0:00:02 > 0:00:07A typical night in A&E. It's like a battlefield.
0:00:07 > 0:00:10Lots of vomit, lots of unconscious bodies lying around.
0:00:10 > 0:00:15Full of twenty-somethings after a night of binge drinking, bad behaviour and brawling.
0:00:15 > 0:00:17Hey, language!
0:00:17 > 0:00:21But not every twenty-something in hospital is a casualty.
0:00:21 > 0:00:24I'm Suzi, I'm one of the doctors, I need to ask you some questions.
0:00:24 > 0:00:27Ready to take care of these patients are an army of people the same age
0:00:27 > 0:00:32who have spent their twenties studying to become doctors.
0:00:32 > 0:00:37Their medical training has cost £150,000 each.
0:00:37 > 0:00:43They are newly qualified and about to face the harsh realities of life on an NHS ward.
0:00:43 > 0:00:44You can pass an exam,
0:00:44 > 0:00:46but it doesn't prove you can be a good doctor.
0:00:46 > 0:00:48I'm sorry!
0:00:48 > 0:00:51It is sort of life and death. HE SIGHS
0:00:51 > 0:00:56He was looking at my badge as if to say, "Who are you? What do you know?"
0:00:56 > 0:01:00Welcome to the world of junior doctors.
0:01:00 > 0:01:02I guess if I really messed up I could kill someone.
0:01:02 > 0:01:06Days like today just make me want to quit medicine.
0:01:06 > 0:01:11Seven newly qualified doctors are sharing this house in Newcastle.
0:01:11 > 0:01:14Second-years Kier, Andy, Jon and Suzi
0:01:14 > 0:01:17have been working on the wards for 12 months.
0:01:17 > 0:01:23I'm only human, so is every other doctor in the world, you know?
0:01:23 > 0:01:27We can't work magic.
0:01:27 > 0:01:29First-years Lucy, Katherine and Adam
0:01:29 > 0:01:32have been qualified doctors for just two weeks.
0:01:32 > 0:01:35I just feel like I'm still out of my depth.
0:01:35 > 0:01:39It's more scary than exciting.
0:01:39 > 0:01:42They have all spent at least five years at medical school
0:01:42 > 0:01:45learning to treat patients and save lives.
0:01:45 > 0:01:48Cardiac arrest. I'm in A&E. Can we get...?
0:01:48 > 0:01:52Until you actually come and do the job, you don't really realise
0:01:52 > 0:01:54that you will have this level of responsibility.
0:01:54 > 0:01:57You do know your responsibility is going to be changed.
0:01:57 > 0:02:01There is so much to learn. I just feel like I hardly know any of it.
0:02:01 > 0:02:06Now as first-time doctors, they're finding out if they've really got what it takes.
0:02:06 > 0:02:11Could you give me your hand? This needle's just about to drop out.
0:02:11 > 0:02:14Cardiac arrest...turn left or right?
0:02:16 > 0:02:17Which way?
0:02:17 > 0:02:20And they're learning the toughest lesson of all...
0:02:20 > 0:02:27This poor lady we've seen today has been told some of the worst news she's ever going to hear. Ever.
0:02:27 > 0:02:31Her life has literally been taken away from her, like that.
0:02:31 > 0:02:33..that they can't cure everyone.
0:02:49 > 0:02:53Morning in Newcastle. At the house
0:02:53 > 0:02:56that our seven newly qualified junior doctors are sharing,
0:02:56 > 0:03:01they're getting ready for their next shifts at the city's hospitals.
0:03:03 > 0:03:0824-year-old Jon is heading to a new assignment on a new ward.
0:03:08 > 0:03:12I've only been doing this job for 12 months,
0:03:12 > 0:03:16so I'm not proclaiming to be the best in the world.
0:03:16 > 0:03:18As long as I do what's expected of me,
0:03:18 > 0:03:23do the basics, you know, and don't make any massive cock-ups,
0:03:23 > 0:03:26that's kind of really all that can be expected.
0:03:27 > 0:03:32Jon is based at the Royal Victoria Infirmary's Emergency Assessment Unit,
0:03:32 > 0:03:35where he's part of the hospital's crash call team.
0:03:36 > 0:03:40And it's not long before the crash alarm on his phone goes off.
0:03:40 > 0:03:45It means that someone somewhere in the hospital needs urgent attention.
0:03:45 > 0:03:47Cardiac arrest.
0:03:49 > 0:03:54Jon must drop what he's doing, find the patient and try and save them.
0:03:57 > 0:04:00It's a life-or-death situation.
0:04:00 > 0:04:04The patient has gone into cardiac arrest. Her heart is failing.
0:04:04 > 0:04:08Less than 10% are successfully resuscitated.
0:04:08 > 0:04:11Jon is one of the first on the scene.
0:04:14 > 0:04:17The patient has no pulse.
0:04:17 > 0:04:22Jon starts chest compressions to keep blood flowing around the body.
0:04:22 > 0:04:2429...30.
0:04:30 > 0:04:35But with no heartbeat, time is running out.
0:04:53 > 0:04:58- The team have done everything they can.- Thanks, guys.
0:05:01 > 0:05:05The death of a patient is something Jon and his housemates
0:05:05 > 0:05:07will all have to learn how to deal with.
0:05:07 > 0:05:09Just need to find a bin.
0:05:17 > 0:05:18That's it, really...
0:05:20 > 0:05:24It was unsuccessful. Most cardiac arrests you go to are unsuccessful.
0:05:24 > 0:05:28If they're not monitored... If they're not on an actual screen...
0:05:28 > 0:05:31and people don't see them actually have a heart attack,
0:05:31 > 0:05:34there's only about a 10% chance that you get them back.
0:05:34 > 0:05:36This lady was pretty ill...
0:05:36 > 0:05:40in the first place and then had a cardiac arrest on top of it.
0:05:40 > 0:05:45So that was it, really. There was nothing we could do, unfortunately.
0:05:45 > 0:05:48So that's that. Back to the ward.
0:05:48 > 0:05:51All junior medics must come to terms with the fact
0:05:51 > 0:05:54that they can't save every patient.
0:05:54 > 0:05:58Junior doctors really are dealing with other people's lives
0:05:58 > 0:06:03and that's a huge, huge burden of responsibility.
0:06:03 > 0:06:06People feel that and they feel that quite acutely.
0:06:06 > 0:06:09It's a level of responsibility that most people
0:06:09 > 0:06:12would never have to deal with at any point in their lives,
0:06:12 > 0:06:15even when they're quite mature and could perhaps handle it.
0:06:15 > 0:06:18Junior doctors are 23, 24...
0:06:18 > 0:06:21That's a big deal at that age.
0:06:25 > 0:06:27Whether on a crash team or on a ward,
0:06:27 > 0:06:32junior doctors have to face life-and-death situations every day.
0:06:34 > 0:06:39First-year Lucy is starting her medical career on the specialist gastroenterology ward.
0:06:45 > 0:06:48That's a bit strange, our names are on the wall already.
0:06:48 > 0:06:50I know. That's scary, isn't it?
0:06:50 > 0:06:52No pressure.
0:06:52 > 0:06:58The gastro ward deals with all parts of the digestive system, from top to bottom.
0:06:58 > 0:07:02They treat patients with life-threatening bowel and liver disease.
0:07:02 > 0:07:05So Lucy's first experience of working as a doctor
0:07:05 > 0:07:09will be learning to treat some of the most seriously ill patients in the hospital.
0:07:09 > 0:07:14When I saw gastro was on here, it was one of the ones I wanted to get some experience on.
0:07:14 > 0:07:16It's a hard ward to work on.
0:07:16 > 0:07:21A lot of the alcoholic patients are hard to deal with because of their behaviour.
0:07:21 > 0:07:26It's either somewhere you love or you hate, there's no sort of in-between.
0:07:26 > 0:07:30So I guess with gastro, if you're a bit funny on bowels...
0:07:30 > 0:07:34If you don't like bowels and stool samples and things, it's not the place to work.
0:07:34 > 0:07:38With six million young people in the UK regularly binge drinking,
0:07:38 > 0:07:42the gastro ward is seeing many younger alcoholics.
0:07:42 > 0:07:47So 24-year-old Lucy is treating some patients her own age.
0:07:47 > 0:07:50There's a new lady in bed 12, she's an alcohol abuser.
0:07:50 > 0:07:52She's on the detoxing regime.
0:07:52 > 0:07:57She's been referred to the gastro ward to further assess her condition.
0:07:57 > 0:08:00Is the pain there all the time or does it come and go?
0:08:03 > 0:08:07Living situation, do you live by yourself?
0:08:07 > 0:08:09Live in a hostel. OK.
0:08:09 > 0:08:12- Do you mind me asking, do you smoke? - Yeah.
0:08:12 > 0:08:14How long have you smoked for?
0:08:17 > 0:08:20And do you smoke anything other than cigarettes at all?
0:08:20 > 0:08:23- No. Just that.- Just cigarettes, OK.
0:08:23 > 0:08:30And alcohol-wise, I understand you do drink and you're on a detox programme in here, is that right?
0:08:30 > 0:08:31What is it that you drink?
0:08:32 > 0:08:35How much do you reckon you have on an average day?
0:08:41 > 0:08:43- Is that every day?- Yeah.
0:08:58 > 0:09:01So the fact that you're not able to drink is telling you
0:09:01 > 0:09:03that you are very poorly, OK.
0:09:12 > 0:09:14Did that frighten you?
0:09:14 > 0:09:17You're in the right place now to get that sorted. Definitely. OK.
0:09:17 > 0:09:22'We are a similar age and that is a strange feeling, that we're in very different situations.
0:09:22 > 0:09:28'I hope that in talking to me or whoever manages her in the end,'
0:09:28 > 0:09:31it helps her to feel she's being listened to and not judged.
0:09:31 > 0:09:35I mean, I certainly wouldn't judge her for any of the decisions she's made
0:09:35 > 0:09:40because I don't know what's happened in the past, what's started her off with all of that kind of thing.
0:09:40 > 0:09:43It's not for me to say. The most important thing to me
0:09:43 > 0:09:47is if we can, we can get her off it and keep her off it.
0:09:47 > 0:09:48'Just had a chat with Laura.'
0:09:48 > 0:09:51I will go and look at those bloods,
0:09:51 > 0:09:53find her notes,
0:09:53 > 0:09:57and perhaps speak to Vijay about what to do next
0:09:57 > 0:10:00in terms of whether she needs to have that fluid taken off and sent off.
0:10:00 > 0:10:03- So I'll go and document all that. - Lovely. Thanks.- No problem.
0:10:03 > 0:10:08While Lucy is learning to deal with patients with long-term problems,
0:10:08 > 0:10:1324-year-old Jon is working at the sharp end of medicine on the Emergency Assessment Unit.
0:10:13 > 0:10:18When he's not responding to crash calls he has to deal with emergency cases sent in
0:10:18 > 0:10:21from other wards and from local GPs.
0:10:21 > 0:10:24It's one of the most demanding wards in the hospital.
0:10:24 > 0:10:26Hello, my name's Dr Barclay,
0:10:26 > 0:10:30I'm one of the doctors over at the Emergency Admissions Unit at the RVI.
0:10:33 > 0:10:38'We are the receiving ward all from GPs and all accident and emergency,'
0:10:38 > 0:10:41so it all comes and gets funnelled.
0:10:41 > 0:10:44Then some of these patients need to move on to other wards
0:10:44 > 0:10:48but there's a backlog in beds there, so basically we have to accept everyone.
0:10:48 > 0:10:51Yet there's nowhere to send anyone to.
0:10:51 > 0:10:54That's why it's the busiest ward in the hospital.
0:10:55 > 0:11:00The ward assesses up to 50 patients per shift.
0:11:00 > 0:11:04Jon must learn to separate the mundane from the life-threatening.
0:11:04 > 0:11:06A bit of everything, really.
0:11:06 > 0:11:09Just try and plough through the patients as much as possible.
0:11:09 > 0:11:13He's the ward's first line of defence.
0:11:13 > 0:11:16What I'm looking for really in a good junior doctor
0:11:16 > 0:11:17is the ability to manage patients.
0:11:17 > 0:11:19Not just to make the diagnosis.
0:11:19 > 0:11:25What we look for, we look for the transition from being a medical student to becoming a doctor.
0:11:25 > 0:11:30Jon's next patient has lost the feeling down one side of his body.
0:11:30 > 0:11:33Keep it in the air, don't let me push it down.
0:11:33 > 0:11:35Good. This one.
0:11:35 > 0:11:37Keep it on it in the air, don't let me push it down.
0:11:37 > 0:11:39Jon checks for nerve damage.
0:11:39 > 0:11:42It could be a sign of a stroke.
0:11:42 > 0:11:44- Ahh, got very tender feet!- Sorry!
0:11:44 > 0:11:47'When you run your pen down someone's foot'
0:11:47 > 0:11:50it makes their toes curl downwards, but if you have problems
0:11:50 > 0:11:54with the connections in your brain your toes can go upwards instead.
0:11:54 > 0:11:56He's passed the pen test.
0:11:56 > 0:12:00Next, Jon takes some blood for further investigation.
0:12:01 > 0:12:03Have you done this before?
0:12:03 > 0:12:07Just a few hundred times. Scratch.
0:12:07 > 0:12:09- All done.- Oh, sh...
0:12:11 > 0:12:13- Is that it?- That's it for needles.
0:12:13 > 0:12:15Don't forget me cheque!
0:12:15 > 0:12:20The key to Jon's role is prioritising the most serious patients.
0:12:20 > 0:12:22So I have a dilemma.
0:12:22 > 0:12:26These people came in 20 minutes beforehand,
0:12:26 > 0:12:29but this gentleman's slightly sicker.
0:12:31 > 0:12:33Swings and roundabouts, really.
0:12:33 > 0:12:35Let's see the sick guy, shall we?
0:12:35 > 0:12:38Jon's whole life is one big balancing act.
0:12:38 > 0:12:40MUSIC: "Song 2" by Blur
0:12:40 > 0:12:42Woo-hoo!
0:12:44 > 0:12:48I think it's fair to say that doctors have a reputation of work hard, play hard.
0:12:50 > 0:12:54'I do lots of stuff in my spare time. I play with drums in a band.'
0:12:57 > 0:13:00# You give love a bad name. #
0:13:00 > 0:13:01That was great, thank you.
0:13:01 > 0:13:07We have a job which is time-intensive so we don't get a lot of time off.
0:13:07 > 0:13:08And also it can be quite stressful.
0:13:08 > 0:13:11You can be under pressure a lot of the time.
0:13:11 > 0:13:15And so, when you do get a chance to let your hair down,
0:13:15 > 0:13:19a bit of a release, then you want to make the most of that, really.
0:13:27 > 0:13:29'Rugby has a bit of a niche'
0:13:29 > 0:13:34for people of my size and with my abilities.
0:13:36 > 0:13:39He's definitely a big part of the club both on and off the field.
0:13:39 > 0:13:41Size-wise, mainly!
0:13:42 > 0:13:45'Jon Barclay's acceleration is one of the finest you'll see'
0:13:45 > 0:13:49for a guy who is essentially a whale.
0:13:51 > 0:13:54'It can be hard to fit in with my schedule sometimes.
0:13:54 > 0:13:57'Today, I finished night shift this morning so I've been awake...'
0:13:57 > 0:13:59for 26 hours.
0:13:59 > 0:14:03I think it is important to have a life outside of medicine, definitely.
0:14:03 > 0:14:06If you just did medicine I would just get massively depressed.
0:14:06 > 0:14:08I'd get into a rut and it wouldn't be enjoyable any more.
0:14:08 > 0:14:12The time constraints of the job make it hard, but my job's my job.
0:14:12 > 0:14:14This is kind of my fun.
0:14:20 > 0:14:27ALL SING: # Jon Barclay, you suffer from morbid obesity
0:14:27 > 0:14:31# And you're gonna die young Jon Barclay. #
0:14:33 > 0:14:38Back at the hospital the Emergency Assessment Unit is getting busier.
0:14:38 > 0:14:42Hi, mate, are you still doing jobs from the morning? Have you been able to see anyone yet?
0:14:42 > 0:14:45Jon thrives on having lots to do.
0:14:45 > 0:14:48But he needs to prove he can stay on top of the workload.
0:14:48 > 0:14:50It's just frustrating.
0:14:50 > 0:14:53It's pretty busy today. All the beds are taken.
0:14:53 > 0:14:57We've still got people in the waiting room. I've got people I need to see
0:14:57 > 0:15:01but there aren't any rooms free to see people in.
0:15:01 > 0:15:04I don't know why it's such a busy day. It's just a terrible day.
0:15:04 > 0:15:07Sort this guy out, I'll see if the one up here is free.
0:15:07 > 0:15:10And his day isn't getting any easier.
0:15:10 > 0:15:12Another emergency case has arrived.
0:15:12 > 0:15:15A man has been admitted suffering a severe seizure.
0:15:15 > 0:15:18Jon has to try and diagnose the cause.
0:15:18 > 0:15:20You just had another fit.
0:15:20 > 0:15:24You bit your tongue which is why your mouth tastes a bit funny.
0:15:24 > 0:15:29I need to have a look in your mouth, Fred, to see where you bit your tongue.
0:15:31 > 0:15:36He's been admitted to us because he had an alcohol-withdrawal seizure.
0:15:36 > 0:15:40It means that when people drink excessively, when they stop drinking,
0:15:40 > 0:15:43go sort of teetotal, they go into withdrawal.
0:15:43 > 0:15:45Like you would from any other drug.
0:15:45 > 0:15:48So we need to give him enough medication to sort of calm him down a bit.
0:15:48 > 0:15:53Then we can do some investigations to try to get to the bottom of what's wrong with him.
0:15:53 > 0:15:57Jon has stabilised him but there's no let-up.
0:15:58 > 0:16:03I was supposed to see this lady about half an hour ago but the rooms were occupied. I just need to...
0:16:03 > 0:16:06And there's nothing else I can be doing. This is down time.
0:16:06 > 0:16:08I'm literally just waiting.
0:16:13 > 0:16:15A patient has been referred from A&E.
0:16:15 > 0:16:19She's suffering from a severe asthma attack.
0:16:19 > 0:16:22It's years since I've had such a bad attack.
0:16:22 > 0:16:26There's just no way to control it at all.
0:16:26 > 0:16:30And do you feel like you're struggling to catch your breath or...?
0:16:30 > 0:16:32It just seems like there's a blockage. You know?
0:16:32 > 0:16:35- Would you say your chest feels a bit tight?- Uh-huh. Yeah.
0:16:35 > 0:16:38Yes. It was like a brick. Uh-huh.
0:16:38 > 0:16:40Yeah. And it hasn't even eased off.
0:16:40 > 0:16:42- SHE WHEEZES - Just playing itself.
0:16:45 > 0:16:48Do you want to pop up on the couch for me? I'll have a quick examine.
0:16:48 > 0:16:50Just have a listen to your heart and your lungs.
0:16:50 > 0:16:52Then we'll get you sorted.
0:16:52 > 0:16:55Some nice deep breaths in and out through your mouth.
0:16:55 > 0:16:58SHE COUGHS AND WHEEZES
0:17:00 > 0:17:02She's got a history of lung disease,
0:17:02 > 0:17:05so Jon prescribes medication she can inhale
0:17:05 > 0:17:07to get to the root of the problem.
0:17:07 > 0:17:10We'll give you some nebulisers.
0:17:10 > 0:17:13Keep going with that and just try to get on top of that, OK?
0:17:13 > 0:17:15I'd love a cup of tea, actually.
0:17:15 > 0:17:17SHE LAUGHS
0:17:17 > 0:17:19I'll pass that on.
0:17:19 > 0:17:21Another patient dealt with.
0:17:21 > 0:17:24But there's always another to see on the EAU.
0:17:24 > 0:17:28His next job looks like an extreme case of athlete's foot.
0:17:28 > 0:17:30What's been going on with you, then?
0:17:30 > 0:17:36I was a fireman by profession and I got involved in a lot of different chemical jobs, type of things.
0:17:36 > 0:17:38- One doctor put it down to metallic poisoning.- Right.
0:17:38 > 0:17:42- Is it painful?- No.
0:17:42 > 0:17:45Jon prescribes a course of antibiotics.
0:17:46 > 0:17:50His ability under pressure hasn't gone unnoticed.
0:17:50 > 0:17:52His knowledge base is good,
0:17:52 > 0:17:56is sound. He's going to make a very, very safe doctor.
0:17:56 > 0:18:00I would be happy to be looked after by him. For a nurse to say that, that's quite good.
0:18:03 > 0:18:07As a second-year, Jon's responsibilities are growing.
0:18:07 > 0:18:13But on the gastro ward, Lucy's discovering that first-years often have to start at the bottom.
0:18:15 > 0:18:19I wonder whether she's passed some stools and they want me to have a look at it.
0:18:26 > 0:18:28Right, so if I just have a quick look...
0:18:28 > 0:18:32- Doesn't look like there's any blood or anything.- No, there's no blood in it.
0:18:32 > 0:18:36Just greeny, because obviously I've not experienced these things yet.
0:18:36 > 0:18:40Sweet smell. Green, very watery, isn't it?
0:18:40 > 0:18:44A green and watery stool is a sign of a serious infection.
0:18:44 > 0:18:47It could even be the deadly C Difficile bacteria.
0:18:50 > 0:18:53But even stool samples can't dent Lucy's passion for medicine.
0:18:54 > 0:18:59From a young age she's always known she wanted to be a doctor for a very particular reason.
0:19:01 > 0:19:04I've got a little sister, Sophie, she was diagnosed with cystic fibrosis.
0:19:04 > 0:19:06That encompasses a lot of care and treatment.
0:19:06 > 0:19:13From her coming home, really, from hospital during that time, I got involved in her care.
0:19:13 > 0:19:16It really made me want to go further with that kind of thing
0:19:16 > 0:19:19and obviously medicine is the perfect way to do that.
0:19:19 > 0:19:23On paper, the life expectancy, the prognosis isn't great.
0:19:23 > 0:19:27Obviously, that's hard for me and my family when you sit down and actually think about that,
0:19:27 > 0:19:30having someone who's so close to you with that kind of condition.
0:19:31 > 0:19:36It's good to have helpers. Very handy indeed. Makes it a much nicer process.
0:19:36 > 0:19:39Bananas, nuts and I'll add the chocolate chips in a minute.
0:19:39 > 0:19:42When Lucy gets stressed, Lucy gets baking.
0:19:45 > 0:19:47It might be time, Sophie, to test a bit.
0:19:50 > 0:19:55She is the older sister and always wants to look after the younger ones.
0:19:55 > 0:19:59Always feeling that maybe that's her role, but she enjoys it so much.
0:19:59 > 0:20:02The perfect older sister you could ask for, really.
0:20:02 > 0:20:08Lucy's sister is well at the moment but cystic fibrosis is a life-threatening condition.
0:20:08 > 0:20:15There are more than 8,500 sufferers in the UK, and they are often in and out of hospital.
0:20:20 > 0:20:26At the Royal Victoria, cystic fibrosis patients are treated on the hospital's respiratory ward,
0:20:26 > 0:20:31where Lucy's housemate and fellow junior Adam has his first job as a doctor.
0:20:31 > 0:20:37Cystic fibrosis affects the lungs and the pancreas. You get lots and lots of lung infections.
0:20:37 > 0:20:39Your lungs eventually fibrose,
0:20:39 > 0:20:43in that they harden up and shrink down.
0:20:43 > 0:20:47You are not able to produce a lot of the enzymes you need to break down
0:20:47 > 0:20:51foods and you don't absorb things very well.
0:20:51 > 0:20:54So you're malnourished and your lungs are screwed.
0:20:54 > 0:21:02Despite advances in treatment, half of today's sufferers won't survive beyond their 38th birthday.
0:21:02 > 0:21:04Patient Chris is 20 years old.
0:21:04 > 0:21:09What's it like being a young person in and out of hospital so much?
0:21:09 > 0:21:13It didn't used to bother us at all...
0:21:13 > 0:21:17when I first started coming in every two weeks.
0:21:17 > 0:21:21But when you start coming more often...
0:21:21 > 0:21:24I was in Christmas, my birthday.
0:21:24 > 0:21:28It's like my chest can't cope without IVs.
0:21:28 > 0:21:32So as soon as they wear off, I start to develop a cough during the night.
0:21:32 > 0:21:36- Then my appetite goes and I just end up back in.- Mm.
0:21:36 > 0:21:38It's like my Sunderland season ticket.
0:21:38 > 0:21:44- I can't buy one now cos I don't know when I'm going to be in here.- Yeah.
0:21:44 > 0:21:48Are you in hospital more than you are out of hospital at the moment or what?
0:21:48 > 0:21:51It's about 26 out of 52 weeks, yeah.
0:21:51 > 0:21:54Really? That's a lot of weeks in hospital.
0:21:54 > 0:22:01Cystic fibrosis sufferers are often in and out of hospital and they see a lot of junior doctors come and go.
0:22:01 > 0:22:04Next Adam is seeing 28-year-old Laura.
0:22:08 > 0:22:13- So how's it going? Shall we see if we can find some blood from you somewhere?- OK.
0:22:16 > 0:22:18Is that blood coming out?
0:22:18 > 0:22:21- Oh, yeah, it's blood coming out. - SHE LAUGHS
0:22:21 > 0:22:24Adam seems to be making a good impression.
0:22:24 > 0:22:26He's hilarious.
0:22:26 > 0:22:28Brightens your day, actually.
0:22:29 > 0:22:32You get some that are just not very...
0:22:32 > 0:22:36Kind of moody and stroppy teenagers
0:22:36 > 0:22:40cos they're all a lot younger these days, aren't they?
0:22:40 > 0:22:42Scrubs up well,
0:22:42 > 0:22:43as I would say.
0:22:43 > 0:22:45'You know, it's got to be hard for them.'
0:22:45 > 0:22:51I try and empathise as much as I can but it's limited.
0:22:55 > 0:23:02Cystic fibrosis patients bring the junior doctors face to face with the limitations of medicine.
0:23:02 > 0:23:06Lucy's finding out if she can cope with this at work,
0:23:06 > 0:23:10as she's treating other seriously ill patients on the gastro ward.
0:23:12 > 0:23:18It's the start of the shift and she's with consultant Dr Gunn on the ward round.
0:23:18 > 0:23:23Consultant runs the consultation with the patient and junior doctor runs around with the pen,
0:23:23 > 0:23:25scribbles in the notes and orders blood tests
0:23:25 > 0:23:28and writes all the things that need to be done.
0:23:28 > 0:23:30Usual notes hunt is going on.
0:23:32 > 0:23:36They are allegedly in here but they are not actually in here.
0:23:37 > 0:23:42A short history of diarrhoea, sent stools off and she's doing better.
0:23:42 > 0:23:43Fine.
0:23:43 > 0:23:45Let's go and see.
0:23:45 > 0:23:48The ward round is also a chance for juniors like Lucy
0:23:48 > 0:23:52to shadow senior doctors as part of their ongoing training.
0:23:52 > 0:23:55Dr Gunn is really good. She does teaching on the ward round as well.
0:23:55 > 0:23:57Should be a good learning experience.
0:23:57 > 0:24:01Dr Gunn's particularly concerned about one patient.
0:24:04 > 0:24:06She has been admitted with a swollen tummy.
0:24:06 > 0:24:09And you have been unwell on this occasion for how long now?
0:24:09 > 0:24:11It's been going on for 12 weeks.
0:24:11 > 0:24:14OK. And what is it you have been noticing?
0:24:14 > 0:24:17First of all I completely lost my appetite.
0:24:17 > 0:24:20I think I've lost at least a stone and a half.
0:24:20 > 0:24:22OK. Vomit?
0:24:22 > 0:24:24Yesterday.
0:24:24 > 0:24:27OK. Your tummy, then, when did that start to swell up?
0:24:27 > 0:24:30I'm not sure, but it's got increasingly worse.
0:24:30 > 0:24:33How are you with walking around?
0:24:33 > 0:24:36A bit wobbly.
0:24:37 > 0:24:38See you later, Nora.
0:24:38 > 0:24:42The patient has had a number of tests to determine the problem.
0:24:42 > 0:24:43Her X-ray is back.
0:24:43 > 0:24:48As part of her training, Dr Gunn asks Lucy to assess it.
0:24:48 > 0:24:51Bowel-wise, it looks like some gaseous dilation here on the left hand side.
0:24:51 > 0:24:55Here there is this sort of central dilated small bowel.
0:24:55 > 0:24:58We know she is obstructing radiologically
0:24:58 > 0:25:00and it sounds like clinically, because she is acutely distended.
0:25:00 > 0:25:07So she's in trouble. She has now got a fairly rapid change in her clinical status
0:25:07 > 0:25:12in the last six weeks and now got small bowel obstruction. She has not got a curative disease,
0:25:12 > 0:25:14we can't take this out with an operation.
0:25:14 > 0:25:16Chemotherapy is not particularly good.
0:25:16 > 0:25:18She's not going to be fit enough for it anyway.
0:25:18 > 0:25:21I need to assess her clinically but I have to say,
0:25:21 > 0:25:25my gut feeling is we should be conservative because I think this is only going to get worse.
0:25:25 > 0:25:29There isn't an operation to help with this, be that palliative or otherwise.
0:25:29 > 0:25:32Dr Gunn makes the final diagnosis.
0:25:32 > 0:25:34It's pancreatic cancer.
0:25:34 > 0:25:37In this case an operation won't help and the condition is terminal.
0:25:37 > 0:25:39Although she's poorly,
0:25:39 > 0:25:43she's got this bright-eyed happiness about her in a funny kind of way.
0:25:43 > 0:25:46Like she's here and she's being sorted. I don't know,
0:25:46 > 0:25:48I could be misreading it but I get the feeling
0:25:48 > 0:25:52she's not going to have any idea of what's about to be said.
0:25:55 > 0:25:57Dr Gunn must break the news,
0:25:57 > 0:25:58and Lucy accompanies her.
0:26:26 > 0:26:29This poor lady that we've seen today has been told some of the worst news,
0:26:29 > 0:26:32well, the worst news she's ever going to hear. Ever.
0:26:32 > 0:26:36Her life has literally been taken away from her like that,
0:26:36 > 0:26:39and she's just been told, "Right, you're going home to die."
0:26:39 > 0:26:44So...yeah. Anyway...
0:26:44 > 0:26:48Is there anything else you want me to do for her today? Is it all sorted?
0:26:48 > 0:26:52- OK.- Are you all right?- Yeah. - You sure? - LUCY CRIES
0:26:52 > 0:26:53I know it's sad, isn't it?
0:26:53 > 0:26:58She's, um, she's got good family support, which helps a lot
0:26:58 > 0:27:02and we'll get her feeling better, which is the important thing now,
0:27:02 > 0:27:05quality of life, which we can definitely improve on.
0:27:06 > 0:27:09- I'm fine.- I know, it's horrible. The difficulty of course...
0:27:09 > 0:27:12It's all right. Something just came over me.
0:27:12 > 0:27:14I won't be nice because I'll make you worse.
0:27:14 > 0:27:17- All right.- Thank you. That's it for today?
0:27:17 > 0:27:21- Brilliant. OK. No problem. - Thanks, Lucy.- That's all right.
0:27:25 > 0:27:29There's a lot of patients you can't save, if that's the word you use.
0:27:29 > 0:27:32You can improve on patients and that's what a lot of the goals are,
0:27:32 > 0:27:35not necessarily curing them but making them better.
0:27:35 > 0:27:40There are specific challenges, such as the patients who have advanced cancer who come in and die
0:27:40 > 0:27:42and that's very hard, I still find that very hard.
0:27:48 > 0:27:54After a 13-hour shift, Lucy's finally back at home with the other junior doctors.
0:27:56 > 0:27:58Are you OK?
0:27:58 > 0:27:59- Just knackered and had a- BLEEP- day.
0:27:59 > 0:28:01- Why was it a- BLEEP- day?
0:28:01 > 0:28:03Just this awful case.
0:28:03 > 0:28:08A patient has basically been told today that she's got pancreatic cancer.
0:28:08 > 0:28:12I don't know, I thought I would be able to keep my cool and I didn't really,
0:28:12 > 0:28:16- but luckily I was in the doctor's office at that point.- That's when it hits you.- Yeah.
0:28:16 > 0:28:20It just left me completely drained. I sat there and I was just like...
0:28:20 > 0:28:21Anyway, that was my day.
0:28:21 > 0:28:26- Do you need a hug? - Maybe. Thanks, Kier.
0:28:26 > 0:28:30'That was the first time I've been involved in any kind of breaking of bad news.'
0:28:30 > 0:28:33To be honest, I don't think it could have been worse bad news to be breaking
0:28:33 > 0:28:35'to somebody and their family.
0:28:35 > 0:28:40'I'm definitely learning at the moment that there is a limit to what we can do as medics.'
0:28:40 > 0:28:44We are only human, and in some ways in medicine, if we could all turn into the superhero,
0:28:44 > 0:28:47that would be great, not in the sense of ego,
0:28:47 > 0:28:51but in terms of actually being able to save people and cure everybody.
0:28:51 > 0:28:54It would be amazing, but that's never going to happen.
0:28:54 > 0:28:56Obviously, that's what we'd love to see.
0:28:57 > 0:29:03All the junior doctors know that tomorrow, it could be them facing the same situation.
0:29:15 > 0:29:19Suzi has been assigned to accident and emergency, where, every shift,
0:29:19 > 0:29:22she has to deal with critical cases.
0:29:27 > 0:29:29- Are you happy to shock? - I haven't shocked anyone.
0:29:29 > 0:29:35I have been at arrest calls before, but never in an A&E situation.
0:29:38 > 0:29:44Can you squeeze my fingers, please? Squeeze them.
0:29:44 > 0:29:48It's one of the doctors here. How are you feeling?
0:29:54 > 0:29:55Now back in A&E,
0:29:55 > 0:29:58she's facing another major trauma incident.
0:29:58 > 0:30:03A man has attempted suicide by jumping into the River Tyne.
0:30:03 > 0:30:08He was saved from drowning, but after 30 minutes in the river, his core body temperature has dropped
0:30:08 > 0:30:12and he's at risk of severe hypothermia.
0:30:12 > 0:30:17This gentleman's come in. He was in the River Tyne for about half an hour.
0:30:17 > 0:30:20So we have to get him warmed up.
0:30:22 > 0:30:24Sharp scratch coming now.
0:30:24 > 0:30:31An estimated 30,000 people die from exposure to the cold every year in the UK.
0:30:31 > 0:30:33Suzi attempts to bring his temperature back up slowly
0:30:33 > 0:30:36by pumping warm fluid into his bloodstream.
0:30:36 > 0:30:40- Have you had a drink, then, this evening?- That's all I've had.
0:30:42 > 0:30:47Finally, with his temperature stable, Suzi can check for other injuries.
0:30:52 > 0:30:55I was watching the telly this afternoon...
0:30:59 > 0:31:03Is that normally sore for you?
0:31:03 > 0:31:07- It is sore normally? - I've been drinking a lot.
0:31:07 > 0:31:12Could I ask you to take a big deep breath for me? And out?
0:31:12 > 0:31:15HIS CHEST RUMBLES
0:31:20 > 0:31:25That doesn't sound clear. Need to get him a chest X-ray. Saturday night.
0:31:25 > 0:31:29Everyone else is probably out having a drink. I'm here.
0:31:29 > 0:31:32- But I'm helping, so it's fine. What, sorry?- No drink.
0:31:32 > 0:31:33No drink, I know.
0:31:33 > 0:31:38He's stable and out of immediate danger. Suzi and the team have done all they can,
0:31:38 > 0:31:44but he'll have to be referred on to another department for further treatment.
0:31:51 > 0:31:58Also working nights for the first time is Suzi's housemate, 24-year-old Katherine.
0:31:58 > 0:32:03She's a first-year, on call and part of a team covering up to 280 surgical patients.
0:32:03 > 0:32:07With only a couple of weeks' experience as a fully fledged doctor,
0:32:07 > 0:32:09her skills are being severely tested.
0:32:09 > 0:32:12When the pain comes on, do you get any other symptoms?
0:32:12 > 0:32:14Hello, Joyce.
0:32:14 > 0:32:18Can't seem to be able to order any bloods on the computer...
0:32:19 > 0:32:22No-one else seems to be having any problems.
0:32:22 > 0:32:28In her first few weeks, Cambridge graduate Katherine found the workload tough.
0:32:28 > 0:32:30I've just got so much stuff to do.
0:32:30 > 0:32:33I've already got a patient that's been waiting for an hour and a half.
0:32:33 > 0:32:35Cross this out for now.
0:32:35 > 0:32:39I will come back and do that when... I've got quite a lot of jobs to do.
0:32:39 > 0:32:43Right. Let's just stop, then.
0:32:43 > 0:32:47I don't think I appreciated how difficult it is when you're just
0:32:47 > 0:32:54literally being bombarded with jobs to do and everything has to be done in the next ten minutes.
0:32:54 > 0:32:57But now Katherine is working nights,
0:32:57 > 0:33:01a job which brings its own particular challenges.
0:33:03 > 0:33:05It's been pretty busy. Haven't had a break yet.
0:33:05 > 0:33:08I'm pretty tired.
0:33:08 > 0:33:11But no more tired than I would be on the day shifts
0:33:11 > 0:33:16if I'd not had a break until this time anyway, so not too bad.
0:33:16 > 0:33:23Been working... I don't know how many hours, since 8.30 yesterday evening.
0:33:23 > 0:33:26I'm getting quite tired.
0:33:26 > 0:33:31Another patient has arrived and needs a small tube, called a cannula,
0:33:31 > 0:33:38inserted into a vein to allow them to get fluid and medication directly into the patient's bloodstream.
0:33:38 > 0:33:42But this patient doesn't like the sight of her own blood.
0:33:42 > 0:33:46- Let's decide which vein to go for. - I don't look when you put the needle in me.
0:33:46 > 0:33:50I'll let you know when I'm going to put the needle in, so you can look away.
0:33:50 > 0:33:53Sharp scratch.
0:33:53 > 0:33:59- I just don't like to see the blood go out.- All right.
0:34:03 > 0:34:05Could you give me a hand?
0:34:05 > 0:34:08Sorry, this needle's just about to drop out.
0:34:08 > 0:34:10Oh, I think it's coming off.
0:34:10 > 0:34:17- Have you got it now?- Nearly done. Gosh, it's now stuck to the pillow.
0:34:21 > 0:34:25Sorry. The little bung popped out on the end of the cannula.
0:34:25 > 0:34:30We'll just clean it up a bit. The main thing is that it's in and we can give you some fluids.
0:34:30 > 0:34:37Finally, the tube is in, minus a bit of blood, and the patient can get the fluids she needs.
0:34:37 > 0:34:40(It's hard to concentrate when you're really tired.
0:34:40 > 0:34:45(You just have to be careful and be extra cautious
0:34:45 > 0:34:48(and recognise your limitations.)
0:34:52 > 0:34:57All the juniors are learning just how far they can stretch themselves.
0:34:58 > 0:35:02Jon's pushing his limits. He's finished his day job,
0:35:02 > 0:35:05but he's just getting started on a night shift of his own.
0:35:08 > 0:35:11At the moment, we're setting up for the gig.
0:35:11 > 0:35:14We'll do a sound check in a minute when our fourth member finally arrives.
0:35:15 > 0:35:19I just hit myself in the face with a cymbal! That was pretty painful.
0:35:19 > 0:35:22Jon works hard to fit in a social life,
0:35:22 > 0:35:28but even away from the hospital, he can't escape the pressures of being a doctor.
0:35:28 > 0:35:32I'm covering urology on nights next week, and I've never done urology.
0:35:32 > 0:35:40We had a guy in today, a young kid, 17, who had right-testicle pain, swollen for about a week.
0:35:40 > 0:35:44- Did a- BLEEP- ultrasound. It's been dead for two weeks.
0:35:44 > 0:35:46He must have a high pain threshold.
0:35:46 > 0:35:49- What's happened to his testicle? - It got removed.
0:35:49 > 0:35:52Medics tend to talk about medicine outside of work,
0:35:52 > 0:35:58which is really boring. I try my hardest not to, because I talk about it for ten hours a day at work.
0:35:58 > 0:36:01I try not to talk about it in the evenings.
0:36:01 > 0:36:05But I live with medics and I play in a band with medics.
0:36:05 > 0:36:07I play rugby with medics.
0:36:07 > 0:36:12So you kind of end up reverting to horrible medic chat. But it's all right.
0:36:12 > 0:36:16THEY PLAY "Sex On Fire"
0:36:43 > 0:36:46All the junior doctors are learning that it's not the kind of job
0:36:46 > 0:36:48you can leave behind at the end of the day.
0:36:48 > 0:36:51The pressure of work is always on your mind.
0:36:51 > 0:36:57After a run of relentless night shifts, Katherine and Suzi are taking time off to hit the shops.
0:36:57 > 0:37:02Bit of retail therapy's quite good after a stressful weekend on call.
0:37:02 > 0:37:07But even shopping can't keep them off the topic of work for long.
0:37:07 > 0:37:12How do you think everything's going anyway, with work and stuff?
0:37:12 > 0:37:19When I first started on call, I felt completely thrown in at the deep end. And it was horrible.
0:37:19 > 0:37:20I hated my first day on call.
0:37:20 > 0:37:26There'll be days when you wish that the ground would swallow you up there and then,
0:37:26 > 0:37:29or when something bad happens or when it's stressful.
0:37:29 > 0:37:33And you can't get everything done, because you're not Superman.
0:37:35 > 0:37:39Every day, Suzi works long shifts and treats critical cases.
0:37:39 > 0:37:42The work impacts on all areas of her life.
0:37:42 > 0:37:46And even though she's making life-and-death decisions at work,
0:37:46 > 0:37:52she still needs a bit of help from Mum and Dad when it comes to tidying her room.
0:37:52 > 0:37:55I haven't had time to tidy.
0:37:59 > 0:38:03Oh, Suzi! Right, bin liner and skip, Suzi.
0:38:03 > 0:38:08I'm wondering why I can't find anywhere to walk.
0:38:08 > 0:38:12I was up till 1.00 tidying last night!
0:38:14 > 0:38:15What's this here for?
0:38:15 > 0:38:20- I was cleaning the surface. - You keep telling us that normal life is impossible.
0:38:20 > 0:38:23Normal life IS impossible!
0:38:23 > 0:38:27Last week, I worked five 14-hour shifts and two 12-hour shifts.
0:38:27 > 0:38:35I then came home, went to sleep, got up, had a shower, ate some chocolate and went back to work again.
0:38:35 > 0:38:38Suzi has made us proud. That little girl, and we've got pictures of her
0:38:38 > 0:38:46in all sorts of ridiculous poses, is now responsible and doing things which we can only imagine.
0:38:46 > 0:38:51Oops. Can I get back into bed for the rest of the day?
0:38:51 > 0:38:54Your room look like you've spent the last week in bed anyway.
0:38:54 > 0:38:59It is difficult to see her doing what I know she must be doing,
0:38:59 > 0:39:04because she's just our daughter, and...
0:39:05 > 0:39:09The mother would like to get into the hospital and just see her working.
0:39:09 > 0:39:13I would love to see her working. I have no idea what she looks like.
0:39:13 > 0:39:18Yes, I would love to be a fly on the wall when she's in the wards.
0:39:18 > 0:39:22I don't want you to overdo it today. Don't get stressed out.
0:39:22 > 0:39:25Let's go and crack this egg open.
0:39:25 > 0:39:28Right, Suzi, coffee time!
0:39:39 > 0:39:43At the hospital, Lucy is back on the gastro ward.
0:39:43 > 0:39:48It's her first shift since her patient was diagnosed with terminal pancreatic cancer,
0:39:48 > 0:39:52and Lucy's first thought is to find out how she's doing.
0:39:52 > 0:39:56On Saturday, she was quite well.
0:39:56 > 0:40:00She was managing to drink and keep everything down. She wasn't feeling nausea.
0:40:00 > 0:40:03On the Sunday when I came in, she wasn't well at all.
0:40:03 > 0:40:08She couldn't get out of bed, and her blood pressure dropped and her sats dropped.
0:40:08 > 0:40:11It was all in a two-hour period.
0:40:11 > 0:40:16- She passed away. Her family were with her, though.- Oh, good. - She didn't suffer for long.
0:40:16 > 0:40:21- It wasn't playing on her mind. - Yeah. That's really sad.
0:40:29 > 0:40:31Hello, this is Lucy, F1.
0:40:31 > 0:40:35Hi. Yeah.
0:40:35 > 0:40:37Thank you. Bye.
0:40:39 > 0:40:43That was the bereavement office asking me to come and do the death certificate.
0:40:43 > 0:40:46So that's going to be a nice job.
0:40:46 > 0:40:52It's another first for Lucy, but one she would rather do without.
0:40:52 > 0:40:55I don't think it would matter how much talking about it you do,
0:40:55 > 0:41:00no matter how many seminars you have or how many times someone told you about it,
0:41:00 > 0:41:03it never prepares you for when it actually comes to it.
0:41:09 > 0:41:14It's part of the job, unfortunately, and it's one side of it that isn't a nice side, really.
0:41:35 > 0:41:40Lucy's first few weeks on the gastro ward have been a steep learning curve.
0:41:40 > 0:41:46Her housemate Katherine also found it tough on her first set of night shifts, but today she's back on days
0:41:46 > 0:41:49and is feeling much more confident.
0:41:49 > 0:41:55I've been enjoying my job this week, because I don't feel kind of...
0:41:55 > 0:42:01Yeah, I'm busy, but not to a degree where I feel I'm doing a rubbish job.
0:42:01 > 0:42:04Also, none of the patients seem to be getting sick this week.
0:42:04 > 0:42:07Last week, they were all getting sick, which uses up a lot of time.
0:42:07 > 0:42:14Her next patient, 29-year-old Malcolm, has had minor surgery on his finger.
0:42:14 > 0:42:17But now he's complaining of chest pains.
0:42:17 > 0:42:21I've been feeling pain since yesterday morning, but I think it's just to do with work.
0:42:21 > 0:42:26- I think it's just muscle pain. - So it's quite a problem having this pain?
0:42:26 > 0:42:28It's just when I do heavy lifting.
0:42:29 > 0:42:32Did it come on suddenly or gradually?
0:42:32 > 0:42:34- Just gradually.- Do you smoke?
0:42:34 > 0:42:38- Yeah.- Do you drink?- Yeah.
0:42:38 > 0:42:41How many units would you say a week?
0:42:41 > 0:42:45I'm not sure. Probably about 60 pints a week.
0:42:45 > 0:42:48- 60?- I don't know what that is.
0:42:48 > 0:42:52- Sorry, 16 or 60?- 60.
0:42:54 > 0:42:57He drinks about 180 units a week,
0:42:57 > 0:43:02which...is way, way, way over what you should be drinking.
0:43:02 > 0:43:06Katherine is concerned and decides to investigate further.
0:43:13 > 0:43:18From the history, I'm not worried about your heart. The pain's more
0:43:18 > 0:43:24around there? On a typical day, how much would you say you drank?
0:43:24 > 0:43:28All-day sessions. I was drinking 16, 18 pints.
0:43:29 > 0:43:32Do you know if you've ever had any tests done on your liver?
0:43:32 > 0:43:34- No, I haven't.- OK.
0:43:34 > 0:43:39Because when I was feeling, I thought maybe your liver was slightly enlarged.
0:43:39 > 0:43:45I might ask one of my senior colleagues what they think because it's quite a large amount to drink.
0:43:45 > 0:43:52I went to see this guy... This guy, yeah. He's only 29, 30.
0:43:52 > 0:43:56I was taking his social history and he drinks 60 pints a week.
0:43:56 > 0:43:59And I think he's got a bit of an enlarged liver.
0:43:59 > 0:44:0460 pints a week is 120-something units. It's a good spot.
0:44:04 > 0:44:06I thought it was the sort of thing
0:44:06 > 0:44:09I didn't feel I could go home at the end of the day
0:44:09 > 0:44:11having done nothing about.
0:44:11 > 0:44:15So it was good to talk to Ian to talk me through what I should do about it
0:44:15 > 0:44:20and reassure me that I was right to think that it should be followed up.
0:44:20 > 0:44:22If you pop back to the day room...
0:44:22 > 0:44:26Katherine sends the patient for further tests on his liver.
0:44:30 > 0:44:35A successful diagnosis is a boost to confidence. But a few weeks in,
0:44:35 > 0:44:37Katherine is still finding her feet.
0:44:37 > 0:44:40I think it'll be a while still before I settle in.
0:44:40 > 0:44:45I don't feel massively confident about my organisational skills yet
0:44:45 > 0:44:49or my time-management skills. I still need to work on a lot.
0:44:49 > 0:44:53I think I'm getting better, slowly.
0:44:55 > 0:45:00Fellow junior doctor Adam is also still finding his way.
0:45:00 > 0:45:05He's getting to know some of the regular patients on the respiratory ward,
0:45:05 > 0:45:09and he's realising the limits to the care he can give them.
0:45:09 > 0:45:11Are you comfortable there, sir?
0:45:11 > 0:45:1681-year-old John is suffering from an advanced chronic lung disease.
0:45:16 > 0:45:17You sure?
0:45:19 > 0:45:22You look all skew-whiff.
0:45:27 > 0:45:29Just put that cushion up there...
0:45:29 > 0:45:31Yeah, there you go.
0:45:31 > 0:45:33That'll do.
0:45:33 > 0:45:35'He's not really too well. He's on oxygen.'
0:45:35 > 0:45:41He's got quite advanced lung disease and he had a heart attack
0:45:41 > 0:45:45over the weekend as well, which didn't help matters.
0:45:45 > 0:45:48He's a really nice guy, though, so I hope he pulls through.
0:45:48 > 0:45:52But the reality is, he's probably only got a short amount
0:45:52 > 0:45:54of time to live, and he knows that.
0:45:54 > 0:45:59Adam can't cure him. He can just make him feel more comfortable.
0:45:59 > 0:46:04I'm going to write you up for that spray that makes the blood vessels wider,
0:46:04 > 0:46:07so if you do get any pain, please tell the nurses.
0:46:10 > 0:46:11Well, I will take a bit.
0:46:14 > 0:46:16Yeah, they call me a vampire.
0:46:16 > 0:46:20I can't believe I've got such a bad reputation.
0:46:33 > 0:46:34Is that smoking-related?
0:46:42 > 0:46:46If you do get any pain in the chest, let one of the nurses know, OK?
0:46:46 > 0:46:47Don't just sit on it.
0:46:47 > 0:46:50If we can do something about it, we can do something about it.
0:46:52 > 0:46:57The blood bank's full now. Until tomorrow! See you in a bit.
0:46:59 > 0:47:05Adam has spent five years learning how to save lives, but he can't cure John.
0:47:06 > 0:47:10It's difficult when you start to form relations with people on the ward
0:47:10 > 0:47:16when you know that realistically, they're relatively terminal.
0:47:20 > 0:47:24Really pisses me off that he has to sit there and endure
0:47:24 > 0:47:29a quality of life that he doesn't enjoy. It just really pisses me off.
0:47:30 > 0:47:35If that was me and my quality of life was like that
0:47:35 > 0:47:39and I didn't have any choice in the matter and I had to be kept going,
0:47:39 > 0:47:41- I would be really- BLEEP- pissed off.
0:47:52 > 0:47:56The new doctors are all facing the limits to modern medicine
0:47:56 > 0:48:00and of their own abilities to help patients.
0:48:00 > 0:48:05I had a patient I sent home last week who came back in via resus.
0:48:05 > 0:48:12Obviously when I heard that, I was like, "Crap, could I have done anything earlier?"
0:48:12 > 0:48:14But when I saw her, she was fine.
0:48:14 > 0:48:20Her tummy was soft, her obs were fine, there was no indication that anything bad was going to happen.
0:48:20 > 0:48:23You always think, "Would anyone else have kept her there?
0:48:23 > 0:48:25"Should I have done anything else?"
0:48:25 > 0:48:31But then I spoke to the consultant and he said, "You aren't able to see into the future.
0:48:31 > 0:48:36"There's no way of knowing if someone's fine, that they're going to get sick."
0:48:36 > 0:48:38It'd be a really easy job then.
0:48:38 > 0:48:40But it's not.
0:48:40 > 0:48:45There'll always be good days and bad days and some of the bad days are like the worst days ever.
0:48:45 > 0:48:49There is a huge problem, and one that can't be avoided,
0:48:49 > 0:48:55of people expecting us to be perfect.
0:48:55 > 0:48:59We're only human. We're like everybody else.
0:48:59 > 0:49:02The only difference is that we've been to medical school.
0:49:02 > 0:49:05We've been trained. That's the only difference.
0:49:05 > 0:49:10If you could have one superhero power that wasn't the power of healing
0:49:10 > 0:49:14to help you as a doctor, what would it be?
0:49:14 > 0:49:18I'd like to be able to see into the future and know who was going to get sick and treat them
0:49:18 > 0:49:22right as they got sick, and then they'd be fine again.
0:49:22 > 0:49:25But that will never happen, which is why it's hard being a doctor.
0:49:25 > 0:49:32I would like the ability to know where anything was just by thinking about it.
0:49:32 > 0:49:36Not to summon it to your hand?
0:49:36 > 0:49:41It's a very simple thing, knowing where everything is in every IV room or in every crash trolley,
0:49:41 > 0:49:44or simply where the gallstone is or the tumour...
0:49:44 > 0:49:51Just that ability would cut out an awful lot of wasted time.
0:49:51 > 0:49:56I would want something like X-ray vision, with telekinesis.
0:49:56 > 0:50:01I can just see the tumour and fix it without opening up the patient.
0:50:02 > 0:50:07All yours are really interesting. What I'd have is, I'd have this
0:50:07 > 0:50:13unstable DNA that could take all your powers and absorb all of them and put them together,
0:50:13 > 0:50:16and then I'd be a super superhero and it would be amazing.
0:50:19 > 0:50:24One housemate, Jon, is still at work. He may not have any superpowers,
0:50:24 > 0:50:29but in an emergency, he can be a patient's best chance of survival.
0:50:29 > 0:50:32It's not long before he has another emergency on his hands.
0:50:34 > 0:50:37The crash alarm has gone off again.
0:50:37 > 0:50:39Another patient needs urgent assistance.
0:50:39 > 0:50:43Level 2 rehabs place. I don't know where that is.
0:50:45 > 0:50:47Cardiac arrest.
0:50:47 > 0:50:49I've got to find the place first.
0:50:49 > 0:50:52I'll have to see what happens when we get there.
0:50:52 > 0:50:58The quicker he can get to the patient, the greater the chance of survival.
0:50:58 > 0:51:02- I've got to find out where... - Like the other cardiac arrest he was called to,
0:51:02 > 0:51:09it's a life-and-death situation, but the odds are stacked against Jon and the team.
0:51:11 > 0:51:12To the left or right?
0:51:14 > 0:51:15Which way?
0:51:18 > 0:51:21More than 90% of cardiac arrest victims die.
0:51:30 > 0:51:33Just going to move you on to the bed. Someone support his head.
0:51:33 > 0:51:36Breathe, one, two, three.
0:51:36 > 0:51:40The patient's heart rate is crashing.
0:51:40 > 0:51:45The team must stabilise his heart's rhythm, or else the man
0:51:45 > 0:51:47will go into full heart failure.
0:52:02 > 0:52:06Could you roll off a couple of bits of that? Not very long.
0:52:30 > 0:52:34Finally, they get his heart rate back to normal.
0:52:34 > 0:52:38That was a cardiac arrest call.
0:52:38 > 0:52:42This guy didn't actually have a cardiac arrest, he was in what we say is peri-arrest.
0:52:42 > 0:52:44His signs were looking bad,
0:52:44 > 0:52:47so his heart rate was low and his blood pressure had dropped
0:52:47 > 0:52:53and he looked like he might have a cardiac arrest, so we basically pre-empted it.
0:52:53 > 0:52:57Turns out by the time we got there, we just did simple things.
0:52:57 > 0:53:00Put in some lines in the arms, put up some fluid,
0:53:00 > 0:53:02got him on a monitor. He wasn't in too bad a shape.
0:53:04 > 0:53:08Back to the ward, and the end of another long shift.
0:53:09 > 0:53:11- See you later, guys.- See you!
0:53:14 > 0:53:18When you go to an arrest call, everyone else has different roles,
0:53:18 > 0:53:19whether it's sort of...
0:53:21 > 0:53:24Oh, crap, there's a lady over there on the floor.
0:53:26 > 0:53:29But a junior doctor's work is never done.
0:53:29 > 0:53:32Jon, quick!
0:53:32 > 0:53:34A patient has collapsed in the corridor.
0:53:36 > 0:53:38Hello?
0:53:38 > 0:53:40Jon checks for vital signs.
0:53:43 > 0:53:46Her heart's still beating and she's breathing.
0:53:46 > 0:53:48She's pretty wheezy.
0:53:55 > 0:53:57There we are.
0:53:58 > 0:54:01What's the matter? Is it shortness of breath?
0:54:01 > 0:54:04- What happened?- Hello, lovely. Ready? One, two, three.
0:54:18 > 0:54:23To find out the cause of the collapse, she'll need further tests back on the ward.
0:54:23 > 0:54:27Wow! Exciting.
0:54:27 > 0:54:30And Jon can finally head home.
0:54:30 > 0:54:32Bye-bye!
0:54:41 > 0:54:43It's the end of the month.
0:54:43 > 0:54:48After four weeks of learning the ropes and facing the limits of their abilities,
0:54:48 > 0:54:52juniors across the country have been paid their first ever wage packets.
0:54:52 > 0:54:53Except one.
0:54:53 > 0:54:57Please be paid, please be paid.
0:54:57 > 0:55:01The only one who hasn't received a pay slip.
0:55:01 > 0:55:07I think I gave them the wrong... the wrong National Insurance number.
0:55:10 > 0:55:15Yes, I got paid! £99 in credit. Sweet!
0:55:19 > 0:55:24The basic wage for a junior doctor is about £22,500,
0:55:24 > 0:55:29and they're all splashing their new hard-earned cash at the traditional pay-day party.
0:55:32 > 0:55:35You've worked for a month without being struck off.
0:55:35 > 0:55:36That is an achievement.
0:55:36 > 0:55:37It is an achievement!
0:55:37 > 0:55:40Every month, that's what I think to myself.
0:55:40 > 0:55:46"I have not yet been struck off." Here's to a good job well done.
0:55:49 > 0:55:54Next time, is Suzi cut out for the highs and lows of A&E?
0:55:54 > 0:55:56I feel...distressed.
0:55:59 > 0:56:01Is Kier cut out to be a surgeon?
0:56:01 > 0:56:04Patient's looking a bit jaundiced for my liking.
0:56:04 > 0:56:09And after all their training, is medicine really the career for them?
0:56:09 > 0:56:12Basically, days like today make me want to quit medicine.
0:56:20 > 0:56:23Subtitles by Red Bee Media Ltd
0:56:23 > 0:56:25Email subtitling@bbc.co.uk