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00:00On any given day, some 800 inpatients, 800 outpatients and over 240 emergencies are cared
00:08for in one of Ireland's busiest hospitals, Cork University Hospital.
00:12It will take just one patient to come in, that just completely stops you and reminds
00:18you that, whoa, this is somebody's worst day of their lives.
00:21On any given day, some 4,000 staff come to work here, a place where life-changing decisions
00:27are made every minute, and every decision counts.
00:31Because I see a lot of sadness, I get great pleasure giving people the good news when I can.
00:39Here I am, hold my hand.
00:41You're having a heart attack.
00:43Filmed using 27 cameras, following patient journeys across the hospital, each story in
00:49this series was captured in just one single day.
00:52Together, they tell a bigger story of any given day.
00:57I'm here for a long haul, not getting rid of me.
01:02I just broke down what is going on.
01:05I'm getting the chance she didn't get, so I have to grasp it.
01:09A good shift is where you come out the door happy, thinking, I made a positive difference
01:17today, and that's really it.
01:21Yeah.
01:29Can you say, ah, for me?
01:31Ah.
01:32Perfect.
01:32Let's go a little bit further down.
01:34Do you feel a bit of a tickle there?
01:35Uh-huh.
01:37Say E.
01:38E.
01:39Ooh.
01:40Ooh.
01:41Ooh.
01:41There you go.
01:41It's a good cold movement there.
01:43There probably is a little bit of oedema there, but I don't see blood.
01:54How many Bipop circuits around?
01:57Why do you want Bipop, sir?
02:01Patricia Murphy has been rushed to CUH from Mallow Hospital.
02:12She is struggling to breathe and will need a special pressure mask to keep her airways
02:16functioning.
02:17We will need a Bipop circuit here in the next five minutes.
02:21Meeting Patricia off the back of the ambulance, the first thing I see is that she looks scared.
02:25She looks panicked.
02:26Just nice, deep breaths, okay?
02:28Try and focus on your breathing.
02:29And the reality is, when you're trying to literally force air in and out of your lungs,
02:34that is extraordinarily anxiety-inducing, and that's a natural reaction.
02:39I'm just going to listen to your lungs while we sort everything else out.
02:42She is very, very tight.
02:44In Patricia's case, when you see someone who's requiring significant oxygen support,
02:48it still has very elevated work of breathing, breathing 30-plus times a minute, very wheezy,
02:54and then struggling to repeat the full sentence.
02:56That is very dangerous.
02:57Do you have pain anywhere at all?
02:59Yes.
02:59We're just being ready to the left.
03:02Okay.
03:02We're going to get you set up on that breathing mask, Patricia.
03:04It's the way I describe it.
03:05It's like sticking your head out a window, a car going about 80 kilometers an hour, all
03:08right?
03:09So it's like a gust of air in.
03:10Because she was so easy, we were trying to open her lungs, so we placed her on the Bipop
03:15mask, and that's bi-level positive air pressure, okay?
03:20When the patient is taking a breath in, as can be sensed by the computer, then extra air
03:25gets pushed in.
03:26And that can be quite uncomfortable for the patient.
03:29So it feels a bit funny.
03:30This is going to help push air into the lungs.
03:32It's going to open everything up, all right?
03:36So in about 20 minutes time, things will be much quieter, much less noise, all right?
03:43I dropped her up for her to get an MRI.
03:47I was expecting her to go shopping, as she would do.
03:50You've used this before?
03:52Oh, you've never used one of these before?
03:53Oh, they're horrible, aren't they?
03:56I just rang her, and next thing a man answered it, and I said, oh, she's losing the phone.
04:02That's the first thing that came into my head.
04:03He says, I'm the ambulance driver.
04:05He says, and Trish was out there having a, you know, an episode, or whatever you want
04:09to call it.
04:10My name's Jack.
04:11I'm one of the nurses, all right?
04:12And you might be on this for a few hours, okay?
04:16But it is really good.
04:17All right.
04:19So they said, oh, right, fuck.
04:21I'd better get up there.
04:23I'd better be a penny keen in.
04:26And she does, I mean, this is obviously post-Hydra Carson, but she does have...
04:29OK.
04:35Is it a cough that you want to cough?
04:37Yeah, you can let it cough.
04:38Will we take it out?
04:38Yeah.
04:39This is, like, you know, normal for me, but this is an absolute catastrophe for the
04:45person involved.
04:46So, God, you know, I might seem relaxed and so on.
04:50They are in the absolute horrors that they've ended up in that situation.
04:53You have to think of it from their perspective.
04:54I've never heard of any issues with 3% cellar nebs.
04:56Things could get worse.
04:58We'll leave that possibility open.
04:59Yeah, she had a dose of the current patients that I was told.
05:02No, no, not at all.
05:04Not at all.
05:04Just focus on her breathing now.
05:07The high-pressure mask is difficult to tolerate.
05:10Staff are temporarily switching to a nebulizer mask to keep Patricia breathing.
05:16When I walked in, they showed me her, literally, with, I think, four or five people around her.
05:28It's frightening.
05:30I asked questions then.
05:31I said, what way is she?
05:32And they said, she's very, very sick.
05:34What are we, what are you treating her for?
05:37Yeah, Greg, a COPD exacerbation.
05:39Sorry, exacerbation.
05:40I mean, her COPD, the chronic obstructive pulmonary disease.
05:43The tubes and lungs, the bronchioles, the pipes, they're narrowed.
05:48The pressure mask will help push things open.
05:50Right.
05:51That's the rationale of that.
05:52All right.
05:53All right.
05:54Not knowing what's going on is possibly, it's more frightening.
06:00There's nothing about it.
06:01I mean, going up there to find out what's happening.
06:04And I didn't know.
06:05But it is a frightening experience to see it.
06:08Even when it's like, you don't know what's going on there.
06:11We are in a spot of bother.
06:12But she's in a massive trooper.
06:14And she did her son really well to the bypass.
06:16I find not being able to tell me she's getting better.
06:20Or she's getting worse.
06:22And when you're in that situation, you jump to your conclusions.
06:26I'm sorry, I'm in trouble.
06:28No, you're in trouble.
06:29But he's...
06:30No, no.
06:31You're in trouble.
06:32But that's what that's called.
06:34In other words, your shoes are narrowing down.
06:36Right?
06:37So it takes more pressure to walk for them.
06:40But the fire doesn't stop.
06:41What can I do to fix this?
06:43And I can't fix this.
06:45But I mean, they did everything that they could.
06:47There's no question about that.
06:50But I'm afraid then myself, am I able to cope with this?
06:54You know, that's frightening in one sense.
06:57But you don't tell her that.
06:58Like, you know, you don't say that she's enough problems in where she is.
07:02Oh, hello.
07:30Good morning.
07:31Good morning.
07:31Good morning.
07:31Yeah.
07:3277-year-old Peter Crisp has a large aortic aneurysm.
07:36He requires surgery to fix it before it bursts, which would likely prove fatal.
07:41There's a great quote in this morning.
07:43Yes.
07:44Perfect.
07:44I'll hand you that back.
07:46And the next two came that I have here?
07:48Yeah, that would be me and my mum.
07:50Yeah, perfect.
07:50He wasn't ill at all.
07:52There was no symptoms at all.
07:54See, that's the kind of scary thing about aneurysms is that you could have it and not know it's there.
08:00And they only caught it because they were looking for something else.
08:04And it was random.
08:06They were checking to see if he had bowel cancer.
08:08And then they did a scan on his stomach just to check things out.
08:13And they kind of said, oh, no, it's great.
08:15You don't have bowel cancer, but we've discovered something else.
08:17And we need to send you back over here just to check it out.
08:20And that's how they discovered it.
08:22But this was back in 2017.
08:27And they had been checking it every year.
08:29And then it was every six months.
08:31And then every three months to see how big it was getting.
08:34He didn't tell us about this aneurysm until two weeks before the surgery.
08:39It was actually my birthday.
08:41And I, you know, he had known about it, but he hadn't told us.
08:50And you were pre-assessed.
08:52Oh, yes, I was here last week.
08:54The idea is that we go through the groin,
08:56and we put special wires that let us kind of feed the stent into the yorta.
09:00OK.
09:00And you're going in both sides, isn't that right?
09:03Yeah.
09:03Why both sides?
09:05Because the stent, so you have two vessels that branch out of the yorta.
09:09Yeah, I understand that.
09:10So you have to go in through one to put the main body of it.
09:13OK.
09:13And then through the other to put kind of the last little bit.
09:16Right.
09:17So it's a split end.
09:18OK, and that joins onto it.
09:20Exactly.
09:20And it starts.
09:21An aneurysm is an abnormal swelling of a blood vessel.
09:25It's a little bit like having a weak spot on a tire.
09:28Suddenly a bubble forms, and the risk is that it will burst.
09:33At that point, you have, your heart is beating.
09:35It's just putting blood into the system.
09:38But instead of circulating around, there's now a big hole in the hose,
09:41and it just pours out into the tissues around.
09:44And the risk will be that that's very catastrophic for the body,
09:49and in many cases, it's fatal.
09:52Good morning.
09:53Good morning, again.
09:55How are you?
09:56I'm very good.
09:56How are you?
09:57When he said it's at 5.5 centimetres, and if it gets to six,
10:01it'll burst and I'll die.
10:04That's, yeah, that's, we knew it was shocking and very, very scary.
10:08So I didn't sleep for those two weeks, to be honest with you.
10:12So the plan today is to fix your aneurysm
10:14using what's called an endovascular stent graft.
10:17Yeah, an arm stent.
10:18So what that is, is it's a series of stents that are all
10:21slightly different shapes and sizes that are assembled
10:24into one piece inside you.
10:26And what that does is it lines the inside of the aneurysm.
10:30It springs up.
10:31Yes, it diverts the blood just below the aneurysm,
10:35keeping it away from the walls of the aneurysm.
10:36The mortality, it's like you don't think about it
10:39until it starts happening.
10:41And then you have, like, friends that, you know,
10:45are losing, like, their parents.
10:47And then you get to really appreciate your own parents.
10:53He's still a big part of my life.
10:56I need him.
10:57Is he staying overnight?
10:58No, he's staying.
10:59I think for a few days, they said.
11:00Yes.
11:01Peter's complex and life-saving surgery is scheduled to take three hours.
11:06Bye.
11:08See you later.
11:09Take care.
11:10Bye.
11:18Yes.
11:24Shea O'Sullivan is three months old.
11:27Today, he will have an operation to try and correct his cleft lip.
11:33Cleft lip is when there's been a failure of fusion of elements of the face in the womb,
11:37and this can leave gaps in the lip.
11:40It's very traumatic in actual fact.
11:43And some people are very shocked at its appearance.
11:46And there's a grieving process through which most parents go.
11:49I remember walking into the anatomy scan, and my personality is always like,
11:55it's going to be fine.
11:56And Connor was like, are you nervous?
11:58And I remember saying to him, about what?
12:01Like, this is fine.
12:03They start from the face and the head down.
12:06And then when they got to his nose and his lip,
12:10I remember the nurse kind of going over the nose and lip a few times.
12:16So, before she even said it, I remember saying, is there an issue?
12:19Can you see something?
12:20And then she did say, there's a gap here that I'm concerned about.
12:26Hi, Lorraine. How are you?
12:27How are you?
12:28And here's her little man. How are you, Shea?
12:30It's unusual to see a baby that age make eye contact
12:34and focus on whoever he's trying to engage.
12:39So, a very charming young man is what I would say.
12:42I'd say they'll have their hands full when he's older.
12:45He'll be breastfeeding, so we'll stop at 4am,
12:48if you want to give a nice comfort feed then,
12:50because we'll be going down early.
12:52We'll have it all ready tonight
12:53that we'll be ready to go down as soon as theatre are ready.
12:56Yeah. That's good. Great.
12:58All ready for it.
13:00You go through probably all the emotions.
13:03You go through, you know, disappointment,
13:05and then you're angry and you're wondering, is it yourself?
13:08But I suppose even the fact of being able to find out in the anatomy scan
13:12did allow me that time to kind of process before he was born.
13:16My husband, Neil, said he was like,
13:18maybe, does he need it done?
13:19And I was like, when he's in college, he'll definitely be like,
13:21why didn't you get that done?
13:23You're very mean.
13:27Lorraine, I'd watch these too, because I might steal your baby.
13:33You mind yourself now. Bye.
13:37It's been a really great old man.
13:39We sure did.
13:42Bye bye.
13:43Bye bye.
13:44That's my favourite.
13:45Oh, thank you.
13:47Bye.
13:48Isn't it amazing that your name is Rose Higgins,
13:51and my name is Frank Higgins.
13:54You might be related to me.
13:56We might.
13:58Have you the White Staff King gone?
13:59Yep.
14:02Peter Crisp has an aortic aneurysm that has grown significantly,
14:05and the hospital team must intervene before it bursts.
14:08Very straightforward.
14:10You both are better than me this morning.
14:12Perfect.
14:13Yeah.
14:15My dad is from England.
14:16All his friends in England were of either Irish descent
14:19or Nigerian or Jamaican.
14:23I've got one little sticker.
14:26All right.
14:28When he came over here, he felt part of the community and more welcomed.
14:33That's how him and mum got together.
14:36So we're just going to do a trial deployment using the simulator.
14:40CUH is a training hospital.
14:42The surgical team today will include young surgeons in training.
14:45A little bit lower, so that's going to be the marker for the top of your fabric on the stent
14:49graft.
14:50We know that Peter's distance from his lowest renal to his aortic bifurcation,
14:56which is the key distance, is about 90 to 100 centimetres.
15:00So off you go.
15:01See if you can put it in there.
15:05I need people that are going to look after me when I'm old.
15:08Well, actually I am old, but when I'm older.
15:10Okay, so just rotate your gate there.
15:12I was very fortunate when I was a young doctor that I worked with some phenomenal people
15:16who spent the time and effort helping me to be able to do this job.
15:21So the least I can do is try and replicate for this group of doctors in training what those people
15:26did for me.
15:27Advancing the graft there.
15:29So what we're going to be looking at here, just stop for a second,
15:33is you're going to be looking at these two markers here,
15:34which we want to try and move over towards the left side.
15:37So you can see, you can see on the device, those markers represent the top of the fabric.
15:42So there's obviously fabric and metal below this.
15:46We won't be covering them.
15:47Specialist Registrar Niamh Hallinan hopes to execute a critical part of today's surgery.
15:51A first for her.
15:55If you look at how medicine is going, there are more females coming into medical school.
16:02Maybe in surgery.
16:03We haven't caught up yet, but we are catching up.
16:05Surgical training is hard for everybody, whether you're male or female.
16:09Pursuing a career in surgery is difficult.
16:13It's a competition from the get-go.
16:15Getting 600 points of your leaving surgery isn't good enough.
16:17You need to have done all the extracurriculars.
16:19You need to have a bit of research done.
16:20Just keep a little bit of forward pressure on there.
16:23So the back piece back then, you'll see it sprang open.
16:26There you go.
16:27Even now I'm thinking about what's the next competition, and that's, you know, consultant job.
16:32And you're thinking, who's going to be looking for the same job as me in eight or nine years?
16:38And what do I need to do to make myself the best candidate?
16:43If you sit on your laurels, you're going to be left behind.
16:45Thanks.
16:56My name is Ayo.
16:58It actually means joy.
16:59That's the literal translation of it.
17:01It's joy.
17:02So the full name is Ayo Bami, which is joy meets me.
17:05Then the variations I've heard is, I owe, you know, I owe you a fibre.
17:13Oh yeah.
17:15Which is, literally, you turned it the other way.
17:18How?
17:19No.
17:24Three hours ago, Patricia was rushed to the CUH emergency department with severe breathing
17:29difficulties.
17:32She is critically ill.
17:34He's torn today.
17:35She's only 50% of her lungs actually working happily.
17:39Yeah, FEC is, yeah, yeah, yeah.
17:41Probably fine.
17:42Yeah, no, no, we have his letters as well.
17:45Yeah, so no, we don't.
17:45She still, unfortunately, had wheeze, despite the fact she'd gotten steroids, despite the
17:50fact that she'd gotten antibiotics, nebulisers, medications, salbutamol, for example, to open
17:55periods, and she still was profoundly wheezing.
17:58And at that point, I was quite concerned, and I actually asked the intensive care unit
18:01doctors to come down to see Patricia.
18:08How long has it been sore like that?
18:11Since Monday.
18:12Since Monday?
18:14Patricia has been in ill health in recent years, dealing with the respiratory conditions,
18:18COPD, vocal cord problems, and bowel issues.
18:22She had an operation in January, a bowel after.
18:29Trish was caring for people.
18:31She's a healthcare worker.
18:32She was good at what she did.
18:33You'd meet offspring of people she looked after today, and they'd meet her and say,
18:38oh, you know, you were very good to mam or dad or whatever.
18:42And, you know, she always looked after people that way.
18:45And she has that caring thing, I suppose, as far as I come into it.
18:49She looks after me too, I have to say.
18:51Now, is your abdomen hurting you now?
18:54Is it sore?
18:55As my colleague said, the general surgery will see you to make sure...
19:01Everything is okay?
19:02Yes.
19:03The team are trying to find the source of Patricia's acute breathing problem and will investigate
19:07all possibilities, including her abdominal pains.
19:12She acts to be strong, but she's not as strong as that at times.
19:16And she has said to me, and Trish says to me from time to time,
19:20I'm sick of being sick.
19:47I don't want you to go from here, but I mean, that's not the point.
19:59Patricia's breathing continues to be challenged, and she is placed back on the BiPAP machine
20:03to keep her lungs functioning.
20:08From being what she was and what she is today, there's no comparison in one sense.
20:14She's not able to do as much as what she was able to do.
20:18Jeez, we walked miles every day.
20:21We've been on cruises, and we were able to walk into cities and walk all around cities.
20:27Like, we were in different, we were in Monte Carlo, we were in Barcelona.
20:31You know, different cities like that, that we'd never been.
20:35And, you know, we had fun, and we had a great crack there, and every night there was music there,
20:40and you could hear her singing away to the music and stuff like that.
20:44You know, we haven't been on a cruise since she got sick, to be truthful.
20:48Trish was out for anything, you know, she'd probably go two nights a week at least, with her buddy.
20:53They were always following music, they wanted music, and there was a karaoke once a week.
21:05She got sick and stuff like that, people are coming up to me and asking me,
21:08how was Trish, we heard she's sick, is she sick again?
21:12And, you know, I'm trying to say, yeah, look, she'd be all right.
21:18It's tough, and there's no other way, it's tough on her and it's tough on us.
21:21It's tough on everyone, to be honest with you about it, because, like, we've got kids here local to us.
21:28You know, it's tough on them, as well, not being able to see her for maybe two or three weeks,
21:33and she's just, you know, she can't do what she could do.
21:41Patricia remains on critical oxygen support while the team continues to investigate.
22:00Peter is having a large aortic aneurysm fixed.
22:03It's a complex operation led by vascular surgeon Greg Fulton.
22:08Registerer Niamh Hallinan hopes to perform a critical part of the procedure.
22:12OK, I'll actually live again.
22:16It's stressful.
22:17I mean, it would be something, like, that I may be worried about.
22:21As part of my training, that's something I need to learn to deal with,
22:24that at some point in the future, I'm going to be the leader in the room.
22:28Just follow it down until you get to the ligament.
22:30Yep.
22:31You've ultimately got patient to look after, and you want to look after them
22:35the same way that I would expect or hope, you know, somebody belonging to me looked after.
22:40So it is stressful, you want the best outcome for them.
22:42OK.
22:44So just go south of that there.
22:52My dad is like a walking encyclopedia.
22:56We call him the oracle.
22:58He's been getting, like, the National Geographic since 1961.
23:03And he's kind of instilled in us the love of different cultures.
23:08And we've always traveled, and we're always very adventurous.
23:11My dad bought a van.
23:14One of the most crazy holidays we went was 1986, during the communist times.
23:20So we drove in the van from Ireland to Poland.
23:24We witnessed communism.
23:25We witnessed people having to queue up.
23:28We saw, like, amazing things as children.
23:31Both my parents, they see the joy in everything.
23:34They kick out of things.
23:36They're always laughing.
23:38Like, I was coming, and, like, the two of them would be laughing.
23:40And I'm like, what did he do now?
23:42And they can't tell me because they're laughing so much.
23:44I'm like, all right, I'm walking up here.
23:49So you can see the top mark there.
23:53At the very top of the screen.
23:55Yeah, so if you look at the mark that's moving on the device,
23:57it's at the second lowest mark, and it's now up at the top mark.
24:01So we want you to just start about there, okay?
24:06And you use your left hand to sort of push slightly in or pull slightly.
24:11That's pretty good there.
24:12I like that.
24:13No, no, just go.
24:14That's fine.
24:17Okay.
24:19And then it's the same as the simulator.
24:21You just deploy it all the way out until the gate is out.
24:25You watch the top dots.
24:26And as soon as it's out, you stop it, you fix it.
24:30And then we deploy the top cap.
24:32And you want me to deploy smacked in like that, yeah?
24:34Mm-hm.
24:34Yeah.
24:35The most dangerous part of the surgery is the deployment of the main body stent.
24:40So you need to be really careful when you're deploying that stent
24:43to make sure that you do not cover the patient's renal arteries
24:46or the arteries supplying their kidneys.
24:48The twist.
24:50Hold on a second, let's get screaming.
24:53Overlay on.
24:54It's check after check after check to make sure that it's okay.
24:58If you deploy the stent and you've covered the kidneys,
25:02it's a total disaster.
25:04So one quick movement, breast movement with the black.
25:07Pull.
25:08Black.
25:10Well done.
25:11Well done.
25:13Fantastic.
25:14Okay.
25:15The biggest point of jeopardy would either be putting your device in
25:18either too low or too high.
25:20Right?
25:21And this will be just the last confirmation that we are indeed in the right place.
25:26Hold on.
25:29Yeah.
25:31That proves that the balloon is inside the graft and therefore our wire is inside the graft
25:35and therefore we're in the right place.
25:37Very good.
25:38So I think it's jobs a good one.
25:40So we get ready to go home.
25:42All right.
25:43That was the first time I deployed a main body stent.
25:46And I was like, I'm happy to do it if you're happy to let me do it.
25:49And he's like, yes, you need to be well able.
25:51I've seen it done a hundred times.
26:01Are you okay to be in the room?
26:03You're not squeamish or lightheaded or anything like that?
26:05Once it's not me, I'm fine.
26:06Once it's not me, you're good.
26:08And you're okay to have her in the room, isn't it?
26:10Yeah, yeah.
26:11Perfect.
26:11I just have to ask that.
26:17Yeah, I'll touch that.
26:18I'm right.
26:19I'm going to hear.
26:23I'm going to wait.
26:24Yeah.
26:25I know.
26:26You can do nothing but wait.
26:29Sixty-four-year-old Sue Cleary has advanced ovarian cancer.
26:33It's her second diagnosis of the disease.
26:36She is in CUH today for chemotherapy.
26:39How are you keeping?
26:39Not too bad, actually.
26:41Good.
26:41I didn't think I'd get another cancer scare, certainly not.
26:45I thought, I've had my breast cancer, I've had the mastectomy,
26:48that's me done, then this one came along.
26:53And that was a bigger shock.
27:00I was getting very bloated in the tummy.
27:04I said to the doctor that I can't stand this any more.
27:08I said, I can't sleep at night with this tummy.
27:11I said, you have to do something.
27:12And he said, I'm going to send you into the A&E in Cork.
27:17And was seen the next morning.
27:19I had x-rays and scans.
27:23And he brought us both into a little room then.
27:25And that's when he told me that I had the ovarian cancer.
27:31Now, Sue, I'm just going to check and see if there's
27:33nice blood return here in the forest.
27:37Oh, yeah.
27:37Yeah.
27:38All right.
27:39Bye.
27:41I said, well, how long have I got?
27:44And it was sort of mentioned that maybe a few months,
27:47maybe a year.
27:50And that sort of panicked me a bit.
27:52And I sort of stunned, you know, just shot silence, really.
28:01Sue's consultant is clinical director for cancer, Durvala Collins.
28:05Sue has, unfortunately, stage four high-grade serous ovarian cancer.
28:10Hi.
28:11Hello.
28:12How are you doing?
28:13How are you feeling?
28:14How's chemo going?
28:14I'm feeling fine now.
28:15I mean, the week after the chemo was, I might as well forget it.
28:20I suppose they're one of the most vulnerable groups of patients that we have in healthcare.
28:24A lot of times they have a diagnosis that's going to, you know, shorten their lives.
28:29The ability to be able to give people, you know, hope and time was one of the things that I
28:34was really drawn to.
28:35In the week after it, like, how, how washed out are you feeling?
28:39Pretty washed out, yeah.
28:40I suppose good days are when, you know, my patients give me a huge hug,
28:45you know, thank me for everything that I've done.
28:47Those are some of the good days.
28:48The bad days are the days that, you know, you have to tell people that the treatments aren't working
28:54or the treatments aren't right for them and that they have, you know, I suppose, significantly limited time.
29:01They are the devastating days.
29:04But you're looking after her, will any of that fair play to you?
29:06That's the hard part of what we do and, you know, it's tempered by, you know, the good days and,
29:13you know,
29:14the good news and the good results, but there is, unfortunately, sometimes in the clinic, more bad news than good
29:20news.
29:21And who brings you up the cup of tea?
29:22Oh, you bring me up the cup of tea, but that doesn't mean I'm sleeping in.
29:25I mean, you're bringing up my tea at eight o'clock. I mean, that's not sleeping in, is it?
29:28Oh, that's lovely.
29:29Yeah.
29:30How long have you been delivering the tea in the morning?
29:34I suppose since her diagnosis, yeah.
29:37Yeah, yeah, yeah.
29:38It would be very good.
29:39It would bring me up the cup of tea.
29:41In 1999, got to know Susie.
29:45We met in the pub and one thing probably led to another because she had been separated from
29:53her husband at that particular stage and, you know, she was attracted to me and likewise I was attracted to
30:00Susie.
30:01So we started to date, as they say.
30:04We got married in 2002.
30:06We never looked back.
30:08I'm going to finish my coffee.
30:11But her recent sickness there has, putting it mildly, has not dissolved for six, you know.
30:19I actually, I like to be a bit ignorant about this because if I knew all the facts, it would
30:24be too frightening.
30:28Later today, Sue will have a further consultation with Durvilla.
30:32She's hoping to receive positive news about a new cancer trial.
30:42I mean, I'd love to be around long enough, well, I hope I'll be, I mean, my daughter's got another
30:47year to go at college and I hope I'll be around long enough to see her graduate.
30:52That's what I'd like to do.
31:09Three-month-old Shea is being prepped for surgery to repair his cleft lip.
31:16It's quite strange to just hand your baby over to a bunch of strangers and know what he was going
31:21through.
31:22Your initial instinct is to just stay with him.
31:26I just had to go away and just, just trust in that they were all going to look after him
31:32and do their best.
31:33Good boy.
31:49Every time a mother hands their baby over to us, it is a big responsibility to take on.
31:56It's quite daunting. You have to focus right in on something much, much smaller.
32:00But there's also this awareness that you could injure or harm this, this very small person very easily.
32:07My younger brother, I was 12 at the time when he was born. He was born with a cleft lip
32:11and palate.
32:13He had feeding issues. I remember my mother being very upset, concerned that he was going to be admitted to
32:20hospital because he wasn't gaining enough weight.
32:23That journey, I saw, was quite difficult.
32:26It's coming in about 11 millimetres. The filter region this side is definitely shorter.
32:32There is a family history, so you felt bad because you knew it was from yourself.
32:38And, you know, nobody wants anything to be wrong with their baby.
32:42Just draw a line vertically up from that. And just take the pin of the needle again, please.
32:48We take multiple measurements and look at multiple landmarks, including the width of the nostril on the normal side
32:55and the height of where the nostril starts, where it meets the side of the lip.
33:01There's a little bit more distortion maybe than I thought initially, but it's out by at least two.
33:10To get the lip sufficiently long, you might have to sacrifice a little bit of lip width, which is not
33:17as noticeable to the eye.
33:18But there's only so much of that you can do until you distort things.
33:24Where is the nostril sitting? If anything, it's low. If we pull the lip in too far, it will push
33:31it up a bit.
33:32So we just have to get it right. Can I have an 11 blade now, please?
33:43Peter has been in recovery for five hours post-surgery for his aneurysm.
33:47How you doing?
33:48Surgeon Greg Fulton and Registrar Niamh Hallinan delivered the good news.
33:52Two small cuts in the groin.
33:54We managed to put the stent up through the aneurysm and exclude it from the top and the bottom.
33:59That's all dealt with now. So the operation went very well.
34:02I go home in the evening and like, I pick up the phone to my boyfriend and, you know, tell
34:06him about my day.
34:07And I'm kind of like, you know, smiling down the phone, explaining what's going on.
34:12Most people don't love their job. And if you did a poll of surgeons, I'd say most people would tell
34:17you they love it.
34:20We'll be keeping a close eye on you over the next day or two.
34:22Perfect.
34:23We obviously hope there's no problems, but our job is to try and anticipate those and deal them if they
34:28arise.
34:29OK?
34:29The kind of satisfaction for that lasts about five minutes.
34:34Because you know that you've got either that afternoon or the next day, you've got another problem.
34:41Or you may have a problem on the ward that you know at some point is going to crystallize out
34:45into being a real problem on the operating table.
34:46So well done you.
34:48Thanks.
34:48OK. Take care. Bye.
34:50Bye now.
34:59Patricia is exhausted and still struggling to breathe.
35:02She has a range of health problems, including COPD.
35:06She is also complaining of abdominal pains and a scan is arranged to investigate.
35:12You don't say, right, look, what do I do tomorrow morning and nobody here.
35:16You know, erm, that I'm not even thinking about, I'll be very honest.
35:23I'm not, that's not even coming into play.
35:26It's, it's not going to happen to possibly me, you know.
35:34It's not going to happen in the story.
35:43Patricia needs to be admitted but requires a critical care bed.
35:47With none currently available, she will remain in the emergency department overnight.
35:53Patricia, I know you're uncomfortable there.
35:56And unfortunately, I have no beds.
35:59At the moment you need a higher level care bed and the desk will be on for us tonight.
36:03All right, is that OK with you?
36:05Yes.
36:24I do get great sense of satisfaction working in theatre when you go in with a trauma case or an
36:31RTA.
36:31The amount of people from anaesthetics to portraiting to surgeons inside the theatre that are there just for that one
36:38person.
36:39Just to keep that person alive on the table.
36:42It's such a kind of an uplifting experience that you say to yourself,
36:47Jesus, look, if that happened to anyone, this is the effort that's been put in to keep that person alive.
36:52Huge, huge. And I'm part of this.
36:58Baby Shay is having an operation to correct his cleft lip.
37:02Slightly more anterior there, that's it.
37:09I remember coming home in the car and thinking, God, I'm going to have to tell my mum that, you
37:15know, my baby has cleft lip.
37:18And I didn't want to start crying, you know, straight away in front of the kids.
37:22Sure, she could empathise straight away.
37:24She'd been through that, even though she only found out when my brother was born.
37:29And the fact of being able to find out in the anatomy scan did, you know, allow me that time
37:34to kind of process before he was born.
37:38It's still quite different, doesn't it?
37:41It's a bit more...
37:43It's the bulk of this, it's just hard to...
37:46Hmm.
37:47It can be quite frustrating because you're trying to match unequal sort of elements.
37:55I can put one little stitch in that.
37:58So this is the sewing machine technique.
38:02The sewing machine technique is like an invisible stitch.
38:05Which is just a trick to get a stitch into deep tissue without having to go through the skin on
38:11that side.
38:12And drawing the nostrils into a more symmetrical position.
38:15By using this trick which we stole from a good old fashioned sewing machine.
38:22The length is beginning to stretch out now.
38:26Looking better.
38:30Shea was a week overdue.
38:32We had chosen not to find out the sex.
38:34But I was so convinced it was a boy that I had even booked a baby boy in for Santa
38:39in Blarney.
38:40That's how sure I was it was going to be a boy.
38:43So I knew it.
38:45First thing that struck me was the head of black hair and that he looked like Connor.
38:49I think I just thought he was beautiful.
38:51And that was his face.
38:53And he was in great form because he slept and he wasn't that hungry.
38:59Nearly better at it than at home.
39:03Yeah.
39:04Yeah.
39:10It's actually superglue.
39:12It is real superglue.
39:13Same thing.
39:18It's going to be too much longer now I'd say before we get caught.
39:21And how long do you spend when you go down there?
39:24This is actually them calling me.
39:26Hello?
39:26No matter how well you think you do the surgery, there are elements that are going to be out
39:31of your control.
39:32And one of them is how that scar heals.
39:35He's in the recovery.
39:36Perfect.
39:37I'll pop down there now.
39:39Yeah.
39:40Great.
39:40Okay.
39:41Thanks a million.
39:49Do you think I'm too old to have another baby?
39:51Is that what you're trying to tell me?
39:54No, I'm 34.
39:54I know I'm okay.
39:56You're the same age as me and I haven't had any.
39:57So no, I don't think you're too young.
39:59I think you're too young to have two kids is what I think.
40:02Sometimes I think with my first child we're actually brother and sister as opposed to,
40:07do you know what I mean?
40:08Oh, I was 25.
40:09I wasn't exactly, do you know what I'm leaving?
40:11But that's what I tell people so they think I'm really young.
40:14That's nice.
40:15Do you know what I mean?
40:21It's been 16 hours since Patricia was rushed to see you here.
40:27It's been a long time.
40:28Nice to meet you.
40:31My name's Kevin Deasy, one of the respiratory doctors.
40:33A precautionary scan has ruled out Patricia's abdominal pains as a cause.
40:38Doctors continue to investigate.
40:44You're very wheezy, huh?
40:46Okay.
40:51Are you able to talk for me?
40:56How are you feeling?
40:59Weak.
40:59Weak, is it?
41:00Yeah, yeah.
41:02How long have you been sick for?
41:05Three weeks.
41:06Okay.
41:06I know.
41:08Patricia has been in ill health in recent years.
41:11As well as her COPD, she previously had operations on her vocal cords.
41:16Any change in your voice over the last week or so?
41:20I know you've got a problem with your voice normally.
41:22Some of those I can't speak.
41:23Yeah.
41:24Normal.
41:25You get periods where you can breathe okay and then suddenly it gets worse again.
41:29It gets very bad.
41:29I talk too much then.
41:30Yeah.
41:31Yeah.
41:32Yeah.
41:33She's an outgoing person.
41:34And she's always talking to people.
41:37You know?
41:37If they're at the meal for a night, I'd say at the right, stop talking.
41:43You know?
41:43And she'd be explaining what happened the night, that night.
41:46Stop.
41:47Stop.
41:48Tell me tomorrow.
41:49Because I can hear in her voice that she's straining.
41:52She thinks that she should be still talking the way she always was.
41:57When's the last time you had your vocal cords looked at?
42:02Yes.
42:03That's the problem.
42:04In the hospital, literally, it was the very same.
42:07She wanted to communicate.
42:08Wasn't able to.
42:10Wasn't telling that, you know, her breathing wasn't as good as it should be.
42:14Which it wasn't.
42:16And stuff like that, you know.
42:19She wanted to get out of there.
42:20And that was the long and the short of it.
42:22So sometimes you can be reckoned with this because of the lungs.
42:24And sometimes you can be reckoned with this because of the vocal cords or your trachea, okay?
42:28So I'm wondering if there's something up here that's going on.
42:31Professor D has got worse and worse.
42:33We've all seen that.
42:35But she's a fighter.
42:36And a big fighter.
42:38She said, you know, I'm so very stupid.
42:41Yes.
42:42And they said that.
42:42And they said it yes to everybody.
42:44Which we wanted to say.
42:45We get us after, here.
42:47This is why.
42:47This is the other.
42:48Get us after.
42:50And we walk from there.
42:51Everything else is.
42:53We will forget about everything else.
42:56Trish, you know, she's not going to give up by no means.
42:59But it's very unfair, I suppose, in one sense.
43:02To go from being very lively, being out, to going, to this.
43:09Socks.
43:12Pillow.
43:18And the other little bits, I suppose, that you see, being kicked away at times, I suppose.
43:25It's hard, the times, all right, those little things.
43:27But Ian.
43:29Nice.
43:33Any viatis, how are you?
43:36Interesting.
43:48Sue has stage four ovarian cancer.
43:51Though receiving chemotherapy, her tumour continues to grow.
43:55Her oncologist, Dervila Collins, is reviewing her case with consultant radiologist Kevin O'Regan.
44:02So on the CT scan here, which was done on the 22nd of March, you can see a large tumour
44:07mass in the anterior abdominal cavity along the omentum,
44:11which has grown quite significantly compared to the previous scan.
44:15So the thickness of that lesion has increased in the few months.
44:18Dervila has identified a new drug that could potentially help Sue.
44:22However, the drug is only available as part of a clinical trial.
44:26We know that this drug on Gloriosa, we know that it can help Sue.
44:31And if this treatment works well with her, we could be looking at adding a year or two to her
44:36survival.
44:36And that is significant.
44:39We don't expect it to unfortunately cure her cancer.
44:44Have a seat.
44:46All right.
44:47As you know, we've got a clinical trial open here in CUH.
44:50This drug has been shown to be of benefit to patients that have high folate receptor alpha in their cancer.
44:59And fortunately for you, yours has high folate receptor alpha.
45:03And so that's why this clinical trial is an option for you.
45:06Best case scenario is that she gets access to this treatment that she couldn't access anywhere else,
45:11and that her cancer responds to it and controls and shrinks for, you know, hopefully a durable and long period
45:17of time.
45:18I suppose the most important thing about a clinical trial is, you know, it has to be right for you,
45:24and that, you know, it has to be something that you want to go down the road, obviously.
45:27Well, I'm looking forward to having a go at this.
45:29Yeah.
45:30And seeing if it works, you know.
45:31Okay.
45:31I want Sue to be able to access this, you know, Mervituximab, Sorventansine,
45:36this, you know, impossibly named treatment.
45:39And if she doesn't get that, we'll be absolutely, we'll be so disappointed for her.
45:43Well, I'm all for it at the moment anyways.
45:45So the chemotherapy that we give in the second...
45:47Like all clinical trials, there are no guarantees.
45:51Firstly, Sue will need to be deemed a suitable medical candidate.
45:55Selection for treatment is then based on a randomised system where 50% of candidates get the drug.
46:0050% do not.
46:04I'm hoping that this new trial that's coming up will give me something to look forward to, you know.
46:13So this is information for you.
46:15Okay, that's good.
46:16My tears are gone.
46:18As such now, it is only getting the show on the road now and getting Sue better.
46:26I'm hoping that Mick and Susie will be together for a good few years yet.
46:33Never give up.
46:34Whatever you do in life, never give up.
46:37That's the one thing I would say to anybody.
46:40Never ever give up.
46:43Could be worse, I suppose.
46:44I'm not going to.
46:45I'm not going to.
46:45I'm not going to.
46:47I'm not going to.
46:49I'm not going to.
46:50I'm not going to.
46:50I'm not going to.
46:50This is Anna.
46:52She's our therapy dog.
46:54Mom is a golden retriever and dad's a poodle.
46:57I think she has her mom's hair.
47:01I like moustache.
47:04I don't want to live next to them.
47:09Hello.
47:10There he is.
47:11Hi.
47:11There you go.
47:12Hi.
47:13I'm hungry young man.
47:17Yeah.
47:18He's been following a procedure to correct his cleft lip.
47:20He seemed happy with the anaesthetics.
47:22No one thought it was all right.
47:23There was no reaction to it or anything else.
47:25Yeah, yeah.
47:26All right.
47:27It was like my initial instinct was, he was crying.
47:31That I just wanted to comfort him and feed him.
47:34So to, and I asked the nurse straight away, would I be able to feed him?
47:38So I just tried to breastfeed him straight away as a kind of a comfort measure.
47:44Yeah.
47:46Don't think he's doing anything.
47:48When he's drinking, he's just kind of chilling out.
47:57The operation has been a huge success.
48:00His lip looks perfect, like it was always meant to be in that position.
48:04What they can do for cleft lips now, it's really, you know, brilliant.
48:09His life won't be any different.
48:14There you go, baby.
48:16Yeah, I know, I'm not taking it away from you, okay?
48:20Hey, darling girl. Hey, baby.
48:33I still want to keep going, you know, for as long as I can anyway.
48:39But Mick could tell me that ten times in three.
48:42Trish, stop talking.
48:44Get your breath, get your breath.
48:46She's a fighter.
48:48We're not going to give up.
48:49I promise that.
48:50And I promised her that.
48:52It's been tough on him.
48:53It has been tough on him, like.
48:54But he's my rock.
49:21But he's my rock.
49:24And he loves keeping my rock.
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