0:00:02 > 0:00:07This programme contains some strong language.
0:00:07 > 0:00:11- Trauma...- She's got a strong pulse. - ..tears...- It's emotional.- That's all right.- ..and intense pressure.
0:00:11 > 0:00:15EQUIPMENT BEEPS Switching the oxygen over.
0:00:15 > 0:00:17Just another day on medicine's front line.
0:00:21 > 0:00:23They're young,
0:00:23 > 0:00:24they're untested...
0:00:24 > 0:00:27This is my first patient ever.
0:00:27 > 0:00:31..and from their very first day, work is a matter of life and death.
0:00:31 > 0:00:34- Don't let me die.- We're not going to let you go anywhere.
0:00:34 > 0:00:37For a junior doctor fresh out of medical school,
0:00:37 > 0:00:39it's time to put theory into practice.
0:00:43 > 0:00:45No, I haven't.
0:00:45 > 0:00:47We're following seven junior doctors
0:00:47 > 0:00:50over their first three months on the job...
0:00:50 > 0:00:52- Sharp scratch.- Ooh!
0:00:52 > 0:00:55It's all about the glamour. It's all about the bums.
0:00:55 > 0:00:59..where there's a first time for everything...
0:00:59 > 0:01:00Aargh!
0:01:00 > 0:01:04I didn't really know what to do. It's just having the confidence, isn't it?
0:01:04 > 0:01:07..and first impressions count.
0:01:07 > 0:01:09I'm afraid I didn't get it first time either.
0:01:11 > 0:01:17First-years Tom, Emily, Jen, Tristan and Ed
0:01:17 > 0:01:20have been on the wards now for six weeks.
0:01:21 > 0:01:23OK? Yes.
0:01:24 > 0:01:26Squeeze for me.
0:01:26 > 0:01:31Second-years Kiera and Oli have 12 months' experience.
0:01:31 > 0:01:34Sorry about that. I don't usually struggle with this.
0:01:36 > 0:01:40They're working here at the Royal Liverpool University Hospital...
0:01:40 > 0:01:43Hey, they're here to look after you, lad.
0:01:43 > 0:01:47..where they're now starting to find that becoming a junior doctor
0:01:47 > 0:01:50means making big sacrifices in their personal lives.
0:01:52 > 0:01:57This has been one of the hardest points, even in our relationship.
0:01:57 > 0:02:00I've been absolutely shattered cos I've been going to work every day
0:02:00 > 0:02:03and going out every night, seeing my friends.
0:02:03 > 0:02:05I feel like I need to start turning stuff down
0:02:05 > 0:02:07and actually go to bed on time.
0:02:07 > 0:02:11We've just got to get used to this new way of life. Make the best of it.
0:02:32 > 0:02:34Since graduating from medical school
0:02:34 > 0:02:37and beginning their careers in a busy hospital,
0:02:37 > 0:02:40the junior doctors are finding that life is getting harder.
0:02:47 > 0:02:50Six weeks in and the demands of being fully fledged doctors
0:02:50 > 0:02:53are beginning to catch up with them.
0:02:53 > 0:02:55I feel like I am just living in the hospital at the minute.
0:02:55 > 0:02:59Stuff like doing the washing up, changing my bedsheets
0:02:59 > 0:03:02and just stupid things like that just get completely thrown out
0:03:02 > 0:03:06of the window, and I just feel like I need to sort my life out.
0:03:06 > 0:03:10Long hours on the wards mean that achieving a work-life balance
0:03:10 > 0:03:11is becoming increasingly tricky.
0:03:11 > 0:03:15And in the house that some of them share, it's starting to show.
0:03:15 > 0:03:17Tom's room is a shit tip.
0:03:17 > 0:03:19Oh, my God, it really is so messy.
0:03:20 > 0:03:23Half of Tom's dirty washing is in the gym.
0:03:23 > 0:03:25Tom's room is pretty messy.
0:03:25 > 0:03:26Dirty socks.
0:03:26 > 0:03:27My room is pretty messy.
0:03:27 > 0:03:30Dirty shirt.
0:03:30 > 0:03:32I think if it was down to us to do the house,
0:03:32 > 0:03:34it would be disgusting.
0:03:34 > 0:03:39Dirty pants. Pyjama bottoms. And a jumper.
0:03:39 > 0:03:43It has been really hard doing 12 hour days and working weekends
0:03:43 > 0:03:46and things like that, and you just get really overwhelmed.
0:03:46 > 0:03:49This bloody towel. It's Tom's shit everywhere.
0:04:05 > 0:04:09The junior doctors may be struggling to look after themselves but at
0:04:09 > 0:04:13the hospital, there's no shortage of patients who need their attention.
0:04:13 > 0:04:16Is that for the same person or is that for a different person?
0:04:16 > 0:04:17Different person.
0:04:20 > 0:04:23It's early morning on the colorectal ward
0:04:23 > 0:04:26and Emily is aiming to impress after being given a task
0:04:26 > 0:04:30most junior doctors find notoriously tricky.
0:04:30 > 0:04:32I'm just going to take it out for you.
0:04:32 > 0:04:33It just might feel a bit uncomfortable.
0:04:33 > 0:04:36If you want, you can cough.
0:04:36 > 0:04:39One of her patients needs a new nasal tube after problems swallowing
0:04:39 > 0:04:42meant his last one had to come out.
0:04:42 > 0:04:46- Thank you.- Right, then. Let's have a measure.
0:04:51 > 0:04:53The tube will run up through the patient's nose
0:04:53 > 0:04:55and all the way down into his stomach.
0:04:57 > 0:04:59'It's not a painful procedure.'
0:04:59 > 0:05:04It's uncomfortable having somebody put a tube up your nose but
0:05:04 > 0:05:07he is a really nice gentleman and he knows why he needs it
0:05:07 > 0:05:10so I don't think it's going to be too traumatic.
0:05:10 > 0:05:14Emily may appear laidback about inserting a nasal tube but, on
0:05:14 > 0:05:19a recent nightshift, Jen discovered it was anything but straightforward.
0:05:19 > 0:05:21Aargh!
0:05:22 > 0:05:25So, what we will do, once we have got you a pillow
0:05:25 > 0:05:26and got you nice and comfy,
0:05:26 > 0:05:29we'll get you to hold a bit of water in your mouth
0:05:29 > 0:05:32and then this is going to go up your right nostril and then, when it is
0:05:32 > 0:05:35sort of at the back of your throat, I'll just ask you to swallow.
0:05:35 > 0:05:39- And then it will pop down into your belly.- Just like that.- Just easy.
0:05:39 > 0:05:42Just like that. All right, then.
0:05:42 > 0:05:45Emily is being supervised by registrar Femi Oshin
0:05:45 > 0:05:48because the procedure can carry risks.
0:05:48 > 0:05:52- He needs a bit of time to swallow. - OK. All right, then?
0:05:52 > 0:05:54So, pop your head a bit down towards your chest for me.
0:05:54 > 0:05:57- That's lovely. You ready?- Mm-hm.
0:05:57 > 0:06:00OK, and swallow. Swallow.
0:06:02 > 0:06:04Keep swallowing.
0:06:04 > 0:06:05When you hit a bit of resistance,
0:06:05 > 0:06:07you're hitting the back of the throat.
0:06:07 > 0:06:09OK, keep swallowing.
0:06:09 > 0:06:14It's possible the tube may enter the lungs rather than the stomach,
0:06:14 > 0:06:16so it's crucial that Emily gets it right.
0:06:18 > 0:06:23And a bit more. And swallow.
0:06:23 > 0:06:25- Fantastic.- Excellent. Well done.
0:06:25 > 0:06:26And again.
0:06:29 > 0:06:32It will take an X-ray of the man's chest to reveal
0:06:32 > 0:06:36whether Emily has successfully reached the right target.
0:06:36 > 0:06:38So, this is his chest X-ray
0:06:38 > 0:06:44and this line here is the tube going into the tummy.
0:06:44 > 0:06:46So, before, it was around here,
0:06:46 > 0:06:49so I put it in a couple more centimetres so it is here.
0:06:49 > 0:06:52Yeah, I am happy with that so I can go and get the nurse
0:06:52 > 0:06:54and he can start getting fed.
0:06:54 > 0:06:57Emily has got the difficult procedure right first time
0:06:57 > 0:07:00and the improvement for her patient is immediate.
0:07:02 > 0:07:06Oh, yeah. I couldn't do that before.
0:07:06 > 0:07:09- Job done.- Thank you. - Thank you very much.- Thank you.
0:07:09 > 0:07:12- Well done, Emily.- Thank you.
0:07:13 > 0:07:17Yes, I think she did a very good job. She did very well. yeah.
0:07:21 > 0:07:24- Are you going to come and help do breakfast?- No, thank you.
0:07:24 > 0:07:25No, thank you?
0:07:25 > 0:07:27As if life as a junior doctor isn't demanding enough,
0:07:27 > 0:07:31for first-year Tristan, it's even more of a challenge.
0:07:31 > 0:07:34Lottie, are you going to have Lottie-brek for breakfast?
0:07:34 > 0:07:35< Lottie-brek?
0:07:36 > 0:07:40As father to toddler Lottie, he needs to juggle his role as a doctor
0:07:40 > 0:07:43each day with his one as a dad.
0:07:43 > 0:07:46'Obviously, I have to get myself ready
0:07:46 > 0:07:51'and then also Lottie will need nappy changing, clothes changing.
0:07:51 > 0:07:55'She will probably want to play with something or do
0:07:55 > 0:07:58'something in the morning to keep herself entertained or
0:07:58 > 0:08:01'sometimes she is running around my legs as I try to do her breakfast.
0:08:01 > 0:08:04'Oh, and then there is feeding her breakfast and making our breakfast.'
0:08:04 > 0:08:07Lottie, here is your breakfast.
0:08:07 > 0:08:09So, yeah, it adds a lot more little steps,
0:08:09 > 0:08:11but you just build it into your routine.
0:08:15 > 0:08:19Tristan's life is about to become even harder over the next few weeks.
0:08:23 > 0:08:27After dropping Lottie at nursery, he's off to the hospital.
0:08:27 > 0:08:31He's volunteered to do extra shifts on top of his normal hours
0:08:31 > 0:08:34and will also be working the next two weekends.
0:08:39 > 0:08:40'I'm on call this weekend.
0:08:40 > 0:08:44'It's Friday morning so I'm doing my day job today until five
0:08:44 > 0:08:46'and then five till ten, I'll be on call,
0:08:46 > 0:08:49'and then nine till ten Saturday, nine till ten Sunday
0:08:49 > 0:08:50'and then back in work on Monday.
0:08:50 > 0:08:52'Yeah, it should be quite a long one.'
0:08:52 > 0:08:54But that's OK. It's what I signed up for.
0:08:54 > 0:08:57With a young family to support, Tristan has good reason
0:08:57 > 0:09:00for signing up for all the extra work.
0:09:00 > 0:09:03I think it is safe to say that we are in a lot of debt, in terms
0:09:03 > 0:09:08of the fact that we have got not one student loan but two each.
0:09:08 > 0:09:10So I am looking forward to pay day.
0:09:10 > 0:09:13It's going to be nice to start chipping away at the debt.
0:09:15 > 0:09:21'I feel really happy that I will be earning money that will help
0:09:21 > 0:09:24'sustain Jenna and Lottie, my wife and my daughter.'
0:09:24 > 0:09:26I think that's like a real privilege.
0:09:26 > 0:09:29It makes me feel good that I'll be allowing them
0:09:29 > 0:09:33to live the life that they would like to, comfortably.
0:09:33 > 0:09:36Day one of his long run of shifts
0:09:36 > 0:09:39and he's straight into the thick of it.
0:09:39 > 0:09:41BEEPING
0:09:41 > 0:09:43Just got a crash bleep.
0:09:43 > 0:09:46Being on call means that he can be bleeped to attend
0:09:46 > 0:09:49emergencies in other parts of the hospital at any time.
0:09:49 > 0:09:52Said to go to A&E Resus urgently.
0:09:54 > 0:09:56Day two and there are also procedures
0:09:56 > 0:09:59on his own ward of gerontology which need doing.
0:09:59 > 0:10:01Is it OK if I take this canula out?
0:10:04 > 0:10:07Sorry, I'm just going to take the dressing off. OK?
0:10:10 > 0:10:13- Hi, Marge.- What would you like to talk about?
0:10:13 > 0:10:17I just wanted to get an update of what has been going on.
0:10:17 > 0:10:21Marjorie is in the hospital after losing feeling in her hands.
0:10:21 > 0:10:24- As you said, you've been having these problems with your arms.- Yes.
0:10:24 > 0:10:26We did the scan of your neck
0:10:26 > 0:10:31and there is a little bit of narrowing in your spine at the top.
0:10:31 > 0:10:34So you have your vertebra,
0:10:34 > 0:10:37which are the bones that make up your spine,
0:10:37 > 0:10:41and at one or two levels, the nerves that are coming out
0:10:41 > 0:10:45and the cord are slightly compressed where they shouldn't be.
0:10:45 > 0:10:48But we will talk to the neurologist and neurosurgeons, like I said,
0:10:48 > 0:10:51- and get it sorted. Is that OK? - That's good news. Yes, thank you.
0:10:51 > 0:10:55Right, well, I'll see you later and give you an update. See you later.
0:10:55 > 0:11:00Tristan's plain-talking manner is proving to be popular with patients.
0:11:00 > 0:11:04Tristan puts everything easily...
0:11:04 > 0:11:09in words, you know, that you understand.
0:11:09 > 0:11:13And all the time he is talking to you, he is also holding your hand.
0:11:13 > 0:11:18You know, you feel at ease. He's lovely. He really is lovely. Yeah.
0:11:18 > 0:11:19I love him to bits.
0:11:28 > 0:11:32Over in the Acute Medical Unit, Ed is also looking to make
0:11:32 > 0:11:34a good impression on his patients.
0:11:36 > 0:11:38Hello.
0:11:38 > 0:11:41An elderly man is having trouble breathing and it's the Italian
0:11:41 > 0:11:45medic's job to take a sample of fluid surrounding his lungs.
0:11:45 > 0:11:47Use this side because there is more space here.
0:11:47 > 0:11:50This patient has got a particularly large collection
0:11:50 > 0:11:52of fluid in the pleural space.
0:11:52 > 0:11:53So, all this black stuff...
0:11:53 > 0:11:55- Is fluid.- ..is fluid, yeah.
0:11:55 > 0:11:58And the top is towards the skin.
0:12:00 > 0:12:02'I'm going to do it and I have an
0:12:02 > 0:12:06'excellent mentor who will help me out, so I'm sure it will be OK
0:12:06 > 0:12:08'and it will be an excellent learning opportunity.'
0:12:13 > 0:12:16The untested doctor will need to be precise
0:12:16 > 0:12:20if he's to avoid puncturing the patient's lung.
0:12:20 > 0:12:22There is still air in there. There we go.
0:12:23 > 0:12:25So, you're going to have a little stab.
0:12:29 > 0:12:30There you go.
0:12:32 > 0:12:35- OK, sir?- Yes. You can come again, you can.
0:12:37 > 0:12:40Ed's patient is responding well to his positive approach
0:12:40 > 0:12:43but after giving him a local anaesthetic, the junior doctor
0:12:43 > 0:12:46must now use a much larger needle to finish the job.
0:12:48 > 0:12:53Just go straight in, slightly inclined. You need to do that.
0:12:55 > 0:12:59Yeah, straight in. Very good. Keep sucking as you're going in. OK, yeah.
0:13:03 > 0:13:05Is it OK, sir?
0:13:10 > 0:13:13Obviously, if there was a bigger needle...
0:13:16 > 0:13:18Keep the pressure there.
0:13:22 > 0:13:24I want you to take the syringe off.
0:13:24 > 0:13:29As you take the syringe off, I want you to put your thumb on the needle.
0:13:29 > 0:13:30OK.
0:13:34 > 0:13:35That's lovely. That's fine.
0:13:37 > 0:13:39Could you please make a humming noise, sir?
0:13:39 > 0:13:41- HE HUMS - That's lovely.
0:13:41 > 0:13:45The procedure has been a success for both patient and junior doctor.
0:13:45 > 0:13:49OK, sir, we can position you back. Was that all right?
0:13:49 > 0:13:51- That was fine, thank you. - OK, that's good.
0:13:53 > 0:13:56Ed has managed to extract two full syringes of fluid
0:13:56 > 0:14:00and leaves behind one satisfied patient.
0:14:00 > 0:14:03I thought he was excellent. I told him so, didn't I?
0:14:03 > 0:14:07He was excellent. They've got to learn.
0:14:07 > 0:14:10If they don't learn, they're never going to be able to do the job
0:14:10 > 0:14:13and we've all got to learn, whatever we're doing, haven't we?
0:14:20 > 0:14:22It's been a productive day for Ed.
0:14:22 > 0:14:25But all the hours he's been spending in the hospital means
0:14:25 > 0:14:28that his home life with girlfriend Martina has been put on hold.
0:14:30 > 0:14:33I think that with any job, it is very difficult to strike
0:14:33 > 0:14:37a good balance between home and work, but this is fine. I mean,
0:14:37 > 0:14:40this is my job, so that's the priority.
0:14:40 > 0:14:43As a couple, we are missing, of course, the routine
0:14:43 > 0:14:44we were having in Italy.
0:14:44 > 0:14:47We have just got to get used to this new way of life.
0:14:47 > 0:14:48Make the best of it.
0:14:49 > 0:14:52He spends the majority of his time in the hospital
0:14:52 > 0:14:56and when he is not in the hospital he is sat in his studio, typing,
0:14:56 > 0:15:00thinking, studying, doing courses and tests.
0:15:00 > 0:15:03My lullaby is the click, click, click of the computer.
0:15:03 > 0:15:05Click, click, click, click...
0:15:05 > 0:15:10So that is just explanatory on how hard he works and sometimes I just
0:15:10 > 0:15:13look at the clock and it's 1am and I am like,
0:15:13 > 0:15:17"Edward, what the...? I mean, come to bed."
0:15:21 > 0:15:25Tonight, Ed has the chance to make it up to Martina.
0:15:25 > 0:15:27With a relatively early finish at the hospital,
0:15:27 > 0:15:28he's taking her for a curry.
0:15:30 > 0:15:32We never have a meal out.
0:15:32 > 0:15:35Never have a meal out so, yes, we are happy
0:15:35 > 0:15:38and we are really looking forward
0:15:38 > 0:15:40even to just spend some time,
0:15:40 > 0:15:44the two of us, in a different setting. It's nice.
0:15:44 > 0:15:47It's things that a couple might like to do.
0:15:50 > 0:15:53With Martina spending so little time with Ed lately, tonight gives
0:15:53 > 0:15:57her the chance to find out how he's coping with life at the hospital.
0:15:57 > 0:16:00How do you find the new ward? People?
0:16:00 > 0:16:03Do you think you're getting around the system now?
0:16:03 > 0:16:07Do you think you're getting better, understanding how things work?
0:16:07 > 0:16:12Well, I mean, the system itself is much more understandable to me.
0:16:12 > 0:16:15Do you think you're doing things that are up your street
0:16:15 > 0:16:19and you are able to do them? Or are they too easy, too difficult?
0:16:19 > 0:16:20No, they are fine.
0:16:20 > 0:16:24I wish I had a bit more time to see new patients
0:16:24 > 0:16:28and a little bit of time to read up on what to do if I don't know.
0:16:28 > 0:16:33I mean, do you still get the feedback you had asked...from supervisors?
0:16:33 > 0:16:35People tell me if I do something wrong.
0:16:35 > 0:16:39- Do you like the people you're working with?- Oh, yeah, the team is great.
0:16:39 > 0:16:41- I really like it. - That's very good, you know.
0:16:41 > 0:16:44I think I, basically, didn't encounter anybody
0:16:44 > 0:16:47in the Acute Medicine Unit
0:16:47 > 0:16:49- that I disliked or did not get on with.- Really?
0:16:49 > 0:16:53That is so good, Edward. To a bright career for both of us.
0:16:53 > 0:16:55And some peace.
0:17:05 > 0:17:09It's the beginning of a new day in the hospital and one of Britain's
0:17:09 > 0:17:13busiest emergency departments is already full to capacity.
0:17:16 > 0:17:19Second-year Kiera is dealing with Barry,
0:17:19 > 0:17:23a patient who's come in to the department with severe leg pain.
0:17:23 > 0:17:29The green man was on the traffic light and I walked across the road
0:17:29 > 0:17:33but the car came up, and he mustn't have seen me and he just hit me.
0:17:33 > 0:17:36Do you know what sort of speed it was that he hit you at?
0:17:36 > 0:17:39And he hit you from this side, did he?
0:17:39 > 0:17:42Barry was able to walk away from the accident
0:17:42 > 0:17:45but a few hours later, he began to feel the full effects.
0:17:45 > 0:17:46This has blown up, has it, since?
0:17:46 > 0:17:49Do you want to swing your leg up onto the bed for me?
0:17:49 > 0:17:51I need to have a little look at it.
0:17:51 > 0:17:54Do you usually walk with a crutch or do you walk normally?
0:17:54 > 0:17:57I just normally walk normally, like.
0:17:59 > 0:18:03Right, you have got a big swelling of it. Are you all right?
0:18:03 > 0:18:06Are you happy for me to have a little feel of it or would you rather
0:18:06 > 0:18:09- have some more painkillers first? - If you like.- Right.
0:18:09 > 0:18:13Can you bend it up for me? Just gently. Really sore?
0:18:14 > 0:18:17Yeah. I'll bet. How far can you bend it up?
0:18:22 > 0:18:24That's it? Yeah. OK.
0:18:25 > 0:18:28I won't poke too much if you're sore.
0:18:28 > 0:18:31Any pain up here? Sorry.
0:18:31 > 0:18:34- It's really sore, isn't it? - Honest to God, it's fucking killing.
0:18:34 > 0:18:38With Barry in obvious pain, Kiera has a decision to make -
0:18:38 > 0:18:42push on or put the examination on hold?
0:18:42 > 0:18:44His knee is really, really painful and quite swollen at the moment
0:18:44 > 0:18:47so I'm just going to give him a few more painkillers
0:18:47 > 0:18:49before I examine it any further.
0:18:49 > 0:18:52It is still quite a strong pain reaction from him
0:18:52 > 0:18:56and it's a bit mean to poke or prod it any more.
0:18:56 > 0:19:00It's a dilemma that all junior doctors must get to grips with -
0:19:00 > 0:19:05knowing when to treat a patient and when to give them space.
0:19:05 > 0:19:09Unfortunately for Barry, his time out is coming to an end.
0:19:09 > 0:19:14I can't see any fractures within the femur.
0:19:20 > 0:19:23There is nothing broken on the X-ray, which is good.
0:19:23 > 0:19:26But that doesn't mean that you haven't damaged something else.
0:19:26 > 0:19:28With the painkillers kicking in,
0:19:28 > 0:19:31it's time for Kiera to finish what she started.
0:19:33 > 0:19:35That is hurting, that, man.
0:19:35 > 0:19:38Can I sit on your foot?
0:19:38 > 0:19:39Are you having a laugh?
0:19:43 > 0:19:44Fucking hell!
0:19:47 > 0:19:50- I just need to...- Can you just put it down for us, please?
0:19:50 > 0:19:54Barry, I just need to really gently examine something, OK? I'll be quick.
0:19:54 > 0:19:56Well done.
0:19:56 > 0:19:58Any pain around here?
0:19:58 > 0:20:00It's a good job I don't hit women, you know.
0:20:02 > 0:20:04You wouldn't be able to catch me, mate.
0:20:04 > 0:20:08Though no bones are broken, Kiera believes Barry may have
0:20:08 > 0:20:11damaged his ligaments and will need further treatment.
0:20:11 > 0:20:13But for now, a splint should allow him to go home.
0:20:15 > 0:20:18You're like Cinderella, aren't you? A glass slipper.
0:20:27 > 0:20:30That's enough of that, thank you very much, young man.
0:20:32 > 0:20:36Grateful to the second-year junior doctor for all her help,
0:20:36 > 0:20:40Barry's keen that other patients also show their appreciation.
0:20:40 > 0:20:41SHOUTING
0:20:41 > 0:20:47Hey, they are here to look after you, lad. Give it a rest.
0:20:47 > 0:20:49He will come back in to see
0:20:49 > 0:20:52one of our orthopaedic specialists next week.
0:20:52 > 0:20:57And they will order whatever tests and stuff are necessary
0:20:57 > 0:21:00and give him advice from there. He was a bit of a character, bless him.
0:21:00 > 0:21:05Those doctors are here to treat you. Treat them with respect, kid.
0:21:19 > 0:21:22Dealing with seriously ill patients is an everyday occurrence
0:21:22 > 0:21:25for staff in the busy emergency room.
0:21:27 > 0:21:29This is medicine on the frontline.
0:21:29 > 0:21:34Alcohol and drug cases are the norm and new doctors must adapt quickly.
0:21:34 > 0:21:39- How much do you usually drink? - About eight or nine...
0:21:39 > 0:21:40Is that in a day?
0:21:40 > 0:21:42- OK.- A day, yeah.
0:21:42 > 0:21:45In terms of what drugs you took, do you remember?
0:21:45 > 0:21:49Were they tablets, were they liquid? Do you remember anything?
0:21:49 > 0:21:52The newest recruit to this busy department is Carol,
0:21:52 > 0:21:54a second-year medic from Malawi.
0:21:54 > 0:21:57He is alert, he is comfortable but he's definitely jaundiced.
0:21:57 > 0:22:00She's hoping to fill the gap left by Ed after
0:22:00 > 0:22:04he was dropped down a year and moved to the Acute Medical Unit.
0:22:04 > 0:22:09What do we call that? It is a semilunar shape.
0:22:09 > 0:22:11- What do we call them now? - In English?- In English.
0:22:11 > 0:22:13- Yeah, it begins with an M.- Yeah.
0:22:17 > 0:22:19- No.- The meniscus.- meniscus, yeah.
0:22:21 > 0:22:24Carol's on a trial run after moving to the UK
0:22:24 > 0:22:27to be with her husband, a consultant at the hospital.
0:22:27 > 0:22:30Can you just put them... Hold them out? Let's have a look.
0:22:30 > 0:22:32She's only observing
0:22:32 > 0:22:36but she's already had an eye-opening introduction to the department.
0:22:37 > 0:22:40I have never seen a patient who has overdosed with drugs
0:22:40 > 0:22:42before in Malawi.
0:22:42 > 0:22:45The most I've seen is just alcohol intoxication,
0:22:45 > 0:22:49but not recreational drugs, so this is very new, very different.
0:22:50 > 0:22:52One of Carol's first patients
0:22:52 > 0:22:55is a man who has a history of heavy drinking.
0:22:55 > 0:22:58Can you tell me a little bit more about the blood in the stools?
0:22:58 > 0:23:02- Have you been vomiting at all? Have you been vomiting any...?- No, no.
0:23:02 > 0:23:05That's stopped. I used to vomit all the time. I'm on...
0:23:05 > 0:23:07He's come into the emergency room
0:23:07 > 0:23:09because he's bleeding from his bottom.
0:23:09 > 0:23:12Is this the first time it happened, this problem,
0:23:12 > 0:23:15where you're bleeding from the back passage? Any fevers?
0:23:15 > 0:23:18Carol needs to find out more about his symptoms
0:23:18 > 0:23:21but he has a complicated medical history.
0:23:21 > 0:23:22Any tummy pain?
0:23:24 > 0:23:29I've been eating more... and it seems to be just stuck.
0:23:30 > 0:23:31OK.
0:23:31 > 0:23:34No cough, no chest pain?
0:23:34 > 0:23:36- Yeah, I've got quite a cough at the moment.- OK.
0:23:36 > 0:23:41But, then again, I've been smoking the last few weeks.
0:23:41 > 0:23:42And no headaches?
0:23:42 > 0:23:46I've packed in smoking. Very bad headaches. I am on Propranolol.
0:23:46 > 0:23:50Mr Gribbin, you said you had a similar episode last week.
0:23:50 > 0:23:52Sorry, what it is, one of the tablets I am on...
0:23:52 > 0:23:56OK, I will move a bit closer. Can you hear me OK now?
0:23:56 > 0:24:01It's making me go a bit like my ears are full of water.
0:24:01 > 0:24:03How much do you drink?
0:24:03 > 0:24:07At the moment, I am probably on about a litre,
0:24:07 > 0:24:10- half a litre a day. I was on three or four.- Of what?
0:24:10 > 0:24:12Well, cider, beer.
0:24:12 > 0:24:16At least 5 to 7%. But I have stopped spirits.
0:24:16 > 0:24:17I haven't had spirits since...
0:24:17 > 0:24:23So you just take beer. Is that one to half a litre in a day?
0:24:23 > 0:24:27In a day, normally. It takes the edge off the tablets.
0:24:27 > 0:24:29- OK. Do you work?- No.
0:24:29 > 0:24:32God, no.
0:24:32 > 0:24:37- I wish I did, obviously. But at the moment, no.- OK.
0:24:37 > 0:24:42As part of Carol's trial period, senior consultant Dr Jaffe
0:24:42 > 0:24:45wants to test her on what she's concluded about the patient.
0:24:45 > 0:24:47..necrotising pancreatitis.
0:24:47 > 0:24:51I suspect, because of his history of alcohol, it is probably a virus.
0:24:51 > 0:24:54Yeah. What do we call that?
0:25:02 > 0:25:05- Haemorrhoids.- Haemorrhoids.
0:25:05 > 0:25:08First-degree, second-degree, third-degree haemorrhoids.
0:25:08 > 0:25:12So, he has got piles, which are bleeding because his poo's hard.
0:25:12 > 0:25:17- OK.- Is that right?- Most likely. - Most likely. Go and see him?- Yeah.
0:25:23 > 0:25:27With a potential future in the hospital, Carol heads to the house
0:25:27 > 0:25:31after her shift to find out what she's letting herself in for.
0:25:31 > 0:25:34- Hi, welcome.- It's Tom, is it?- It is. Nice to meet you. How's it going?
0:25:34 > 0:25:38- Nice to meet you too.- Come in. Oli's just in the room on the right.
0:25:38 > 0:25:40Just the kitchen.
0:25:40 > 0:25:43It's an opportunity to meet the other junior doctors
0:25:43 > 0:25:45and get the lowdown on life in Liverpool.
0:25:45 > 0:25:49- Hi.- This is Carol. Carol, Emily. - Hello, Emily. Nice to meet you.
0:25:49 > 0:25:52It's also a chance for the doctors to find out
0:25:52 > 0:25:54what it's like being a medic in Malawi.
0:25:54 > 0:25:56Is it completely different in Malawi?
0:25:56 > 0:25:59Gosh, yes, it is very different. It is so different.
0:25:59 > 0:26:02It's not like here, where you have got patient attendants,
0:26:02 > 0:26:04you've got nursing staff, you've got registrars.
0:26:04 > 0:26:06We are so thin on the ground.
0:26:06 > 0:26:09Have you been here a lot, then? Been to the UK loads of times?
0:26:09 > 0:26:13Yeah, I have visited about three or four times before eventually
0:26:13 > 0:26:16- coming over.- Presumably, Liverpool. - Yes, yeah, yeah. Liverpool.
0:26:16 > 0:26:18I've got my husband here.
0:26:20 > 0:26:22So, has he moved over with you?
0:26:22 > 0:26:24No, he has been here... Oh, very nice.
0:26:24 > 0:26:29He has been living and working here for a while now.
0:26:29 > 0:26:31- Is he a doctor too?- Yeah.
0:26:31 > 0:26:34- So, you know the area quite well, then?- No. Getting used to it.
0:26:34 > 0:26:37- We'll have to take you out... - That would be great, yes.
0:26:37 > 0:26:40- Get to see the Liverpool life. - Yeah, that'd be really good.
0:26:40 > 0:26:42Someone told me that Liverpool women,
0:26:42 > 0:26:44they have to wear short skirts and have to have a man with
0:26:44 > 0:26:49- a tattoo, and then you know they're from Liverpool. Is that true?- Yes.
0:26:49 > 0:26:51- Is that true? - I'm not saying anything.
0:27:01 > 0:27:05'Cardiac arrest Ward 5b. Urgent.'
0:27:05 > 0:27:06See you later.
0:27:06 > 0:27:09Tristan is in the middle of a demanding run of shifts.
0:27:09 > 0:27:12Matt, can you put my bag in that locker room?
0:27:12 > 0:27:16He's a young father to two-year-old Lottie, but being in the hospital so much
0:27:16 > 0:27:20means he's spending little time at home.
0:27:20 > 0:27:26The worst thing about the job so far, I think, is not seeing Lottie and Jenna as much as I'd like.
0:27:26 > 0:27:30To be honest, I think Lottie is suffering a little bit because I'm not around.
0:27:30 > 0:27:34She just seems a little bit more anxious, so I feel really bad about that.
0:27:34 > 0:27:37In an effort to see more of his girls, he's invited them
0:27:37 > 0:27:40to have a quick lunch with him in the doctors' mess.
0:27:42 > 0:27:45- Boo!- Oh look, there he is! - Come on in!
0:27:45 > 0:27:52Quick! Secret entrance. Hi. You OK?
0:27:52 > 0:27:57- It's my daddy.- Your daddy? You OK? Hello. Shall we go in?
0:27:57 > 0:28:02- My rice cake.- Your rice cake? There's pizza available and you're going for a rice cake.
0:28:02 > 0:28:04You sure she's related to me?
0:28:04 > 0:28:06I've really got to go, Jen.
0:28:06 > 0:28:09- Will you be OK to... - Give Daddy a kiss and a cuddle. - See you.
0:28:09 > 0:28:16- Shall we have a family squeeze? Ready, steady... Squidge.- Squidge. See you.
0:28:16 > 0:28:20It was really nice to see Jenna and Lottie. A nice break in the day.
0:28:20 > 0:28:23It's been a bit difficult. You can definitely see it at home, sort of.
0:28:23 > 0:28:28The dishes are piling up slightly higher each day.
0:28:28 > 0:28:31- Hello again.- Hello. - I'm just going to pull the curtains round, if it's OK.
0:28:31 > 0:28:35- I just need to ask you some questions.- OK.
0:28:35 > 0:28:39One of his favourite patients, Marjorie, has added to her problems
0:28:39 > 0:28:42by slipping when she got out of bed in the hospital.
0:28:43 > 0:28:47- You know you had that fall on Saturday?- Yes.- Um...
0:28:48 > 0:28:52I don't know what happened. I don't remember falling.
0:28:52 > 0:28:54I don't remember anything about it.
0:28:54 > 0:28:59- OK.- I only know now that I've got one breast bigger than the other.
0:28:59 > 0:29:02It's all I know. And it's huge.
0:29:04 > 0:29:07Tristan takes a look at an X-ray of Marjorie's chest,
0:29:07 > 0:29:10and he's concerned at what he sees.
0:29:11 > 0:29:12So this is the X-ray.
0:29:14 > 0:29:17The darker areas here are the lungs and this should be...
0:29:17 > 0:29:20the heart outline would be roughly there.
0:29:20 > 0:29:24You should be able to see lung tissue all around.
0:29:24 > 0:29:25But obviously, all of this is fluid.
0:29:25 > 0:29:28And you can tell it's fluid because you have a meniscus,
0:29:28 > 0:29:31the curving of the fluid coming round
0:29:31 > 0:29:32the bottom of the lung there.
0:29:32 > 0:29:35Um...just like you get in a glass of water.
0:29:35 > 0:29:37This is very dangerous if it's not treated.
0:29:40 > 0:29:44But it's the end of a long shift for Tristan
0:29:44 > 0:29:46and he now has a decision to make.
0:29:48 > 0:29:51He could hand the patient over to another doctor to treat,
0:29:51 > 0:29:53or stay and see it through.
0:29:57 > 0:30:00I don't think I'd be happy going home tonight,
0:30:00 > 0:30:04having just sort of left the equivalent of a Post-It note
0:30:04 > 0:30:08somewhere to make sure that she gets checked out, so I want to get the plan in place.
0:30:12 > 0:30:13He decides to stay,
0:30:13 > 0:30:16so he can take some sample fluid from the swollen area.
0:30:18 > 0:30:21- It's going to be a sharp scratch, OK?- OK.
0:30:21 > 0:30:23Try and stay still as possible. Ready?
0:30:30 > 0:30:32The needle coming out now. Well done.
0:30:37 > 0:30:41Staying behind to help means that it's another late finish for Tristan.
0:30:42 > 0:30:46I'm looking forward to going home and seeing Jenna and Lottie.
0:30:46 > 0:30:49It's a bit later than I'd like so, you know,
0:30:49 > 0:30:52I'm not going to see much of Lottie before she has to go to bed
0:30:52 > 0:30:53but I have to make the most of it.
0:31:13 > 0:31:16The junior doctors may no longer be in medical school,
0:31:16 > 0:31:19but that doesn't mean they've seen the back of the classroom.
0:31:20 > 0:31:25Today, Ed will be taking part in an advanced life-support course.
0:31:27 > 0:31:31He's playing catch-up with the other first-year junior doctors,
0:31:31 > 0:31:35who have already qualified to deal with emergency situations in the hospital.
0:31:38 > 0:31:42If, today, I get my certificate for the advanced life-support course,
0:31:42 > 0:31:44it shows that I've been qualified
0:31:44 > 0:31:48and trained to give support to work in the team
0:31:48 > 0:31:51that will take care of a patient during cardiac arrest.
0:31:51 > 0:31:52I'm pretty excited about the day
0:31:52 > 0:31:56because it's something that I've wanted to do for a long time
0:31:56 > 0:31:58and I get the opportunity to do it today.
0:31:58 > 0:32:02It's a milestone in my training. So, yes, it is an important day.
0:32:04 > 0:32:06It's a necessary part of a doctor's training.
0:32:07 > 0:32:11It just works towards being a better practitioner, I suppose.
0:32:13 > 0:32:16OK, so I would ask Jack if he can hear me, so...
0:32:16 > 0:32:18"Jack, can you hear me?"
0:32:18 > 0:32:22GURGLING
0:32:22 > 0:32:25- OK. So the airway is not clear.- OK.
0:32:25 > 0:32:27So the first thing I'm going to do is try...
0:32:27 > 0:32:32The course will give him the qualification he needs to be part of the hospital crash team.
0:32:37 > 0:32:39'I'm doing this course because I want to be
0:32:39 > 0:32:43'competent in the unfortunate but not so unlikely
0:32:43 > 0:32:46'situation of being called at the bed of an acutely ill patient.
0:32:46 > 0:32:48'I just want to know what to do.'
0:32:48 > 0:32:51Well, 75 could be his denture just fell off.
0:32:51 > 0:32:55- Very often it comes back on. Can you see anything?- I can't see anything.
0:32:55 > 0:32:57Right, what else could be in there?
0:32:57 > 0:33:01'I'll be able to bridge the time between the advanced team
0:33:01 > 0:33:06'arrives and the first call for help is issued.' So, measure the...
0:33:07 > 0:33:12- I'm always keeping the head tilted, because otherwise his airway...- Excellent, yes.
0:33:12 > 0:33:15Ed's only got a few hours of training before he'll be
0:33:15 > 0:33:18given a tough exam, designed to test if he's ready to take on
0:33:18 > 0:33:22the responsibility of dealing with emergency crash calls on the wards.
0:33:23 > 0:33:26There is no pulse and there's no sign, OK?
0:33:27 > 0:33:29'I'm feeling a bit nervous, of course.
0:33:29 > 0:33:35'You're always a bit nervous before an examination, but I'm also looking forward to it very much.'
0:33:35 > 0:33:37So, for the last time, you give 300, 300.
0:33:37 > 0:33:43After some final revision, Ed's big moment has finally arrived.
0:33:45 > 0:33:47This is the final exam, yes.
0:33:47 > 0:33:54Let's hope in a decent scenario or I'll fail miserably and murder my patient and my career.
0:33:54 > 0:33:56Ed's given a life-threatening scenario which
0:33:56 > 0:33:59he might attend as part of the crash team.
0:33:59 > 0:34:02And he's a 25-year-old young man with asthma
0:34:02 > 0:34:07and he's become acutely short of breath.
0:34:07 > 0:34:10OK. All right. Um...
0:34:12 > 0:34:15Charlie, hello, can you hear me?
0:34:16 > 0:34:20- So he's trying to talk to you but he's really struggling to get his breath.- OK.
0:34:20 > 0:34:23And he's stopped breathing and there's no palpable pulse.
0:34:23 > 0:34:28OK, all right, so... this is a cardiac arrest.
0:34:28 > 0:34:34- Could you please call the crash team and I will start the CPR.- Yep. - Thank you.
0:34:34 > 0:34:37We need to do an immediate decompression and that would be a...
0:34:37 > 0:34:40Yes, so tell me how you would do that.
0:34:40 > 0:34:44Well, mid-clavicle line. Second intercostal space.
0:34:44 > 0:34:46BEEPING
0:34:46 > 0:34:50Everybody is clear. I'm going to give him a shock. OK.
0:34:50 > 0:34:54OK, he's starting to breathe and he's got a palpable pulse.
0:34:54 > 0:34:58- He's got a palpable pulse. OK.- If you wouldn't mind stepping outside.
0:34:58 > 0:35:01We'll call you back in very soon, so don't go anywhere.
0:35:07 > 0:35:10It's an anxious few minutes while Ed waits for his test results.
0:35:14 > 0:35:16Difficult. That was a difficult case.
0:35:19 > 0:35:21I didn't do that very well, unfortunately.
0:35:21 > 0:35:25We hadn't tried an asthma case earlier and they just are difficult.
0:35:30 > 0:35:33- Right, congratulations. - Oh, thank you.
0:35:33 > 0:35:37You passed your crash test. We thought you did very well.
0:35:37 > 0:35:41Positive feedback for you was that you asked for intubation
0:35:41 > 0:35:43early on for your patient, so...
0:35:43 > 0:35:46OK. That's good, thank you.
0:35:48 > 0:35:53She just told me very simply that I'd got 88%, so that was pretty good and I'm happy.
0:35:53 > 0:35:54Yeah. Very happy.
0:35:54 > 0:35:58Ed's girlfriend Martina has arrived to celebrate the news that he
0:35:58 > 0:36:01can now take his place alongside the other junior doctors
0:36:01 > 0:36:04saving lives in the hospital.
0:36:04 > 0:36:06That's very good. I'm very proud of him. Very happy.
0:36:21 > 0:36:25Also being assessed this week is second-year Oli.
0:36:25 > 0:36:29He's due to take the first part of a Royal College of Physicians diploma -
0:36:29 > 0:36:34a qualification that will set him on the path to becoming a consultant.
0:36:34 > 0:36:36But he's not feeling too confident.
0:36:36 > 0:36:38It's a tricky one with this exam.
0:36:38 > 0:36:41Because, like, previous exams, I've always sort of known that
0:36:41 > 0:36:44I could probably pass it if I put in a certain amount of effort.
0:36:44 > 0:36:47You just have to put in the extra effort to get a good result.
0:36:47 > 0:36:52This is just a pass/fail exam and it's quite difficult to pass.
0:36:52 > 0:36:56It's quite common for a lot of people to fail it maybe the first or second time.
0:36:56 > 0:37:01If Oli fails, it won't just be his pride that's damaged.
0:37:01 > 0:37:05Yeah, it costs 400 quid. This is one of three parts.
0:37:05 > 0:37:08First part is £400, then I think it gets a little bit steeper each time.
0:37:08 > 0:37:11So if I fail, that's sort of 400 quid down the drain,
0:37:11 > 0:37:13which would be a disaster.
0:37:19 > 0:37:21The exam may be playing on his mind
0:37:21 > 0:37:24but Oli still has a list of patients to get through.
0:37:27 > 0:37:31He's on the morning ward round with consultant Dr Dyack.
0:37:32 > 0:37:35Had a dizzy episode yesterday morning about eight o'clock.
0:37:37 > 0:37:40And she fell after going to the toilet. So let's go and talk to her.
0:37:40 > 0:37:44- She's not hypoxic, particularly. - These are actually all right.
0:37:44 > 0:37:4892-year-old Lillian Harrison can't remember
0:37:48 > 0:37:51anything about the fall she had yesterday.
0:37:51 > 0:37:54Dr Dyack and Oli are concerned about her memory loss.
0:37:54 > 0:37:58Mrs Harrison? My name is Dr Dyack. I'm one of the consultants.
0:37:58 > 0:38:02This is Dr Harris. Did you have a fall yesterday?
0:38:02 > 0:38:06- Not that I remember.- Did you collapse?- I'm in fine health.- Good.
0:38:06 > 0:38:09- Do you know where you are at the moment?- Yes, the Royal.
0:38:09 > 0:38:12- And what year is it?- Oh...
0:38:12 > 0:38:17I haven't the faintest idea. Is it...
0:38:17 > 0:38:21I'm not going to tell lies. I don't know, to be quite honest.
0:38:21 > 0:38:26- It's all right. It's 2012.- Oh, yes.
0:38:28 > 0:38:29OK, you ready? Going for a scan.
0:38:34 > 0:38:35May see you on the way back.
0:38:35 > 0:38:38Lillian will need a scan of her heart to determine the cause of the fall.
0:38:38 > 0:38:41And is there an MSU result on that?
0:38:41 > 0:38:45But when Dr Dyack and Oli get the results of some of the patient's
0:38:45 > 0:38:49other tests, concerns are raised about a bigger problem.
0:38:49 > 0:38:51It's one of the SHOs here from AMU.
0:38:51 > 0:38:54We have a patient who is put in for a V/Q scan.
0:38:54 > 0:38:55OK, great.
0:38:55 > 0:38:58I saw that it been put through as a normal request but we want
0:38:58 > 0:39:00to sort of change it to urgent.
0:39:02 > 0:39:04When Lillian gets back to the ward,
0:39:04 > 0:39:07Oli needs to test her mental faculties.
0:39:07 > 0:39:09These are just silly questions.
0:39:09 > 0:39:12If you could just play along with it and answer them as best as you can.
0:39:12 > 0:39:16Can you repeat a sentence after me? "No ifs, ands or buts."
0:39:16 > 0:39:20- No ifs, ands or buts. - Very good, well done.
0:39:20 > 0:39:25- Now can you take seven away from 100?- 93.- Very good. OK.
0:39:25 > 0:39:29What I'm going to get you to do, just follow a command.
0:39:29 > 0:39:31So take the index finger from your right hand,
0:39:31 > 0:39:34place it onto your nose and then onto your left ear.
0:39:37 > 0:39:43- Perfect. Done.- Yes.- All right? - I've enjoyed it.
0:39:43 > 0:39:45I'll leave you in peace to get a bit of rest, OK?
0:39:48 > 0:39:51She's a great character, yes. Not bad for 92.
0:39:51 > 0:39:55Her memory may be slowly improving but when the scan results come back,
0:39:55 > 0:39:57the doctors' fears are confirmed.
0:39:57 > 0:40:02- She has a suspected blood clot on her lung.- Lillian Harrison. V/Q.
0:40:02 > 0:40:07- High probability.- You're joking? - No.- Right. Glad we did that.- Yes.
0:40:10 > 0:40:14It's down to Oli to deliver the news.
0:40:16 > 0:40:18You've had your scan.
0:40:18 > 0:40:24- Yes.- And the scan suggests that there may be a clot on your lungs. - Yes.
0:40:24 > 0:40:28OK? In all likelihood, you are going to be with us for a couple of days.
0:40:28 > 0:40:31I know. It's not what you wanted to hear, is it?
0:40:31 > 0:40:33If it's got to be, it's got to be.
0:40:33 > 0:40:34It does have to be, unfortunately.
0:40:34 > 0:40:38- It's no good doing half a job. - I agree, yes.- You're boss.
0:40:39 > 0:40:44- OK, you're boss. Don't worry. - Thanks for explaining it.
0:40:44 > 0:40:46Yes, no worries. See you later, Lil.
0:40:46 > 0:40:50OK. And there was me thinking I was going home for tonight. Never mind.
0:40:50 > 0:40:52What has to be, will be.
0:40:52 > 0:40:55She was a really lovely patient. And really good fun.
0:40:55 > 0:40:57Definitely miss her on tomorrow's ward round.
0:40:57 > 0:41:00She obviously brightened up a few people's day in there.
0:41:05 > 0:41:08MRCP is, what, a third or something?
0:41:08 > 0:41:10About a third of people pass MRCP, yes.
0:41:10 > 0:41:11With Oli's shift over,
0:41:11 > 0:41:14back at the house, the other junior doctors are quizzing him about
0:41:14 > 0:41:19his Royal College of Physicians exam and its notoriously low pass rate.
0:41:19 > 0:41:22How many hours of revision have you been doing a day?
0:41:22 > 0:41:24Because you get some study leave, don't you?
0:41:24 > 0:41:29I have been doing... I don't know. A few questions a day.
0:41:29 > 0:41:32I've not been doing as long as I should do. Let's be honest.
0:41:32 > 0:41:34Revising is boring and I hate it.
0:41:34 > 0:41:37I would rather be doing a million other things.
0:41:37 > 0:41:39I'd rather tidy my room. I'd rather cook for myself.
0:41:39 > 0:41:41I'd rather clean my clothes.
0:41:42 > 0:41:46I'd rather dust this house of cobwebs than revise.
0:41:46 > 0:41:50- Were you like that in medical school?- A bit of a last-minute man, yes.
0:41:50 > 0:41:52If I just open the book and left it on my chest,
0:41:52 > 0:41:54like that, it will probably get absorbed into me somehow.
0:41:54 > 0:41:57I just hate it. There's nothing worse on earth than sitting down
0:41:57 > 0:41:59and trying to read dry, dry books.
0:41:59 > 0:42:02Do you not get, like, into it after you've started and you get going a bit?
0:42:02 > 0:42:04No, not even a little bit.
0:42:04 > 0:42:08It's nice to see yourself getting better, obviously.
0:42:08 > 0:42:10But it is tedious and it is a slog.
0:42:10 > 0:42:12It is boring, but you have to do it.
0:42:14 > 0:42:19With only 24 hours to go until the exam, Oli is knuckling down
0:42:19 > 0:42:22to some revision, powered by his own unique choice of fuel.
0:42:22 > 0:42:25They're amazing when you come back after a night out.
0:42:28 > 0:42:31When you're revising, you just sort of get urges.
0:42:31 > 0:42:35You have to satisfy those urges, otherwise you can't revise.
0:42:35 > 0:42:38It's a bit like... I think it's probably what being pregnant is like.
0:42:38 > 0:42:41That's why I've got chocolate and pickled cucumbers and beer.
0:42:41 > 0:42:44And then I can revise. Otherwise, it would be useless.
0:42:47 > 0:42:51As both time and beer begin to run out, there's little more that
0:42:51 > 0:42:53Oli can do before tomorrow's test.
0:42:54 > 0:42:57Yeah, I think you get a standard feeling before all exams,
0:42:57 > 0:43:01isn't it, when you think "Oh, I could have done a bit more."
0:43:01 > 0:43:03If only I had revised this and this.
0:43:03 > 0:43:08And your brain comes up with a million things you wish you'd had to look over, so...
0:43:08 > 0:43:11best not to listen to that, though, because you're going to panic
0:43:11 > 0:43:14and never sleep, and do even worse in the exam, so...
0:43:15 > 0:43:18It's about 10.50 now, so I will go to bed fairly soon-ish.
0:43:18 > 0:43:22Thing is, I get up really late, cos I'm lazy, when I'm revising,
0:43:22 > 0:43:25so it means I won't be able to sleep very easily, so...
0:43:25 > 0:43:27I don't know.
0:43:27 > 0:43:31I will have to be a bit tired tomorrow but I'll be able to live with that.
0:43:31 > 0:43:33After it's all done, that's it.
0:43:33 > 0:43:37Clean clothes, I'll have a shower. I'll shave off the exam beard. I'll be a new man.
0:43:46 > 0:43:49The next morning, and Oli's big day has finally arrived.
0:43:55 > 0:43:57Come on, taxi.
0:44:10 > 0:44:13The exam that he's sitting will last six hours.
0:44:14 > 0:44:18While Oli sweats it out in the exam room, on the wards,
0:44:18 > 0:44:21the other junior doctors are dealing with their own pressures.
0:44:28 > 0:44:30On the colorectal ward, Emily's patient,
0:44:30 > 0:44:33who she fitted a nasal tube to earlier in the week, has collapsed.
0:44:38 > 0:44:41Staff who arrive on the scene first manage to get him
0:44:41 > 0:44:44back into bed, but it's up to first-year Emily to try
0:44:44 > 0:44:47and get to the bottom of why he fell.
0:44:51 > 0:44:55- How are you feeling?- Not so bad. - Any weakness in your legs at all?
0:44:55 > 0:44:57Do you feel like you can't move them at all? No? Good.
0:44:57 > 0:45:00Would we be able to get a lying and standing blood pressure on him?
0:45:00 > 0:45:03- Standing one as well? - When he's feeling up to it.
0:45:03 > 0:45:05- Are you all right?- For what?
0:45:05 > 0:45:08- Do you think you could stand up for a minute?- Oh, yes. No problem.
0:45:08 > 0:45:11Just so I can check your blood pressure.
0:45:11 > 0:45:14He's just fallen over so we're just assessing him to make sure
0:45:14 > 0:45:18there's nothing serious going on that could have caused his fall.
0:45:18 > 0:45:21Emily has arranged for the patient to have an ECG
0:45:21 > 0:45:25a test that will identify any problems he may have with his heart.
0:45:25 > 0:45:28Are you all right? Marvellous.
0:45:28 > 0:45:31The results are in, but will Emily understand them?
0:45:31 > 0:45:35So an ECG is like a tracing of the electrical, um...
0:45:35 > 0:45:39activity in your heart and I just find them really hard to understand.
0:45:39 > 0:45:41If I show you one, like...
0:45:41 > 0:45:46just working out what that means is just ridiculous.
0:45:47 > 0:45:51Emily calls a senior doctor to discuss what
0:45:51 > 0:45:53she thinks the ECG results mean.
0:45:55 > 0:45:57I've got Mr Stanley's ECG.
0:45:59 > 0:46:01Mr Stanley, who fell over.
0:46:01 > 0:46:06He's got an irregular arrhythmia and I think he's in atrial flutter.
0:46:06 > 0:46:08Yes.
0:46:08 > 0:46:10Um...62.
0:46:10 > 0:46:15But her senior thinks the results reveal something different.
0:46:15 > 0:46:19Oh. What is it? I suppose you can't tell without seeing it.
0:46:19 > 0:46:23Oh... I'm not sure. I can't really tell.
0:46:23 > 0:46:26Emily has interpreted the results incorrectly.
0:46:26 > 0:46:30For the junior doctor, it's another important lesson learnt on the job.
0:46:30 > 0:46:32I thought he was in atrial flutter,
0:46:32 > 0:46:36but he was actually in atrial fibrillation.
0:46:36 > 0:46:38And James is really good.
0:46:38 > 0:46:42He taught me the difference between the two so I know next time.
0:46:42 > 0:46:45He's going to do some more teaching this afternoon.
0:46:50 > 0:46:53Oli's exam is finally over, but he's unsure
0:46:53 > 0:46:56whether his last-minute revision has done the trick.
0:46:56 > 0:46:57It's difficult to say with that exam
0:46:57 > 0:47:00whether the revision paid off,
0:47:00 > 0:47:03because maybe three or four things that I revised over the past couple of days
0:47:03 > 0:47:06actually came up and maybe that'll make the difference,
0:47:06 > 0:47:08but otherwise, it was pot luck, really.
0:47:15 > 0:47:19Oli can now head into town for some well-deserved time out.
0:47:19 > 0:47:21And he's not the only one looking to escape
0:47:21 > 0:47:23the pressures of life as a medic.
0:47:25 > 0:47:30Tonight, Emily's getting in touch with her arty side at a life-drawing class.
0:47:30 > 0:47:33I definitely really wanted to study art.
0:47:33 > 0:47:36I've done, like, art courses most summers and when I was at uni,
0:47:36 > 0:47:38I did lots of art.
0:47:38 > 0:47:41This is the first time I've ever been able to do life drawing
0:47:41 > 0:47:44since I started work, so it's really nice to get back into it.
0:47:44 > 0:47:47I think that when you're life drawing,
0:47:47 > 0:47:50there's a lot more focus on kind of lighting and shadow and line,
0:47:50 > 0:47:56rather than kind of bones to be fixed or blood vessels to be severed, and things like that,
0:47:56 > 0:47:58so it's completely different.
0:47:58 > 0:48:01I have appalling knowledge of anatomy.
0:48:01 > 0:48:04Don't ask me what any muscles are.
0:48:04 > 0:48:07I think that I'm quite...
0:48:07 > 0:48:12I kind of bring the emotional, creative side of me onto the wards, in a way,
0:48:12 > 0:48:17because, I don't know, I'm more into the social side of medicine
0:48:17 > 0:48:19than the scientific side of medicine.
0:48:19 > 0:48:22I really enjoy patient interaction, kind of involving
0:48:22 > 0:48:25patients in the decision-making rather than reading my textbooks,
0:48:25 > 0:48:28so I think that you can definitely bring the two things together.
0:48:28 > 0:48:31I don't think the two things are totally distinct.
0:48:34 > 0:48:36It's been a welcome break from the wards,
0:48:36 > 0:48:39but with a long shift in the morning, Emily is wondering
0:48:39 > 0:48:43whether she's getting the balance right between work and play.
0:48:44 > 0:48:47I really try to make sure that that side of work hasn't had
0:48:47 > 0:48:49an impact on my social life, but I think
0:48:49 > 0:48:51because of that, I've been absolutely shattered,
0:48:51 > 0:48:53because I've been going to work every day,
0:48:53 > 0:48:56then going out every night, seeing my friends
0:48:56 > 0:48:58and doing different things every night, so I feel
0:48:58 > 0:49:02I need to start turning stuff down and actually going to bed on time.
0:49:13 > 0:49:18Oli's Royal College of Physicians exam results have been posted online this morning.
0:49:19 > 0:49:23If he passes, he'll have taken another step towards moving up
0:49:23 > 0:49:25the medical career ladder.
0:49:25 > 0:49:29Fail, and he'll have spent £400 with nothing to show for it.
0:49:31 > 0:49:32I passed.
0:49:35 > 0:49:37No, I wasn't really expecting that.
0:49:38 > 0:49:41When I came out the exam, I wasn't sure, so...
0:49:42 > 0:49:45It's a relief, more than anything.
0:49:47 > 0:49:50That is good. I'm happy. Not a waste of £400.
0:50:01 > 0:50:04Tristan has been working hard to support his young family
0:50:04 > 0:50:06by taking on extra shifts.
0:50:08 > 0:50:11Today marks the end of a long stint, which has involved working
0:50:11 > 0:50:15two weekends on top of his regular hours.
0:50:15 > 0:50:18All sitting down? It might be a little bit tricky for them.
0:50:18 > 0:50:22'It's been hard, especially when he's been getting home at about 11pm,'
0:50:22 > 0:50:26so she'll see him for an hour in the morning and that's it, and when it comes to
0:50:26 > 0:50:30dinner time and bedtime, she's kind of looking at me, like, where's Daddy? What's going on?
0:50:30 > 0:50:34Daddy is going to take you to nursery and give you a big squeeze.
0:50:35 > 0:50:39Daddy's at work and he's helping people and things like that.
0:50:39 > 0:50:41It reminds me why he's doing it. He is doing it for us.
0:50:41 > 0:50:44But obviously, at the end of the day, I'm really tired.
0:50:44 > 0:50:50It's getting pretty difficult. I think this has been one of hardest points, even in our relationship.
0:50:52 > 0:50:56But Jenna and Lottie still have one final shift to wait before he's back home.
0:50:56 > 0:50:58OK? Right. Sorted.
0:51:01 > 0:51:04In the hospital, the junior doctor is on a ward round
0:51:04 > 0:51:08and finally has some good news to pass on to his patient, Marjorie.
0:51:09 > 0:51:12Hi, Marge. Sorry to interrupt your tea.
0:51:12 > 0:51:15I just wanted to let you know that that blood test we did,
0:51:15 > 0:51:19it showed that the potassium, which is what we were most
0:51:19 > 0:51:24- interested in, has come back to normal on its own. - So I can go home?
0:51:24 > 0:51:26Exactly. It can be this evening or tomorrow morning.
0:51:26 > 0:51:28- Is that OK?- Fine.
0:51:28 > 0:51:32The swelling from her fall in the hospital has gone down
0:51:32 > 0:51:36and her original problem of lost feeling in her hands has eased.
0:51:36 > 0:51:39Going home is the news that she'd been hoping for
0:51:39 > 0:51:42but it seems Marjorie will miss her favourite junior doctor.
0:51:42 > 0:51:48Well, what can you say about Tristan? He's the doctor, isn't he? THE doctor.
0:51:48 > 0:51:51I think he's smashing. I really do.
0:51:51 > 0:51:54I think everybody feels the same way, as well.
0:51:54 > 0:51:56He's lovely, isn't he?
0:51:56 > 0:51:59I could take him home with me, couldn't I, really?
0:52:01 > 0:52:04Marjorie's not the only one leaving the hospital.
0:52:04 > 0:52:07It's been a long time coming but, at last, Tristan can finally head home
0:52:07 > 0:52:10for a day off with Jenna and Lottie.
0:52:10 > 0:52:12LOTTIE SQUEALS
0:52:12 > 0:52:16- Lottie! Hey, can I have a cuddle? - Give Daddy a cuddle.
0:52:16 > 0:52:20- Do you want to be thrown in the air?- Yes.
0:52:21 > 0:52:25His long stint at the hospital has been a sharp reminder
0:52:25 > 0:52:29of the demands that the job can place on a junior doctor.
0:52:29 > 0:52:32I do feel like a few...
0:52:32 > 0:52:34over the last couple of weeks,
0:52:34 > 0:52:38a lot of the things that have been happening in Jenna and Lottie's life
0:52:38 > 0:52:41have almost just been...
0:52:41 > 0:52:46on this parallel track to mine that I can't quite sort of keep hold of,
0:52:46 > 0:52:49so it's a bit of a shame in that regard.
0:52:49 > 0:52:51I'm looking forward to, after this,
0:52:51 > 0:52:54having a couple of days to really focus and spend time with them.
0:53:05 > 0:53:09The junior doctors have made it to the end of another tough week in the hospital.
0:53:11 > 0:53:15Most of them are meeting up at the house, and Tristan is bringing
0:53:15 > 0:53:18Lottie and Jenna to see everyone for the first time.
0:53:18 > 0:53:22Hello! Come in.
0:53:28 > 0:53:31- And how old are you now?- Three. - No. Not quite three.
0:53:31 > 0:53:36- This many. How many is that?- Two. - That's right.
0:53:36 > 0:53:38We're having a party.
0:53:39 > 0:53:44What a lovely party. Oh, wow! This is so nice to come to come home to.
0:53:44 > 0:53:46So many nights, I just finish late.
0:53:46 > 0:53:49Um... Awesome.
0:53:49 > 0:53:51Nice to see you.
0:53:51 > 0:53:53I don't know how you do it. I can barely feed myself.
0:53:53 > 0:54:00I couldn't even imagine. I've eaten Doritos for tea.
0:54:00 > 0:54:03And then I'm going to have a glass of wine later.
0:54:03 > 0:54:05And in the mornings, I take her to nursery,
0:54:05 > 0:54:12- but it's only a few minutes out of the day.- I think it's like anything.
0:54:12 > 0:54:14If you want it enough, you can do both.
0:54:14 > 0:54:17I think I'm going to have to plough everything into my career
0:54:17 > 0:54:20because that's what I have at the moment.
0:54:20 > 0:54:24You know, because that's what I want to do at the moment, you know.
0:54:24 > 0:54:28If I was, like, desperate to have a kid, I'd think of a different career path.
0:54:28 > 0:54:30I do want to have kids at some point, but I'm not really bothered
0:54:30 > 0:54:36- if it's somewhere in my 30s, to be an old mum.- Daddy.- Yes?
0:54:36 > 0:54:40I want to adopt a baby. I don't like the idea of pregnancy.
0:54:40 > 0:54:43We see what Tristan does because we do it too.
0:54:43 > 0:54:49I do just think, "How?" I come home after a day, like, "Ugh!"
0:54:49 > 0:54:54Every ounce of effort just melts into the sofa when you sit down.
0:54:54 > 0:54:58But for you guys, you just carry on and you just keep it going. I...
0:54:58 > 0:55:02I don't know. I don't know if I'd have it in me. I think it's amazing.
0:55:02 > 0:55:04It sets us apart NOW
0:55:04 > 0:55:09because we're just one of the few people who are juniors with kids,
0:55:09 > 0:55:13but it's not like we're the only people in the world who have kids.
0:55:14 > 0:55:17- It really hard but it's worth it. - Can we have a baby?- No.
0:55:23 > 0:55:25Next week on Junior Doctors...
0:55:25 > 0:55:28- I think that's "cardiology". - I'm not used to this writing.
0:55:28 > 0:55:31What they don't teach you in medical school...
0:55:31 > 0:55:35I think the more senior you get, the worse your writing gets.
0:55:35 > 0:55:37Sharp scratch.
0:55:37 > 0:55:42A visitor to the Emergency Room puts Kiera's knowledge to the test.
0:55:42 > 0:55:46Are you all right, sir? What's wrong there, sir?
0:55:46 > 0:55:51Can be quite a potentially dangerous problem so we need to get onto it quite quickly and make sure he's OK.
0:55:52 > 0:55:56Jen is hit hard by the loss of her first patient.
0:55:56 > 0:56:02I'm not used to this kind of thing happening in my life every day, but I'm OK.
0:56:07 > 0:56:10And an escaped prisoner causes chaos at the hospital.
0:56:10 > 0:56:14So we believe that the convict is
0:56:14 > 0:56:16still in the ventilation system.
0:56:16 > 0:56:20I've never seen anything like this. This is bonkers, absolutely bonkers.
0:56:20 > 0:56:23It's all kicking off out here.
0:56:36 > 0:56:41Subtitles by Red Bee Media Ltd