0:00:05 > 0:00:06Emergencies.
0:00:10 > 0:00:11Bad behaviour.
0:00:13 > 0:00:15Bedside battles.
0:00:15 > 0:00:16Alfie, Alfie.
0:00:16 > 0:00:19And 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 you're young.
0:00:25 > 0:00:27Am I right or not?
0:00:27 > 0:00:31I feel like a child, really. In your their eyes, you probably are.
0:00:31 > 0:00:33Untried...
0:00:33 > 0:00:36I don't want to scare you. It's my second day.
0:00:36 > 0:00:39The first time any of us do anything, we're going to be BLEEP.
0:00:39 > 0:00:41..and inexperienced.
0:00:41 > 0:00:44- Everyone's in the same boat. - Push it through, twiddle, twiddle.
0:00:44 > 0:00:46No-one knows what they're doing.
0:00:46 > 0:00:50- But after years of studying... - Oh, dear.
0:00:50 > 0:00:55..it's time to put theory into practice on medicine's front line.
0:00:55 > 0:00:59No-one's died yet, which is good, but maybe I'm being a bit TOO careful.
0:00:59 > 0:01:01Come on.
0:01:03 > 0:01:05Come on, Lucy.
0:01:05 > 0:01:08You seriously throw like a girl.
0:01:08 > 0:01:13Our eight newly-qualified doctors are living and working together.
0:01:13 > 0:01:17Amieth and Ben have been doctors for just 12 months.
0:01:17 > 0:01:19Suddenly you need to know what you're doing,
0:01:19 > 0:01:22or at least seem like you know what you're doing.
0:01:22 > 0:01:24With just six weeks' experience are Sameer,
0:01:24 > 0:01:27Milla and Andy.
0:01:27 > 0:01:29We know the white coats will look terrible.
0:01:29 > 0:01:33Lucy, Priya and Aki.
0:01:33 > 0:01:35It's, like, in your face, isn't it?
0:01:35 > 0:01:40All are striving to live up to their new identities as doctors.
0:01:40 > 0:01:44They must earn the trust of their patients...
0:01:44 > 0:01:47- You can't help me? - I would like to help you.
0:01:47 > 0:01:49- I just need your- BLEEP- help.
0:01:49 > 0:01:52- Pulse, blood pressure? - ..the respect of their colleagues...
0:01:52 > 0:01:54AMT?
0:01:54 > 0:01:57I would have thought the AMT would be nine or ten.
0:01:57 > 0:01:59You can't guess it, Aki.
0:01:59 > 0:02:03..and learn that being a doctor doesn't always fit the image.
0:02:03 > 0:02:06It's just complete BLEEP, basically.
0:02:20 > 0:02:23# Birds flying high... #
0:02:23 > 0:02:26It's a giant leap from student to doctor.
0:02:26 > 0:02:30The juniors are starting to think about image
0:02:30 > 0:02:32and how doctors should dress.
0:02:32 > 0:02:36I think first impressions are quite important.
0:02:36 > 0:02:38We all have to wear smart clothes.
0:02:38 > 0:02:42That kind of image shows the professionalism of the doctors.
0:02:42 > 0:02:47I don't think you need to wear a uniform to be a good doctor
0:02:47 > 0:02:51but I think a lot of our job is managing people's expectations
0:02:51 > 0:02:53and one thing that they expect
0:02:53 > 0:02:56is you to be turned out in a certain way.
0:02:56 > 0:03:00I think traditionally, people imagine doctors to be old and crusty
0:03:00 > 0:03:03with a white coat on, and flying around on a ward round.
0:03:03 > 0:03:06I think that's quite different now.
0:03:06 > 0:03:08# And I'm feeling good
0:03:13 > 0:03:19# River running free You know how I feel... #
0:03:19 > 0:03:21Are you excited?
0:03:21 > 0:03:23At the hospital,
0:03:23 > 0:03:27the management has its own ideas about looking professional.
0:03:28 > 0:03:30We do think it's important.
0:03:30 > 0:03:33You may not think it's a fashion accessory, as you've alluded to,
0:03:33 > 0:03:37but in the small number of other trusts that have done this already,
0:03:37 > 0:03:40the junior doctors have actually got to like it.
0:03:42 > 0:03:44To help them look the part,
0:03:44 > 0:03:48all the junior doctors must now wear white coats.
0:03:48 > 0:03:52- I actually quite like it. How does it look, Aki?- You look the part.
0:03:52 > 0:03:58- That's not the look I'm going for. - How do I look?- You look OK.- Thanks!
0:03:58 > 0:03:59I feel like a man.
0:03:59 > 0:04:02Oh, that's funny, because you look like one.
0:04:02 > 0:04:03You look lovely.
0:04:03 > 0:04:08But for one, white coats are definitely not in vogue.
0:04:08 > 0:04:10I guess it's quite disappointing
0:04:10 > 0:04:12that the white coat covers your outfit.
0:04:21 > 0:04:26Down in A & E, Amieth escapes the white coat.
0:04:26 > 0:04:28Hello, this is Amieth. I'm one of the doctors in A & E.
0:04:28 > 0:04:31'If you look around A & E, we're all wearing scrubs.
0:04:31 > 0:04:33'Scrubs are certainly much easier to wear.'
0:04:33 > 0:04:37I don't have to worry about ironing or washing my clothes so much,
0:04:37 > 0:04:39so that's certainly much easier.
0:04:39 > 0:04:44But the shapeless blue scrubs are not popular with some patients.
0:04:48 > 0:04:52They look as if they've just come out of Wormwood Scrubs.
0:05:05 > 0:05:07He's a right bobby-dazzler.
0:05:07 > 0:05:09Bobby-dazzler, aren't you?
0:05:09 > 0:05:13I understand that you've come in with a cough
0:05:13 > 0:05:15and some breathing problems.
0:05:15 > 0:05:19And Bob James is Amieth's first patient.
0:05:19 > 0:05:22What's been going on, please? How long has it been lasting?
0:05:27 > 0:05:29When was that?
0:05:31 > 0:05:32Short of breath.
0:05:32 > 0:05:35What do you take for diabetes, normally?
0:05:35 > 0:05:38So you just control it with your diet, watching what you eat?
0:05:38 > 0:05:40Right.
0:05:42 > 0:05:44His chest still sounds a bit wheezy,
0:05:44 > 0:05:46but he himself feels more comfortable.
0:05:46 > 0:05:47Right, OK.
0:05:47 > 0:05:51Baffled by Bob's symptoms, Amieth asks for advice.
0:05:52 > 0:05:54Well, do you think he can go home?
0:05:54 > 0:05:57Well, I wasn't sure, really. Um...
0:05:57 > 0:06:00- He looks OK in the bed, but I think...- Is this him?
0:06:00 > 0:06:02Yeah, he's put his oxygen mask back on.
0:06:02 > 0:06:04He didn't have it on when I was there.
0:06:04 > 0:06:06'I would have hoped, at this stage'
0:06:06 > 0:06:10of his time in A & E, he would have been making decisions
0:06:10 > 0:06:11with a little bit more autonomy
0:06:11 > 0:06:14and a little bit more confidence in himself.
0:06:14 > 0:06:19Second-year doctors like Amieth are expected to diagnose
0:06:19 > 0:06:21and treat patients themselves...
0:06:24 > 0:06:27..but Amieth hasn't always got it right...
0:06:27 > 0:06:29We're going to get a scan of the head
0:06:29 > 0:06:32to make sure there's no bleeding in the brain.
0:06:32 > 0:06:35- You want to do it when he's bleeding that much?- Yeah, I think so.
0:06:35 > 0:06:37- Have you seen the back of him?- Yeah.
0:06:37 > 0:06:40- All the way down the back? - Shall we stitch first, then?
0:06:40 > 0:06:42I think we should stitch first.
0:06:42 > 0:06:45Now we just have to make small talk for a few minutes.
0:06:49 > 0:06:52..and he's still struggling.
0:06:52 > 0:06:56We're not going to be able to get him well enough in four hours,
0:06:56 > 0:06:58so let's get him upstairs.
0:06:58 > 0:07:02Although Amieth thought Bob's infection wasn't serious,
0:07:02 > 0:07:05his senior disagrees.
0:07:05 > 0:07:07I've just had a chat to one of my seniors
0:07:07 > 0:07:09and he felt that it might be sensible
0:07:09 > 0:07:12for you to come into the hospital for maybe a day,
0:07:12 > 0:07:15so that we can give you some good strong antibiotics into the vein
0:07:15 > 0:07:18to really help get rid of this chest infection,
0:07:18 > 0:07:21and once you're a little bit better with your breathing,
0:07:21 > 0:07:24then we can get you back home with some oral tablets
0:07:24 > 0:07:25- to finish the course.- OK.
0:07:34 > 0:07:36While Amieth wrestles with the demands of A & E,
0:07:37 > 0:07:40housemate Lucy is about to face her next big challenge...
0:07:41 > 0:07:45- Do you want me to reinstate it, then?- The morning dose...
0:07:45 > 0:07:47..her very first night shift.
0:07:49 > 0:07:51Eye patches and earplugs.
0:07:51 > 0:07:53I've ordered those.
0:07:53 > 0:07:55Oh, well done.
0:07:55 > 0:07:57Bring food.
0:07:57 > 0:07:59What kind of food - nibbles?
0:07:59 > 0:08:03The worst thing is to be hungry at 4am because you're tired,
0:08:03 > 0:08:07- and so you just get more and more angry. You need grumpy nuts.- Yeah.
0:08:07 > 0:08:10'The first nights aren't fun. It feels like you're on your own.'
0:08:10 > 0:08:14Any problems occur, you're the first port of call,
0:08:14 > 0:08:16and it's very different to the ward work.
0:08:16 > 0:08:21Ward work, as you'll see, is just coordinating a lot of admin stuff
0:08:21 > 0:08:24and actually, a lot of the medical decisions are made by higher.
0:08:24 > 0:08:28But on nights, that's when you actually have to make some decisions
0:08:28 > 0:08:30and that's a tough one to start with.
0:08:30 > 0:08:32So far, her organisational skills
0:08:32 > 0:08:36have helped Lucy stay ahead of the game.
0:08:36 > 0:08:37# Bounce
0:08:40 > 0:08:41# Bounce... #
0:08:41 > 0:08:44I'm quite exacting. I've just got very set ideas.
0:08:44 > 0:08:47I'm very definite about how I want things to be done and why.
0:08:47 > 0:08:50The organisation of my room looks like this.
0:08:50 > 0:08:52Coats. Summer coats.
0:08:52 > 0:08:55Going-out shirts. Normal shirts. Work skirts. Other skirts.
0:08:55 > 0:08:58Shoes I don't wear that much and love go in boxes.
0:08:58 > 0:09:00Weekend shoes and work shoes.
0:09:00 > 0:09:02Oh, and at the end I've got belts.
0:09:02 > 0:09:06Maybe a touch of OCD, maybe.
0:09:08 > 0:09:13I keep lists on my phone, like lists and lists and lists.
0:09:13 > 0:09:15Stuff I need to take home, places I need to go,
0:09:15 > 0:09:17errands to run, people to contact.
0:09:17 > 0:09:19You know, just all normal stuff.
0:09:19 > 0:09:22Just a few lists,
0:09:22 > 0:09:25because lists make me feel better about myself.
0:09:25 > 0:09:28When I start something, even if I don't enjoy it,
0:09:28 > 0:09:29I make sure I finish it,
0:09:29 > 0:09:32because it's just not in me to leave things half done.
0:09:36 > 0:09:41Her first job of the night - the handover from fellow doctor Michael.
0:09:41 > 0:09:44Would you mind, with that list, keeping it?
0:09:44 > 0:09:48- Not at all.- There's stuff from the weekend handover list
0:09:48 > 0:09:51that I just want to check off against it
0:09:51 > 0:09:55to make sure we've at least chased it - if not today, tomorrow.
0:09:55 > 0:09:58Yes, of course. You've got another list, under there?
0:09:58 > 0:10:00As well as Michael's list of patients to work through,
0:10:00 > 0:10:04Lucy is on call for all medical wards across the hospital.
0:10:04 > 0:10:09Emergency bleeps will have to take priority over her precious lists...
0:10:09 > 0:10:13- BLEEPING - ..throwing any planning to the wind.
0:10:13 > 0:10:16Hi, it's Lucy, the on-call medic.
0:10:16 > 0:10:19I don't know anything about this patient,
0:10:19 > 0:10:21so if you'd like to tell me about him...
0:10:21 > 0:10:25If he feels OK and somebody can go with him, I can't see a problem.
0:10:25 > 0:10:27OK, thanks.
0:10:27 > 0:10:31Can somebody go out for a BLEEP smoke? I don't BLEEP know!
0:10:31 > 0:10:35- Thanks for all your help.- I hope it's all right. See you in the morning.
0:10:36 > 0:10:38I've handed over quite a lot of stuff to Lucy,
0:10:38 > 0:10:39so I hope it's all right for her.
0:10:39 > 0:10:42Hopefully she won't get as many bleeps as I did today.
0:10:42 > 0:10:44No, Gwen.
0:10:45 > 0:10:48And what bed, sorry? Right, I'll be there in a moment.
0:10:48 > 0:10:51- Have you got her ECG? - Yeah, everything's there.
0:10:51 > 0:10:53- OK. I'm just...- Also...
0:10:53 > 0:10:55INDISTINCT
0:10:55 > 0:10:57Yes, back in a minute.
0:10:57 > 0:11:00This time, she has to go.
0:11:00 > 0:11:02You're feeling what, sorry, lovely?
0:11:03 > 0:11:04Yeah?
0:11:04 > 0:11:06Down in where, sorry?
0:11:07 > 0:11:09The right corner.
0:11:09 > 0:11:10Here?
0:11:10 > 0:11:13And it's worse when you breathe in?
0:11:15 > 0:11:18The patient has a severe chest pain.
0:11:18 > 0:11:21Have you ever had any pain like this before?
0:11:23 > 0:11:27No? And it's made worse when you breathe in?
0:11:27 > 0:11:28Is it sharp?
0:11:34 > 0:11:38Unsure about a diagnosis, she calls for advice.
0:11:40 > 0:11:43We've got a patient here, a 70-year-old patient,
0:11:43 > 0:11:45who I've just been to see,
0:11:45 > 0:11:48because she had a drop in saturations of 86%,
0:11:48 > 0:11:51but she's still complaining of a sharp pain in her left side.
0:11:51 > 0:11:55Just to make sure I'm doing the right thing, a bit of reassurance.
0:11:55 > 0:11:57I don't really want to be seeing her on my own,
0:11:57 > 0:12:00not having had any advice at all.
0:12:00 > 0:12:03She's got ongoing chest pain.
0:12:03 > 0:12:08So it's just for a bit of reassurance, I think.
0:12:08 > 0:12:12Quickly, Lucy gives the registrar a briefing.
0:12:12 > 0:12:14We started treating her for a chest infection
0:12:14 > 0:12:17- but her chest X-ray wasn't convincing.- OK.
0:12:17 > 0:12:19She's also got heart failure.
0:12:22 > 0:12:26No, not when you examine her, and she's moving normally as well.
0:12:26 > 0:12:28When you sit her forward, she's fine.
0:12:28 > 0:12:30She's not complaining of any pain on movement.
0:12:37 > 0:12:40It's a false alarm,
0:12:40 > 0:12:43as it turns out to be a simple case of indigestion.
0:12:43 > 0:12:46Not a great start to Lucy's night.
0:12:48 > 0:12:51SIREN WAILS
0:12:54 > 0:12:58While Lucy toughs it out on nights, Aki and Andy reminisce
0:12:58 > 0:13:00about life before medicine.
0:13:02 > 0:13:06When I was at school, I was in this pop-punk band.
0:13:06 > 0:13:10- Really?- Yeah. - That's hilarious. Same.
0:13:10 > 0:13:12- No, bullshit.- I was. - No, you weren't.
0:13:12 > 0:13:17I was in a shit punk band called Zapruder.
0:13:17 > 0:13:20- What?- And we did gigs around Leeds and stuff.- Zapruder?
0:13:20 > 0:13:23The camera guy that filmed the assassination of JFK.
0:13:23 > 0:13:28- What did you play in your band? - I played bass, cos...- Nice.
0:13:28 > 0:13:31..it was less strings than the guitar,
0:13:31 > 0:13:33so I thought it'd be easy.
0:13:33 > 0:13:36- Do you like my meat earring? - Yeah, lovely.
0:13:36 > 0:13:39And I wanted to sing but they wouldn't let me.
0:13:39 > 0:13:42- I think that's wise.- Yeah! - HE LAUGHS
0:13:42 > 0:13:44Did you do gigs and stuff, then?
0:13:44 > 0:13:47Yeah, we thought we were so good.
0:13:47 > 0:13:51- You thought we you were going to make it, didn't you?- Yeah.
0:13:51 > 0:13:56We thought, you know, "Screw GCSEs - let's become rock stars."
0:13:56 > 0:14:01In lower sixth, I organised this tour to Japan.
0:14:01 > 0:14:03- What?!- So we gigged around in Tokyo for a week.
0:14:03 > 0:14:06- You're joking?- No, for real. - That's amazing.
0:14:06 > 0:14:09- So you made it big in Japan? - Well, I wouldn't say big.
0:14:09 > 0:14:11We made it TO Japan.
0:14:11 > 0:14:15- Create dreams or save lives. - True.
0:14:15 > 0:14:17Aki, you know what?
0:14:17 > 0:14:19Screw being a doctor - let's become rock stars.
0:14:19 > 0:14:23# Cos we all just wanna be big rock stars
0:14:23 > 0:14:26# And live in hilltop houses driving 15 cars
0:14:26 > 0:14:30# Hey, hey I wanna be a rock star... #
0:14:33 > 0:14:35Back at the hospital,
0:14:35 > 0:14:39Lucy is attempting to get through the patients on her list.
0:14:39 > 0:14:41BLEEPING
0:14:41 > 0:14:44As soon as you start doing something, you get bleeped.
0:14:44 > 0:14:47But the beeps keep coming and the workload grows.
0:14:47 > 0:14:49I don't like leaving it, you see.
0:14:49 > 0:14:52So... It might be here, actually.
0:14:52 > 0:14:55The difficulty is, being on call, you're in lots of different rooms
0:14:55 > 0:14:58and you're unsure about where they keep everything.
0:14:58 > 0:15:02Right. So, I need to go and answer my bleep thing.
0:15:02 > 0:15:03That's my next job.
0:15:05 > 0:15:07# Two hands... #
0:15:07 > 0:15:11So, this is a lady in bed B1...
0:15:23 > 0:15:26BLEEP
0:15:28 > 0:15:32Ah! Nope... Five new messages.
0:15:32 > 0:15:35'You can't anticipate what's going to come up,'
0:15:35 > 0:15:38and flexibility is not my greatest strength.
0:15:41 > 0:15:45# Clap your hands if you're working too hard... #
0:15:45 > 0:15:50Righty-ho, if you wouldn't mind just leaning forward for me...
0:15:50 > 0:15:54Carry on with your nebulisers. If you feel more short of breath,
0:15:54 > 0:15:59let the nurses know - each hour we'll monitor your oxygen levels. Perfect.
0:15:59 > 0:16:01BLEEP
0:16:01 > 0:16:06# Two hands, what you supposed to do with two hands? #
0:16:06 > 0:16:08I got four bleeps just then.
0:16:08 > 0:16:10BLEEP
0:16:13 > 0:16:18While Lucy tries to reduce her patient list,
0:16:18 > 0:16:22her housemates enjoy some time away from the hospital.
0:16:22 > 0:16:26I think you did an awesome job organising all this, seriously.
0:16:26 > 0:16:30Serious, man, I'm happy about the turnout.
0:16:30 > 0:16:34Tell us about the biggest balls-up you've made in the last 12 days!
0:16:39 > 0:16:42I've lost my pen somewhere.
0:16:42 > 0:16:43BLEEP
0:16:49 > 0:16:52Sorry, sweetheart, you look... Are you all right?
0:16:55 > 0:17:00Back at the hospital, Lucy's finally getting on top of her list.
0:17:03 > 0:17:07- I'm going to put this pillow underneath...- Yes.
0:17:07 > 0:17:10If you can keep it slightly higher, that might do it. Yeah.
0:17:12 > 0:17:15You develop a plan about what you're going to do,
0:17:15 > 0:17:18then it gets usurped by something on the bleep!
0:17:18 > 0:17:19ALARM BLARES
0:17:19 > 0:17:24And her plans are scuppered by an emergency.
0:17:27 > 0:17:30Oh! Right, let's go in...
0:17:30 > 0:17:34- Lucy is just going to hold your hand.- All right, sweetheart.
0:17:34 > 0:17:38A man with a bowel obstruction needs urgent attention.
0:17:38 > 0:17:42We're going to pass this tube into your stomach -
0:17:42 > 0:17:45when you feel it in the back of your throat...
0:17:45 > 0:17:47It is something Lucy has never done before...
0:17:47 > 0:17:50Can you feel it in the back of your mouth?
0:17:50 > 0:17:53..inserting a tube into the patient's stomach.
0:17:53 > 0:17:56When we get this tube in, the vomiting will stop, I promise.
0:17:56 > 0:18:00Have we got another tray to drain this into?
0:18:00 > 0:18:02Thank you.
0:18:02 > 0:18:05It's all right - everything's sorted now.
0:18:07 > 0:18:10Right...
0:18:13 > 0:18:16- Because... - Because I've not had time.- Yeah.
0:18:16 > 0:18:18It's the end of her shift,
0:18:18 > 0:18:22but Lucy hasn't managed to stay on top of her patient list.
0:18:22 > 0:18:24It went down the pan at the last minute.
0:18:24 > 0:18:28I was quite enjoying it until about five, and then...
0:18:28 > 0:18:32I've not even looked at the clock since five, that's how BLEEP it is.
0:18:32 > 0:18:35- I'm really sorry there's so much. - Don't be sorry.
0:18:35 > 0:18:40- I handed over more than that last night.- I don't think you did.
0:18:40 > 0:18:42It's complete BLEEP, basically.
0:18:42 > 0:18:45Handing over unseen patients to the day team
0:18:45 > 0:18:47is not what Lucy calls success.
0:18:55 > 0:18:58- How was it? - At home, Aki is keen to find out
0:18:58 > 0:19:01how she coped with her first night shift.
0:19:01 > 0:19:04God, I feel like I look like a pile of spanners.
0:19:04 > 0:19:07- Lucy, you look beautiful. - Oh, shut up!
0:19:07 > 0:19:12- I'm surprised you've done a night shift!- I actually scare myself.
0:19:12 > 0:19:15- My reflection is awful.- How was it?
0:19:15 > 0:19:19- It was a bit crap.- Expand.
0:19:19 > 0:19:23- Obviously a massive handover, but you get bleeped all the time.- Yeah.
0:19:23 > 0:19:28You end up with job lists that are literally pages and pages long.
0:19:28 > 0:19:31It's just crap.
0:19:31 > 0:19:35Not the best ever. How was your Saturday night, more to the point?
0:19:35 > 0:19:38We went to a house party,
0:19:38 > 0:19:41then we went to Shoreditch.
0:19:41 > 0:19:43It was a good night.
0:19:43 > 0:19:47- Came back at, like, five.- And you went to that last night?- Yeah.
0:19:47 > 0:19:51Oh, my God - that sounds like heaven!
0:19:51 > 0:19:55It's nice to know there's something beyond Chelsea and Westminster Hospital!
0:20:08 > 0:20:12Radio Chelsea and Westminster broadcasting live on Channel 6
0:20:12 > 0:20:16- from the second floor... - The hospital's in-house radio
0:20:16 > 0:20:18often broadcasts interviews with staff.
0:20:18 > 0:20:23This week, it's featuring junior doctors Aki and Amieth.
0:20:23 > 0:20:27..you can find out more about the people working to make you better.
0:20:27 > 0:20:31- Aki, you said you'd been thrown in at the deep end.- Mm-hmm.
0:20:31 > 0:20:34Did you find that university and studying
0:20:34 > 0:20:37helped prepare you for what it's really like?
0:20:37 > 0:20:41I don't think anyone can learn anything at university of what...
0:20:41 > 0:20:46I mean, how it actually applies in hospital is very, very different.
0:20:46 > 0:20:51It is an apprenticeship. It doesn't matter how many hours of work
0:20:51 > 0:20:55you put in at home, working on your desk,
0:20:55 > 0:20:59you just really have to learn, erm, on the job.
0:20:59 > 0:21:03How do you make a good impression to colleagues and patients?
0:21:03 > 0:21:08There's a really steep learning curve when you first start practising.
0:21:08 > 0:21:12Your colleagues don't really expect you to know everything,
0:21:12 > 0:21:14it's easy to get on with your colleagues
0:21:14 > 0:21:18if you're honest with them and always try your best.
0:21:18 > 0:21:22I made sure that I got stuck in, did everything that was asked for,
0:21:22 > 0:21:27erm, and make sure that you keep a smile on your face,
0:21:27 > 0:21:31even though you're 12 hours through your day, and exhausted.
0:21:31 > 0:21:36You just keep ploughing on - you don't want anyone grumpy around you.
0:21:36 > 0:21:41Aki has always suffered from a lack of self-confidence.
0:21:43 > 0:21:46Go! Go on, Aki!
0:21:46 > 0:21:51'During med school, I wouldn't say I was the top examination results.'
0:21:51 > 0:21:54Woo!
0:21:54 > 0:21:57'Maybe academically I wasn't that bright.'
0:21:57 > 0:22:01I don't feel like a real doctor yet. I need to get drunk first.
0:22:01 > 0:22:03It's disgusting!
0:22:03 > 0:22:07In terms of academia, I think I know where my limits are.
0:22:07 > 0:22:11Gaps in his knowledge have shown up on the ward.
0:22:11 > 0:22:15Before we do that, which trial evidence to you know of
0:22:15 > 0:22:17for the use of Atorvastatin?
0:22:19 > 0:22:21Erm...
0:22:24 > 0:22:28There was a time when I knew so many studies.
0:22:28 > 0:22:31When was that time?
0:22:31 > 0:22:35- About two months ago. - That time's come and gone already!
0:22:35 > 0:22:38It's only your first day!
0:22:38 > 0:22:43Aki's back on the ward, eager to prove his medical knowledge.
0:22:45 > 0:22:49Hello. I'm just going to find out how you came into hospital -
0:22:49 > 0:22:53- would that be OK?- Fine.- Would it be OK if I take a seat...?
0:22:53 > 0:22:57His next patient is 79-year-old Monica.
0:22:57 > 0:23:00Skin cancer on your tongue - is that right?
0:23:05 > 0:23:09They put a new tongue in? Wow.
0:23:13 > 0:23:16Where did you start feeling dizzy?
0:23:17 > 0:23:21Back home. OK.
0:23:28 > 0:23:31OK.
0:23:33 > 0:23:36Right.
0:23:37 > 0:23:42So, usually you can walk around, do your shopping, absolutely fine?
0:23:42 > 0:23:45Once he's got the relevant information,
0:23:45 > 0:23:48Aki has to present it to his senior.
0:23:48 > 0:23:52- So, the problem today, dizziness. - That's right.
0:23:52 > 0:23:55OK - pulse, blood pressure?
0:23:55 > 0:23:58Yep. It was there, sorry, it's by the bedside,
0:23:58 > 0:24:02- the obs is by the bedside. - Do you remember what they were?
0:24:02 > 0:24:05Erm, the...
0:24:05 > 0:24:09sats were normal - it was pretty much normal, I do remember this.
0:24:09 > 0:24:12- Did you do a lying/standing blood pressure?- No.- OK.
0:24:12 > 0:24:16- AMT?- I haven't done that, I've got that to do.
0:24:16 > 0:24:18- OK.- Sorry.
0:24:18 > 0:24:22Erm, I would have thought the AMT would be nine or ten.
0:24:22 > 0:24:25No point guessing, you've got to take it.
0:24:25 > 0:24:29Having missed out a number of checks, it's back to the patient,
0:24:29 > 0:24:33- where his senior, Nidi, must do them.- Can I listen to your heart?
0:24:33 > 0:24:37- Sure.- Nidi grills Aki on his medical knowledge.
0:24:37 > 0:24:40..proprioception and...erm,
0:24:40 > 0:24:43hand...
0:24:43 > 0:24:46and, er, yeah, propriosection.
0:24:46 > 0:24:48N-no?
0:24:48 > 0:24:50The...
0:24:57 > 0:25:01'I did feel like I let her down a bit.
0:25:01 > 0:25:05'When your seniors kind of go over things, you think, "Oh, damn,
0:25:05 > 0:25:08'"I forgot to do this or that."'
0:25:08 > 0:25:10Further down the line, if this continues,
0:25:10 > 0:25:13I'll be quite frustrated with myself.
0:25:20 > 0:25:23In A & E, Amieth's starting to take his own decisions
0:25:23 > 0:25:25about patient symptoms.
0:25:25 > 0:25:30His next patient is a 24-year-old soldier.
0:25:30 > 0:25:32You've suddenly developed severe back pain today
0:25:32 > 0:25:35- but you've had pain for some time, is that right?- Yes.
0:25:35 > 0:25:38Start at the beginning and tell me what's been going on.
0:25:42 > 0:25:43Right.
0:25:48 > 0:25:52- Did you feel any pains going down either of your legs at all?- No.
0:25:52 > 0:25:55No, OK. So it just stayed in the back.
0:25:55 > 0:25:58Can you lift this leg straight up in the air, please?
0:26:00 > 0:26:03I'm not 100% sure that this is what's going on.
0:26:03 > 0:26:06There could be other things causing the back pain.
0:26:06 > 0:26:09So first things first, we'll give him some pain relief.
0:26:09 > 0:26:13Amieth goes for the strongest painkiller, morphine.
0:26:13 > 0:26:16A little scratch.
0:26:16 > 0:26:18I thought that was quite difficult
0:26:18 > 0:26:21because I couldn't actually feel his veins.
0:26:21 > 0:26:24I saw a vague hint of blue and aimed for it,
0:26:24 > 0:26:25and it just happened to go in.
0:26:25 > 0:26:27It was quite lucky.
0:26:27 > 0:26:30After getting a line into the patient,
0:26:30 > 0:26:32he runs his plan past his consultant.
0:26:32 > 0:26:37This is the first time he's come to medical attention with back pain.
0:26:37 > 0:26:42I've written him up for some morphine because he is very sore.
0:26:44 > 0:26:45No.
0:26:50 > 0:26:54Her advice is to use a less powerful painkiller.
0:26:54 > 0:26:57Amieth needs to cancel his instructions.
0:27:03 > 0:27:04No.
0:27:04 > 0:27:06He's got there just in time.
0:27:06 > 0:27:09No, we'll keep it spare and try codeine first.
0:27:09 > 0:27:13- Because I spoke to the consultant and that's what she suggested.- OK.
0:27:13 > 0:27:15I don't think it was a bad decision
0:27:15 > 0:27:18but I don't think he was thinking of the long-term plan
0:27:18 > 0:27:21as in, if morphine relieves the pain, what are we going to do then?
0:27:21 > 0:27:23Send him home? He can't go home with morphine.
0:27:23 > 0:27:26I think if he went back and saw the patient again
0:27:26 > 0:27:28he would manage that quite differently.
0:27:33 > 0:27:36As a junior in acute admissions,
0:27:36 > 0:27:40Aki is dealing with a wide range of patients.
0:27:40 > 0:27:44A Korean woman with a suspected stomach ulcer is next.
0:27:44 > 0:27:47Hi, I'm going to introduce myself. Dr Fukutomi, or Aki.
0:27:47 > 0:27:51I'm going to start by taking some bloods, if that's OK.
0:27:51 > 0:27:54Whilst we're talking they can be analysed.
0:27:54 > 0:27:55Aki is pleased to learn
0:27:55 > 0:27:59that she speaks his native language, Japanese.
0:27:59 > 0:28:00TRANSLATED FROM JAPANESE
0:28:07 > 0:28:08SHE LAUGHS
0:28:15 > 0:28:18I think, once upon a time, I could say I was bilingual.
0:28:18 > 0:28:20My Japanese is getting very rusty.
0:28:20 > 0:28:23I really like these opportunities
0:28:23 > 0:28:26to kind of top up my Japanese vocab skills.
0:28:26 > 0:28:31She asked a lot of questions about where I was from,
0:28:31 > 0:28:34if both my parents were Japanese, things like that,
0:28:34 > 0:28:37which I guess I don't get with other patients.
0:28:42 > 0:28:47For Aki, speaking Japanese has turned his thoughts to home.
0:28:47 > 0:28:50I think because my family are so far away,
0:28:50 > 0:28:53I naturally become closer to my friends
0:28:53 > 0:28:55and they do become more of a family.
0:28:55 > 0:28:58When you get forms which say "next of kin",
0:28:58 > 0:29:01I'd put my friend instead of a family member,
0:29:01 > 0:29:02just because it's easier.
0:29:02 > 0:29:05I think I'd like to be a bit closer to my father.
0:29:05 > 0:29:09We don't really see each other or even keep in contact.
0:29:10 > 0:29:12Since becoming a doctor,
0:29:12 > 0:29:14Aki has had no contact with his father.
0:29:14 > 0:29:18But now, missing home, he decides to call.
0:29:18 > 0:29:20TRANSLATED FROM JAPANESE
0:29:33 > 0:29:35"HANGING UP" JINGLE
0:29:35 > 0:29:37Me and my dad have never really been very close.
0:29:37 > 0:29:41I don't think there's anything in particular that...
0:29:42 > 0:29:44..I might see him be proud of
0:29:44 > 0:29:47or he would be really proud of that I've done yet.
0:29:49 > 0:29:52With his family on the other side of the world,
0:29:52 > 0:29:54friends for Aki are very important.
0:29:54 > 0:30:00I think I'm naturally closer to my housemates and my friends.
0:30:00 > 0:30:02I think they know a lot more about me
0:30:02 > 0:30:05than any of my family members do, to be honest.
0:30:08 > 0:30:10We should start a band or something.
0:30:10 > 0:30:15Probably the least musical band to ever form. But, yeah.
0:30:15 > 0:30:17Who's going to sing? Cos I can't.
0:30:17 > 0:30:21- Lucy can sing a bit, can't she? - Probably.
0:30:21 > 0:30:22Yeah. We could call ourselves
0:30:22 > 0:30:25Lucy Hollingworth and the Gastric Bands.
0:30:25 > 0:30:27How about that?
0:30:34 > 0:30:37Hey, are you all right?
0:30:37 > 0:30:40A new day, and Andy is on the general surgery ward.
0:30:41 > 0:30:45- It's good to see you.- All right? - I'm good, how are you?
0:30:46 > 0:30:48Sorry?
0:30:49 > 0:30:51Oh, right. Thank you.
0:30:51 > 0:30:55Like many junior doctors, he's been struggling with his confidence.
0:30:57 > 0:31:00- Did I not communicate it to the nurses clearly?- It's not your fault.
0:31:00 > 0:31:03If you've told the nurse, then what can you do?
0:31:03 > 0:31:06- As long as I made it clear.- Yeah.
0:31:06 > 0:31:08- This is you.- Yeah.
0:31:08 > 0:31:11You've written it clearly, they have no excuse.
0:31:11 > 0:31:14But maybe I wasn't clear enough verbally. I thought I said but...
0:31:14 > 0:31:17But nurses should be reading the notes, Andy,
0:31:17 > 0:31:19- don't blame yourself.- All right.
0:31:20 > 0:31:21She'll be through here.
0:31:21 > 0:31:24On the ward, Andy is called to an elderly patient
0:31:24 > 0:31:27who's waiting to hear if he needs an operation.
0:31:27 > 0:31:29What I'm going to do is take some blood from you.
0:31:29 > 0:31:32If you're improving and you're feeling better,
0:31:32 > 0:31:35you might not need this ERCP.
0:31:35 > 0:31:39Part of Andy's job as a junior doctor
0:31:39 > 0:31:41is to reassure him.
0:31:53 > 0:31:54So...
0:31:56 > 0:31:58So the condition you've got,
0:31:58 > 0:32:01which we think is inflammation of your gall bladder and gallstones,
0:32:01 > 0:32:03that's what we think it is.
0:32:03 > 0:32:04Correct.
0:32:06 > 0:32:09We can investigate that by putting a tube down,
0:32:09 > 0:32:11and then looking for these...
0:32:11 > 0:32:13Yes, that I knew, I knew that.
0:32:14 > 0:32:18But you meant they might not do even that?
0:32:18 > 0:32:21What you've got can resolve itself, OK?
0:32:21 > 0:32:25It can. So what we're doing is checking your bloods to see if it is.
0:32:25 > 0:32:29- Oh, yes, oh, yes.- It does look like it's getting better by itself.
0:32:30 > 0:32:32It looks like it.
0:32:32 > 0:32:35We need to keep taking bloods to see if it is getting better.
0:32:35 > 0:32:37Of course, say no more.
0:32:37 > 0:32:39Despite being just 23,
0:32:39 > 0:32:43Andy is the main support for patients like Luigi.
0:32:43 > 0:32:45Brilliant. So we'll get...
0:32:45 > 0:32:48- Of course.- Thank you for everything.
0:32:52 > 0:32:54I'm very sorry about that.
0:32:57 > 0:32:59He seemed quite emotional
0:32:59 > 0:33:03when he was talking about his personal life.
0:33:03 > 0:33:05Yeah, a lot of the people that come into hospital
0:33:05 > 0:33:09are at the age where they might be losing relatives, friends.
0:33:09 > 0:33:12I think sometimes it's quite nice for them to have someone to talk to
0:33:12 > 0:33:16or even just to let them know what's going on with our investigations.
0:33:16 > 0:33:21Sometimes, as junior doctors, we are that port of call.
0:33:21 > 0:33:26It's easy to think that we're just doing routine investigations,
0:33:26 > 0:33:30ordering things, the house bitches as it were.
0:33:30 > 0:33:33But we can make a big difference, I think.
0:33:33 > 0:33:35- What does that say? - Bloods this morning.
0:33:35 > 0:33:38The blood test results are back
0:33:38 > 0:33:40and for Luigi, it's good news.
0:33:40 > 0:33:44We've taken the catheter out, we'll do the paperwork.
0:33:44 > 0:33:45In a few hours, we'll let you go home.
0:33:45 > 0:33:48Thank you so much, thank you.
0:33:48 > 0:33:50Take care.
0:33:50 > 0:33:53See you soon, Mr Rossi. Bye-bye.
0:33:59 > 0:34:04Downstairs in A & E, another busy shift for Amieth...
0:34:04 > 0:34:07The abdomen is very soft, non-tender.
0:34:07 > 0:34:11..as he makes progress diagnosing patients on his own.
0:34:12 > 0:34:14Next for Amieth is George,
0:34:14 > 0:34:16a patient constantly in and out of A & E
0:34:16 > 0:34:19complaining about a swollen hand.
0:34:20 > 0:34:24- Look at the size of my arm. - Yeah, it's gone very swollen.
0:34:24 > 0:34:29- Can you move your hand at all, open it at all?- I can open it with help.
0:34:29 > 0:34:32With help from the other hand.
0:34:32 > 0:34:37- What about the elbow, is your elbow normal?- It's right up to the arm.
0:34:37 > 0:34:38The elbow is fine.
0:34:38 > 0:34:41What sort of treatment have you had for your hand?
0:34:41 > 0:34:44- They won't give me nothing.- OK.
0:34:44 > 0:34:47So you had an X-ray yesterday.
0:34:50 > 0:34:53Amieth consults the notes and decides not to do any further tests.
0:34:55 > 0:34:58So what's wrong with my hand, can you please tell me?
0:34:58 > 0:35:01I don't know what's wrong with your hand.
0:35:01 > 0:35:06I see that you've come in yesterday, the day before and a couple of days before that...
0:35:06 > 0:35:08Yeah.
0:35:08 > 0:35:12..and no-one's been able to really help you with your hand.
0:35:12 > 0:35:16- No, no-one will help me. They don't know what's wrong with it.- No.
0:35:16 > 0:35:18I saw that you had an X-ray yesterday
0:35:18 > 0:35:20and that there was no breaks in the hand.
0:35:20 > 0:35:23Yeah, but they can't find what's wrong with it.
0:35:23 > 0:35:26It doesn't look red or infected,
0:35:26 > 0:35:30but it is swollen and it's not moving very much.
0:35:30 > 0:35:32It's not moving at all.
0:35:32 > 0:35:34In terms of the swelling,
0:35:34 > 0:35:38the best way to get rid of that would be elevation.
0:35:38 > 0:35:40That would be to give you a sling.
0:35:40 > 0:35:43But there's no medications as such that would help this hand.
0:35:43 > 0:35:45It's absolutely killing me.
0:35:45 > 0:35:48I can offer you some painkillers if you need them.
0:35:48 > 0:35:51- What painkillers can you give me? - The normal tablets you take.
0:35:51 > 0:35:53But in terms of the hand swelling,
0:35:53 > 0:35:57apart from elevation, I can't offer you anything to reduce that.
0:35:57 > 0:36:00No, no, so you can't help me?
0:36:00 > 0:36:03No-one can help me with this arm.
0:36:03 > 0:36:05Why can't no-one help me?!
0:36:05 > 0:36:06I would like to help you.
0:36:06 > 0:36:10I need some help, I need some BLEEP help.
0:36:10 > 0:36:13- I know.- And no hospital's helping me.
0:36:13 > 0:36:17I'll find someone for you now.
0:36:17 > 0:36:20He's come in multiple times with a swollen hand.
0:36:20 > 0:36:22Rather than send the patient away,
0:36:22 > 0:36:26Amieth decides to seek help.
0:36:26 > 0:36:31A senior doctor checks the patient and performs an ultrasound scan.
0:36:31 > 0:36:35We've got this clot in one of the veins.
0:36:35 > 0:36:37It's causing the blood to back up.
0:36:41 > 0:36:45It's the blood clot that's causing the pain in George's arm.
0:36:46 > 0:36:49He's been seen by multiple doctors,
0:36:49 > 0:36:54and I was under the impression that he had been fully investigated.
0:36:54 > 0:36:58The ultrasound scan was one of the things that I had considered
0:36:58 > 0:37:02but I had wrongly assumed that it would already come back normal.
0:37:02 > 0:37:05I'm a little bit disappointed that I didn't suggest it myself,
0:37:05 > 0:37:09but I was wrong to assume that these tests had already been done.
0:37:20 > 0:37:23Lucy is back on nights.
0:37:23 > 0:37:26That's great, OK.
0:37:26 > 0:37:29And there's a special delivery for her.
0:37:33 > 0:37:35Just one minute.
0:37:35 > 0:37:38- Is it gorgeous? - Oh, I wouldn't know.
0:37:44 > 0:37:45Lovely.
0:37:47 > 0:37:49Slimmer?
0:37:49 > 0:37:51Wow, God.
0:37:51 > 0:37:55Can you imagine if it doesn't fit, doesn't even meet?
0:37:55 > 0:37:58Lovely! Does it look nice?
0:38:01 > 0:38:03Thank you. Hand-delivered!
0:38:06 > 0:38:08OK, thank you very much.
0:38:12 > 0:38:16- Who was that?- I don't know!
0:38:16 > 0:38:20I was already hot but now I'm boiling!
0:38:20 > 0:38:23God, I can't wear this all day, it's ridiculous!
0:38:24 > 0:38:27- What's up, Luce?- Hello.
0:38:27 > 0:38:30So I've now got an extra-small coat.
0:38:30 > 0:38:32And when I said, "It's too hot,"
0:38:32 > 0:38:35they said, "You can wear the coat with no blouse on."
0:38:35 > 0:38:40- Nice.- Apparently you're supposed to wear them like a tunic.- Oh, is it?
0:38:40 > 0:38:41Hilarious.
0:38:41 > 0:38:45- So I can wear it without a shirt on? - I wouldn't do that.
0:38:45 > 0:38:48- Nobody wants to see it, OK? - That's so sexist!
0:38:49 > 0:38:53After a frustrating first night shift,
0:38:53 > 0:38:58Lucy is determined to get on top of things and make this night a success.
0:38:58 > 0:39:01- What's the story? - He's got a gastric ulcer.
0:39:01 > 0:39:03He had an AGD today, he's bleeding,
0:39:03 > 0:39:05he's been having two units transfusion
0:39:05 > 0:39:08which was supposed to finish at about 11 o'clock.
0:39:08 > 0:39:12Lucy and registrar Philip attend to a patient
0:39:12 > 0:39:15showing signs of internal bleeding.
0:39:15 > 0:39:17Show me your tongue.
0:39:17 > 0:39:18It's a bit dry.
0:39:18 > 0:39:22Do you suffer from any chest problems? Bronchitis, asthma?
0:39:22 > 0:39:24Can I have some gloves?
0:39:26 > 0:39:28No, do you want me to phone the lab?
0:39:29 > 0:39:33The patient is in urgent need of a transfusion,
0:39:33 > 0:39:35and his blood type needs matching immediately.
0:39:35 > 0:39:38Is it be possible to cross-match another four units?
0:39:38 > 0:39:40He's got very low blood pressure
0:39:40 > 0:39:42and we think he might be bleeding out.
0:39:42 > 0:39:44I can run down with them, would you prefer that?
0:39:44 > 0:39:48- I think I would. - Yeah. OK. See you in a minute.
0:39:55 > 0:40:00Hello, can I get an urgent analysis of these bloods, please?
0:40:03 > 0:40:05Thanks to Lucy's swift action,
0:40:05 > 0:40:09a transfusion stabilises the patient.
0:40:11 > 0:40:14But then Lucy's called to another patient struggling to breathe.
0:40:14 > 0:40:16Hello, sir.
0:40:17 > 0:40:21I'm one of the doctors. My name's Lucy.
0:40:21 > 0:40:23I believe you're starting to feel a little bit breathless.
0:40:23 > 0:40:25Is that right?
0:40:25 > 0:40:27More than usual?
0:40:27 > 0:40:29After a quick examination,
0:40:29 > 0:40:33Lucy is concerned enough to ask registrar Phil for a second opinion.
0:40:33 > 0:40:37He's had increasing shortness of breath since this afternoon.
0:40:37 > 0:40:40He's saturated at 94% at the moment on two litres.
0:40:40 > 0:40:43On examination, his trachea is pretty difficult to feel,
0:40:43 > 0:40:46but I think it might be deviated to the left.
0:40:46 > 0:40:50He's hyperresonant on his right side where the drain's inserted.
0:40:50 > 0:40:52- Where is he?- D2.
0:40:52 > 0:40:55- Right, good.- You've done the right thing though.- Thank you.
0:40:55 > 0:40:58If you'd left it any longer...
0:40:58 > 0:41:00Good. Well spotted.
0:41:01 > 0:41:03I don't trust myself, that's the thing.
0:41:03 > 0:41:05- You know the story of the stuff? - Eh? Yeah.
0:41:05 > 0:41:08'There were a fair few emergencies that happened on the ward
0:41:08 > 0:41:10'and she dealt with it very well.'
0:41:10 > 0:41:12She probably didn't realise it,
0:41:12 > 0:41:15but she probably saved the life of someone
0:41:15 > 0:41:16who had a blocked chest drain
0:41:16 > 0:41:19by promptly coming to get me to assess the patient.
0:41:19 > 0:41:22I was quite impressed with that. Lucy's done pretty well, actually.
0:41:22 > 0:41:28For Lucy, it's confirmation that she can cope with being on call night or day.
0:41:28 > 0:41:30He had a chest drain in because he had some air
0:41:30 > 0:41:34between his lung and chest wall a few days ago.
0:41:34 > 0:41:37It's still in there. It's still draining away.
0:41:37 > 0:41:41Sometimes, if the chest drain isn't draining very well,
0:41:41 > 0:41:43the air pocket builds up and pushes your lung over.
0:41:43 > 0:41:48'He needed seeing cos if we'd left him, it would have got worse.
0:41:48 > 0:41:50'I was pleased I went to see him.'
0:41:50 > 0:41:53Phil did say, "Well done." That's always nice.
0:41:53 > 0:41:56A pat on the back during a night shift.
0:41:56 > 0:41:58How was the rest of the night?
0:41:58 > 0:41:59It was fine. Yeah, it was fine.
0:42:01 > 0:42:03# I think I got a fever
0:42:04 > 0:42:08# I'm hot Somebody better cool me down... #
0:42:09 > 0:42:12In accident & emergency, after a challenging shift,
0:42:12 > 0:42:15Amieth again has to deal with a patient on his own.
0:42:15 > 0:42:21What I'm going to do is, I'm going to get some local anaesthetic
0:42:21 > 0:42:23and it will numb the area.
0:42:23 > 0:42:25SHE GASPS IN PAIN
0:42:25 > 0:42:27Hind has gashed her foot on broken glass.
0:42:27 > 0:42:32This time, Amieth doesn't need to call for help.
0:42:32 > 0:42:35When I put the anaesthetic in, it will sting.
0:42:35 > 0:42:36It's important to wash it out
0:42:36 > 0:42:39to make sure there's no glass trapped in there.
0:42:39 > 0:42:41OK?
0:42:41 > 0:42:44He knows exactly what to do.
0:42:44 > 0:42:47Why don't you put your legs back up on the bed?
0:42:47 > 0:42:51- Where are you going to inject it? - Where?- Yeah.- Just around the wound.
0:42:51 > 0:42:55It will sting to begin with and then it will go numb
0:42:55 > 0:42:57and you won't feel anything.
0:43:00 > 0:43:03It's important to make sure there's no glass trapped in there.
0:43:10 > 0:43:14The cut looks a little bit deep.
0:43:16 > 0:43:19I think so, but now that the local anaesthetic is in,
0:43:19 > 0:43:21the stitches won't hurt.
0:43:23 > 0:43:26Amieth neatly stitches Hind's foot.
0:43:28 > 0:43:31Normal tablet painkillers that you can buy over the counter.
0:43:31 > 0:43:35- Visit your GP practice nurse to have the stitches removed.- OK.
0:43:35 > 0:43:38The dressing will prevent it from rubbing.
0:43:38 > 0:43:41Even if it hurts, I should be able to put pressure on it?
0:43:41 > 0:43:44You should be able to put pressure on it.
0:43:44 > 0:43:49Amieth's finally satisfied he can trust his own judgement.
0:43:49 > 0:43:52The stitches are there to support the wound so it can heal itself.
0:43:52 > 0:43:57It's the best way of healing wounds.
0:43:57 > 0:44:00I know it's a bit unpleasant to have them put in, but...
0:44:00 > 0:44:02- OK?- Thank you so much. - You're welcome.
0:44:02 > 0:44:07He looked after me very well, very caring, made me patient,
0:44:07 > 0:44:12and even though I'm always terrified and scared of injections etc,
0:44:12 > 0:44:16stitches, it was a great experience with him. He was good.
0:44:16 > 0:44:18Cherry, thank you.
0:44:18 > 0:44:19'There is quite a big difference'
0:44:19 > 0:44:23between Amieth now and, say, seven weeks ago when he first started.
0:44:23 > 0:44:25'He's built up his confidence.
0:44:25 > 0:44:28'He's seen some cases without having to ask quite so much.
0:44:28 > 0:44:30'Over the next two months, I'd like to see him continue'
0:44:30 > 0:44:33to develop and feel more confident and independent
0:44:33 > 0:44:34in his management of patients.
0:44:38 > 0:44:42Its A & E's night out and Amieth is invited.
0:44:46 > 0:44:49A chance for the team to get to know him.
0:44:49 > 0:44:52Nice to see you all not wearing scrubs as well.
0:44:52 > 0:44:55It will be interesting to see Amieth out of work,
0:44:55 > 0:45:00because he's still very quiet and shy, I think, in work.
0:45:00 > 0:45:02It will be interesting to see the other side of him.
0:45:07 > 0:45:09Hey, hey, hey!
0:45:11 > 0:45:15- You said you hadn't played for ten years!- I haven't.- Yeah, right.
0:45:15 > 0:45:18Have you been practising secretly?
0:45:20 > 0:45:23'The impression I get from him when he's at work,'
0:45:23 > 0:45:26there's a guard on him in some ways
0:45:26 > 0:45:30'and he's let that down today, which is quite nice.'
0:45:30 > 0:45:32The FY2 beat the registrar.
0:45:34 > 0:45:37Bowling's a great leveller.
0:45:37 > 0:45:40Finally, Amieth is part of the team.
0:45:42 > 0:45:46It's nice being out of the hospital and getting a chance to know them
0:45:46 > 0:45:50more socially and seeing them wear something that's not blue pyjamas.
0:46:00 > 0:46:04On the acute assessment unit, Aki is under pressure.
0:46:04 > 0:46:07I'm really behind. I need to get to know all these patients.
0:46:07 > 0:46:09A lot of them are new.
0:46:09 > 0:46:12And a lot of things haven't been done since last night
0:46:12 > 0:46:15so I just need to get on top of everything.
0:46:15 > 0:46:17Today, the pressure is even greater
0:46:17 > 0:46:22because on the ward is one of the hospital's most senior doctors,
0:46:22 > 0:46:23Dr Morgan.
0:46:25 > 0:46:27OK, if you don't mind, would you be able to tell me
0:46:27 > 0:46:30what's been going on in the last few days?
0:46:30 > 0:46:34The first patient on Aki's list is Mr Scanlon.
0:46:34 > 0:46:38Would you say your tummy pain is the main problem...
0:46:38 > 0:46:41that's stopping you from doing anything?
0:46:41 > 0:46:43- Is that the main problem? - And I'm full of gas all the time.
0:46:43 > 0:46:47You know, constantly burping.
0:46:47 > 0:46:50A couple of days ago, after treatment for a stomach ulcer,
0:46:50 > 0:46:52Mr Scanlon was discharged.
0:46:52 > 0:46:54Have you been able to eat anything?
0:46:54 > 0:46:59- A bit of toast this morning and an egg that stayed in.- OK.
0:46:59 > 0:47:04- Let me know if I'm causing any pain. - Makes me want to burp.- OK.
0:47:04 > 0:47:07- See you later.- See you later.
0:47:08 > 0:47:13My honest answer is that he stopped his medications
0:47:13 > 0:47:16and I think one of them he should have continued.
0:47:16 > 0:47:19So, I'm a bit worried that there might be
0:47:19 > 0:47:22a little bit of a problem, but this is just my impression.
0:47:24 > 0:47:27Dr Morgan's here, so why don't we present the one
0:47:27 > 0:47:30- you've just spoken to me about?- OK.
0:47:31 > 0:47:34Presenting to Dr Morgan will give Aki the chance
0:47:34 > 0:47:36to demonstrate his medical knowledge.
0:47:36 > 0:47:39'Junior doctors do find it very nerve-racking'
0:47:39 > 0:47:41when they first present to consultants
0:47:41 > 0:47:44and it's probably nerve-racking
0:47:44 > 0:47:47for the first six months to a year, I would have thought.
0:47:47 > 0:47:50The more worried you are about presenting to a consultant,
0:47:50 > 0:47:53the more flustered and nervous you get.
0:47:58 > 0:48:02I just need to prepare myself, make sure I'm ready for it.
0:48:03 > 0:48:07Aki must now present his diagnosis to Dr Morgan.
0:48:11 > 0:48:16- I've got another one over in the next bay.- Let's deal with him.- OK.
0:48:16 > 0:48:23It's a 46-year-old gentleman who was discharged on 16th September
0:48:23 > 0:48:26after being diagnosed with a GI bleed.
0:48:26 > 0:48:32And it was stopped, Dr Steel did an endoscopy.
0:48:32 > 0:48:34- Let's go and have a look.- OK.
0:48:34 > 0:48:38Having listened to Aki, Dr Morgan double-checks the patient.
0:48:38 > 0:48:41The blood tests are good.
0:48:52 > 0:48:55- Fantastic.- Aki has got it right.
0:48:55 > 0:48:59At last, his medical knowledge hasn't failed him.
0:48:59 > 0:49:02- Let's give him a small dose of the meds. Let's give him 20.- OK.
0:49:02 > 0:49:05- OK?- Yep, no problem.- Good. - Thank you.
0:49:07 > 0:49:10It was really nice when Dr Morgan reviewed Mr Scanlon
0:49:10 > 0:49:13and agreed with my diagnosis.
0:49:14 > 0:49:18It's a nice feeling when your seniors agree with you
0:49:18 > 0:49:21and you feel like you've actually contributed
0:49:21 > 0:49:24and you came up with something that is the right answer.
0:49:35 > 0:49:38Hello!
0:49:38 > 0:49:40Two months into the job
0:49:40 > 0:49:43and the junior doctors can make the most of a rare night out together.
0:49:43 > 0:49:47SLURRED SINGING
0:49:51 > 0:49:55It's a karaoke evening and a reminder for Aki of life in Japan.
0:49:55 > 0:49:59If you go out to get drunk, people go, "Shall we do karaoke?"
0:49:59 > 0:50:02- Yeah, nostalgia. - Are you not homesick?
0:50:02 > 0:50:05Yeah, but in another way,
0:50:05 > 0:50:08it's the kind of like we are in Tokyo right now.
0:50:08 > 0:50:11- It's kind of nice... - You have to take us all!
0:50:11 > 0:50:14Oh, my God, you guys should come, you'd love it.
0:50:14 > 0:50:17My confidence has grown, I would say, significantly.
0:50:17 > 0:50:20I think the future is bright.
0:50:20 > 0:50:23Cheers, guys!
0:50:26 > 0:50:29And perfectionist Lucy has learnt that sometimes,
0:50:29 > 0:50:31near-perfect will do.
0:50:31 > 0:50:32When you start out,
0:50:32 > 0:50:35it's like when you get the first bit of post through
0:50:35 > 0:50:37when you first start on your first day and you say,
0:50:37 > 0:50:40"Hi, I'm Lucy, I'm one of the doctors." And you just think,
0:50:40 > 0:50:43"Oh, no, this is just way too big for me."
0:50:43 > 0:50:46But, actually, you grow into it.
0:50:46 > 0:50:49It is quite nice to see your development, you know, when I think,
0:50:49 > 0:50:53this is something that I didn't know what I was doing a few weeks ago.
0:50:53 > 0:50:56I didn't know how to approach it or I felt nervous.
0:50:56 > 0:50:59And now I'm doing it for the second time and I know what I'm doing.
0:51:08 > 0:51:10- Next time... - So, it's all done?
0:51:10 > 0:51:12No, not yet, that was just the anaesthetic.
0:51:12 > 0:51:16After weeks at the bottom rung of the ladder...
0:51:16 > 0:51:18I'll be here for half an hour.
0:51:18 > 0:51:20I've got to stick my finger up someone's bum.
0:51:20 > 0:51:23..the juniors begin to wonder if it's all worth it.
0:51:23 > 0:51:28I'm quite tired and almost a bit disinterested.
0:51:28 > 0:51:31I've had days when I've thought, "Is this what I want to do?
0:51:31 > 0:51:33"Is this right for me, medicine?"
0:51:52 > 0:51:56Subtitles by Red Bee Media Ltd