0:00:02 > 0:00:05Glasgow's skyline has changed.
0:00:05 > 0:00:09Four of the city's oldest hospitals have closed their doors,
0:00:09 > 0:00:12and Scotland's biggest and most talked-about hospital
0:00:12 > 0:00:14has taken over.
0:00:14 > 0:00:17Are you ready, my big girl? Up you get.
0:00:18 > 0:00:21Three quarters of a million patients are treated here every year...
0:00:21 > 0:00:23SCREAMING
0:00:23 > 0:00:25I think it's quite fetching!
0:00:25 > 0:00:28The scans are up, equipment's ready, the lucky socks are on.
0:00:28 > 0:00:30..using state-of-the-art technology...
0:00:30 > 0:00:33I've got the manoeuvrability down there with the robot.
0:00:33 > 0:00:36..cutting-edge operations
0:00:36 > 0:00:39and world-class scientific research.
0:00:39 > 0:00:42He said it had been grown in a laboratory in America.
0:00:42 > 0:00:44You know what I mean? Grown!
0:00:44 > 0:00:46This massive building
0:00:46 > 0:00:49is transforming health care in Scotland.
0:00:49 > 0:00:52There is nowhere else in Scotland that could have done everything
0:00:52 > 0:00:53that we've done.
0:00:53 > 0:00:57But is big necessarily better?
0:00:57 > 0:01:01I think we all have trackers now to see how many miles we do a day.
0:01:01 > 0:01:04Am I in an airport or am I in a hotel?
0:01:04 > 0:01:05It's a cross between the two.
0:01:05 > 0:01:07And in a hospital this size,
0:01:07 > 0:01:11are they in danger of losing the human touch?
0:01:11 > 0:01:14You could go home irredeemably mad
0:01:14 > 0:01:17if you spent all your time in a single room.
0:01:17 > 0:01:20It's all technology in here now. I don't like it at all.
0:01:20 > 0:01:23You're so grateful.
0:01:23 > 0:01:24Can you hear me?
0:01:33 > 0:01:35Since opening two years ago,
0:01:35 > 0:01:38the Royal Hospital for Children in Glasgow
0:01:38 > 0:01:41has treated 180,000 children.
0:01:42 > 0:01:44With 256 beds,
0:01:44 > 0:01:48it's the largest purpose-built children's hospital in Scotland.
0:01:48 > 0:01:50GIGGLING
0:01:50 > 0:01:52Today, four-year-old Charlotte
0:01:52 > 0:01:55has come in with her mum and dad for an operation.
0:01:55 > 0:01:56Do you want a chair over?
0:01:58 > 0:02:01Charlotte spent four months in intensive care when she was born
0:02:01 > 0:02:04premature at 23 weeks.
0:02:04 > 0:02:07See what you can do. Oh, look!
0:02:07 > 0:02:11She weighed one pound six ounce.
0:02:11 > 0:02:13So she was like...
0:02:13 > 0:02:16the size of your hand, really. As you can see, there's my...
0:02:16 > 0:02:20that's my hand and this is the size of Charlotte.
0:02:20 > 0:02:23A bit of a scare when she came out that size.
0:02:23 > 0:02:27When she was first born, the only thing I kept saying to Richard was,
0:02:27 > 0:02:31"I'm sorry. I'm sorry." He was like, "Why are you sorry?"
0:02:31 > 0:02:34I was like, "I don't know."
0:02:34 > 0:02:37The fact is she's here, she's fought all the way,
0:02:37 > 0:02:39and, to be honest, still fighting.
0:02:41 > 0:02:44OK, Charlotte. Do you want to come through?
0:02:44 > 0:02:47- Are you taking Boo Boo? - Oh, got to bring them along.
0:02:47 > 0:02:49Charlotte is being admitted
0:02:49 > 0:02:53for an operation with specialist surgeon Tash Kunanandam.
0:02:53 > 0:02:55She's hoping to fix a problem caused
0:02:55 > 0:02:59during Charlotte's time in intensive care.
0:02:59 > 0:03:02Charlotte probably came to my clinic almost a year ago.
0:03:02 > 0:03:03She was born early,
0:03:03 > 0:03:06so she went to the neo-natal intensive care unit
0:03:06 > 0:03:09and she had a period of intubation, so she was on the ventilator.
0:03:09 > 0:03:11And we know that,
0:03:11 > 0:03:15although it's life-saving at the time and absolutely necessary,
0:03:15 > 0:03:18it can actually lead to some problems with swelling and scarring
0:03:18 > 0:03:22in the windpipe just under the voice box, and later on in life
0:03:22 > 0:03:27that scarring can give rise to a narrowing in their airway.
0:03:27 > 0:03:30As a result, Charlotte is susceptible to croup,
0:03:30 > 0:03:34a condition that causes swelling in her windpipe and makes it difficult
0:03:34 > 0:03:35to breathe.
0:03:35 > 0:03:39She's required numerous hospital admissions so they've never been
0:03:39 > 0:03:42mild enough episodes that she gets one dose of steroids
0:03:42 > 0:03:44and everything's fine.
0:03:44 > 0:03:47If you speak to the family, you know it does impact on their life,
0:03:47 > 0:03:50they're almost scared of this happening
0:03:50 > 0:03:52and the numerous trips to hospital.
0:03:54 > 0:03:57Mum Charlene has had some scary times.
0:03:57 > 0:04:00Croup, it doesn't sound as serious but when Charlotte's to the point
0:04:00 > 0:04:04where she's barely breathing, that's when I feel myself it is serious.
0:04:04 > 0:04:06There was a point where...
0:04:06 > 0:04:08I was taking her to the hospital
0:04:08 > 0:04:11and she actually turned blue and passed out in the car.
0:04:11 > 0:04:15She was barely breathing when we got to the hospital.
0:04:16 > 0:04:19And the fact that I've heard stories of people dying with the croup,
0:04:19 > 0:04:22which I don't know if it is true, but I have heard,
0:04:22 > 0:04:26and I just think that puts the fear through me even more -
0:04:26 > 0:04:30that after her fighting for as long as she did, that I might actually
0:04:30 > 0:04:33lose her through something silly like the croup.
0:04:40 > 0:04:45With winter approaching, the dangers of croup increase,
0:04:45 > 0:04:49so Tash is going to carry out a complex operation to permanently
0:04:49 > 0:04:54enlarge Charlotte's airway, using a piece of her own rib cartilage.
0:04:54 > 0:04:55We will make a cut into the airway,
0:04:55 > 0:04:58going through all the tissue in the neck,
0:04:58 > 0:05:00and divide the airway
0:05:00 > 0:05:04- so we can open up and see the area that's narrowed.- OK.- OK?
0:05:04 > 0:05:08We can just then measure the area that's needed to be grafted. OK?
0:05:08 > 0:05:11So we take a nice bit of rib tissue,
0:05:11 > 0:05:15carve it out and pop it into the airway.
0:05:16 > 0:05:20- Are you all right?- I don't know if I want to hear any more.
0:05:20 > 0:05:24You've been through a lot with her. I know it's a big operation
0:05:24 > 0:05:26but we're doing it with the aim that we can try to get things better
0:05:26 > 0:05:31- for her.- I know that, and that's what we want done, but it's just
0:05:31 > 0:05:34hearing the actual procedures...
0:05:38 > 0:05:39It is a big operation
0:05:39 > 0:05:43but it is something that we do lots of in this hospital.
0:05:43 > 0:05:46You know, it's a specialised area.
0:05:46 > 0:05:48That's why you've come to us.
0:05:48 > 0:05:50There's a whole team of people.
0:05:50 > 0:05:53They'll all be absolutely looking to do the best for you.
0:06:03 > 0:06:08Glasgow's adult neurology department has been here for 44 years.
0:06:08 > 0:06:12Beside it stands the new hospital and a cutting-edge research centre.
0:06:15 > 0:06:17Here, teams are working on one of the most complex
0:06:17 > 0:06:23but least understood parts of the human body - the brain.
0:06:23 > 0:06:28For neurosurgeon Roddy O'Kane it's his passion.
0:06:28 > 0:06:31It's one of the fields of medicine, I suppose, one of the last areas
0:06:31 > 0:06:35that we don't really know much about, to some degree.
0:06:35 > 0:06:39And in that, that makes it an exciting field because things
0:06:39 > 0:06:41are changing all the time.
0:06:41 > 0:06:4451-year-old Peter is in for a scan
0:06:44 > 0:06:47before a potentially life-changing operation.
0:06:49 > 0:06:51This is the new winter range,
0:06:51 > 0:06:54courtesy of Greater Glasgow Health Board.
0:06:54 > 0:06:58Wrap round for the winter, keep you nice and warm.
0:06:58 > 0:07:02There you go, have a nice day now!
0:07:02 > 0:07:07Peter is having surgery to remove a tumour deep within his brain.
0:07:07 > 0:07:12It's been increasing in size and causing him regular epileptic fits.
0:07:13 > 0:07:16One seizure that I did have recently
0:07:16 > 0:07:19lasted for 6.5 hours, I've been told.
0:07:19 > 0:07:21I have no recollection of it.
0:07:23 > 0:07:28Peter found out he had the tumour a week after meeting his partner, Sam.
0:07:28 > 0:07:32I get told I had a brain tumour - I never had one until I met you.
0:07:32 > 0:07:35At least I didnae run!
0:07:35 > 0:07:38- I know you didnae run, hen. - I know.
0:07:38 > 0:07:40OK, thank you.
0:07:40 > 0:07:42Roddy O'Kane is Peter's surgeon.
0:07:44 > 0:07:47- Now! How are you? - Fine, how are you?- Hi, folks.
0:07:47 > 0:07:50So people always say, "What are you going to chop out of me?"
0:07:50 > 0:07:51I'm going with this...
0:07:51 > 0:07:55Peter's tumour has grown to six centimetres.
0:07:55 > 0:07:57All of this white stuff, OK?
0:07:57 > 0:07:59Roddy suspects it's cancerous.
0:07:59 > 0:08:01So he has proposed an operation
0:08:01 > 0:08:06the team only attempt on around ten patients a year.
0:08:06 > 0:08:11When Roddy first told me about the procedure for the operation, right,
0:08:11 > 0:08:14eh, I wasn't too impressed.
0:08:14 > 0:08:17It's a case of awake surgery, right?
0:08:17 > 0:08:23And for people that don't know what that is, they sedate you,
0:08:23 > 0:08:28cut the top of your head off, or part of your skull off,
0:08:28 > 0:08:30then wake you up again.
0:08:30 > 0:08:35When Roddy first told me this, I had visions of them standing,
0:08:35 > 0:08:39having a talk, having a fag and using my head as an ashtray!
0:08:39 > 0:08:43Roddy's going to perform what is called an awake craniotomy.
0:08:43 > 0:08:47The operation that we're planning to do then is to put you asleep,
0:08:47 > 0:08:50open up the head, then wake you up,
0:08:50 > 0:08:52which allows us to take as much away
0:08:52 > 0:08:56as possible without causing you damage.
0:08:56 > 0:08:59This is a very important part of the brain.
0:08:59 > 0:09:02This lies in what is called your primary motor strip.
0:09:02 > 0:09:06If I chop that out in anybody, I paralyse them.
0:09:06 > 0:09:08OK? So in your right side
0:09:08 > 0:09:12- I would paralyse your left, and you are left-hand dominated?- Yes.
0:09:12 > 0:09:14It's a big surgery,
0:09:14 > 0:09:19and you've got to appreciate that comes with risks.
0:09:19 > 0:09:21So whilst you have walked into hospital,
0:09:21 > 0:09:25you may have problems getting out. That is a possibility.
0:09:25 > 0:09:29We could change your seizures, so we could make your seizures different
0:09:29 > 0:09:32or more frequent or more intense, OK?
0:09:32 > 0:09:35And everything I do carries a risk of death.
0:09:35 > 0:09:40OK? Small it may be, it's there.
0:09:40 > 0:09:44- In Rod I trust! Right?- OK.
0:09:44 > 0:09:47Right, the way I've got it in my head just now is that I'm going to
0:09:47 > 0:09:51- lose power on the left-hand side. - Uh-huh.
0:09:51 > 0:09:54If it turns out that I don't lose the power and I get recovery,
0:09:54 > 0:09:56it's a bonus. It's a Brucie Bonus.
0:09:56 > 0:10:01I've got the worst-case scenario now, if I lose power altogether.
0:10:01 > 0:10:04- So if you do a good job, happy days. - That's it. You're just
0:10:04 > 0:10:07- batting the pressure back to me. - Aye.- Good man.
0:10:07 > 0:10:10- OK.- See you Monday.
0:10:10 > 0:10:11OK, good, good. Well done.
0:10:11 > 0:10:15- OK, folks, see you, then. - Thank you.- All right.
0:10:17 > 0:10:20Because of the risks involved,
0:10:20 > 0:10:24not all surgeons would choose to operate on Peter's tumour.
0:10:24 > 0:10:27What we're embarking on is not a black and white area.
0:10:27 > 0:10:30It's an opinion-based area.
0:10:30 > 0:10:32I have a more aggressive mind-set
0:10:32 > 0:10:35to deal with this here, without a shadow of a doubt, yeah,
0:10:35 > 0:10:37but I freely admit that.
0:10:40 > 0:10:43He's young. He's fit, he's healthy, he's engaging,
0:10:43 > 0:10:47he's the right type of patient to undergo an awake craniotomy
0:10:47 > 0:10:50and he, I think, has fully taken on board
0:10:50 > 0:10:53the different options that we have,
0:10:53 > 0:10:55weighed them up and made his decision,
0:10:55 > 0:11:00which, if he feels is right, it's the right decision for Peter.
0:11:00 > 0:11:03Very brave. I think anybody going under surgery is brave.
0:11:06 > 0:11:09- So, it's Peter Fury, is that correct?- Yes.- Can you tell me
0:11:09 > 0:11:11in your own words what you are getting done today?
0:11:11 > 0:11:14- Brain tumour removed.- OK.
0:11:14 > 0:11:18- I cannae remember...- Yep, so it's an awake right frontal craniotomy.
0:11:18 > 0:11:21- Aye.- OK. So you're going to be awake during this procedure.
0:11:21 > 0:11:24- Yes.- Okey dokey? Now, are you allergic to anything at all?
0:11:24 > 0:11:27- Ex-wives!- None of them are surgeons, are they?
0:11:27 > 0:11:28- No.- OK.
0:11:30 > 0:11:32Going ahead with this operation
0:11:32 > 0:11:36is a big undertaking for both Peter and Roddy.
0:11:36 > 0:11:39I'd like to pretend I'm calm and collected. I'm not. There is a joke
0:11:39 > 0:11:41about why surgeons wear theatre masks,
0:11:41 > 0:11:43that's cos we're screaming underneath it.
0:11:52 > 0:11:54At any one time in the hospital,
0:11:54 > 0:11:57there are over 500 trials taking place,
0:11:57 > 0:12:01testing new treatments to help advance medical care.
0:12:02 > 0:12:04The renal and vascular departments
0:12:04 > 0:12:07in the adult hospital are world leaders
0:12:07 > 0:12:10in specialist procedures for patients on dialysis.
0:12:12 > 0:12:17Surgeon David Kingsmore is leading this work.
0:12:17 > 0:12:20We've got the best facility in the world in cutting-edge research
0:12:20 > 0:12:23and it's here in Govan. It's fantastic.
0:12:23 > 0:12:28Today's a big day for him, with an exciting arrival from America.
0:12:30 > 0:12:33This is science fiction being brought to the real world.
0:12:35 > 0:12:39This package contains a 40-centimetre-long blood vessel,
0:12:39 > 0:12:43or vein, grown entirely in a laboratory from human cells.
0:12:44 > 0:12:47If you went back to 1985
0:12:47 > 0:12:50and you said in a few decades
0:12:50 > 0:12:54we would be able to grow something in a test tube to implant,
0:12:54 > 0:12:57people would have thought you were mad.
0:12:57 > 0:13:01Its arrival here marks the start of a clinical trial to find out if this
0:13:01 > 0:13:05laboratory-grown blood vessel can help patients on dialysis.
0:13:06 > 0:13:10The hospital is the first place in Europe to take part in the research.
0:13:13 > 0:13:17In terms of cutting edge, this is on the front edge of science,
0:13:17 > 0:13:18not just medicine.
0:13:21 > 0:13:26One of Mr Kingsmore's dialysis patients is 47-year-old Dougie.
0:13:26 > 0:13:28There she goes.
0:13:28 > 0:13:30Dialysis is a life-saving treatment
0:13:30 > 0:13:34that cleans the blood of patients with kidney failure.
0:13:36 > 0:13:38I get it done three times a week,
0:13:38 > 0:13:41eight o'clock at night till one o'clock in the morning.
0:13:41 > 0:13:44Basically, I'm on dialysis until I get a transplant. That's...
0:13:45 > 0:13:49That's cast iron. It's not as if you get dialysis one week,
0:13:49 > 0:13:51miss it for a month and then come back,
0:13:51 > 0:13:54if I don't come back here for the dialysis,
0:13:54 > 0:13:57there is every chance they'll be phoning an undertaker.
0:13:59 > 0:14:03Dougie has had a lot of problems connecting to the machines because
0:14:03 > 0:14:07long-term dialysis weakens the veins and they become blocked.
0:14:09 > 0:14:1434-year-old David is also struggling with dialysis.
0:14:14 > 0:14:17I currently am dialysing through a line in my chest,
0:14:17 > 0:14:20connected to the arteries. It's not working so well at the moment.
0:14:20 > 0:14:22I'm pretty lethargic and pretty tired
0:14:22 > 0:14:26with not getting a great dialysis.
0:14:26 > 0:14:30Three quarters of patients will never get a kidney transplant,
0:14:30 > 0:14:32so dialysis is their only option.
0:14:34 > 0:14:37If you don't have a good, reliable system for doing that,
0:14:37 > 0:14:39your life is really tough.
0:14:39 > 0:14:41You'd never get your blood filtered,
0:14:41 > 0:14:44your fluid builds up and you are in and out trying to get
0:14:44 > 0:14:48lines and things working and it dominates your life.
0:14:48 > 0:14:50Your life is about staying alive.
0:14:51 > 0:14:54The next stage for patients like David and Dougie is to have
0:14:54 > 0:14:57a plastic vein or graft implanted
0:14:57 > 0:15:01in their arms, but plastic grafts have their problems.
0:15:02 > 0:15:05We have had plastic tubes and grafts for 20 years.
0:15:05 > 0:15:07They get blocked once or twice a year,
0:15:07 > 0:15:11they get infections which can be up to 5% to 10%,
0:15:11 > 0:15:13in which case they have to come out.
0:15:13 > 0:15:17They are in hospital for a period of time. And they are very footery.
0:15:17 > 0:15:21The new laboratory-grown blood vessel could be the answer.
0:15:21 > 0:15:24David and Dougie have agreed to be part of the trial to test it.
0:15:27 > 0:15:30He said it had been grown in a laboratory in America.
0:15:30 > 0:15:33You know what I mean? Grown! So...
0:15:34 > 0:15:36Aye, something different!
0:15:36 > 0:15:39Dr Jeff Lawson, who pioneered this research,
0:15:39 > 0:15:42is here from America to oversee the trial.
0:15:42 > 0:15:48One of the things that brought us here to Glasgow is Dr Kingsmore.
0:15:48 > 0:15:52He's an internationally recognised vascular access surgeon who cares
0:15:52 > 0:15:54for these dialysis patients.
0:15:54 > 0:15:57This is Dr Jeff Lawson from the States, he's across here.
0:15:57 > 0:16:00Dougie is getting fed up getting recurrent operations
0:16:00 > 0:16:03- and wants something that's going to work.- It's nice to meet you.
0:16:03 > 0:16:07And you're part of the cutting edge of all this tissue engineering.
0:16:07 > 0:16:08It's exciting times.
0:16:08 > 0:16:12Well, it's exciting but we really respect you helping out.
0:16:14 > 0:16:18Hello? This is Dr Lawson from the States.
0:16:18 > 0:16:22- All the way across.- How are you, sir? Nice to meet you...
0:16:22 > 0:16:23But there's a catch.
0:16:23 > 0:16:27In this clinical trial, a computer will decide whether a patient
0:16:27 > 0:16:31receives the new lab-grown vein or the plastic tube.
0:16:31 > 0:16:35No-one will know until surgery begins tomorrow.
0:16:35 > 0:16:37- Right, see you in the morning, then. - It's nice to see you.
0:16:37 > 0:16:39- Right, buddy, you take care.- Thanks.
0:16:39 > 0:16:42- See you in the morning. - Have a good night yourself.
0:16:42 > 0:16:43Get a good night's sleep.
0:16:54 > 0:16:56Over in the children's hospital,
0:16:56 > 0:16:59it's the morning of four-year-old Charlotte's operation.
0:17:02 > 0:17:04Take a deep breath for us, darling.
0:17:05 > 0:17:07That's it.
0:17:07 > 0:17:09I'll lift you up to this trolley.
0:17:09 > 0:17:13- This is the trolley?- This is the trolley. We ready, my big girl?
0:17:13 > 0:17:17Up you get. Good girl. I'll put this side up.
0:17:17 > 0:17:20How comfy is that? Is that comfy?
0:17:22 > 0:17:25Charlotte is having an operation to enlarge her airway
0:17:25 > 0:17:29to try to prevent dangerous bouts of croup.
0:17:30 > 0:17:34So if you think of your airways as a tube here, we make a cut
0:17:34 > 0:17:39into the very front end, so that opens up and then we use a bit of
0:17:39 > 0:17:43cartilage to plug that gap
0:17:43 > 0:17:46and stitch it in, allowing it to heal up.
0:17:46 > 0:17:50But it will have made the overall size of the airway much bigger.
0:17:50 > 0:17:55You singing? Oh, she's giving us a song.
0:17:55 > 0:17:58You can only hope it goes the way we want it to and she doesn't
0:17:58 > 0:18:03get the croup any more. We're hopeful. Really hopeful, so...
0:18:23 > 0:18:26Knowing Charlotte and her family for a little while now,
0:18:26 > 0:18:28I'm hoping, very much like them,
0:18:28 > 0:18:31that they will find this life-changing.
0:18:31 > 0:18:34I would like to think that although this is something that technically
0:18:34 > 0:18:37I enjoy, that this would be a fantastic result for the family.
0:18:39 > 0:18:42I think once you start operating
0:18:42 > 0:18:46you're always aware of who it is but it's much easier just to be focused
0:18:46 > 0:18:48on the area that you are working on.
0:18:48 > 0:18:51So I don't tend to have pictures
0:18:51 > 0:18:54of Charlotte running round in my head at that point.
0:19:00 > 0:19:02This is the only hospital in Scotland where this complex
0:19:02 > 0:19:07operation takes place, so Tash has medical students observing.
0:19:10 > 0:19:14So, we're starting with the chest area to get our rib graft material.
0:19:14 > 0:19:17So we're going to find a nice cartilage bit of it,
0:19:17 > 0:19:21which is softer, and put that safely to one side.
0:19:21 > 0:19:23The first stage of the operation
0:19:23 > 0:19:27is to remove a piece of Charlotte's soft rib cartilage.
0:19:29 > 0:19:30Tash will work on it later.
0:19:33 > 0:19:36- Knife, please.- Obviously, because she's smaller, we need to just be
0:19:36 > 0:19:39careful that we're not affecting her vocal cords.
0:19:39 > 0:19:43Now she opens up Charlotte's windpipe.
0:19:43 > 0:19:46- A little bit of bleeding there. - Yeah, we'll just...
0:19:48 > 0:19:50You know, if you stay in the lower half of it,
0:19:50 > 0:19:52- you're going to be safe, aren't you? - Yeah.
0:19:56 > 0:19:57Knife, please.
0:19:57 > 0:20:01The operation takes at least three hours.
0:20:01 > 0:20:05A long wait for Charlotte's mum and dad.
0:20:05 > 0:20:07I'm hoping it goes well.
0:20:09 > 0:20:12I just try not to think about it too much.
0:20:12 > 0:20:13I just hope she gets through it.
0:20:21 > 0:20:24Tash now needs to shape the piece of soft cartilage
0:20:24 > 0:20:26they took out earlier.
0:20:27 > 0:20:30It must be the right size to fill the gap they've created
0:20:30 > 0:20:32in Charlotte's windpipe.
0:20:36 > 0:20:39So, using a piece of your own body
0:20:39 > 0:20:42is always going to reduce the problems that you can get with
0:20:42 > 0:20:46the area healing up, and in children particularly they have nice soft
0:20:46 > 0:20:49cartilage, in adults this is calcified and hard,
0:20:49 > 0:20:52so soft cartilage we can carve into a nice shape
0:20:52 > 0:20:56to fit into the airway to expand it.
0:21:02 > 0:21:05Tash is working the soft cartilage into place.
0:21:07 > 0:21:11I can actually feel it click in just at the top now.
0:21:11 > 0:21:14- I think it's looking in place, isn't it?- It looks good, doesn't it?
0:21:27 > 0:21:31After three and a half hours of surgery,
0:21:31 > 0:21:33Charlotte is on the intensive care ward.
0:21:33 > 0:21:36The next few days are critical.
0:21:36 > 0:21:40Her airway must heal before she can breathe for herself.
0:21:45 > 0:21:48The superhospital has the largest square footage of any hospital
0:21:48 > 0:21:55in the UK. With 10,000 staff, and at any one time over 2,000 patients,
0:21:55 > 0:21:58it has the population of a small town.
0:21:58 > 0:22:02Down in the basement, robots have taken over.
0:22:02 > 0:22:05I've been with them for over a year
0:22:05 > 0:22:07and they have got their own wee kind of quirks.
0:22:07 > 0:22:11It's like you maybe send one to do a job and it decides
0:22:11 > 0:22:13it's no' going to do it, it'll go to charge.
0:22:13 > 0:22:17They just do whatever they want sometimes.
0:22:19 > 0:22:22The 26 robots find their way using sensors
0:22:22 > 0:22:26and are each capable of lifting half a tonne.
0:22:30 > 0:22:34'Attention: vehicle changes direction.'
0:22:34 > 0:22:37If it wasn't for the robots, we wouldn't be able to run the hospital
0:22:37 > 0:22:39because of the sheer size of it.
0:22:39 > 0:22:42We're doing something like 900 jobs every 24 hours.
0:22:46 > 0:22:50They cover an average of 225 miles a day.
0:22:52 > 0:22:54When it suits them!
0:22:54 > 0:22:56Well, the other smart thing they do
0:22:56 > 0:22:58is they basically chuck you out of the lift!
0:22:59 > 0:23:03There it goes. It stole the lift off me.
0:23:03 > 0:23:06I'm stuck here at the moment.
0:23:06 > 0:23:09'Attention: automatic transport.'
0:23:15 > 0:23:18On the second floor of the hospital,
0:23:18 > 0:23:22a ground-breaking human graft trial is under way.
0:23:22 > 0:23:2415 years ago they didn't exist.
0:23:24 > 0:23:28- That's correct. - And it's science fiction, really,
0:23:28 > 0:23:31what we are talking about!
0:23:31 > 0:23:34Dialysis patient David needs a new blood vessel.
0:23:37 > 0:23:40For the first time in Western Europe,
0:23:40 > 0:23:44he may be about to get one grown from human cells in a laboratory.
0:23:46 > 0:23:50Let's just put that on. Have you got everything you need? You are OK?
0:23:50 > 0:23:52But it's a lottery.
0:23:52 > 0:23:56Following strict trial conditions, a randomising computer programme
0:23:56 > 0:24:00will decide whether David will get the new blood vessel or the standard
0:24:00 > 0:24:02plastic tube.
0:24:02 > 0:24:06This is the standard comparator, and this is the vessel.
0:24:06 > 0:24:09It's sterile in here, that's actually the vessel itself.
0:24:09 > 0:24:13The team have both options standing by.
0:24:13 > 0:24:17David Kingsmore has performed over 230 graft operations
0:24:17 > 0:24:21in the last five years but today is different.
0:24:21 > 0:24:24Any time you do an operation you run things through your mind,
0:24:24 > 0:24:28what you might anticipate. There is always a bit of uncertainty.
0:24:28 > 0:24:32But this, it's all heightened for several reasons, but, one, you are now
0:24:32 > 0:24:34involved in something that's new, that's different,
0:24:34 > 0:24:37it's a first procedure.
0:24:37 > 0:24:40You want to make sure that everything is set up,
0:24:40 > 0:24:42that it runs smoothly and well.
0:24:42 > 0:24:47So, yes, that is ramped up by quite a considerable amount.
0:24:47 > 0:24:52This is prestigious and really very exciting for the hospital,
0:24:52 > 0:24:56something to be really proud of that we've got enough of a reputation to
0:24:56 > 0:24:59be wanted to be included and asked to participate in this.
0:24:59 > 0:25:02It's a real honour. It's a real honour. It certainly is.
0:25:08 > 0:25:12The first step is to open David's arm to find the right kind of vein.
0:25:13 > 0:25:16It's got to be big enough to carry the blood,
0:25:16 > 0:25:19soft enough to sew onto and deal with.
0:25:19 > 0:25:22If there are narrowings or kinks or blockages, it won't work.
0:25:22 > 0:25:25So when looking at the vein, that's what we're looking for, the size,
0:25:25 > 0:25:29the calibre and whether it's nice and soft if we can use it to take
0:25:29 > 0:25:30back blood to the heart.
0:25:30 > 0:25:33- I think it'll be OK.- Do you think? - Yeah.
0:25:33 > 0:25:36Mr Kingsmore finds a suitable vein.
0:25:36 > 0:25:39Beautiful. Wonderful.
0:25:39 > 0:25:42Hayley, we have a suitable vessel,
0:25:42 > 0:25:44so can we now randomise, please?
0:25:44 > 0:25:46It's 40 centimetres long...
0:25:46 > 0:25:48Only the computer can decide
0:25:48 > 0:25:51if David is getting the radical new blood vessel.
0:25:53 > 0:25:55The suspense is killing me here.
0:25:58 > 0:26:00We have it. We have the HAV,
0:26:00 > 0:26:05the treatment arm, so this patient will get it. So congratulations.
0:26:05 > 0:26:08It's been worth the wait.
0:26:08 > 0:26:11David is receiving the laboratory-grown vein.
0:26:14 > 0:26:18This ground-breaking blood vessel is the culmination of 20 years of
0:26:18 > 0:26:23research by 12 medical centres around the world.
0:26:23 > 0:26:27It's nice to be part of something which isn't just one to one but has
0:26:27 > 0:26:30implications, not just for here or Scotland, but actually
0:26:30 > 0:26:34its worldwide implications of helping people all around the world
0:26:34 > 0:26:37who are in the same situations, who are suffering, and advancing
0:26:37 > 0:26:40that knowledge a wee bit further, making their treatment a bit better,
0:26:40 > 0:26:44giving them another option, so it means a lot to be a part of that.
0:26:44 > 0:26:46INDISTINCT CHATTER
0:26:55 > 0:26:59- Does that feel OK? - Yeah. Yeah.- Good.
0:26:59 > 0:27:03Jeff's keen to find out what Mr Kingsmore thinks of
0:27:03 > 0:27:05the lab-grown vessel.
0:27:05 > 0:27:08So from a handleability?
0:27:08 > 0:27:11It's easy. It's lovely. It's just like a nice, lovely bit of vein.
0:27:11 > 0:27:14In some ways I think it has a little more structure than a vein.
0:27:14 > 0:27:16- Absolutely.- So it's easier to handle.- Oh, absolutely.
0:27:16 > 0:27:20And to be the first people in the UK, never mind mainland Europe,
0:27:20 > 0:27:24is just fantastic, it's just brilliant. I'm very excited.
0:27:25 > 0:27:29It's hard not to get excited about the new graft.
0:27:29 > 0:27:32It really is very, very good to use.
0:27:32 > 0:27:35It's like a perfect blood vessel. It's hard to go back to a cheaper
0:27:35 > 0:27:38car when you've been in a very, very expensive one.
0:27:38 > 0:27:42The surgical step of the trial has been a success.
0:27:42 > 0:27:46But David Kingsmore had two patients today.
0:27:46 > 0:27:50For Dougie, it's been a disappointment.
0:27:50 > 0:27:52I didn't get the one that was coming from America,
0:27:52 > 0:27:54neither I did.
0:27:54 > 0:27:57I got the bit of plastic!
0:27:57 > 0:28:00But...not to worry.
0:28:00 > 0:28:03Not to worry.
0:28:03 > 0:28:06Dougie may not have made medical history but the standard plastic
0:28:06 > 0:28:10tube that he's had implanted in his arm should mean a better connection
0:28:10 > 0:28:13for dialysis and there's always
0:28:13 > 0:28:16the hope that he'll get a kidney transplant.
0:28:23 > 0:28:25In adult neurology theatre two,
0:28:25 > 0:28:29the operation to remove Peter's brain tumour is under way.
0:28:32 > 0:28:35We do a sweep like that, an S line.
0:28:35 > 0:28:39Surgeon Roddy O'Kane suspects that it's cancerous
0:28:39 > 0:28:43so the aim is to remove as much of it as possible.
0:28:43 > 0:28:45The risk is I'm going to paralyse him,
0:28:45 > 0:28:48I'm going to paralyse his face and he won't recover,
0:28:48 > 0:28:50so he will have a slumped, drooped face.
0:28:50 > 0:28:54He will have a weak arm and potentially a leg.
0:28:54 > 0:28:56That could be a complete paralysis -
0:28:56 > 0:28:58an arm that does no activity whatever.
0:28:58 > 0:29:01It might do some but not have fine dexterity.
0:29:01 > 0:29:04And, of course, if he has a paralysed leg,
0:29:04 > 0:29:08which is a bit further, but we could still damage it in the fibres coming
0:29:08 > 0:29:11down, he wouldn't be able to walk.
0:29:13 > 0:29:16To minimise the risks, Roddy will wake Peter up
0:29:16 > 0:29:20when he reaches the deepest section of his tumour.
0:29:25 > 0:29:27But while Peter's fully anaesthetised,
0:29:27 > 0:29:31Roddy's first step is to remove a section of his skull.
0:29:37 > 0:29:41Primary brain tumours tend to be mixed into brain.
0:29:41 > 0:29:44So there is normal brain mixed in where the tumour is.
0:29:44 > 0:29:46It's a mixed bag.
0:29:46 > 0:29:50So in taking tumour you're going to damage brain, and depending on which
0:29:50 > 0:29:51part of the brain that is,
0:29:51 > 0:29:54that can have very profound consequences to patients.
0:29:57 > 0:29:59A team of neurophysiologists
0:29:59 > 0:30:03have helped wire Peter up with electrodes to help pinpoint
0:30:03 > 0:30:06which tumour-affected areas of his brain control which parts
0:30:06 > 0:30:07of his body.
0:30:11 > 0:30:13- Happy?- Yep.
0:30:14 > 0:30:18They help identify a small piece of tumour Roddy can safely remove while
0:30:18 > 0:30:20Peter is asleep.
0:30:23 > 0:30:25I think the next part is just to wake him up.
0:30:25 > 0:30:29Because that's what's going to aid what's going to go.
0:30:29 > 0:30:31Now he's deeper into the brain,
0:30:31 > 0:30:35it isn't safe to continue without waking Peter up.
0:30:35 > 0:30:37Peter, Peter...
0:30:39 > 0:30:43Some patients are too groggy to rouse during surgery but Roddy
0:30:43 > 0:30:46can't continue with this operation unless Peter comes round.
0:30:48 > 0:30:51Not only are you nervous for the patient waking up,
0:30:51 > 0:30:54cos you want them to wake up, but you're nervous because there can be
0:30:54 > 0:30:56problems with brain swelling.
0:30:56 > 0:31:00So you're concentrating on multiple different events at that time.
0:31:00 > 0:31:03That is always anxious.
0:31:05 > 0:31:06Peter?
0:31:14 > 0:31:15Peter?
0:31:23 > 0:31:25Good afternoon, ward 3A, Debbie speaking, how can I help you?
0:31:25 > 0:31:28Next door in the children's hospital,
0:31:28 > 0:31:31it's seven days since Charlotte's airway operation.
0:31:31 > 0:31:35Her ventilator tube has been removed and she's back on the ward.
0:31:38 > 0:31:41You get your own room!
0:31:41 > 0:31:43How good's that?!
0:31:43 > 0:31:48And this is Mummy's bed. Your own space! Yes!
0:31:48 > 0:31:49Where are the toys?
0:31:49 > 0:31:51Where are the toys?
0:31:51 > 0:31:54There is a playroom where you can go
0:31:54 > 0:31:57play with the toys but once you're a wee bit better.
0:31:57 > 0:31:59Now that she's got the tube out
0:31:59 > 0:32:02we can actually have a conversation with her and see her
0:32:02 > 0:32:06- a little bit more alert. - She's a wee battler.
0:32:08 > 0:32:12She always has fought, ever since she was born, so...
0:32:14 > 0:32:19Nothing's going to stop her. It just seems like she's back to normal,
0:32:19 > 0:32:21bossing everybody around.
0:32:21 > 0:32:23- One...- One...
0:32:23 > 0:32:26- Two... Three...- Ah!
0:32:26 > 0:32:29Obviously you still worry about your kids but...
0:32:29 > 0:32:33at least we can see forward.
0:32:33 > 0:32:35So I just kind of hope with the winter coming around now
0:32:35 > 0:32:40that there will be no more croup.
0:32:40 > 0:32:41That's all I can hope for.
0:32:42 > 0:32:44In the next couple of days,
0:32:44 > 0:32:48Charlotte should have her feeding tube removed and she'll be able to
0:32:48 > 0:32:49go home.
0:32:49 > 0:32:54Cold winter weather will be the real test to find out if she avoids any
0:32:54 > 0:32:57further life-threatening bouts of croup.
0:32:57 > 0:32:58Where did it go?
0:33:02 > 0:33:09In neurology, it's two hours into Peter's open brain operation.
0:33:09 > 0:33:10Try this one...
0:33:12 > 0:33:14You are. You are.
0:33:14 > 0:33:15Peter, how are you doing?
0:33:15 > 0:33:19Don't nod your head. Remember, you can't nod it.
0:33:19 > 0:33:21The brain is unique in every individual.
0:33:21 > 0:33:25We don't know exactly how it works in every individual.
0:33:25 > 0:33:28The only way we know it is to have the patient do the tasks that we
0:33:28 > 0:33:31want them to do, and so you have to wake them up.
0:33:31 > 0:33:34Squeeze hard. Hard.
0:33:34 > 0:33:36That's as hard as you can do it?
0:33:36 > 0:33:38Speech and language specialist Jennifer Bowers
0:33:38 > 0:33:41is assessing his hand strength and facial movements,
0:33:41 > 0:33:45so she can feed back any changes to surgeon Roddy.
0:33:45 > 0:33:48So I'm going to need you to just keep on and off squeezing my hand
0:33:48 > 0:33:50like this. OK?
0:33:50 > 0:33:52Can you wiggle your ankle for me?
0:33:53 > 0:33:55Yeah. Yeah.
0:33:55 > 0:33:59- Can he smile? - Open wide and do a big cheeser.
0:33:59 > 0:34:03Yeah, no. Upper and lower quadrants weaker.
0:34:03 > 0:34:07Some weakness in Peter's face is not too much of a concern.
0:34:07 > 0:34:11Facial muscles are controlled by both sides of the brain,
0:34:11 > 0:34:14so there's good potential for recovery.
0:34:21 > 0:34:25Peter's been awake for 15 minutes.
0:34:25 > 0:34:27But something isn't quite right.
0:34:27 > 0:34:30He's started to twitch uncontrollably.
0:34:30 > 0:34:32Yeah, a good bit of facial twitching.
0:34:32 > 0:34:35- We're not doing anything. - OK. OK.
0:34:35 > 0:34:38He's having an epileptic fit.
0:34:38 > 0:34:41You're all right, Peter. It just feels a bit funny.
0:34:41 > 0:34:46- Just keep looking at me. - You're doing really well.
0:34:46 > 0:34:48Are we having a seizure?
0:34:48 > 0:34:51You're all right, Roddy's doing something about it, don't worry.
0:34:51 > 0:34:52Just keep looking at me.
0:34:52 > 0:34:54The only way to stop it
0:34:54 > 0:34:58is to pour ice-cold water directly onto his brain.
0:35:00 > 0:35:02Maybe about the last 30 seconds.
0:35:02 > 0:35:04I still see some twitching here.
0:35:04 > 0:35:06You're all right. Give me a big squeeze in this hand.
0:35:06 > 0:35:09Yeah, you're feeling stronger again.
0:35:09 > 0:35:11You're doing really, really well.
0:35:11 > 0:35:14By slowing down the misfiring electrical activity
0:35:14 > 0:35:18in Peter's brain, the icy water has stopped his fit.
0:35:20 > 0:35:23- OK, I'm going to carry on. - Are you feeling quite calm?
0:35:23 > 0:35:26Good. Calmer than you thought you would?
0:35:29 > 0:35:30Of course, of course.
0:35:32 > 0:35:34Good.
0:35:34 > 0:35:36OK.
0:35:36 > 0:35:39How do you feel? Can you feel anything in your face?
0:35:41 > 0:35:43Let me just check your mouth again.
0:35:43 > 0:35:45Spread and forward like this.
0:35:45 > 0:35:48OK, and spread and forward.
0:35:50 > 0:35:53No, you've still got that pout, good stuff!
0:35:53 > 0:35:55So, what do you prefer,
0:35:55 > 0:35:59is it a different kind of holiday if you go to Turkey or Benidorm?
0:35:59 > 0:36:01Benidorm is just a big party!
0:36:01 > 0:36:03Along with Jennifer's observations,
0:36:03 > 0:36:08Roddy continues to rely on the neurophysiologists' electrical readings
0:36:08 > 0:36:11and Peter himself.
0:36:11 > 0:36:13Getting twitching in the hands.
0:36:13 > 0:36:16You OK?
0:36:16 > 0:36:17Oh, we got another twitch there.
0:36:19 > 0:36:23The signs are that Roddy is in an area of brain that could leave Peter
0:36:23 > 0:36:27paralysed if too much tumour is taken out.
0:36:27 > 0:36:30I'm starting to get a bit nervous to take that one.
0:36:30 > 0:36:33There is a fight in your own ego.
0:36:33 > 0:36:35You can't help but want to do more
0:36:35 > 0:36:40but you've got to do that sensibly and you've got to know...
0:36:40 > 0:36:43Training when to stop is probably a very big thing about training.
0:36:43 > 0:36:47And that's what you gain with experience, it's about when to stop.
0:36:47 > 0:36:53I think I'm done. I think I'd rather preserve more hand than take
0:36:53 > 0:36:57the extra 6% of normality.
0:36:57 > 0:37:00Pieces of the tumour are sent to the lab.
0:37:01 > 0:37:03Only when Roddy gets the results back
0:37:03 > 0:37:06will he know how serious Peter's cancer is,
0:37:06 > 0:37:08and whether it's treatable.
0:37:08 > 0:37:12Before an operation, we can have a guess from what we see on the scans
0:37:12 > 0:37:15but we don't ultimately know what we're going to get.
0:37:15 > 0:37:18And it takes a week for that result to come through.
0:37:18 > 0:37:21So it's about getting them over the operation before we deal with the
0:37:21 > 0:37:23pathology we're going to deal with.
0:37:25 > 0:37:27Over in the renal department,
0:37:27 > 0:37:30it's the next stage of the clinical trial.
0:37:33 > 0:37:37David is the first person in Western Europe to have a laboratory-grown
0:37:37 > 0:37:39blood vessel implanted into his arm.
0:37:41 > 0:37:44This is obviously the implant here.
0:37:44 > 0:37:46I can feel it, the blood rushing through.
0:37:46 > 0:37:52It was once described to me as like a racetrack, with a racing car,
0:37:52 > 0:37:55very high flow, high volume of blood that will go through it.
0:37:59 > 0:38:01Two weeks on from the operation,
0:38:01 > 0:38:04David's new implant has had time to heal
0:38:04 > 0:38:08but it hasn't yet been tested on the dialysis machine.
0:38:08 > 0:38:12It's the moment of truth for Mr Kingsmore.
0:38:12 > 0:38:16- No pressure now, hey? - I know.
0:38:17 > 0:38:21- Did you find that quite soft going in there?- Really soft. It just felt
0:38:21 > 0:38:25- like a normal human vein.- This is everything that we would hope for
0:38:25 > 0:38:28and the proof of the pudding is somebody who's experienced,
0:38:28 > 0:38:32and I actually felt quite straightforward and surprised
0:38:32 > 0:38:36as to how easy it is and how good to use it is,
0:38:36 > 0:38:38it is just everything. For a difficult health problem,
0:38:38 > 0:38:40this makes it a lot easier.
0:38:40 > 0:38:43This is the cutting edge of where technology is at. You've heard all
0:38:43 > 0:38:47- of this technology in the past from Dolly the sheep onwards.- Yeah.
0:38:47 > 0:38:49This is the practical result of all that.
0:38:49 > 0:38:51Now it's coming through and it's taken 20 years for that.
0:38:51 > 0:38:53- MACHINE BEEPS - That means something.
0:38:53 > 0:38:56The machine has identified an issue.
0:38:56 > 0:38:58The pressure is too low.
0:38:58 > 0:39:00It means it's working too well!
0:39:00 > 0:39:02Usually with grafts,
0:39:02 > 0:39:05you have to pump quite hard to drive the blood through.
0:39:05 > 0:39:08The fact this is going straight through, the machine goes,
0:39:08 > 0:39:10"I think there's a problem here."
0:39:10 > 0:39:12It doesn't recognise that that's really, really good.
0:39:12 > 0:39:16That is absolutely fantastic. Absolutely brilliant.
0:39:20 > 0:39:24Over in the children's hospital there's another trial taking place.
0:39:25 > 0:39:29The paediatric renal department is the largest in Scotland and they're
0:39:29 > 0:39:33piloting a new programme to help children on dialysis.
0:39:34 > 0:39:38Going to hospital three times a week means children on dialysis can miss
0:39:38 > 0:39:42out on as much as 60% of school.
0:39:42 > 0:39:44But the new pilot could change that.
0:39:47 > 0:39:51Seven-year-old Milo is first to take part.
0:39:51 > 0:39:55He's come to the hospital with dad Kevin from their home in Fife.
0:39:58 > 0:40:02That's a dialysis machine.
0:40:02 > 0:40:05- What's it do? - It sends blood into me, I think.
0:40:05 > 0:40:09Cos my kidneys are going and it works the exact same as a kidney.
0:40:10 > 0:40:13Most parents would say the same thing about their children but Milo
0:40:13 > 0:40:18is a lovely character. Really, he's very chilled out, he's always happy.
0:40:18 > 0:40:20He just kind of gets on with things,
0:40:20 > 0:40:22nothing ever really seems to bother him.
0:40:22 > 0:40:25He's a lovely boy, quite an obliging little soul, bless.
0:40:25 > 0:40:29We often call him a little Tonka truck, because he just seems to,
0:40:29 > 0:40:32whatever comes his way, he just seems to deal with it
0:40:32 > 0:40:33and get on with it.
0:40:33 > 0:40:37Three years ago, Milo was diagnosed with a rare and advanced form of
0:40:37 > 0:40:39kidney cancer.
0:40:39 > 0:40:43His treatment resulted in him having both kidneys removed.
0:40:43 > 0:40:48Milo's family now have to make a 110-mile round trip to hospital
0:40:48 > 0:40:50three days a week.
0:40:52 > 0:40:56It's boring at dialysis sometimes.
0:40:56 > 0:40:58And I'd rather be at school.
0:41:00 > 0:41:02Life on dialysis is difficult.
0:41:02 > 0:41:05And it leaves most patients feeling very unwell.
0:41:08 > 0:41:14But a new portable machine could transform Milo's life.
0:41:14 > 0:41:17It's exciting to have this new dialysis machine.
0:41:17 > 0:41:18They can get the dialysis at home.
0:41:18 > 0:41:21This means that they can socialise with their family and friends more.
0:41:21 > 0:41:26They can attend school on a daily basis and they won't have as many
0:41:26 > 0:41:29restrictions when it comes to their diet and fluid.
0:41:29 > 0:41:30They'll have more energy
0:41:30 > 0:41:33and in general just feel much better about themselves.
0:41:33 > 0:41:36It will just change the family's life completely.
0:41:36 > 0:41:40Another advantage is that Milo can get dialysis more frequently,
0:41:40 > 0:41:43which should mean a big improvement in how he feels.
0:41:47 > 0:41:49First, Zoe must train up Kevin
0:41:49 > 0:41:53so that the family will be able to use the machine by themselves.
0:41:54 > 0:41:55Make sure you clamp.
0:41:57 > 0:42:01If you didn't clamp, you would very soon remember to clamp.
0:42:01 > 0:42:03Because of the blood pouring out.
0:42:03 > 0:42:06It is probably the most intense thing I've ever done, actually.
0:42:06 > 0:42:09Because I'm used to, you know, if you go on a course through work,
0:42:09 > 0:42:12whatever, you come out and you don't understand and you miss a bit,
0:42:12 > 0:42:14in the work that I do,
0:42:14 > 0:42:17no-one dies because of it or no-one becomes unwell because of it.
0:42:17 > 0:42:21So we're very much aware the stakes are really, really high in this.
0:42:21 > 0:42:23After a week of theory,
0:42:23 > 0:42:28Kevin is going to attempt to put Milo onto the machine himself.
0:42:28 > 0:42:31- What are you doing? - I'm getting you ready.
0:42:31 > 0:42:35My lines! My lines!
0:42:35 > 0:42:39He's following Zoe's newly created step-by-step guide.
0:42:43 > 0:42:44- So there's how many steps?- 114...
0:42:44 > 0:42:49114 steps of "Attach this to this. Clamp."
0:42:49 > 0:42:52So it's a bit of a foolproof
0:42:52 > 0:42:55idiot's guide to setting up this machine.
0:42:57 > 0:43:00Halfway through, Kevin hits a problem.
0:43:00 > 0:43:04Zoe, this bit, where I went to unclamp this one...
0:43:06 > 0:43:08So I touched it with my hands.
0:43:08 > 0:43:10Oh, did you? We should start again.
0:43:13 > 0:43:15Touching the end of a tube means
0:43:15 > 0:43:19there's a risk of giving Milo an infection.
0:43:19 > 0:43:22- So we need to start again. - Good practice!
0:43:23 > 0:43:25Right!
0:43:25 > 0:43:30There are many complications and dangers of dialysis in general.
0:43:30 > 0:43:33So for the parents to be doing this dialysis at home,
0:43:33 > 0:43:35obviously if something is to go wrong,
0:43:35 > 0:43:40then it would be them dealing with the situation, be it an infection
0:43:40 > 0:43:43or a drop in blood pressure or a problem with the line.
0:43:43 > 0:43:45There's lots of complications
0:43:45 > 0:43:47that they need to be taught how to deal with
0:43:47 > 0:43:50in case any of these problems do arise.
0:43:51 > 0:43:55Getting the next step right is critical for Milo's health.
0:43:59 > 0:44:02- Then just take this one out?- Yeah.
0:44:02 > 0:44:05Yeah, you feel it? So just push that one back in.
0:44:05 > 0:44:06Just leave it about a mil there.
0:44:06 > 0:44:09And then we'll see what his next line's like.
0:44:09 > 0:44:10Yeah.
0:44:10 > 0:44:14We're actually sucking all the blood out of his body,
0:44:14 > 0:44:17putting it through the machine that we've set up,
0:44:17 > 0:44:21and hopefully giving it back to him in a correct manner
0:44:21 > 0:44:25based on our calculations of how much we should be giving him.
0:44:25 > 0:44:28It is a responsibility.
0:44:28 > 0:44:31Perfect. All connected, so clamp off, clamp off.
0:44:33 > 0:44:35Best, green for go.
0:44:35 > 0:44:39That's only three hours it's taken me to do a 20-minute process!
0:44:39 > 0:44:41In just a week,
0:44:41 > 0:44:44the family will take the portable machine home and Milo will depend on
0:44:44 > 0:44:48his mum and dad for his life-saving dialysis.
0:44:57 > 0:45:01One benefit of the superhospital's design is that all ages can be
0:45:01 > 0:45:03looked after on the same site,
0:45:03 > 0:45:06from premature babies to the elderly.
0:45:08 > 0:45:12In Scotland, the number of people over 90 has increased by 20%
0:45:12 > 0:45:13in the last five years.
0:45:16 > 0:45:21I think it's fair to say that as the population ages that it does put a
0:45:21 > 0:45:23pressure within the hospitals
0:45:23 > 0:45:27and we are finding that we are getting busier.
0:45:27 > 0:45:29Hello...
0:45:29 > 0:45:34At the superhospital, the first port of call for emergency
0:45:34 > 0:45:38elderly patients is a new specialist acute receiving unit.
0:45:40 > 0:45:4488-year-old Rose was brought in last night by ambulance
0:45:44 > 0:45:46after she collapsed at home.
0:45:46 > 0:45:50Oh, it was awful. The next thing, I thought I was
0:45:50 > 0:45:55going to die. I thought it was my time, I was going to go.
0:45:55 > 0:45:57I was so frightened.
0:45:59 > 0:46:02- Hello, Rose.- Hello, Doctor.
0:46:02 > 0:46:04Nice to see you again.
0:46:04 > 0:46:06So, I suppose first of all, how are you feeling now?
0:46:06 > 0:46:08I feel good, Doctor.
0:46:08 > 0:46:12Good. So we want to do an ultrasound scan of your tummy,
0:46:12 > 0:46:14just to see what's going on there
0:46:14 > 0:46:17and make sure there's no inflammation going on.
0:46:17 > 0:46:20As long as you keep me living for another wee while.
0:46:20 > 0:46:24- Absolutely, that's what we're here for.- I don't want to die yet.
0:46:24 > 0:46:27- OK. See you later. - OK.
0:46:27 > 0:46:31The staff here focus on finding out about their patients' circumstances
0:46:31 > 0:46:33outwith the hospital.
0:46:34 > 0:46:37Do you want to try and stay at home? Is that what you want?
0:46:37 > 0:46:40- Mm-hm.- That's what you'd like. OK.
0:46:40 > 0:46:43I think it would be fair to say that the vast majority of elderly
0:46:43 > 0:46:47patients who come into hospital want to be at home, and often as soon as
0:46:47 > 0:46:50possible. So one of my jobs as an elderly-care physician
0:46:50 > 0:46:53is to try and get them back home to living within the community
0:46:53 > 0:46:57ideally in their own home as soon as that's safe to do so.
0:47:01 > 0:47:05I hope I'll go home soon.
0:47:05 > 0:47:08It's nice to get into hospital
0:47:08 > 0:47:11and to go home when you're well.
0:47:11 > 0:47:13Whatever happens this time,
0:47:13 > 0:47:17whether I stay on my own again, or with one of my daughters...
0:47:17 > 0:47:21One of my daughters has stairs to the bathroom,
0:47:21 > 0:47:23which is no good to me.
0:47:23 > 0:47:26Rose has spent all her time here
0:47:26 > 0:47:29in one of the new hospital's single rooms.
0:47:29 > 0:47:32I'd rather the old hospital,
0:47:32 > 0:47:35because you would have patients next to you.
0:47:35 > 0:47:38See, at this hospital, you're on your own.
0:47:38 > 0:47:40You know, the likes of me anyway.
0:47:40 > 0:47:43And you have nobody to talk to. You know, when you get older,
0:47:43 > 0:47:45we like to have a wee gossip
0:47:45 > 0:47:49or something, but we can't have everything, can we?
0:47:49 > 0:47:53No, we can't have everything.
0:47:53 > 0:47:57Just along the corridor, John, who's been in with a chest infection,
0:47:57 > 0:47:59can't help but agree.
0:47:59 > 0:48:01There is a lot to be said for single rooms
0:48:01 > 0:48:04but it's a lonely, lonely wait.
0:48:04 > 0:48:06I'm only here for a couple of days
0:48:06 > 0:48:11but if you're stuck in hospital for three months because you're unwell,
0:48:11 > 0:48:13you know,
0:48:13 > 0:48:17you could enter with a twisted ankle
0:48:17 > 0:48:22and go home as irredeemably mad...
0:48:22 > 0:48:24if you spent all your time in a single room!
0:48:32 > 0:48:34On the adult neurology ward,
0:48:34 > 0:48:37Peter's recovering in his own room.
0:48:37 > 0:48:41It's been 18 hours since his awake brain surgery.
0:48:41 > 0:48:44I was thinking you were going to be
0:48:44 > 0:48:46sleeping and tubes everywhere
0:48:46 > 0:48:49and not being able to talk and, of course,
0:48:49 > 0:48:52not being able to move your arm,
0:48:52 > 0:48:54so when you waved to me,
0:48:54 > 0:48:57I was in total shock!
0:48:57 > 0:48:59You're absolutely amazing.
0:48:59 > 0:49:01I know I am, I telt you that.
0:49:01 > 0:49:03That's how you fell for me in the first place.
0:49:06 > 0:49:10Peter's six-hour operation has left its mark.
0:49:10 > 0:49:12Surgeon Roddy wants to know how it's affected him.
0:49:12 > 0:49:16- Well, my man?- Still got a bit of brain freeze with you throwing ice
0:49:16 > 0:49:18- on me.- Is that right? Still a bit cold in the head.
0:49:18 > 0:49:21What about this arm, then, how has it been doing today?
0:49:21 > 0:49:24- Are you able to squeeze it?- A wee bit.- That's way better.
0:49:24 > 0:49:27Squeeze it again. That's even better than yesterday.
0:49:27 > 0:49:30Yesterday you had nothing on it at the end of the operation.
0:49:30 > 0:49:32Looking good. OK.
0:49:32 > 0:49:35A bit of physio. A bit of rehab, you'll be doing the Riverdance soon.
0:49:35 > 0:49:39- I'd like to try it. - OK, the new Michael Flatley.
0:49:39 > 0:49:40Put it there.
0:49:40 > 0:49:44- You're a grand man. See you later. Thank you.- See you later.
0:49:46 > 0:49:49Performance surgery like this is kind of strange.
0:49:50 > 0:49:53This morning when I see him moving his hand a lot more,
0:49:53 > 0:49:57I always have that negative thought of, "I haven't taken enough."
0:49:57 > 0:50:00Whereas alternatively when I see patients afterwards and they are
0:50:00 > 0:50:02very weak, I think,
0:50:02 > 0:50:04"I've taken too much."
0:50:04 > 0:50:09You always have the balance of trying to justify what you're doing
0:50:09 > 0:50:12but there's never a happy feeling afterwards.
0:50:12 > 0:50:16Yeah? It's either I've taken too much and damaged them
0:50:16 > 0:50:19or I've taken too little and they're intact.
0:50:19 > 0:50:23But we'll see what the diagnosis is and what I've done on the scale.
0:50:25 > 0:50:28Roddy has left Peter with no paralysis but he won't know
0:50:28 > 0:50:32how serious his cancer is until the results come back from the lab.
0:50:40 > 0:50:42Up on the children's renal ward,
0:50:42 > 0:50:46it's an important day for seven-year-old Milo and his family.
0:50:48 > 0:50:50Get him off the machine,
0:50:50 > 0:50:55close his lines then he's finished and that's it.
0:50:55 > 0:50:56Simple as that!
0:50:58 > 0:51:01What are you laughing at?
0:51:01 > 0:51:03After two weeks of intensive training,
0:51:03 > 0:51:08Milo's mum is taking home the portable dialysis kit.
0:51:08 > 0:51:11Milo will be the first child in Scotland
0:51:11 > 0:51:14to use this new machine at home.
0:51:14 > 0:51:16I'm clamping blue.
0:51:16 > 0:51:19Now you're still bleeding him back the same.
0:51:19 > 0:51:22- This is where you're going to get confused.- This is...
0:51:22 > 0:51:25You're still bleeding back exactly the same,
0:51:25 > 0:51:28- it's when you come to locking his lumens that it'll be different.- OK.
0:51:30 > 0:51:33- Right, OK. - Yeah?- Yeah.
0:51:37 > 0:51:42Today has been quite stressful, just making sure that I've asked Zoe,
0:51:42 > 0:51:46our nurse, everything that I need to know and just make sure that we're
0:51:46 > 0:51:49organised and that we're ready for it.
0:51:50 > 0:51:52All done, dude.
0:51:54 > 0:51:57If the trial works, it will be rolled out to other children
0:51:57 > 0:51:58across Scotland.
0:51:58 > 0:52:01I feel like it's on my shoulders a little bit, that if it doesn't work,
0:52:01 > 0:52:04obviously it's not just me in the team, there are other people
0:52:04 > 0:52:09in the team as well, but if it wasn't to be successful, then, yes,
0:52:09 > 0:52:13I would feel that it was on my head.
0:52:15 > 0:52:19Milo will be able to go to school every day by using the machine
0:52:19 > 0:52:21at home.
0:52:21 > 0:52:23I think because Milo loves school
0:52:23 > 0:52:25and he's looking forward to going back to school
0:52:25 > 0:52:27and seeing all his friends,
0:52:27 > 0:52:30I definitely think you're not going to miss us, are you?
0:52:30 > 0:52:32I'm going to miss you!
0:52:33 > 0:52:35Right, don't lose this folder.
0:52:37 > 0:52:41Don't go too fast, we don't want to damage the machine, it's precious.
0:52:45 > 0:52:48Over the last year, three times a week
0:52:48 > 0:52:52the family have been travelling from Fife to get Milo on dialysis.
0:52:56 > 0:52:58I feel the wind in my hair!
0:52:58 > 0:53:00Yeah, it's good. We're free!
0:53:07 > 0:53:10With Milo being younger, I think he kind of just takes it all in his
0:53:10 > 0:53:14stride that now his mum and dad will do it and doesn't quite
0:53:14 > 0:53:17understand the burden that his mum and dad are taking on in performing
0:53:17 > 0:53:18this treatment for him.
0:53:22 > 0:53:26A life being tied to the hospital may be coming to an end.
0:53:35 > 0:53:36The Queen Elizabeth University Hospital
0:53:36 > 0:53:40has a pathology department on site.
0:53:40 > 0:53:45It's the largest in the UK and employs just under 200 staff.
0:53:45 > 0:53:50They deal with an average of 7,000 samples every week.
0:53:50 > 0:53:54This is where Peter's brain tumour has been analysed by specialists.
0:53:54 > 0:53:59Ten days after his operation, he's back for the results.
0:53:59 > 0:54:04- This was the hardest bit, waiting. - I know. It is.
0:54:04 > 0:54:08It is common for us to explain that tumours are incurable and the
0:54:08 > 0:54:11survival might be anything from weeks to months.
0:54:11 > 0:54:14We can never actually tell how long somebody is going to survive.
0:54:14 > 0:54:18But we can break pretty... tragic news to people
0:54:18 > 0:54:22that ultimately is telling them that they're not going to survive
0:54:22 > 0:54:25for very long and that they may not have any treatments available.
0:54:25 > 0:54:28That's part of the job.
0:54:28 > 0:54:30But it happens.
0:54:34 > 0:54:38Thought this was a brain tumour. It is a brain tumour.
0:54:38 > 0:54:42It is a low-grade tumour called oligodendroglioma.
0:54:42 > 0:54:45This is probably the best of the selection box of different types
0:54:45 > 0:54:48of tumours that you can get, OK?
0:54:48 > 0:54:54It has probably the best favourable prognosis.
0:54:54 > 0:54:57When I heard it, knowing that all the things that you can get,
0:54:57 > 0:54:59I had a big smile on my face.
0:54:59 > 0:55:01Yes. It was all good.
0:55:01 > 0:55:04- Does that make sense? - All good.- Fantastic.
0:55:04 > 0:55:08They do impact your overall survivability
0:55:08 > 0:55:10in terms of life expectancy,
0:55:10 > 0:55:13it is reduced compared to somebody without one
0:55:13 > 0:55:18but I think we can be optimistic that,
0:55:18 > 0:55:24you know, we're in years, not months in that type of picture, OK?
0:55:24 > 0:55:28- Good man. - Happy days.
0:55:28 > 0:55:29All right.
0:55:31 > 0:55:33You get to know your patients quite well,
0:55:33 > 0:55:37you kind of nearly become their friend in one sense, so...
0:55:37 > 0:55:40you can't help but be a wee bit emotional with them.
0:55:40 > 0:55:44It might sound stupid but in one sense there's a happiness with me
0:55:44 > 0:55:46that he is able to do everything
0:55:46 > 0:55:51and is recovering well and that his diagnosis is...
0:55:51 > 0:55:55favourable in the spectrum of where it could be.
0:55:55 > 0:56:01I had my consultation, it's a year of chemotherapy
0:56:01 > 0:56:05and five weeks' intensive radiation.
0:56:05 > 0:56:08We'll just see what happens from there.
0:56:08 > 0:56:10But I'm feeling really fantastic.
0:56:10 > 0:56:12You cannae take the smile aff my face.
0:56:17 > 0:56:20And there's some great news on the renal ward.
0:56:20 > 0:56:2347-year-old Dougie is back.
0:56:23 > 0:56:27He wasn't picked for the pioneering laboratory-grown blood vessel
0:56:27 > 0:56:32in the trial, but 48 hours ago he got something better.
0:56:33 > 0:56:36Saturday morning I was getting ready to go out to work
0:56:36 > 0:56:38and then I got the phone call to come to the Queen Elizabeth
0:56:38 > 0:56:40because they'd...
0:56:40 > 0:56:42got me a kidney.
0:56:42 > 0:56:46So I come up here on Saturday morning and...
0:56:46 > 0:56:49everything was good to go. They done the tests and...
0:56:49 > 0:56:52they operated on Saturday night...
0:56:52 > 0:56:54and Bob's your uncle.
0:56:55 > 0:56:58The kidney is working well,
0:56:58 > 0:57:02the stress of life on dialysis for Dougie looks like it's over.
0:57:02 > 0:57:05So what are you looking forward to most?
0:57:05 > 0:57:06A fish supper.
0:57:08 > 0:57:10The finer things in life. Just a fish supper.
0:57:22 > 0:57:25Since it opened two years ago, Scotland's supersized hospital
0:57:25 > 0:57:29has witnessed the transformation of lives every day.
0:57:31 > 0:57:34Charlotte had her operation six months ago.
0:57:34 > 0:57:37She's had her first winter without any croup.
0:57:37 > 0:57:40It's been a great thing.
0:57:40 > 0:57:44No more midnight rushes to hospital for medicine.
0:57:44 > 0:57:47It's good to actually see her being a child and getting out to play.
0:57:52 > 0:57:56Peter's had his first two rounds of chemotherapy.
0:57:56 > 0:57:59Medication is keeping his epileptic fits under control.
0:58:04 > 0:58:06And after three months of home dialysis,
0:58:06 > 0:58:09Milo has seen much more of his friends and school
0:58:09 > 0:58:12and his overall health has improved.
0:58:14 > 0:58:16Other families have now moved on to doing this.
0:58:16 > 0:58:20I think Zoe's now trained... I think she's on her fourth family,
0:58:20 > 0:58:22which is a massive difference.
0:58:22 > 0:58:25It's going to make such a difference to everyone's lives.
0:58:25 > 0:58:28KIDS SHOUT