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00:02Surgeons they can change your life forever as they tread the line between life and death we go to bed
00:11What's it really like to hold someone's life in your hands it's miracles and disasters nothing in between
00:19And how do you balance the needs of others with the needs of your family?
00:30Love you, mom. Bye now we go behind the mask to find out just what it takes
00:36To live life as a surgeon
00:44It all went really well professor Omar is number one
01:03The idea that somebody is going to operate on your brain is a huge thing you know
01:07It's it's who you are. It's where you carry your memories. It's where you form your new memories. It's your
01:12personality
01:12It's who we are. It's our consciousness
01:1745 year old Omar Patmonarban is a consultant neurosurgeon at Salford Royal Hospital in Greater Manchester
01:27He's been operating on people's brains for the last 20 years
01:34As clinical director Omar and a team of leading surgeons are responsible for over 3,500 brain surgeries every year
01:45Morning
02:14I
02:15Hello
02:17Nice 45 year old a ditcher recently found out. He has a rare brain tumor
02:21That has been growing since he was born
02:26Now the tumor needs to be removed if it isn't it will continue to grow and eventually kill him all
02:33right
02:34How have you been it's some time like a little bit of business and everything, but overall is okay. Yeah,
02:42okay good
02:44The couple live in Manchester with their three daughters
02:52She's told me we are going to refer you to neurosurgeon and I was why and they say it's like
02:58brain tumor and I said oh my goodness
03:00That's a big word tumor
03:04Yeah, it was it was scary. Yeah, it was
03:08So this is your brain stem you can see that there's a difference between the two sides can't you already
03:13at this point and that's because we're seeing this
03:16Epidermoid cyst and that's why you've been getting the balance problems the dizziness you've gone deaf in that air. Yeah
03:23That's why because of the effect of this epidermoid cyst, okay
03:29um
03:29In terms of risks from the surgery so bleeding, okay
03:35stroke
03:37Yeah, okay
03:39How is happening? What's going to happen? This tumor is going to kill me what they are going to do?
03:45She's in a GCSE. She's in a
03:48Primary school, so anything happen and I'm die who's going to look after my family
03:55Very tough
03:57We're going to take good care of you and you know, my anticipation is that that you know, you're going
04:02to be good
04:04The ditcher hopes he'll get the hearing back in his right ear
04:06So it's going to recover or not like can I hear a hundred percent? It's a good it's a good
04:12question
04:12And it's not something I want to promise to you
04:15But it's possible there could be some recovery
04:17But I think you should consider it a bonus if you get some recovery because it's been quite a long
04:22time that that's been gone now
04:23Okay
04:24Okay, yep
04:28No, I'm very positive about the surgery. It should be give me
04:33Good longer life. I think so better life
04:36Hopefully hopefully improve the quality long term. Yeah. Yeah
04:41You never want to take away somebody's hope. I mean hope is is a basic fundamental requirement for people
04:50Sometimes if you don't get that balance in the conversation quite right or even if the patient is not quite
04:56in the right place yet
04:57All right, thank you
04:59Those are the most challenging of discussions
05:20Aditya and his family have arrived at hospital for his surgery
05:25Across the UK over a hundred thousand people are living with brain tumors
05:30So Addy's tumor is about the size of a tangerine and it sits in a space that would normally only
05:37be a few millimeters wide
05:38And it's insinuated itself in between all the nerves and the blood vessels that sit in that area normally and
05:46it has compressed
05:46His brain stem and it's compressed his cerebellum and that's what's caused him to lose his hearing his balance and
05:54to develop facial pain
05:55So over the last
05:5845 46 years this has been slowly accumulating over time
06:02until it's got to the point where his functions have started to decompensate because they can't cope anymore with the
06:09level of pressure and
06:11Tension that they've been put under by this cyst
06:14Any issues with your hearing?
06:17Yeah, I can hear
06:20I think sometimes it is hard for patients to
06:24Get their head around the fact
06:25Potentially after surgery they can feel worse than they do now before they get better
06:30So for Addy for instance, he lost his hearing some time ago as part of this process
06:35And we certainly can't guarantee to him that we'll be getting any hearing back for him
06:42Hello
06:47Okay
06:51Okay, yeah, can I hold her?
06:53Yes, of course
06:59Yeah, yeah, yeah, bye bye
07:03Bye bye
07:04Bye bye
07:05That didn't worry
07:06Yeah
07:07Okay, Jamie, Jamie, Jamie, Jamie
07:09Jamie
07:12Okay
07:18I think patients want us to be superheroes
07:21Particularly when they're facing the most serious consequences and the most serious diseases that could change their life forever
07:30But sometimes the decisions we make the advice that we give can make you a villain in the same breath
07:36that you can be a hero
07:40I hope the next like 10 hours also go like super quick
07:45It's a big surgery we know but
07:49Yeah, you'll be fine
07:51He will bring him back
07:54Aditya's life is now in surgeon omar's hands
08:13This morning neurosurgeon omar patmanabhan is about to begin life-changing brain surgery on dad of three aditya
08:26Aditya's tumour is between the brainstem and the cerebellum which helps coordinate movement and balance
08:33Omar will cut through the skin and nearby muscle and then the bony section of the skull behind aditya's right
08:40ear
08:42Once he's reached it he will cut away the tumour to release pressure on the cranial nerves
08:48Which control hearing balance and facial functions?
08:53Operating in this area of the brain is high risk one wrong move could lead to irreversible damage causing a
09:01stroke or paralysis
09:03It could even be fatal
09:06Good okay pins going in
09:10The tumour is causing a ditcher pain dizziness imbalance and loss of hearing
09:18Stopping
09:24I'll just go straight down to bone here now
09:28First of all aditya's skull needs to be opened then muscle must be cut to get to the brain tumour
09:36So we're doing the initial exposure down onto the bone just behind the mastoid which is the
09:44bony prominence just behind
09:47Adi's ear
09:48So to do that we have to get through some really big tough muscles
09:53And soft tissue to get down to this bit because we've got lots of attachments of muscles
09:59Onto the skull at this point
10:06Something that's always struck me is the uh the sharp contrast between the sort of brutality of using
10:13powered instrument drills and
10:16steel to get through this
10:19bone and then the delicacy and serenity of the brain that's underneath it
10:26So
10:37Scissors please
10:40You can start to see some pearly pellets
10:42We call them pearly tumours
10:45Because it looks like mother of pearl and we're starting to see a piece of mother of pearl appearing there
10:51After nearly an hour and a half of drilling
10:54Omar can see the tumour which is buried deep inside a ditcher's brain
11:00You can see why it's gone deaf can't you yep
11:05Yep
11:08As omar begins cutting out the tumour he has to be extremely careful
11:13It's crucial he avoids harming any of the nerves
11:16Any damage could cause a life-changing complications
11:21So we're we're in the space that sits between
11:25The cerebellum a bit of brain that controls
11:28movement coordination and
11:30The brain stem which is a obviously a critical structure the stalk which connects the brain to
11:37The spinal cord and the rest of the body
11:40So we're looking currently
11:43At the lower cranial nerve so these nerves control your voice you're swallowing
11:49Prior to coming down here we've just found the seventh and eighth cranial nerves and those are responsible for
11:55Facial expression the seventh nerve facial nerve
11:59And then we'd found
12:00The eighth nerve which supplies hearing and balance and they were really really very compressed by this lesion
12:08Which explains why he's had such difficulties with balance
12:12And why he's gone deaf in that ear
12:16Even if omar manages to remove the tumour there is no guarantee that a ditches hearing will return
12:24He's been deaf because of this for a number of years so it's probably quite unlikely but I have
12:30I have had cases where hearing has been restored or improved at least
12:35It would be a big bonus if you got a hit any hearing back
12:39Because it's wrapped up in that capsule stuck down
12:44Faucet the fine-tool faucet
12:46I'll do the blockage yeah, so this is a two-man job as we start to remove that bit of
12:51tumour
12:52Okay, bit of suction on that piece now
12:55Watch this watch this side of the suction on the nerves
12:58Okay, good
13:00And we need to be careful about how we remove the tumour because this particular type of epidermoid cyst
13:06Wraps itself and insinuates around these nerves so you can find
13:11The nerves and the vessels within this the structures that you're removing with the lesion you're removing
13:18Gradually parts of the tumour begin to be released
13:22That's around it's welded as you'd expect after
13:28Over four decades going on for five decades of being slowly insinuated into this space, but
13:36It's coming bit by bit
13:41It's stuck to the veins here i think yep
13:45Just going to debulk it initially
13:48Some of the pressure off that nerve forceps please
13:53Thank you
13:54So we're getting a view of some of that more classically pearly pearlescent
13:59Material there that we see which is quite quite beautiful actually
14:06So this is the part of the tumour that's been causing adi's facial pain
14:13This is trigeminal nerve which is the nerve supplying sensation to the face
14:21Sarah just working around the trigeminal nerve
14:25On occasions we can cause the heart to stop by manipulating the nerve scissors please
14:34We have to be careful that we're not damaging the facial nerve that would paralyze his face
14:47It's 99% out now we're just picking away at the few little remnant bits
14:55So we've been able to give him an excellent clearance and hopefully
15:00Very little chance that he's going to ever need another operation for this in his lifetime, hopefully
15:16I'm back into the cerebellum, the peduncle there
15:22Some loose bits floating but nothing solid is this
15:26Okay, that's great. Thank you
15:27Yeah, right
15:29Let's wash it out with two liters of warm wash
15:33So we've removed the the epidermoid cyst and then we'll be making sure there's no bleeding
15:40And then closing up
15:43Three hours in and Oma has removed all of the tumour
15:49Another boring day at the office is all we want
15:57Yeah, that's good
15:58Yeah, that's good
16:00There we go
16:01Not much more than a haircut
16:03Sorted
16:05All right
16:06So this is the worst bit of time for me now waiting to see how he does
16:12Not very optimistic he's going to get any hearing back
16:15We have to wait now to see that he wakes up well
16:21Hi adi everything went really well
16:24All went exactly as we wanted it to
16:27Okay, you're just coming around now, so i'll talk to you again in a bit
16:31It all went really well
16:41Now only time will tell if any of Adich's hearing will return
17:01Neurosurgeon omar lives in cheshire with his wife annabelle who is also a surgeon and their three children all under
17:0816
17:11i think that we're constantly juggling so many balls and dropping various ones
17:18i think i think we're just putting one foot in front of the other one like everybody else
17:2321 band
17:26We were in the same halls in the first year of university so we met then but we didn't really
17:31know each other knew each other just sort of in passing
17:35He's noticeable on the dance floor he really clears himself for space
17:41i got that he's shaking that ass award didn't i when we left medical school
17:48Computer are you ready for you we've got two minutes yeah
17:51Yeah i'm coming okay cool computer off
17:56We think that we know a lot about each other's specialties you in particular you think you could do my
18:00job
18:00I think yeah i think i think i think i've got a damn pat now
18:05How are we doing for you
18:10Have a good day love you sorry dipped my hair in your bottle
18:15Yeah it's a pretty even split i think i'd like to think
18:21He constantly tells me i have no idea how much he does
18:35I think it's it's still the case that you take you take more of the burden here
18:40What we coat on where's my belt it's stuck behind you
19:02Morning everyone how are you here okay
19:05Good morning mate fabulous yeah all right brilliant thanks very much cheers thank you bye bye
19:11I will excellent
19:18We got a bed we got a bed
19:21Do you want to just let um dr sebastian know
19:25Yeah yeah yeah exactly tell him he's got some more work to do um good
19:3245 year old service manager emmanuel
19:36Has a rare type of tumor that started in his nose before spreading towards his brain
19:41He's here with his wife corcor knock knock
19:45Good morning hello good to see you good to see you hello we haven't met nice to meet you
19:52I'm an avan you're a surgeon this is adi our fellow as well okay take a seat take a seat
19:57I don't see the tumor is cancerous and due to its size and position
20:02Emmanuel needed over 36 rounds of chemotherapy and radiotherapy to shrink it
20:08It's now small enough for omar to safely operate on you know i said to you before that everything
20:13On the day is positive energy now we've done all the consent forms and everything else but have you got
20:17any questions about
20:19About that anything we went through i want to say a big thank you to you and your team
20:24I'm trusting you do
20:27Your very best as you do always oh thank you very much we're going to take good care of you
20:32And we hope that it will improve the length of time you've got but we can't promise that okay all
20:39right
20:40okay
20:44Okay all right nice to meet you and see you again soon
20:48Like yeah the reality is turning on me
20:59It's been amazing
21:02Always thanking her for that
21:05That support
21:06And this actually gives the true meaning of for better for worse
21:12And she's giving meaning to that she stayed with me in my difficult and trying moments
21:18She's been there for me
21:20We can't wait to get to the end i think we are nearly there nearly there
21:31You ready let's go baby come on
21:39All the best see you
21:46Yeah yeah yeah yeah
21:50Emmanuel surgery is a joint case with ear nose and throat specialist raj bala
21:56So between may and october so quite considerable sort of shrinkage yeah
22:03Emmanuel's got a rare type of cancer that started in his nose and then grew up to involve the border
22:09between the nasal passages in the brain
22:11We are operating around all the most important sensors okay
22:16So we're operating around where you get your sense of smell we're operating around your vision
22:21We're operating around the blood supply that supplies the brain and we're operating around the base of the brain
22:28Where you've got some of your most important functions
22:31With lots of potential risks from operating in that area the tumor is involving
22:36The olfactory bulbs which are the nerves which carry all of the smell from your nose into your brain
22:44And when he wakes up he will not have smell again
22:48We want to achieve a high quality of life
22:53But at the same time achieve a better duration of life
22:58For him
22:59Right Emmanuel
23:00You do have a brain
23:03It's a good start
23:04Okay right so there's a good start
23:07Emmanuel is in a really good frame of mind this morning
23:12Patients feeling positive and and good just before they go into surgery is is really important
23:17So everything looks perfect and what we'll do is start drifting off to sleep
23:38Emmanuel's cancerous tumor will be removed in three phases
23:42Known as the approach resection and finally reconstruction
23:47So that is all the preparation
23:50Let's scissors and forcep to discard please
23:53ENT surgeon Raj will gain access to the tumor through Emmanuel's nose
23:59Preventing surgery through his face
24:03Next Omar will carry out the resection
24:07Meaning he'll cut out the tumor and the olfactory bulbs
24:11Causing Emmanuel to lose his sense of smell
24:15Finally using tissue from Emmanuel's scalp
24:17Omar will reconstruct the seal between his nasal cavity and the brain
24:25Okay room lights down please folks
24:28Reg patties with adrenaline going in
24:34One more of this
24:36Raj and his team begin phase one of the operation
24:40Creating access to the base of Emmanuel's skull through his nose
24:45Okay, and then we'll come up into
24:48The roof of the nose the vault of the nose
24:49And we'll make a vertical incision
24:52Okay, just down to there
24:54Okay, then we'll go back up into the roof of the nose
24:58And then do the same on the nasal septum
25:03Blood pressure okay? You happy?
25:04Yeah, yeah
25:07Okay, so I've just communicated those two flaps
25:15I'll take the suction again just the fenestrated suction if you've got it now please
25:19Okay, so just up into the roof of the nose now
25:25This will allow a shri now okay to get to the posterior table here okay
25:33This is drilling through the base of the skull
25:36After just over two hours
25:38The base of Emmanuel's skull has been successfully reached
25:42Okay, so now I'm just starting to thin the bone
25:45to the base of the skull
25:48Starting to expose dura
25:52I'll be there just two ticks Raj
25:55With a clear route to the tumour
25:58Omar can now take over and start to remove it
26:02And I'll take it bipolar please
26:04Got one
26:06Thank you
26:08The team won't know if Emmanuel has suffered any further damage until the tumour is out
26:15The undersurface of the frontal lobe is looking healthy which is good news
26:19We weren't sure if it was going to look potentially like there was invasion
26:26Beautiful isn't it?
26:30There we are there's the frontal lobe on the right
26:36Still instinctively a little bit shocking to see the brain through the nose isn't it?
26:40Mm-hmm
26:42There we go final bit
26:45And there you can see this is the olfactory bulb
26:51Here so this is the nerve that would be carrying all the smell from your nose and the outside world
26:57into your brain
26:58Unfortunately here is as you can see running directly into all of this tumour
27:04We're going to be removing that and sadly also with it his sense of smell
27:12It's the right-sided olfactory bulb
27:15Smell nerve
27:17There's always a certain amount of sadness that comes with dividing a nerve but it needs to be done in
27:24this case
27:25Right olfactory bulb
27:27Yep
27:29So all of the tumour
27:31You can see it's quite a challenge to fight this bulk as we're dissecting and removing the tumour
27:37But we're battling on at the moment to see if we can achieve this
27:40en bloc
27:42Removing the tumour means emmanuelle will no longer be able to smell anything
27:55There's a lot going through my mind right now
27:59I've been waiting for five hours already
28:03I hope it's over soon
28:06He's my world he's a good dad
28:10And he's my love and life partner so yeah
28:14I need him back because there's so many things we need to do together
28:19And when we are together we are a team
28:29So now it's just hampering at progress
28:33Omar has managed to loosen the tumour and can now start to bring it out through the nose
28:39It's probably free isn't it to have the ball probe
28:43So now the challenge is going to be whether or not we can actually remove this large piece
28:49through the nose or not
28:56So now there's parts of it to that part of the septal part
29:01He's removed the first part now he needs to get the rest out
29:05So now it's maybe
29:06It's coming
29:10It's coming
29:13There we go
29:15The tumour
29:33The tumour
29:35We'll be able to see the size of the defect
29:39With the tumour now all out
29:40The gap that's been made between the top of Emmanuel's nose and his brain
29:45Now needs to be repaired
29:49Yeah it looks perfect
29:51This is a fibrin glue
29:53That we're going to use now to secure that onto the edges of the dura
30:00To fill the gap
30:02Omar needs to add a layer of fresh tissue with a strong blood supply from Emmanuel's scalp
30:08A bit of local adrenaline going in
30:14So Adi's going to make a cut down here
30:16I'm going to assist him from this side
30:24There we go
30:26Good healthy scalp
30:28And the layer that we're going for is the layer that sits right on top of the skull
30:33The pericranium we call it
30:35And it's a lovely robust layer of tissue
30:40With a fantastic blood supply
30:42And it's going to give us some nice healthy tissue to place down to repair the defect
30:50The team must carefully remove the layer of tissue
30:54Any damage caused to the tissues blood supply
30:57Could mean serious complications
31:00We want to take this flap of tissue all the way down to the rim of the orbit so just
31:04above the eyes
31:07And what we'll do is we'll make an opening then once we've raised this flap in the bone just over
31:13the glabella into the frontal sinus
31:15And that will allow us to post this tissue from his scalp into his nose to use for the reconstruction
31:23You know I actually look at this and see hope
31:27Because I look at although it's a huge thing to put somebody through and it it seems
31:33You know to the to the outside eye this seems somewhat grotesque to be exposing somebody's skull in this way
31:40But but this gives us the ability to do something that otherwise
31:44He would not have been able to have and he would not have had this opportunity
31:48At a potential
31:51Extended life good quality of life
31:54Without this tissue so I look at this and I see
31:57A fantastic piece of tissue that's going to help him survive
32:04Next omar will need to attach this tissue to the gap between emmanuel's brain and nose
32:10This is critical in order for the operation to be a success
32:26Neurosurgeon omar and his team have removed a tumor from emmanuel's brain behind his nose
32:33Next thing we're going to need a drill so we put the light source inside the nose
32:38So this is emmanuel's skull and then as we come back down we're seeing the frontal sinus and this is
32:43our window now
32:44Where we're going to enter through into the nasal space to pass our flat
32:48To be able to enter the nose and the nose to the nose of the nose
32:54There we go
33:01Raj is just putting a stitch in and we'll feed that stitch through and then he'll come into the nose
33:06and bring it down using that stitch
33:10Okay, stop stop pulling that in for me first. Yep. Yep. Yep. Go on pull. Yep. Keep pulling
33:17Keep going keep pulling keep pulling pull pull pull
33:23Thank you. It's nice isn't it? It's beautiful
33:28You can see that lovely pink healthy tissue with blood supply now really helpful
33:34And we're using that to create a vascularized so a piece of tissue with a blood supply to help this
33:40heal
33:42Once we've done this we'll put some some support within the nose to help secure all of this and then
33:48we'll close the scalp
33:50And then that's it
34:00Yeah, you should never see the brain through the notion
34:05We're done
34:07The most stressful part of an operation is when the operation is done and you're waiting for the patient to
34:14wake up
34:14It might only take it five fifteen twenty minutes
34:18It feels like forever
34:21Because until you see your patient wake up even if everything's gone perfectly well in an operation
34:26You don't know how they're going to do you don't know for sure that they're going to wake up as
34:30you want them to wake up
34:49It is yeah 10 minutes after the operation finished
34:54Emmanuel comes round
34:56Where's your hands? Give me your hands
34:58Everything went really well
35:00Oh
35:01Went fantastic. Thank you so much. Oh, you're very welcome. We went exactly as we wanted it to go. Okay,
35:07so I'm really pleased
35:10Okay, so now it's over to you to get better. All right, you rest now
35:15Shall I go and let the boss know that you're doing okay? She'll be pleased to hear I think won't
35:20she
35:22Are you ready for a drink?
35:25Yeah
35:30Hello? Hello? Hello, is that Coco? Oh my goodness. Are you done?
35:34Yes, we're all done and Emmanuel's awake. He's just woken up. He's woken up
35:39He's in the recovery area and he's doing really well. Oh my goodness. Thank you
35:44Yes, and everything went exactly as we hoped it would
35:46I'm in the room with him. I can hear you. Are you close to Emmanuel?
35:53Yeah Coco, thank you so much. Yeah, are you okay? I'm okay by the grace of love
36:00I hear you are awake. I'm so glad. I can't wait to see you. I'm coming about to see you
36:07It won't be long before you can come up and see him. Okay. Okay. All right. Thank you so much.
36:12Thank you
36:13Thank you. Okay. Bye bye. Thank you. Thank you
36:19Oh my goodness
36:21I'm glad he's awake looks like everything went well
36:26Thank God. I'm so grateful. I can't wait to see him
36:32Okay, it's okay. How's that?
36:34I'm relieved now that we've been able to perform the surgery and that we said we would for him
36:40but there's going to be another step now
36:42To get him through his recovery and he's going to be at risk now for a few weeks of things
36:48like cerebrospinal
36:49fluid leak meningitis
36:51We've got to give him time and hope that the combination of treatments we've given him now will keep things
36:57under control
36:58But he's got a very aggressive cancer. So the long-term outcome you know remains remains open for him
37:17Having undergone extensive radiotherapy chemotherapy and brain surgery
37:22Emmanuel will now remain in hospital until he's well enough to be discharged
37:26Oh
37:40Praying and hoping that this is the very final lap
37:43And then we can have our lives back
37:46Yeah, because we have a lot planned for end of year and next year
37:51We can't wait to do it together
37:57I think
37:59No, I'm here for you. Yeah. Thank God that yeah well
38:16It's the end of the week
38:18and omar's mum ann and his aunt and her partner have come for dinner
38:2515 year old theo is cooking it it doesn't look like a bum that's hit does it when you finish
38:31doing all the cooking it does i think i'm probably a dosing dad i probably let them
38:40get away with too much but uh yeah i'm i'm a i'm a relaxer i think
38:59my dad left um when i was about 10 weeks old and and so i didn't have a father figure
39:06in my life
39:08i had an amazing mum who filled that easily um and was my role model growing up but i
39:16did not want to embark on being a parent unless i was going to make a commitment that i would
39:23be there and be present because i did you know it's i did feel that i would have liked to
39:31have
39:31had that presence in my life when when i was at that age and and i i didn't want that
39:36to play out
39:37again in another generation when i met my father in my 20s it wasn't straightforward
39:46there's an expectation that you will have a father-son relationship but actually that doesn't
39:54just magic itself out of nowhere it was hard to realize that you're never going to rebuild
40:02what you haven't had and then to just accept and have peace with the fact that you can't rewrite
40:10history but you can start again from where you are now
40:27it's been 24 hours since omar operated on a ditcher knock knock it's still unknown whether his hearing
40:35has returned how are you feeling all right yep good well done well done feel like you've been
40:44hit by a bus this morning yeah yeah you're looking really well actually considering what you what you
40:49had done yesterday yeah yeah and you probably won't remember but it was very very stuck to your facial
40:54nerves so i'll just just show me your smile fabulous okay you can relax that's that's good
40:59what about hearing i wasn't i can hear you can hear on that side now that's amazing well that's
41:07very positive i wasn't necessarily expecting that because it had really stretched your hearing and
41:13balance nerve um and was stuck so i wasn't surprised that you'd lost your hearing but but that's a that's
41:19a great sign if you've already got some hearing but currently there is no deepening nothing
41:27everything goes well all right you've got to take it easy when you get home hey i have to be
41:32treated
41:32like a prince when he gets home yeah yeah okay we'll leave you to it for now thank you so
41:39much
41:40thank you okay she's actually got some hearing back in that ear
41:53dr omar said now treat him like a prince for the next three months you've never heard of prince
41:59treatment princess treatment feeling good professor omar is number one i can hear again on my this ear
42:10it's amazing it's amazing it's miracle for me it's clear even no tightening no uh dizziness nothing
42:19right now i really appreciate whatever the dr omar done for me it's really miracle
42:43i absolutely love my job you need a significant level of confidence to be able to be a surgeon
42:52there is a difference between being egotistical and having a level of confidence and striving to be
43:00the best that you can be how are you nice to see you nice to see you nice to see
43:05you good yeah good
43:06i like to get to know my patients as well as i possibly can
43:12i think that you are under more pressure when you're emotionally invested
43:16because you really care about what matters to them makes you better at what you do
43:23neurosurgery is miracles and disasters nothing in between okay started
43:37thank you too i'm happy you are still here with me
43:55i'm happy you are still here with me
44:00heart surgeon inda carries out life-saving surgery
44:04we've got the 18 with us today the trickiest moment is going to be at the end
44:09is going to be at the end will this heart work will this heart work will be too
44:14so
44:26so
44:42Transcription by CastingWords
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