Pennod 5

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0:00:01 > 0:00:06- It's a new term and the cameras are - back at the School of Medicine...

0:00:06 > 0:00:08- ..following young students...

0:00:09 > 0:00:11- I don't know where I'm going.

0:00:11 > 0:00:12- ..on a unique course.

0:00:13 > 0:00:15- I'm looking for scrubs.

0:00:15 > 0:00:18- Stepping into the medical world - for the first time.

0:00:19 > 0:00:22- I'm opening the airway - and tilting the head back.

0:00:23 > 0:00:25- Facing the emergencies - of our health service.

0:00:26 > 0:00:30- Every bed is taken, - especially after the bank holiday.

0:00:30 > 0:00:34- People sitting in corridors, - it's the reality of a busy hospital.

0:00:34 > 0:00:37- Is that alcohol-free?

0:00:39 > 0:00:43- The women's ward is full. - One casualty patient is waiting.

0:00:43 > 0:00:46- It's become so busy - during the past 20 minutes.

0:00:46 > 0:00:49- Treating life-threatening illnesses.

0:00:49 > 0:00:51- Is this patient high risk?

0:00:52 > 0:00:56- They assessed the patient and - there's a high risk of fatality.

0:00:57 > 0:00:59- Fragile lives.

0:00:59 > 0:01:02- How long have I got?

0:01:02 > 0:01:06- He's been worried about today - since the scan three weeks ago.

0:01:06 > 0:01:09- What's going to happen - with my family?

0:01:09 > 0:01:12- These are tomorrow's doctors.

0:01:12 > 0:01:14- I want to help people.

0:01:14 > 0:01:15- I want to help people.- - Thank you, Mos.

0:01:26 > 0:01:28- It's mid-term.

0:01:28 > 0:01:33- First-year students are getting - used to the challenging lectures.

0:01:33 > 0:01:38- ATGL is adipose triglyceride lipase.

0:01:38 > 0:01:41- The first term is the worst.

0:01:41 > 0:01:43- It's a huge shock to the system.

0:01:43 > 0:01:47- You've done A Levels - and were happy studying A levels.

0:01:48 > 0:01:51- When you reach university, - it's a kick up the backside.

0:01:51 > 0:01:55- They're testing you - to make sure you're good enough.

0:01:56 > 0:02:00- Understanding every lecture - is a struggle in itself.

0:02:00 > 0:02:03- That acid is able to cross - the blood brain barrier.

0:02:04 > 0:02:08- Excelling in class - isn't enough on this course.

0:02:12 > 0:02:15- Remarkable interpersonal skills - are also needed.

0:02:16 > 0:02:20- I just want to know a bit about - your background, why you're here.

0:02:21 > 0:02:23- What caused you to be admitted?

0:02:23 > 0:02:25- Well, 27 years ago...

0:02:26 > 0:02:28- ..I had a major heart attack.

0:02:28 > 0:02:32- Third-year student Ffion - is on a placement in Bridgend.

0:02:34 > 0:02:38- It's a very different community - to her home area.

0:02:38 > 0:02:41- I come from Porthmadog. - It's a small town.

0:02:41 > 0:02:45- It's a community where the Welsh - language is strong...

0:02:45 > 0:02:48- ..where everyone knows everyone.

0:02:48 > 0:02:54- I think my friends would describe me - as a quiet, shy person.

0:02:56 > 0:02:59- Once you get to know me, - I'm far more extrovert.

0:02:59 > 0:03:04- Shy or not, she manages - to talk freely to patients.

0:03:05 > 0:03:08- When I was having the pain, - it was all here.

0:03:08 > 0:03:11- No diabetes, no asthma, - nothing like that.

0:03:12 > 0:03:13- No other heart troubles.

0:03:13 > 0:03:15- No other heart troubles.- - Just a craving for a pint.

0:03:19 > 0:03:22- One of the reasons - I chose this course...

0:03:22 > 0:03:26- ..was because you're not - in a lecture hall 9-5 every day.

0:03:26 > 0:03:29- It's hands-on in the first year.

0:03:29 > 0:03:33- We meet patients and we're taught - communication skills.

0:03:35 > 0:03:36- Is that OK for your knees?

0:03:37 > 0:03:41- Mr Mullins has been having - angina pains in his chest.

0:03:45 > 0:03:50- They're trying to determine the - probability of another heart attack.

0:03:50 > 0:03:53- If there are problems - with the valves in his heart...

0:03:53 > 0:03:55- ..if there's a blockage...

0:03:56 > 0:04:00- ..it will become evident - when the patient is exercising.

0:04:00 > 0:04:02- The heart has to work harder.

0:04:09 > 0:04:11- How does this work?

0:04:11 > 0:04:14- He's had a previous heart attack...

0:04:14 > 0:04:19- It's interesting seeing how doctors - treat patients from the other side.

0:04:19 > 0:04:22- I've never been a patient...

0:04:22 > 0:04:26- ..but members of my family - have been patients.

0:04:26 > 0:04:28- Grandmothers and grandfathers.

0:04:29 > 0:04:32- It's influenced my decision - to become a doctor.

0:04:32 > 0:04:35- This test provides - so much information.

0:04:39 > 0:04:42- It's a challenging test - for the patient.

0:04:43 > 0:04:45- It could bring on another attack.

0:04:55 > 0:04:58- Fortunately, - this time the results are clear.

0:04:59 > 0:05:04- There are no signs that Mr Mullins - is at risk of a heart attack.

0:05:04 > 0:05:06- He can be discharged.

0:05:07 > 0:05:12- They'll carry out further tests to - try and determine what's going on.

0:05:19 > 0:05:21- Over in Newport...

0:05:21 > 0:05:26- ..third-year student Dafydd - is also dealing with a patient...

0:05:26 > 0:05:28- ..who has symptoms - similar to angina.

0:05:29 > 0:05:30- How are you feeling?

0:05:30 > 0:05:32- How are you feeling?- - Fine, fine, excellent.

0:05:32 > 0:05:35- I met the patient this morning, - his name's Wayne.

0:05:36 > 0:05:38- He's had chest pains for four days.

0:05:38 > 0:05:41- He's put it down to his asthma.

0:05:42 > 0:05:44- He didn't really want to visit - the GP.

0:05:45 > 0:05:49- How did that feel? Not like - anything you've experienced?

0:05:49 > 0:05:53- No, no. It was just a non-event.

0:05:53 > 0:05:58- Sometimes, patients don't realize - they're having a heart attack.

0:05:58 > 0:06:00- I've had worse headaches.

0:06:00 > 0:06:04- To determine what exactly - is happening to Wayne...

0:06:04 > 0:06:07- ..he's having a scan - in the Cardiology Department.

0:06:08 > 0:06:13- Dafydd wears specialist clothing - to protect him from radiation.

0:06:14 > 0:06:16- It's heavy!

0:06:16 > 0:06:18- Loads more.

0:06:19 > 0:06:23- This is my training. - Weight training.

0:06:26 > 0:06:32- Unfortunately, the scan shows - that Wayne suffered a heart attack.

0:06:32 > 0:06:35- He came in - and they've done an angiogram.

0:06:35 > 0:06:38- Some of the arteries - in his heart are narrow.

0:06:39 > 0:06:42- Even though the symptoms - caused him little pain...

0:06:43 > 0:06:44- ..the damage is serious.

0:06:45 > 0:06:47- He's got too many narrowings.

0:06:48 > 0:06:51- Would they do - the by-pass operation otherwise?

0:06:58 > 0:07:02- They're hoping to do - a more major operation...

0:07:03 > 0:07:04- ..a by-pass operation.

0:07:05 > 0:07:06- It's major surgery.

0:07:08 > 0:07:12- Wayne is transferred to the - University Hospital in Cardiff...

0:07:12 > 0:07:14- ..for specialist care.

0:07:23 > 0:07:27- In North Wales, third-year student - Jess is on location...

0:07:27 > 0:07:29- ..in the emergency ward.

0:07:30 > 0:07:36- Today, trying to diagnose - Mr Langowski is proving difficult.

0:07:36 > 0:07:38- He's 91 years old.

0:07:38 > 0:07:44- Elderly people tend to become - breathless rapidly when they walk.

0:07:44 > 0:07:48- He's out of breath when he's - sitting, or at rest as we call it.

0:07:49 > 0:07:52- You were still short of breath - despite the oxygen.

0:07:52 > 0:07:57- The problem is we can't determine - what exactly is wrong with him...

0:07:58 > 0:08:01- ..by observing and examining him.

0:08:01 > 0:08:03- Am I right in saying - you used to smoke?

0:08:04 > 0:08:05- No, I never did.

0:08:05 > 0:08:08- No, I never did.- - No. Did you work in the mines?

0:08:08 > 0:08:09- No.

0:08:09 > 0:08:12- So how come you've got bad lungs?

0:08:12 > 0:08:15- In his notes, it says he has COPD...

0:08:15 > 0:08:18- ..Chronic Obstructive - Pulmonary Disease.

0:08:18 > 0:08:23- It's a lung disease - usually caused by smoking.

0:08:24 > 0:08:27- Everyone I've seen with the disease - is a past smoker.

0:08:28 > 0:08:30- Look over to the side.

0:08:30 > 0:08:34- It's strange - that he has this diagnosis of COPD.

0:08:34 > 0:08:39- I'll have a listen to your heart - and lungs now if that's OK.

0:08:39 > 0:08:44- On the ward today, doctors' work - is similar to detectives' work.

0:08:44 > 0:08:49- You're safe going to lectures, - there are no patients there.

0:08:49 > 0:08:52- Lecturers teach you - and give you the information.

0:08:53 > 0:08:56- On placement, often - it's a case of trial and error.

0:08:56 > 0:09:01- You go with your gut instinct and - try and learn as much as you can.

0:09:01 > 0:09:03- Thank you, sir, you can rest back.

0:09:03 > 0:09:06- He heard something - at the bottom of his lungs.

0:09:07 > 0:09:10- That could signify an infection.

0:09:11 > 0:09:14- The other option - is a pulmonary embolism.

0:09:14 > 0:09:17- It's a small clot - in one of the arteries.

0:09:17 > 0:09:22- We'll do some blood tests and we - might do some scans of your lungs.

0:09:22 > 0:09:25- He's being given oxygen - 16 hours a day.

0:09:25 > 0:09:27- He is very ill.

0:09:27 > 0:09:32- We have to keep an eye on him - and make sure we do all we can...

0:09:33 > 0:09:35- ..as soon as possible.

0:09:35 > 0:09:40- You're worried about what happened. - I can understand, I'm worried too.

0:09:40 > 0:09:43- We'll try to work out what it is - and help you.

0:09:49 > 0:09:52- In the Caribbean, - 4,000 miles away from Wales...

0:09:52 > 0:09:58- ..fifth-year student Eleri has been - on a month's placement in Antigua...

0:09:58 > 0:10:01- ..where health care is free.

0:10:01 > 0:10:04- We treat patients - who have no other choice.

0:10:04 > 0:10:06- We're their only hope for treatment.

0:10:10 > 0:10:14- Today she's travelling to work - on another small island...

0:10:15 > 0:10:16- ..Barbuda.

0:10:21 > 0:10:24- As she arrives at the hospital - for the first time...

0:10:24 > 0:10:26- ..she looks for a welcome.

0:10:26 > 0:10:29- There's no sign of anyone.

0:10:30 > 0:10:37- Looking from the outside, it looks - as if no-one's been here in years.

0:10:40 > 0:10:42- No patients.

0:10:46 > 0:10:47- No doctors.

0:10:50 > 0:10:53- It's quite a shock. It feels - as if I've gone back in time.

0:10:54 > 0:10:57- A thousand people - live on the island.

0:10:57 > 0:11:00- On a Sunday morning, it's deserted.

0:11:02 > 0:11:06- It's a bit of quandary for Eleri - until the doctor arrives.

0:11:10 > 0:11:12- Hello.

0:11:12 > 0:11:14- It's lovely to meet you. I'm Eleri.

0:11:14 > 0:11:16- It's lovely to meet you. I'm Eleri.- - Nice to meet you too. I'm Jeremy.

0:11:16 > 0:11:20- Welcome to Barbuda. - Welcome to Hannah Thomas Hospital.

0:11:20 > 0:11:23- It's very different - to what I've seen before.

0:11:23 > 0:11:28- Eight-bed facility, - comprising of a maternity ward...

0:11:28 > 0:11:32- ..casualty department, - triage area, pharmacist.

0:11:32 > 0:11:36- We have the dentistry lab and - a laboratory section on that side.

0:11:37 > 0:11:41- It's a big compound but - a small facility. It works for us!

0:11:41 > 0:11:44- Soon, the patients start to arrive.

0:11:47 > 0:11:51- In this room, he holds a clinic - similar to a GP clinic at home.

0:11:51 > 0:11:55- He sees patients in the morning. - They pay a small fee.

0:11:55 > 0:11:58- Did you give him anything - for the fever?

0:11:58 > 0:12:03- He decides if they can to be treated - at home or should be admitted.

0:12:03 > 0:12:07- One of the most important things - you don't want is dehydration.

0:12:08 > 0:12:10- He looks well heavy.

0:12:10 > 0:12:12- Open your mouth, ah.

0:12:13 > 0:12:15- At this time of year...

0:12:15 > 0:12:19- ..cases of gastroenteritis - are common in Barbuda.

0:12:19 > 0:12:21- They have this every year.

0:12:21 > 0:12:25- The temperature changes - from winter to spring.

0:12:25 > 0:12:27- The virus thrives - in this temperature.

0:12:28 > 0:12:30- High five.

0:12:30 > 0:12:34- Between this and viral - respiratory tract infections...

0:12:34 > 0:12:37- ..that's all they see - for three weeks.

0:12:37 > 0:12:41- This morning, Dr Jeremy Deazle - has a more pressing diagnosis.

0:12:49 > 0:12:53- This patient fainted - during a service at a local church.

0:12:55 > 0:13:01- On such a small island, Dr Jeremy - knows most of the patients.

0:13:04 > 0:13:09- He knows that this girl has suffered - with emotional episodes.

0:13:09 > 0:13:12- He thinks it might be - religious hysteria.

0:13:13 > 0:13:16- This patient has a history - of these symptoms.

0:13:17 > 0:13:20- She's suffered with anxiety - in the past.

0:13:23 > 0:13:28- Within minutes, - two more women arrive.

0:13:28 > 0:13:31- Both have come from the same church - and have the same symptoms.

0:13:33 > 0:13:36- There are only eight beds - in the hospital.

0:13:36 > 0:13:39- They're filling up quickly.

0:13:40 > 0:13:43- The hospital has gone - from one patient...

0:13:44 > 0:13:47- ..to the women's ward being full.

0:13:47 > 0:13:50- There's one patient in casualty.

0:13:51 > 0:13:53- It's been so busy - in the past 20 minutes.

0:13:53 > 0:13:56- They all have similar symptoms.

0:13:57 > 0:14:00- By now, Dr Jeremy is quite sure - what happened.

0:14:14 > 0:14:18- The chemical - probably triggered off her asthma.

0:14:18 > 0:14:20- It triggered a spasm - in these people.

0:14:22 > 0:14:24- Dr Jeremy comes from Barbuda.

0:14:24 > 0:14:26- After studying in Florida...

0:14:26 > 0:14:29- ..he returned to care - for the thousand residents.

0:14:31 > 0:14:34- It's a great responsibility - with little resources.

0:14:35 > 0:14:39- Dr Jeremy is 28 years old, - not a lot older than me.

0:14:40 > 0:14:45- He's looking after the health of - a thousand people on a small island.

0:14:46 > 0:14:50- Seeing what he could do with - the help of a couple of nurses...

0:14:50 > 0:14:54- ..and the difference - they make to the community.

0:14:54 > 0:14:56- We're used to more resources - in Wales.

0:14:57 > 0:15:02- It's fantastic and something I'll - use as inspiration for a long time.

0:15:03 > 0:15:05- Feel the pain. General discomfort.

0:15:05 > 0:15:10- It was important to him to give - something back to the community.

0:15:10 > 0:15:15- He's inspired me to return home to - North Wales to work in the future.

0:15:15 > 0:15:20- I'd like to work with a team that - uses the Welsh language positively.

0:15:20 > 0:15:24- If you don't feel better - in a few days, you must return.

0:15:24 > 0:15:25- Come, come.

0:15:25 > 0:15:26- .

0:15:29 > 0:15:29- Subtitles

0:15:29 > 0:15:31- Subtitles- - Subtitles

0:15:34 > 0:15:36- A hot summer's day.

0:15:37 > 0:15:41- Seven ambulances have arrived - with unexpected emergency cases.

0:15:41 > 0:15:44- Ysbyty Gwynedd is already busy.

0:15:44 > 0:15:47- In reality, - this is a busy hospital.

0:15:47 > 0:15:52- Every bed has been taken, - especially after the bank holiday.

0:15:52 > 0:15:55- People are sitting in the corridor.

0:15:55 > 0:15:58- You see people - rushing around all the time.

0:15:58 > 0:15:59- The staff work really hard.

0:15:59 > 0:16:01- The staff work really hard.- - It's exciting.

0:16:01 > 0:16:03- You don't know what'll come in next.

0:16:03 > 0:16:07- It could be another emergency. - It's very interesting.

0:16:09 > 0:16:13- The staff work so hard. - They work under so much pressure.

0:16:13 > 0:16:17- It shows their concern - for the patients.

0:16:17 > 0:16:22- Gwyneth Pritchard is a - 73-year-old lady with chest pain...

0:16:22 > 0:16:24- ..and motor neurone disease.

0:16:25 > 0:16:27- Good morning.

0:16:27 > 0:16:32- Breathing is one of the things that - can be affected by your condition.

0:16:32 > 0:16:38- Jess sees that treating the patient - differs to treating the illness.

0:16:38 > 0:16:41- It's something you can't learn - in a lecture.

0:16:41 > 0:16:43- It doesn't show you in a book...

0:16:43 > 0:16:47- ..this is what you should do - in this situation.

0:16:47 > 0:16:49- Books are simple ABC.

0:16:49 > 0:16:55- In reality, when you see a patient, - it might not suit them as a person.

0:16:55 > 0:17:00- If you're in bed and the bottom of - the lung doesn't get enough air...

0:17:00 > 0:17:02- They go through the treatment.

0:17:02 > 0:17:06- It's important to consider - what they want too...

0:17:06 > 0:17:08- ..in addition to what you should do.

0:17:08 > 0:17:12- The greatest skill of a doctor - is empathy.

0:17:13 > 0:17:17- There was a question whether - you'd put a clot into your lungs.

0:17:17 > 0:17:19- You'll have a scan for that.

0:17:19 > 0:17:22- Then we can say yes or no.

0:17:23 > 0:17:26- Jessica will take a bit more blood - from you later on.

0:17:26 > 0:17:29- She might ask another student - to help if that's OK.

0:17:29 > 0:17:31- That's fine.

0:17:31 > 0:17:34- The pressure on the system - gives Jess and Rhodri...

0:17:35 > 0:17:37- ..more experience than usual.

0:17:37 > 0:17:39- They trust us, I think...

0:17:40 > 0:17:43- ..to do jobs - like clerking patients...

0:17:44 > 0:17:46- ..and taking their bloods.

0:17:46 > 0:17:49- They're small jobs - but they are time-consuming.

0:17:49 > 0:17:55- It's interesting and very exciting - to be in these busy surroundings.

0:17:56 > 0:17:58- There's an intensity to the place.

0:17:58 > 0:18:00- There's an intensity to the place.- - It's tiring, it's painful.

0:18:00 > 0:18:04- It is worth it because we get - so much out of the experience.

0:18:09 > 0:18:13- Is it OK if our student, Jess, - takes the sample?

0:18:14 > 0:18:17- It's really difficult - to get blood from the patient.

0:18:17 > 0:18:20- She has motor neurone disease.

0:18:20 > 0:18:24- She has little strength left - in her hands and arms.

0:18:24 > 0:18:25- You have to pull it.

0:18:25 > 0:18:26- You have to pull it.- - That's fine.

0:18:27 > 0:18:31- You want the patient to extend - their wrist to get the sample.

0:18:31 > 0:18:34- This wasn't possible with her.

0:18:34 > 0:18:36- Sharp scratch.

0:18:36 > 0:18:38- We need this sample.

0:18:39 > 0:18:44- With motor neurone disease, muscles - in the chest don't work properly...

0:18:44 > 0:18:46- ..and they're very weak.

0:18:46 > 0:18:49- Her lungs won't be working properly.

0:18:50 > 0:18:51- This is a good test.

0:18:52 > 0:18:56- The blood comes from the arteries, - which come from the lungs...

0:18:56 > 0:18:58- ..and from the heart.

0:18:58 > 0:19:02- It's an accurate indication - of the CO2 level in her blood.

0:19:02 > 0:19:06- It's really difficult - getting the needle into the artery.

0:19:07 > 0:19:12- It's very painful but it's important - as we try and help the patient.

0:19:13 > 0:19:15- After a few attempts, it worked.

0:19:20 > 0:19:23- While we were talking - to the patient...

0:19:23 > 0:19:26- ..the F1 doctor we were following - was bleeped.

0:19:27 > 0:19:29- There'd been a cardiac arrest.

0:19:29 > 0:19:34- She rushed off to deal with it while - we were talking to this patient.

0:19:34 > 0:19:38- She's back now but they're - still doing CPR on this patient.

0:19:38 > 0:19:43- It shows how busy this ward is and - how quickly you have to respond...

0:19:43 > 0:19:47- ..when a bleep comes in - because she rushed off suddenly.

0:19:48 > 0:19:52- It's so busy in Bangor, - Jess and Rhodri almost forgot...

0:19:52 > 0:19:56- ..about an important event - back at the university.

0:19:56 > 0:20:00- We've just found out that - the results of our last exam is out.

0:20:01 > 0:20:03- This is the last exam of this year.

0:20:03 > 0:20:05- Fingers crossed.

0:20:05 > 0:20:09- The marks count - towards our rankings.

0:20:09 > 0:20:12- They help us get a job - when we graduate.

0:20:12 > 0:20:14- Fingers crossed.

0:20:19 > 0:20:23- I have a rule of not opening results - in front of people!

0:20:30 > 0:20:32- Here we go.

0:20:36 > 0:20:38- Where is it?

0:20:38 > 0:20:40- Go to the top. Go down.

0:20:40 > 0:20:44- The blue bit, Module and Assessment - Results, right there.

0:20:49 > 0:20:51- 2017 and I passed!

0:20:52 > 0:20:55- Me too. I did better than last time. - I'm chuffed.

0:20:56 > 0:20:58- Oh, great.

0:20:58 > 0:21:00- Happy days then.

0:21:01 > 0:21:02- Yay!

0:21:05 > 0:21:07- In such a busy hospital...

0:21:07 > 0:21:10- ..celebrations - will have to wait until tonight.

0:21:10 > 0:21:15- Gwyneth has had her scan - and is on her way back to the ward.

0:21:16 > 0:21:19- We're trying to get her home now.

0:21:19 > 0:21:22- Because of her - motor neurone disease...

0:21:22 > 0:21:24- ..a special ambulance is required.

0:21:25 > 0:21:29- The scans she had - take so long to return.

0:21:29 > 0:21:34- It looks likely that she'll have - to stay here for another night.

0:21:34 > 0:21:38- When you're learning - how to treat patients...

0:21:38 > 0:21:42- ..you learn to do this and that, - then they recover and go home.

0:21:43 > 0:21:46- But in reality, - it doesn't always work like that.

0:21:46 > 0:21:49- She wants to go home and - the doctors want her to go home...

0:21:50 > 0:21:52- ..to release another bed.

0:21:52 > 0:21:56- It's the reality - of being in a busy hospital.

0:22:02 > 0:22:04- Experience with the patients.

0:22:04 > 0:22:08- That's the difference - between a student and a doctor.

0:22:08 > 0:22:13- As soon as students - start dealing with people...

0:22:13 > 0:22:19- ..they soon realize that it's not - only a matter of X-rays and ECGs...

0:22:20 > 0:22:25- ..and not only chemical elements - and cells in a book.

0:22:26 > 0:22:30- The patient is an actual person, - a member of society...

0:22:30 > 0:22:32- ..and we need - to get them back there.

0:22:33 > 0:22:37- The opportunity to treat people - and speak to people...

0:22:37 > 0:22:38- ..is the reason we're here.

0:22:39 > 0:22:43- I really thrive in that situation - and I enjoy it.

0:22:45 > 0:22:50- Since we filmed, Gwyneth lost - her battle against the illness.

0:22:51 > 0:22:55- In September 2017, - Hurricane Irma battered Barbuda.

0:22:55 > 0:22:58- The hospital, and nearly all - other buildings, were destroyed.

0:22:59 > 0:23:03- All the residents - were forced to leave the island.

0:23:22 > 0:23:25- S4C Subtitles by Testun Cyf.

0:23:25 > 0:23:26- .