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00:01Midnight, deepest winter.
00:03On the icy steps of a London church lies an 18-year-old girl.
00:08Weak with hunger, she's close to death.
00:12Suddenly, she's approached by a man.
00:15He's been scouring the streets since dusk, looking for someone vulnerable.
00:20He finds the young woman and saves her life.
00:26The year...
00:30is 1742.
00:35This is St Bartholomew's, Britain's oldest hospital.
00:41This hospital has cared for people through the reign of Henry VIII,
00:45through the plague, the Great Fire of London, the Covid pandemic and beyond.
00:51Over nine centuries of scientific discoveries are here at my fingertips.
00:56There's something extremely special in this box.
01:01Now, for the first time...
01:03Oh, wow, okay.
01:04I'll reveal how the breakthroughs of the past...
01:07You've got to see this with your own eyes.
01:09...are helping to write the future of medicine.
01:12I am absolutely blown away by this.
01:16I'll step inside the day-to-day of this state-of-the-art institution...
01:20That is incredible.
01:22...where they've been saving lives and making history...
01:25Oh, wow!
01:27...for nearly a thousand years.
01:29And behind every door is a new secret, just waiting to be discovered.
01:42St Bartholomew's, in the heart of London, admits over 77,000 patients a year.
01:47Your name will go to the top, it will go green, and say,
01:50bay, tube, bay, whatever, and you just go through the double doors.
01:54Its specialist wards have room for almost 300 patients to stay at the hospital.
01:58You see this one here?
02:00Just go and put the brakes on.
02:04BART offers life-saving and life-enhancing treatment and operations to a huge range of people.
02:11Now, for some of them, this is their local hospital,
02:14whereas others come from further afield for the specialist care here.
02:18But for most patients, the journey starts with a referral from their GP.
02:24But it hasn't always been that way.
02:28Let me take you back to Tudor times,
02:32to the mid-1500s when King Henry VIII was on the throne.
02:37When BART had a very different process for admitting patients,
02:41the hospital was tasked with getting the sick off the streets.
02:45People could be referred here from their parishes,
02:49but the hospital was also actively going out into the community
02:53and looking for patients.
02:57And they weren't short of cases.
02:59In the 1500s, diseases were rife in the area surrounding BARTs.
03:05As well as smallpox, tuberculosis, typhus and dysentery,
03:10there were regular outbreaks of the plague.
03:14Finding the sick and bringing them into the hospital
03:16was the job of certain officers called Beedles.
03:21In the mid-1500s, BARTs was employing a team of Beedles,
03:26officers who would go out into the streets of London,
03:29looking for people who needed treatment in the hospital.
03:33Almost 500 years ago, there were only three surgeons at BARTs,
03:38yet the demand for medical care was so great that the hospital employed eight Beedles.
03:43But there were rules on who they could take.
03:45So here's a young man who looks like he's in need of some healthcare.
03:49He's got sores around his lips and then there's more around his nose here.
03:54Now, I'm looking at that and thinking we could help you in the hospital, potentially,
03:59but I really don't want you to infect any of my other patients.
04:02I can't allow contagion into BARTs.
04:05So are you coughing?
04:07OK, you can get on the cart there, we'll take you in.
04:11Back then, if you were rich, you could pay to see a doctor.
04:14But if you were poor and sick, you depended on charity,
04:18especially if what you had was catching.
04:23She's definitely infectious. Look at this.
04:26There are pustules all over her hands and her forearms
04:31and all over her face as well.
04:33I think I'm looking at the face of Pox.
04:37I can't take you in, I'm afraid.
04:40I can't let Pox into BARTs.
04:43Too much of a risk for the other patients.
04:46People with contagious diseases would have been sent to the hospital's outhouses
04:51beyond the city.
04:53Thankfully, today, the doors to BARTs are always open,
04:56with the staff providing world-class care 24-7.
05:02But patients may not realise how close the hospital came to collapse
05:06in the 1500s, thanks to our most infamous monarch, King Henry VIII.
05:12Henry had turned the country upside down, divorcing his first wife
05:17and marrying Anne Boleyn.
05:18He broke from the church in Rome, and he seized land and cash from monasteries,
05:25including St Bartholomew's Priory.
05:27Although BARTs effectively stayed open as a hospital,
05:31Henry had taken away its property, leaving it penniless.
05:36BARTs struggled on for seven years.
05:39Eventually, the citizens of London persuaded Henry to restore its property,
05:45pointing out that sick people were littering the streets
05:48and BARTs could solve that eyesore.
05:51Henry was convinced, and a new charter was drawn up.
05:55Oh, wow, OK.
05:56Amazingly, this extraordinary treasure still survives.
06:00It's enormous.
06:02This almost 500-year-old document is so precious,
06:06it's kept under lock and key.
06:09But today, archivist Kate Jarman is letting me have a look.
06:12This is the actual Tudor re-foundation document.
06:17That's right. This is the charter issued by someone whose signature
06:20is right up here at the top above the main document.
06:23Yeah.
06:24Henry R. That's his signature.
06:26Henry Rex, Rex being king.
06:28He's got slightly wobbly handwriting.
06:30Well, he would have done, because at this stage, Henry was very ill.
06:33In fact, the hospital was lucky to be granted this charter almost,
06:36because it was only granted a few weeks before his death.
06:39Really?
06:39Wow, and that seal has made it through intact through the centuries.
06:44So is this Henry?
06:46Henry or a knight on horseback.
06:48And here's a Tudor rose.
06:50This is an incredibly important document.
06:52Yeah, this lays out the new arrangements for the new hospital.
06:55The need for the hospital is a public health issue,
06:58that there are sick people around the city who need to be cared for.
07:03It's amazing that survived.
07:05Yes, this is one of the most important documents in the hospital archives.
07:09And to keep sick people off the streets, as Bartz had promised Henry,
07:13this is when, in 1547, the role of the beadle was created.
07:19At the time of the beadles, the hospital employed just 30 staff.
07:23But flash forward to today, and there are 3,000.
07:28Okay, my dear, when you've had your treatment,
07:30someone will come and take you back up to the water, okay?
07:32Look after yourself, okay?
07:34James Conroy is one of Bartz's 40 porters.
07:37He's going to turn you around.
07:39Transporting patients around the hospital.
07:41We are ready to go.
07:43And he's famous for his speed.
07:46I'm fast and furious all around the hospital,
07:48so my nickname is Rocket.
07:52Are we going to go the quick way?
07:53That's the way I am.
07:54Where are we going?
07:56He's got to be fast and furious all the time.
07:59He's fast.
08:00Trying to catch him up.
08:05Every day, James moves up to 30 patients and covers five buildings,
08:09playing a vital role in keeping the hospital running.
08:12Every single job that you do, you treat it as an emergency.
08:16Just going to pull your curtain back?
08:17Because anything can happen from A to B.
08:19Are you warm, love?
08:20It's not about the money, it's about you and your heart.
08:24Do you want a blanket over here?
08:25No. You sure? Yeah.
08:26OK.
08:27James' role dates back to the early days of the hospital.
08:31In the 1400s, Bartz had just one porter.
08:35He lived by the entrance gate
08:37and was in charge of checking who came in and out.
08:40By the 1800s, the job had grown to managing the water pumps
08:45and coal supplies
08:47and ensuring all the hospital lamps were lit at night.
08:51That's all right, thank you. Thank you very much.
08:55As a modern-day porter,
08:57James doesn't just whisk patients around the hospital.
09:00My next job is blood.
09:03So we're going to second floor.
09:05He also collects vital supplies.
09:08Today, it's platelets, a component of blood,
09:11from the blood transfusion unit.
09:13Hello.
09:15Come to get a platelet, please.
09:17Thank you much. Thank you.
09:19All right, now we're going back to the ward.
09:22We're going to take it to 5C.
09:28So you've got to get there in a minute of time
09:30because it's critical for the patient.
09:33The patient could be bleeding, could be dying.
09:36So you've got to get there as fast as possible.
09:40Hello, I've got a platelet for you.
09:42He's known for his speed.
09:44Thank you. Have a nice day.
09:47The swift delivery of blood to treat patients is a routine process at the hospital today.
09:53But 400 years ago, people were rather confused about blood and how it moved around the body.
09:59They had ideas that the arteries carried air, not blood.
10:02Until an incredible discovery by a Bart's doctor paved the way for modern medicine.
10:08Also coming up, I'll be getting close to some bloodsuckers.
10:12Here's a nice piece of liver for you little leeches.
10:15I think he's feeding.
10:16And I'll discover the extraordinary story that Bart's had immortalised in glass.
10:21It's so luminous.
10:32Across a lifetime, a human heart will beat an incredible two and a half billion times.
10:38From the first contraction in the womb at around four weeks,
10:41to the very last pulse at the end of a life.
10:45The heart is a dependable workhorse.
10:49But when it does fail, Bart's is here to help.
10:54Over its long history, Bart's has been the birthplace of some pioneering medical discoveries.
11:01Especially in understanding how our hearts function.
11:05For centuries, people tried to work out how the heart and the circulation worked.
11:10And they came up with all sorts of weird and wonderful theories.
11:14They had ideas that the arteries carried air, not blood.
11:18That there were tiny holes and the blood flowed from one side of the heart to the other.
11:22Or that the heart pumped out blood and then somehow blood was magically regenerated in the liver.
11:29So, all this confusion.
11:32And then suddenly, there was a breakthrough.
11:36This breakthrough happened around 400 years ago, courtesy of Bart's most famous doctor, William Harvey.
11:45In the early 1600s, when William Shakespeare was writing the likes of Hamlet and Macbeth,
11:51Harvey was away in Italy studying medicine.
11:55He was obsessed with discovering how blood moved around the body.
11:59When he joined Bart's in 1609, he was experimenting on live animals.
12:05Dogs, eels and even wasps to watch the heart pumping.
12:13Fortunately, today we have less brutal ways of observing a living heart.
12:18Hi Alice.
12:18So, I'm going to be a guinea pig.
12:20So, today we're going to do the scan of your heart.
12:23With some help from cardiac physiologists Delphine Encarnacion and Florence Lorenzo.
12:29Just going to be a bit cold.
12:31All right.
12:32Florence is going straight to the four chamber images.
12:35Straight in. There's my heart.
12:38Invented in 1953, 375 years after William Harvey was born,
12:44an echocardiogram uses sound waves to create moving images of the heart and blood vessels.
12:51It's something Harvey could only have dreamed of.
12:54This is the right side of the heart and the left side of the heart.
12:57And the apex is at the top of the image.
12:59Correct, yeah.
13:01And then your right atrium here.
13:04Despite having worked as a doctor and an anatomy lecturer,
13:07looking at my own heart gives me a thrilling glimpse of this incredible organ in action.
13:14Four chambers pumping away with valves to keep blood flowing in the right direction.
13:20You know, I know this anatomy so well, but there's something really quite mesmerising and impressive
13:26about seeing it in real time.
13:29And I bet William Harvey would have loved to have seen this.
13:32I mean, my goodness, it would have blown his mind.
13:36But Harvey wasn't just interested in the heart.
13:39He wanted to find out how blood moved around the body.
13:44He knew that veins had valves in them.
13:47And he thought that might be to keep blood flowing in one direction.
13:51So he conducted some experiments on beefy farm workers who had big veins.
13:56He saw that by putting pressure on their veins and then releasing it,
14:00the blood flowed in one direction towards the heart.
14:05After a decade of painstaking research, in 1628, William Harvey finally published his revolutionary discoveries.
14:14I've come to the Royal College of Physicians to see a truly extraordinary treasure of medical history.
14:22Oh, there's something extremely special in this box.
14:27And it is a first edition of Harvey's book.
14:33I lift it up very carefully.
14:34This always feels like such an amazing privilege.
14:40Published in 1628.
14:46And at this point, he's worked as a physician at Bart's.
14:50He's worked as an anatomy lecturer, rather like me, although I never made a breakthrough like this.
14:59Oh, look at that.
15:02So here's one of the most famous illustrations from this book.
15:06And Harvey's demonstrating that if you empty the veins just by the pressure of a finger on the vein,
15:12you can work out which way the blood is flowing along that vein.
15:16So he's working out that the blood is coming from the tips of the fingers back up the arm.
15:22This is absolutely crucial.
15:26It's about the motion of the heart and the blood.
15:32It may seem simple, even obvious to us nowadays,
15:36but Harvey's work overturned theories that had held sway for centuries.
15:41So this is really important because he's saying that the blood is constantly circulating.
15:47It's a phrase that we just throw out now as though we've always had that knowledge
15:52that the circulation is circular.
15:57I would like to have met William Harvey.
16:00I would love to just travel back in time to the 17th century
16:05and walk into Bart's hospital and go and talk to him.
16:09He's there at such an interesting time in medicine.
16:11You know, people are really starting to challenge all those classical ideas of medicine.
16:16And I think there's something really, really important in this book,
16:20which is about the fact that if you want to understand the human body,
16:25you can read what other people have written.
16:28But if you really want to know, you've got to look at the body itself.
16:33You've got to see this with your own eyes.
16:36It's so powerful to see the real thing.
16:39But yeah, I would love to have met him.
16:45Flash forward 400 years, and today, William Harvey's amazing discovery is making operations for patients like 65-year-old Edith
16:54Pugh possible.
16:55Two months ago, while out and about, Edith experienced a sudden and sharp pain in her chest.
17:01It was caused by a large tear in the main artery carrying blood from her heart.
17:06It's a life-threatening condition.
17:09She's travelled from Belfast with her family, including son Will.
17:13She's a go-getter. Like, the woman never stops.
17:16She's always on the go. She loves her hill walking.
17:19She loves shopping. She loves just being out and about.
17:22So, it's something that none of us will ever expect, and it just, it's a shock to the system, for
17:28all of us.
17:31Today, Edith will undergo an incredibly complex operation that could take up to 10 hours.
17:38Her consultant is Professor Ong Ou, a world-renowned heart surgeon and clinical lead at Barts.
17:50Professor Ong Ou is one of only a handful of people in the world with the expertise to treat such
17:56a challenging case.
18:00Edith has a tear in her aorta, the largest artery, carrying oxygen-rich blood from the heart to the rest
18:08of the body.
18:09This damaged section supplies blood from the heart to the kidneys, liver, stomach, bowel and spinal cord.
18:16So, it's vital it's repaired quickly.
18:19Professor Ong Ou's plan is to replace the torn aorta with a synthetic substitute.
18:26It is a very dangerous operation.
18:28It's one of the most complex operations that you can perform in the aortic surgery.
18:33Too many things can go wrong with the ACE operation.
18:35So, it is a big privilege, as well as a big pressure on my shoulder.
18:42Good morning, everybody.
18:44These operations are quite long operations.
18:46And you need to prepare mentally.
18:51All ready to go?
18:53I'm ready.
18:54Playing a vital role in this incredibly complex procedure is Pete Reeves, a perfusionist.
19:00My colleagues, they just say, where's Pete the pump?
19:04Today, Pete the pump is using a heart-lung machine.
19:09The machine will divert Edith's blood out of the left side of her heart, bypassing her damaged aorta and allowing
19:17Professor Ong to remove it.
19:19Pete will then pump the blood back into Edith's body through the femoral artery in her leg.
19:26This whole miraculous process is only possible if you understand how the circulation works, thanks to pioneers like Harvey.
19:34It makes it possible for Professor Ong to replace her aorta.
19:38Basically, we're here to supply the surgeon with a clear bloodless field in which to work.
19:44Edith is now under general anaesthetic, and after two hours of prep, the surgery can begin.
19:50Trying to remove the tiny bit of this thing there.
19:53With the blood flow to the lower body and spinal cord being provided by the perfusionists, Professor Ong can start
20:00the procedure.
20:01Clamping the lower thoracic.
20:03Lower thoracic.
20:04Opening the aorta.
20:06Maybe a bit of blood.
20:09This will be the artificial aorta to replace her.
20:13This synthetic aorta is made from a type of polyester material that's also used in upholstery and soft toys.
20:21Replacement aortas date back to the 1950s, when the first synthetic grafts were successfully used in surgery.
20:31In modern medicine, doctors often need to get blood into a patient.
20:36But historically, they were just as concerned with getting blood out of them.
20:42Bloodletting, intentionally removing blood from a patient, was believed to help rid the body of excess blood to rebalance it.
20:50It's been done for thousands of years, and was practised up until the late 1800s, as a way to prevent
20:56or cure illness.
20:58Including here at Barts.
21:00And one of the most common tools for extracting blood used to be found in a long forgotten corner of
21:06the hospital.
21:08Just round here was where the apothecary shop was, where you could pick up various remedies, pills, medicines, and something
21:16a bit more alive.
21:20By meeting archivist Ginny Dore Woodings to investigate the bloodsuckers of Barts.
21:27Ginny, that's got to be among the largest books that you've got in the archive, surely.
21:31It's definitely up there.
21:32A Count of Drugs, it says.
21:34Yeah, so this covers the 1860s to the 1890s.
21:37Okay.
21:37And it's got big lists of everything that you might need to run a pharmacy shop.
21:42So it includes all your herbs, your alcohols.
21:44Brandy.
21:46More brandy.
21:48A lot of brandy.
21:50All very intriguing, but I'm looking for something more wriggly.
21:54So Herudo Medicinalis is the medical leech.
21:57Absolutely.
21:58So yeah, and this is where you start to see the amounts they're buying per week, and how much they're
22:02paying, and the dates that they're buying them on.
22:04That's strange that they're listed in the pharmacy.
22:06In the way that you would give someone some pills, you might give someone some leeches to treat them for
22:10various things.
22:11Leeches were used to treat a wide range of conditions, from inflammation to headaches.
22:17And the word leech itself goes back even further.
22:20It comes from the Anglo-Saxon word for doctor.
22:25So where did they come from?
22:26In the 1700s, you would buy them off people who, particularly women and children, who'd go and wade in boggy,
22:32marshy areas and get them attached to their legs, and then bring them and they'd sell them.
22:35People were wading into rivers as bait themselves.
22:40Yeah.
22:40So how many leeches? Hundreds, actually. Each of these orders is 100.
22:44Yeah, every couple of weeks and buying 100 a dime.
22:47So 1,100 leeches in 1891.
22:50Might seem like a lot, but 50 years earlier they were using much, much more.
22:53Really? Yes.
22:54Letters from the hospital treasurer reveal the height of Bart's leech mania.
22:59By 1837, you're getting 96,300.
23:04No, in one year?
23:06Yeah.
23:06So almost 100,000 leeches being used every year.
23:10By the late 1800s, this love affair with leeches had come to an end.
23:15But I'm keen to see one in action.
23:17So I'm meeting medical historian Leslie Smith.
23:21So you've got the leeches and I've got their dinner.
23:23You have.
23:24Right.
23:25So...
23:25Got some tweezers.
23:26Let's see what they do when we drop it in.
23:29Here's a nice piece of liver for your little leeches.
23:35Absolutely nothing.
23:37Look.
23:38Oh, no.
23:38What's he doing?
23:39I think he's feeding.
23:40He is.
23:41He's attached.
23:41Yeah, he's on it already.
23:42Yeah.
23:43Look, this one's thinking.
23:44How do I get there?
23:45Oh, here he comes.
23:46Look.
23:47He's making his way over.
23:49A leech has around 100 sharp teeth across three circular sets of jaws.
23:56Fortunately for the patient, having a leech latch on is pretty painless as their saliva contains substances that numb the
24:03area.
24:06I think they've actually sucked the blood out of it.
24:08Shall we stick in another piece?
24:09Then we'll be able to see.
24:11Oh, it's much pinker.
24:13Yeah, look at that.
24:13Look at that.
24:14Difference in colour.
24:15And apparently they can take five to ten millilitres of blood.
24:19And if you think about a medicine spoon, you know, it's usually five mil.
24:22Well, they can take up to twice that amount, which considering their size is remarkable.
24:27It is.
24:28That was a very good experiment.
24:30It worked.
24:30There.
24:33Coming up.
24:34Now we're going to remove this clump.
24:37Five hours into Edith's operation and her new aorta is in position.
24:41Okay, move in the distal clump.
24:43Okay.
24:44A life-saving donation from a son to his mum.
24:47He feels quite proud he's doing it, I think.
24:49And my needlework is put to the test.
24:52Okay.
24:53So we've made a start.
24:54As I learn all about the origins of suturing.
24:57What have I done?
24:58Right, I'm starting again.
25:07St. Bartholomew's Hospital in central London is home to the world-leading Barts Heart Centre.
25:15Two days ago, 65-year-old retired mental health support worker Edith flew over from Belfast.
25:22The patient's doing fine.
25:24They're quite stable throughout the neuromonitoring.
25:28Okay.
25:29After five long and challenging hours in theatre, Edith's torn aorta has been replaced with a synthetic one.
25:36I know it's been a long day for everybody.
25:38Now Professor Wu needs to check whether it will function correctly.
25:42Now we're going to remove this clump at the lower end, allow the blood to come back into the growl
25:48and see any bleeding from this joining.
25:51Okay.
25:52Now off the heart-lung machine, Edith's heart is pumping blood through her new aorta and around her body.
26:00Centuries of medical discoveries have come together to provide this life-saving treatment for Edith.
26:05Everybody has a role to make sure this operation is successful.
26:11As one of only a few experts pioneering this cutting-edge surgery, Professor Wu has learned ways to cope with
26:17the responsibility of his role.
26:19The job that I do involves quite a lot of high pressure, so it is important to have a time
26:26where you can rest and relax and having some solitary moment to reflect and then rejuvenate to carry on.
26:37Professor Wu was born in Burma, now Myanmar.
26:41His father was the country's first heart surgeon.
26:44He followed in his footsteps, but also learned a valuable skill from him.
26:48My father was very keen for meditation, and then he asked us as children to start meditation quite early on.
26:58As he gets older, I understand that the value of it, I can concentrate in the middle of all the
27:05things going on with all the noises and all the stressful kind of scenario going on.
27:10And then focus my mind and then complete the task without having to be distracted a lot.
27:16The surgery has gone well, but it will take the team another two hours to stem any bleeding and close
27:22up Edith's chest.
27:25Meanwhile, Professor Wu calls Edith's family.
27:28So the operation was successful, everything went fine as we expected, so we would let her sleep.
27:36Whenever a patient has an open wound, whether it's the result of complex surgery like Edith's, or from a minor
27:43injury, the tissue usually needs to be stitched together to allow it to heal.
27:50Stitching wounds, or suturing, is something I did back when I was a doctor.
27:54It dates back thousands of years.
27:57The first mention of suturing comes from the world's oldest known surgical textbook, the Edwin Smith Papyrus, written over three
28:06and a half thousand years ago in ancient Egypt.
28:08It describes how to treat a variety of wounds, drawing the edges together by stitching.
28:15Over a thousand years later, in the sixth century BCE, pioneering Indian surgeon Shashruta wrote a guide to suturing techniques.
28:25One way involved using large ants to bite the edges of a wound together like staples.
28:31I want to learn more about these ancient methods, and maybe even have a go myself.
28:36OK, so it's rather a long time since I've done any suturing, so I think I need a bit of
28:41a refresher.
28:42Glad to help.
28:44Cardiologist Stephen Hampshire is on hand, and I'm hoping there are no ants involved.
28:49Suturing's been around now for many, many, many years, using like hair of horses and things like that along the
28:54way.
28:55But obviously, trying to get into the wound, they had to use many different types of needles.
28:58Yeah.
28:59Including things like bone needles, which are very used for a long time.
29:02Oh, they're chunky.
29:03Yeah.
29:04I wouldn't like to be stitched up using one of those.
29:06No, so over time got much smaller.
29:09Almost 2,000 years ago, the Roman physician Galen described using needles like this, and something called catgut, to stitch
29:18the wounds of gladiators.
29:19The use of catgut survived until the 1990s, but no cats are actually involved.
29:26It's basically the byproduct or the gut of large animals such as cows.
29:31So it is gut?
29:32It is gut.
29:32It's just that it's not cat?
29:34It's not cat.
29:34OK.
29:34The reason behind why it was so good is the body actually absorbs it back into itself, so it will
29:40dissolve in the patient itself.
29:42Nowadays, sutures are mostly made from synthetic polymers, but despite advances in materials, many of the methods described by Galen
29:51are still used by surgeons today.
29:53Time for me to have a go.
29:55So this is the kind of suture that Galen would have done going back 2,000 years?
29:58Yes.
29:59Exactly the same as he proposed.
30:00What we're going to do is do a continuous suture from this end of this cut all the way down
30:04to the other end.
30:05OK.
30:06Nice bit of skin.
30:07Go down.
30:08Use your forceps to the other side to take off the needle and pull through.
30:15OK.
30:16Perfect.
30:16So we've made a start.
30:18Made a start.
30:18Now what we need to do is make sure that it's secure.
30:21So what we're going to do is a surgical knot.
30:22Used since at least the first century, surgical knots are vital for keeping stitches in place.
30:28There are several different types of knots and tying one is a skill that can take years to master.
30:34It's part of every medical student's training in the UK.
30:38And this is why, Stephen, I became an anatomist.
30:42What have I done?
30:43Right, I'm starting again.
30:44Yep.
30:46Pull it through.
30:49So now, that is nicely stuck.
30:52So now we can get the needle back in our forceps.
30:54And now go diagonal across and just go through like we did before.
30:59Out the other side.
31:02And pull through.
31:07Oh, it pulled through.
31:08It pulled through, look.
31:09Yes.
31:10I've gone too close to the edge and it's pulled straight through.
31:13What do I do now?
31:14So the choices are...
31:15Clearly, I'm a little rusty, but it's extraordinary to imagine gladiators 2,000 years ago being sewn up with these
31:22very same techniques.
31:2326.
31:24Have I passed?
31:24You've passed.
31:25Not bad for the first time in how many years now?
31:2726.
31:28Not bad at all.
31:29Not very much.
31:32Okay, just going on the ground floor.
31:34Just a nice smooth ride.
31:36At Bart's Hospital, ancient medical techniques sit alongside very modern ones.
31:42Bart's is a centre of excellence for treating blood cancer, a disease that 40,000 of us are diagnosed with
31:49every year.
31:51Dr. Heather Ockovey is a consultant haemato-oncologist leading Bart's pioneering department.
31:57Hello, Lynn. How are you today?
31:59All right.
32:00So I look after patients with a variety of different blood cancers.
32:03The cells you collected yesterday will probably be the same volume.
32:07So we've had great fortune in haematology over the last few decades,
32:11whereby we've been able to make massive improvements in patient care because of scientific advancements.
32:18How long have we been looking after you here?
32:2015 years.
32:22Yeah.
32:23But it's the best hospital going.
32:27One of Heather's patients is Lorraine Gunn.
32:30She'd been feeling unwell for a few years.
32:34I had aches and pains.
32:36You know, you were sure could it be menopause?
32:38Could it be this?
32:40But, um, yeah, I wasn't expecting cancer really.
32:43So I've been on a bit of a roller coaster since then.
32:46Hi, Lorraine.
32:47How are you today?
32:48Not too bad, thank you.
32:49So Lorraine has a condition called myelodysplastic syndrome.
32:51The bone marrow cells do not make blood properly.
32:54Bone marrow is the soft tissue inside our bones.
32:59Much of it is yellow and is mostly fat.
33:02But some bones around the centre of the body contain red bone marrow, which makes blood cells.
33:08But Lorraine's bone marrow makes faulty blood cells.
33:11And she's at high risk of developing leukaemia.
33:15Have you had your chemotherapy yet today?
33:16I'm having it at the moment.
33:17Heather's plan is to destroy Lorraine's bone marrow and then use cells from a donor to help her make healthy
33:24blood.
33:25The process is known as a bone marrow transplant and it has its roots in World War II.
33:31Doctors studying radiation sickness discovered that high levels of radiation damaged bone marrow
33:37and that a transplant could restore the blood cells.
33:40The first successful bone marrow transplant was done in 1956 by Edward Donald Thomas on a leukaemia patient with their
33:49identical twin as a donor.
33:53Usually we'd use a fully matched sibling, but Lorraine didn't have a suitable fully matched sibling.
33:59But fortunately, Lorraine's 27-year-old son, James, who works for the Crown Prosecution Service, is a good match.
34:09James is feeling a bit trepidation.
34:13And I think he thought if it goes wrong, it's something to do with him.
34:16So we've been trying to sort of say to him, it's nothing to do with that.
34:18You've given me a chance.
34:19You know, you've given me hope.
34:20Let's try to relax.
34:22The first stage in the process involves James giving blood.
34:27Among the many cells in blood are some very special ones called stem cells.
34:32These have the ability to transform into many different cell types.
34:37So far, so good.
34:39Lorraine's daughter, Catherine, is supporting her mum and brother.
34:43We don't know how this is going to go.
34:44We can hope for the best.
34:46And we are hoping for the best.
34:48We've also not really had cancer in our family before, so it's quite, yeah, a shock in that sense.
34:54I mean, James doing this as well.
34:57We always laugh that he's a bit of a mummy's boy.
34:59And I think now he'll be definitely get the spot as the favourite child.
35:04James's stem cells are transferred into Lorraine's bloodstream.
35:08They'll move into her marrow and start producing healthy blood cells.
35:12I'm quite excited, really.
35:14It was a very nice thing that he's doing for me.
35:17So, yeah, great gift, really.
35:21But he feels quite proud he's doing it, I think.
35:25Yeah, nearly done, isn't it?
35:27Woo-hoo-hoo!
35:34St Bartholomew's Hospital is known for its world-class care and state-of-the-art facilities.
35:41But much of this modern hospital exists inside buildings that date back centuries.
35:48The Grade 1-listed North Wing, designed in the 1720s, has never had a medical function.
35:55It housed the hospital clerks and meeting rooms.
35:59For the past 18 months, it's been undergoing major restoration.
36:03And that's included the most spectacular part of the building.
36:09The Great Hall.
36:12The Great Hall was the jewel in Bartz's crown.
36:16It was a venue for lavish events to tempt generous benefactors into donating to the hospital.
36:23To bring the hall back to its former glory, the team have carefully repaired the panelling,
36:28meticulously restored the plasterwork and re-gilded the ornate ceiling.
36:36Its 36 sash windows dating back 300 years have also undergone conservation work.
36:44Steve Logan is one of the restoration specialists.
36:48The process of each window basically is to get the new wood to look old
36:53and the old wood to look a bit newer.
36:55Now, when you look at this, you can see those are brand new.
36:59That's actually a brand new bit of oak.
37:01So we've got to condition that so it looks as if it's 300-year-old.
37:07So it's filling, it's rubbing down, it's coating up.
37:10So you're talking on each window between eight coats of paint, outside and inside.
37:16It's great getting a hold of something that somebody else would put in a skip
37:20and you do the job that you do it to get it looking like that again.
37:23I absolutely love it. I love the job. I absolutely love the job.
37:28The great hall's windows filled the space with daylight, but in the 1700s that light came at a premium.
37:36King William III began taxing people according to how many windows they had.
37:41The tax was aimed at the wealthy owners of bigger houses.
37:45To avoid paying up, homeowners bricked up their windows, a site that can still be spotted today.
37:53And this tax may have inspired the phrase daylight robbery.
37:58Luckily for Bart's, with its many windows, the tax was repealed in 1851.
38:05Coming up.
38:06Wow.
38:07Yeah.
38:07Isn't it fantastic?
38:09The most treasured window at Bart's scrubs up nicely.
38:12Faces are incredible actually, especially looking at the face of Henry VIII himself.
38:17Edith's on her way home.
38:18Let's go. Let's go.
38:20It's her first time actually getting a bit of sunshine, getting a bit of air under the lungs.
38:24But the road is not quite so smooth for Lorraine.
38:27She had a nasty bacterial infection during her transplant.
38:41St Bartholomew's Hospital in the heart of London admits around 248 patients a day onto its 20 wards.
38:49As well as doctors and nurses to look after all those patients, essential services and utilities have always played a
38:57vital role.
38:58A hospital needs a water supply.
39:01And Bart's was ahead of its time.
39:03In 1433, it had its own piped water.
39:08The water flowed through wooden pipes into a cistern.
39:12And in fact, it was a bit unreliable.
39:14So then a well was dug right here in the centre of the courtyard.
39:19And a pump was installed in the 1700s.
39:21So you can imagine that this would have been a very busy space with people coming to collect their water.
39:27But not everyone was a fan of this pump.
39:29Charles Dickens wrote about it.
39:31He said, in the centre of this space, there's an ugly circular pump.
39:36It looks like a slice of an old worn out steam boiler with a lamp on top.
39:42And in 1859, this ugly pump was torn down and replaced with this rather beautiful fountain.
39:51The courtyard with its fountain became a place for patients to convalesce.
39:56And it's still a focal point of the hospital.
40:01Paying it a visit today is Edith.
40:04She's accompanied by her son, Will.
40:08First time in four weeks, can I say?
40:09Let's go.
40:12A month since undergoing major surgery, Edith has made remarkable progress.
40:18The last time she was here, she was just coming out of the ambulance.
40:20So it's her first time actually getting out and getting a bit of sunshine,
40:23getting a bit of air under the lungs.
40:25In two days' time, Edith and her new aorta will be travelling home to Belfast.
40:30Can't wait to get home.
40:32It's been a long journey, but we've got here finally.
40:36The hospital is just incredible.
40:38The staff, everything, we've treated so well since she got here.
40:41It gave us peace of mind too, knowing that she was here and she was being well looked after.
40:48Across the courtyard in Bart's historic Great Hall,
40:52specialist conservators continue repairing the windows.
40:56One of them, the charter window, is so precious and complex,
41:00it was taken off-site for several months for restoration.
41:05Brilliant.
41:08That's the charter window.
41:10Oh, wow.
41:11Yeah.
41:12Isn't it fantastic?
41:13It's beautiful.
41:14I'm so lucky to be one of the first to be let into the Great Hall
41:17to see how it's been brought back to life.
41:20It's so luminous.
41:21Yes, it's been away for a year as well on its conservation journey.
41:26Heritage and Health Engagement Manager Caroline Hampson is decoding it for me.
41:31And there he is handing a document down.
41:36That is the Royal Charter.
41:38So that's the re-founding charter, which is how the window gets its name.
41:42Oh, that's amazing.
41:44The charter window is a 17th century depiction of one of the most important moments in Bart's history.
41:51Henry VIII closed Bart's Priory, taking away the hospital's income.
41:57Fortunately, he was persuaded to return its money-making property,
42:00and in 1547, a new charter protecting the hospital was drawn up.
42:05And it's got his great seal, hasn't it?
42:07Yeah.
42:08That's his great seal hanging down underneath it.
42:10Yes.
42:10That's amazing.
42:11He looks quite healthy there, doesn't he?
42:13With his son next to him there on the right-hand side.
42:17So that's Edward.
42:18Oh, yes.
42:19And his purple cloak.
42:20You can see it's been repaired quite a few times.
42:23Absolutely.
42:23Henry did have two large pieces of lead work across his face, which distorted the image.
42:30So if you can just see on his left eye there...
42:32There is a crack coming down.
42:33So they removed that old lead, once they were sure that it wouldn't obviously damage the glass,
42:39and fixed that back together so he just looks beautiful.
42:43The faces are incredible actually, especially looking at the face of Henry VIII himself.
42:47He does look very benevolent.
42:49He does look very benevolent.
42:50I mean, it's very lovely of him to re-found the hospital, having confiscated all its lands to begin with.
42:58Yes.
42:58But he did give it back, and it has been serving the community for the last 900 years.
43:04Yeah, yeah.
43:06Back in the King George V building, there's been some good news for blood cancer patient Lorraine.
43:12Today I'm going home.
43:14Yay!
43:15After a month and two days, I'm going home.
43:18All the best.
43:19Thank you very much.
43:19Yeah?
43:20You're welcome.
43:20I'm quite overwhelmed actually.
43:23Yeah.
43:24I've been quite cool all the way through it, but yeah.
43:27Yeah.
43:29I thought she'd be home.
43:32Since receiving her son's stem cells, it's been a touch and go recovery.
43:38Lorraine's blood count recovered a few days ago, having been very low for a week or so.
43:43She had a nasty bacterial infection during her transplant, but she's completed her quite long course of antibiotics for that.
43:51So she's well and good to go home today.
43:54It's gone openly.
43:55It's always good to go home, isn't it?
43:57Own bed.
43:58And food, yeah.
43:59Be lovely.
44:04Next time, I discover the uncomfortable truth of what happened when the plague came to Barts.
44:10The two physicians just left town.
44:12Who is left running the hospital?
44:14And I reveal how the work of a pioneering World War One surgeon
44:18He's gradually restoring his face. Look at that.
44:22Paved the way for cutting edge operations at Barts today.
44:25The very last stitch is going in.
44:27So I'll be happy with how she looks.
44:32And that's brand new.
44:33Our hospital through time next Wednesday at 8.
44:36What does a country with a population of 1.4 billion look like?
44:40Alexander Armstrong explores ancient and vibrant India in a brand new adventure tomorrow at 8.
44:45Next is either a miracle or a disaster, says brain surgeon Omar when describing each operation.
44:50We follow him brand new after the break.
44:53The only two people in the cake.
44:56And that's why I have been so overwhelmed.
44:57Okay, cool.
44:57What will a place for you?
44:57Before we see you,ïżœ suggesting the recording is an idiot bar.
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