Pennod 6 Doctoriaid Yfory


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Pennod 6

Yn rhaglen olaf y gyfres mae'r myfyrwyr yn delio â chleifion sydd â symptomau heriol. In the final programme, Jess and Rhodri are dealing with someone who has fallen out of a tree.


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-.

0:00:000:00:00

-It's a new term and the cameras are

-back at the School of Medicine...

0:00:010:00:06

-..following young students...

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

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-..on a unique course.

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-I'm looking for scrubs.

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-Stepping into the medical world

-for the first time.

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-I'm opening the airway

-and tilting the head back.

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-Facing the emergencies

-of our health service.

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-Every bed is taken,

-especially after the bank holiday.

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-People sitting in corridors,

-it's the reality of a busy hospital.

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-That's alcohol free.

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-The women's ward is full.

-One casualty patient is waiting.

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-It's become so busy

-during the past 20 minutes.

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-Treating life-threatening illnesses.

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-Is this patient high risk?

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-They assessed the patient and

-there's a high risk of fatality.

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-Fragile lives.

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-How long have I got?

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-He's been worried about today

-since the scan three weeks ago.

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-What's going to happen

-with my family?

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-These are tomorrow's doctors.

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-I want to help people.

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-I want to help people.

-

-Thank you, Mos.

0:01:140:01:15

-In Newport's Gwent Hospital,

-some of the third-year students...

0:01:280:01:32

-..receive practical experience

-in different departments.

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-Eben joins the surgery team.

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-I'm on my way

-to the anaesthesia department.

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-I'll be going to the theatre where

-they specialise in emergencies.

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-I've never been to a theatre where

-I can watch the anaesthesia before.

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-Today we'll see a patient with

-a femoral hernia in the groin.

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-Mrs Haynes is in her 70s. This

-operation is not without its risks.

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-To lessen the risk, she'll only

-receive a local anaesthetic.

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-She'll stay awake

-during the operation.

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-It's not a common hernia.

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-Inguinal hernias are more common.

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-They do happen and when they do,

-they're removed by surgery.

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-Two teams work together -

-the surgeons and the anaesthetists.

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-The patient receives a cannula

-into her hand.

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-She'll receive

-the anaesthetic through her back.

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-There'll be no pain from here down,

-in the legs.

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-The patient will be awake

-during the surgery...

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-..but they won't feel a thing.

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-She doesn't have great bones

-in her back - she has arthritis.

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-Her back isn't straight.

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-There's more bone

-than there is in a normal person.

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-It took quite a while

-to give her the injection.

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-Can you feel this here?

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-To test

-whether she feels pain at all...

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-..they spray her

-with some water droplets.

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-They do that because the

-spinothalamic tract in the body...

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-..can detect pain and sensation.

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-She can still feel the water.

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-The doctors decide to administer

-a general anaesthetic...

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-..to send her to sleep.

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-Communication between all parties

-is now as important as ever.

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-They have to get everything right.

-There's no room for error.

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-They must get the right amount

-of medicine in the right place.

0:03:490:03:54

-It all looks very complicated.

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-They'll burn her skin, then stretch

-it open to see the hernia.

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-They've had to move the structures

-such as the femoral artery.

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-They pushed the hernia

-under these structures...

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-..to stop it re-emerging.

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-After doing that, they'll put

-a mesh over it to keep it in place.

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-What I find interesting is how many

-people from different departments...

0:04:340:04:39

-..in this hospital work together...

0:04:390:04:42

-..to provide the best care

-for the patient.

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-I learnt a lot

-from the anaesthetic team.

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-I didn't realise

-there was so much communication...

0:04:520:04:55

-..between the anaesthetists,

-surgeons and patient.

0:04:550:04:58

-I've learnt a lot.

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-Surgery is over. We're moving

-the patient to recovery now.

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-I was on telly!

0:05:190:05:21

-Bye.

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-The patient was very buoyant

-which made it all so much easier.

0:05:240:05:28

-There was a relationship there

-from the start.

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-It's so important to have a good

-relationship with the patient.

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-No problem.

0:05:370:05:39

-It was lovely to meet you.

-You get better soon, alright?

0:05:400:05:44

-You're very, very welcome. Bye.

0:05:450:05:47

-How many children have you fostered?

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-Between 60 and 70 but some

-were called supporting lodgings.

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-I still called them my foster kids.

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-That's amazing.

0:05:570:05:59

-This woman is incredible.

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-She has 21 grandchildren too.

0:06:020:06:05

-21 grandchildren.

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-She's 74 years old.

-She's done remarkably well.

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-My grandchildren can talk Welsh.

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-Better than their Welsh grandmother.

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-As the academic year

-draws to a close...

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-..Eleri completes her fifth year

-as a medical student...

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-..on a placement near her home.

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-It's strange being back

-in Ysbyty Gwynedd.

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-When I had appointments as a child,

-I'd come to Ysbyty Gwynedd.

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-It's nice to be close to home

-for the final block.

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-Many patients speak Welsh

-which isn't the case down south.

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-Good morning.

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-How do you feel?

0:06:560:06:58

-How do you feel?

-

-Quite good, thanks.

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-Today, Eleri is responsible

-for Mr Jenkins.

0:07:000:07:03

-He's having problems

-with his gall bladder...

0:07:030:07:07

-..which has caused

-a case of jaundice.

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-You were meant to go home last week.

0:07:110:07:13

-I had the stents inserted last week

-to unblock the gall bladder.

0:07:130:07:20

-My blood hasn't recovered.

0:07:210:07:23

-They're checking every day,

-fair play to them.

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-It's nice speaking Welsh

-to the patients.

0:07:270:07:30

-It's so important to get a community

-of Welsh-speaking doctors...

0:07:300:07:35

-..who can speak

-and treat patients in Welsh.

0:07:350:07:39

-The hope is that the stent can make

-the blood tests on the liver easier.

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-That's right.

0:07:440:07:46

-It makes the treatment

-more personal.

0:07:460:07:48

-Thank you very much.

0:07:490:07:50

-They can speak Welsh to the team,

-the doctors and nurses.

0:07:500:07:54

-That makes such a difference.

0:07:550:07:56

-We want more students

-from Wales...

0:07:580:08:04

-..to study medicine in Wales

-and then stay in Wales...

0:08:040:08:08

-..to work as doctors.

0:08:090:08:11

-That's the course.

0:08:110:08:13

-Mr Jenkins has seen a few changes

-in his blood tests over the weekend.

0:08:150:08:20

-They've been deteriorating.

0:08:200:08:22

-He's going to have another stent

-inserted.

0:08:230:08:26

-He had one last week.

-They think the stent has moved.

0:08:260:08:29

-The plan is to insert another

-to see if it works...

0:08:290:08:32

-..in the hope of getting him home

-soon because he's been here so long.

0:08:320:08:36

-We're going down

-to the X-ray department...

0:08:370:08:40

-..where the procedure will happen.

0:08:400:08:43

-It's tight in here.

0:08:460:08:48

-I hope it doesn't break down and

-we're stuck here for half an hour.

0:08:490:08:54

-You're on a bed if we do get stuck!

0:08:550:08:57

-.

0:09:010:09:01

-Subtitles

0:09:050:09:05

-Subtitles

-

-Subtitles

0:09:050:09:07

-On a placement in Ysbyty Gwynedd...

0:09:150:09:18

-..Jess can practise

-her blood-taking skills.

0:09:180:09:22

-Are you happy for me

-to take your blood?

0:09:220:09:25

-Yes. It'll be the second time today.

0:09:250:09:27

-Have you had your blood

-taken already?

0:09:270:09:30

-Make sure you leave some behind.

0:09:300:09:32

-I'll try my best. I need a lot.

0:09:330:09:37

-Oh, yes?

0:09:370:09:38

-Not too painful?

0:09:420:09:44

-No, it's fine.

0:09:440:09:46

-I definitely want to stay in Wales

-when I start working.

0:09:460:09:51

-I grew up here,

-it's where I come from.

0:09:510:09:55

-It's a wonderful place to work.

0:09:560:09:59

-I'm bleeding you dry!

0:09:590:10:01

-The opportunity to speak Welsh

-in work is a great help.

0:10:020:10:06

-That's alcohol-free.

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-That's one of the main reasons

-I want to stay in Wales.

0:10:100:10:14

-Thank you.

-Thanks for letting me do that.

0:10:140:10:16

-Not many people like having students

-doing that.

0:10:170:10:20

-You have to learn.

0:10:200:10:22

-It's a great feeling when

-you're doing it for the first time.

0:10:220:10:26

-You've seen a doctor doing it,

-you've seen it on TV. It looks easy.

0:10:270:10:30

-When you're there for the first

-time, you forget everything.

0:10:310:10:34

-I managed to get some blood.

0:10:350:10:38

-I needed quite a lot, four bottles.

-It's a good feeling when you get it.

0:10:380:10:42

-These are going to the lab.

0:10:430:10:44

-I'm very nervous thinking

-that in two years' time...

0:10:470:10:50

-..I won't be able to hide behind

-my student lanyard.

0:10:510:10:54

-People will look up to me

-as a real doctor.

0:10:560:10:59

-I'll be treating patients

-and making decisions.

0:11:000:11:03

-I've grown so much this year

-and learnt so much.

0:11:050:11:10

-Within two years, I hope I'll be

-ready to go out into the world...

0:11:100:11:15

-..to treat people as a doctor.

0:11:160:11:17

-Every single patient, you should

-ask yourself, "Is this sepsis?"

0:11:180:11:23

-I want you to spot it.

-It will not get through.

0:11:230:11:26

-As the third year

-draws to a close...

0:11:280:11:30

-..Rhodri also feels

-the pressure mounting.

0:11:300:11:33

-During my time in medical school...

0:11:350:11:38

-..the expectations rise every year.

0:11:380:11:41

-By this time of year, we've almost

-completed the third year...

0:11:410:11:46

-..we're expected...

0:11:460:11:48

-..to be able to diagnose a patient.

0:11:490:11:51

-What could be causing

-these symptoms?

0:11:510:11:54

-While taking

-a patient's medical history...

0:11:540:11:58

-..students should spot significant

-changes in their condition.

0:11:580:12:02

-Do you have any family history

-of medical conditions?

0:12:030:12:06

-A heart murmur when I was born.

0:12:060:12:08

-With Mrs Hodgson, there's concern

-about her recent weight loss.

0:12:080:12:14

-How long has that weight loss

-gone on for?

0:12:150:12:18

-Since January.

0:12:180:12:19

-How much do you think you've lost?

0:12:200:12:23

-About 50kgs.

0:12:240:12:25

-50? Gosh, that is a lot, isn't it?

0:12:260:12:28

-That's serious.

0:12:290:12:30

-I've got no clothes that fit me.

-I put things on and they hang.

0:12:300:12:34

-The rings don't fit your fingers?

0:12:340:12:36

-No wedding ring, no engagement ring.

0:12:370:12:39

-There's a history of reflux.

0:12:400:12:42

-Every time she ate,

-she gets a reflux.

0:12:430:12:45

-She also has a pain in her chest.

0:12:450:12:48

-Right now,

-sometimes she starts gagging...

0:12:490:12:51

-..which causes her a lot of pain

-and she can't eat a thing.

0:12:520:12:57

-How much are you managing to eat?

0:12:570:12:59

-How much are you managing to eat?

-

-Just about nothing.

0:12:590:13:00

-Just about nothing.

0:13:000:13:02

-You mentioned about the crackers.

0:13:030:13:05

-How many of them

-would you have in a day?

0:13:050:13:08

-Maybe one.

0:13:080:13:10

-Have you had the camera tests?

-How were they?

0:13:110:13:14

-Everything came back fine.

0:13:150:13:18

-Any other medical conditions?

-Do you have diabetes?

0:13:180:13:21

-I have had diabetes but my doctor

-says I've lost so much weight...

0:13:220:13:27

-..there's no way

-I've got diabetes now.

0:13:270:13:30

-Do you drink any alcohol?

0:13:310:13:32

-Do you drink any alcohol?

-

-I do but not much.

0:13:320:13:33

-How much alcohol do you drink?

0:13:330:13:36

-Brandy diluted in a glass like that.

0:13:360:13:39

-Every night?

0:13:390:13:40

-Every night.

-It's the only way I can sleep.

0:13:400:13:43

-OK.

0:13:440:13:45

-When you're in so much pain,

-you need something.

0:13:450:13:49

-It's apparent that Mrs Hodgson's

-problems are complex...

0:14:000:14:04

-..and she requires more tests.

0:14:050:14:07

-There are simple tests you can do.

0:14:100:14:13

-I'm going to write everything up

-about everything we discussed.

0:14:140:14:18

-Then I'll research some

-of the conditions or illnesses...

0:14:190:14:23

-..she could have.

0:14:230:14:25

-I'll then start thinking

-about a plan for her...

0:14:250:14:29

-..and get her home

-as quickly as I can.

0:14:290:14:31

-After a month of tests and treatment

-in hospital...

0:14:320:14:35

-..Mrs Hodgson gained enough weight

-to return home.

0:14:360:14:39

-Jess has taken

-Mr Jones' medical history...

0:14:460:14:49

-..after he was admitted

-to the emergency department...

0:14:490:14:52

-..short of breath.

0:14:520:14:53

-She will present the information

-to the consultant...

0:14:540:14:57

-..Dr Subbe.

0:14:570:14:59

-He has left-sided chest pain

-but I think that's more muscular...

0:14:590:15:03

-..because he's had several rib

-fractures after falling from a tree!

0:15:030:15:07

-You fell out of a tree?

0:15:100:15:11

-You fell out of a tree?

-

-Yes.

0:15:110:15:12

-That's good enough, yeah.

0:15:140:15:16

-Given that we know he climbs

-into trees, he's normally very fit.

0:15:170:15:22

-I'm 72, my brother is 74.

-They can't stop him.

0:15:220:15:27

-The other one is 76.

-They can't stop him.

0:15:280:15:30

-Not everybody over the age of 70

-is still in trees.

0:15:300:15:34

-I was a patient in A&E a few times

-when I was younger.

0:15:360:15:40

-I was just clumsy, I broke bones.

0:15:410:15:44

-These haven't disconnected.

-They're really free.

0:15:440:15:48

-Family members

-have attended hospital.

0:15:480:15:51

-It has changed how I see patients.

0:15:510:15:55

-That's a good perspective to have

-when you're on a placement.

0:15:550:16:01

-You're looking for lung markings,

-those lines going to the periphery.

0:16:010:16:06

-In most areas, I can see that.

0:16:070:16:09

-We're happy there's no obvious cause

-of breathlessness.

0:16:090:16:13

-Two minutes.

0:16:160:16:17

-Two minutes.

-

-You're getting Welsh on me now!

0:16:170:16:19

-We'll have a look at your tracing

-of the heart to see what's going on.

0:16:220:16:26

-You have a slow pulse.

0:16:260:16:28

-There's a beat that looks different.

-It could be a ventricular ectopic.

0:16:300:16:34

-That would give you also

-different morphology, wouldn't it?

0:16:350:16:39

-The heart has got a pump

-and it's got electricity.

0:16:390:16:43

-The electricity normally starts

-at the top bit of the heart.

0:16:430:16:47

-The normal is always like this.

0:16:480:16:50

-So now, that only works

-when all the electricity is proper.

0:16:520:16:55

-What happens in your case is...

0:16:560:16:58

-Pop, pop, pop.

0:17:000:17:02

-Occasionally you miss a beat there.

0:17:020:17:05

-That means your heart is much slower

-than it would otherwise be.

0:17:050:17:09

-If you would run up a tree,

-the pulse should go faster.

0:17:090:17:13

-The heart needs to pump more oxygen.

-In your case, it drops a few beats.

0:17:130:17:17

-Then you start getting short

-of breath. That's what happens.

0:17:170:17:21

-Would a clock thing sort that out?

0:17:220:17:25

-If you would have a pacemaker...

0:17:250:17:27

-..then it might do extra beats...

0:17:280:17:31

-..and you might have better function

-and more oxygen delivered...

0:17:310:17:35

-..and you might be

-less short of breath.

0:17:350:17:38

-Is that alright? OK.

0:17:380:17:40

-Thank you.

0:17:400:17:42

-Thank you.

0:17:430:17:44

-Thank you.

-

-Thank you.

0:17:440:17:46

-On the Tryfan ward, on her

-final placement on the course...

0:17:520:17:56

-..fifth-year student Eleri

-is treating Mr Jenkins.

0:17:560:18:01

-I'm expecting

-I'll get another camera.

0:18:020:18:05

-Another camera?

0:18:050:18:07

-He has stomach problems

-and jaundice.

0:18:070:18:11

-My blood isn't recovering.

0:18:130:18:15

-He feels OK himself. He doesn't have

-the symptoms he had when he came in.

0:18:160:18:21

-He just wants to get

-his blood back...

0:18:210:18:24

-..to the base line it was

-before these symptoms started.

0:18:250:18:28

-OK, great.

0:18:280:18:30

-He's on his way to theatre...

0:18:320:18:35

-..to have a small camera

-inserted down his throat.

0:18:350:18:39

-At the moment,

-they're just sedating Mr Jenkins.

0:18:400:18:42

-I haven't seen

-this procedure before.

0:18:450:18:48

-Last week, the doctors

-inserted a stent in his stomach.

0:18:500:18:54

-There seems to be

-some kind of blockage there.

0:18:540:18:58

-We're looking for

-the bilirubin level.

0:18:590:19:01

-That's created in the gall bladder.

0:19:020:19:05

-The bile can't travel out.

0:19:050:19:08

-That's blocked right now.

0:19:090:19:11

-We're trying to insert a stent

-to release it.

0:19:110:19:13

-When the bile is released, hopefully

-the bilirubin will come down.

0:19:140:19:18

-The bilirubin

-has caused his jaundice.

0:19:190:19:22

-The blood tests will improve,

-as will his skin colour.

0:19:240:19:27

-They've inserted the stent

-to help release the bile.

0:19:300:19:35

-It looks as if it's working.

0:19:380:19:40

-That was really interesting.

0:19:490:19:51

-It's the first time

-I've witnessed that treatment.

0:19:510:19:55

-It was uncomfortable to watch...

0:19:550:19:57

-..since they inserted a tube

-while he was still awake.

0:19:570:20:01

-He was sedated but not too much.

0:20:020:20:05

-I could see the stent

-they'd inserted last week.

0:20:060:20:10

-They've stretched the stent

-with another balloon...

0:20:100:20:14

-..to help release more bile.

0:20:140:20:16

-As her fifth year

-draws to a close...

0:20:220:20:25

-..Mr Jenkins will be one

-of the final patients...

0:20:250:20:28

-..Eleri will treat as a student.

0:20:290:20:31

-The next step is to start work

-next month.

0:20:310:20:34

-It's huge.

0:20:350:20:36

-Taking that step, taking this

-lanyard off and starting work...

0:20:360:20:40

-..I don't think one person can

-say that without feeling some fear.

0:20:400:20:45

-Hello, how do you feel now?

0:20:460:20:48

-Hello, how do you feel now?

-

-Better, thanks.

0:20:480:20:49

-We have more responsibility

-when we start work...

0:20:490:20:53

-..but we've learnt to work

-as a team.

0:20:540:20:56

-We don't work alone. There are

-so many people around us to help.

0:20:570:21:01

-I'll see you tomorrow.

0:21:010:21:03

-That makes me feel more comfortable

-about starting the job.

0:21:030:21:08

-From their first lecture...

0:21:120:21:14

-From their first lecture...

-

-I'll introduce something else...

0:21:140:21:17

-..to the graduation ceremony

-at the end of the course...

0:21:180:21:22

-..it's a long journey

-for tomorrow's doctors.

0:21:220:21:25

-Is that cold?

0:21:260:21:28

-It's quite fiddly.

-Do you pull it towards you?

0:21:280:21:31

-This year, they've mastered

-all kinds of new skills.

0:21:310:21:36

-This is a difficult skill.

0:21:360:21:38

-This is a difficult skill.

-

-It's uncomfortable for the patient.

0:21:380:21:41

-I'm going to pretend to be a doctor.

0:21:420:21:44

-I'm going to pretend to be a doctor.

-

-Yay!

0:21:440:21:46

-They've seen patients

-at their most vulnerable.

0:21:470:21:51

-They've learnt how to build

-a relationship with them.

0:21:560:21:59

-How are you feeling

-about going in today?

0:21:590:22:02

-Really nervous.

0:22:020:22:04

-That's such a weight off my mind.

0:22:040:22:06

-Lovely. Thank you, Mos.

-Thank you very much.

0:22:070:22:09

-Some of them have matured.

0:22:100:22:12

-It's taken four years but I think

-I've found the right balance.

0:22:120:22:18

-They're all a step closer

-to becoming tomorrow's doctors.

0:22:180:22:23

-They're very special young people.

0:22:230:22:26

-We want more of them.

0:22:260:22:28

-Is it an honour to be a doctor?

-Yes, it is.

0:22:310:22:34

-It's a wrap.

0:22:350:22:36

-S4C Subtitles by Testun Cyf.

0:22:560:22:58

-.

0:22:590:22:59

Yn rhaglen olaf y gyfres mae'r myfyrwyr yn delio â chleifion sydd â symptomau heriol. In the final programme, Jess and Rhodri are dealing with someone who has fallen out of a tree.