0:00:04 > 0:00:06Emergencies...
0:00:09 > 0:00:10Have we got paddles on?
0:00:10 > 0:00:12..bad behaviour...
0:00:13 > 0:00:14..bedside battles...
0:00:14 > 0:00:16Alfie, Alfie, Alfie...
0:00:16 > 0:00:19..and buckets of blood.
0:00:19 > 0:00:21It's a tough job being a doctor.
0:00:22 > 0:00:25It's even tougher when they're young...
0:00:25 > 0:00:27Am I right or not?
0:00:27 > 0:00:31I feel like a child, really, cos in their eyes I think you probably are.
0:00:31 > 0:00:33..untried...
0:00:33 > 0:00:37I said to her, "I want the nurse, please don't touch it."
0:00:37 > 0:00:39The first time any of us do anything,
0:00:39 > 0:00:40we're going to be ...
0:00:40 > 0:00:42..and inexperienced.
0:00:42 > 0:00:44Everyone's in the same boat.
0:00:44 > 0:00:45Push it through...
0:00:45 > 0:00:47No-one knows what they're doing.
0:00:47 > 0:00:49But after years of studying...
0:00:49 > 0:00:51Oh! Oh dear.
0:00:51 > 0:00:56..it's time to put theory into practice on medicine's frontline.
0:00:56 > 0:01:00Facing the biggest challenge of their lives are eight junior doctors.
0:01:00 > 0:01:02Clear!
0:01:02 > 0:01:04CHEERING
0:01:04 > 0:01:06The youngest - 22-year-old Andy.
0:01:06 > 0:01:10The first day I start I will be terrified, honestly, I will be.
0:01:10 > 0:01:12Self-confessed princess, Priya.
0:01:12 > 0:01:15- Your tea.- Thank you, good morning.
0:01:15 > 0:01:18I get pampered, bless my parents, they do everything for me.
0:01:18 > 0:01:20Outgoing Aki.
0:01:20 > 0:01:23Some people describe me as Kensington meets rock 'n' roll.
0:01:23 > 0:01:26Chelsea girl Milla.
0:01:26 > 0:01:29This is by the Queen's hatmaker, isn't it?
0:01:29 > 0:01:32I love going to balls, I get invited to many of them.
0:01:32 > 0:01:35From a family of doctors, Sameer.
0:01:35 > 0:01:37I don't feel like a real doctor yet.
0:01:37 > 0:01:40At the moment I feel like a fake doctor.
0:01:40 > 0:01:42Rugby player Ben.
0:01:42 > 0:01:44Rugby's something you have to put 100% into.
0:01:44 > 0:01:47I always expect 100% of myself.
0:01:47 > 0:01:48Laid-back Amieth.
0:01:48 > 0:01:52I quite enjoy watching life unfolding in front of me.
0:01:52 > 0:01:54Lucy, the perfectionist.
0:01:54 > 0:01:57I don't feel like a doctor, and now it's come round I think,
0:01:57 > 0:02:00"Just go away and leave me for another year, I'm not ready!"
0:02:01 > 0:02:03After a rigorous induction...
0:02:03 > 0:02:05Bit more help, the patient is responding.
0:02:05 > 0:02:08They'll be starting in one of London's busiest hospitals.
0:02:08 > 0:02:09BABY CRYING
0:02:09 > 0:02:11I'm sorry.
0:02:11 > 0:02:12Dealing with life...
0:02:12 > 0:02:14and death...
0:02:14 > 0:02:16Any pulse?
0:02:16 > 0:02:17..highs...
0:02:17 > 0:02:19I'm so happy.
0:02:19 > 0:02:20..lows...
0:02:20 > 0:02:24It's just complete ..., basically.
0:02:24 > 0:02:25..and the unexpected.
0:02:25 > 0:02:28You know how you have those receipt spikes?
0:02:28 > 0:02:30She's impaled her hand on that.
0:02:32 > 0:02:35But have they got what it takes to be doctors?
0:02:35 > 0:02:38The patient I saw earlier has fainted.
0:02:38 > 0:02:41If you made a bad mistake, worst case scenario
0:02:41 > 0:02:44someone could die, simple as that, really.
0:03:04 > 0:03:10This house in south-west London is home to our eight junior doctors.
0:03:10 > 0:03:12Can we get six large pizzas, please?
0:03:12 > 0:03:14They're all about to start new jobs.
0:03:16 > 0:03:20Do we know what these are, or are we just guessing?
0:03:28 > 0:03:31I would like us to toast to an amazing year, actually,
0:03:31 > 0:03:35and hopefully an incredible start to our careers - cheers.
0:03:35 > 0:03:39Six are first years and have never been doctors before.
0:03:39 > 0:03:43If they work out you're useless in the first few days,
0:03:43 > 0:03:45it's not a good place to be, probably.
0:03:45 > 0:03:49I've got an awful memory, and I really have to work around that.
0:03:49 > 0:03:52Just make sure you write everything down.
0:03:52 > 0:03:54I do, but then I lose my paper.
0:03:54 > 0:03:57Second years Amieth and Ben have only 12 months experience
0:03:57 > 0:04:01and are facing new challenges in a new hospital.
0:04:01 > 0:04:04How did you guys feel on your first day, in your first week?
0:04:04 > 0:04:05Petrified.
0:04:05 > 0:04:09It's terrifying, and the first set of nights are horrible.
0:04:09 > 0:04:10Oh, no!
0:04:10 > 0:04:13OK, I'm not going to ask you any more questions!
0:04:13 > 0:04:16Is anyone up for a revision session tonight?
0:04:17 > 0:04:18No.
0:04:18 > 0:04:21I need to go through my finals notes.
0:04:28 > 0:04:31Even after six years at medical school,
0:04:31 > 0:04:34apprehensive Aki is getting in some last-minute revision.
0:04:34 > 0:04:37I'm going to be a little bit nervous on the first day.
0:04:37 > 0:04:43Especially when you're looking after some pretty sick patients,
0:04:43 > 0:04:49they could deteriorate quite quickly, so I want to make sure I'm prepared.
0:04:58 > 0:05:02ALARM BEEPING
0:05:08 > 0:05:12Everything our junior doctors have trained for starts today.
0:05:12 > 0:05:16I'm not going to lie, I am quite nervous about it.
0:05:16 > 0:05:19It's exactly the same feeling as starting a different job.
0:05:19 > 0:05:22I've done other drops before, and that's the same,
0:05:22 > 0:05:26or starting school, but I guess you've got that added pressure
0:05:26 > 0:05:31that it's people's lives, rather than, erm...schoolwork.
0:05:33 > 0:05:36- See you later, man.- Enjoy. - See you this evening.
0:05:36 > 0:05:38Across Britain, it's the same story...
0:05:38 > 0:05:39See you later.
0:05:39 > 0:05:43Thousands of junior doctors are facing their first shifts on the wards.
0:05:43 > 0:05:47For ours, it's an early start - except for one.
0:05:47 > 0:05:48I've just woken up,
0:05:48 > 0:05:52but it's good because my shift actually starts at 11 o'clock,
0:05:52 > 0:05:55so I have a nice bit of a lie in on my first day,
0:05:55 > 0:05:57I can have a leisurely breakfast.
0:05:59 > 0:06:02That's my bus!
0:06:04 > 0:06:07You're listing to Radio Chelsea and Westminster,
0:06:07 > 0:06:10broadcasting live from the hospital here on the Fulham Road.
0:06:10 > 0:06:13If you spot one of our new recruits, be sure to give them a cheery
0:06:13 > 0:06:18welcome and please be patient as they settle in and learn the ropes.
0:06:18 > 0:06:20Hi, it's my first day, I'm Andy.
0:06:20 > 0:06:24We're your new doctors, my name's Lucy.
0:06:24 > 0:06:26It is historically known as Black Wednesday,
0:06:26 > 0:06:31because it is the day that junior doctors arrive on the ward.
0:06:31 > 0:06:34We're the new doctors, we thought we'd introduce ourselves early.
0:06:34 > 0:06:36It is renowned within nursing
0:06:36 > 0:06:40that the changeover period on that day in August can be very fraught,
0:06:40 > 0:06:44so most of the time if you're sensible you don't roster yourself to work.
0:06:49 > 0:06:51Hello, Mr Straw.
0:06:51 > 0:06:54How are you feeling today?
0:06:54 > 0:06:57Andy's first job is in trauma and orthopaedics,
0:06:57 > 0:06:59dealing with bone and joint problems.
0:06:59 > 0:07:05OK, so I'm going to have a go at doing, erm,
0:07:05 > 0:07:07a cannula, if that's all right?
0:07:07 > 0:07:10He's fitting a device called a cannula to Mr Straw.
0:07:10 > 0:07:15It's a difficult job, but one every junior doctor has to master.
0:07:15 > 0:07:16All right.
0:07:16 > 0:07:19OK, so, sharp scratch coming up.
0:07:19 > 0:07:25He must find a vein and insert a hollow needle for medicine to be injected through.
0:07:28 > 0:07:30Right, that's not in.
0:07:30 > 0:07:33So, let's have a look at this hand, shall we?
0:07:33 > 0:07:35- You all right there? - Yeah, fine.- Good.
0:07:35 > 0:07:39After several attempts, and worried about hurting the patient,
0:07:39 > 0:07:41Andy stops.
0:07:41 > 0:07:45On second thoughts, I think you need a bit of a half an hour break,
0:07:45 > 0:07:47because obviously it's quite painful.
0:07:47 > 0:07:49- All right? Is that OK?- It's fine.
0:07:49 > 0:07:52I'm sorry I didn't manage to get that in there, OK?
0:07:55 > 0:07:57I couldn't get it in, I think it's four times,
0:07:57 > 0:08:01so I'm going to come back later, give him a bit of a break,
0:08:01 > 0:08:02cos it's not that nice
0:08:02 > 0:08:06having someone repeatedly stab you with a needle.
0:08:06 > 0:08:09It is frustrating, not being able to do something first-time,
0:08:09 > 0:08:15but sometimes you've got to be determined and not give up, I guess.
0:08:17 > 0:08:19Cannulating is a real skill.
0:08:19 > 0:08:23If they come to me or any of my staff and say, "I'm struggling,"
0:08:23 > 0:08:24good on them.
0:08:24 > 0:08:27What I don't want is a patient sitting there
0:08:27 > 0:08:30like a pincushion having had six or seven attempts.
0:08:30 > 0:08:33If you haven't got it in two attempts, it's not your day,
0:08:33 > 0:08:35let's get somebody else in to do it.
0:08:41 > 0:08:43These look like my size.
0:08:44 > 0:08:46That looks about right.
0:08:46 > 0:08:51Amieth is out of bed and ready for his first shift in accident and emergency.
0:08:51 > 0:08:55Trousers, top - we're sorted.
0:08:55 > 0:08:57As a second year, Amieth only has a year's experience
0:08:57 > 0:09:01and is new to this hospital and department.
0:09:02 > 0:09:06This is the first task, to find the main desk
0:09:06 > 0:09:08so I can see the next patient.
0:09:08 > 0:09:12I think A&E potentially could make or break a doctor.
0:09:12 > 0:09:15Every day we see life and death situations, and we have to make
0:09:15 > 0:09:18very quick decisions as to how to turn that around.
0:09:18 > 0:09:21I think it's very nerve-racking for junior doctors at first
0:09:21 > 0:09:24and it's interesting to see how they cope with it.
0:09:24 > 0:09:29His first patient has blood in his urine and Amieth starts with some standard tests.
0:09:29 > 0:09:33That's pretty good, so I'd like to examine the prostate.
0:09:33 > 0:09:35Do you know how that's examined?
0:09:35 > 0:09:38It's through the back passage, OK?
0:09:38 > 0:09:39SHE LAUGHS
0:09:39 > 0:09:41He said, "I don't enjoy that."
0:09:41 > 0:09:43I don't enjoy it either.
0:09:44 > 0:09:48So, for this job you need a finger,
0:09:48 > 0:09:51some gloves and some lubricating jelly.
0:09:53 > 0:09:56He may be starting his new job at the bottom,
0:09:56 > 0:09:59but Amieth doesn't let things get him down.
0:10:03 > 0:10:05I'm a serious guy.
0:10:05 > 0:10:06Haven't you noticed yet?
0:10:06 > 0:10:09I'm very serious, all the time.
0:10:09 > 0:10:12I can't even say that with a straight face!
0:10:14 > 0:10:17I think I'm very funny, but most people don't tend to laugh at my jokes,
0:10:17 > 0:10:20and I don't know if it's because they don't know I'm telling a joke
0:10:20 > 0:10:22or just cos it's not funny.
0:10:25 > 0:10:29I'm just very laid-back and I let things happen.
0:10:29 > 0:10:32I've got a very laissez-faire attitude, as Del Boy would say.
0:10:36 > 0:10:40I'm not particularly ambitious, I'm not particularly driven,
0:10:40 > 0:10:44I like to just float along through life and let things happen.
0:10:46 > 0:10:49I'm not really looking for glory or riches.
0:10:49 > 0:10:52I figure I'll just turn up to work,
0:10:52 > 0:10:55try and make as many people better as are plonked in front of me
0:10:55 > 0:10:58and then go home at the end of the day.
0:11:00 > 0:11:02PHONE RINGS
0:11:02 > 0:11:06Back in A&E, Amieth's relaxed attitude is about to be tested.
0:11:08 > 0:11:10Hello, Chelsea and Westminster?
0:11:10 > 0:11:13It's an emergency call.
0:11:13 > 0:11:17An ambulance is on its way with a patient in critical condition.
0:11:19 > 0:11:22Senior doctor Barbara Cleaver and her staff get ready.
0:11:25 > 0:11:30This is Amieth's first resuscitation with the A&E team.
0:11:32 > 0:11:35SIREN
0:11:39 > 0:11:42The patient's heart has stopped beating
0:11:42 > 0:11:46and has been in cardiac arrest for more than 20 minutes.
0:11:48 > 0:11:50The chances of survival are falling.
0:11:50 > 0:11:55The emergency routine kicks in, and Amieth must move fast to keep up.
0:11:55 > 0:11:59Two people either side need to be getting a line in now, please.
0:11:59 > 0:12:01Amieth, pop a line in, please.
0:12:01 > 0:12:03He must get a needle into a vein.
0:12:03 > 0:12:08With that, they can inject adrenaline to help restart the heart.
0:12:08 > 0:12:10BUSILY CONFERRING VOICES
0:12:10 > 0:12:14OK, can we stop and see what this rhythm is?
0:12:14 > 0:12:16MACHINES BEEPING
0:12:16 > 0:12:18Is it shockable?
0:12:18 > 0:12:21Yeah, have we got paddles on?
0:12:21 > 0:12:23Compressions, please.
0:12:23 > 0:12:26Carry on compressions, please.
0:12:26 > 0:12:30Pumping the chest keeps blood and oxygen flowing round the body,
0:12:30 > 0:12:33and makes it possible for Amieth to find a vein.
0:12:33 > 0:12:35OK, charging.
0:12:35 > 0:12:39OK, everybody, stand back.
0:12:39 > 0:12:41Oxygen off, delivering shock.
0:12:41 > 0:12:42Shock delivered.
0:12:42 > 0:12:45They try a shock to the heart, but it doesn't work.
0:12:45 > 0:12:48There are still no veins he can use in the hand.
0:12:48 > 0:12:50Shut down.
0:12:50 > 0:12:54I'm going to see if I can get a line in for you.
0:12:54 > 0:12:56Do we have any access yet?
0:12:56 > 0:13:00Time's running out, so he tries the foot.
0:13:00 > 0:13:03- Has anyone got any access? - No, not yet.
0:13:06 > 0:13:08Are you in? Lovely, OK, we've got a line in the foot.
0:13:10 > 0:13:12OK, well done, that's a good line.
0:13:12 > 0:13:15A milligram of adrenaline ready, please.
0:13:15 > 0:13:18And, Amieth, you should be wearing gloves, as well.
0:13:20 > 0:13:24- Adrenaline in.- One milligram of adrenaline has been given...
0:13:24 > 0:13:28Adrenaline flowing, the team has a better chance of saving the patient.
0:13:28 > 0:13:30Stop for a rhythm check, please.
0:13:30 > 0:13:33Have we got any output with that at all?
0:13:33 > 0:13:34Continue CPR.
0:13:34 > 0:13:37I'll do it.
0:13:37 > 0:13:38Bit faster, Amieth.
0:13:38 > 0:13:42Amieth pumps the chest...
0:13:42 > 0:13:44and more adrenaline goes in.
0:13:44 > 0:13:46Amieth, stop CPR.
0:13:46 > 0:13:48Any pulse?
0:13:48 > 0:13:49No pulse.
0:13:49 > 0:13:51Carry on CPR.
0:13:51 > 0:13:53But the team is losing the patient.
0:13:53 > 0:13:54Charging.
0:13:54 > 0:13:56Shock it, yeah, let go.
0:13:56 > 0:13:59Everybody, stand back. Shock delivered.
0:13:59 > 0:14:02In the hope of kick-starting the heart, they give one last shock.
0:14:02 > 0:14:04Any output from anybody?
0:14:04 > 0:14:07OK, Amieth can you continue CPR, please?
0:14:11 > 0:14:15Despite the team's best efforts, there's no response.
0:14:17 > 0:14:20OK, Amieth, I think what we've done what we can for this lady,
0:14:20 > 0:14:24so I'm going to get you to pop back and carry on seeing your patient, if that's OK?
0:14:24 > 0:14:25Sure.
0:14:25 > 0:14:28Thank you very much for your help.
0:14:28 > 0:14:29You're welcome.
0:14:33 > 0:14:36A&E is full of the ups and downs, really,
0:14:36 > 0:14:39people living and dying in the same room.
0:14:39 > 0:14:43Unfortunately we were unsuccessful today.
0:14:43 > 0:14:45It's sad,
0:14:45 > 0:14:51and sometimes there's nothing you can do, despite everything you try.
0:14:54 > 0:14:59That's his first major cardiac arrest in our department.
0:14:59 > 0:15:01I thought he dealt with it quite well.
0:15:01 > 0:15:02It's quite a fraught situation,
0:15:02 > 0:15:05it's emotionally quite stressful and demanding,
0:15:05 > 0:15:08and he kept his cool quite well.
0:15:16 > 0:15:18PHONE RINGS
0:15:18 > 0:15:21Hello...
0:15:21 > 0:15:23Yes, I only just started today.
0:15:23 > 0:15:27I have some background about her.
0:15:27 > 0:15:33First year, Aki, is starting in one of the busiest wards in the hospital, the acute assessment unit.
0:15:33 > 0:15:36He is taking a call from an outside line.
0:15:36 > 0:15:40Can you give me two seconds, I'll go and get her notes.
0:15:40 > 0:15:44One rule that all doctors should know, it's illegal to give
0:15:44 > 0:15:47patients' confidential information out to callers.
0:15:47 > 0:15:52She had a Troponin rise and also a rise in Amylase.
0:15:52 > 0:15:57So, we think she's had a myocardial infarction and also...
0:15:59 > 0:16:01Sorry, I'm not sure.
0:16:05 > 0:16:08I can put you through to the registrar,
0:16:08 > 0:16:11who's been looking after her for a bit longer.
0:16:11 > 0:16:13She might be able to give you a better idea.
0:16:14 > 0:16:17Can you just hold on and I'll just go and speak to her.
0:16:18 > 0:16:21Needing more information about the patient,
0:16:21 > 0:16:23Aki goes to his senior doctor.
0:16:23 > 0:16:28Sorry to bother you. There's a doctor on the phone from the insurance company.
0:16:28 > 0:16:31She wants to know what investigations we've done.
0:16:36 > 0:16:38I've been giving her a bit of information.
0:16:39 > 0:16:42I don't know if you want to talk to her.
0:16:42 > 0:16:44That's the phone.
0:16:52 > 0:16:57Patient confidentiality is crucial because my patient is placing
0:16:57 > 0:17:00a trust in me and any other doctor that comes to see them.
0:17:00 > 0:17:03You must be cautious in knowing what you can and can't say.
0:17:05 > 0:17:08One of the nurses says, "Are you looking after this patient?"
0:17:08 > 0:17:11I was like, "Yeah, I guess I am."
0:17:11 > 0:17:14She said, "OK, there's another doctor on the line."
0:17:14 > 0:17:17I knew I shouldn't have picked it up, but I did.
0:17:17 > 0:17:19The responsibility is on me.
0:17:20 > 0:17:24A mistake in front of the new boss isn't the start Aki hoped for.
0:17:31 > 0:17:34Like Aki, Andy's day hasn't started well.
0:17:34 > 0:17:39I was just coming in to ask you, at some point if I could put that thing in again.
0:17:39 > 0:17:41I'll try and get it in this time, the cannula.
0:17:41 > 0:17:45Time for him to have another go at finding a vein in Mr Straw.
0:17:47 > 0:17:50I'm afraid so, but I've done lots in the past.
0:17:53 > 0:17:56If I don't get it in in the first few goes,
0:17:56 > 0:17:59then I'll get someone else to have a go, if you want.
0:18:02 > 0:18:07Just that sometimes it helps with a fresh pair of eyes, you know.
0:18:10 > 0:18:11Yes.
0:18:14 > 0:18:17All right. Two goes, yes?
0:18:17 > 0:18:19All right, I'll grab the stuff.
0:18:19 > 0:18:22Then after two goes... But we'll get it first time, promise.
0:18:24 > 0:18:26Any luck with the cannula?
0:18:26 > 0:18:29About an hour ago, I had a few misses.
0:18:29 > 0:18:32I'm going to try again.
0:18:32 > 0:18:34But, are you any good at cannulas?
0:18:34 > 0:18:36No.
0:18:36 > 0:18:39OK, fine, no problem.
0:18:39 > 0:18:44Something I've got to get really good at, so I'm going to have another few goes on my own.
0:18:47 > 0:18:49HE SIGHS
0:18:57 > 0:19:02I grew up in Otley, which is a small market town, near Leeds.
0:19:02 > 0:19:06I like to play football, go for a drink, see my friends and stuff.
0:19:09 > 0:19:11I'm 22.
0:19:11 > 0:19:14I'm probably one of the youngest,
0:19:14 > 0:19:18if not the youngest doctors to start at Chelsea and Westminster Hospital.
0:19:22 > 0:19:25I was the youngest in my year, I didn't take a gap year.
0:19:25 > 0:19:28Really wanted to get straight into it, get involved, get working.
0:19:28 > 0:19:32- You can't grow a beard.- That's true.
0:19:32 > 0:19:36- How long?- My biggest weakness is not being able to grow facial hair.
0:19:38 > 0:19:40I'm quite a competitive person.
0:19:40 > 0:19:43If we're playing on the Xbox, I always get into it and want to win.
0:19:43 > 0:19:46It's not fun if you lose every time.
0:19:46 > 0:19:50Andrew James Steval.
0:19:50 > 0:19:51So proud of you.
0:19:51 > 0:19:53I know I should be able to do the job
0:19:53 > 0:19:55but I am going to be terrified.
0:19:55 > 0:20:00As the youngest doctor in the hospital, Andy has plenty to prove.
0:20:00 > 0:20:04He's got two more chances at finding a vein in Mr Straw.
0:20:18 > 0:20:20Time for needle number one.
0:20:32 > 0:20:35Needle number two and Andy's last chance.
0:20:59 > 0:21:03Yes, didn't manage to get it in again. That's kind of annoying.
0:21:03 > 0:21:06You know...
0:21:06 > 0:21:09I guess I'm glad I persisted because you've just got to do it.
0:21:09 > 0:21:13I'm going to get one of the others to come and have a go.
0:21:13 > 0:21:17Then, yes... Hey, next time.
0:21:25 > 0:21:30I don't think her blood tests are back or she might not have had them done this morning.
0:21:30 > 0:21:32Andy's not the only one struggling.
0:21:32 > 0:21:38After his mistake with the phone call, Aki needs to show new boss, Dr Mukherjee, he's on top of things.
0:21:38 > 0:21:41Before we do that, which trial evidence do you know of for use
0:21:41 > 0:21:44of statins in acute coronary syndrome?
0:21:44 > 0:21:45Erm...
0:21:50 > 0:21:53There was a time when I knew so many studies.
0:21:53 > 0:21:55I know this doesn't help.
0:21:55 > 0:21:57- When was that time? - About two months ago.
0:21:57 > 0:22:01That time has come and gone, already! It's only your first day.
0:22:01 > 0:22:05Aki's finding it tough going and, never a top performer,
0:22:05 > 0:22:08he's had to work hard to become a doctor.
0:22:11 > 0:22:12I was born in Tokyo.
0:22:12 > 0:22:16When I was three moved to the wonderful country of Shropshire.
0:22:16 > 0:22:19# What kind of person should you be
0:22:19 > 0:22:21# When you want to make people accept you? #
0:22:21 > 0:22:25My friend, he described me once, as Kensington meets rock 'n' roll.
0:22:25 > 0:22:28I think I'm very sociable.
0:22:31 > 0:22:36During med school, I wouldn't say I was the top examination results.
0:22:36 > 0:22:40Maybe, academically, I wasn't that bright.
0:22:40 > 0:22:42ALL: Whoo!
0:22:42 > 0:22:46I don't feel like a real doctor yet. I need to get drunk first.
0:22:46 > 0:22:47It's disgusting.
0:22:47 > 0:22:51There are a lot of people who got better grades, but did better in exams.
0:22:51 > 0:22:55And, I'm a bit worried about the consultants
0:22:55 > 0:22:59and my seniors grilling me about types of disease and I'm not going to know
0:22:59 > 0:23:01and it will be very embarrassing.
0:23:02 > 0:23:03This is the crunch time.
0:23:03 > 0:23:06Mistakes can be fatal.
0:23:06 > 0:23:10Back in the hospital, Aki's being tested again.
0:23:10 > 0:23:13It's a chance on him to make up for his shaky start.
0:23:15 > 0:23:18What do you look for in a patient?
0:23:18 > 0:23:20- Chest pain.- Yes.- Syncope.
0:23:20 > 0:23:24- OK, what if they were dizzy or fainted?- Shortness of breath.
0:23:24 > 0:23:26OK, good.
0:23:26 > 0:23:30He's assisting with a 54-year-old man, admitted with a dangerously, irregular heartbeat.
0:23:30 > 0:23:35You've made sure we consulted the patient and made sure he understands what we are doing?
0:23:35 > 0:23:36Yes.
0:23:36 > 0:23:41Under supervision from senior doctor, Ramiz Khamis, this is Aki's chance to prove himself.
0:23:41 > 0:23:44Are you all right, sir?
0:23:44 > 0:23:48- If you got a lot of hair, what do you think may happen?- It could burn.
0:23:48 > 0:23:52Yes, it could cause a nasty smell afterwards, which is not very nice.
0:23:54 > 0:23:57Aki's responsible for forcing the patient's heart
0:23:57 > 0:24:01back to a normal rhythm, with a single electric shock.
0:24:01 > 0:24:03All right, that'll do.
0:24:06 > 0:24:07OK.
0:24:09 > 0:24:14Just take three nice deep breaths for me, all the way in and all the way out.
0:24:22 > 0:24:25- Are you ready?- Yes.- OK.
0:24:26 > 0:24:29- So you know what you're doing? - One shock.
0:24:29 > 0:24:32- So make sure everyone is clear. Say it loud.- Clear.
0:24:32 > 0:24:35- Well, hang on. Oxygen away.- Oxygen away.
0:24:35 > 0:24:38Checked the top, the middle and the bottom of the bed.
0:24:38 > 0:24:41- Make sure you're not touching the bed.- Charge.- Charge.
0:24:41 > 0:24:43- Are you all away from the bed?- Yes.
0:24:44 > 0:24:47- OK. Say, "shocking."- Shocking.
0:24:51 > 0:24:55- All right? Were we successful? Did it work?- I think so. - Of course it did, well done.
0:24:55 > 0:24:58- That's it.- It's amazing.
0:24:58 > 0:25:00It's a better start for Aki.
0:25:00 > 0:25:02He's beginning to feel more like a doctor.
0:25:02 > 0:25:06The only time I've touched one of those machines is on a mannequin and not on a real person.
0:25:06 > 0:25:09It's a very different feeling.
0:25:09 > 0:25:13When you're on a mannequin, it doesn't matter what you press.
0:25:13 > 0:25:15You don't kill anyone.
0:25:15 > 0:25:18With a real patient you're always a bit wary of what you're doing
0:25:18 > 0:25:20and you have to be absolutely sure.
0:25:24 > 0:25:26All right, my friends, I'm off.
0:25:26 > 0:25:30After a day of mixed results on the hospital front line,
0:25:30 > 0:25:31the juniors head home.
0:25:31 > 0:25:34All right, Emily, I'm off. See you tomorrow?
0:25:34 > 0:25:36- Yeah.- All right, see you soon.
0:25:36 > 0:25:38On his way out, Andy bumps into Aki,
0:25:38 > 0:25:41just back from fixing his patient's heart.
0:25:41 > 0:25:45- Really?- It was a patient with atrial flutter.
0:25:45 > 0:25:48- Did they sort of, like... Did they show you how to do it?- Yeah.
0:25:48 > 0:25:51- The Reg was there, telling me what to do step by step.- What?
0:25:51 > 0:25:53- And then you just press the button? - Pretty much.- Sweet!
0:25:53 > 0:25:58- The patient's better, so that's good. How was your day?- Yeah, good.
0:25:58 > 0:26:00Just did general jobs.
0:26:00 > 0:26:05- All right, are you coming this way? - I don't finish till ten.
0:26:05 > 0:26:07So, we're good.
0:26:07 > 0:26:10- Bye. - All right, see you in a bit, man.
0:26:10 > 0:26:14I met Aki just coming down the stairs. He said he had done, like...
0:26:14 > 0:26:17He cardioverted someone, which is quite cool.
0:26:17 > 0:26:21It uses the defibrillator. It's like a cool thing to do.
0:26:21 > 0:26:23Yeah, I guess I'm a bit jealous
0:26:23 > 0:26:26because that's a really cool thing to do.
0:26:26 > 0:26:29Maybe on AAU, he gets to do more of that kind of stuff.
0:26:29 > 0:26:33# My mirror disappoints me
0:26:33 > 0:26:36# And
0:26:36 > 0:26:40# Am I the only one?
0:26:40 > 0:26:45# It's all I need, all, all I need
0:26:45 > 0:26:48# Is you, smiling. #
0:26:50 > 0:26:52Not all the juniors are clocking off.
0:26:52 > 0:26:54First year Milla is just arriving.
0:26:54 > 0:26:58Sorry to bother you, I'm just starting on medical on-call tonight.
0:26:59 > 0:27:00Oh, I'm so sorry.
0:27:00 > 0:27:03Oh, right. OK, so I'm early.
0:27:05 > 0:27:06OK, thank you.
0:27:06 > 0:27:09Thrown in at the deep end, she's kicking off her career
0:27:09 > 0:27:11with a gruelling 12-hour night shift.
0:27:23 > 0:27:27This is by the Queen's hat maker, isn't it? I love this one.
0:27:27 > 0:27:30I think I would describe myself as a bit of a Chelsea girl, yeah.
0:27:30 > 0:27:32- # She's class. # - What do you think, Mummy?
0:27:32 > 0:27:35# Candy for the eye and a twinkle in her smile. #
0:27:35 > 0:27:37- Oh, I love it.- Fantastic!
0:27:37 > 0:27:39I love going to balls. I get invited to many of them.
0:27:39 > 0:27:42Elton John better invite me to his.
0:27:42 > 0:27:44# Her daddy's rich
0:27:44 > 0:27:47# You can see she comes from money but she's still a little honey. #
0:27:47 > 0:27:49My interest in medicine started when I think I was
0:27:49 > 0:27:51around about six years old.
0:27:51 > 0:27:54It sounds a little bit silly, but because I love my parents
0:27:54 > 0:27:57so much, I always wanted them to be alive forever.
0:27:57 > 0:28:01So, I wanted to create this medicine of life
0:28:01 > 0:28:05and to actually have them around forever, I guess.
0:28:05 > 0:28:07It's wonderful.
0:28:07 > 0:28:11The Chelsea hospital, you know, I've only ever wanted to work there.
0:28:11 > 0:28:12So, I am really happy.
0:28:12 > 0:28:17Yeah, I think I'm ready emotionally as well as intellectually
0:28:17 > 0:28:22for the responsibility that being a doctor comes with. Yeah.
0:28:22 > 0:28:24# Posh girls have manners... #
0:28:26 > 0:28:28Now, Milla is facing one of the toughest tests
0:28:28 > 0:28:31of any junior doctor - working nights.
0:28:31 > 0:28:34I've never actually had to use one of these. It sounds really silly.
0:28:34 > 0:28:38- It's a bit awkward.- OK.- But you just double press the green button.
0:28:38 > 0:28:40Double press the green to stop it.
0:28:40 > 0:28:41Every time her pager goes off,
0:28:41 > 0:28:44someone somewhere needs her attention.
0:28:44 > 0:28:47- But it's definitely going to go off? - It will definitely go off.- OK.
0:28:47 > 0:28:50- You'd be very lucky if it never went off.- So, this is how begins?
0:28:50 > 0:28:52This is how begins.
0:28:52 > 0:28:55In a hospital with up to 400 patients,
0:28:55 > 0:28:58Milla could be called to deal with almost anything.
0:28:58 > 0:29:01- BEEP - Ah-ha! And there is my first beep.
0:29:01 > 0:29:03OK.
0:29:07 > 0:29:10Hello. Hi.
0:29:10 > 0:29:14Somebody called me up to come and certify I think a death.
0:29:14 > 0:29:17- For?- To certify a death. Somebody.
0:29:17 > 0:29:20A patient has died and the death must be confirmed by a doctor,
0:29:20 > 0:29:24even one with just a few hours experience.
0:29:24 > 0:29:27Can I borrow...? Can I possibly borrow you?
0:29:27 > 0:29:29I've never done it before.
0:29:29 > 0:29:32So, I just want to know exactly what I need to do.
0:29:32 > 0:29:34OK.
0:29:35 > 0:29:38And can you...? I've never...
0:29:38 > 0:29:41I mean, it's my first night, my first shift,
0:29:41 > 0:29:43so I've never had to certify a death.
0:29:43 > 0:29:45So...
0:29:45 > 0:29:48If you can help me out, I'd be most grateful.
0:29:51 > 0:29:55Before she can sign the death certificate,
0:29:55 > 0:29:58Milla must be sure there is no trace of life.
0:29:58 > 0:30:01OK.
0:30:01 > 0:30:03Just so you know...
0:30:16 > 0:30:18First, she checks for a heart beat.
0:30:23 > 0:30:25Then checks again.
0:30:40 > 0:30:43He was still warm.
0:30:43 > 0:30:47I think that was kind of... is probably part of the really
0:30:47 > 0:30:52scary bit, because you, kind of, expect him to have a pulse.
0:30:52 > 0:30:54So, it's quite weird.
0:30:54 > 0:30:58Yeah, and just to look into his eyes and stuff, too.
0:30:58 > 0:31:00Yeah, quite shocking, actually.
0:31:00 > 0:31:03I guess I didn't really expect that on my first night.
0:31:15 > 0:31:19Back at the house, the other junior doctors can relax.
0:31:24 > 0:31:27What's the most awesome thing you've done so far?
0:31:27 > 0:31:30OK, so there was a patient, who had an operation,
0:31:30 > 0:31:35but one of the stitches on the inside got infected so,
0:31:35 > 0:31:37the surgeon was like, "Do you want to take it out?"
0:31:37 > 0:31:40He literally watched me, supervised me, guided me,
0:31:40 > 0:31:43made sure there was no room for error.
0:31:43 > 0:31:45- Wow!- What was the most exciting thing you did?
0:31:45 > 0:31:49Prescribed someone laxatives so they're no longer constipated.
0:31:49 > 0:31:54- Oh, wow(!) Life-changing.- That was quite life-changing, actually.
0:31:54 > 0:31:59After a long day on the wards, Lucy is one of the last to get home.
0:31:59 > 0:32:01Hello!
0:32:01 > 0:32:05- Hello.- Come in.- Oh, God!
0:32:06 > 0:32:08That was...a hard day.
0:32:08 > 0:32:11Basically went food shopping to make myself feel better.
0:32:11 > 0:32:15So I bought Jammie Dodgers that I ate on the way home because I walked.
0:32:15 > 0:32:18And I bought curry. I can never do that.
0:32:18 > 0:32:21- What, like a ready-made one?- Yeah.
0:32:22 > 0:32:26- So, how were your days anyway? - It was all right.
0:32:26 > 0:32:29I missed a few cannulas, which was annoying
0:32:29 > 0:32:31because I hate not doing things.
0:32:31 > 0:32:34I want to be good at things.
0:32:43 > 0:32:45I'm the kind of person that likes to be good at things.
0:32:45 > 0:32:49It's just frustrating for me not to be able to do it every time.
0:32:49 > 0:32:53So, I'm going to go in tomorrow and just get better.
0:32:53 > 0:32:56I really want to get better at stuff.
0:33:12 > 0:33:14You've got 24 hours to do your discharges.
0:33:14 > 0:33:15If you don't do it in time,
0:33:15 > 0:33:18the whole discharge process could collapse.
0:33:18 > 0:33:2224-year-old Lucy is starting her life as a doctor in rheumatology
0:33:22 > 0:33:23and general medicine.
0:33:23 > 0:33:26She'll be treating elderly patients with a wide range of illnesses,
0:33:26 > 0:33:29including joint diseases like arthritis.
0:33:29 > 0:33:32Those things I'm dreading are things that I should be able to do
0:33:32 > 0:33:35and I should feel comfortable about.
0:33:35 > 0:33:39So, just dead simple stuff like bloods and cannulas.
0:33:39 > 0:33:41Everything else I feel quite comfortable
0:33:41 > 0:33:42being uncomfortable about.
0:33:42 > 0:33:45I don't want to come away kicking myself over something
0:33:45 > 0:33:48that really should have been quite straightforward.
0:33:48 > 0:33:53- Hello, sir.- Hi again.- Hello.
0:33:53 > 0:33:56Right, I just need to take a blood test today,
0:33:56 > 0:33:58just to make sure that your clotting is OK.
0:33:58 > 0:33:59Is that all right?
0:34:02 > 0:34:05Lucy's first patient has a bacterial infection
0:34:05 > 0:34:07and she needs some blood for testing.
0:34:07 > 0:34:10It's her first attempt at the tough task of getting
0:34:10 > 0:34:12a needle into a vein.
0:34:13 > 0:34:15Good, good. That's nice for us.
0:34:17 > 0:34:18Really?
0:34:23 > 0:34:26I've not done it yet, that's why!
0:34:26 > 0:34:29Sharp scratch now, sir.
0:34:29 > 0:34:33- There you go, all good. - A success.- Right, all done.
0:34:33 > 0:34:34Thank you very much.
0:34:37 > 0:34:41That's very nice. Did you bring these with you?
0:34:44 > 0:34:46Are you giving them away to too many people?
0:34:48 > 0:34:51I don't feel like I've done anything to take it.
0:34:51 > 0:34:53Well, thank you very much.
0:34:56 > 0:35:00Did I put my stethoscope down? Oh, I've got it on!
0:35:02 > 0:35:03Bye.
0:35:08 > 0:35:11I still think I dread practical jobs, despite having done my first blood.
0:35:11 > 0:35:15But the patient was so understanding that he gave me this lovely
0:35:15 > 0:35:19picture of an English rose, which I think I will put on the ward wall.
0:35:19 > 0:35:22For everybody to enjoy. So, that was very nice of him.
0:35:23 > 0:35:26She's a true English rose. Yeah.
0:35:39 > 0:35:44My name is Andy. I'm one of the junior doctors here in the wards.
0:35:44 > 0:35:48While Lucy hits a vein, it isn't always so straightforward.
0:35:48 > 0:35:50Andy has yet to be on target.
0:35:50 > 0:35:52- Hello, there.- Hi. - Mr McGee, are you all right?
0:35:52 > 0:35:54- You look in a bit of pain.- I am.
0:35:54 > 0:35:58- Is it your knee?- Yes.- Yeah. - Now he has another patient,
0:35:58 > 0:36:02another cannula and another chance to prove himself.
0:36:02 > 0:36:05So, let's pull this around.
0:36:10 > 0:36:14It's hard to see what's a vein and what's a bruise from somewhere
0:36:14 > 0:36:17- where someone has already stubbed you.- Yeah, exactly.- With a needle.
0:36:17 > 0:36:19Sharp scratch.
0:36:19 > 0:36:24Andy's patient, Paul, urgently needs painkillers after knee surgery.
0:36:24 > 0:36:28It's important Andy quickly gets it right.
0:36:28 > 0:36:31- You all right there? - Yeah, don't worry about that.
0:36:31 > 0:36:34- It's the knee that's hurting. - Yeah, I realise that.
0:36:34 > 0:36:37- I had it for a second there, actually.- Did you?
0:36:39 > 0:36:42With a bit of luck, that should be in there.
0:36:42 > 0:36:46- But I'll just check by flushing it with some salty water.- Lovely.
0:36:48 > 0:36:50There we go. I'm pretty sure it is.
0:36:52 > 0:36:56Sometimes the hardest bit is getting the sticker on.
0:36:59 > 0:37:02Well, I messed the sticker up, but the hard bit is done,
0:37:02 > 0:37:04so I'll just get something to stick it down with.
0:37:04 > 0:37:08- Just be really careful with it. - Yep.- Really careful.- Yep.
0:37:08 > 0:37:13- That's good. Sorry.- Lovely. - I'll be back in a second.
0:37:14 > 0:37:18That was the first cannula I've put in as a doctor.
0:37:18 > 0:37:20Yeah, it felt good.
0:37:20 > 0:37:23It felt good to get it in. I got it in the first time, which is good.
0:37:23 > 0:37:24No problems.
0:37:24 > 0:37:28Success. But the patient is unaware
0:37:28 > 0:37:31of just how much is new cannula means to Andy.
0:37:31 > 0:37:34Mr McGee, just be really careful with that cannula.
0:37:34 > 0:37:38- It's not actually stuck down properly yet.- OK.- Be really careful.
0:37:38 > 0:37:40- I just need to get something. - OK, no problem,
0:37:40 > 0:37:45just be careful of the cannula, or it'll pull out. I'm going to...
0:37:45 > 0:37:47Like Andy,
0:37:47 > 0:37:51all the juniors are beginning to find their feet in their new jobs.
0:37:53 > 0:37:57I'm going to put my finger up your bottom.
0:37:57 > 0:38:00Just untangle myself.
0:38:07 > 0:38:11Oh, quite a few people in the waiting room today.
0:38:11 > 0:38:14As the day comes to an end,
0:38:14 > 0:38:16it's a first night shift on A&E for Amieth.
0:38:16 > 0:38:19Looks like it's going to be a pretty busy night.
0:38:19 > 0:38:21We just had an ambulance in.
0:38:21 > 0:38:26And quite a few ambulances have pitched up just before we arrived.
0:38:26 > 0:38:30With patients backing up, his skills and speed are going to be tested.
0:38:30 > 0:38:33I think, what will have to do, is have quick turnover.
0:38:33 > 0:38:36So, take a history and get the tests going,
0:38:36 > 0:38:37any of investigations that you need,
0:38:37 > 0:38:40and perhaps even move on to the next person whilst you're figuring out
0:38:40 > 0:38:44what's going on with the first. Does that make sense?
0:38:44 > 0:38:47A bit of multi-tasking. Any questions?
0:38:47 > 0:38:51A&E is a varied mix between very poorly people who require
0:38:51 > 0:38:54emergency treatment in the resuscitation room
0:38:54 > 0:38:56to our walk-in patients.
0:38:56 > 0:38:58We try and get through the minor patients as quick as we can.
0:38:58 > 0:39:00If something really major comes in, you're not than having
0:39:00 > 0:39:03patients waiting for hours in the waiting room.
0:39:03 > 0:39:08A good start. 15 minutes in, Amieth has already seen a patient
0:39:08 > 0:39:11and is admitting them to another ward.
0:39:11 > 0:39:13You just need to voom, voom, quick, quick.
0:39:13 > 0:39:16Quick, it needs to go straight upstairs.
0:39:16 > 0:39:18Hello, it's Amieth, I'm one of the A&E SHOs.
0:39:18 > 0:39:21I have a patient I'd like to refer to you, please.
0:39:24 > 0:39:26There's no option.
0:39:26 > 0:39:28I am referring.
0:39:28 > 0:39:33- It's not, "I'd like to refer," it's, "I am referring."- OK.
0:39:33 > 0:39:35Don't give them a get-out clause.
0:39:35 > 0:39:39He needs to be making decisions and he needs to be making them swiftly.
0:39:39 > 0:39:42Patients sitting in an A&E department while they're being
0:39:42 > 0:39:48discussed over periods of time are not getting the treatment they need.
0:39:48 > 0:39:51We need to be making quick, rapid, safe decisions.
0:39:51 > 0:39:56The patients keep on coming. Next, it's 26-year-old Ekaterina.
0:39:56 > 0:40:00- I had the worst ear pain in my life yesterday night.- OK.
0:40:00 > 0:40:03Is it affecting both ears or just one ear?
0:40:03 > 0:40:07The pain was mostly in this ear, but I can't hear anything in this ear.
0:40:07 > 0:40:13- But I did try house-remedy kinds of things.- What did you try?
0:40:13 > 0:40:16My mom told me a mixture. It's like mainly alcohol.
0:40:16 > 0:40:19It's vodka, which I put in my ears.
0:40:19 > 0:40:23So I might have like cotton or something.
0:40:23 > 0:40:26Did you have any problems hearing in that ear
0:40:26 > 0:40:28before you put vodka into it?
0:40:28 > 0:40:32- No. Basically, I've taken a couple of paracetamols and so on.- Yeah.
0:40:32 > 0:40:35Did that help with the pain? Or are you still having pain in your ears?
0:40:35 > 0:40:38I don't know. Yesterday night nothing really seemed to help,
0:40:38 > 0:40:41- but now it's OK.- It's OK. - It's still very uncomfortable.
0:40:41 > 0:40:44Have you noticed any discharge coming out of the ears at all?
0:40:46 > 0:40:50I don't really know because I had vodka with cotton in there
0:40:50 > 0:40:54- until I came here.- Right.
0:40:54 > 0:40:57Amieth checks Ekaterina's vodka-soaked ear.
0:40:57 > 0:41:03- Sorry.- It is super irritated.- Yeah.
0:41:03 > 0:41:06I can't see any bits of cotton wool in there.
0:41:06 > 0:41:09There's no obvious signs of infection in the ears or in the middle ears,
0:41:09 > 0:41:13but sometimes you get referred pain to the ears,
0:41:13 > 0:41:15so it can still cause pain in the ears.
0:41:15 > 0:41:18Are you 100% sure that there is nothing in this ear?
0:41:18 > 0:41:22- Like no cotton?- I couldn't... - Cos I can't hear anything.
0:41:22 > 0:41:26It's as if I had something stuck in that ear.
0:41:26 > 0:41:28I couldn't see any cotton.
0:41:28 > 0:41:33It doesn't look like there's any wax or cotton in there.
0:41:33 > 0:41:37He's still at the very slow stage of going through things
0:41:37 > 0:41:39very methodically.
0:41:39 > 0:41:42He'll need to speed up and start to get the instincts of who's well,
0:41:42 > 0:41:46who's not well and deciding very quickly whether he can admit
0:41:46 > 0:41:49patients to the medical doctors, surgical doctors,
0:41:49 > 0:41:53or whether to keep them down here for further tests, treatments, etc.
0:41:53 > 0:41:57Painkillers and things you can usually get from the chemists cheaper
0:41:57 > 0:41:58than on prescriptions.
0:41:58 > 0:42:02Amieth sends her on her way with a more conventional treatment
0:42:02 > 0:42:03for an infected ear.
0:42:03 > 0:42:08- Hope you're not too late for work today.- No. Thank you very much. Bye.
0:42:08 > 0:42:11I've never heard of people putting vodka in their ears,
0:42:11 > 0:42:15so it is quite amusing. I didn't keep a straight face,
0:42:15 > 0:42:19but that was OK because she knew it was a slightly unusual thing to do.
0:42:19 > 0:42:23While Amieth tries to get up to speed in A&E...
0:42:27 > 0:42:31..upstairs Milla is learning just how busy the night shift can be.
0:42:31 > 0:42:34You asked me to come and see somebody?
0:42:34 > 0:42:36Oh, dear.
0:42:36 > 0:42:39- BEEPS - Sorry.
0:42:39 > 0:42:41# Don't stop, don't stop, don't stop. #
0:42:41 > 0:42:46OK. OK. Yeah, so many things to do.
0:42:46 > 0:42:50And then your bleep starts going off again and again, just like this.
0:42:50 > 0:42:54- BEEPS - It's just one bleep after another.
0:42:54 > 0:42:59Do you normally have any tummy problems?
0:42:59 > 0:43:02But you don't have any medical conditions?
0:43:02 > 0:43:07OK, can you tell me a bit about them?
0:43:26 > 0:43:29Yes, you do. Oh, dear.
0:43:33 > 0:43:36Oh, my God, I'm not going to get my jobs done.
0:43:37 > 0:43:44I had dinner at like six o'clock and it's now 2am, so this is my cereal.
0:43:46 > 0:43:50Now, where is this ward? Have I just come from it? Yes? OK.
0:44:03 > 0:44:05I have absolutely no idea what time it is.
0:44:05 > 0:44:10And that is my call to run off and answer my ten million bleeps.
0:44:18 > 0:44:21- Is anyone coming to the hospital? - Yeah, I'm going.
0:44:21 > 0:44:23I'll just come with my toast.
0:44:23 > 0:44:26I don't feel any different to when I was a medical student.
0:44:26 > 0:44:30But I'm not that much different. I mean, really, a month ago I was
0:44:30 > 0:44:33a medical student, so I've not changed at all since then.
0:44:33 > 0:44:37So, it's just getting all the really basic stuff in order at the moment.
0:44:37 > 0:44:40I haven't had anything that challenging to sort out.
0:44:44 > 0:44:48But now, Lucy is facing one of the biggest challenges for a new
0:44:48 > 0:44:50junior doctor.
0:44:50 > 0:44:53Is there a maximum dose that we can give them? Thank you.
0:44:53 > 0:44:58Today, she is on-call across the whole hospital.
0:44:58 > 0:45:00She is the first stop for anyone needing a doctor.
0:45:00 > 0:45:05It's a huge responsibility for a junior only just graduated.
0:45:05 > 0:45:07BEEPS
0:45:07 > 0:45:095851.
0:45:12 > 0:45:17Hello, I've just been bleeped. OK, and what has happened to her, sorry?
0:45:17 > 0:45:22A nurse has paged Lucy. A patient has collapsed.
0:45:22 > 0:45:24Have you called the crash team?
0:45:25 > 0:45:28She's not breathing or she is breathing?
0:45:28 > 0:45:34It would be the crash team, but you need to tell him it's a peri-arrest.
0:45:34 > 0:45:37The patient is breathing, but if Lucy is right,
0:45:37 > 0:45:38she may be in peri-arrest,
0:45:38 > 0:45:40with a falling heartbeat and blood pressure,
0:45:40 > 0:45:44a sign her heart may be about to stop completely.
0:45:44 > 0:45:48If she has collapsed, she is peri-arrest.
0:45:48 > 0:45:51You need to call the crash team.
0:45:51 > 0:45:55Am I right? It would be a peri-arrest call.
0:45:55 > 0:45:58Call the crash team and say it's a peri-arrest and that you need them.
0:45:58 > 0:46:01OK, thank you, bye. Am I right or not?
0:46:01 > 0:46:03- Did she stop breathing? - She stopped breathing,
0:46:03 > 0:46:05but she came back round and she's breathing again.
0:46:05 > 0:46:09I'm just going to go see the patient and see what's going on.
0:46:10 > 0:46:12Lucy heads off to see for herself.
0:46:17 > 0:46:21Hello. I just spoke to somebody about a patient
0:46:21 > 0:46:22that apparently collapsed.
0:46:22 > 0:46:27Lucy arrives to find she is the first doctor present.
0:46:27 > 0:46:29With no choice, she takes charge.
0:46:35 > 0:46:38Lucy checks the patient's vital signs...
0:46:38 > 0:46:42Her heart rate is 46 now.
0:46:42 > 0:46:44Yeah.
0:46:44 > 0:46:47..monitors her risk of cardiac arrest
0:46:47 > 0:46:50and gives her oxygen to breathe.
0:46:55 > 0:46:59After ten minutes, the patient comes round.
0:47:05 > 0:47:07Lucy make sure she's stable.
0:47:14 > 0:47:17I'll come and see you in a few minutes, OK?
0:47:17 > 0:47:19- OK.- Thank you.
0:47:20 > 0:47:23I still feel largely unprepared, like I'm useless,
0:47:23 > 0:47:28but in the end, I'm sure that this kind of experience really helps.
0:47:28 > 0:47:30So, it's just about doing it and trying to do your best.
0:47:30 > 0:47:34I don't know whether I did all good job or not, but I tried.
0:47:41 > 0:47:45While Lucy is showing she is ready to take on new responsibilities...
0:47:45 > 0:47:50So, you have the borders of the mid-auxiliary line.
0:47:50 > 0:47:53..Aki still wants to prove himself to Dr Mukherjee.
0:47:53 > 0:47:56- Chest drains are quite nasty, so really deep anaesthetic.- OK.
0:47:56 > 0:48:00- Just so you know, I haven't done this before.- I'll talk you through it.- OK.
0:48:00 > 0:48:02And she has asked him to drain fluid from a patient's chest.
0:48:02 > 0:48:06It's an advanced and difficult procedure for a junior
0:48:06 > 0:48:09- in his first week.- Yeah, my God.
0:48:09 > 0:48:12- What's wrong?- Chest drain.
0:48:12 > 0:48:15- Have you done one?- Yeah, you'll love it.- I'm sure I will.
0:48:15 > 0:48:19All right, see you tomorrow.
0:48:19 > 0:48:25- Lucy is one of the first to hear the news.- Hey, guys.- Hi.
0:48:25 > 0:48:28- I'm about to do a chest drain. - You are?- Yeah.- Cool.
0:48:28 > 0:48:30- No!- I'm excited. See you later.
0:48:32 > 0:48:34Exciting.
0:48:36 > 0:48:40Aki's first job is to put his patient at her ease.
0:48:40 > 0:48:45I'm not cheating you here, I'm going to be really honest with you.
0:48:45 > 0:48:47This is... I don't want scare you.
0:48:47 > 0:48:49This is the first time you've done this.
0:48:49 > 0:48:53Yes. And it's my second day.
0:48:54 > 0:48:58The patient has breast cancer that has spread to her lungs.
0:48:58 > 0:49:02It causes a dangerous build-up of fluid in her chest.
0:49:02 > 0:49:03It's Aki's job to drain it.
0:49:03 > 0:49:06We're going to get some pain relief even before we've started.
0:49:06 > 0:49:09OK? So you're going to get some oramorph coming.
0:49:09 > 0:49:13- So, go straight through. - Yeah.- So, sharp scratch here.
0:49:13 > 0:49:16First, Aki anesthetizes the whole area.
0:49:16 > 0:49:18Now stop there, draw back.
0:49:19 > 0:49:23Next, he must pierce the chest from behind,
0:49:23 > 0:49:27avoiding vital organs like the heart and several major blood vessels.
0:49:27 > 0:49:31- So...- In and then with your needle,
0:49:31 > 0:49:33you're going to go straight in, perpendicular to the skin.
0:49:33 > 0:49:36Like that.
0:49:36 > 0:49:40- OK, or going to give it a try now. - Can you feel that?- No.
0:49:40 > 0:49:44Hold the needle and remember not to let go of that guard.
0:49:44 > 0:49:50Finally, using a wire, he must guide the tube carefully into the chest.
0:49:50 > 0:49:53OK, so push it through. Twiddle, twiddle, twiddle.
0:49:53 > 0:49:59- Sorry.- How are you doing there?- It's hurting.- Is that bearable?- Just.- OK.
0:50:01 > 0:50:02If Aki's got it right,
0:50:02 > 0:50:06fluid can now be drained from the patient's chest.
0:50:08 > 0:50:12Take a big breath in for me, please.
0:50:12 > 0:50:16You can see it's swinging, yeah? Good. Well done.
0:50:18 > 0:50:20- Congratulations.- Thank you very much. - Your first drain.
0:50:20 > 0:50:24- It was my first drain.- I'm really, really, really proud of Aki.
0:50:24 > 0:50:27He did really, really well. There are bits that can go badly wrong,
0:50:27 > 0:50:29for example, losing the wire in the chest.
0:50:29 > 0:50:31And he didn't, he held onto it.
0:50:31 > 0:50:33And, actually, the patient was really comfortable as well.
0:50:33 > 0:50:36And that's really satisfying. So, no, job well done.
0:50:38 > 0:50:41That was really cool.
0:50:44 > 0:50:46Job done.
0:50:49 > 0:50:53It's really nice to do something for the first time,
0:50:53 > 0:50:54and to do it right.
0:50:56 > 0:50:57I am so happy.
0:51:01 > 0:51:04I think every year I have a moment where I think,
0:51:04 > 0:51:06"Oh, my God, this is the best job ever."
0:51:06 > 0:51:08Aki finishes for the day.
0:51:08 > 0:51:12- Hi.- Hey.- Hello.
0:51:12 > 0:51:16As Milla's night shift begins, he hands the patient over to her.
0:51:16 > 0:51:20- I'm really happy, I just put a chest drain in.- Oh, my gosh! Wow!
0:51:20 > 0:51:21That's exciting.
0:51:21 > 0:51:25I just requested an X-ray, just to check that it's in the right place,
0:51:25 > 0:51:27- so if you could just review that. - Oh, right, yeah.
0:51:27 > 0:51:30- Have a good night.- Thank you.
0:51:34 > 0:51:39Hello, my friend, I'm just going to put a little needle in your hand.
0:51:39 > 0:51:40OK?
0:51:40 > 0:51:43As the night shift starts, Amieth is back in A&E,
0:51:43 > 0:51:45while upstairs...
0:51:45 > 0:51:48- I need to take some blood. - Yes.- Is that OK?
0:51:48 > 0:51:51Milla is part of the team covering the rest of the hospital.
0:51:51 > 0:51:53That's it.
0:51:53 > 0:51:55Fantastic. OK.
0:51:55 > 0:51:59BEEPS
0:52:01 > 0:52:04'Cardiac arrest, A&E.
0:52:04 > 0:52:06'Cardiac arrest, A&E.'
0:52:11 > 0:52:14Oh, my gosh! I don't have a card! Shit!
0:52:14 > 0:52:16There's an emergency in A&E.
0:52:16 > 0:52:19'Cardiac arrest, A&E.'
0:52:19 > 0:52:22They've called for backup from the night team.
0:52:22 > 0:52:26The patient's heart has stopped, they are in cardiac arrest.
0:52:28 > 0:52:31It's Milla's first ever crash call to A&E,
0:52:31 > 0:52:34but she's four floors up and on the other side of the hospital.
0:52:45 > 0:52:49Less than 10% of cardiac arrest victims survive.
0:52:49 > 0:52:51Every second counts.
0:53:06 > 0:53:11- Hi, Milla.- Hello. Let me know if you need me to do anything, yes?
0:53:11 > 0:53:13As Milla arrives,
0:53:13 > 0:53:16Amieth and the team have managed to restart the patient's heart.
0:53:16 > 0:53:21- Do you mind getting another grey cannula from in there?- Grey?
0:53:21 > 0:53:23And another 20 ml syringe, as well.
0:53:23 > 0:53:29The team must get fluid in to boost the dangerously low blood pressure.
0:53:38 > 0:53:42Amieth injects fluids, but the patient crashes again.
0:53:44 > 0:53:46After two cardiac arrests,
0:53:46 > 0:53:49the chances of survival are falling rapidly.
0:53:58 > 0:54:04They manage to restart the heart again. But the pulse is very weak.
0:54:04 > 0:54:06OK, so let's get one person's fingers on the pulse,
0:54:06 > 0:54:08if they could stay with that.
0:54:08 > 0:54:11Milla checks the heartbeat manually
0:54:11 > 0:54:14by monitoring the pulse in the wrist.
0:54:14 > 0:54:16PH 6.99.
0:54:16 > 0:54:19It's now her responsibility to call out
0:54:19 > 0:54:21if the patient's heart stops again.
0:54:21 > 0:54:22It says -24.
0:54:22 > 0:54:26I still need to continue. Yes, thank you.
0:54:26 > 0:54:28It's the most important job going.
0:54:31 > 0:54:35After almost an hour, the team stabilizes the patient.
0:54:39 > 0:54:43With her first crash call over, Milla can head back to the wards.
0:54:43 > 0:54:47- Anything else I can do?- No, thank you very much.- Thanks very much.
0:54:47 > 0:54:50When you get there, it's quite overwhelming
0:54:50 > 0:54:53because as a medical student, you get there and you stand back,
0:54:53 > 0:54:56where as this is the time that you get in there.
0:54:56 > 0:54:59And you do everything that you can.
0:54:59 > 0:55:03So it's a very different feeling, I think, doing it as a doctor.
0:55:09 > 0:55:11I've been looking forward to tonight so much.
0:55:11 > 0:55:12It's Friday night.
0:55:12 > 0:55:14Are you going to get trashed?
0:55:14 > 0:55:16No, I'm just going to have a good chat and a dance.
0:55:16 > 0:55:20It's the end of their first few shifts as doctors.
0:55:20 > 0:55:23And the juniors get a chance to let off steam.
0:55:23 > 0:55:27- It's been hard, but brilliant.- It's nice when the patient is so kind.
0:55:27 > 0:55:30When you discharge them and they go, "Thank you so much for your help."
0:55:30 > 0:55:33And you're like, "Oh, he's talking to me"!
0:55:33 > 0:55:35What has been your best memory?
0:55:35 > 0:55:39Just, like, feeling that you fit in a bit more with the team.
0:55:39 > 0:55:42It's nice to come in the morning and people remember your name.
0:55:42 > 0:55:45They'll be, like, "Hi, Andy." Or, "Hi, Adam."
0:55:45 > 0:55:49In which case, they're not actually remembering my name. But it's close.
0:55:52 > 0:55:54- Ready?- Yeah.
0:55:54 > 0:55:58I think I'm slowly feeling like a doctor.
0:55:58 > 0:56:04I'm definitely not confident to treat patients by myself at all.
0:56:04 > 0:56:06But I'm slowly working my way.
0:56:08 > 0:56:12It still feels a bit strange when people say Dr Steval.
0:56:12 > 0:56:16I still feel a bit like I'm a bit of a fraud in that respect.
0:56:16 > 0:56:19But I guess I'm doing the job, so I guess I must be a doctor.
0:56:19 > 0:56:22Good tequila.
0:56:22 > 0:56:25Next time on Junior Doctors...
0:56:25 > 0:56:29- Can Ben cut it treating kids? - I can't do it!
0:56:29 > 0:56:32HE CRIES Alfie, Alfie.
0:56:32 > 0:56:36- Can Amieth make the right calls in A&E?- Have you seen the back?- Yeah.
0:56:36 > 0:56:39- All the way down the back? - All right, shall we stitch first?
0:56:39 > 0:56:41And Priya faces some tough challenges.
0:56:41 > 0:56:44Your line has come out, we need to put another one in.
0:56:44 > 0:56:47I said to her, "I want the nurse." Please don't touch it.
0:56:55 > 0:56:59Subtitles by Red Bee Media Ltd