0:00:05 > 0:00:07Emergencies...
0:00:10 > 0:00:13..bad behaviour,
0:00:13 > 0:00:16bedside battles,
0:00:16 > 0:00:19and buckets of blood.
0:00:19 > 0:00:21It's a tough job being a doctor.
0:00:21 > 0:00:25It's even tougher when they're young...
0:00:25 > 0:00:27Am I right, or not?
0:00:27 > 0:00:29'I feel like a child, because in their eyes,'
0:00:29 > 0:00:31I think you probably are.
0:00:31 > 0:00:33- I don't want to scare you. - ..Untried...
0:00:33 > 0:00:35It's my second day.
0:00:35 > 0:00:38The first time any of us do anything, we're going to be...
0:00:38 > 0:00:40..and inexperienced.
0:00:40 > 0:00:43- 'Everyone's in the same boat.' - Push it through.
0:00:43 > 0:00:45No-one knows what they're doing.
0:00:45 > 0:00:47But after years of studying...
0:00:47 > 0:00:49Oh, dear.
0:00:49 > 0:00:53..it's time to put theory into practice on medicine's front line.
0:00:53 > 0:00:55Clear.
0:00:56 > 0:00:59Sharing this house in London...
0:00:59 > 0:01:01I'm crap at table tennis anyway.
0:01:01 > 0:01:03..are eight junior doctors.
0:01:03 > 0:01:08Second years Ben and Amieth have been qualified for just 12 months.
0:01:08 > 0:01:12I thought, "Oh, my God, what am I going to do?"
0:01:12 > 0:01:15First years Aki, Sameer, and Lucy...
0:01:15 > 0:01:19He was like, "Thanks a lot," when I put his catheter in.
0:01:19 > 0:01:24..Milla, Andy and Priya have been doctors for two weeks.
0:01:24 > 0:01:28Men should stay at home and do the cooking, women should go out and become good doctors.
0:01:28 > 0:01:32Now they're finding out how tough life on the wards can really be...
0:01:32 > 0:01:34- Have you seen the back of him?- Yeah.
0:01:34 > 0:01:37All the way down the back.
0:01:37 > 0:01:40Your line's come out and we need to put another one in.
0:01:40 > 0:01:43I said to her, I want the nurse, please, don't touch it.
0:01:43 > 0:01:46There should be a disclaimer on every doctor's forehead that says,
0:01:46 > 0:01:50- "Everything we try and do is in your best interests." - ..and face the reality
0:01:50 > 0:01:52that they can't save everyone.
0:01:52 > 0:01:55I don't think there's anything extra we could have done, really.
0:01:55 > 0:01:59Everybody has got to die, and I think that's what she wanted,
0:01:59 > 0:02:01to drift away, and that's exactly what she did.
0:02:15 > 0:02:17It's morning in South-West London.
0:02:19 > 0:02:24At the house they're sharing, our eight newly-qualified doctors
0:02:24 > 0:02:28get ready for their next shifts at the Chelsea and Westminster Hospital.
0:02:35 > 0:02:38Second-year Ben is working in paediatric surgery.
0:02:38 > 0:02:42Working with kids is something he's always wanted to do.
0:02:42 > 0:02:44I've been looking forward to it for years.
0:02:44 > 0:02:47I'm nervous, because all the skills are different.
0:02:47 > 0:02:49Because you're working on tiny little kids...
0:02:49 > 0:02:53I'm a little bit nervous as well, but really excited about starting.
0:03:00 > 0:03:02Hello, who's your favourite Star Wars character?
0:03:02 > 0:03:04Darth Vader.
0:03:04 > 0:03:07The Chelsea and Westminster's children's wards
0:03:07 > 0:03:09look after over 75,000 kids a year...
0:03:09 > 0:03:12We're just taking the bandages off.
0:03:12 > 0:03:16..many of them born with life-threatening conditions.
0:03:16 > 0:03:17Don't start crying on us.
0:03:17 > 0:03:22Four-month-old Yaseen has been on the ward since birth.
0:03:22 > 0:03:26Today, he's being prepared for a stomach operation.
0:03:28 > 0:03:30Ben needs to take blood for testing,
0:03:30 > 0:03:34but getting it from such a tiny baby is a tricky job.
0:03:34 > 0:03:37Perhaps a bit lower down? Because he's holding it high.
0:03:37 > 0:03:40You're not giving us any more, are you?
0:03:40 > 0:03:45It's even tougher under the watchful eye of a worried mum.
0:03:48 > 0:03:50I'm sorry.
0:03:50 > 0:03:53Yaseem.
0:03:53 > 0:03:54OK, OK.
0:03:56 > 0:03:59BABY CRIES
0:03:59 > 0:04:03'It's a nightmare getting blood from teeny, teeny little babies.
0:04:04 > 0:04:06'It is completely different from taking it from an adult.'
0:04:06 > 0:04:11You've got a tiny needle and little drips of blood to try and collect,
0:04:11 > 0:04:16it's a completely different process and one that I need to learn.
0:04:16 > 0:04:20Not all Ben's patients are so small.
0:04:20 > 0:04:21You all right there, Alfie?
0:04:21 > 0:04:24Hiya. Right, you still got that magic cream on?
0:04:24 > 0:04:26Alfie is five years old.
0:04:26 > 0:04:30He needs a hollow needle, called a cannula, inserted into a vein,
0:04:30 > 0:04:34before a vital bowel operation tomorrow.
0:04:34 > 0:04:36I'm going to spray it on your arm, OK?
0:04:36 > 0:04:38Ready? It should make it all go numb in a minute.
0:04:38 > 0:04:41It's a chance for Ben to practise on a larger patient,
0:04:41 > 0:04:43with bigger veins.
0:04:44 > 0:04:46What's that?
0:04:46 > 0:04:48It's a little needle that we need
0:04:48 > 0:04:50to put in your hand,
0:04:50 > 0:04:52to give you some medication, OK?
0:04:52 > 0:04:55Do you want to hold Mummy's hand and lie back whilst we do it?
0:04:55 > 0:04:56It's all right.
0:04:56 > 0:04:59You've got the cream on there, so it shouldn't hurt.
0:04:59 > 0:05:00It should be all right.
0:05:00 > 0:05:02- You don't need to watch. - Look at Mummy, there we go.
0:05:02 > 0:05:04It hurts!
0:05:04 > 0:05:06That's it, lie your head back, there you are,
0:05:06 > 0:05:08look round at Mummy, there you are,
0:05:08 > 0:05:11and think what nice treat she's going to get you for this.
0:05:11 > 0:05:14I can't do it!
0:05:14 > 0:05:15HE SOBS
0:05:15 > 0:05:17Alfie...
0:05:17 > 0:05:22Ben might be eager to work with kids, but Alfie has other ideas.
0:05:22 > 0:05:24Alfie, Alfie...
0:05:25 > 0:05:26OK.
0:05:26 > 0:05:28Get off, get off me!
0:05:28 > 0:05:30Alfie, Alfie...
0:05:30 > 0:05:34- Come on, lay down, lay down. - Alfie, Alfie?
0:05:34 > 0:05:39It's all right, give him a minute. Alfie...
0:05:39 > 0:05:43I don't want it on there. I don't want it!
0:05:43 > 0:05:47Alfie, we'll do it very quickly, get it over and done with.
0:05:47 > 0:05:49Can you be big and brave and strong for us?
0:05:51 > 0:05:53Don't be silly.
0:05:53 > 0:05:54I don't like it here!
0:05:54 > 0:05:59I know you don't, but come here, and me and you will go for a walk.
0:06:01 > 0:06:05He was very keen at the beginning to watch and see what was going on.
0:06:05 > 0:06:09If I'd been thinking a bit more, I'd have probably got him lying down
0:06:09 > 0:06:11and not watching at all to start with,
0:06:11 > 0:06:15so he didn't see the needle the first time and freak out.
0:06:15 > 0:06:18But he has to have his operation tomorrow, it's a big operation,
0:06:18 > 0:06:20it's been planned with a specialist team
0:06:20 > 0:06:23coming in from another hospital, so it's frustrating.
0:06:27 > 0:06:31- I think we need to X-ray that.- OK.
0:06:31 > 0:06:33The thing that we're worried about is a break.
0:06:33 > 0:06:37Like Ben, second year Amieth is trying to prove himself
0:06:37 > 0:06:41in a new department with unique challenges.
0:06:41 > 0:06:43He's working in A&E,
0:06:43 > 0:06:46where life-and-death decisions are made every day.
0:06:50 > 0:06:53The first emergency of the day is coming in.
0:06:53 > 0:06:57We need to do a 12 V, is anyone able to do a 12 V for us?
0:07:01 > 0:07:04A man is suffering severe breathing difficulties.
0:07:05 > 0:07:11- Shall we sit you up a little bit? - Sit up a little bit more, sir.
0:07:11 > 0:07:15Everything else is normal. Amieth, if you could get a line.
0:07:15 > 0:07:18OK, I'm taking the keys off. I'm going to pop them in your pocket.
0:07:18 > 0:07:22Amieth must find a vein, to get some blood for essential tests.
0:07:22 > 0:07:25I'm just going to put a needle into your hand, OK?
0:07:25 > 0:07:28So I'll just put this stretchy thing around you.
0:07:28 > 0:07:32Can you make a fist ten times? Ten times.
0:07:47 > 0:07:50I'll run that and I'll come back and do the line.
0:07:52 > 0:07:54He finally gets a line in
0:07:54 > 0:07:56and can test the blood.
0:07:59 > 0:08:00PH 7.41.
0:08:00 > 0:08:04The results show the patient is out of immediate danger.
0:08:08 > 0:08:11But as the team stabilise him, another call comes in.
0:08:11 > 0:08:14PHONE RINGS
0:08:14 > 0:08:18This time, it's not an emergency - it's Amieth's personal mobile.
0:08:18 > 0:08:20Stop ringing me!
0:08:21 > 0:08:23PHONE CONTINUES TO RING
0:08:27 > 0:08:29I'm not going to answer it.
0:08:36 > 0:08:40'My mobile phone kept ringing, which was a little bit embarrassing.'
0:08:40 > 0:08:42Every time it rings, I think to myself,
0:08:42 > 0:08:45should I stop what I'm doing and cancel it,
0:08:45 > 0:08:48or should I ignore it and let it ring?
0:08:48 > 0:08:50Because it does make a lot of noise.
0:08:50 > 0:08:53It's a bad habit I should address.
0:08:53 > 0:08:58Amieth will have to work extra hard to impress his boss, Doctor Cleaver.
0:08:58 > 0:09:02Oh, Amieth. This is the problem with doing it like that.
0:09:02 > 0:09:05When you take the seal off the tube, one of the pitfalls
0:09:05 > 0:09:10is that you loosen the top of the tube. OK?
0:09:10 > 0:09:14- It's still a bit wobbly, actually. - It's still a bit wobbly.
0:09:14 > 0:09:17'Amieth has had quite a busy day today. There were a few issues.'
0:09:17 > 0:09:21He struggled to put the lid on one of the blood tests, firmly down,
0:09:21 > 0:09:24so when he handed them to me, there was blood everywhere.
0:09:24 > 0:09:26And in a resus situation,
0:09:26 > 0:09:28there's nothing worse than a phone going off.
0:09:28 > 0:09:31It would be something I'd like him to avoid in future.
0:09:31 > 0:09:33Just a few learning points.
0:09:33 > 0:09:35'Lots of slip-ups today.'
0:09:35 > 0:09:37Blood leaking out of the bottle,
0:09:37 > 0:09:39and my phone kept going off.
0:09:39 > 0:09:43This was a little bit of a calamitous day.
0:09:50 > 0:09:52Can I have a look at your hands then, Alfie?
0:09:52 > 0:09:56Back in Paediatrics, time's running out
0:09:56 > 0:09:59for Ben to fit a cannula to Alfie before his essential bowel surgery.
0:09:59 > 0:10:02It will be very quick and then it'll all be done, OK?
0:10:02 > 0:10:05I don't want it!
0:10:05 > 0:10:08- He's not going to do it.- It's not going to go in with him doing that.
0:10:08 > 0:10:10Get off me, get off me!
0:10:10 > 0:10:12All of these things that you have had done...
0:10:12 > 0:10:14I'm not listening.
0:10:14 > 0:10:16All these things...
0:10:16 > 0:10:17I'm not listening!
0:10:17 > 0:10:19..and you're getting upset over this!
0:10:19 > 0:10:20I'm not listening!
0:10:20 > 0:10:22I can put it in his foot,
0:10:22 > 0:10:26but I don't think he'll like that any more than his hand.
0:10:26 > 0:10:29Do you want me to do it in your foot instead?
0:10:29 > 0:10:31Alfie, can we come to a deal?
0:10:31 > 0:10:34I won't put the big needle in. I'll just use a tiny little...
0:10:34 > 0:10:37- No, no!- Alfie, listen to me.
0:10:37 > 0:10:39No!
0:10:39 > 0:10:40I'm not doing it.
0:10:40 > 0:10:46Ben's not used to failure. He's always been driven to succeed.
0:10:50 > 0:10:53I'm the first person in my family to do medicine.
0:10:53 > 0:10:57You feel like you can do something and make an immediate difference.
0:10:57 > 0:11:01Yeah. With you, it's the God complex!
0:11:01 > 0:11:02The family are pleased.
0:11:02 > 0:11:06Grandparents are happy, parents were happy that I was going into medicine.
0:11:08 > 0:11:10I've been playing rugby since I was about 11,
0:11:10 > 0:11:12and that's what I do to relax.
0:11:12 > 0:11:16Rugby is one of those things that you have to put 100% into.
0:11:16 > 0:11:19I always expect 100% of myself.
0:11:19 > 0:11:21Ben is pretty competitive.
0:11:21 > 0:11:25I mean, he will not stop. He's freakishly driven.
0:11:28 > 0:11:32I got good grades, I was always happy with how I did at med school.
0:11:32 > 0:11:35Touch wood, I didn't fail anything, and I hopefully won't now.
0:11:37 > 0:11:38Back on the children's ward,
0:11:38 > 0:11:41Ben has to admit to senior surgeon Simon Clarke
0:11:41 > 0:11:44that he can't get a cannula into Alfie.
0:11:44 > 0:11:47No, he's not had any bloods or cannulas because he was so agitated.
0:11:47 > 0:11:49Why was he so difficult?
0:11:49 > 0:11:51- Just not cooperative? - Just not cooperative.
0:11:51 > 0:11:54- Four people holding him down. - Thumping you?
0:11:54 > 0:11:59- Not me, just his mum and dad. - Welcome to Paediatrics. OK.
0:11:59 > 0:12:02We're not going to do any of the bloods or cannulas now,
0:12:02 > 0:12:06they'll wait till he's asleep and they'll do them all in theatre.
0:12:06 > 0:12:10- It seemed the more sensible option. - Is he going down at 2:30?
0:12:10 > 0:12:11I don't know when he's going down...
0:12:11 > 0:12:14This time, they'll put the cannula in
0:12:14 > 0:12:16after Alfie's under general anaesthetic.
0:12:16 > 0:12:18Alfie, we'll get you down later on.
0:12:18 > 0:12:21We're not going to put any needles in you today.
0:12:21 > 0:12:24- Not until you're asleep.- Aah!
0:12:25 > 0:12:28It's a relief for Alfie and for Ben.
0:12:28 > 0:12:30See you later, Alfie.
0:12:40 > 0:12:46For some of our junior doctors, it's the end of another tough day.
0:12:46 > 0:12:47Hello, Priya.
0:12:47 > 0:12:49Oh, hello, stranger.
0:12:49 > 0:12:51For others, it's just the start.
0:12:51 > 0:12:56This will be the first night shift for 24-year-old Priya.
0:12:56 > 0:12:59I do feel really nervous, Amieth.
0:12:59 > 0:13:02Fine, I've been in the hospital for a week now,
0:13:02 > 0:13:06but I've had to do, sort of, day-to-day tasks with a team,
0:13:06 > 0:13:09and loads of people around.
0:13:09 > 0:13:11Loads of people I can call.
0:13:11 > 0:13:13But now it's just a quiet hospital at night
0:13:13 > 0:13:17and I don't want to keep annoying my SHO and be like,
0:13:17 > 0:13:20"How do I do this? I can't do this." Do you know what I mean?
0:13:20 > 0:13:23It's often a case of keeping the patient comfortable,
0:13:23 > 0:13:25and alive,
0:13:25 > 0:13:28until the regular team comes in in the morning.
0:13:28 > 0:13:31I'm going upstairs, I'll see you later.
0:13:31 > 0:13:32- Wish me luck.- Good luck.
0:13:32 > 0:13:38'I feel that at night time, you don't really have that much of...comfort.'
0:13:38 > 0:13:41In the day, there's the security of having other medical staff around
0:13:41 > 0:13:45that you can ask, or you can ask one of your colleagues,
0:13:45 > 0:13:47if you don't want to ask someone more senior.
0:13:47 > 0:13:50But every time the bleep goes off, my heart sinks.
0:13:50 > 0:13:52I'm like, "Oh, no, not another bleep!"
0:13:52 > 0:13:55And going it alone as a doctor is an especially big step for Priya,
0:13:55 > 0:13:58who's used to being protected by her family.
0:14:02 > 0:14:06There are certain career options that I have considered in my life.
0:14:06 > 0:14:09One of the more fun ones is becoming a Bollywood actress,
0:14:09 > 0:14:14and that was something that I held on to for such a long time,
0:14:14 > 0:14:16from my younger years.
0:14:16 > 0:14:19Even recently, I know it's really sad, but I'll watch videos of songs
0:14:19 > 0:14:23and then I'll re-enact them in front of the mirror.
0:14:24 > 0:14:28I always felt that, yes, definitely, ultimately, I would become a doctor.
0:14:28 > 0:14:30It was a given from a very young age.
0:14:30 > 0:14:33# My mama told me when I was young... #
0:14:33 > 0:14:36- Beautiful!- Oh, thanks, Mum.- Oh!
0:14:37 > 0:14:40My family is very important to me and I hold the motto -
0:14:40 > 0:14:43family first. I'm very, very close to them.
0:14:43 > 0:14:47They give me so much love and appreciation. I lean on them a lot.
0:14:47 > 0:14:49I like to think they lean on me a bit, too.
0:14:52 > 0:14:55- Tea?- Yes...
0:14:55 > 0:14:57'She is still the family's baby,'
0:14:57 > 0:15:00so we look after her very well.
0:15:00 > 0:15:03# ..I'm beautiful in my way... #
0:15:03 > 0:15:06I get pampered, bless my parents.
0:15:06 > 0:15:09They do everything for me. It's really, really naughty.
0:15:09 > 0:15:10Even when I try to tell them not to,
0:15:10 > 0:15:13because I'm 24 now, I can do this myself,
0:15:13 > 0:15:15they're like, "No, we will do this for you."
0:15:15 > 0:15:18And they see me as a little Bollywood princess at times.
0:15:18 > 0:15:20# The night is alive
0:15:20 > 0:15:22# You can feel the heart beat... #
0:15:22 > 0:15:25'Broadcasting live on Channel 6
0:15:25 > 0:15:26'from the second floor of'
0:15:26 > 0:15:28the hospital, here on the Fulham Road.
0:15:28 > 0:15:30Throughout the night,
0:15:30 > 0:15:34Priya will be the first port of call for patients on the surgical wards.
0:15:34 > 0:15:37A big responsibility for a junior doctor
0:15:37 > 0:15:39with just two weeks' experience.
0:15:39 > 0:15:41BLEEPING
0:15:41 > 0:15:45Good evening, surgical F1, on call. Got a bleep.
0:15:45 > 0:15:47Cannula? OK, that's fine.
0:15:47 > 0:15:51Just remind me, what's it for, fluids or antibiotics?
0:15:51 > 0:15:54OK. Thanks, bye-bye.
0:15:56 > 0:15:59Priya has been called to see 72-year-old Mrs John,
0:15:59 > 0:16:02recovering after a stomach operation.
0:16:02 > 0:16:05She needs to be given medicine by drip,
0:16:05 > 0:16:09so Priya will have to find a vein and use a needle.
0:16:09 > 0:16:11Mrs John, how are you?
0:16:11 > 0:16:12The line's come off in your arm,
0:16:12 > 0:16:14so I'll need to put in another one.
0:16:14 > 0:16:15I'll try. I'll find it.
0:16:15 > 0:16:17Why do you prefer that one?
0:16:21 > 0:16:24Like many of her fellow juniors, Priya hasn't had much experience
0:16:24 > 0:16:29doing this important, but tricky procedure.
0:16:29 > 0:16:31OK, I tell you what, I'll try here,
0:16:31 > 0:16:34- but if I don't get it, I'll have to try over there, OK?- OK.
0:16:34 > 0:16:36You have very thin veins here.
0:16:36 > 0:16:40But I'll give it a go.
0:16:41 > 0:16:44OK, Mrs John, sharp scratch coming up.
0:16:44 > 0:16:46Ouch.
0:16:46 > 0:16:49I'm sorry, I know it's painful.
0:16:51 > 0:16:53Ow, ow, ow.
0:16:53 > 0:16:56No, I'm afraid not.
0:16:56 > 0:17:00With no success, Priya calls her senior house officer for advice.
0:17:00 > 0:17:06I got bleeped to do a cannula and this lady won't let me do it in her arm whatsoever,
0:17:06 > 0:17:08and she hasn't got good veins in her hand,
0:17:08 > 0:17:12and she said, "If you can't do it in my hand, I want you to ask somebody else to."
0:17:12 > 0:17:13So...
0:17:14 > 0:17:17I'll have another go.
0:17:17 > 0:17:19And then if she refuses?
0:17:21 > 0:17:25OK, that's fine. I'm happy to have another go, it's just that, you know,
0:17:25 > 0:17:27she seems very annoyed, but, OK.
0:17:27 > 0:17:29No, that's fine. I'll tell her.
0:17:29 > 0:17:31That was my SHO.
0:17:31 > 0:17:36She was saying that you shouldn't let your patient boss you around,
0:17:36 > 0:17:40you should do it where it's best for you to get access.
0:17:40 > 0:17:43And where I get access is best for her as well.
0:17:43 > 0:17:46Hello, Mrs John, I've just had a word with one of my seniors
0:17:46 > 0:17:49and she said that the best place is the arm,
0:17:49 > 0:17:52and unfortunately, she can't come and she's told me to try over here.
0:17:52 > 0:17:55It's important we get this line in
0:17:55 > 0:17:58so you can have your antibiotics.
0:18:03 > 0:18:07OK, well, I'm the doctor that's on call. It's your choice.
0:18:07 > 0:18:11I can't stress that it's important for you to have the antibiotics,
0:18:11 > 0:18:14and right now, there's nobody else that can do it. My senior's busy.
0:18:16 > 0:18:18In your arm?
0:18:21 > 0:18:24All right, Mrs John. Sharp scratch.
0:18:24 > 0:18:28The more you shake, the more it will hurt.
0:18:28 > 0:18:30Just keep your arm still.
0:18:38 > 0:18:40OK, that's fine.
0:18:40 > 0:18:43- You are going to have to wait, I'm afraid.- OK.
0:18:43 > 0:18:45'It was unsuccessful.'
0:18:45 > 0:18:49I persuaded her into letting me put it in her arm,
0:18:49 > 0:18:54then I put the tourniquet on her arm, and looked for a vein,
0:18:54 > 0:18:59and my heart just sank when she had bad veins in her arm too.
0:19:00 > 0:19:04So now I feel really, really, really deflated.
0:19:12 > 0:19:14- Hi, David.- How's it going?- Good.
0:19:14 > 0:19:15- Have a good day.- See you.
0:19:15 > 0:19:17See you later.
0:19:24 > 0:19:28Hi, I'm the on-call F1 for trolleys.
0:19:28 > 0:19:34Today, first year Sameer is working on call across the whole hospital.
0:19:34 > 0:19:37Hello. So, I'm just going to
0:19:37 > 0:19:39ask you a few questions.
0:19:39 > 0:19:42He's been paged to see Ms Jamedar, who's suffered a fall.
0:19:42 > 0:19:44Can you tell me where you are?
0:19:47 > 0:19:50Sameer must check for any possible damage to her brain,
0:19:50 > 0:19:53by asking some simple questions.
0:19:53 > 0:19:55I want you to remember this address -
0:19:55 > 0:19:5842 West Street. Can you say that to me?
0:20:00 > 0:20:02And can you count backwards from 20?
0:20:07 > 0:20:09Can you say "British constitution"?
0:20:12 > 0:20:14Can you say, "red lorry, yellow lorry"?
0:20:17 > 0:20:18Can you keep saying it?
0:20:21 > 0:20:23All right, thanks for bearing with me.
0:20:23 > 0:20:26- OK.- OK? And I'll see you later.
0:20:27 > 0:20:29Red lorry, yellow lorry. Red lorry,
0:20:29 > 0:20:31yellow lorry. So that's the thing,
0:20:31 > 0:20:33I don't want to be hypocritical
0:20:33 > 0:20:36and judge her when I can't say it myself!
0:20:39 > 0:20:44# I don't know who you are... #
0:20:44 > 0:20:48I'd describe myself as fun, fair...
0:20:48 > 0:20:52um, but not funfair.
0:20:52 > 0:20:55Maybe you'd like a new suit.
0:20:55 > 0:20:56That's what Dad wears.
0:20:56 > 0:20:57Oh, no. Is it?
0:20:57 > 0:21:00- Actually, you don't want to end up looking like Dad.- No.
0:21:00 > 0:21:02He is an enigma.
0:21:02 > 0:21:03# ..Are you from another world...? #
0:21:03 > 0:21:08I can't say I know that much about him,
0:21:08 > 0:21:10and that's strange, being his sister.
0:21:10 > 0:21:14My parents are threatening to get me an arranged marriage.
0:21:14 > 0:21:16I don't want to be swapped into some random marriage,
0:21:16 > 0:21:20in exchange for, like, a cow or a microwave.
0:21:20 > 0:21:23# ..Beautiful stranger
0:21:23 > 0:21:25# How do you do? #
0:21:25 > 0:21:28I don't feel like a real doctor yet.
0:21:28 > 0:21:31I think once you're making decisions independently
0:21:31 > 0:21:34and you're managing patients on your own,
0:21:34 > 0:21:36is when you really feel like a real doctor.
0:21:36 > 0:21:39I think at the moment, I feel like a fake doctor.
0:21:42 > 0:21:46# Club Tropicana drinks are free
0:21:46 > 0:21:48# Fun and sunshine
0:21:48 > 0:21:51# There's enough for everyone... #
0:21:51 > 0:21:54Wham! and Club Tropicana on Radio Chelsea and Westminster,
0:21:54 > 0:21:57chosen by Andy, one of the two junior doctors.
0:21:57 > 0:21:59As two of the newest doctors,
0:21:59 > 0:22:03Sameer and housemate Andy are being interviewed on hospital radio.
0:22:03 > 0:22:08It's broadcast to entertain patients and staff on the wards.
0:22:08 > 0:22:13Does it really feel like you're actually doctors yet?
0:22:13 > 0:22:15I haven't actually done any notes yet.
0:22:15 > 0:22:18I think, after I've done that first set of notes,
0:22:18 > 0:22:21I might feel more ready to be, yes, I'm a doctor.
0:22:21 > 0:22:25Sometimes, I feel like a medical student trapped in the hospital.
0:22:25 > 0:22:27Trapped in the hospital?
0:22:27 > 0:22:30Are you not enjoying yourself? Here's a question,
0:22:30 > 0:22:32if you could be the personal doctor
0:22:32 > 0:22:36to anyone in the world, famous or otherwise, who would it be and why?
0:22:36 > 0:22:37Sameer?
0:22:37 > 0:22:40I'd like to treat extraterrestrials,
0:22:40 > 0:22:42because I think in the future,
0:22:42 > 0:22:46when the humans come in contact with the alien master race,
0:22:46 > 0:22:50it will be interesting to kind of learn about their anatomy.
0:22:50 > 0:22:54- LAUGHTER - Right, that was very unexpected.
0:22:54 > 0:22:58- Fantastic. Are you are a sci-fi fan, Sameer?- No.- Right, OK.
0:22:58 > 0:23:00I'd like to treat Sameer,
0:23:00 > 0:23:02so I can explore what's going on in his brain, possibly.
0:23:02 > 0:23:04For you guys, if you weren't doctors,
0:23:04 > 0:23:08what would be your ideal job?
0:23:08 > 0:23:10I'd be Batman.
0:23:10 > 0:23:11LAUGHTER
0:23:11 > 0:23:15And why, Sameer? Why would you be Batman?
0:23:15 > 0:23:20I went into medicine so I could help people from disease
0:23:20 > 0:23:23and if I couldn't do that, I would like to help them from...
0:23:23 > 0:23:25save them from organised crime.
0:23:25 > 0:23:28Right, and drive a cool car?
0:23:28 > 0:23:31Yes, an environmentally friendly car.
0:23:37 > 0:23:41For Priya, it's the end of a long night shift.
0:23:41 > 0:23:45She's learning fast that challenging situations
0:23:45 > 0:23:46can be a difficult part of the job.
0:23:46 > 0:23:49Hi, did you bleep me?
0:23:49 > 0:23:52- Yes.- Which patient is it? - In six.- In six.
0:23:52 > 0:23:57She's been called back to see Mrs John,
0:23:57 > 0:24:01who was less than impressed with Priya's last visit.
0:24:01 > 0:24:03This is the lady who I tried
0:24:03 > 0:24:04to cannulate yesterday,
0:24:04 > 0:24:08um, and I didn't manage to get it in
0:24:08 > 0:24:11and she got really, really angry.
0:24:11 > 0:24:13She needs another cannula.
0:24:13 > 0:24:16So, this should be interesting.
0:24:16 > 0:24:18Good morning, how are you?
0:24:20 > 0:24:21How are you feeling, Mrs John?
0:24:23 > 0:24:25Your line's come out
0:24:25 > 0:24:26and we need to put another one in.
0:24:33 > 0:24:34OK, may I ask why?
0:24:41 > 0:24:44OK, I understand. You need to have your antibiotics
0:24:44 > 0:24:46at eight in the morning, that's the reason we need the line.
0:24:46 > 0:24:49I'll ask the nurse...
0:24:49 > 0:24:50OK. OK.
0:24:52 > 0:24:54OK. That's fine.
0:24:56 > 0:25:00'It was a bit embarrassing when she said, "I don't want you to do it."
0:25:00 > 0:25:02'It's important not to take it personally.'
0:25:02 > 0:25:05I didn't take it as if she was having a go at me.
0:25:05 > 0:25:09It was more a combination of how she was feeling, not feeling that great,
0:25:09 > 0:25:12and then having me, who probably wouldn't have got it in,
0:25:12 > 0:25:15just about to go and annoy her.
0:25:15 > 0:25:19Her experience with Priya means junior doctors
0:25:19 > 0:25:21get little sympathy from Mrs John.
0:25:21 > 0:25:24Absolutely, they need to learn and they need to be given a chance,
0:25:24 > 0:25:27but they've either got a feel for it or they haven't.
0:25:27 > 0:25:32And you don't keep looking for a vein and, can you find it, can you find it?
0:25:32 > 0:25:36You've either got it, or you haven't got it, I'm sorry.
0:25:44 > 0:25:48Hiya, how you doing? All right?
0:25:48 > 0:25:51- Come to do the crem form for me? - Yes.
0:25:51 > 0:25:54All the juniors are trained to save lives.
0:25:54 > 0:25:56But Sameer is finding out that dealing with death
0:25:56 > 0:25:59is also an inevitable part of being a doctor.
0:25:59 > 0:26:01Thank you.
0:26:01 > 0:26:04He's in the mortuary, where dead bodies are stored.
0:26:04 > 0:26:07Before a body can be cremated,
0:26:07 > 0:26:11it must be checked for dangerous foreign objects by a doctor.
0:26:11 > 0:26:15Today, it's Sameer's responsibility. He's never done this before.
0:26:32 > 0:26:36You don't think it's going to be risky?
0:26:36 > 0:26:40Pacemakers are explosion risks. Shouldn't be anything like that?
0:26:40 > 0:26:41I think it is.
0:26:46 > 0:26:49Because it's not part of a doctor's normal duties,
0:26:49 > 0:26:53they are paid just over £70 for each cremation form they fill out.
0:26:53 > 0:26:56I just feel quite uncomfortable with the fact
0:26:56 > 0:26:58that I'm getting money for this.
0:26:58 > 0:27:02I know a lot of people will give it to charity because I think
0:27:02 > 0:27:06they'd feel strange about accepting this money,
0:27:06 > 0:27:08um, as part of, you know,
0:27:08 > 0:27:11the death of a patient.
0:27:11 > 0:27:13I think I feel the same way.
0:27:13 > 0:27:15He was a bit nervous, but that's expected.
0:27:15 > 0:27:18I think there's a difference between
0:27:18 > 0:27:21if you're on the ward, somebody dies and they're kind of,
0:27:21 > 0:27:24freshly dead, for want of a better expression.
0:27:24 > 0:27:28Decomposition, it's just a smell you get with the dead.
0:27:28 > 0:27:30Some people might just hate the smell of death.
0:27:30 > 0:27:32Thanks, Sameer. Cheers, cheers.
0:27:40 > 0:27:43So you're not allowed to have anything to eat.
0:27:43 > 0:27:46Upstairs, in the children's ward,
0:27:46 > 0:27:50Ben has another chance to improve on putting young patients at ease.
0:27:50 > 0:27:52- Shall we sit this bed up a bit? - Which button?- Which button is it?
0:27:52 > 0:27:54Press that one.
0:27:54 > 0:27:56- Which one?- That one.
0:27:57 > 0:27:59Go on, keep pressing. Is that far enough?
0:27:59 > 0:28:01There we go. Right.
0:28:01 > 0:28:05Three-year-old Gabriella is in for life-saving surgery
0:28:05 > 0:28:08and Ben will be assisting.
0:28:08 > 0:28:09I've been in theatre a few times
0:28:09 > 0:28:13as a student, but first paediatrics, since qualifying.
0:28:13 > 0:28:16It's always nice to get to theatre
0:28:16 > 0:28:17as much as possible.
0:28:17 > 0:28:20Gabriella was born with a defect.
0:28:20 > 0:28:23Her intestines were outside her body.
0:28:23 > 0:28:26Much of her bowel had to be removed.
0:28:26 > 0:28:32Now she is partly fed through a tube under her skin.
0:28:32 > 0:28:35Ben is helping to put in a new line, under the careful eye
0:28:35 > 0:28:37of surgeon Simon Clarke and his team.
0:28:37 > 0:28:41It's the sort of condition that... 30, 40 years ago,
0:28:41 > 0:28:47before TPN, intravenous food was commonplace,
0:28:47 > 0:28:50patients like Gabriella didn't make it.
0:28:50 > 0:28:53This is the line we're going to put onto the tunnel
0:28:53 > 0:28:57and when we pull it through the line, we'll then be under the skin
0:28:57 > 0:29:01and we can feed the end into the vein, which we've already isolated.
0:29:01 > 0:29:06Ben helps pull the intravenous line through Gabriella's skin.
0:29:06 > 0:29:11So you're going to pull on the tunnel. I'm going to feed the line.
0:29:11 > 0:29:13- Ready, everyone?- Yes.
0:29:13 > 0:29:16- Let's go.- OK.
0:29:16 > 0:29:20Keep pulling. Good. Pull it, but make sure
0:29:20 > 0:29:23you don't touch anything with that bit of line.
0:29:26 > 0:29:29Can you reach over? Thank you.
0:29:31 > 0:29:35Now the line is in, Ben has to carefully stitch Gabriella's wound.
0:29:35 > 0:29:41- OK?- Personally, I'd never want to pick up the skin with tipped forceps
0:29:41 > 0:29:44- because you leave little bruises all along there.- OK.
0:29:44 > 0:29:48- So, if you just use your finger on the skin.- OK.
0:29:48 > 0:29:50That's good, but it's difficult to make it look nice
0:29:50 > 0:29:52when you've gone through a scar.
0:29:52 > 0:29:58- You've probably made it look nicer than I did.- Well done.- Thank you.
0:29:58 > 0:29:59The operation has gone well.
0:29:59 > 0:30:03And after being frustrated with other challenges on the wards,
0:30:03 > 0:30:05it's a positive step for Ben.
0:30:07 > 0:30:12It's nice to be in surgery and get some hands-on experience.
0:30:12 > 0:30:14I was expecting to hold little bits for someone else.
0:30:14 > 0:30:18Mr Clarke was really good about letting me do stuff
0:30:18 > 0:30:21and got me far more involved than I thought I'd be able to.
0:30:21 > 0:30:23No, it was a great experience.
0:30:23 > 0:30:28He showed a lot of skill that he'd picked up along his first
0:30:28 > 0:30:29foundation year, so I couldn't
0:30:29 > 0:30:32ask for more in a foundation doctor.
0:30:32 > 0:30:34So far, so good.
0:30:40 > 0:30:45Also making a positive start in her new job is housemate Lucy.
0:30:45 > 0:30:47You need to chase her blood results.
0:30:47 > 0:30:50Do you want to type in the number and I'll give you it?
0:30:50 > 0:30:53She's working in General Medicine and Rheumatology.
0:30:53 > 0:30:57They deal with many elderly patients with chronic and incurable conditions.
0:30:57 > 0:31:00She wants to die, she wants to be left alone.
0:31:00 > 0:31:02She doesn't want to eat or drink anything,
0:31:02 > 0:31:04so that has to be addressed,
0:31:04 > 0:31:07and whether we give her fluids and go down that road...
0:31:07 > 0:31:09I am worried. We can't get her to drink anything.
0:31:09 > 0:31:12Well, as soon as we've split jobs, we'll come and examine her.
0:31:12 > 0:31:15- OK. I'll leave it with you. - Thank you.- Thank you.
0:31:15 > 0:31:18A patient has said she just wants to die.
0:31:18 > 0:31:22It's Lucy's job to try and motivate her to take food and water.
0:31:24 > 0:31:28Hello. My name's Lucy.
0:31:28 > 0:31:31Now, I hear you're not drinking very much at the moment.
0:31:34 > 0:31:36We're worried that you're not passing enough urine.
0:31:40 > 0:31:42Listen, I know it's a little bit of a bother,
0:31:42 > 0:31:47but it's important that you do. If you could drink a little bit more when you remember,
0:31:47 > 0:31:49even if you don't feel thirsty, then that would be lovely.
0:31:57 > 0:32:00I will come and see you again in a little while.
0:32:00 > 0:32:02I want you to carry on drinking.
0:32:02 > 0:32:05Just try to encourage as much oral intake as possible.
0:32:05 > 0:32:09If you can just prompt her as much as you can, that would be great.
0:32:12 > 0:32:18'When you see old people who are having a tough time and they're'
0:32:18 > 0:32:20deteriorating mentally and physically
0:32:20 > 0:32:25and they say that they want to give up, I understand that
0:32:25 > 0:32:29because I think if that was one of my family saying that to me,
0:32:29 > 0:32:31you can't help but understand their position.
0:32:31 > 0:32:34People don't say they want to give up for no reason.
0:32:34 > 0:32:35So although it's a difficult one,
0:32:35 > 0:32:38and I think it's something that you become more used to
0:32:38 > 0:32:44as you go along, I think it's trying your hardest to understand
0:32:44 > 0:32:48their thinking, and that makes it, sometimes, a little bit easier.
0:32:52 > 0:32:55All the junior doctors are discovering
0:32:55 > 0:32:59that they will face life-and-death situations every day.
0:33:00 > 0:33:04Sameer is back on call across the whole hospital.
0:33:04 > 0:33:11And this call is a major emergency - a cardiac arrest.
0:33:31 > 0:33:33The patient's heart is failing.
0:33:33 > 0:33:35OK, adrenaline, please.
0:33:40 > 0:33:42Sameer's job is to support the emergency team.
0:33:44 > 0:33:47The patient urgently needs fluids.
0:33:47 > 0:33:51They must find a vein, insert a line, and get fluids flowing.
0:34:07 > 0:34:11With the line in, Sameer takes over chest compressions.
0:34:12 > 0:34:15The team fight to restart the heart.
0:34:15 > 0:34:17But the odds are against them.
0:34:21 > 0:34:24Fewer than 10% of cardiac arrest victims survive.
0:34:26 > 0:34:28It went on for about 40 minutes
0:34:28 > 0:34:32and we were trying to get a pulse back, but we failed in the end
0:34:32 > 0:34:34and the patient died.
0:34:43 > 0:34:46It didn't feel like an hour, it felt like five minutes.
0:34:46 > 0:34:51It felt really quick... I can't believe that that was an hour.
0:34:56 > 0:35:00I feel...quite bad,
0:35:00 > 0:35:05but I don't think there's anything extra we could have done.
0:35:05 > 0:35:09Losing patients is a reality all junior doctors
0:35:09 > 0:35:11must come to terms with.
0:35:11 > 0:35:16It was a bit... It's a bit weird and you kind of feel sad,
0:35:16 > 0:35:19especially because you're watching him
0:35:19 > 0:35:23and you're looking at him as you're doing all this.
0:35:23 > 0:35:26I guess, as you have more of these experiences,
0:35:26 > 0:35:29you learn to cope with them better.
0:35:29 > 0:35:32Um...yeah.
0:35:38 > 0:35:43In the evenings, there's a rare chance for some of the junior doctors to catch up.
0:35:43 > 0:35:46- Are you eating a ke-bab? - A ke-bab?!
0:35:47 > 0:35:49I'm not feeling like cooking.
0:35:49 > 0:35:52That's a serious amount of food for one person.
0:35:52 > 0:35:55Yeah, but I don't have to eat it all today, do I?
0:35:55 > 0:35:59The encounter with her unhappy patient, Mrs John,
0:35:59 > 0:36:00is still on Priya's mind.
0:36:00 > 0:36:05I had one patient who, literally, was like, "No, I don't want anything
0:36:05 > 0:36:09"from you... You really, really hurt me the other day," implying that
0:36:09 > 0:36:14I was rubbish, and I said, "Would you mind letting me have a go?"
0:36:14 > 0:36:17And she said, "No, I absolutely refuse."
0:36:17 > 0:36:20And it sort of made me feel really crappy, but then again,
0:36:20 > 0:36:23I thought of it like this. It was half five in the morning,
0:36:23 > 0:36:24I had just woken her up,
0:36:24 > 0:36:28and she's in hospital, she's obviously not feeling well anyway.
0:36:28 > 0:36:30Cos when I'm ill, I know I get very princess-y and moany.
0:36:30 > 0:36:33- When you're ill?- When I'm ill, I do!
0:36:41 > 0:36:45Priya is back on the General Surgery ward.
0:36:46 > 0:36:49- Is she here now?- Yeah. - OK, I might just go and see her.
0:36:49 > 0:36:52Today, she's prepping someone for a life-saving operation.
0:36:52 > 0:36:56It's a chance to regain her confidence in dealing with patients.
0:36:56 > 0:37:01Is it OK if I just ask you get on to the bed so I can examine you?
0:37:01 > 0:37:02Just lie back.
0:37:03 > 0:37:04Four years ago,
0:37:04 > 0:37:09Bridget had surgery to remove part of her intestine affected by cancer.
0:37:09 > 0:37:14Tomorrow, she must undergo a further operation.
0:37:14 > 0:37:19I see you have a scar from your previous removal of the bowel.
0:37:19 > 0:37:22- Any pain, at the moment, in your tummy?- Not really.
0:37:22 > 0:37:25No, OK, I'm just going to press down, let me know
0:37:25 > 0:37:27if there's any pain.
0:37:27 > 0:37:31- Does that hurt?- Sensitive.
0:37:31 > 0:37:33OK, that's fine.
0:37:38 > 0:37:40I think so. I don't know the exact details...
0:37:44 > 0:37:45The scar, yes.
0:37:45 > 0:37:47I must admit, I'm not entirely sure
0:37:47 > 0:37:51whether you're having the keyhole or the actual cut.
0:37:51 > 0:37:53With Bridget convinced she can have keyhole surgery,
0:37:53 > 0:37:58which is less scarring, Priya has to check what the procedure will be.
0:38:07 > 0:38:10She said, "Oh, it's keyhole, isn't it?" That threw me off.
0:38:10 > 0:38:14I spoke to one of the SHOs and he said that your operation
0:38:14 > 0:38:17is going to be with a cut and not keyhole.
0:38:17 > 0:38:20As you've had so many previous operations,
0:38:20 > 0:38:23it would be hard to access the areas.
0:38:23 > 0:38:28I just dread being bed-ridden, so... I just don't know!
0:38:28 > 0:38:29What can I do?
0:38:29 > 0:38:33Well, if you're offered that, I'm not entirely sure.
0:38:33 > 0:38:36I mean, based on my knowledge, I would have assumed it would
0:38:36 > 0:38:39have been an open approach, with a cut,
0:38:39 > 0:38:43but if somebody's spoken to you about this,
0:38:43 > 0:38:47I just may not be aware that there could be a keyhole option for you.
0:38:47 > 0:38:51They did say that they would start off with laparoscopic and then,
0:38:51 > 0:38:54if it wasn't possible to complete the operation,
0:38:54 > 0:38:57there may be a small incision. So...
0:38:57 > 0:39:00All I can do is keep my fingers crossed,
0:39:00 > 0:39:03because I don't know what's going to happen.
0:39:03 > 0:39:06Rest assured, whatever approach they take,
0:39:06 > 0:39:09it's in your best interests and it's the best thing for you at that time.
0:39:09 > 0:39:11'It's hard dealing with people's
0:39:11 > 0:39:13'expectations at times, especially if they'
0:39:13 > 0:39:17were hoping for something that's near impossible,
0:39:17 > 0:39:22especially because you want to keep the patient happy
0:39:22 > 0:39:25and you have to respect their right to say yes or no.
0:39:25 > 0:39:28But when options are limited,
0:39:28 > 0:39:31you know you're going to disappoint the patient.
0:39:34 > 0:39:37Over in A&E, after his calamitous day,
0:39:37 > 0:39:42Amieth still needs to prove himself to his new colleagues.
0:39:45 > 0:39:49The next job on his list - a man with a badly bleeding head.
0:39:50 > 0:39:53Could you tell me what happened to you today?
0:39:53 > 0:39:56I fell down about 15 or 20 stairs.
0:39:56 > 0:39:58Oh, really? OK.
0:39:58 > 0:40:04- And at the bottom, I hit the wall with my head.- OK.- I just went.
0:40:04 > 0:40:07- I honestly don't know why.- OK.
0:40:07 > 0:40:13Since then, how do you feel, apart from the fact you're bleeding?
0:40:13 > 0:40:16- I've got a severe headache.- OK.
0:40:16 > 0:40:18Stick out your tongue.
0:40:18 > 0:40:21With head injuries, it's crucial to look for brain damage,
0:40:21 > 0:40:23so Amieth runs through the standard checks.
0:40:23 > 0:40:26Close your eyes and when I touch you, say "Yes."
0:40:26 > 0:40:29Yes.
0:40:29 > 0:40:33Follow it with your eyes and let me know if you see two or not.
0:40:33 > 0:40:37- No.- I think you're probably going to need some stitches in your head
0:40:37 > 0:40:39to help with the bleeding,
0:40:39 > 0:40:42but I think it might be sensible to get the scan first
0:40:42 > 0:40:47- just to make sure there's no bleeding inside the skull, OK?- OK.
0:40:47 > 0:40:50While Amieth is keen to send the patient for a head scan
0:40:50 > 0:40:53before stitching, a nurse disagrees.
0:40:55 > 0:40:56Yeah, I think so.
0:40:56 > 0:40:58Yeah.
0:40:59 > 0:41:01All right, shall we stitch first, then?
0:41:03 > 0:41:05All right, can I do it?
0:41:06 > 0:41:10'In A&E, you're never surprised to see patients covered in blood,'
0:41:10 > 0:41:13but surprised at the decision by a junior doctor to send
0:41:13 > 0:41:15somebody to a different department.
0:41:15 > 0:41:17A lot of doctors will think,
0:41:17 > 0:41:18"Right, I've got a patient,"
0:41:18 > 0:41:22and they'll just look at the statistics and do all the numbers
0:41:22 > 0:41:26and they think, "Ah, this is what I've been taught at university,"
0:41:26 > 0:41:29but actually, you have to step back and say, "Actually,
0:41:29 > 0:41:32"the patient needs this before they can go anywhere."
0:41:32 > 0:41:34- Have you had a look at the wound yet?- No, not yet.
0:41:34 > 0:41:37Amieth's boss, registrar Jamie Fryer,
0:41:37 > 0:41:40is called in to check the wound.
0:41:40 > 0:41:42Now, sir, the problem with heads
0:41:42 > 0:41:44is that they've got such good blood supply
0:41:44 > 0:41:47that when they bleed, they really bleed.
0:41:47 > 0:41:49- Can you see where the wound is? - Yeah.
0:41:49 > 0:41:53The best way of sorting out these sorts of bleeds is to put
0:41:53 > 0:41:55some good pressure on for a while.
0:41:55 > 0:41:58I think we'll be able to make you pretty again!
0:41:58 > 0:42:02So now we just have to make small talk for a few minutes!
0:42:06 > 0:42:08Pressure will help stop the bleeding,
0:42:08 > 0:42:12but Amieth still needs something to help impress his new team.
0:42:12 > 0:42:14'It's usually the simple steps first'
0:42:14 > 0:42:16and in this patient's case,
0:42:16 > 0:42:18what Amieth probably failed to realise
0:42:18 > 0:42:20is that the bleeding hadn't stopped.
0:42:20 > 0:42:24On hindsight, he really should have double-checked that first.
0:42:31 > 0:42:35Upstairs, Lucy is back on the ward to see the elderly patient
0:42:35 > 0:42:38who wanted to die.
0:42:39 > 0:42:41She was quite stable this morning.
0:42:41 > 0:42:42We're treating her for an infection
0:42:42 > 0:42:44because she had recurrent infections,
0:42:44 > 0:42:46and she ended up dying this afternoon.
0:42:46 > 0:42:49Um...but she completely stopped eating,
0:42:49 > 0:42:52and I think that was a voluntary thing, really.
0:42:52 > 0:42:56You could encourage her to take very small amounts,
0:42:56 > 0:43:00but I think she was starting to suffer from the effects of not eating,
0:43:00 > 0:43:03and I think she just drifted off.
0:43:03 > 0:43:07I think everybody's got to die and I think she wanted to drift away,
0:43:07 > 0:43:09and that's exactly what she did.
0:43:09 > 0:43:14Every junior must learn to cope with the death of their patients.
0:43:21 > 0:43:26- Back at the house, Lucy confides in Milla.- I had my first death today.
0:43:26 > 0:43:31- What happened?- She was old, she didn't really want any treatment.
0:43:31 > 0:43:35Yeah, I think she was fed up, really. It was understandable.
0:43:35 > 0:43:39You do get to a point where dying is going to happen soon-ish
0:43:39 > 0:43:42and you want it just to be...
0:43:42 > 0:43:44quiet.
0:43:44 > 0:43:47I've never really had to deal with it
0:43:47 > 0:43:50- in my family. - I don't think it's anything that
0:43:50 > 0:43:52- you'll ever feel comfortable with.- No.
0:43:52 > 0:43:55It is just something that you have to grin and bear and do it,
0:43:55 > 0:43:58because it's one of your jobs.
0:44:09 > 0:44:14A new day in the hospital and a new challenge for Priya.
0:44:14 > 0:44:17Today, she's assisting in theatre.
0:44:17 > 0:44:20I guess it will be an exciting experience.
0:44:20 > 0:44:22I get to scrub in as well, which is nice.
0:44:22 > 0:44:24There we go, that is beautiful.
0:44:24 > 0:44:27The team are operating on Priya's patient, Bridget,
0:44:27 > 0:44:29to remove a cancerous tumour.
0:44:29 > 0:44:30Another 3A, please.
0:44:33 > 0:44:37Bridget had wanted less-invasive keyhole surgery, but the team
0:44:37 > 0:44:42have decided it can only be done through a large incision.
0:44:42 > 0:44:44It's supposed to be in relation to the right renal vein.
0:44:44 > 0:44:46So we need to get the...
0:44:46 > 0:44:47Maybe behind it...
0:44:47 > 0:44:49Yeah, you're right.
0:44:49 > 0:44:52I think you've got the lump in your hand.
0:44:52 > 0:44:54I think you're right.
0:44:54 > 0:44:55See what's going on?
0:44:55 > 0:44:57Yes.
0:44:57 > 0:44:59That's the tumour.
0:44:59 > 0:45:01I'm wondering if this is the thing.
0:45:01 > 0:45:04- That's it. That's the tumour.- Yeah.
0:45:04 > 0:45:05With the tumour removed,
0:45:05 > 0:45:08and under supervision from Professor Allen-Mersh,
0:45:08 > 0:45:11Priya has the responsibility of stitching the wound,
0:45:11 > 0:45:14and determining how much of a scar is left after the operation.
0:45:14 > 0:45:17- You see this layer where the skin ends and the fat starts?- Yes.
0:45:17 > 0:45:20- That's where to go into.- OK.
0:45:20 > 0:45:23Push it in and bring it out. All right?
0:45:23 > 0:45:24OK. And then...over here?
0:45:25 > 0:45:28Yeah. In.
0:45:28 > 0:45:30Now she at least looks like a surgeon.
0:45:32 > 0:45:35You'll stab your finger. Push away.
0:45:35 > 0:45:37Yes. Yay!
0:45:40 > 0:45:41OK?
0:45:41 > 0:45:44Pull it. Beautifully done.
0:45:44 > 0:45:47All right? That's a nice clean dressing for the patient.
0:45:47 > 0:45:49It's gone well for Priya,
0:45:49 > 0:45:51but she's worried about what the patient will think.
0:45:51 > 0:45:53I think she expected keyhole surgery,
0:45:53 > 0:45:56which is highly, highly unlikely and
0:45:56 > 0:46:01just before the operation, we did explain again. The consultant came and told her and said,
0:46:01 > 0:46:04this is the situation, so hopefully she's come to terms with that,
0:46:04 > 0:46:08but the last thing you want is something that you didn't really want in the first place.
0:46:08 > 0:46:11But I think when you look at the risk and benefit,
0:46:11 > 0:46:14there's either have the cancer in, with no new scar,
0:46:14 > 0:46:18or take part of it out with a scar.
0:46:23 > 0:46:25Hello? A&E.
0:46:25 > 0:46:30Downstairs, Amieth's on another busy shift in Accident and Emergency.
0:46:30 > 0:46:33We've got a computer that tells us how long a patient's been here.
0:46:33 > 0:46:35They can't be here more than four hours.
0:46:35 > 0:46:39So when it's busy, like today, there's lots of patients to see,
0:46:39 > 0:46:43we need to really crack on through them quickly and that can be quite
0:46:43 > 0:46:44a pressurised situation.
0:46:44 > 0:46:48Amieth needs to prove to his seniors that he can deal with patients quickly
0:46:48 > 0:46:50and without any mistakes.
0:46:54 > 0:46:58I understand that you've been having some pains in the chest
0:46:58 > 0:47:01and that's why you've come into the hospital today, is that right?
0:47:05 > 0:47:07PHONE RINGS
0:47:07 > 0:47:08Oh, great(!)
0:47:08 > 0:47:09PHONE RINGS
0:47:13 > 0:47:15I think it's just a sprain, OK?
0:47:15 > 0:47:19- You don't need to rest it for a long time, maybe just the weekend.- OK.
0:47:19 > 0:47:22Take regular painkillers. And crutches, to help with the weight.
0:47:22 > 0:47:25- Is that it, am I done?- Done. - Thank you!- All right.
0:47:27 > 0:47:32There's a constant stream of people today, but we've managed to get through them quickly.
0:47:39 > 0:47:43So the next gentleman is 40 years old,
0:47:43 > 0:47:46of no fixed abode, and he's come in with...
0:47:46 > 0:47:49some injury to the nose.
0:47:49 > 0:47:55He's well known to Accident and Emergency services across London, apparently.
0:47:55 > 0:47:58Why did you save him for me, as such?
0:47:58 > 0:48:02It's part of your introduction into A&E.
0:48:02 > 0:48:06- Hello. - SNORING
0:48:06 > 0:48:10Hello! Come on, open your eyes. Wake up.
0:48:10 > 0:48:14SNORING CONTINUES
0:48:14 > 0:48:15Oh...
0:48:15 > 0:48:17Hello.
0:48:17 > 0:48:19Oh...
0:48:19 > 0:48:21I'm one of the doctors.
0:48:21 > 0:48:22Oh...
0:48:22 > 0:48:24Any pain at the moment?
0:48:42 > 0:48:44We can get you that.
0:48:53 > 0:48:57It's just a question of sobering him up and sending him on his way,
0:48:57 > 0:49:00I think. We'll see if we can get him that sandwich.
0:49:04 > 0:49:08You have to really kind of get stuck in and fight quite hard against
0:49:08 > 0:49:12the tide of patients. I think he's done very well.
0:49:12 > 0:49:14Things are looking up for Amieth,
0:49:14 > 0:49:16But he's still got more patients to see.
0:49:16 > 0:49:19This is a gentleman who's injured his right hand,
0:49:19 > 0:49:22who punched a door or something Wednesday night.
0:49:22 > 0:49:26He's seen patients really very well and he's referring people that
0:49:26 > 0:49:29he needs to refer, often without having to ask
0:49:29 > 0:49:30and just letting me know about it,
0:49:30 > 0:49:32which is exactly what I want to see.
0:49:42 > 0:49:44While Amieth's finally starting to show his potential,
0:49:44 > 0:49:46Ben's seeing the results of his surgery.
0:49:46 > 0:49:48Hey, Gabriella.
0:49:48 > 0:49:51First is three-year-old Gabriella, who Ben helped operate on.
0:49:51 > 0:49:56- Can we have a little look? - Yep.- Yeah, are you going to show me?
0:49:57 > 0:50:00It looks fine. When it's changed, it will look beautiful.
0:50:00 > 0:50:04- Yeah.- Obviously, make sure... You know this, don't you?
0:50:04 > 0:50:07- Make sure it's always got the curl in it.- Yeah.
0:50:07 > 0:50:11- Is it home, or is it back to...? - I think you're going back to your local hospital.- Yeah.
0:50:11 > 0:50:13OK, Gabriella.
0:50:13 > 0:50:16- See you later.- Bye!
0:50:16 > 0:50:20'It feels good to be able to help patients.'
0:50:20 > 0:50:22You want to make a difference to people's lives.
0:50:22 > 0:50:26It's a fantastic feeling. It's nice to have been involved in that.
0:50:26 > 0:50:29That's the essence of medicine, trying to help people.
0:50:29 > 0:50:33That's certainly why I do it and I think why most medics do it,
0:50:33 > 0:50:35to try and make a difference.
0:50:35 > 0:50:40With Gabriella's operation a success, Ben's next patient
0:50:40 > 0:50:44is five-year-old Alfie, also recovering after surgery.
0:50:44 > 0:50:49So today, just drink slowly, and then we'll go from there.
0:50:49 > 0:50:52Alfie didn't like Ben's last attempt to use a needle on him.
0:50:52 > 0:50:55Someone needs to bleed him again,
0:50:55 > 0:50:58just to check that after the operation, everything is still OK,
0:50:58 > 0:51:01so we're going to do that with the registrar.
0:51:01 > 0:51:03But it falls to Ben to take on the task.
0:51:03 > 0:51:05It won't hurt, darling. Not this time, it won't.
0:51:05 > 0:51:08Just going to take the plaster off for you, Alfie.
0:51:08 > 0:51:10They're just going to get it out of the way.
0:51:10 > 0:51:14ALFIE CRIES
0:51:14 > 0:51:17We're doing it. It's nearly done.
0:51:17 > 0:51:20- It's hurting, it's hurting! - Really good.
0:51:20 > 0:51:23- Try and take your mind off it.- Ow!
0:51:23 > 0:51:24It's done, Alfie.
0:51:24 > 0:51:27You were a superstar. All done.
0:51:28 > 0:51:31Despite Alfie's tears, Ben manages to take his blood.
0:51:31 > 0:51:35All sorted. All sorted.
0:51:35 > 0:51:37Alfie is doing very well.
0:51:37 > 0:51:41He should, hopefully, if he doesn't have a temperature, go home tomorrow.
0:51:41 > 0:51:44He doesn't need to be subjected to me taking blood from him any more.
0:51:51 > 0:51:58- Bridget Lavelle.- Ah...- Today, Priya will also find out if the operation
0:51:58 > 0:52:00she helped with has been a success.
0:52:00 > 0:52:03Bright-eyed, bushy-tailed,
0:52:03 > 0:52:05after your big operation.
0:52:05 > 0:52:10The patient is Bridget. She wanted keyhole surgery to remove a tumour.
0:52:10 > 0:52:15But the team had to make an incision, which Priya then stitched up.
0:52:15 > 0:52:19I wasn't happy to hear it hadn't been all done in the first place.
0:52:19 > 0:52:21You're a very hard person to please.
0:52:21 > 0:52:24Anyway, let me have a look at your tummy and see how it's going.
0:52:26 > 0:52:28That's lovely.
0:52:28 > 0:52:31This could not have been done through the keyhole.
0:52:31 > 0:52:34Impossible to do it that way.
0:52:34 > 0:52:38Despite seeing her patient through life-saving surgery,
0:52:38 > 0:52:41Priya is finding out the hard way that being a doctor means
0:52:41 > 0:52:42you can't please everyone.
0:52:42 > 0:52:46There should be a disclaimer on every doctor's forehead that says,
0:52:46 > 0:52:49"Everything we try and do is in your best interests."
0:52:49 > 0:52:55If we are going to give a cut in the tummy instead of keyhole surgery,
0:52:55 > 0:52:58it's not because we want to, or we particularly enjoy that.
0:52:58 > 0:53:02It's because it's the best option for you at that point.
0:53:06 > 0:53:09After four weeks on medicine's front line,
0:53:09 > 0:53:13our junior doctors finally get what they've all been waiting for.
0:53:13 > 0:53:14Apparently, it's pay day.
0:53:14 > 0:53:17I got a bit over-excited last night before I went to bed
0:53:17 > 0:53:19and checked my account about 2am.
0:53:19 > 0:53:21It hadn't quite hit it yet.
0:53:21 > 0:53:26Hopefully, by the end of today, it will be there.
0:53:26 > 0:53:30The annual wage for a junior doctor is around £25,000.
0:53:30 > 0:53:33I'm really excited because I haven't ever had money put into my account
0:53:33 > 0:53:36from anybody other than my parents.
0:53:36 > 0:53:37It's just amazing.
0:53:37 > 0:53:42What I'll be spending my money on mainly is repaying my student debt.
0:53:42 > 0:53:45Let's have a look.
0:53:45 > 0:53:50Oh, wow! OK, it's more than I expected, which is very nice.
0:53:50 > 0:53:52I think I might have to go shopping now!
0:53:54 > 0:53:56We can finally spend our pay cheques.
0:53:56 > 0:53:59This is going to be really fun.
0:54:01 > 0:54:06- I absolutely love this. The colour's so me.- That's so you.- It's fantastic.
0:54:06 > 0:54:10- Do you feel like you really deserve that pay cheque?- Yeah.
0:54:10 > 0:54:13We have seriously worked for every penny of it.
0:54:13 > 0:54:16It's so stressful and it's just been so overwhelming
0:54:16 > 0:54:19that I think it's really well deserved.
0:54:19 > 0:54:22We should have some nice lunch somewhere as well.
0:54:22 > 0:54:25- A little reward at the end of that horrible month.- Yeah.
0:54:25 > 0:54:31Amieth is also treating himself in his own way.
0:54:31 > 0:54:33I need some butter, I need some onions.
0:54:33 > 0:54:37I should probably get some tomatoes, maybe an apple.
0:54:37 > 0:54:40Got to put food on the table, you know.
0:54:49 > 0:54:52Well, hello, boys!
0:54:52 > 0:54:55We can be ladies of leisure. We can just relax.
0:54:57 > 0:54:58Cheers, guys.
0:54:58 > 0:55:01Having celebrated their first pay cheques,
0:55:01 > 0:55:04the life-and-death struggles they faced
0:55:04 > 0:55:08make some of the junior doctors ask big questions.
0:55:08 > 0:55:13Lucy, if it was your last day on Earth, who would you sleep with?
0:55:16 > 0:55:22- That's morbid, but weird.- You're not dodging this question, Lucy.
0:55:22 > 0:55:25I don't think I'd sleep with anyone. I'd dance in the rain naked.
0:55:25 > 0:55:29Who would you want to take you out for dinner?
0:55:29 > 0:55:31That's so random. My family, of course.
0:55:31 > 0:55:33There's no doubt about it.
0:55:33 > 0:55:36I'm incredibly close to my mother.
0:55:36 > 0:55:38We're talking about it as though...
0:55:38 > 0:55:39We're perfectly well,
0:55:39 > 0:55:43and we can go off and do whatever we wanted to do
0:55:43 > 0:55:45and it would be over tomorrow.
0:55:45 > 0:55:47Whereas, actually, in reality,
0:55:47 > 0:55:49you'd be quite unwell, feeling quite sick.
0:55:49 > 0:55:53We all know we're going to die. It's the only bloody guarantee, isn't it?
0:55:53 > 0:55:59- The only thing certain in life is death.- And taxes.- And taxes, yeah.
0:56:02 > 0:56:06Next time, the Junior Doctors face some challenging cases.
0:56:06 > 0:56:08She's impaled her hand on a spike.
0:56:08 > 0:56:12When you're young and inexperienced, it's hard to take charge...
0:56:12 > 0:56:16It's not helpful. It's a loaded question I find offensive.
0:56:16 > 0:56:18..appear confident...
0:56:18 > 0:56:20It's just a matter of keeping going.
0:56:20 > 0:56:22- I should know. - ..and on top of things.
0:56:22 > 0:56:26No-one's died yet, which is good, but maybe I'm being a bit too careful.
0:56:50 > 0:56:53Subtitles by Red Bee Media Ltd