- 1 week ago
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00:00It's early morning at Fitzpatrick referrals and the team are dealing with an emergency
00:26So do you say you'd like the leg pulled forward or back?
00:33Late last night a 13 year old Border Terrier was hit by a car in the practice car park and
00:39suffered life-threatening injuries.
00:45Everyone is in shock because it's Noel's beloved dog, Kira.
00:51I was leaving to practice like I always do.
01:00I never have run a lead between the back door and the car and I've done it thousands of
01:08times.
01:09I held the door open and then a car came speeding from the left.
01:20He was going too fast and he wouldn't stop, he didn't see me.
01:28It all happened in less than two seconds.
01:35Kira is in a critical condition with a smashed pelvis and possible abdominal damage.
01:53No one knows if she'll pull through.
01:56And the vet known for finding solutions for even the most complex challenges.
02:02Daddy's here, it's okay.
02:05No, no, no.
02:06Must face the fact that his own dog may not be fixable.
02:10I remember vividly the very first day Kira came into my life.
02:32I was working in my very first referral practice and at the time things were really tough at
02:38the practice.
02:39I was trying to raise the money to build what has become Fitzpatrick referrals.
02:44So this is Halfway Farm.
02:47This is going to be the main practice building.
02:49I think I was in like a seven hour op or something.
02:54And then when I came out of theatre and she was there, it just blew my mind.
02:59I was just like a tidal wave of love flowed over me and she was just this ball of furry joy.
03:10And you couldn't look at her without wanting to smile.
03:13I was very infatuated with Kira Knightley.
03:18And I called her Kira, which was very funny actually because I met her husband and I said to him, I'll call my dog after your wife.
03:33He was very, he took it in very good spirits.
03:38Lovely guy.
03:39And I, yeah, good looking, charming, talented.
03:44Kira.
03:47Kira.
03:48Kira.
03:49Kira.
03:50Kira.
03:51Originally from Ireland.
03:52How are you today?
03:53What are you up to?
03:55World class neuro-orthopaedic surgeon Noel Fitzpatrick has spent the last 25 years
04:00evolving surgical techniques in veterinary medicine.
04:04Okay then Billy.
04:05Bernie, please.
04:06Bernie.
04:07Now, Adam.
04:08From his practice in Liefy Surrey.
04:10When I was 17, I got offered veterinary school and Human Medical school the same day.
04:16and I remember I chose animal medicine because it was abundantly clear to me from day one
04:24that animals were not being given a fair deal.
04:29So this is a swimming pool for the dogs.
04:32I wanted to build the best hospital in the world to give animals the very best level of care that I could provide
04:39and Ciara was by my side all the way.
04:42When Ciara first came in, she was like a little tiny bundle of fluff.
04:48She was absolutely gorgeous.
04:51What's happening?
04:51What is your day today?
04:53How is your day today?
04:55She literally moved into the new practice when it was built, so she's been here from the beginning.
05:01Ciara was certainly a sort of inspiration for Noel and a bit like a muse.
05:06Ciara has just been unbelievably important for me.
05:12And I would say that she's as big a reason that Fitzpatrick Fitzgerald exists as I am.
05:24She gave me a reason big enough, really, a reason to go on.
05:30She's just getting quite distressed.
05:52So we just want her to be a bit calmer.
05:57She just responds quite dramatically to your voice.
06:02Noel's colleague, Poreg, was one of the first people on the scene when Ciara was rushed into the practice last night.
06:08Over the first few seconds, I didn't really know what to do.
06:14No, no, no, no. It's me, Poreg.
06:18We're used to dealing with emergency situations, but because Ciara's one of our own,
06:22and Noel was so upset, it affects all of us.
06:27It's okay, baby. It's okay.
06:30We had a full team of vets ready with everything needed to start resuscitation.
06:35If it came to that.
06:37Then you have to just do the job that needs doing.
06:42Ciara is a patient.
06:44She's no longer Ciara that trots around the practice.
06:47She's Ciara that needs her life saving.
06:51I know that unless we act quickly, she's going to die.
07:00CT and ultrasound scans show that Ciara's pelvis and sacrum have been crushed,
07:06her hip dislocated, and she may have abdominal damage.
07:09She was really quiet and not very responsive.
07:16The team know there's the likelihood that she has further injuries that they can't yet see.
07:22When an accident comes in, it's not always obvious what the problem is.
07:27It's almost like you have a puzzle and you have to put the vets together.
07:32Please, baby girl, you've got to say something.
07:35We didn't know if there was a major organ compromise or a major bleed
07:41that could actually take her life in a matter of minutes.
07:46Noel fixes things. That's what he does every day.
07:48He comes to work and he fixes things and he wanted to fix it.
07:52I wanted to be there as a vet. I wanted to be there as a dad.
07:57But I couldn't help because I wasn't thinking straight.
07:59He could not make good decisions.
08:04So I had to ask him to leave.
08:08He's all right.
08:10Shall I start love?
08:12For somebody who's always in control of the situation
08:15and always making the decisions of life and death,
08:21that was tough.
08:23Yeah.
08:23I told him, Noel, just let us do the work that you taught us to do.
08:30It's OK.
08:32I know, I know.
08:33I know.
08:34You have to put the family aside,
08:37even if the family is Noel Fitzpatrick's.
08:40You have to say,
08:42we will do it.
08:44We will do our best.
08:47Having managed to stabilise Keira,
08:49the team start to take a more detailed look at her injuries.
08:55And that's when we found out that her urine output
08:58was not matching how much fluid we were putting in.
09:02So we went looking for it.
09:03And we found that Keira has urine leaking into her tummy.
09:11That is life-threatening.
09:15Oh, poor old daddy is so upset.
09:17Oh, poor old daddy is so upset.
09:19Sometimes knowing medical knowledge in those situations
09:21can make them worse
09:24because you know that maybe not everything's going to be OK.
09:28She's having trouble regulating her blood pressure
09:31and her heart rate has been all over the place.
09:35Keira needs emergency treatment.
09:37Should I just go?
09:39I probably should just go.
09:40Should I?
09:40This evening, she'll be transferred
09:45to Fitzpatrick's sister clinic in Guildford
09:48that specialises in injuries of soft tissues,
09:51including internal organs.
09:53This place was built for our heart.
10:03And now,
10:05I just hope
10:06that the team will save our life.
10:09I will be, it's me.
10:35It's me.
10:36It's daddy.
10:37Daddy's here.
10:38Daddy's here.
10:40Noel's beloved border terrier, Keira,
10:43is in a critical condition
10:44after being hit by a car.
10:47Daddy's here.
10:49Good girl.
10:52Good girl.
10:53Earlier this evening,
10:54Noel transferred her
10:55to his oncology
10:56and soft tissue surgery hospital
10:58in Guildford.
11:00We discovered that
11:02she wasn't able to pee
11:03and it turned out
11:05that there was urine leaking
11:06into her belly.
11:09I'm not a soft tissue
11:10surgery specialist,
11:12but that's what this other hospital exists for.
11:16So I got her in the car
11:17and I brought her straight over here.
11:25Noel's second animal hospital
11:27celebrated its launch
11:28in September 2015
11:30to treat cancer
11:35and offer specialist
11:37soft tissue surgery.
11:39Sarah's just placing an IV in him now.
11:43The world-class team
11:44also undertake clinical research
11:46to help define the treatments
11:48of the future.
11:49Noel's vision for the clinic,
11:55when you distill it down,
11:57he just wants to be able to help
11:59any animal
12:00that calls on us to help them.
12:05I really feel that Keira
12:07has been a driving force
12:08behind that.
12:11You have this little friend
12:12that you want to ensure
12:14is looked after
12:15and cared for.
12:17He's pulled that team together
12:19created this perfect recipe
12:21to help get animals out of pain.
12:26She is my muse.
12:28When I think about
12:29any animal
12:31that comes through these doors,
12:33I think about
12:34how would I treat her,
12:36what environment
12:37would I like for her,
12:38what choices
12:40would I like for her,
12:41and most importantly,
12:42how much love
12:43would I like her to have.
12:47After the general of it here.
12:49Whenever you're on call,
12:54you're going to get something
12:55which is slightly out of left field
12:57and slightly unexpected.
13:00And call came to say
13:02that Noel's dog's been hit by a car
13:04and she needs to come across.
13:07Everyone was kind of on tent hooks
13:08as soon as we heard.
13:09You don't really know
13:10what you're going to see
13:11when she arrives.
13:12The urine leaking into Kira's abdomen
13:15is causing her to go downhill fast.
13:19Urine is not meant to be in the body.
13:22The body has a very sophisticated mechanism
13:25for getting rid of toxic wastes.
13:28When it's outside those organs,
13:30the body's not getting rid of those toxins.
13:32So, we have a patient
13:35who is becoming profoundly sick.
13:36I could see it in her eyes.
13:40She was on the way out for sure.
13:42I reckon that she would have died
13:44within a couple of hours.
13:45The team runs CT contrast studies
13:51of the urinary system and the bladder.
13:53By putting Di into her bloodstream
13:55and then into the bladder itself,
13:57they can track it and locate the leak.
14:01Thankfully, the kidneys
14:02and both of her ureters were OK.
14:05But there was a very obvious leak
14:07coming from the bladder.
14:10Urine was just flowing
14:11into her abdominal cavity.
14:13To have any chance of surviving,
14:16Kira needs emergency surgery.
14:19I needed to make a decision
14:21whether it was ethically right
14:24to keep going with a 13-year-old dog
14:28or should we let her pass peacefully away.
14:34Come on.
14:36Come on.
14:38I am not married
14:40and I don't have children.
14:42So, Kira has been a one relationship
14:45that I have had consistently
14:47throughout the evolution
14:48of Fitzpatrick referrals.
14:52No leaves for this job.
14:54Come on.
14:55Certainly not going to work 9 to 5, we know.
14:59Does he sleep?
15:01Does he know that Netflix exists?
15:03I wonder.
15:04Your veterinary career
15:06isn't the easiest thing in the world
15:09and we all depend on our animals at home.
15:11We depend on them to be there for us.
15:15She hasn't just been my best friend.
15:20She's been my confidant, my cuddled pal,
15:29my reason to get up in the morning some days.
15:32She's his life and it's not any different
15:45from a father and a daughter.
15:47It is his girl.
15:49It's a very special relationship.
15:51I think no one but the two of them
15:54can really understand.
15:56It's a special bond for sure.
15:57So, we're just going with two IVs.
16:09I wonder if we should put some bottom
16:12right of her before absorbing urine.
16:16After consulting with his colleagues
16:17about the ethical considerations,
16:20Noel has decided to fight for Kira
16:22and go ahead with the abdominal surgery.
16:24I did feel more tense than normal
16:28because he is the boss.
16:31Noel wanted to come in and observe
16:33what we found during surgery
16:35and it was clearly pretty tough for him
16:37to see what was going on.
16:40When Jonathan made the first incision,
16:42I felt like vomiting my guts out
16:43because my little girl was lying there on the table
16:48and I remember thinking to myself,
16:51if I stay in here,
16:53that would probably not be good for Jonathan.
16:56So, I walked outside.
17:02When something that small
17:04has been hit by something as big as a car,
17:07there's a lot of injury.
17:09The six centimetre hole in Kira's bladder
17:12is sewn up.
17:13But it isn't the only damage.
17:15All of the abdominal muscles
17:18down one side of her spine
17:20had been pulled off.
17:21The muscles don't hold sutures terribly well.
17:24So, that was the more challenging part
17:26of the surgery.
17:28If we hadn't have seen her
17:29in that day or within the following day,
17:32she would have gone for sure.
17:37Kira is still in a very critical condition.
17:40Coming from primary care,
17:45you see cases like this
17:46and normally they don't
17:48tend to have great prognosis.
17:49You know, the older they are, the more.
17:51The longer it takes them to recover
17:52and the riskier it is for them to pull through.
17:57I love you, Bobby.
17:59If she makes it through the next few days,
18:02the team will be able to consider
18:03the major pelvis operation
18:05that is planned for her
18:06to allow her to walk again.
18:09I just hope she knows I'm here.
18:30Although Kira has just been through major surgery...
18:33FITZPATRICK referrals is a 24-7 hospital.
18:45Hey guys, how are you doing today?
18:46Come on in.
18:48And she isn't the only animal
18:49in need of Noel's help.
18:52Right, mister.
18:53You can take that lead off,
18:55I'll pop this one on
18:56and then off we go.
18:57And how's your dog doing now?
18:59Not good.
19:00So, I'm very worried today.
19:01It's incredibly tough to keep going
19:04when you know that your family member,
19:07albeit a furry one,
19:08is stuck in hospital.
19:10It's very scary.
19:12Yeah, it's extremely scary.
19:13I love her as much as you love him, you know.
19:15Yeah.
19:16That voice at the back of your head
19:18never stops.
19:19How are they?
19:20Are they comfortable enough?
19:21Is their pain relief all right?
19:23It's hard being on the other side of the fence.
19:24Hey, mate.
19:27Hey, mate.
19:28How are you?
19:29How are you?
19:29How's Cary?
19:30Not good.
19:31No.
19:33Something that we advise all of our clients,
19:36if you don't get up every day
19:37and do what you normally do every day,
19:39you're going to drive yourself crazy.
19:42And I'm really, really glad
19:43that he actually followed his own advice
19:45because sometimes he doesn't.
19:47I've never really understood
19:50what it felt like before.
19:52I've been doing this 30 years
19:53and I didn't know.
19:54Yeah.
19:56That's really hit me
19:59like a tsunami of awareness
20:01that I'm not just fixing an animal,
20:03I'm fixing an entire family.
20:05I'm fixing lives.
20:10Ciara's been up and down
20:12since the surgery on her abdomen.
20:15It's been utterly nerve-wracking
20:18every single day,
20:19waiting for news.
20:21Hey, hi, guys.
20:22Thank you so much for looking after her.
20:25Noel has been spending every moment he can
20:27at Fitzpatrick's Hospital in Guildford.
20:30Good girl.
20:32Good girl.
20:33Hey, Bupi.
20:34Are you lifting your head for Dada?
20:37Are you lifting your head for Dada?
20:40Hi, Bupi.
20:41It's Dada.
20:41Over the last 24 hours,
20:43Ciara has had two blood transfusions
20:45and is finally showing signs of improving.
20:49She's looking much more alert,
20:50which is the most important thing,
20:51and she seems much more comfortable too.
20:54She's under the care of internal medicine specialist
20:57Gerard McLaughlin.
21:00You can see we put the tube in her nose there
21:02just to allow us to start giving her some nutrition.
21:04So she's got some protein and calories.
21:07Exactly.
21:09I've treated Ciara before,
21:11so we all love her over here.
21:12She's super cute.
21:13She's very much a spoiled princess
21:15when she comes over here,
21:16but I suspect she's a spoiled princess
21:17in her day-to-day life with Noel,
21:19because I know that he absolutely
21:21worships the ground she walks on.
21:23She looks so much brighter.
21:24So much better,
21:25and I think we're going to get to that point
21:26where she will...
21:27It'll just be an upward trajectory now, hopefully.
21:29What we want to do is just make sure
21:30she's strong enough to go through
21:32the anaesthetic for the pelvic fracture repair.
21:34Of course, yeah.
21:36Ciara's pelvis and sacrum were crushed in the accident,
21:39and she's unable to stand.
21:41To have any quality of life,
21:44an operation to repair the multiple fractures is planned.
21:48Oh, Boopie.
21:50Oh, Boopie.
21:51You're so much better.
21:53Good God.
21:54And Noel will need to decide
21:55if it will be him performing the surgery.
21:59It's difficult, isn't it?
22:00Because I know a lot of vets don't...
22:02You know, they don't want to operate on their own dogs.
22:03No.
22:04What John did saved her life,
22:06and that's not my skill set,
22:07so I can't do what John did.
22:08But I would judge anybody's screw
22:11if they were one millimetre out
22:12on the x-ray picture
22:14in terms of fixing her pelvis.
22:18I understand why he doesn't want other people
22:20to have the pressure of doing it.
22:22It's pressure enough looking after the bossy's dog.
22:25It's probably doubly stressful
22:27doing orthopaedic surgery
22:28and Noel Fitzpatrick's dog.
22:30I know that psychologically
22:33I'll be fine as soon as I go into theatre,
22:36but I'd be more worried
22:37if somebody else was doing
22:40what I do every day of the week.
22:45He's Professor Noel Fitzpatrick, the super vet.
22:48Of course he's going to operate on his own dog,
22:51but sometimes operations don't go well, you know,
22:54and he has to be successful
22:56for her to be able to walk again.
23:00Noel has operated on thousands of animals
23:02in his 30-year career,
23:04performing some of the most complicated
23:07orthopaedic and neurosurgery in the world.
23:10You've got to get your strength up
23:12and then I'll make sure you can walk again, okay?
23:18But fixing Kira
23:20will be unlike anything he's ever faced before.
23:23I'll fix it.
23:30I can just tell that dog's saying,
23:47sausages, sausages.
23:49I can smell sausages.
23:56Kira, Noel's border terrier,
23:58is recovering from major surgery
24:00after being hit by a car.
24:03It's Donna.
24:04Any updates on Kira?
24:05And across the practice,
24:09there's talk of little else.
24:12Paul, little.
24:13Kira.
24:14Yeah, Kira.
24:15It's such a tragedy.
24:18We're getting calls from all over the world.
24:21Everybody within the team, within the practice,
24:24we're calling each other randomly,
24:26just, have you heard anything,
24:27any updates on Kira?
24:29Let's hope she pulls through.
24:32Because she's not a spring chicken, bless her.
24:33No, she's not.
24:34She's going to take longer to heal.
24:40Come on, pups.
24:43Since she was a pup,
24:45Noel has shared the parenting of Kira
24:46with former Fitzpatrick's nurse Amy
24:48and her son Kyle.
24:51Because I spend 12 to 16 hours a day
24:55consulting and operating,
24:57I just worried that Kira will be lonely.
25:01I don't do the kisses.
25:03That's what Dad does, yeah.
25:05Sherry has been fantastic
25:06because Kira and Kyle have obviously grown up together.
25:09She's always there for me.
25:10She's always around.
25:12I've never known anything different.
25:13It's just how it is.
25:16She's grown up in the practice
25:17or being at Noel's or at mine,
25:20so I think she's just got three homes
25:22and rules them all.
25:24It's wonderful that she has a mum
25:26and a brother and a dad.
25:28Hi, girls.
25:29Not to mention her extended Fitz family.
25:33As much as Kira's Noel's baby,
25:35she's our baby too.
25:37Come on, come on.
25:38She knows she's important here.
25:41It's her home.
25:42Hi, Kira.
25:43Do you just see her plodding up
25:47and down the corridors?
25:48It's just like, yeah, this is my building
25:50and, yeah, you're taking me for a walk.
25:53Come on.
25:54Hi, sweetie.
25:56Hey, Kira.
25:57It's almost like, in a way,
25:59she's also our boss, you know,
26:00a little bit of source of authority.
26:03I think it's good to go to theatre.
26:05Probably Kira gave me the job.
26:07Oh, got a little tail wag.
26:14Oh, that's nice.
26:16Over at Fitzpatrick's sister hospital,
26:18there's good news for all of Kira's family.
26:22Oh, I have never been happier for you
26:24to stick your tongue up my nose.
26:26Oh, thank you, boofy.
26:28Oh, I love it.
26:29Every day she is starting to look
26:30a little bit more interested in us
26:33and a bit more responsive to us.
26:34It's just a bit of our personality
26:36starts to come back.
26:38Now, we'll try something to eat, sweetie.
26:40The question remains
26:41whether she's yet strong enough
26:43to have the surgery on her pelvis.
26:46We essentially just need to give her time
26:48for her body to recover
26:49because, you know,
26:51there's no point fixing a leg
26:53in a dog who doesn't make it
26:54through the anaesthetic,
26:55let's be brutally honest here.
26:57Oh, it's my favourite.
27:00Noel's asked me
27:02if he can do the surgery on her.
27:04And obviously there was no question.
27:06This is what he does
27:07and this is what she needs right now
27:10and he's the only guy for the job.
27:14We've been designing a special plate
27:16to fix the main fracture in her pelvis
27:19because if the plate's already
27:22anatomically contoured
27:23and it's perfect,
27:25then the surgery will take less time.
27:28Oh, yeah.
27:31Good girl.
27:32Kira's plate is being designed
27:37and created by another brainchild of Noel's,
27:40Fitz Bionics.
27:43We have just two to three days
27:45to design and process an implant
27:48for a Kira.
27:50We process the CT images
27:52and we can manipulate the bone fragments,
27:55realign them,
27:55and then design a solution
27:58for that particular problem.
28:00For the last 15 years,
28:02Noel and his team
28:03have been creating implants
28:05for animals with complex challenges.
28:07We're effectively reinventing a body part.
28:11I feel very strongly
28:14that dogs and cats deserve
28:16the best level of treatment
28:18akin to what happens in human medicine
28:20and sometimes
28:22that requires us
28:25to think beyond
28:26what is currently available.
28:28We've got a mechanical disc
28:30now replacing
28:31the biological disc.
28:32and to innovate implants
28:35with good ethics,
28:36good evidence,
28:37and good efficacy
28:38to solve problems.
28:40And that's why Fitz Bionics exists.
28:43Take out the honor now, Jay,
28:45and we're going to have to move the radios.
28:47Trying to figure out
28:48what's going on inside Noel's head
28:50is the most difficult part
28:51of trying to learn something
28:52that he's doing.
28:54Let's see what you do
28:55with those bad boys.
28:57He's definitely a mad genius.
28:59Look at that.
29:00A little bit like
29:02Leonardo da Vici, I would say.
29:04He's got the curvature
29:05of a piece of art.
29:08Noel's brain is like a computer
29:10and he just thinks
29:1310 hours ahead of everybody else.
29:16So we're probably going to have to go
29:17with a solid one again.
29:19No, I can thicken them up.
29:21But obviously we,
29:23as mere mortals,
29:25are way behind.
29:27Boom.
29:27That's straight.
29:29I'm actually really pleased
29:30with that.
29:35Looks good at the moment.
29:37That's probably about halfway through.
29:42Kira's implant is being 3D milled
29:45from raw titanium,
29:47a metal that's highly compatible
29:48with the body.
29:51I didn't think
29:52in my wildest imagination
29:53that Fitz Bionics
29:55would provide a solution
29:56for my own dog.
29:58But boy,
29:59am I glad that
30:00all those years of effort
30:02will help Kira.
30:04Listen to Daddy.
30:05If you stay eating
30:07and you get stronger,
30:09then I will fix your pelvis
30:11in a couple of days.
30:13OK?
30:14I'm making a special plate
30:15for you right now
30:16so that it's exactly right
30:19for my girl.
30:21Oh, yeah.
30:23See you tomorrow, OK?
30:26See you tomorrow.
30:27OK?
30:27See you tomorrow.
30:29They've on their way now.
30:49He's left.
30:50So he's on his way.
30:51Yeah.
30:53You've got to just escape this.
30:54Oh, Loki.
30:55This is just...
30:56This is what we do
30:57every single day of the week.
31:00Just over a week
31:01since the car accident
31:02that shattered her pelvis
31:03and sacrum...
31:04Off we go.
31:07Kira's custom-made implant
31:08is ready.
31:09All right, Boopie.
31:10Good girl.
31:11Good girl.
31:12OK.
31:13And Noel is about to attempt
31:14the most emotionally challenging
31:15operation of his life.
31:17Good girl.
31:18It's going to be fine, sweetheart.
31:20It's going to be fine.
31:23Although it's something
31:25that I do every day,
31:26it's Kira.
31:28And that changes everything
31:29that I'm thinking
31:30because I'm picking up
31:33a scalper blade
31:33on my baby.
31:38Kira's on her way
31:39and I'm worried.
31:40I'm worried about Kira.
31:42I'm worried about Noel.
31:44He's got to perform.
31:46And I'm worried about the team.
31:50They know how important
31:53Kira is to Noel.
31:55Kira is important to them.
31:59And it adds a lot of pressure.
32:05Morning.
32:06Hello, Kira.
32:07Morning.
32:08Hey, Kira.
32:09Morning.
32:10Hey, little one.
32:12Good to see you.
32:13You're looking a lot better.
32:14What's our plan?
32:19It's over to you.
32:20We'll give her a little epidural
32:21and crack on.
32:23Yeah.
32:23Now,
32:32her ultimate survival
32:34and function
32:35rests on my shoulders
32:36and my shoulders alone, really.
32:40I'll go prepare my head
32:41and you guys get the rats.
32:43Yeah.
32:45I'm afraid.
32:46Well, I've got to
32:50manage the fear.
32:52That's it.
32:58So I've got to switch off
32:59part of my brain now
33:00and become a surgeon.
33:02I've got to try not to think
33:04about her as my baby.
33:06I've got to try and
33:07go into battle
33:08and do my job.
33:10Are you ready for this?
33:12I think so.
33:12It's what we went
33:14to school for.
33:16Okay, here we go.
33:24Kira's pelvis
33:25is fractured
33:26and separated
33:27from her fragmented sacrum
33:29and her right hip
33:30is dislocated.
33:31No plans to realign
33:34the sacroiliac joint
33:35then reattach the ilium
33:37to the sacrum
33:38with screws.
33:40He will then attempt
33:41to fix the fracture
33:42behind the left hip socket
33:43using the custom-made plate.
33:47Finally,
33:48No will use
33:49a toggle technique
33:50to replace
33:51the torn ligament
33:52of her right hip joint
33:53and stop it
33:55slipping out of place.
33:56Show me the diagram, please.
34:09Using templates
34:10made at Fitzbionics,
34:12Noel attaches
34:13a 3D printed guide.
34:15This allows him
34:17to drill precisely
34:18in the right place
34:18to attach the ilium
34:20back onto the sacrum.
34:24It's quite amazing
34:26that he can
34:27put his emotions
34:28to one side
34:29and proceed
34:30with a surgery.
34:32He believes
34:32in himself.
34:34Whoever's on the table
34:35under his hands
34:37is treated
34:38with utmost care
34:39and respect.
34:41But for Kira,
34:42it just must have been
34:43overwhelmingly pressured.
34:46First,
34:47we've drilled a hole
34:48into the sacrum.
34:50Now we've drilled
34:51a hole into the ilium.
34:53As Noel inserts
34:56the screw,
34:56it should position
34:57the ilium
34:58back onto the sacrum.
35:01Hold that, Mario.
35:09Oh,
35:10doesn't want to move.
35:15Oh dear.
35:16The ilium bone
35:18has been dislocated
35:19for over a week
35:20and it's refusing
35:22to budge.
35:24Just not want to move.
35:29I've repaired
35:30this kind of injury
35:33hundreds of times.
35:35But Kira's situation
35:36was the perfect storm.
35:39It was a long time
35:40after the car
35:41had hit her,
35:41so the muscle
35:42had clamped down
35:43in the wrong position
35:45and it was really
35:46difficult to move
35:47the bones.
35:49No,
35:50forget it,
35:51forget it,
35:51forget it.
35:51It doesn't want to move.
35:53And that wasn't
35:54the only problem.
35:55What the CT scan
35:56did not show
35:57was all the tiny
35:59fissures
36:00within the side
36:02of the sacrum.
36:04And basically
36:04when I tried
36:05to put screws
36:06into it,
36:06it started to crumble
36:07like an avalanche
36:09of rocks.
36:11That's a disaster.
36:13I'm having real
36:33difficulty
36:33getting this
36:33back in here.
36:36It doesn't want to go.
36:40Noel is partway
36:41through one
36:41of the most
36:42crucial surgeries
36:43of his life.
36:45Let go.
36:47Attempting to repair
36:48his precious Kira
36:49smashed pelvis.
36:52Yeah,
36:53it just does not
36:54want to go back
36:54far enough.
36:56But it's taking
36:57twice as long
36:58as it should.
37:03There was a moment
37:04when I just
37:06felt like crying.
37:07I'm like,
37:08why is it happening
37:09now to Kira
37:10when a lot
37:11of the time
37:12I can just
37:12do this
37:14straight away
37:14in half an hour?
37:16You can't
37:17translate it
37:18back enough
37:18to get the screw in.
37:19That's right.
37:22Kira's ilium
37:23is wedged
37:23in the wrong position
37:24and the sacrum
37:25is crumbling
37:26when Noel
37:27attempts to
37:27connect them
37:28back together.
37:31Watching
37:32another surgeon
37:33struggle
37:33to complete
37:34a task
37:34is one
37:35of the
37:35hardest
37:35things
37:36to do.
37:38I've operated
37:39by his side
37:40for 10 years
37:40now.
37:41There's lots
37:42of incredibly
37:42difficult cases
37:43we've encountered
37:44but Kira
37:45adds something
37:46very different
37:47to the mix.
37:50Relax, relax.
37:52Doesn't want to go.
37:55Yeah.
37:56Hasn't gone well,
37:57Torek.
37:58No.
37:59This was always
38:00going to be horrible.
38:01after an hour
38:03of trying
38:04Noel finally
38:05manages to move
38:06the ilium
38:06into position
38:07but the sacrum
38:09is crumbling
38:10where the screws
38:11should go
38:11so Noel
38:13discards
38:13the surgery guides
38:14and repositions
38:15the screws
38:16by eye.
38:18To be able
38:19to adapt
38:20is just
38:20an ability
38:21that Noel
38:22has developed
38:23over the years
38:25that he can
38:26just see
38:27the potential
38:28that he will
38:29then go for.
38:31I shouldn't
38:31have gone
38:32with the guides
38:32at all.
38:33I should have
38:33just gone
38:33old school.
38:36Thought I was
38:36doing the best
38:37for her
38:37but I should
38:38have just
38:38eyeballed it.
38:43Now the ilium
38:44is reconnected
38:45to the sacrum
38:46Noel needs
38:47to address
38:47the second
38:48fracture
38:48behind Kira's
38:49opposite hip joint.
38:54So I'm trying
38:54to isolate
38:55the sciatic nerve
38:56here so I don't
38:56damage it.
38:59The fracture
39:00is directly
39:00beneath a major
39:01nerve to the leg
39:02and the jagged
39:04bone has been
39:04causing Kira
39:05pain.
39:08OK so we've
39:09moved the bank
39:09up roughly
39:10into position
39:10now.
39:13The bone
39:14segments aligned
39:15Noel can insert
39:16the plate
39:17custom made
39:18by Jay and
39:18the team
39:19which should
39:20sit smoothly
39:21under the nerve.
39:23So the plate
39:24fits perfect
39:25which is good
39:26news.
39:26thank God
39:28for something.
39:33Finally
39:33Kira is
39:34repositioned
39:35so that Noel
39:36can repair
39:36her hip ligament
39:37that was ripped
39:38apart in the
39:39accident.
39:39Noel uses
39:51a toggle
39:51technique
39:52to replace
39:53the original
39:53ligament
39:54with a
39:55synthetic
39:55one.
39:57Mini
39:58tight rod
39:58please.
40:00But Kira
40:01has now been
40:01in surgery
40:02for a long
40:03time.
40:05The longer
40:06the anesthesia
40:06goes on for
40:07you worry
40:08that is she
40:08going to
40:08decompensate
40:09is something
40:10going to
40:10go wrong.
40:12And we pull
40:12them all
40:13tight we
40:13slide the
40:14button down.
40:15You just
40:16kind of want
40:16to wake
40:16her up
40:17and get
40:17her sort
40:17of in
40:18recovery
40:18as fast
40:19as possible.
40:22Yeah
40:23so that's
40:24tight
40:25doesn't want
40:26to come
40:27out now
40:27so that's
40:27good.
40:35I think
40:35she'll be
40:35a lot happier
40:36now that
40:37she's got
40:37a solid
40:37hip.
40:41Right
40:42missus
40:42off to
40:43x-ray
40:43please.
40:43Good
40:44girl.
40:45Kira
40:46can
40:46finally
40:46leave
40:47theatre.
40:55Well done
40:55boob.
40:56Good
40:56girl.
40:57Thank
40:58you
40:58everybody.
40:59The
41:00presents
41:00are in
41:00the
41:01past.
41:04So I've
41:04done my
41:04best.
41:06I was hoping
41:08my best
41:09is good
41:10enough.
41:12I had prepared
41:13for 30
41:14years for
41:15that moment
41:16to step
41:18up to the
41:18plate and
41:19take the
41:19shot.
41:21And it's her
41:21kennel ready.
41:24VIP.
41:25I was really
41:28glad it was
41:29me.
41:30What do you need
41:31for the
41:31baby's daddy?
41:34Kira's age
41:35and previous
41:36trauma make
41:36her a higher
41:37risk patient.
41:39She's by no
41:41means out of the
41:42woods because
41:43there's so many
41:44factors at play
41:45here.
41:46Good
41:47cat.
41:48Don't get
41:49upset.
41:49It's okay.
41:50It's okay.
41:51It's okay.
41:52Her recovery
41:53will take
41:54some time.
41:57No, you
41:58good.
42:00No, you
42:01good.
42:01No, you.
42:01No, you
42:02good.
42:03No, you
42:03good.
42:04No, you
42:04good.
42:05No, you
42:05good.
42:06No, you
42:06good.
42:07No, you
42:07good.
42:08No, you
42:08good.
42:09No, you
42:09good.
42:10No, you
42:10good.
42:11No, you
42:11good.
42:12No, you
42:12good.
42:13Four days
42:13later, and
42:14Noel has an
42:15appointment with
42:15Gerard to
42:16discuss
42:17Kira's
42:17progress.
42:20I just
42:20thought that
42:21she wasn't
42:22as bright as
42:23she had been.
42:25Used to
42:26managing his
42:27client's
42:27expectations,
42:28this time
42:29it's Noel
42:30who's the
42:31worried parent.
42:32So my
42:33concerns in
42:34order are
42:34number one,
42:36inflammation in
42:36her abdomen.
42:38Noel's the
42:38worst client in
42:39the world.
42:41He will pick
42:41up the phone at
42:42any hour of
42:42the day and
42:42night and
42:43wake someone
42:44up that he
42:44thinks Kira
42:45needs.
42:46Last night
42:46when I saw
42:47her, she
42:48was very
42:48depressed.
42:49If I was
42:50the vet
42:51dealing with
42:51me, my
42:54patients would
42:54be severely
42:55tried.
42:56Obviously
42:57she had a
42:57load of
42:57urine in
42:58the abdomen
42:58and that's
42:59very hurting.
43:00I know
43:01too much,
43:02I ask
43:02too many
43:02questions and
43:03I'm
43:03obsessive
43:04about
43:04detail.
43:06Number
43:06two, I'm
43:07concerned about
43:08the swelling
43:08in her
43:09back legs.
43:10He's
43:10definitely more
43:11pessimistic than
43:11I am, I
43:12think, at
43:12times about.
43:14What do
43:14you see
43:14in Audrey?
43:16She still
43:17has a bit
43:17of reactive
43:18peritoneum,
43:19which is not
43:19unexpected.
43:21I think he
43:22just feels
43:22it's a bit
43:22out of his
43:23control at
43:24the moment.
43:25So it's
43:25all looking
43:26quite as
43:28expected, I
43:28would say,
43:29Noel.
43:29Good.
43:30In
43:31Kira's case,
43:32she's lucky
43:32to have
43:33Noel as
43:34her dad.
43:36We'll be able
43:36to name awards
43:37after you
43:37when you pay
43:38this bill.
43:38Yeah, that's
43:39right.
43:39Yes.
43:41Or at least
43:42one kennel.
43:42you're not
43:52going to make
43:52daddy get in.
43:54Hello, everybody.
43:55I'm having my
43:56hydrotherapy today.
43:58I'm getting
43:58stronger all the
43:59time.
44:00Despite Noel's
44:01concerns...
44:02That's it.
44:04Good girl.
44:05...over the last
44:06few months,
44:07Kira has slowly
44:07been recovering
44:08nerve function and
44:09building up her
44:10weakened muscles.
44:12You love
44:13gravy bones.
44:14Come on.
44:15It's like suddenly
44:16the whole weight of
44:18the world has been
44:18lifted off my
44:19shoulders, you know.
44:20Are you ready?
44:22One pee?
44:23Oh, yeah.
44:24I know she's not
44:25going to live forever.
44:25I completely understand
44:26that, but she's my
44:29little girl.
44:30Well done,
44:30sweetheart.
44:31Well done.
44:32Seven months
44:34since the accident,
44:35today, Kira's
44:37finally strong
44:38enough to return
44:39to reign over
44:40the practice.
44:41Hi, guys.
44:41Hi, Kira.
44:42Hey.
44:43Oh, she's back.
44:44Hi.
44:45Hi, everybody.
44:48It's just a miracle,
44:49really.
44:50Everyone's just
44:51really happy to see
44:52her doing so well.
44:53Hello, everybody.
44:54I'm back.
44:56I'm back.
44:57I'm back to
44:57supervise.
44:58She's probably
45:00going to live to
45:00100.
45:01That's what we're
45:02aiming for, anyway.
45:03Thank you, everybody.
45:04Thank you for
45:05looking after me.
45:06For Noel, I think
45:07seeing her recover
45:09is hopefully a
45:10reaffirmation of
45:11what we do,
45:12that the team
45:13that he created
45:14has actually saved
45:16Kira's life.
45:17Come on.
45:17Go for it, though.
45:18Yes.
45:19I hope he was
45:20proud of us,
45:21and I hope he was
45:22proud of himself
45:22because we are all
45:24in this together
45:25thanks to him.
45:26Come on, Boop.
45:28Good girl.
45:29Hold on.
45:30Come on, Boopie.
45:31Good girl.
45:32Good girl.
45:37Twelve years ago,
45:38Kira and I stood
45:39right here in this
45:40field and looked at
45:42Derlich Farm
45:42buildings.
45:44She is the reason
45:46this practice exists.
45:48High five.
45:49Good boy.
45:50I feel like the
45:52two hospitals were
45:53built for her
45:54and for dogs
45:56just like her
45:57and people just
45:58like me.
45:59I'm very lucky
46:00that we have
46:01this magnificent
46:02team.
46:03They have allowed
46:04my baby to live.
46:09There's hope.
46:11There always has
46:11to be hope
46:12because love,
46:14hope, and faith
46:15is all we got.
46:17And she's all of
46:18that to me
46:18every single day.
46:19God damn it.
46:21God damn it.
46:24God damn it.
46:24Give me hope.
46:24I feel like
46:24God damn it.
46:25God damn it.
46:26God damn it.
46:26God damn it.
46:27Transcription by CastingWords
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