We're hoping that this is the place for Ciaran,
0:52:27 > 0:52:29'but, obviously, being out in the community,
0:52:29 > 0:52:31'it's always at the back of your mind
0:52:31 > 0:52:33'when you're going to get the phone call'
0:52:33 > 0:52:35to say something's happened,
0:52:35 > 0:52:37or he's gone into a diabetic coma, or...
0:52:37 > 0:52:39Yeah, you're just waiting for that phone call, you know?
0:52:39 > 0:52:45All Ciaran's previous attempts to live independently have failed.
0:52:45 > 0:52:47The NHS found him a place at a residential college,
0:52:47 > 0:52:51but it was only weeks before his behaviour deteriorated
0:52:51 > 0:52:53and he was sectioned back to a secure hospital.
0:52:54 > 0:52:57'Ciaran obviously was buying the wrong types of food,
0:52:57 > 0:52:59'wasn't taking his insulin.'
0:52:59 > 0:53:01He threatened a couple of the teachers down there
0:53:01 > 0:53:03who were more than good to him.
0:53:03 > 0:53:07The different bodies were all brought in, social services, doctor.
0:53:07 > 0:53:11Ciaran was put in the back of the ambulance
0:53:11 > 0:53:14and, for his own safety, Ciaran was then handcuffed,
0:53:14 > 0:53:16because obviously he tried to jump out,
0:53:16 > 0:53:20and he was taken up to a secure accommodation
0:53:20 > 0:53:22on the outskirts of Belfast.
0:53:24 > 0:53:28But, yeah, the worst day of our lives, that was. It was awful.
0:53:37 > 0:53:39'We're obviously sceptical
0:53:39 > 0:53:41'of what way things are going to go for Ciaran,
0:53:41 > 0:53:46'but he's trying, and we're hoping that it'll be'
0:53:46 > 0:53:49the place for him to stay and make a life for himself,
0:53:49 > 0:53:53and hopefully live as long as he can, you know?
0:53:53 > 0:53:58'I'm a 25-year-old man, I don't need to be treated like a two-year-old.'
0:53:58 > 0:54:02I just want to get on with my normal life, before...
0:54:02 > 0:54:07Like the rest of people do, like yourself. I just love independence.
0:54:08 > 0:54:12'The freedom now that he's got out in the community is still worrying,
0:54:12 > 0:54:14'because we know he can still
0:54:14 > 0:54:17'do his wee Houdini tricks and get the food.'
0:54:17 > 0:54:20We spend as much time as we can with him.
0:54:20 > 0:54:25As much as he'll let us - because he's independent now!
0:54:25 > 0:54:28- I was in that bar last weekend. - Is it any good?
0:54:28 > 0:54:30How the hell did you get home from that?
0:54:30 > 0:54:32Doesn't take long to get up home.
0:54:32 > 0:54:35You walked all the way up there on your own?
0:54:35 > 0:54:36THEY LAUGH
0:54:43 > 0:54:46Ram has managed to stem baby Kyran's bleeding
0:54:46 > 0:54:48and he is now stable.
0:54:51 > 0:54:53All went well.
0:54:53 > 0:54:54We opened the chest
0:54:54 > 0:54:58and then... There were tiny little holes, which were bleeding actually,
0:54:58 > 0:55:01where we took the needles through the patch we used to repair.
0:55:01 > 0:55:04What we did is, we reinforced all those tiny little holes
0:55:04 > 0:55:08and then we put some material and stuff to help it seal up.
0:55:08 > 0:55:11So, as you can see, there's not much coming out through the drains,
0:55:11 > 0:55:15and earlier on there was blood all over, which is all gone now.
0:55:15 > 0:55:19So hope that we're on top of things.
0:55:19 > 0:55:21OK. Yeah. Good, yeah.
0:55:32 > 0:55:35'Surgery today has saved my son's life.
0:55:35 > 0:55:39'If it weren't for people like Ram, he wouldn't be here now.'
0:55:41 > 0:55:44'We don't know what the future holds for Kyran.
0:55:44 > 0:55:47'After a few months he might need another operation.
0:55:47 > 0:55:53'It's going to be very stressful for all of us,
0:55:53 > 0:55:57'but we are lucky, because Kyran did pull through today.
0:55:57 > 0:56:03'That's a lot for a little baby to go through. So proud of him.'
0:56:12 > 0:56:14- HE LAUGHS - Part-timer!
0:56:14 > 0:56:18Eight o'clock to eight o'clock in the evening. Still a part-timer.
0:56:24 > 0:56:25Yeah, I'm in a hotel tonight
0:56:25 > 0:56:29because I'm on call for the hospital patients.
0:56:29 > 0:56:32It's 11 o'clock at night, we've just had a call.
0:56:32 > 0:56:35Someone coming from one of our district hospitals.
0:56:35 > 0:56:38He's having a heart attack now.
0:56:38 > 0:56:41He should be with us any minute.
0:56:52 > 0:56:55- It's a wonderful place.- It is.
0:56:55 > 0:57:00MUSIC: "Gimme Some Lovin'" By The Spencer Davis Group
0:57:37 > 0:57:40To order your free copy of the Open University's booklet,
0:57:40 > 0:57:44Working To Save Lives, which accompanies this series, call...
0:57:48 > 0:57:50..or go to...
0:57:52 > 0:57:54..and follow the links to the OU.
0:58:08 > 0:58:11Subtitles by Red Bee Media Ltd