0:00:02 > 0:00:08This programme contains some scenes which some viewers may find upsetting
0:00:08 > 0:00:11Skin, shafts, heads, knees.
0:00:11 > 0:00:13OK. Left eye is out.
0:00:13 > 0:00:15Every year, thousands agree
0:00:15 > 0:00:17for their loved one's tissues to be donated.
0:00:17 > 0:00:23We rely on the kindness of people to understand that,
0:00:23 > 0:00:28once they're gone, they don't need their eyes, their meniscus,
0:00:28 > 0:00:30their skin, their heart valves.
0:00:30 > 0:00:32They help change the lives of thousands of people
0:00:32 > 0:00:34across the country.
0:00:34 > 0:00:36You don't expect it to happen to you.
0:00:36 > 0:00:39I'm just appreciative that someone would donate their eyes,
0:00:39 > 0:00:41cos it's going to improve my quality of life.
0:00:41 > 0:00:43This series follows the staff of Liverpool's
0:00:43 > 0:00:45National Human Tissue Bank...
0:00:45 > 0:00:48OK, you ready? Should we get cracking?
0:00:48 > 0:00:50People expect it to be, like, middle-aged men.
0:00:50 > 0:00:54Or kind of massively gothic people, for some reason.
0:00:54 > 0:00:56My dad always used to say things like,
0:00:56 > 0:00:59"Oh, you'll never get a boyfriend doing that kind of job."
0:00:59 > 0:01:00..as they grapple with death...
0:01:00 > 0:01:03I don't normally ever get upset, ever, about it all.
0:01:03 > 0:01:04..to help the living.
0:01:04 > 0:01:07I do think what we're doing is incredible.
0:01:07 > 0:01:10This job is really important because
0:01:10 > 0:01:13we're saving peoples' lives.
0:01:13 > 0:01:17This week, 18-year-old Reuben needs a life-changing operation...
0:01:17 > 0:01:21I do miss working. Working's my life really, I love it.
0:01:21 > 0:01:25So now I've got barely nothing, really.
0:01:25 > 0:01:27My mum's having to support me.
0:01:27 > 0:01:31..and the emotional pressure of the job starts to take its toll.
0:01:31 > 0:01:36I'm hearing someone's died, maybe 25 times a day
0:01:36 > 0:01:39and I can't do it forever, cos I'll...
0:01:39 > 0:01:41I'll forget everything else about
0:01:41 > 0:01:43nursing isn't just about death, is it?
0:01:54 > 0:01:58It's early December at the National Human Tissue Bank.
0:01:58 > 0:02:00On the outskirts of Liverpool,
0:02:00 > 0:02:02this vast building is stacked with freezers full
0:02:02 > 0:02:06of the country's life-saving heart valves, skin, and bone.
0:02:06 > 0:02:09PHONE RINGS
0:02:09 > 0:02:11My name's Leanne Langford, I'm one of the nurses
0:02:11 > 0:02:13calling from NHS Blood and Transplant...
0:02:13 > 0:02:17Making such supplies possible are the specialist nurses,
0:02:17 > 0:02:21who have the difficult job of calling recently bereaved families.
0:02:21 > 0:02:24My name's Laura, I'm one of the specialist nurses
0:02:24 > 0:02:26calling you from NHS Blood and Transplant.
0:02:26 > 0:02:28A woman has died,
0:02:28 > 0:02:31and 28-year-old Laura is calling her husband.
0:02:31 > 0:02:34Now, I'm just calling with some information for you.
0:02:34 > 0:02:38Before I do that, I just wanted to offer you my condolences.
0:02:38 > 0:02:40- 'Thank you. Thank you very much.' - You're welcome.
0:02:40 > 0:02:43OK, my role in the tissue bank is
0:02:43 > 0:02:46to consent with the family for the donation.
0:02:46 > 0:02:49And then follow that up with arranging for the donation
0:02:49 > 0:02:51and releasing tissue.
0:02:51 > 0:02:54Now, the corneas are the very front part of your eye,
0:02:54 > 0:02:56where you'd wear a contact lens,
0:02:56 > 0:03:01and that cornea is what is used in transplants, OK?
0:03:02 > 0:03:05Now, it is a very delicate part of the eye,
0:03:05 > 0:03:09so we do require the whole of both eyes being donated.
0:03:09 > 0:03:13It can be quite tough, but it's also very nice when you can follow out
0:03:13 > 0:03:16the family's and the deceased's wishes.
0:03:16 > 0:03:19It has its bonuses to the job.
0:03:20 > 0:03:23The team speak to over 5,000 families every year,
0:03:23 > 0:03:27helping them decide whether to donate their loved one's tissues.
0:03:28 > 0:03:32I'm just arranging a donation for someone
0:03:32 > 0:03:34who passed away with sudden collapse.
0:03:34 > 0:03:38Went into A & E and was pronounced dead yesterday afternoon.
0:03:38 > 0:03:41The family has agreed to donate their son's tissues.
0:03:41 > 0:03:44As the donor is young, it's a rare donation for the bank.
0:03:44 > 0:03:48Last year, only 8% of the donors were under 30.
0:03:48 > 0:03:50See you in a bit. Bye.
0:03:50 > 0:03:51Right, OK, then.
0:03:51 > 0:03:54Along the corridor are the tissue donation specialists.
0:03:54 > 0:03:59Today, 33-year-old Francesca will be taking the tissues from the donor.
0:03:59 > 0:04:02- Right. Any tattoos, piercings, distinguishing features?- No.
0:04:02 > 0:04:05- Is there going to be a post-mortem? - Yeah.
0:04:05 > 0:04:08So what tissue has been consented for?
0:04:08 > 0:04:13- Erm... Skin...- Radius and ulna.
0:04:13 > 0:04:16U-L-N-A. Ulna.
0:04:16 > 0:04:17Oh!
0:04:17 > 0:04:18THEY LAUGH
0:04:19 > 0:04:21It were jumpy then. Just write it again.
0:04:21 > 0:04:24It would help if I knew how to spell it, wouldn't it?
0:04:24 > 0:04:25- OK, thank you.- Thanks.
0:04:28 > 0:04:30Once Francesca's collected the equipment,
0:04:30 > 0:04:33she and colleague Mel will head north to the mortuary,
0:04:33 > 0:04:35to carry out the donation.
0:04:37 > 0:04:39Taking tissue from recently deceased young donors
0:04:39 > 0:04:41is never easy.
0:04:41 > 0:04:44Some cases you do think about the donors, erm..
0:04:44 > 0:04:49..who they were, especially on the ones where it
0:04:49 > 0:04:52was like a sudden death or maybe a younger person or things like that
0:04:52 > 0:04:55and you might think more about, you know,
0:04:55 > 0:04:58who they were or what they had ahead of them and their families
0:04:58 > 0:05:01and parents and stuff and how it's going to affect them.
0:05:01 > 0:05:03- You all right getting set up, then? - Yep.
0:05:03 > 0:05:05Bit of ethanol in the air.
0:05:07 > 0:05:10Just stops the smell sometimes.
0:05:10 > 0:05:12Francesca's been in the job for eight years,
0:05:12 > 0:05:15and has developed her own way of working with the dead.
0:05:18 > 0:05:19That's the only thing
0:05:19 > 0:05:20that can be a bit strange,
0:05:20 > 0:05:22if people have got their eyes open.
0:05:22 > 0:05:25Some people, if they've got their eyes open,
0:05:25 > 0:05:28don't quite look dead.
0:05:28 > 0:05:31Seeing someone's eyes and stuff doesn't freak me out,
0:05:31 > 0:05:34but it makes it more difficult to detach, in a way.
0:05:34 > 0:05:37Most people don't die with their eyes closed peacefully,
0:05:37 > 0:05:40as you kind of imagine on TV or films,
0:05:40 > 0:05:43so that's why I try and make sure, people die,
0:05:43 > 0:05:45their eyelids get closed.
0:05:45 > 0:05:47It's more peaceful for them.
0:05:47 > 0:05:50As the donor is young, they're likely to have
0:05:50 > 0:05:52more healthy tissue to donate.
0:05:52 > 0:05:56Each donation follows a set order to avoid damaging vital tissue.
0:05:56 > 0:05:59So we're doing all three bones in the arms,
0:05:59 > 0:06:02so humerus, which is the top part of the arm,
0:06:02 > 0:06:06radius and ulna, which is in your lower forearm.
0:06:07 > 0:06:10Donated bones are in big demand at the tissue bank,
0:06:10 > 0:06:13as they're often used to replace cancerous bones
0:06:13 > 0:06:15and repair sports injuries.
0:06:15 > 0:06:17One humerus.
0:06:17 > 0:06:20So it'd go that way round in that arm.
0:06:20 > 0:06:22Here we have the ulna,
0:06:22 > 0:06:25which kind of goes underneath
0:06:25 > 0:06:27and cos the donor is very young,
0:06:27 > 0:06:32the bones are really nice and white and smooth and clear.
0:06:32 > 0:06:35While the girls are building up the tissue bank's stocks,
0:06:35 > 0:06:37back at base in customer services,
0:06:37 > 0:06:39the orders are coming in thick and fast.
0:06:39 > 0:06:43Good afternoon, Tissue Services, Daniel speaking, how can I help?
0:06:48 > 0:06:49Right. Do you know what size
0:06:49 > 0:06:52Achilles' tendon that your surgeon wants?
0:06:52 > 0:06:56The most popular tissues are often in short supply.
0:06:56 > 0:07:01We have got a 19cm here, so I've allocated that one for you.
0:07:01 > 0:07:05That's great, so that's one Achilles tendon at 19cm.
0:07:05 > 0:07:08I'll fit deliver tomorrow, before 9am, for Mr Hallstead.
0:07:08 > 0:07:10That's great.
0:07:10 > 0:07:12All right, I'll send the confirmation shortly.
0:07:12 > 0:07:14Thank you. Bye-bye. Bye.
0:07:15 > 0:07:18Supplying 350 hospitals nationwide,
0:07:18 > 0:07:23it's a constant battle to keep up with demand.
0:07:23 > 0:07:25Right, erm, freeze-dried bone,
0:07:25 > 0:07:28do you want that fine ground, medium ground, or coarse ground?
0:07:28 > 0:07:32And, with regards to delivery, do you need this before 9am,
0:07:32 > 0:07:35or are you happy for it to come in before noon?
0:07:35 > 0:07:39One patient, who is on the hospital waiting list for a donor bone graft,
0:07:39 > 0:07:41is 18-year-old Reuben.
0:07:46 > 0:07:49We're going off to the site that I was working at
0:07:49 > 0:07:52before my knee become how it is now.
0:07:52 > 0:07:56But I haven't been back here since, actually.
0:07:56 > 0:07:58So it'll be quite interesting to find out
0:07:58 > 0:08:00how it's looking and all that, really.
0:08:00 > 0:08:03Reuben was working as a carpenter
0:08:03 > 0:08:07when, eight months ago, he noticed a problem with his knee.
0:08:08 > 0:08:10When I first started the job, it was OK,
0:08:10 > 0:08:14my knee weren't too bad, it was all right,
0:08:14 > 0:08:16and then I first sort of noticed the trouble
0:08:16 > 0:08:18when I was doing the walls and that.
0:08:18 > 0:08:20And then when I had to get down on the floor
0:08:20 > 0:08:23and when I had to sort of stand up quite quick to grab tools
0:08:23 > 0:08:26and whatnot, that's when I found it most hard.
0:08:26 > 0:08:28Yeah, my knee at the end of the day was really,
0:08:28 > 0:08:30really hurting at the end of the day.
0:08:30 > 0:08:33It was aching and that's when I had the MRI scan
0:08:33 > 0:08:35to tell me, like, you've got a tumour.
0:08:35 > 0:08:38If the doctors don't remove the tumour,
0:08:38 > 0:08:40Reuben's knee could be destroyed.
0:08:40 > 0:08:45I was a bit upset, really, big ball in my throat and all that.
0:08:45 > 0:08:48You don't expect it to happen to you.
0:08:48 > 0:08:51You just have to get along with it and be positive, really.
0:08:52 > 0:08:55It was my first big job that I've ever done.
0:08:55 > 0:08:58I loved it, I loved every minute of it.
0:08:58 > 0:09:02Well, you see, I done the old stud walls, these are the partitions.
0:09:02 > 0:09:06This is, obviously, the kitchen to the living room.
0:09:06 > 0:09:08And also I done the...
0:09:08 > 0:09:11I put these door linings in.
0:09:11 > 0:09:12I done all these door linings
0:09:12 > 0:09:16and also you can see here the stud walls and stuff.
0:09:17 > 0:09:22I do miss not working, working's my life really, I love it.
0:09:22 > 0:09:25It's just like it gives you something to wake up for, don't it?
0:09:25 > 0:09:28For my age and that, I was earning a good 300...
0:09:28 > 0:09:30300 a week.
0:09:31 > 0:09:35Now, I've got barely nothing, really.
0:09:35 > 0:09:37My mum's having to support me.
0:09:37 > 0:09:40Gutted, absolutely gutted.
0:09:41 > 0:09:45For now, all Reuben can do is wait for his surgery.
0:09:45 > 0:09:48Back in the mortuary, after three hours,
0:09:48 > 0:09:51Francesca and Mel are halfway through a donation
0:09:51 > 0:09:54that could improve the lives of dozens of people.
0:09:54 > 0:09:57What we're doing next is bones in the leg, the whole knee
0:09:57 > 0:10:01and then once we've done all that, we've got Achilles tendons as well.
0:10:01 > 0:10:06Very big femoral heads there, being a young, fit, healthy donor.
0:10:06 > 0:10:09- 'God, it is massive.' - Nice strong bones.
0:10:09 > 0:10:10It's a femoral head, like this,
0:10:10 > 0:10:13that will be ground down into tiny pieces
0:10:13 > 0:10:15and used to help repair Reuben's knee.
0:10:15 > 0:10:17Er, I wouldn't say it's difficult to cut through bone
0:10:17 > 0:10:20because the blades are very sharp and they're battery-powered.
0:10:20 > 0:10:24We used to have handsaws, but they were near-enough impossible to use.
0:10:24 > 0:10:26# Cos it's your heart
0:10:26 > 0:10:28# It's alive
0:10:28 > 0:10:32# It's pumping blood... #
0:10:32 > 0:10:35While Reuben awaits news of his operation,
0:10:35 > 0:10:38he can only dream of happy footballing days.
0:10:38 > 0:10:41I played for reserves for about a season and half,
0:10:41 > 0:10:44but I just couldn't play at all.
0:10:44 > 0:10:47- All right, Tom, me old mate? - Hi, Reuben.
0:10:47 > 0:10:50- How did you get on today?- We won 2-1. - Did you?- Yeah.- Excellent.
0:10:50 > 0:10:53- I scored the winner.- Did you? - Yeah.- Excellent.
0:10:53 > 0:10:57- What sort of goal was it like? - Chip-cross in the air.- Really?
0:10:58 > 0:11:01I was a substitute, really, I weren't that good.
0:11:01 > 0:11:02HE LAUGHS
0:11:02 > 0:11:06So, erm, he's got my job now.
0:11:06 > 0:11:08I was just there if they needed me, sort of thing, really.
0:11:08 > 0:11:11I loved it, though, it was a good laugh.
0:11:11 > 0:11:15Playing footy on a Saturday, you can't beat it.
0:11:16 > 0:11:18After five hours in the mortuary,
0:11:18 > 0:11:21the girls have retrieved valuable arm and leg bones
0:11:21 > 0:11:22for the tissue bank.
0:11:22 > 0:11:26Now, they'll use reconstructive techniques so that the donor
0:11:26 > 0:11:28looks the same as when they arrived.
0:11:29 > 0:11:37So, this is the full arm prosthesis, Meccano pieces if you like.
0:11:37 > 0:11:40So, like, the leg one we can make it longer or shorter.
0:11:40 > 0:11:42Erm, I do think, you know,
0:11:42 > 0:11:45the concept of what we're doing is incredible,
0:11:45 > 0:11:50that we can take bones and skin from somebody else
0:11:50 > 0:11:54and then they can be processed and transplanted into somebody else.
0:11:54 > 0:11:55It's amazing.
0:11:55 > 0:12:00For Mel and Francesca, every job is a physical and mental challenge.
0:12:00 > 0:12:06It's been just over six hours from getting into the mortuary
0:12:06 > 0:12:11so far, so ready for a cold drink.
0:12:11 > 0:12:13You know, it is a long day,
0:12:13 > 0:12:17it does take its toll when you've done it a few days in a row,
0:12:17 > 0:12:18but I'd much rather do this
0:12:18 > 0:12:23than be sitting in an office nine to five, definitely.
0:12:23 > 0:12:25After seven long hours in the mortuary,
0:12:25 > 0:12:29the donation is complete and the girls are off home.
0:12:33 > 0:12:38My mum is just completely proud of me, she absolutely loves my job,
0:12:38 > 0:12:42she loves that I'm saving lives and that I'm happy, so.
0:12:42 > 0:12:44My dad always used to say things like,
0:12:44 > 0:12:46"Oh, you know, you'll never get a boyfriend doing that kind of job."
0:12:46 > 0:12:49And, again, I think it's just because it's the unknown,
0:12:49 > 0:12:51cos for my dad, he just thinks, you know,
0:12:51 > 0:12:53you're cutting up dead people and it's a bit weird.
0:12:53 > 0:12:55My dad always wanted me to be a weather girl,
0:12:55 > 0:12:56or in marketing, that's it,
0:12:56 > 0:12:58that's basically all my dad wanted me to be.
0:12:58 > 0:12:59"I think you should be a weather girl."
0:12:59 > 0:13:02I think it's probably because he loves watching the news
0:13:02 > 0:13:05so I'd be there every day like, "And today, it's going to be raining
0:13:05 > 0:13:06"and tomorrow, it's going to be snowing."
0:13:06 > 0:13:07It's either that
0:13:07 > 0:13:10or he didn't think I was intelligent enough to do anything else.
0:13:12 > 0:13:13On the other side of Liverpool,
0:13:13 > 0:13:17Francesca is getting home to husband Mike.
0:13:17 > 0:13:20Smells good, smells very good!
0:13:22 > 0:13:24How long have we got to wait?
0:13:24 > 0:13:27I'm fine with meat after doing donations and things.
0:13:27 > 0:13:32Erm, the worst thing is liver, raw liver...
0:13:32 > 0:13:35to cut up is more...
0:13:35 > 0:13:36I don't know. Not that we...
0:13:36 > 0:13:38We don't retrieve organs or anything
0:13:38 > 0:13:42but I don't know why but I think raw liver is the thing that
0:13:42 > 0:13:44I just get a bit funny about.
0:13:44 > 0:13:47While Francesca might have a strong stomach for the job,
0:13:47 > 0:13:49hubby Mike certainly doesn't.
0:13:49 > 0:13:54We were watching Silent Witness, there was an autopsy scene
0:13:54 > 0:13:57and I'm like that, ugh,
0:13:57 > 0:14:00and Chess is like, "That doesn't even look real."
0:14:00 > 0:14:02I'm looking, thinking, "It looks pretty real to me."
0:14:02 > 0:14:05It's an unusual job, but she's just a normal person,
0:14:05 > 0:14:07just like everyone else on the team.
0:14:07 > 0:14:09Well, you'd imagine you'd go in there and they'd all
0:14:09 > 0:14:12look like the Addams family or something, something like, you know,
0:14:12 > 0:14:16you'd think, "Oh, they look...yeah, they look a bit strange, them lot."
0:14:16 > 0:14:18Well, I'm not saying they all don't look strange,
0:14:18 > 0:14:21but Chess looks pretty normal.
0:14:22 > 0:14:25For every donation that Francesca carries out,
0:14:25 > 0:14:29a difficult, but necessary call will have been made to a family.
0:14:29 > 0:14:33Would you be comfortable with the bone donation from his arms?
0:14:33 > 0:14:35- 'Yep.'- Yeah, OK.
0:14:35 > 0:14:38It's the week before Christmas and for the nurses,
0:14:38 > 0:14:40one of the toughest times of the year.
0:14:40 > 0:14:44Now, he would also be able to donate his Achilles tendons,
0:14:44 > 0:14:47so these are the tendons at your back of your ankle
0:14:47 > 0:14:51so it's giving people back their mobility and their independence
0:14:51 > 0:14:52and things like that.
0:14:52 > 0:14:54There would be a small scar down the back of the ankle
0:14:54 > 0:14:57and we would also take a small part of the heel bone, OK?
0:14:57 > 0:15:00But again, you know, he would be dressed if you want to go
0:15:00 > 0:15:02and see him so that would be fine.
0:15:02 > 0:15:04- Is that OK for you? - 'Yep, that's fine.'- All right.
0:15:04 > 0:15:07Speaking to over a dozen bereaved families every day
0:15:07 > 0:15:10can be hard and especially during the festive season.
0:15:10 > 0:15:12Brave, brave family.
0:15:14 > 0:15:18- Make me a brew.- All right?- Yeah.
0:15:18 > 0:15:22It's just his dad was so brave, and just, honestly...
0:15:24 > 0:15:27..I don't know where they get their strength from, ever.
0:15:27 > 0:15:30Always helps, always helps.
0:15:32 > 0:15:34Ladies...
0:15:34 > 0:15:35After a chocolate lift,
0:15:35 > 0:15:38Laura's ready to make her third consent call of the day
0:15:38 > 0:15:40in the designated family liaison room.
0:15:40 > 0:15:45My name's Laura, I'm one of the nurses just giving you a call back.
0:15:45 > 0:15:49Erm, just before I go any further, I want to offer you my condolences.
0:15:49 > 0:15:51# One night to be confused
0:15:51 > 0:15:54# One night to be speed up truth
0:15:54 > 0:15:55# We had a promise made... #
0:15:55 > 0:15:59I know you were having some time to think about becoming a donor
0:15:59 > 0:16:02and I just wanted to know what your thoughts were now?
0:16:06 > 0:16:08OK.
0:16:09 > 0:16:11Oh, dear.
0:16:15 > 0:16:17You'll decline.
0:16:17 > 0:16:21You have every right to decline, OK.
0:16:21 > 0:16:23If it doesn't make you both comfortable,
0:16:23 > 0:16:27then it wouldn't make me comfortable either.
0:16:27 > 0:16:29You only get one chance when someone's dying
0:16:29 > 0:16:32or when someone's died to make things right for somebody else.
0:16:34 > 0:16:38I know that I can make such a bad situation for families
0:16:38 > 0:16:40a little bit better.
0:16:41 > 0:16:43And I like to do that.
0:16:43 > 0:16:46I want to be a nurse because I like to help people.
0:16:48 > 0:16:50Although they're working with the bereaved daily,
0:16:50 > 0:16:54the nurses try hard not to let it affect their personal lives.
0:16:54 > 0:16:57I think if we let it change our opinion on the way
0:16:57 > 0:17:00- we do things, we wouldn't go out of the door.- Yes.
0:17:00 > 0:17:03You wouldn't move, you wouldn't do anything adventurous,
0:17:03 > 0:17:06you'd just wrap yourself and your family up, wouldn't you?
0:17:06 > 0:17:08And never leave the house.
0:17:08 > 0:17:10You end up doing more as well because you know that,
0:17:10 > 0:17:13- you know, life...- Yes, you don't know what's around the corner.
0:17:13 > 0:17:16- You're aware of your own mortality.- Absolutely.- Definitely.
0:17:17 > 0:17:20While the consent calls can be difficult,
0:17:20 > 0:17:24they're vital to maintain the tissue bank supplies.
0:17:24 > 0:17:27For donation specialist Becky it often means an early start.
0:17:27 > 0:17:30We've got a donor today, me and Chris have got to do
0:17:30 > 0:17:32pretty much everything,
0:17:32 > 0:17:34so it's going to take a while.
0:17:34 > 0:17:37We could be there for, I don't know, six hours.
0:17:37 > 0:17:39We've got skin, bone, heart, eyes.
0:17:41 > 0:17:44Do you want some breakfast?
0:17:46 > 0:17:47Hello.
0:17:47 > 0:17:50Yes, this job can really affect your home life because, you know,
0:17:50 > 0:17:52cos I've got the dog and the cat and stuff,
0:17:52 > 0:17:56if I don't come back until about 11 or 12 at night.
0:17:56 > 0:17:59Luckily, I've got a friend around the corner
0:17:59 > 0:18:02who's got a spare key and he's got dogs and stuff so he'll come
0:18:02 > 0:18:05and pick her up and look after her for a bit if I need him to,
0:18:05 > 0:18:08but I don't know what I'd do if I had kids and stuff, you know,
0:18:08 > 0:18:11childcare and... It'd be a nightmare.
0:18:20 > 0:18:22Oh, God, it's freezing.
0:18:24 > 0:18:27You see, this is the kind of weather where you just want to
0:18:27 > 0:18:31get back into bed and not emerge until spring.
0:18:31 > 0:18:34I could quite happily hibernate.
0:18:36 > 0:18:39A donor has died in the early hours of the morning
0:18:39 > 0:18:43and his family has agreed to donate his skin and leg bones.
0:18:43 > 0:18:47We're going to retrieve the bone from the legs,
0:18:47 > 0:18:50so we're going to retrieve the femur and the knee.
0:18:50 > 0:18:55This bit can be one of the most physical parts of the job,
0:18:55 > 0:19:00especially on larger donors as well because you have to lift the skin
0:19:00 > 0:19:05and muscle and any fat that's there away so you can expose the bone.
0:19:05 > 0:19:08Then you have to dislocate the hip joint
0:19:08 > 0:19:10which you kind of have to do a bit blind.
0:19:10 > 0:19:13You just have to pop your hands in and feel around which is difficult
0:19:13 > 0:19:16when you've got a sharp blade so you have to be really, really careful.
0:19:18 > 0:19:20You can get donors every day of the year
0:19:20 > 0:19:25and I think especially at this time of year families are maybe
0:19:25 > 0:19:29more keen to donate because it's kind of the season of giving.
0:19:31 > 0:19:35While Becky and Chris are hard at work on the donation,
0:19:35 > 0:19:37nurses Linda and Laura have drawn the short straw,
0:19:37 > 0:19:39to man the phones at Christmas...
0:19:39 > 0:19:41I'll see you next week I think.
0:19:41 > 0:19:44You're in New Year's Day with me, aren't you?
0:19:46 > 0:19:50..meanwhile their colleagues enjoy Christmas lunch downstairs.
0:19:58 > 0:20:03It is particularly difficult at Christmas.
0:20:04 > 0:20:08Everybody's getting ready for Christmas and this family,
0:20:08 > 0:20:11within an instant,
0:20:11 > 0:20:13are now not getting ready for Christmas.
0:20:13 > 0:20:15Christmas is all on the back burner, in fact, it's gone.
0:20:15 > 0:20:19And they're just getting on with dealing with what they have to deal with here.
0:20:20 > 0:20:23Back in the mortuary Becky and colleague Chris are still
0:20:23 > 0:20:25hard at work collecting life-saving tissues
0:20:25 > 0:20:29while most of the country is out Christmas shopping.
0:20:29 > 0:20:31We try not to think about families and stuff
0:20:31 > 0:20:35but I think when it's this time of year you do a bit more, don't you?
0:20:35 > 0:20:38You know, someone has just lost someone at Christmas.
0:20:38 > 0:20:41It's the last gift they can give as well.
0:20:41 > 0:20:42That's very poignant, Chris!
0:20:42 > 0:20:45It's hard to organise a social life.
0:20:45 > 0:20:48If you're on a retrieval shift, there's no point in booking anything,
0:20:48 > 0:20:50you can't book to go out for tea,
0:20:50 > 0:20:54you can't say you'll be home for such and such a time because you've got no idea
0:20:54 > 0:20:56and you can't predict when people are going to die!
0:20:58 > 0:21:01I think all of our friends and families are just used to us
0:21:01 > 0:21:03saying, "I'm sorry, I can't make it.
0:21:03 > 0:21:06"I'm out in a mortuary in the middle of nowhere somewhere, so..."
0:21:06 > 0:21:08But you can use it to your advantage
0:21:08 > 0:21:11so if someone says you're invited to such and such, if you don't
0:21:11 > 0:21:14want to go, you just say, "Oh, I can't, I'm on a retrieval shift!"
0:21:14 > 0:21:17Cos you've never done that before, Becky(!)
0:21:17 > 0:21:19Never made up a retrieval shift(!)
0:21:19 > 0:21:23Most of us have worked here for a long time
0:21:23 > 0:21:27so we've known each other for, you know, through marriages
0:21:27 > 0:21:33and buying houses and all sorts so I think we are like a family.
0:21:33 > 0:21:36There's definitely kind of the mums and dads
0:21:36 > 0:21:39and the naughty kids in the group.
0:21:39 > 0:21:42And families argue and families stick together and stick up for
0:21:42 > 0:21:44each other but bicker and stuff,
0:21:44 > 0:21:47so I'd definitely say we act like a family.
0:21:48 > 0:21:49Yes, a dysfunctional one.
0:21:51 > 0:21:53- Right, we finished then, Becky? - Yes, job done.
0:21:53 > 0:21:57By nine o'clock in the evening, Chris and Becky are finally finished
0:21:57 > 0:21:59and off to celebrate Christmas with their families.
0:21:59 > 0:22:03Thankfully someone else is on the Christmas Day shift.
0:22:13 > 0:22:15With Christmas gone and most of January,
0:22:15 > 0:22:16Laura's in the thick of it.
0:22:18 > 0:22:21Today she has to call the family of a young man
0:22:21 > 0:22:23who died in the last few hours.
0:22:25 > 0:22:32This is a 21-year-old male who passed away in the London area
0:22:32 > 0:22:36following a cancer diagnosis.
0:22:36 > 0:22:39He expressed his wishes to donate anything he could.
0:22:39 > 0:22:43Because of his condition he could only donate his eyes.
0:22:48 > 0:22:53Can you tell me what diagnosis Reece had, please?
0:22:53 > 0:22:56'Reece was diagnosed with kidney cancer.'
0:22:56 > 0:22:58Kidney cancer, OK.
0:22:58 > 0:23:01Donors who die of cancer can't donate their tissues
0:23:01 > 0:23:04because of the risk of infection to the transplant patient.
0:23:04 > 0:23:08There is one exception, the cornea, the lens of the eye.
0:23:08 > 0:23:11Did Reece drink alcohol?
0:23:11 > 0:23:16'Reece never drank alcohol. Very, very rarely.
0:23:16 > 0:23:19'He was going to be a fitness instructor.'
0:23:19 > 0:23:23Has Reece travelled outside the UK in the last 12 months?
0:23:23 > 0:23:29'He has been to Spain, Portugal,
0:23:29 > 0:23:32'Tenerife, oh, that is Spain,
0:23:32 > 0:23:35'Um, he's been to Thailand,
0:23:35 > 0:23:37'Egypt and France.'
0:23:37 > 0:23:44In the last 12 months has Reece had any treatment like acupuncture,
0:23:44 > 0:23:49tattoos, piercings, cosmetic treatment, anything like that?
0:23:49 > 0:23:51'Yes, Reece has had a tattoo.'
0:23:51 > 0:23:53There's a hitch.
0:23:53 > 0:23:57Strict rules around the safety of tissue may mean Reece could be
0:23:57 > 0:24:01barred from donating his eyes. Laura has to break the news to the family.
0:24:01 > 0:24:04So, when somebody's had a tattoo,
0:24:04 > 0:24:07they can't donate if it's been in the last four months.
0:24:07 > 0:24:11Now, I know we are at the end of January, OK,
0:24:11 > 0:24:14so when in the September did he have it?
0:24:14 > 0:24:17'I'm only guessing September.'
0:24:17 > 0:24:21To protect transplant patients from disease or infection,
0:24:21 > 0:24:24donors must not have had any recent tattoos or piercings.
0:24:24 > 0:24:29For Laura, it's bad news on a tough call.
0:24:29 > 0:24:32I've had in the last few days really young donors.
0:24:32 > 0:24:39I think just listening to the fact that he has not long been diagnosed,
0:24:39 > 0:24:43you know, it has been a year, he's done all this travel in a year,
0:24:43 > 0:24:46he's maintained a relationship with his girlfriend,
0:24:46 > 0:24:49she's stayed there, and then his family are obviously distressed,
0:24:49 > 0:24:51it's really sad but...
0:24:51 > 0:24:55It's hard sometimes when you have a lot of emotion behind
0:24:55 > 0:24:59what's happening on that donation, during that conversation.
0:24:59 > 0:25:01I didn't want to make a mistake
0:25:01 > 0:25:05because we didn't want to take the donation and then have to,
0:25:05 > 0:25:09you know, dispose of his donation because we can't give it back.
0:25:09 > 0:25:12Hopefully it can go ahead,
0:25:12 > 0:25:14but obviously it's going to be really sad if it can't
0:25:14 > 0:25:17because that's his wishes.
0:25:17 > 0:25:21If the donation can't go ahead, it's not only frustrating
0:25:21 > 0:25:25for the family, it also means a longer wait for people like George.
0:25:25 > 0:25:27Our first paddle this morning.
0:25:27 > 0:25:29We haven't been out on the water
0:25:29 > 0:25:34since Christmas due to high tides and a bit of a push on gym work.
0:25:35 > 0:25:38In Chester, 25-year-old amateur rower George
0:25:38 > 0:25:41is waiting for a corneal transplant.
0:25:50 > 0:25:53Diagnosed with a degenerative condition of the eye
0:25:53 > 0:25:57he has already had one transplant on his right eye.
0:25:57 > 0:25:59Now the left eye has deteriorated.
0:25:59 > 0:26:02Stuff's there, it's just nothing really focuses, blurred vision.
0:26:02 > 0:26:04I couldn't really read anything.
0:26:04 > 0:26:08So, yeah, this is sort of the next step now with the operation
0:26:08 > 0:26:10to get things better, make it a bit more stable
0:26:10 > 0:26:13and then I can rely on having two eyes again.
0:26:13 > 0:26:16George's condition means his best chance of success
0:26:16 > 0:26:19is a cornea from a donor of a similar age,
0:26:19 > 0:26:23but last year only 3% of corneas donated were from those under 30.
0:26:23 > 0:26:26It was tough as a kid really.
0:26:26 > 0:26:29You know, my big love as a kid was rugby.
0:26:29 > 0:26:31I played a lot of rugby.
0:26:31 > 0:26:34I had to stop that because my vision was a bit poor
0:26:34 > 0:26:37and the contact lenses weren't working for contact sports,
0:26:37 > 0:26:38so that's why I turned to rowing.
0:26:38 > 0:26:42It turns out I am a bit of a better rower than I am a rugby player!
0:26:42 > 0:26:45So every cloud's got a silver lining.
0:26:45 > 0:26:47George works in the construction industry
0:26:47 > 0:26:49and needs good vision to do his job.
0:26:49 > 0:26:53Without a corneal transplant, he could find himself unemployed.
0:26:53 > 0:26:55This is a soft lens
0:26:55 > 0:26:59so this is a lens that I put on on my grafted eye at the moment
0:26:59 > 0:27:03so I use this lens with a glasses prescription as well.
0:27:09 > 0:27:11So, yes, that's done.
0:27:14 > 0:27:17George's cornea is currently so deformed
0:27:17 > 0:27:19that the contact lens is difficult to wear.
0:27:19 > 0:27:22I lost a lens for a while and I couldn't get a replacement,
0:27:22 > 0:27:25I had to take a week off work. I managed to lose it on a night out,
0:27:25 > 0:27:26flicked out of my eye
0:27:26 > 0:27:30and my reflexes weren't quite quick enough at the time to catch it
0:27:30 > 0:27:35so I was sprawling around on the floor, trying to find my lens.
0:27:35 > 0:27:37So, yeah, not ideal.
0:27:37 > 0:27:40The hospital waiting list for corneal transplants
0:27:40 > 0:27:41can be up to two years.
0:27:41 > 0:27:44So George could be scrambling on nightclub floors
0:27:44 > 0:27:46for a long time to come.
0:27:49 > 0:27:53For every patient like George, there is a need for a donor.
0:27:55 > 0:27:58I've just consented his daughter
0:27:58 > 0:28:01and she's happy to go ahead with donation and he was also
0:28:01 > 0:28:04on the organ donor register with no restrictions as well.
0:28:04 > 0:28:08Almost 500,000 people in the UK die every year
0:28:08 > 0:28:11but less than 1% of them will donate their tissues.
0:28:11 > 0:28:16I'm just ringing to see is the death certificate for Reece being issued?
0:28:17 > 0:28:19It's the end of the day
0:28:19 > 0:28:23and Laura is still trying to grant the dying wish of a young man.
0:28:23 > 0:28:25He's just had his 21st birthday.
0:28:27 > 0:28:3021-year-old Reece wanted to donate his eyes to help
0:28:30 > 0:28:34save someone's sight but a recent tattoo may now prevent this.
0:28:39 > 0:28:42Hi, is that Lorna? Hiya, Lorna.
0:28:42 > 0:28:46Laura needs to confirm that the tattoo is more than four months old,
0:28:46 > 0:28:48otherwise Reece can't donate.
0:28:48 > 0:28:51As a last attempt, she calls his girlfriend.
0:28:51 > 0:28:57There's just one concern that I've got about Reece having tattoos, OK?
0:28:57 > 0:29:03- 'Yes.'- First of all, do you know when he had his last tattoo?
0:29:03 > 0:29:07'He's only got one on his arm which he had done ages ago in Portugal,
0:29:07 > 0:29:11'about two years ago and then he's got my name on his bum
0:29:11 > 0:29:15'but that was done about a year ago as well.'
0:29:15 > 0:29:17- It was a year ago?- 'Yes, yes.'- OK.
0:29:17 > 0:29:21OK. Well, that's brilliant to know that, Lorna.
0:29:21 > 0:29:24That is all the answers that I needed from you, Lorna.
0:29:24 > 0:29:27- You take care now.- 'OK, thank you.'
0:29:27 > 0:29:29- Bye.- 'Thanks, bye.'- Bye.
0:29:31 > 0:29:33So it's all good.
0:29:33 > 0:29:35And he hadn't had a tattoo recently.
0:29:37 > 0:29:38It's sad, isn't it?
0:29:41 > 0:29:44I don't normally ever get upset ever about it all.
0:29:45 > 0:29:50I think it's just because he was so fit, he was going on holiday,
0:29:50 > 0:29:53he's so young, he's got his girlfriend, he's got her name
0:29:53 > 0:29:57tattooed on his bum, he sounds like he's been a right laugh.
0:29:58 > 0:30:00You know, up for a good time,
0:30:00 > 0:30:03and then he's got kidney cancer.
0:30:06 > 0:30:07And now he's died.
0:30:09 > 0:30:12While it's a positive outcome to a long day and another valuable
0:30:12 > 0:30:16donation for the bank, the pressure is starting to get to Laura.
0:30:20 > 0:30:23It is really hard listening to sad stories all the time.
0:30:25 > 0:30:29It's hard for anybody else to understand your job and how,
0:30:29 > 0:30:32like, what you've been through on that day.
0:30:32 > 0:30:35People don't want to talk about it to you
0:30:35 > 0:30:39cos they don't want to think about death, illness.
0:30:43 > 0:30:46In Suffolk, 18-year-old Reuben is hoping
0:30:46 > 0:30:51donated bone will be his chance to get back to work and a normal life.
0:30:52 > 0:30:54Better pack my slippers.
0:30:54 > 0:30:57I've got to have my baggy top.
0:30:57 > 0:31:02I've got to have my Muppets PJs.
0:31:02 > 0:31:06Reuben's been lucky. Because his knee operation doesn't require
0:31:06 > 0:31:09a special size of bone, he hasn't had to wait months for a match.
0:31:11 > 0:31:13I'm grateful that someone's took that sort of choice,
0:31:13 > 0:31:16that they've give their bone in, you know.
0:31:16 > 0:31:18I think we need more like that really,
0:31:18 > 0:31:22we need more people like that. I would be up, I would do it.
0:31:22 > 0:31:25When I'm dead and gone I would definitely,
0:31:25 > 0:31:28I would give my organs or whatever away.
0:31:28 > 0:31:30It's just... I think people, it's one of them things
0:31:30 > 0:31:33that people should do, to be honest with you.
0:31:33 > 0:31:37Whilst you're here, you might as well enjoy your body and that
0:31:37 > 0:31:42but when you're gone, you should just give your parts away, you know.
0:31:44 > 0:31:45Reuben?
0:31:45 > 0:31:47Hurry up.
0:31:53 > 0:31:58Reuben has been referred to us with a tumour in his left knee.
0:31:58 > 0:32:01It's a rare tumour called a chondroblastoma.
0:32:01 > 0:32:06Now, we know how to treat these in that they needed detailed curettage,
0:32:06 > 0:32:09which really means scraping out the tumour
0:32:09 > 0:32:13and then we're going to pack this with bone graft.
0:32:13 > 0:32:15It's a specialist operation
0:32:15 > 0:32:19so Reuben, his mum and nan have to travel 160 miles north
0:32:19 > 0:32:22to Birmingham's Royal Orthopaedic Hospital.
0:32:23 > 0:32:26The nerves are sort of kicking in a little bit now.
0:32:26 > 0:32:28I know everything will be all right,
0:32:28 > 0:32:32it's just you always get a bit nervous.
0:32:33 > 0:32:36Once the surgeons remove the tumour, he'll fill the space left with
0:32:36 > 0:32:41donor bone, but first he has to use a medical meat grinder to crush it.
0:32:41 > 0:32:42This is the grinding machine.
0:32:42 > 0:32:45As you can see, it's a fairly substantial piece of equipment
0:32:45 > 0:32:50and essentially we're going to be putting these femoral heads
0:32:50 > 0:32:53through the mincer and grinding it into bone chips.
0:32:53 > 0:32:56It'll look like a pile of wood shavings really,
0:32:56 > 0:32:59from the carpenter's workshop.
0:32:59 > 0:33:04Most of the techniques we use are much the same as a carpenter.
0:33:04 > 0:33:07Reuben - I'm sure he would be quite capable of doing this as well.
0:33:08 > 0:33:12This is making beautiful bone graft which we'll incorporate
0:33:12 > 0:33:15and then gradually grow into healthy new bone for Reuben.
0:33:21 > 0:33:24Look at this. This is the bone graft that we've milled
0:33:24 > 0:33:27and this is all going to go in very nicely
0:33:27 > 0:33:30and that will fill the bone cyst in Reuben's leg.
0:33:32 > 0:33:35With the bone ground down, Reuben is brought into theatre.
0:33:35 > 0:33:37There you are.
0:33:39 > 0:33:41We're making a vertical incision.
0:33:41 > 0:33:45I'm now going to use this diathermy to make a little window
0:33:45 > 0:33:48into the knee joint very carefully.
0:33:48 > 0:33:50So we're now going to pack the cavity
0:33:50 > 0:33:51with our beautiful bone graft.
0:33:53 > 0:33:55We want this nicely compressed in there.
0:33:55 > 0:33:57I'm pushing quite firmly there.
0:33:58 > 0:34:01The outcome following packing with this type of bone graft is
0:34:01 > 0:34:04generally excellent and therefore this should do the trick
0:34:04 > 0:34:06very, very nicely.
0:34:06 > 0:34:10Reuben's operation is complete and his knee is stitched closed.
0:34:13 > 0:34:15I was very pleased with the way things went.
0:34:15 > 0:34:18I think there's a good chance that this is going to cure his
0:34:18 > 0:34:21chondroblastoma, it was one of those that we were able to get at
0:34:21 > 0:34:23reasonably well, better than I feared.
0:34:23 > 0:34:26Why don't you rest back with your head on the pillow?
0:34:26 > 0:34:27Oh, I'll be all right, mate.
0:34:27 > 0:34:30Reuben should be able to walk again after eight weeks.
0:34:30 > 0:34:32You're a bit like one of those Yogi bear dolls,
0:34:32 > 0:34:34you might fall over if I let go of you.
0:34:39 > 0:34:42It's February and Becky and Adam on their way to
0:34:42 > 0:34:45a mortuary in Salford, 30 miles from the tissue bank.
0:34:46 > 0:34:48Right, so am I getting on the M60 here or not?
0:34:48 > 0:34:50Am I staying on the M602?
0:34:50 > 0:34:53M602, Salford.
0:34:54 > 0:34:56All right, smart-arse.
0:34:58 > 0:35:02Well, we live in the north, let's head north.
0:35:02 > 0:35:04Let's dance!
0:35:06 > 0:35:09- Oh, you've dropped your phone. - Yeah, I know. I didn't drop it.
0:35:09 > 0:35:11It's your erratic driving.
0:35:13 > 0:35:15You know, little bit more... little bit less gas,
0:35:15 > 0:35:16a little bit more composure.
0:35:18 > 0:35:22The donor is a man in his early 50s who passed away suddenly last night.
0:35:22 > 0:35:27We've got consent for skin and for bone
0:35:27 > 0:35:32and for Achilles tendons as well so it's quite a lot.
0:35:41 > 0:35:44Ideally we try and take 20cm strips minimum
0:35:44 > 0:35:47and it needs to be a certain width as well.
0:35:47 > 0:35:50I think minimum width is something like six or 5.5 centimetres,
0:35:50 > 0:35:55so when we're taking it now we're trying to get it anything from
0:35:55 > 0:35:5720 to 60 centimetres in one strip
0:35:57 > 0:36:00and above 5.5 centimetres in width.
0:36:00 > 0:36:03Lovely. It's really good skin.
0:36:07 > 0:36:09Nobody talks about death,
0:36:09 > 0:36:13which I think is part of the problem why we don't have enough donors,
0:36:13 > 0:36:17is because people still think of death and dying
0:36:17 > 0:36:21and donation as well, to a certain extent, as like a taboo subject.
0:36:22 > 0:36:25But everybody has to die so it seems a bit daft that
0:36:25 > 0:36:29no-one actually talks about it as if it's never going to happen.
0:36:29 > 0:36:32Even though Adam has carried out hundreds of donations,
0:36:32 > 0:36:34some still affect him.
0:36:36 > 0:36:41There's a certain age range, where it's harder
0:36:41 > 0:36:44and then also if there's a donor that's the same age as
0:36:44 > 0:36:48your parents that always can be a little bit like...
0:36:48 > 0:36:50they're not going to be here forever, you know what I mean?
0:36:50 > 0:36:54It makes you think more about the fact that
0:36:54 > 0:36:56life's quite short
0:36:56 > 0:36:58and that you need to... if you want to do something
0:36:58 > 0:37:01just go out and do it and not to worry about it too much.
0:37:01 > 0:37:03The job may affect the teams emotionally,
0:37:03 > 0:37:05but it's thanks to their work
0:37:05 > 0:37:09that life-changing tissue is available for patients nationwide.
0:37:12 > 0:37:16Over in Doncaster, 27-year-old rugby coach Daniel
0:37:16 > 0:37:20is waiting for the right meniscus to be found.
0:37:20 > 0:37:22I'm going to be really naughty and park in my space...
0:37:24 > 0:37:25..the disabled space!
0:37:27 > 0:37:30I suppose I could class myself as that. Well, nearly.
0:37:34 > 0:37:37Daniel's knee was seriously injured playing rugby.
0:37:39 > 0:37:42The dream was to play professional rugby all my life.
0:37:42 > 0:37:44I twisted my knee,
0:37:44 > 0:37:49my left knee, in a tackle where I just collapsed on the floor
0:37:49 > 0:37:53and the guy looked at it and he says something's wrong and I was gutted.
0:37:53 > 0:37:55Daniel had torn the meniscus,
0:37:55 > 0:37:58the shock absorber that protects the knee.
0:37:58 > 0:38:03My knee locked out and I couldn't move it so I went home
0:38:03 > 0:38:07and iced it and slowly started moving it ever so gently
0:38:07 > 0:38:10and took the painkillers as I always do,
0:38:10 > 0:38:13and it was OK for another day after
0:38:13 > 0:38:16but then it started again so I rang the surgeon up
0:38:16 > 0:38:18and he had a look at it and he said something's not right.
0:38:18 > 0:38:21Daniel needs a meniscus that's an exact fit
0:38:21 > 0:38:24from a donor of a similar age and size.
0:38:24 > 0:38:29The alternative is a metal prosthesis, meaning an end to playing rugby.
0:38:29 > 0:38:33As soon as I first trained and played, I just got the bug
0:38:33 > 0:38:36straightaway and I was actually good at it...
0:38:37 > 0:38:39Cos I was quite fast in them days,
0:38:39 > 0:38:42I'm not any more, but as a kid I was lightning fast.
0:38:42 > 0:38:47The height of it, led me to play for England under-18s
0:38:47 > 0:38:50which was probably the highlight of my career.
0:38:50 > 0:38:53Playing for your country is massive.
0:38:53 > 0:38:55So this is the game we always play,
0:38:55 > 0:38:57well, I always play by myself at training,
0:38:57 > 0:39:00cross-bar challenge, and they all hate me for it cos
0:39:00 > 0:39:03nine times out of ten I hit it, so we'll see.
0:39:07 > 0:39:10A meniscus transplant is a major operation.
0:39:10 > 0:39:12Until he gets back on his feet,
0:39:12 > 0:39:15Daniel is moving back home to his mum's.
0:39:16 > 0:39:19This is the dog. This is Archie.
0:39:19 > 0:39:21What's the matter?
0:39:21 > 0:39:24I will be bed-bound, I won't be moving much.
0:39:24 > 0:39:26I will need someone to get my things,
0:39:26 > 0:39:29get me something to eat, get me something to drink.
0:39:29 > 0:39:31It will be nice, I suppose, for the first week or so
0:39:31 > 0:39:35but then I will be wanting to get up and do it myself
0:39:35 > 0:39:38but I know I won't be able to so,
0:39:38 > 0:39:40yeah, she's got a lot of work to do, my mum.
0:39:40 > 0:39:43My poor mum!
0:39:44 > 0:39:48While Daniel prepares for his operation, back at the tissue bank
0:39:48 > 0:39:50donation specialist Mel is with the nurses,
0:39:50 > 0:39:53learning more about their side of donation.
0:39:54 > 0:40:00I've been in and listened to the actual consent taking place.
0:40:00 > 0:40:03Most of us would say we can do our job but we could never do their job,
0:40:03 > 0:40:08we couldn't speak to bereaved families and take consent.
0:40:08 > 0:40:11I couldn't imagine doing that kind of job,
0:40:11 > 0:40:14whereas my job a lot of people would say,
0:40:14 > 0:40:16"Oh, I don't know how you do that,"
0:40:16 > 0:40:19but I suppose it's just each to their own,
0:40:19 > 0:40:21but, yeah, I couldn't do this job.
0:40:21 > 0:40:24For the nurses, ensuring the donations go ahead
0:40:24 > 0:40:27requires emotional stamina that only comes with experience.
0:40:27 > 0:40:30The staff at the hospital asked me to give you a ring and speak to you
0:40:30 > 0:40:35about the possibility of your husband donating his corneas for transplant?
0:40:35 > 0:40:37'I don't think you'd get them, darling,
0:40:37 > 0:40:39'cos his eyes were buggered.'
0:40:39 > 0:40:42- Ah, were they! - 'His eyes were buggered, bless him.'
0:40:42 > 0:40:45I know that Henry was only 13,
0:40:45 > 0:40:49but I obviously do have to ask these questions.
0:40:49 > 0:40:52When you're speaking to bereaved people constantly,
0:40:52 > 0:40:55there are days when it will really get to you.
0:40:55 > 0:40:59Eve, we did talk about Henry possibly donating his heart
0:40:59 > 0:41:04- for the two heart valves.- 'Yep.'
0:41:04 > 0:41:06We have a right to show our emotions
0:41:06 > 0:41:08and to feel quite, you know, quite upset,
0:41:08 > 0:41:12but it's upset in a different way because, as I said, it's not our grief.
0:41:12 > 0:41:15Speaking to families so soon after a death
0:41:15 > 0:41:18is hard for everyone concerned.
0:41:20 > 0:41:22Are you OK? MUFFLED SPEECH
0:41:22 > 0:41:23Do you want to take a minute?
0:41:31 > 0:41:34WOMAN SOBS
0:41:34 > 0:41:36SHE SIGHS
0:41:36 > 0:41:39- 'I'm OK.'- Are you OK? - 'OK, yes, thank you.'
0:41:39 > 0:41:42'It's really difficult. I do appreciate
0:41:42 > 0:41:45'you going through it with me.'
0:41:45 > 0:41:47What happens now, as I said earlier,
0:41:47 > 0:41:50from a practical point of view, you know, I go away
0:41:50 > 0:41:53and organise the donation to happen within this 24 to 48 hours.
0:41:53 > 0:41:56- 'Right, OK.'- Are you OK?
0:41:56 > 0:41:59- Well, thank you very much indeed for that.- 'OK.'
0:41:59 > 0:42:01You just take care now. I will speak to you later.
0:42:01 > 0:42:04- 'All right, thanks, Linda.' - Take care, bye-bye.
0:42:11 > 0:42:13That was hard for me. Um...
0:42:26 > 0:42:30My husband's 63 and as fit as a fiddle, like this guy was.
0:42:30 > 0:42:32It just...it's a bit...
0:42:32 > 0:42:35It's too close to home sometimes.
0:42:35 > 0:42:37But I'm OK.
0:42:40 > 0:42:46I think it is difficult when it's something that you relate to.
0:42:47 > 0:42:50We all relate to the children and different things...
0:42:52 > 0:42:56..and we do particularly relate to donations of...
0:42:56 > 0:42:58like this.
0:42:59 > 0:43:00Sorry about that.
0:43:01 > 0:43:03All of the nurses find it tough,
0:43:03 > 0:43:07but for one of them it's the end of the road.
0:43:07 > 0:43:09It's rare for the nurses to leave the job,
0:43:09 > 0:43:13but, after two years at the tissue bank, Laura has decided to move on.
0:43:15 > 0:43:19I'm hearing someone's died maybe 25 times a day
0:43:19 > 0:43:23and I can't do it forever cos I'll forget everything else
0:43:23 > 0:43:27about nursing isn't just about death, is it?
0:43:27 > 0:43:30I need to do something else whilst I still can.
0:43:30 > 0:43:32So I've got a job as a district nurse,
0:43:32 > 0:43:35so I'll be starting that in six weeks.
0:43:35 > 0:43:37So I'm looking forward to doing that.
0:43:37 > 0:43:40Be a new chapter. New experience.
0:43:43 > 0:43:45But without the nurses and the donations,
0:43:45 > 0:43:48people like George would never get the operations they need.
0:43:48 > 0:43:51Today, after months of waiting,
0:43:51 > 0:43:53he'll finally receive a donated cornea.
0:43:53 > 0:43:55Being donor tissue,
0:43:55 > 0:43:58and that sort of thing, you think about the fact that it is sort of
0:43:58 > 0:44:02coming from somebody who's passed away, and that sort of stuff.
0:44:02 > 0:44:05I sort of, not block it out, but I don't know really, it's a bit weird
0:44:05 > 0:44:09sort of thinking where the tissue has come from
0:44:09 > 0:44:12and that someone else has been using it and now it's going to be
0:44:12 > 0:44:16sort of stitched into my eye instead, so, yeah, it is weird.
0:44:16 > 0:44:20This will be George's second corneal transplant.
0:44:20 > 0:44:25I'm going to have two people's sort of donor tissue now.
0:44:25 > 0:44:28There is, like, a two-year waiting list at the moment
0:44:28 > 0:44:34for corneal transplants, so it is important that people do sign up
0:44:34 > 0:44:38to be donors and that the donor tissue keeps on coming in really.
0:44:40 > 0:44:45The corneas collected by the tissue team are stored at Manchester's eye bank.
0:44:49 > 0:44:50Next door is the eye hospital,
0:44:50 > 0:44:54where George's new cornea is being prepared for transplant.
0:44:57 > 0:45:00I hope that I wake up and I can hopefully see...
0:45:00 > 0:45:04see a little bit more... maybe out of my right eye.
0:45:04 > 0:45:07The graft was quite slow to get some vision back last time.
0:45:07 > 0:45:12George is having a partial graft, so a donor cornea, split into two,
0:45:12 > 0:45:14will be used to replace his damaged cornea.
0:45:14 > 0:45:18There is always the risk of complications, you know,
0:45:18 > 0:45:21you can lose your sight
0:45:21 > 0:45:25or you can have a sudden haemorrhage within the eye.
0:45:25 > 0:45:28That can lead to the contents of the eye coming out.
0:45:28 > 0:45:31It is very rare but they can occur.
0:45:37 > 0:45:40What we're going to do now is split the layer.
0:45:40 > 0:45:42It's called the "big-bubble technique",
0:45:42 > 0:45:45which splits the deeper layer from the front layer.
0:45:47 > 0:45:50The surgeon uses a super-fine blade to slice through the cornea,
0:45:50 > 0:45:53removing the front layer.
0:45:53 > 0:45:56He then stitches the donated cornea in place.
0:45:56 > 0:45:58When he wakes up, he'll be able to see out of that
0:45:58 > 0:46:00but everything will be very blurred.
0:46:00 > 0:46:03Deep breaths, George, it's all finished for you.
0:46:03 > 0:46:05George, operation's finished.
0:46:05 > 0:46:08Open wide and we'll take this out for you.
0:46:08 > 0:46:12George should know in a matter of days whether his sight is restored.
0:46:16 > 0:46:19It's a busy Monday morning at the tissue bank,
0:46:19 > 0:46:22with four donations under way.
0:46:22 > 0:46:24Becky and Chris are on duty in house.
0:46:24 > 0:46:29We've got a donor coming in to retrieve
0:46:29 > 0:46:32pretty much as many of the tissues as we can retrieve really.
0:46:32 > 0:46:36We've got heart, pericardium, skin,
0:46:36 > 0:46:40bone, tendons,
0:46:40 > 0:46:42and we're even retrieving arms.
0:46:42 > 0:46:45It might be worth saying that we're retrieving the bones from the arms,
0:46:45 > 0:46:46- not the ARMS!- Yes, true.
0:46:48 > 0:46:53Among the tissues Becky and Chris will be taking is the much sought-after meniscus.
0:46:53 > 0:46:57The meniscus are... they're like the shock absorbers in the knee joints
0:46:57 > 0:47:00so you've got the two bones in the knee joint like that
0:47:00 > 0:47:03and as they move, as they articulate,
0:47:03 > 0:47:05obviously because there's a lot of weight on the knee joint,
0:47:05 > 0:47:10they are little cartilage kind of D shapes under in the knee joint
0:47:10 > 0:47:14so it helps absorb all of the shock and the force in the knee.
0:47:16 > 0:47:19A lot of the tissues we provide aren't termed as life-saving,
0:47:19 > 0:47:24they're life-enhancing. So you know rugby players that they can't play
0:47:24 > 0:47:27their sport any more because of their injury,
0:47:27 > 0:47:30you know, their life, you could say, is over
0:47:30 > 0:47:32because what their passion is, what they love to do,
0:47:32 > 0:47:35they can't do any more, so if we provide a meniscus to somebody so
0:47:35 > 0:47:37they can get back on their feet,
0:47:37 > 0:47:39get back on the pitch and start playing again,
0:47:39 > 0:47:42then potentially you could say, well, you are saving their life,
0:47:42 > 0:47:45cos what life would they have if they had to give all of that up?
0:47:45 > 0:47:50The meniscus can only be taken from donors aged 18 to 45.
0:47:50 > 0:47:53In the last year the team took 12 of them,
0:47:53 > 0:47:56but with hundreds of people on the waiting list it's not enough.
0:47:56 > 0:47:58We've taken this out as a whole knee,
0:47:58 > 0:48:01as opposed to the separate bone grafts
0:48:01 > 0:48:04and then, within the knee joint as well, we've also got the meniscus
0:48:04 > 0:48:08so we're going to package this all up together in some fluid which will
0:48:08 > 0:48:12protect everything, keep everything moist, and then that will go to
0:48:12 > 0:48:16the production team and they will then dissect the various parts off.
0:48:20 > 0:48:26There will definitely be a point when I say I can't do this any more.
0:48:26 > 0:48:31I definitely don't think that will be because of the donation aspect
0:48:31 > 0:48:37of it and the physical donor part and the dead body side of things,
0:48:37 > 0:48:40and thinking that's too hard, that's too emotional,
0:48:40 > 0:48:45because I've been doing it so long it doesn't...it doesn't bother me.
0:48:47 > 0:48:51While Becky's staying in the job, for Laura it's time to move on.
0:48:52 > 0:48:56Today is my last day in Tissue Services.
0:48:56 > 0:49:02So I'm on the early and it's a Sunday morning, 7am.
0:49:03 > 0:49:07A part of me just wants to go up to bed. I've got my P45.
0:49:07 > 0:49:11They didn't waste time giving me that! Came straightaway yesterday.
0:49:11 > 0:49:14I was like, "Oh, Cheers, I won't come in tomorrow!"
0:49:14 > 0:49:16OK, bye, cat.
0:49:28 > 0:49:31The sad thing is there's not going to be a big...
0:49:33 > 0:49:34..celebration.
0:49:35 > 0:49:38That'll be when I've actually gone.
0:49:40 > 0:49:45- Hi, Jill.- Hello.- Last day. - I know! Can't believe it.
0:49:47 > 0:49:50- Any from overnight? - Yes, just getting them up.- Cool.
0:49:50 > 0:49:52Tomorrow I start my new job...
0:49:52 > 0:49:54in the district.
0:49:56 > 0:50:00I'm having a panic attack about it now.
0:50:02 > 0:50:04I watched too many Call The Midwifes.
0:50:04 > 0:50:07I thought I'd end up in this glamorous role
0:50:07 > 0:50:09but I don't think it is going to be like that.
0:50:09 > 0:50:10SHE GIGGLES
0:50:12 > 0:50:17Down the corridor the customer service team are busy fulfilling orders for patients.
0:50:18 > 0:50:21Good morning, Tissue Services. Daniel speaking, how can I help?
0:50:21 > 0:50:26It looks like the perfect meniscus has finally be found for rugby coach Daniel.
0:50:26 > 0:50:29OK, just bear with me for a moment and I will get the order form up.
0:50:29 > 0:50:32Well, with the meniscus we generally get the request
0:50:32 > 0:50:35through from the surgeon with all the information
0:50:35 > 0:50:38they can provide, measurements of the patient's knee.
0:50:38 > 0:50:42It's then down to ourselves to allocate a match
0:50:42 > 0:50:44based on the surgeon's measurements.
0:50:44 > 0:50:49OK, so the request for a left meniscus lateral for your surgeon...
0:50:49 > 0:50:51Mr Spalding being one surgeon, in particular,
0:50:51 > 0:50:55he is very fussy on the size of the grafts that he receives
0:50:55 > 0:50:59for the knee. It does have to be pretty much exact.
0:50:59 > 0:51:00Right, so delivery this Friday.
0:51:00 > 0:51:04The one I've just had is one he's been enquiring about for a while.
0:51:04 > 0:51:06We eventually found a match for him
0:51:06 > 0:51:09and we've been holding it on reserve till he can allocate a surgery date.
0:51:09 > 0:51:12It has been a long wait for the patient
0:51:12 > 0:51:15but it has been worth it to find the match at the end of it all.
0:51:15 > 0:51:18OK, that's great. You have a nice day now.
0:51:18 > 0:51:20OK, thank you. Bye-bye.
0:51:20 > 0:51:22Without the donors, I'd be out of a job, I suppose.
0:51:24 > 0:51:26With the meniscus on its way,
0:51:26 > 0:51:30Daniel in Doncaster is about to set off for the hospital.
0:51:34 > 0:51:37We are going to St Cross Hospital in Rugby.
0:51:37 > 0:51:40That's where the operation's taking place, so just on the motorway now.
0:51:42 > 0:51:45Looking forward to getting it done and coming home
0:51:45 > 0:51:48and starting the boring recovery process.
0:51:48 > 0:51:51I'm not bothered at all where it's come from.
0:51:51 > 0:51:55I know it's healthy cos they do all various testing and stuff for it,
0:51:55 > 0:51:58so I think it's a great thing to do, I think it's something worth doing,
0:51:58 > 0:52:01putting your name down for donors, donor cards and stuff like that.
0:52:01 > 0:52:03So, no, just really grateful for it
0:52:03 > 0:52:06and I know it's going to give me a better quality of life after it.
0:52:07 > 0:52:09Hopefully, fingers crossed!
0:52:14 > 0:52:18So, today we're doing lateral meniscal transplant.
0:52:18 > 0:52:20So that is a donor meniscus,
0:52:20 > 0:52:23a dead person's meniscus,
0:52:23 > 0:52:25harvested and then kept in a tissue bank.
0:52:25 > 0:52:28We size the meniscus from measuring it
0:52:28 > 0:52:31and then the patient has a particular size of their knee.
0:52:31 > 0:52:35We match that up, and then this is to insert that meniscus in the knee.
0:52:35 > 0:52:38This is where it was and then it's been taken out in the middle part
0:52:38 > 0:52:45after a tear. This is the passport device that pops in here.
0:52:46 > 0:52:48Then we can pass through there.
0:52:48 > 0:52:51The instrument in the meniscus is going to go in here.
0:52:51 > 0:52:55We've got our posterior horn, the back-end,
0:52:55 > 0:52:57and then the middle part to pull through.
0:52:57 > 0:52:59So we're going to pull on the posterior...
0:53:01 > 0:53:03Pulling a bit on the middle now to give it some traction...
0:53:05 > 0:53:07..letting it just slide into the joint,
0:53:07 > 0:53:11pull a bit more in the middle, keeping it orientated that way.
0:53:11 > 0:53:14So, there's the meniscus, we've got to set it in there.
0:53:14 > 0:53:16We got the word "top" in the right place?
0:53:16 > 0:53:18Yes.
0:53:18 > 0:53:20So we're happy.
0:53:20 > 0:53:22We're happy with that. That went well.
0:53:23 > 0:53:26Good hold, good fix, good size meniscus.
0:53:26 > 0:53:29And the joint surface is not too bad so he should have a good result.
0:53:29 > 0:53:32For Daniel there'll be no chance of rugby for a long time to come
0:53:32 > 0:53:35but at least he'll be able to walk again.
0:53:37 > 0:53:41Back at the tissue bank, it's the end of Laura's last shift.
0:53:41 > 0:53:44- Right, well, good luck in your new job.- Thank you.
0:53:44 > 0:53:46All right, you take care.
0:53:46 > 0:53:50The job may have had its highs and lows but Laura is sad to go.
0:53:51 > 0:53:54I'm going to really miss the people that I worked with.
0:53:55 > 0:53:57Really miss them.
0:53:57 > 0:54:00It's a new start for Laura, but for the rest of the tissue team,
0:54:00 > 0:54:03dealing with death to help the living goes on.
0:54:03 > 0:54:06I don't think we see ourselves as superheroes.
0:54:06 > 0:54:10We are still really grounded in what we do and humbled by the donors,
0:54:10 > 0:54:14the families, and what this tissue is doing.
0:54:14 > 0:54:18So, even if just one person's life has been able to be changed
0:54:18 > 0:54:21dramatically or saved, I think that makes it worthwhile.
0:54:21 > 0:54:26We rely so much on the kindness
0:54:26 > 0:54:29and the selflessness of people
0:54:29 > 0:54:34to understand that once they're gone, they don't need their eyes,
0:54:34 > 0:54:37their meniscus, their skin, their heart valves,
0:54:37 > 0:54:40and that, if somebody is alive,
0:54:40 > 0:54:43if they can use it, then why not give it to them?
0:54:48 > 0:54:51Three months after his meniscus operation,
0:54:51 > 0:54:53Daniel is back home with his girlfriend.
0:54:53 > 0:54:58It's a bit sore and a bit stiff but generally it's not been too bad.
0:54:59 > 0:55:01Well, it's 15 weeks since I had the operation
0:55:01 > 0:55:04and he said it was successful. I've took everything slowly.
0:55:04 > 0:55:08I'm quite optimistic. Hopefully it will work.
0:55:08 > 0:55:10If I do go back to sport that will be 18 months.
0:55:10 > 0:55:13I'd love to play again. I'm only 27, I don't want to retire just yet,
0:55:13 > 0:55:15but if it all goes well, and it's back to normal,
0:55:15 > 0:55:18I don't want to risk it and risk damaging it again.
0:55:18 > 0:55:22But my heart will probably rule the head and I will play.
0:55:22 > 0:55:23I think I will play.
0:55:26 > 0:55:30In Chester, George is back down the pub with his rowing mates.
0:55:30 > 0:55:32How's your eye?
0:55:34 > 0:55:35So subtle!
0:55:35 > 0:55:37Yeah, it's all right, really.
0:55:37 > 0:55:43I had my left eye corneal graft operation three months ago now.
0:55:43 > 0:55:45Everything seems to be going quite well.
0:55:45 > 0:55:48They seem to be happy with it. I can see out of it.
0:55:48 > 0:55:52I don't think it ever will sort of get amazing vision out of it
0:55:52 > 0:55:56uncorrected, it just means that they can correct it
0:55:56 > 0:55:59with contact lenses or glasses,
0:55:59 > 0:56:02so it will be nice to have vision out of two eyes again.
0:56:02 > 0:56:06And in Saxmundham, Reuben is back at work.
0:56:06 > 0:56:08It's been three months since I had the operation
0:56:08 > 0:56:10and it's just 100% better.
0:56:10 > 0:56:12It's like having a new knee.
0:56:12 > 0:56:14It's healing up quite nicely.
0:56:14 > 0:56:17He did apologise about the scar but as my muscle's grown
0:56:17 > 0:56:21it's stretched and it's opened up the scar a little bit here,
0:56:21 > 0:56:23but I'm not too bothered about that.
0:56:23 > 0:56:25It's something cool to tell my mates, so, you know,
0:56:25 > 0:56:27it will be there for the rest of my life.
0:56:27 > 0:56:29It will be all right, you know.