0:00:02 > 0:00:05# This is an emergency... #
0:00:06 > 0:00:08A typical night in A&E.
0:00:08 > 0:00:11It's like a battlefield.
0:00:11 > 0:00:12Language!
0:00:12 > 0:00:15Full of twenty somethings after a big night out.
0:00:15 > 0:00:17Lots of vomit, lots of unconscious bodies lying around.
0:00:17 > 0:00:19But not everyone is a casualty.
0:00:19 > 0:00:22Squeeze my fingers, please!
0:00:22 > 0:00:26Taking care of them is an army of doctors, the same age.
0:00:26 > 0:00:29They've had five years of training...
0:00:29 > 0:00:34- Cardiac arrest in A&E. - ..and a rigorous induction into hospital life.
0:00:34 > 0:00:38Take full advantage of being in a bloody good city and a bloody good NHS Trust.
0:00:38 > 0:00:40Hello.
0:00:40 > 0:00:42- # This is an emergency... # - Never done this before.
0:00:42 > 0:00:46Now they face the reality of life on the wards.
0:00:47 > 0:00:49You are the skivvy, the ward bitch.
0:00:49 > 0:00:54He was looking at my badge as if to say, "Who are you? What do you know?"
0:00:54 > 0:00:59We'll be following seven junior doctors at work...
0:00:59 > 0:01:00and at home.
0:01:03 > 0:01:0624-year-old Adam is from a family of medics.
0:01:06 > 0:01:10There's the massive pedigree within the family that I'll have to live up to.
0:01:10 > 0:01:15- Cambridge graduate Katherine. - I definitely feel I have to work at things.
0:01:15 > 0:01:18If I want to achieve something.
0:01:18 > 0:01:20Animal lover Lucy, 24.
0:01:20 > 0:01:23If I'm feeling stressed, you'll probably see it.
0:01:23 > 0:01:26If I'm feeling a bit emotional, I might have to bite my lip.
0:01:26 > 0:01:28If I get embarrassed, I blush.
0:01:29 > 0:01:32Aspiring surgeon Andy, 25.
0:01:32 > 0:01:34- I was- BLEEP! - HE LAUGHS
0:01:34 > 0:01:38Calm. And I'm cool in the traditional sense of the word.
0:01:38 > 0:01:40Wine buff Keir.
0:01:40 > 0:01:41I'm a bit of a show-off at times.
0:01:41 > 0:01:43Rather lovely!
0:01:43 > 0:01:47But sensitive. Very, very useful to me in medicine.
0:01:47 > 0:01:50Rugby captain Jon.
0:01:50 > 0:01:52As a medical student, you have no responsibility.
0:01:52 > 0:01:55Where as a junior doctor, the buck stops with you.
0:01:55 > 0:01:56And party girl Suzi.
0:01:56 > 0:02:02Someone's life in our hands. I'm 24 and that's like a massive thing.
0:02:04 > 0:02:08They'll be working in two of Newcastle's busiest hospitals.
0:02:08 > 0:02:10HE GROANS
0:02:10 > 0:02:12Cardiac arrest!
0:02:12 > 0:02:15Dealing with life and death situations.
0:02:15 > 0:02:18She's just been told, "You're going home to die."
0:02:18 > 0:02:21And sometimes the bizarre.
0:02:21 > 0:02:25I saw a man that had a toilet brush up his bottom!
0:02:25 > 0:02:27But are they up to the job?
0:02:27 > 0:02:30You're doing well, sir. You're doing well.
0:02:30 > 0:02:32I guess if I really messed up I would kill someone.
0:02:32 > 0:02:35We're doctors. We've grown up.
0:02:35 > 0:02:37But I don't feel as though I've grown up.
0:02:37 > 0:02:42I'm still out of my depth and that is more scary than exciting.
0:02:57 > 0:03:02Newcastle upon Tyne - the party city of the North East.
0:03:05 > 0:03:08Where our seven junior doctors are sharing this house.
0:03:11 > 0:03:16- Guys, it's ready!- Tomorrow they're all starting new jobs.
0:03:16 > 0:03:17GLASSES CLINK
0:03:18 > 0:03:21And the question on everybody's lips is...
0:03:21 > 0:03:23..are they ready?
0:03:23 > 0:03:27I just keep telling myself that it's literally tens of thousands of people
0:03:27 > 0:03:32who are in exactly my position that are going to be going on the wards. And at least one of those people
0:03:32 > 0:03:35are going to make a worse mistake than me!
0:03:35 > 0:03:37And that's what's keeping me going!
0:03:37 > 0:03:39Look on the bright side, people did it before us.
0:03:39 > 0:03:41- There is no reason why we can't do it.- Exactly.
0:03:41 > 0:03:45You will never be ready for it, you just have to deal with it.
0:03:45 > 0:03:48It's just that episode of ER when the firemen... Has anyone else seen it?
0:03:48 > 0:03:54You're not basing your entire medical fears on what you've seen on TV!
0:03:54 > 0:03:57I know, but it was so scary and so horrible!
0:03:57 > 0:04:01What do you think it's like? You make mistakes and people can die.
0:04:01 > 0:04:03- Isn't that scary?- Nah! - It scares me quite a lot.
0:04:06 > 0:04:12As Suzi gets ready for bed, her new responsibility starts to weigh on her mind.
0:04:12 > 0:04:15Worst case is that someone could be really sick
0:04:15 > 0:04:17and could die,
0:04:17 > 0:04:19or there could be a sick child or something.
0:04:19 > 0:04:22Things that just kind of knock you...
0:04:22 > 0:04:26emotionally, I think, are the scariest things
0:04:26 > 0:04:28because you don't know how you're going to cope.
0:04:41 > 0:04:43- How are you this morning?- Good.
0:04:43 > 0:04:45HE YAWNS
0:04:45 > 0:04:47It's day one of their new jobs.
0:04:49 > 0:04:51Adam's a first year.
0:04:51 > 0:04:57He only graduated a few weeks ago and will be working as a doctor for the first time.
0:04:57 > 0:05:01I really don't want to look stupid compared to my peers.
0:05:01 > 0:05:04If we start the job and everyone else seems to be coping well,
0:05:04 > 0:05:07and I'm coping really badly... you know.
0:05:07 > 0:05:11I'm worried that I'm going to try really hard and fail.
0:05:12 > 0:05:15I'm not feeling very well. I don't feel ideal.
0:05:15 > 0:05:20But hopefully, I'll feel better as the day goes on.
0:05:20 > 0:05:24Despite having done a year on the wards,
0:05:24 > 0:05:28second year Suzi is still nervous.
0:05:28 > 0:05:31I'm scared because I can send patients home from hospital
0:05:31 > 0:05:34without speaking to anyone else, and that scares me,
0:05:34 > 0:05:36because then you've got the potential to send home
0:05:36 > 0:05:37people that are really sick.
0:05:37 > 0:05:42On his first day, Adam's keen to dress to impress.
0:05:42 > 0:05:46You get a lot more respect when you dress properly, when you're wearing good clothes.
0:05:46 > 0:05:48I think it's important to look good on the job.
0:05:48 > 0:05:51I've got my new trainers for A&E and everything.
0:05:51 > 0:05:53And they're pink! I need pink trainers,
0:05:53 > 0:05:55because I've got a pink stethoscope.
0:05:55 > 0:05:59So I need to co-ordinate my shoes and my stethoscope.
0:06:02 > 0:06:06# I like to wait to see how things turn out
0:06:06 > 0:06:07# If you apply some pressure... #
0:06:07 > 0:06:10Suzi is working at Newcastle's General Hospital,
0:06:10 > 0:06:12in Accident and Emergency.
0:06:15 > 0:06:20A&E is demanding and unpredictable, with over 200 cases a day.
0:06:20 > 0:06:23These are our new team.
0:06:23 > 0:06:26Today, Suzi starts with a full induction.
0:06:26 > 0:06:29On your right is the resuscitation room and the monitoring bay.
0:06:29 > 0:06:35On your left are three rooms for walk-in type patients.
0:06:35 > 0:06:39Shoulder injuries and things, so that's fairly low intensity.
0:06:39 > 0:06:41Any questions?
0:06:41 > 0:06:45What I'd like to do now is divide you guys up into groups,
0:06:45 > 0:06:48of either twos or threes each.
0:06:48 > 0:06:50Choose your groups and I'll come back to you.
0:06:52 > 0:06:55I think it's quite difficult, especially for a junior doctor,
0:06:55 > 0:06:59the first few days, they're under tremendous pressure.
0:06:59 > 0:07:05They have to get stuck in, they have to work, right from day one.
0:07:07 > 0:07:11One of the things that you often see in junior doctors is what we call
0:07:11 > 0:07:13the frozen doctor syndrome.
0:07:13 > 0:07:19They come across a critical case, and they just don't know what to do.
0:07:19 > 0:07:21ALARM SOUNDS
0:07:22 > 0:07:25And Suzi's nerve is about to be put to the test,
0:07:25 > 0:07:26as an emergency's coming in.
0:07:26 > 0:07:28Suzi, it's all set.
0:07:28 > 0:07:32The patient's heart has stopped beating, and it's the team's job
0:07:32 > 0:07:34to try and get it started again.
0:07:34 > 0:07:37We're waiting for a cardiac arrest call that's come in,
0:07:37 > 0:07:40so everyone's just waiting, ready to go.
0:07:40 > 0:07:43I'm really excited, but also really scared.
0:07:43 > 0:07:47I'm trying to get all my bits and pieces gathered.
0:07:50 > 0:07:52Suzi, are you happy to check?
0:07:52 > 0:07:54Yeah? OK.
0:07:54 > 0:07:56Are you happy to shock?
0:07:56 > 0:07:58Can do. I haven't shocked anyone before.
0:07:58 > 0:08:00- You haven't?- No.
0:08:00 > 0:08:03OK, fine. We'll show you, then.
0:08:05 > 0:08:09This is the first time Suzi has experienced any emergency like this.
0:08:09 > 0:08:14I've been at arrest beds before, but never in an A&E situation.
0:08:14 > 0:08:17So this is a bit different.
0:08:17 > 0:08:23And yeah...the pressure's on, but I want pressure, so that's fine.
0:08:23 > 0:08:25SIREN BLARES
0:08:31 > 0:08:33The paramedics have got the patient's heart started
0:08:33 > 0:08:35in the ambulance.
0:08:35 > 0:08:38But the patient arrives in a critical condition.
0:08:38 > 0:08:43He was en route with ST elevation MI, when he arrested in an ambulance
0:08:43 > 0:08:44with VTAC.
0:08:44 > 0:08:48The paramedics shocked him out of VTAC, he's now in sinus with them.
0:08:48 > 0:08:52Blood pressure of 114, but he remains unconscious.
0:08:52 > 0:08:55'Suzi's first job is to take blood.'
0:08:55 > 0:08:58We're in. I haven't got much blood out.
0:08:58 > 0:09:00Get some more on the other side as well.
0:09:02 > 0:09:05The patient is unconscious, but his body is writhing,
0:09:05 > 0:09:07because of the shortage of oxygen to his brain.
0:09:07 > 0:09:09If you come round to that side,
0:09:09 > 0:09:12the carotid ring is just under the Adam's apple,
0:09:12 > 0:09:16and when he starts to go up, we need direct pressure back into the bed.
0:09:18 > 0:09:22They need to put a tube into the patient's lungs to help him breathe.
0:09:22 > 0:09:25Suzi needs to apply pressure to his throat to stabilise the windpipe.
0:09:25 > 0:09:29All right, try and relax for me, sweetheart.
0:09:29 > 0:09:31Try and relax for a second.
0:09:31 > 0:09:33- All right.- That's fine.
0:09:33 > 0:09:35Well done.
0:09:36 > 0:09:38OK.
0:09:38 > 0:09:41Finally, the patient's been stabilised,
0:09:41 > 0:09:44ready to be transferred to a specialist department.
0:09:46 > 0:09:49Probably one of the most difficult I've seen for a long time.
0:09:49 > 0:09:54The reason it was so difficult was because he was so combative.
0:09:54 > 0:09:59Due to the cardiac arrest, his brain was not getting the oxygen,
0:09:59 > 0:10:02the brain was starved of oxygen.
0:10:02 > 0:10:06The reaction I saw from Suzi was absolutely brilliant.
0:10:06 > 0:10:10She got stuck in. She did a few tasks which are quite difficult.
0:10:10 > 0:10:17She was confident in what she did, didn't take long to make decisions, so I think she's very good.
0:10:17 > 0:10:20Suzi's made a good first impression,
0:10:20 > 0:10:22but she isn't always taken seriously.
0:10:29 > 0:10:34Most people age me about 19, 20. I've had 16 before.
0:10:34 > 0:10:39- I look 12.- Did you get your ID, Suzi? - Yes, I have my ID!
0:10:39 > 0:10:45I'm blonde, I like the colour pink, I'm a bit girly, I like wearing dresses, I like getting glammed up.
0:10:45 > 0:10:50People are always really surprised when they find out I'm a doctor.
0:10:50 > 0:10:56I was shopping out in Leeds once and I was wearing a short skirt and boots
0:10:56 > 0:11:00and I could see this man on the ground who was unconscious.
0:11:00 > 0:11:03So I went, "I'm a doctor," and everyone went...
0:11:03 > 0:11:07And I was like, "I AM a doctor!" And no-one believed me!
0:11:09 > 0:11:13I think they think that I haven't got a brain and I don't work hard,
0:11:13 > 0:11:16but, you know, I work very hard, this is how I've got here.
0:11:16 > 0:11:23I would like people to think that I was a doctor, because it's got that kind of air of respect and things.
0:11:23 > 0:11:28And I AM a doctor, so maybe I should get some of that sometimes.
0:11:32 > 0:11:34It's only the first day in her new job,
0:11:34 > 0:11:39but Suzi's already starting to get the recognition she's been waiting for.
0:11:39 > 0:11:43It's a little scary, because it isn't what I pictured today being.
0:11:43 > 0:11:46I thought it would be sit and have a chat, this is how everything works.
0:11:46 > 0:11:52But it's A&E, and that isn't how A&E goes so... I'm enjoying it, though. It's good.
0:11:52 > 0:11:53SIREN WAILS
0:11:58 > 0:12:01While Suzi's getting to grips with her new job,
0:12:01 > 0:12:05her housemates, Adam, Lucy and Katherine are also starting work.
0:12:05 > 0:12:11For all three, this will be their first experience working as doctors.
0:12:11 > 0:12:15I'm thinking I just want to prove to everybody that I'm a good doctor.
0:12:15 > 0:12:18And how I'm going to go about doing that!
0:12:18 > 0:12:22Adam's joining ward 52, respiratory.
0:12:22 > 0:12:28He'll have to deal with seriously ill patients who have breathing difficulties and lung disease.
0:12:28 > 0:12:32The most important thing today is getting through the day...
0:12:32 > 0:12:36I'd say not killing anyone, but I think everyone's quite stable,
0:12:36 > 0:12:41but, erm...just making sure that you're good to your patients and that you get everything done.
0:12:41 > 0:12:48So I've just got some bloods to do, just kind of routine bloods, just making sure there's no infections.
0:12:48 > 0:12:53Adam gets his hands on his first proper patient. Hilda is 81 years old.
0:12:53 > 0:12:57Hi, I'm Adam, would it be all right to take some blood from you?
0:13:01 > 0:13:06It's got to go to the black pudding factory. You're single-handedly keeping it open.
0:13:06 > 0:13:08Sharp scratch.
0:13:08 > 0:13:10I'm sorry.
0:13:13 > 0:13:14Oh, oh, careful.
0:13:14 > 0:13:17You don't need to prick yourself.
0:13:17 > 0:13:20Right, can you just hold that for me for a second?
0:13:20 > 0:13:22That'll be all right.
0:13:22 > 0:13:25A bit of a bruise, I'm sorry.
0:13:25 > 0:13:28Hilda has suspected Addison's disease,
0:13:28 > 0:13:32but can Adam remember what he's learned when put to the test by a senior doctor?
0:13:32 > 0:13:38Do you know what Addison's disease is? Do you know what the original Addison's disease was?
0:13:38 > 0:13:41Is the original... Right, I'm trying to think whether it was...
0:13:41 > 0:13:44Is the original Addison's disease from pit...
0:13:44 > 0:13:46No, it's primary, isn't it?
0:13:46 > 0:13:51- Yeah.- Do you know what I'm thinking of? Anyway, never mind...
0:13:51 > 0:13:58So it's primary adrenal failure, and what did Addison describe on postmortem in the adrenal glands?
0:13:58 > 0:14:01What was actually causing adrenal destruction?
0:14:01 > 0:14:04- Was it an autoimmune...? - No, it was TB.
0:14:04 > 0:14:08TB is the most worldwide... Yeah.
0:14:08 > 0:14:13I just got flustered, because it's difficult when you're...
0:14:13 > 0:14:19Well, first day as a doctor, and people are trying to assess how much you know,
0:14:19 > 0:14:24what level of competency you're at, and you want so badly to make a good first impression.
0:14:24 > 0:14:29There's that pressure that I know I could come out with all these things,
0:14:29 > 0:14:33but actually coming out with them is a different story.
0:14:33 > 0:14:36I could have sounded really smart. I didn't sound smart, I sounded stupid.
0:14:42 > 0:14:49With Adam left trying to find his feet, Suzi is back in at the deep end with another emergency.
0:14:49 > 0:14:52A woman has been admitted following an overdose.
0:14:52 > 0:14:55Can you speak to me? My name is Suzi, I'm one of the doctors.
0:14:55 > 0:14:59I need to ask you some questions. ..Can we get some oxygen as well?
0:14:59 > 0:15:04And Suzi needs to find out what she's taken and whether the drug cocktail is lethal.
0:15:04 > 0:15:08Can I have a quick look in your eyes if that's OK?
0:15:08 > 0:15:10Hello! How are you?
0:15:10 > 0:15:15A blood sample would provide her with vital clues, but first she needs to calm the patient down.
0:15:15 > 0:15:19Trying to give her as much oxygen as we can,
0:15:19 > 0:15:22and try and get her to respond.
0:15:22 > 0:15:24Relax.
0:15:24 > 0:15:25Just leave that on.
0:15:25 > 0:15:28It hurts.
0:15:28 > 0:15:30I'm just checking your blood pressure.
0:15:30 > 0:15:32It's hurting me!
0:15:34 > 0:15:38We're just trying to make you feel a little bit better.
0:15:38 > 0:15:41- Come and have a lie down.- Come on.
0:15:41 > 0:15:44So that's better, isn't it? There we go.
0:15:44 > 0:15:48We just want to get some bloods, but we're not sure it's the best time,
0:15:48 > 0:15:50which is a shame, because it would be really useful, wouldn't it?
0:15:50 > 0:15:53It might give us a gauge of what she's taken.
0:15:53 > 0:15:57We just managed to get a blood pressure off her leg,
0:15:57 > 0:16:02because if you put it on her arm, she writhes around a lot.
0:16:02 > 0:16:07And she's haemodynamically stable, which means her blood pressure is fine and her pulse is fine.
0:16:07 > 0:16:10And the patient is much more settled.
0:16:10 > 0:16:13Suzi's shift comes to an end.
0:16:13 > 0:16:16It's now down to the night team to try and help the patient.
0:16:34 > 0:16:39Back at the house, Suzi catches up with the other junior doctors.
0:16:39 > 0:16:41How was your first day?
0:16:41 > 0:16:43A learning curve like this.
0:16:43 > 0:16:50Back on myself! My first patient was a cardiac arrest in an ambulance who was then taken there.
0:16:50 > 0:16:54He was like, "Do you want to help?" I was like, "Yeah, I suppose."
0:16:54 > 0:16:57But it was good. But he was really sick.
0:16:57 > 0:16:59Yeah, yeah, of course.
0:16:59 > 0:17:01But, yeah, I kind of enjoyed it.
0:17:01 > 0:17:04- Did you?- Mmm, I know! - Stressful but enjoyable.- Yeah.
0:17:05 > 0:17:09I guess I was a little jealous that Suzi was doing A&E,
0:17:09 > 0:17:13because it is something that I really want to get to grips with.
0:17:13 > 0:17:18You know, do this with a patient, take this, do that, this procedure,
0:17:18 > 0:17:22give him this medication, inject this, blah-blah-blah.
0:17:22 > 0:17:26Suzi came back with loads of stories from A&E, and that was like awesome.
0:17:26 > 0:17:30Adam doesn't see himself as a typical doctor.
0:17:32 > 0:17:34# One, two, three, four
0:17:34 > 0:17:37# Uno, do, tre... #
0:17:37 > 0:17:41If you asked my friends to describe me, they'd probably say that I was cheeky.
0:17:41 > 0:17:44Some would say that I borderlined on sleazy, that is not true.
0:17:44 > 0:17:46I would say I'm just being myself.
0:17:46 > 0:17:50He's got a terrible reputation with nurses.
0:17:50 > 0:17:52That's all I'm saying, but there's been a few tears.
0:17:55 > 0:17:57My dad's a respected doctor.
0:17:57 > 0:18:01Since I was six, I've wanted to follow in his footsteps.
0:18:01 > 0:18:04My mum's also a doctor, my brother's a doctor.
0:18:04 > 0:18:08My mum's mother was a doctor back in the day.
0:18:08 > 0:18:12There's a massive pedigree within the family that I'm going to have to live up to.
0:18:12 > 0:18:16I always put too much pressure on myself, and I'm always really hard on myself,
0:18:16 > 0:18:20and I never say I've done a good job unless I've done the best job.
0:18:21 > 0:18:26I would want to make a difference to as many people as possible
0:18:26 > 0:18:29and do something that was absolutely huge.
0:18:29 > 0:18:33In essence...I want to save the world.
0:18:44 > 0:18:49As he starts another day, it's an opportunity for Adam to make his mark,
0:18:49 > 0:18:52but he's hit with a mountain of paperwork.
0:18:52 > 0:18:57I'm rubbish at paperwork. Probably because I don't care.
0:18:57 > 0:19:00About paperwork, I care about people.
0:19:00 > 0:19:03I need to do this, I need to sort this out.
0:19:03 > 0:19:07It's just not stimulating at all.
0:19:07 > 0:19:10You are the skivvy, the ward bitch, basically.
0:19:10 > 0:19:17The part of me that wants to do medicine, I really want some complex task to figure out.
0:19:17 > 0:19:20And it's not long before he finds one.
0:19:20 > 0:19:22I dropped some stuff in here. Ah...
0:19:25 > 0:19:32After five years of medical training, Adam at last has a chance to practise his surgical skills.
0:19:34 > 0:19:38I don't even need this pen, I just really want to get it now.
0:19:40 > 0:19:42I almost got it!
0:19:43 > 0:19:47I need to get it now, because it will be in there forever otherwise.
0:19:52 > 0:19:54Sweet!
0:19:54 > 0:20:01OK. A lesson to learn, don't drop these in without them being in bags.
0:20:08 > 0:20:11While the job's not yet living up to Adam's expectations,
0:20:11 > 0:20:15the other housemates are settling into their new jobs.
0:20:15 > 0:20:21I have a dilemma. These people came in 20 minutes beforehand.
0:20:21 > 0:20:23But this gentleman's slightly sicker.
0:20:26 > 0:20:31If there's not an arrow on, we might sew up that ear by mistake, and that would be silly.
0:20:31 > 0:20:35Lucy is starting work in gastroenterology.
0:20:37 > 0:20:43She'll be treating patients with digestive problems, including liver disease caused by alcohol abuse.
0:20:43 > 0:20:46You need to be careful with that.
0:20:46 > 0:20:50Alcoholic patients are often quite difficult to treat.
0:20:50 > 0:20:56They get agitated and aggressive and start smashing the place up.
0:20:58 > 0:21:04For first year Lucy, learning to dealing with addiction is as important as saving lives.
0:21:04 > 0:21:07I'm Lucy, I'm one of the junior doctors on this ward.
0:21:07 > 0:21:10Just tell me a little bit about what's brought you into hospital.
0:21:10 > 0:21:15- There's notes here, but it's easier if you tell me a bit yourself.- Pain.
0:21:15 > 0:21:18- What pain have you been having? - Me legs.- Your legs, OK.
0:21:18 > 0:21:23- I understand as well that you've been sick with some blood.- I was, I was.
0:21:23 > 0:21:26You see I'm an alcoholic,
0:21:26 > 0:21:31and I used to drink 20 cans a day.
0:21:31 > 0:21:33- Cans of?- Lager.
0:21:33 > 0:21:37- Lager.- And then I reduced, reduced, reduced,
0:21:37 > 0:21:41now I only take two max.
0:21:41 > 0:21:44I don't drink any more. I really, really don't.
0:21:44 > 0:21:48If you can come off it completely, that would be the best bet.
0:21:48 > 0:21:53- Eventually, because obviously if your liver's damaged already...- It is.
0:21:53 > 0:21:58- Any alcohol's not going to make it any better.- Oh, I know. I know.
0:21:58 > 0:22:01OK. Thanks very much.
0:22:01 > 0:22:06It's great to be part of the team. A proper role within a working team
0:22:06 > 0:22:09in the middle of a big hospital. It's really quite exciting.
0:22:12 > 0:22:15Can you speak to me? My name's Suzi, I'm one of the doctors.
0:22:15 > 0:22:20In A&E, Suzi's back at the emergency frontline.
0:22:20 > 0:22:2552-year-old Chris is suffering from a serious epileptic fit
0:22:25 > 0:22:29and Suzi and the team urgently need to stop it.
0:22:29 > 0:22:30We were up here from London.
0:22:30 > 0:22:33He's forgot his medication.
0:22:33 > 0:22:36Yeah, I know. How long do they normally last for?
0:22:36 > 0:22:41I'm not too sure, but the last one that he had when we come up here was about an hour and a half.
0:22:41 > 0:22:46A long seizure like this can cause brain damage or can even be fatal.
0:22:47 > 0:22:50Suzi checks her drug guide.
0:22:50 > 0:22:53She urgently needs to prescribe the right anti-epileptic.
0:22:53 > 0:22:56It's quite serious if he's had such a long fit earlier on.
0:22:56 > 0:22:58We need to put these anti-epileptic drugs into him.
0:22:58 > 0:23:01The drugs are given intravenously.
0:23:01 > 0:23:04The patient starts to regain consciousness.
0:23:04 > 0:23:06Sorry that we're poking you from all sides, but...
0:23:06 > 0:23:08Yes, they're just there to help you.
0:23:08 > 0:23:12- It's really important.- I know you can hear me, Chris, right?
0:23:12 > 0:23:16Just try your very, very best, babes.
0:23:18 > 0:23:24He hasn't had his anti-epileptic medicine now for coming on to two days, a day-and-a-half,
0:23:24 > 0:23:30so we've given him something to stop the fit for the time being. Anything's better than nothing.
0:23:30 > 0:23:35He's going to a wedding tomorrow, he's doing the first reading at the wedding, which starts at 2pm.
0:23:37 > 0:23:41I don't know if he's going to make it now, just because of all the fits,
0:23:41 > 0:23:47which would be a shame, but if he'd had his anti-epileptics, this probably wouldn't have happened.
0:23:52 > 0:23:57As Suzi's emergencies continue to roll in,
0:23:57 > 0:24:01Adam's day fills up with more run-of-the-mill jobs.
0:24:07 > 0:24:1160-70% of the job's probably paperwork, I reckon.
0:24:11 > 0:24:15It's something that second year John knows only too well.
0:24:15 > 0:24:21Everyone becomes a doctor to see patients and treat patients, not to do paperwork and write letters.
0:24:21 > 0:24:24And we've all done that, we've all had those days.
0:24:24 > 0:24:26Unfortunately it's got to be done.
0:24:26 > 0:24:30And when Adam's not doing paperwork, he's taking blood.
0:24:30 > 0:24:31Bloods or paperwork, bloods or paperwork.
0:24:38 > 0:24:42Adam still feels like he's not making his mark,
0:24:42 > 0:24:47but over in the gastro ward, Lucy's next job is a speciality.
0:24:47 > 0:24:50The only thing that's left is for you to go and do a PR examination.
0:24:50 > 0:24:53Thanks. Looks like I've drawn the short straw, yes.
0:24:53 > 0:24:55The per rectal.
0:24:55 > 0:24:57Known in the business as the PR.
0:24:57 > 0:24:59The internal bottom examination.
0:25:01 > 0:25:04And this is Lucy's first time.
0:25:04 > 0:25:07I've never had to perform one as a student.
0:25:07 > 0:25:10I mean, we'd done them on models.
0:25:10 > 0:25:14There are model bottoms that we can use to practise these things on!
0:25:14 > 0:25:17I will be as pain-free as possible.
0:25:17 > 0:25:23Second year John has had a year's practice, so he's an old hand at the rectal exam.
0:25:24 > 0:25:31OK, so just a small amount of jelly on my finger, all right?
0:25:32 > 0:25:36Sticking your finger up someone's bum isn't the most pleasant job!
0:25:36 > 0:25:37I'd be lying if I said it was.
0:25:37 > 0:25:40So if you just pull your trousers down to your knees for me.
0:25:40 > 0:25:43'I obviously didn't reveal the fact that I'd never actually done one before.'
0:25:43 > 0:25:47But if you can exude confidence, even if inside you're thinking, "Oh my goodness,"
0:25:47 > 0:25:51then at least the patient has confidence in what you're doing.
0:25:51 > 0:25:54If you can roll onto your left side.
0:25:54 > 0:25:57You put a glove on, it's not really optional...
0:25:57 > 0:25:59You explain what's happening...
0:25:59 > 0:26:03I'm going to put some lubricant on my finger, OK?
0:26:03 > 0:26:07You get them to scrunch their knees up to their chest...
0:26:07 > 0:26:12If you just try and relax as much as possible, I'm going to put my finger just into your bottom.
0:26:12 > 0:26:15You just have to rise above the embarrassment factor
0:26:15 > 0:26:18because the patient is more scared about the experience than you are.
0:26:18 > 0:26:21Shouldn't be too painful, it might just feel a little bit strange.
0:26:21 > 0:26:24- Perfect.- All right?
0:26:24 > 0:26:28All done. My worst ever experience, I went to put my finger in
0:26:28 > 0:26:32and diarrhoea started coming out, and it ran down my hand.
0:26:32 > 0:26:35And you kind of saw it, and it gets to the brim of the glove...
0:26:35 > 0:26:40and then it went over the brim of the glove and on to my forearm.
0:26:40 > 0:26:42I was like, "This is minging, this is minging!"
0:26:42 > 0:26:44I'm going to take my finger out now.
0:26:44 > 0:26:51So all round, a rather strange experience, I suppose, but something that's very important.
0:26:57 > 0:27:02The day shift's coming to an end and Adam's wrapping up for the day.
0:27:02 > 0:27:06I'm trying to get jobs for tomorrow sorted,
0:27:06 > 0:27:11and hopefully I can come in tomorrow and not be, like,
0:27:11 > 0:27:14a clown, like this morning.
0:27:14 > 0:27:19I just want to be a bit more prepared tomorrow, so I can kind of hit the ground running.
0:27:35 > 0:27:38At home, Adam vents his frustrations.
0:27:38 > 0:27:42I haven't used my brain since finals and everyone thinks I'm really thick.
0:27:42 > 0:27:46Even those things that don't seem important, they really are.
0:27:46 > 0:27:52Even though it seems you haven't really been trained to fill in forms every day.
0:27:52 > 0:27:58I get really bored if I'm not stimulated, so I just feel like I'm not really doing anything.
0:27:58 > 0:28:05You are though. You will have that day when you have to go and deal with your first really sick patient.
0:28:05 > 0:28:13I do have like really big plans for, you know, what I want to get out of medicine.
0:28:13 > 0:28:16But there's a lot of paperwork and a lot of routine stuff.
0:28:16 > 0:28:21I've just go to take that one on the chin and know that I'm still doing a good thing,
0:28:21 > 0:28:23even if it's not as stimulating as I would have hoped.
0:28:32 > 0:28:36Adam's not the only one struggling.
0:28:36 > 0:28:40Katherine's also starting to feel the pressure of being a junior doctor.
0:28:40 > 0:28:44I'm worried that it's just going to be like a never-ending day.
0:28:44 > 0:28:48I'm worried that everything's going to take me so long
0:28:48 > 0:28:51that I'm just not going to get home until like 10pm.
0:28:51 > 0:28:56Because every job's going to take me just that bit longer
0:28:56 > 0:28:59because I don't really know what I'm doing.
0:29:01 > 0:29:07And because I'm the only one on the ward, the only junior on the ward,
0:29:07 > 0:29:12I don't really have anyone to share the jobs with or anything like that.
0:29:19 > 0:29:21Katherine's working in the Plastic Surgery Department.
0:29:21 > 0:29:25One of her first jobs is to take blood.
0:29:25 > 0:29:28But it isn't proving easy to find a vein.
0:29:28 > 0:29:32The arm's quite swollen. I think it's going to be quite difficult.
0:29:32 > 0:29:35I just can't see or feel the vein at all.
0:29:35 > 0:29:40I don't want to take it out of that arm. I could do your foot.
0:29:44 > 0:29:47- I can see a little one here. - Put a tourniquet on.
0:29:47 > 0:29:50Yeah, I'll put a tourniquet on.
0:29:50 > 0:29:53It's quite small.
0:29:53 > 0:29:59I don't know if I can make it bigger though with a tourniquet.
0:29:59 > 0:30:00I'll have a go if that's all right.
0:30:05 > 0:30:08I'm really not convinced this is going to work.
0:30:17 > 0:30:21No, that's not going to go.
0:30:21 > 0:30:24Sorry about that, that's quite embarrassing.
0:30:24 > 0:30:25I can't get blood.
0:30:25 > 0:30:28Thanks.
0:30:28 > 0:30:32The patient needs bloods taking and it's really difficult finding a vein.
0:30:32 > 0:30:37So I'm going to have to phone someone more senior to ask them what I should do about it.
0:30:41 > 0:30:43It's a bit embarrassing.
0:30:43 > 0:30:47But once he sees the veins, I don't think he'll mind.
0:30:47 > 0:30:49Hi, it's Katherine.
0:30:49 > 0:30:52Hi, sorry to phone you. This is really embarrassing.
0:30:52 > 0:30:57But I've got a patient and I can't get a vein on her anywhere.
0:30:57 > 0:31:00So I've tried her foot, but I couldn't get it.
0:31:01 > 0:31:05OK, thanks very much. Cheers, bye.
0:31:05 > 0:31:08So, help is on its way.
0:31:08 > 0:31:10I'll just go and let the nurse know.
0:31:19 > 0:31:25Whilst Adam's managed to take blood from a patient, he's missed the deadline to the lab.
0:31:25 > 0:31:30Because I did it after five, it means I have to get it sent in a taxi.
0:31:30 > 0:31:32Which means a run-in with Head Nurse Doreen.
0:31:32 > 0:31:39Doreen, would it be possible to get a taxi for a sample of blood
0:31:39 > 0:31:42to go to the Freeman Microbiology?
0:31:42 > 0:31:46It's after five and I didn't realise that, when it's after five, you have to...
0:31:46 > 0:31:52Right. We'll have to check with Patient Services, cos we're not using taxis because of the cost.
0:31:52 > 0:31:56- Yeah...- Right. I'll ring and check. - Thank you. Thanks. Sorry about that.
0:32:00 > 0:32:04I should probably check first before I take his blood.
0:32:05 > 0:32:07Doreen knows I'm new.
0:32:07 > 0:32:09She knows I'm not a twat.
0:32:09 > 0:32:11So... And that I will have learned from it.
0:32:11 > 0:32:15So, you know, I can imagine Doreen could get angry.
0:32:15 > 0:32:19But that was probably her, kind of, nice, "I'm not impressed."
0:32:19 > 0:32:23It should have been done long before five o'clock.
0:32:23 > 0:32:27The thing is... You're quite right, but because it was at six
0:32:27 > 0:32:30and they told me to do it an hour before his gent thingy,
0:32:30 > 0:32:33I didn't realise it had to get sent to the Freeman.
0:32:33 > 0:32:34I know now. At least I know now.
0:32:34 > 0:32:37- You know now. OK. - Anyway, sorry about that.
0:32:37 > 0:32:39- Thanks. Thank you very much. - You're welcome.
0:32:39 > 0:32:46All junior doctors rely on the nurses to help them get to grips with the job.
0:32:46 > 0:32:48The nurses are fantastic.
0:32:48 > 0:32:51Screwed without them.
0:32:51 > 0:32:52If they're new in the hospital,
0:32:52 > 0:32:55they don't necessarily know how the system works.
0:32:55 > 0:32:57It's our job to try and tell them.
0:32:57 > 0:33:02I always make a point of going in and saying, look, I know you're new.
0:33:02 > 0:33:03It must be horrible.
0:33:03 > 0:33:06If there's anything you're not sure about, ask.
0:33:06 > 0:33:11- Did you know you can get medical degrees off iPhones?- Err...
0:33:11 > 0:33:13SHE LAUGHS
0:33:13 > 0:33:16We were all students once. We all had to start at the bottom.
0:33:16 > 0:33:18You've got to cut them a bit of slack.
0:33:20 > 0:33:27Despite support from the nursing staff, first-year Katherine is finding the workload demanding.
0:33:29 > 0:33:33- Do you want us to help you? - I've just got so much stuff to do. MOBILE RINGS
0:33:33 > 0:33:38I've already got a patient that's been waiting for an hour-and-a-half now, down in clinic. Hello?
0:33:38 > 0:33:43We are busy. We've got a lot of discharges today. We've already got names waiting to go in the beds.
0:33:46 > 0:33:50Would you mind if I do these buds? I'm a bit more sorted after I've done these.
0:33:50 > 0:33:54I'm trying to help her, but I can't write scripts for her or anything like that.
0:33:54 > 0:33:59As a second year, housemate Keir is more experienced.
0:33:59 > 0:34:03Cross this out for now. I will come back and do that when I've...
0:34:03 > 0:34:06Yeah, I've got quite a lot of jobs to do, still.
0:34:06 > 0:34:09Right, let's just stop, then.
0:34:09 > 0:34:12The busier you are, the more you need to stop. OK?
0:34:12 > 0:34:14Let's just stop.
0:34:14 > 0:34:17Go through the list of stuff and write it in order of priority.
0:34:17 > 0:34:22Katherine's learning that you have to be tough to make it as a doctor.
0:34:26 > 0:34:29I think I like ballet because it looks really girlie and pretty,
0:34:29 > 0:34:33but you have to be really quite tough to do it.
0:34:33 > 0:34:41My first year at university, I failed two of my exams and I had to spend the entire summer studying.
0:34:41 > 0:34:45That was hard. I lost a lot of confidence and I really had
0:34:45 > 0:34:48a chip on my shoulder that I wasn't good enough to be there.
0:34:48 > 0:34:53I was working just as hard as everyone else, but everybody else had passed and I'd failed.
0:34:53 > 0:34:56That was really difficult, to build up my confidence after that.
0:35:02 > 0:35:05She knows her own mind and she's very determined.
0:35:05 > 0:35:07She's always worked very hard.
0:35:07 > 0:35:12So she knows what she wants and everything else just sort of floats by her, really.
0:35:12 > 0:35:17I think she comes across as this smiley, bubbly little girl.
0:35:17 > 0:35:21But, actually, she is pretty resilient.
0:35:23 > 0:35:26I definitely feel I have to work at things
0:35:26 > 0:35:29if I want to achieve something.
0:35:29 > 0:35:34Only a few days into her job, there's a lot to work at.
0:35:34 > 0:35:40- Ward 11's the next priority, that's a child. Children are important to deal with quickly.- I'll do that.- OK.
0:35:40 > 0:35:44Then we've got loads of discharge scripts that need writing.
0:35:44 > 0:35:47We've got drug charts that need copying up.
0:35:47 > 0:35:49Now that we're at four o'clock,
0:35:49 > 0:35:52there will be people who won't get home tonight
0:35:52 > 0:35:55if we don't start getting through discharges, OK?
0:35:56 > 0:36:01After a tough first week, Katherine lets off steam to boyfriend Tim.
0:36:01 > 0:36:04Hey, how's it going?
0:36:04 > 0:36:07I found it really stressful. I felt out of my depth
0:36:07 > 0:36:11and I just came home thinking, "What if it doesn't get better?
0:36:11 > 0:36:14"What if I actually can't do a good job?"
0:36:14 > 0:36:16I don't know if I'm cut out to do this.
0:36:16 > 0:36:20Yeah, I think I'm going to have to develop a bit of a thicker skin.
0:36:23 > 0:36:25It's the weekend,
0:36:25 > 0:36:28and a big night out in Newcastle.
0:36:28 > 0:36:32Katherine gets to see Tim for the first time since she moved up here.
0:36:34 > 0:36:38# Yeah, yeah We bring the stars out
0:36:38 > 0:36:41# We bring the women and the cars and the cards out... #
0:36:41 > 0:36:45Adam, Andy, Keir and John are on a boys' night out.
0:36:45 > 0:36:49And Suzi's also getting ready for some Friday-night action.
0:36:50 > 0:36:54She's about to start her first set of night shifts.
0:36:54 > 0:36:57It's a Friday night in Newcastle.
0:36:57 > 0:36:59So I think it's going to be pretty busy.
0:36:59 > 0:37:03The weekends are the busiest nights for casualty.
0:37:03 > 0:37:08In the UK, one million people a year are taken to hospital after drinking.
0:37:08 > 0:37:10A & E's a scary job because you don't know
0:37:10 > 0:37:12what's coming in through the door.
0:37:12 > 0:37:14Is it one casualty, is it ten?
0:37:14 > 0:37:16Is it someone that's well, someone that's sick?
0:37:22 > 0:37:25From Suzi to Dr Batchelor.
0:37:25 > 0:37:26It's going to be really busy.
0:37:26 > 0:37:30As the pubs and bars close, it's going to get busier. It's a bit scary.
0:37:30 > 0:37:32THEY SHOUT
0:37:39 > 0:37:43I've heard they usually have some paramedics on standby here. But right now, it seems...
0:37:43 > 0:37:45Where are they tonight?
0:37:45 > 0:37:47I've not seen any hint of trouble...
0:37:47 > 0:37:48Wey!
0:37:48 > 0:37:54Add in a few more drinks in a couple of hours' time and I'll be like, "Good luck, Suzi!"
0:37:54 > 0:37:58# ..around here... #
0:37:58 > 0:38:02In A & E, the casualties are piling up.
0:38:02 > 0:38:04Suzi will find it hard. She will notice,
0:38:04 > 0:38:06at night, it's completely different.
0:38:06 > 0:38:10It is like a war zone. There are bodies everywhere. She will have to do more.
0:38:10 > 0:38:12The pressure on her will be intense.
0:38:12 > 0:38:16# They said it changes when the sun goes down... #
0:38:16 > 0:38:19Friday and Saturday nights can be ridiculously busy.
0:38:19 > 0:38:23Things, as you might expect, can be related to alcohol.
0:38:23 > 0:38:26Which can be a bit challenging, at times.
0:38:26 > 0:38:29- BLEEP!- Calm down.
0:38:29 > 0:38:32# ..around here... #
0:38:33 > 0:38:38Suzi's struggling to find her next patient amongst the mayhem.
0:38:38 > 0:38:41No? My God!
0:38:44 > 0:38:47It's that guy there, in the corridor with the fluid on.
0:38:47 > 0:38:51It's not surprising she's finding it hard to locate him.
0:38:51 > 0:38:53He's unconscious on a trolley.
0:38:57 > 0:38:59Let's get him into a room, shall we?
0:39:01 > 0:39:05The department sees an average of 220 patients over the weekend.
0:39:05 > 0:39:09One in five will be treated for alcohol-related problems.
0:39:09 > 0:39:12Can you squeeze my fingers, please?
0:39:12 > 0:39:19Squeeze them. I think he's had a little bit too much to drink.
0:39:19 > 0:39:23So we've got fluids going in to help sober him up.
0:39:23 > 0:39:25It's one of the doctors here.
0:39:25 > 0:39:27How are you feeling?
0:39:34 > 0:39:36HE SNORTS
0:39:36 > 0:39:40I have a good time and enjoy a drink when I'm out.
0:39:40 > 0:39:43But I have never been to A & E.
0:39:43 > 0:39:45Bonus!
0:39:53 > 0:39:58Night shifts and irregular hours are part and parcel of a doctor's life,
0:39:58 > 0:40:01as the housemates are all discovering.
0:40:01 > 0:40:04We have such peculiar shift patterns
0:40:04 > 0:40:07and we have such peculiar, kind of, lifestyles
0:40:07 > 0:40:11that, ultimately, you end up having to socialise with a lot of people
0:40:11 > 0:40:12that you work with as well.
0:40:12 > 0:40:15You work long hours and no-one's going to understand that,
0:40:15 > 0:40:19apart from other doctors, because they have to do the same thing.
0:40:19 > 0:40:22You can never say, "I will definitely be finished at five,"
0:40:22 > 0:40:24or definitely be finished at this time.
0:40:24 > 0:40:27Something might crop up and you have to stay.
0:40:27 > 0:40:33Out of the seven junior doctors living together, Suzi's having the toughest week.
0:40:33 > 0:40:38- Suzi's next patient is sober, but in a lot of pain.- Hello.
0:40:38 > 0:40:42Obviously I see what your problem and everything is.
0:40:42 > 0:40:46Are you fine with me looking, or would you rather have a guy?
0:40:46 > 0:40:48You're fine, yeah?
0:40:48 > 0:40:53Tony's stitches have split, following a recent operation to his testicle.
0:40:53 > 0:40:56OK, so where is it that's been sore? Round here?
0:40:56 > 0:40:58It all the way round there.
0:40:58 > 0:41:02It feels like somebody's keeping hold of them, squeezing them.
0:41:02 > 0:41:05Probably speak to a urologist about that.
0:41:05 > 0:41:09It's generally quite inflamed still, isn't it?
0:41:09 > 0:41:14Righty-o. I'll go and have a chat with them and pop back.
0:41:14 > 0:41:17- Thanks again.- Cheers.
0:41:17 > 0:41:20Don't mess with it. I would give whoever's on call in urology and say
0:41:20 > 0:41:22- you want somebody to have a look. - Right.
0:41:22 > 0:41:26In A & E, I haven't ever seen any testicles before.
0:41:27 > 0:41:30As a medical student, I saw them a couple of times,
0:41:30 > 0:41:34but not a lot of times.
0:41:34 > 0:41:39Pictures are quite a good way of passing on information clearly.
0:41:39 > 0:41:41That's why I'm drawing pictures.
0:41:41 > 0:41:44If I didn't need to, I wouldn't, because I'm terrible at art.
0:41:44 > 0:41:49I think it's awkward, examining a man's testicles who's the same age as me.
0:41:49 > 0:41:55And if it was me, I'd be weird if it was a man looking, if I had any problems down there or anything.
0:41:55 > 0:41:59It doesn't bother me, being seen by female doctors, you know.
0:41:59 > 0:42:02Just as long as it's getting rid of the pain, that's the main thing.
0:42:02 > 0:42:08Suzi gives him some painkillers and sends him to theatre to be re-stitched.
0:42:41 > 0:42:44The housemates are feeling the impact of their new jobs.
0:42:44 > 0:42:50My day was quite hectic. I feel like it's less of a job and more of some sort of
0:42:50 > 0:42:55sick initiation ceremony to allow you to be a real doctor.
0:42:55 > 0:42:59I don't think being a doctor is all it's cracked up to be. It's just being a ward bitch.
0:42:59 > 0:43:03You're saying that you feel experienced enough to be a doctor?
0:43:03 > 0:43:08Do you feel ready to give somebody the diagnosis that they've only got three weeks to live?
0:43:08 > 0:43:10- Yes.- Are you sure you could actually
0:43:10 > 0:43:13tell somebody they've only got weeks to live?
0:43:13 > 0:43:17Because that took me a long time to actually have the courage
0:43:17 > 0:43:20to say that to somebody. It's not easy.
0:43:20 > 0:43:25There's nothing more I can do without actually being a doctor. So, yeah, I do feel ready.
0:43:25 > 0:43:30I need the experience now to hone my skills, and to...
0:43:30 > 0:43:34I think it's quite dangerous, in a sense, to have that
0:43:34 > 0:43:40understandable confidence that says, "I'm ready to be a doctor."
0:43:40 > 0:43:45These are the sorts of things you only get from decades of experience.
0:43:45 > 0:43:46That is on fire!
0:43:54 > 0:43:56I think that, erm...
0:43:56 > 0:43:59- It's the paper, it's the paper. - It's stopped now.
0:43:59 > 0:44:03This week, it seems like Adam can't do anything right.
0:44:03 > 0:44:06He needs a chance to prove himself.
0:44:06 > 0:44:09You don't realise how much crappy paperwork there is
0:44:09 > 0:44:11- and- BLEEP- to do until you start doing the job.
0:44:11 > 0:44:15I got into medicine for reasons other than my entire day
0:44:15 > 0:44:17being taken up doing paperwork.
0:44:17 > 0:44:19So I hope that's going to change.
0:44:19 > 0:44:21Theoretically, if that didn't change
0:44:21 > 0:44:24and I was doing this amount of paperwork for the rest of my days,
0:44:24 > 0:44:25I'd quit tomorrow.
0:44:32 > 0:44:36But now, Adam could finally get the break he's been waiting for.
0:44:36 > 0:44:38He's going on-call.
0:44:38 > 0:44:44Covering up to 170 patients over five wards,
0:44:44 > 0:44:48he will be the first doctor to see any patients needing medical help.
0:44:51 > 0:44:54MOBILE RINGS
0:44:55 > 0:45:00Hello. OK, I'm coming, thanks.
0:45:00 > 0:45:05A patient is trying to discharge himself against medical advice
0:45:05 > 0:45:08and Adam has been asked to try and stop him.
0:45:08 > 0:45:13Hi, so you know we just want what's best for you, right?
0:45:13 > 0:45:18Please, just look at me, sir. Please, please. Come on. I'm not that bad looking!
0:45:18 > 0:45:21You know it's best for you to stay in hospital, don't you?
0:45:21 > 0:45:25You do understand that I want to stay for your asthma and to get you better.
0:45:25 > 0:45:29- If you go...- I'm all right. - ..it's against medical advice.
0:45:29 > 0:45:33- I understand that.- Do you understand? - Yes, I do.- You do realise that? - Yes, I do.
0:45:33 > 0:45:36You know we just want to take care of you.
0:45:36 > 0:45:37I want to go home.
0:45:37 > 0:45:40Despite Adams's best efforts, the patient leaves.
0:45:40 > 0:45:44He wouldn't stay in hospital, so unfortunately he has absconded
0:45:44 > 0:45:49against medical advice. I don't really know what to do about that.
0:45:49 > 0:45:51If he wanted to go, he'd probably end up going anyway.
0:45:51 > 0:45:54I know. I can't physically force him to stay.
0:45:54 > 0:45:59I did as much as I could to persuade him to stay.
0:45:59 > 0:46:01Did we come off 30 or 31?
0:46:01 > 0:46:04Where were we at before? Oh, crap!
0:46:08 > 0:46:12- And then, at last, he finally gets his first real emergency. - BEEPING
0:46:12 > 0:46:14Cardiac, adult, RV.
0:46:14 > 0:46:17It's a crash call.
0:46:17 > 0:46:23It means a patient somewhere in the hospital needs immediate attention and could be in cardiac arrest.
0:46:23 > 0:46:25Hello?
0:46:25 > 0:46:30He needs to find the patient as quickly as possible and try to save them.
0:46:30 > 0:46:33Less than 10% who suffer a cardiac arrest survive.
0:46:41 > 0:46:43He's got a pulse, peripherally.
0:46:45 > 0:46:49Adam takes his place in the crash team.
0:46:49 > 0:46:53The patient is unconscious, so he checks the patient's pulse.
0:46:53 > 0:46:55Fortunately, his heart is still beating.
0:46:57 > 0:46:59Then they give him oxygen to bring him round.
0:47:01 > 0:47:04You feel the adrenaline just hitting you so hard.
0:47:04 > 0:47:08Your heart's pumping so fast and you feel sick.
0:47:08 > 0:47:12And, you know, you're sweating and you're like, "OK, what's going on here?"
0:47:12 > 0:47:16You see somebody collapsed and you need to assess the situation.
0:47:16 > 0:47:19You need to do something quickly and to be decisive.
0:47:21 > 0:47:23- BLEEP- finally hit us.
0:47:23 > 0:47:25We're actual doctors now.
0:47:30 > 0:47:34On the other side of the hospital, Adam's been called to see
0:47:34 > 0:47:3685-year-old Lester with a lung complaint.
0:47:36 > 0:47:40Tonight, his condition has deteriorated.
0:47:41 > 0:47:44Hi, I'm just going to get you up a bit.
0:47:47 > 0:47:49How are you doing?
0:47:49 > 0:47:53OK, he's not well. He's not well at all.
0:47:53 > 0:47:55Adam decides to investigate further.
0:47:55 > 0:48:00He orders a second chest X-ray to compare with the old one.
0:48:00 > 0:48:03I could be convinced that the new one is a bit worse actually.
0:48:03 > 0:48:09I think it's the heart that's the problem and it's backed up into the lungs.
0:48:09 > 0:48:13Yeah, I think the new one is definitely worse. Definitely.
0:48:13 > 0:48:17Adam thinks the patient should be on additional medication,
0:48:17 > 0:48:21but first he needs to check if he's right with a senior doctor.
0:48:21 > 0:48:26Do you think I can give him Frusemide, or is it not really a decision I should be making?
0:48:26 > 0:48:30- No, if you're comfortable and you know what you're doing.- Cool, sweet.
0:48:30 > 0:48:32Adam's confident he has got it right.
0:48:32 > 0:48:37Yeah, I'm going to give him Frusemide. I'm going to give him Frusemide. I knew it.
0:48:39 > 0:48:43This is the first time, as a doctor, he has made a diagnosis.
0:48:46 > 0:48:48BEEP!
0:48:49 > 0:48:54OK, can we start Furosemide?
0:48:54 > 0:48:5740. I'll hand it over and she'll come over.
0:48:57 > 0:48:59Thanks very much.
0:48:59 > 0:49:04Now, that is different from the day job.
0:49:04 > 0:49:05Very different.
0:49:10 > 0:49:11That's why you are a doctor.
0:49:16 > 0:49:18The first time I'd seen a sick patient on my own
0:49:18 > 0:49:20I didn't really know what to do
0:49:20 > 0:49:22and I was kind of sat there, thinking,
0:49:22 > 0:49:24"What's going on with this guy?"
0:49:24 > 0:49:28And the thing is, my gut instinct told me something's going on.
0:49:28 > 0:49:29That was pretty much it.
0:49:33 > 0:49:38The next day, and Adam is back to check on Lester's progress.
0:49:38 > 0:49:41Good evening. How's it going?
0:49:41 > 0:49:45The ward nurse has some good news.
0:49:45 > 0:49:47His family are chuffed to bits.
0:49:47 > 0:49:50It's nice to see something you've put in motion have a good result.
0:49:50 > 0:49:54- I'll have a chat with him. - He'll be delighted to see you.
0:49:54 > 0:49:58- I'm so happy about that. - Seriously, good job.- Yeah, yeah.
0:50:02 > 0:50:05Hello. How are you feeling today?
0:50:05 > 0:50:08I feel much better than what I did yesterday.
0:50:08 > 0:50:11OK, good. I'm glad to hear it.
0:50:11 > 0:50:13And so am I.
0:50:13 > 0:50:16'It's my first real taste of doing good.'
0:50:16 > 0:50:20It's so nice when you feel you've made a difference in someone's life.
0:50:20 > 0:50:22And forever, I'll have that moment.
0:50:26 > 0:50:29With the first week under their belt,
0:50:29 > 0:50:34some of the junior doctors finally get a chance to let their hair down.
0:50:34 > 0:50:36I'm so glad to be finished!
0:50:36 > 0:50:38LAUGHTER
0:50:38 > 0:50:40Dirty laundry, public.
0:50:41 > 0:50:44LAUGHTER
0:50:46 > 0:50:48I'm really surprised, actually,
0:50:48 > 0:50:54at how I haven't hated it, and I've actually quite enjoyed it. It's been good.
0:50:54 > 0:50:58But it's just been so up and down, like really good things and then really bad things.
0:50:58 > 0:51:00My life has changed within about a week
0:51:00 > 0:51:03from sitting at home, playing PlayStation...
0:51:03 > 0:51:05Yeah.
0:51:05 > 0:51:10..to running after crash calls and dealing with critically-ill patients.
0:51:10 > 0:51:14- It's like you go from nothing to like...- Welcome to the club.
0:51:16 > 0:51:19- Thank you very much. - It's all right!
0:51:19 > 0:51:24'I do question, sometimes, what I'm meant to do in life.'
0:51:24 > 0:51:27I still feel, on balance, that being a doctor,
0:51:27 > 0:51:29I feel is what I was meant to do.
0:51:29 > 0:51:32But I'll just have to wait to see if I fulfil that prophecy or not.
0:51:32 > 0:51:37These seven nights have been probably the most challenging seven days I've had in medicine,
0:51:37 > 0:51:44but that's what A & E is and that's what life is, so you can't really moan about it or complain.
0:51:44 > 0:51:46It's just something that needs doing.
0:51:46 > 0:51:48Next time...
0:51:48 > 0:51:50Cardiac arrest. Cardiac arrest?
0:51:50 > 0:51:55- John's on emergency call. - You're doing well, sir, you're doing well. Fluid.
0:51:55 > 0:51:58And Lucy learns she can't save everyone.
0:51:58 > 0:52:03This poor lady has been told the worst news she's ever going to hear.
0:52:03 > 0:52:06She's just been told, "Right, you're going to go home to die."
0:52:06 > 0:52:07That's... So...
0:52:14 > 0:52:17Subtitles by Red Bee Media Ltd
0:52:17 > 0:52:20E-mail subtitling@bbc.co.uk