Pennod 5 Doctoriaid Yfory

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-It's a new term and the cameras are

-back at the School of Medicine...

-..following young students...

-I don't know where I'm going.

-..on a unique course.

-I'm looking for scrubs.

-Stepping into the medical world

-for the first time.

-I'm opening the airway

-and tilting the head back.

-Facing the emergencies

-of our health service.

-Every bed is taken,

-especially after the bank holiday.

-People sitting in corridors,

-it's the reality of a busy hospital.

-Is that alcohol-free?

-The women's ward is full.

-One casualty patient is waiting.

-It's become so busy

-during the past 20 minutes.

-Treating life-threatening illnesses.

-Is this patient high risk?

-They assessed the patient and

-there's a high risk of fatality.

-Fragile lives.

-How long have I got?

-He's been worried about today

-since the scan three weeks ago.

-What's going to happen

-with my family?

-These are tomorrow's doctors.

-I want to help people.

-I want to help people.

-

-Thank you, Mos.

-It's mid-term.

-First-year students are getting

-used to the challenging lectures.

-ATGL is adipose triglyceride lipase.

-The first term is the worst.

-It's a huge shock to the system.

-You've done A Levels

-and were happy studying A levels.

-When you reach university,

-it's a kick up the backside.

-They're testing you

-to make sure you're good enough.

-Understanding every lecture

-is a struggle in itself.

-That acid is able to cross

-the blood brain barrier.

-Excelling in class

-isn't enough on this course.

-Remarkable interpersonal skills

-are also needed.

-I just want to know a bit about

-your background, why you're here.

-What caused you to be admitted?

-Well, 27 years ago...

-..I had a major heart attack.

-Third-year student Ffion

-is on a placement in Bridgend.

-It's a very different community

-to her home area.

-I come from Porthmadog.

-It's a small town.

-It's a community where the Welsh

-language is strong...

-..where everyone knows everyone.

-I think my friends would describe me

-as a quiet, shy person.

-Once you get to know me,

-I'm far more extrovert.

-Shy or not, she manages

-to talk freely to patients.

-When I was having the pain,

-it was all here.

-No diabetes, no asthma,

-nothing like that.

-No other heart troubles.

-No other heart troubles.

-

-Just a craving for a pint.

-One of the reasons

-I chose this course...

-..was because you're not

-in a lecture hall 9-5 every day.

-It's hands-on in the first year.

-We meet patients and we're taught

-communication skills.

-Is that OK for your knees?

-Mr Mullins has been having

-angina pains in his chest.

-They're trying to determine the

-probability of another heart attack.

-If there are problems

-with the valves in his heart...

-..if there's a blockage...

-..it will become evident

-when the patient is exercising.

-The heart has to work harder.

-How does this work?

-He's had a previous heart attack...

-It's interesting seeing how doctors

-treat patients from the other side.

-I've never been a patient...

-..but members of my family

-have been patients.

-Grandmothers and grandfathers.

-It's influenced my decision

-to become a doctor.

-This test provides

-so much information.

-It's a challenging test

-for the patient.

-It could bring on another attack.

-Fortunately,

-this time the results are clear.

-There are no signs that Mr Mullins

-is at risk of a heart attack.

-He can be discharged.

-They'll carry out further tests to

-try and determine what's going on.

-Over in Newport...

-..third-year student Dafydd

-is also dealing with a patient...

-..who has symptoms

-similar to angina.

-How are you feeling?

-How are you feeling?

-

-Fine, fine, excellent.

-I met the patient this morning,

-his name's Wayne.

-He's had chest pains for four days.

-He's put it down to his asthma.

-He didn't really want to visit

-the GP.

-How did that feel? Not like

-anything you've experienced?

-No, no. It was just a non-event.

-Sometimes, patients don't realize

-they're having a heart attack.

-I've had worse headaches.

-To determine what exactly

-is happening to Wayne...

-..he's having a scan

-in the Cardiology Department.

-Dafydd wears specialist clothing

-to protect him from radiation.

-It's heavy!

-Loads more.

-This is my training.

-Weight training.

-Unfortunately, the scan shows

-that Wayne suffered a heart attack.

-He came in

-and they've done an angiogram.

-Some of the arteries

-in his heart are narrow.

-Even though the symptoms

-caused him little pain...

-..the damage is serious.

-He's got too many narrowings.

-Would they do

-the by-pass operation otherwise?

-They're hoping to do

-a more major operation...

-..a by-pass operation.

-It's major surgery.

-Wayne is transferred to the

-University Hospital in Cardiff...

-..for specialist care.

-In North Wales, third-year student

-Jess is on location...

-..in the emergency ward.

-Today, trying to diagnose

-Mr Langowski is proving difficult.

-He's 91 years old.

-Elderly people tend to become

-breathless rapidly when they walk.

-He's out of breath when he's

-sitting, or at rest as we call it.

-You were still short of breath

-despite the oxygen.

-The problem is we can't determine

-what exactly is wrong with him...

-..by observing and examining him.

-Am I right in saying

-you used to smoke?

-No, I never did.

-No, I never did.

-

-No. Did you work in the mines?

-No.

-So how come you've got bad lungs?

-In his notes, it says he has COPD...

-..Chronic Obstructive

-Pulmonary Disease.

-It's a lung disease

-usually caused by smoking.

-Everyone I've seen with the disease

-is a past smoker.

-Look over to the side.

-It's strange

-that he has this diagnosis of COPD.

-I'll have a listen to your heart

-and lungs now if that's OK.

-On the ward today, doctors' work

-is similar to detectives' work.

-You're safe going to lectures,

-there are no patients there.

-Lecturers teach you

-and give you the information.

-On placement, often

-it's a case of trial and error.

-You go with your gut instinct and

-try and learn as much as you can.

-Thank you, sir, you can rest back.

-He heard something

-at the bottom of his lungs.

-That could signify an infection.

-The other option

-is a pulmonary embolism.

-It's a small clot

-in one of the arteries.

-We'll do some blood tests and we

-might do some scans of your lungs.

-He's being given oxygen

-16 hours a day.

-He is very ill.

-We have to keep an eye on him

-and make sure we do all we can...

-..as soon as possible.

-You're worried about what happened.

-I can understand, I'm worried too.

-We'll try to work out what it is

-and help you.

-In the Caribbean,

-4,000 miles away from Wales...

-..fifth-year student Eleri has been

-on a month's placement in Antigua...

-..where health care is free.

-We treat patients

-who have no other choice.

-We're their only hope for treatment.

-Today she's travelling to work

-on another small island...

-..Barbuda.

-As she arrives at the hospital

-for the first time...

-..she looks for a welcome.

-There's no sign of anyone.

-Looking from the outside, it looks

-as if no-one's been here in years.

-No patients.

-No doctors.

-It's quite a shock. It feels

-as if I've gone back in time.

-A thousand people

-live on the island.

-On a Sunday morning, it's deserted.

-It's a bit of quandary for Eleri

-until the doctor arrives.

-Hello.

-It's lovely to meet you. I'm Eleri.

-It's lovely to meet you. I'm Eleri.

-

-Nice to meet you too. I'm Jeremy.

-Welcome to Barbuda.

-Welcome to Hannah Thomas Hospital.

-It's very different

-to what I've seen before.

-Eight-bed facility,

-comprising of a maternity ward...

-..casualty department,

-triage area, pharmacist.

-We have the dentistry lab and

-a laboratory section on that side.

-It's a big compound but

-a small facility. It works for us!

-Soon, the patients start to arrive.

-In this room, he holds a clinic

-similar to a GP clinic at home.

-He sees patients in the morning.

-They pay a small fee.

-Did you give him anything

-for the fever?

-He decides if they can to be treated

-at home or should be admitted.

-One of the most important things

-you don't want is dehydration.

-He looks well heavy.

-Open your mouth, ah.

-At this time of year...

-..cases of gastroenteritis

-are common in Barbuda.

-They have this every year.

-The temperature changes

-from winter to spring.

-The virus thrives

-in this temperature.

-High five.

-Between this and viral

-respiratory tract infections...

-..that's all they see

-for three weeks.

-This morning, Dr Jeremy Deazle

-has a more pressing diagnosis.

-This patient fainted

-during a service at a local church.

-On such a small island, Dr Jeremy

-knows most of the patients.

-He knows that this girl has suffered

-with emotional episodes.

-He thinks it might be

-religious hysteria.

-This patient has a history

-of these symptoms.

-She's suffered with anxiety

-in the past.

-Within minutes,

-two more women arrive.

-Both have come from the same church

-and have the same symptoms.

-There are only eight beds

-in the hospital.

-They're filling up quickly.

-The hospital has gone

-from one patient...

-..to the women's ward being full.

-There's one patient in casualty.

-It's been so busy

-in the past 20 minutes.

-They all have similar symptoms.

-By now, Dr Jeremy is quite sure

-what happened.

-The chemical

-probably triggered off her asthma.

-It triggered a spasm

-in these people.

-Dr Jeremy comes from Barbuda.

-After studying in Florida...

-..he returned to care

-for the thousand residents.

-It's a great responsibility

-with little resources.

-Dr Jeremy is 28 years old,

-not a lot older than me.

-He's looking after the health of

-a thousand people on a small island.

-Seeing what he could do with

-the help of a couple of nurses...

-..and the difference

-they make to the community.

-We're used to more resources

-in Wales.

-It's fantastic and something I'll

-use as inspiration for a long time.

-Feel the pain. General discomfort.

-It was important to him to give

-something back to the community.

-He's inspired me to return home to

-North Wales to work in the future.

-I'd like to work with a team that

-uses the Welsh language positively.

-If you don't feel better

-in a few days, you must return.

-Come, come.

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-A hot summer's day.

-Seven ambulances have arrived

-with unexpected emergency cases.

-Ysbyty Gwynedd is already busy.

-In reality,

-this is a busy hospital.

-Every bed has been taken,

-especially after the bank holiday.

-People are sitting in the corridor.

-You see people

-rushing around all the time.

-The staff work really hard.

-The staff work really hard.

-

-It's exciting.

-You don't know what'll come in next.

-It could be another emergency.

-It's very interesting.

-The staff work so hard.

-They work under so much pressure.

-It shows their concern

-for the patients.

-Gwyneth Pritchard is a

-73-year-old lady with chest pain...

-..and motor neurone disease.

-Good morning.

-Breathing is one of the things that

-can be affected by your condition.

-Jess sees that treating the patient

-differs to treating the illness.

-It's something you can't learn

-in a lecture.

-It doesn't show you in a book...

-..this is what you should do

-in this situation.

-Books are simple ABC.

-In reality, when you see a patient,

-it might not suit them as a person.

-If you're in bed and the bottom of

-the lung doesn't get enough air...

-They go through the treatment.

-It's important to consider

-what they want too...

-..in addition to what you should do.

-The greatest skill of a doctor

-is empathy.

-There was a question whether

-you'd put a clot into your lungs.

-You'll have a scan for that.

-Then we can say yes or no.

-Jessica will take a bit more blood

-from you later on.

-She might ask another student

-to help if that's OK.

-That's fine.

-The pressure on the system

-gives Jess and Rhodri...

-..more experience than usual.

-They trust us, I think...

-..to do jobs

-like clerking patients...

-..and taking their bloods.

-They're small jobs

-but they are time-consuming.

-It's interesting and very exciting

-to be in these busy surroundings.

-There's an intensity to the place.

-There's an intensity to the place.

-

-It's tiring, it's painful.

-It is worth it because we get

-so much out of the experience.

-Is it OK if our student, Jess,

-takes the sample?

-It's really difficult

-to get blood from the patient.

-She has motor neurone disease.

-She has little strength left

-in her hands and arms.

-You have to pull it.

-You have to pull it.

-

-That's fine.

-You want the patient to extend

-their wrist to get the sample.

-This wasn't possible with her.

-Sharp scratch.

-We need this sample.

-With motor neurone disease, muscles

-in the chest don't work properly...

-..and they're very weak.

-Her lungs won't be working properly.

-This is a good test.

-The blood comes from the arteries,

-which come from the lungs...

-..and from the heart.

-It's an accurate indication

-of the CO2 level in her blood.

-It's really difficult

-getting the needle into the artery.

-It's very painful but it's important

-as we try and help the patient.

-After a few attempts, it worked.

-While we were talking

-to the patient...

-..the F1 doctor we were following

-was bleeped.

-There'd been a cardiac arrest.

-She rushed off to deal with it while

-we were talking to this patient.

-She's back now but they're

-still doing CPR on this patient.

-It shows how busy this ward is and

-how quickly you have to respond...

-..when a bleep comes in

-because she rushed off suddenly.

-It's so busy in Bangor,

-Jess and Rhodri almost forgot...

-..about an important event

-back at the university.

-We've just found out that

-the results of our last exam is out.

-This is the last exam of this year.

-Fingers crossed.

-The marks count

-towards our rankings.

-They help us get a job

-when we graduate.

-Fingers crossed.

-I have a rule of not opening results

-in front of people!

-Here we go.

-Where is it?

-Go to the top. Go down.

-The blue bit, Module and Assessment

-Results, right there.

-2017 and I passed!

-Me too. I did better than last time.

-I'm chuffed.

-Oh, great.

-Happy days then.

-Yay!

-In such a busy hospital...

-..celebrations

-will have to wait until tonight.

-Gwyneth has had her scan

-and is on her way back to the ward.

-We're trying to get her home now.

-Because of her

-motor neurone disease...

-..a special ambulance is required.

-The scans she had

-take so long to return.

-It looks likely that she'll have

-to stay here for another night.

-When you're learning

-how to treat patients...

-..you learn to do this and that,

-then they recover and go home.

-But in reality,

-it doesn't always work like that.

-She wants to go home and

-the doctors want her to go home...

-..to release another bed.

-It's the reality

-of being in a busy hospital.

-Experience with the patients.

-That's the difference

-between a student and a doctor.

-As soon as students

-start dealing with people...

-..they soon realize that it's not

-only a matter of X-rays and ECGs...

-..and not only chemical elements

-and cells in a book.

-The patient is an actual person,

-a member of society...

-..and we need

-to get them back there.

-The opportunity to treat people

-and speak to people...

-..is the reason we're here.

-I really thrive in that situation

-and I enjoy it.

-Since we filmed, Gwyneth lost

-her battle against the illness.

-In September 2017,

-Hurricane Irma battered Barbuda.

-The hospital, and nearly all

-other buildings, were destroyed.

-All the residents

-were forced to leave the island.

-S4C Subtitles by Testun Cyf.

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