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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 this series
00:49was 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 that 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 R for me?
01:31R. Perfect.
01:32Let's go a little bit further down.
01:34So you feel a bit of a tickle there?
01:35Uh-huh.
01:37Say E.
01:38E.
01:39O.
01:40O.
01:41There you go.
01:41So good cold movements there.
01:43And there probably is a little bit of oedema there, but I don't see blood.
01:54How many BiPOPs are concerned?
01:57BiPOPs are concerned.
01:57Why do you want BiPOPs there?
01:59Good-in-lady coming in from Mallow, Trisha Murphy, 62, severe COPD.
02:03In here?
02:03It's not like, can you just come in to reach us?
02:05Yeah.
02:05Yeah?
02:06Okay.
02:08Patricia 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 going for her, the first thing I could see is
02:24that she looked scared.
02:25She looked 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,
02:48which still has very elevated work of breathing.
02:51Breathing 30 plus times a minute, very wheezy, and then struggling to breathe full sentence.
02:56That is very dangerous.
02:57Do you have pain anywhere at all?
02:59Chest.
02:59You're just breathing with you 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.
03:08All right?
03:09It's like gusts of air in.
03:10Because she was so wheezy, we were trying to open her lungs.
03:13So we placed her on the BiPAP mask, and that's bi-level positive air pressure.
03:19Okay?
03:20When the patient is taking a breath in, as can be sensed by the computer,
03:24then extra air gets 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 your lungs.
03:32It's going to open everything up.
03:34All right?
03:35So in about 20 minutes time, things will be much quieter, much less noise.
03:40All right?
03:43I dropped her up for 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.
03:57And next thing, a man answered it.
03:59And 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 is after having an episode or whatever you want to 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.
04:14OK?
04:16But it is really good.
04:17All right?
04:18And they said, oh, right.
04:20Fuck.
04:21I ain't going to get up there.
04:23I ain't going to be panicking in.
04:24Come on.
04:26And she does, I mean, this is obviously post-hide of course, but she does have...
04:29OK.
04:35Is it the cough that you want to cough?
04:37Yeah, you can let out a cough.
04:38We'll take it out.
04:38OK.
04:39OK.
04:40This is like, you know, normal for me.
04:42But this is an absolute catastrophe for the person 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 of 3% cellular nebs.
04:56Things could get worse.
04:58We'll leave that possibility open.
04:59Yeah, I'll share the dose of the current patients that it's cold.
05:02No, no.
05:03Not 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, well, why 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.
05:39So, exacerbation, you know, her COPD, the chronic obstructive pulmonary disease.
05:43The tubes and lungs, the bronchioles, 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.
05:54Not knowing what's going on is possibly, it's more frightening.
06:00There's no other way.
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.
06:10So, we are in a spot of bother.
06:12But she's a massive trooper.
06:14And she did her son really well to the bypass.
06:16I thought not being able to tell me, she's getting better or she's getting worse.
06:21And when you're in that situation, you jump to your conclusions.
06:26I thought I'm in trouble, sir.
06:28No, you're in trouble, but he's...
06:30No, no.
06:31You're in trouble, but that's what that's called.
06:34In other words, your tubes are at narrowing down.
06:36Right?
06:37So, it takes more pleasure to walk with 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 in 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.
07:02We've got to get our body out, yeah?
07:23Hello.
07:30Good morning.
07:31Good morning.
07:3277-year-old Peter Crisp has a large aortic aneurysm.
07:36He requires surgery to fix it before it bursts,
07:39which would likely prove fatal.
07:41This is a great bulletin this morning.
07:43Yes.
07:44Perfect. I'll hand you that back.
07:46And the next decadent that I have here?
07:48Yeah, that would be me and my mum.
07:50See, it wasn't ill at all.
07:52There was no symptoms at all.
07:54See, that's the kind of scary thing about aneurysms,
07:56is that you could have it and not know it's there,
08:00and they only caught it because they were looking for something else
08:03and 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,
08:14oh, no, it's great, you don't have bowel cancer,
08:16but 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
08:26and they had been checking it every year
08:29and then it was every six months
08:30and then every three months to see how big it was getting.
08:34He didn't tell us about this aneurysm
08:36until two weeks before the surgery.
08:39It was actually my birthday
08:41and I, you know, he had known about it
08:43but 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 put special wires that let us kind of feed the stent into the aorta.
09:00Okay, and you're going in both sides, isn't that right?
09:03Yeah, okay. Why both sides?
09:05Because it's done, so you have two vessels that branch out of the aorta.
09:09Yeah, I'm so bad.
09:10So you have to go in through one to put the main body of it
09:13and then through the other to put kind of the last little bit.
09:16Right.
09:17So it's a split and...
09:18Okay, and that joins onto it.
09:20Exactly.
09:21An aneurysm is an abnormal swelling of a blood vessel.
09:25It's a little bit like having a weak spot on a tyre.
09:28Suddenly a bubble forms
09:30and the risk is that it will burst.
09:33At that point, your heart is beating.
09:35It's just putting blood into the system.
09:38But instead of circulating around,
09:40there'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 proud of you.
09:57When he said it's at 5.5 centimetres
10:00and if it gets to 6, it'll burst and I'll die,
10:04that's, yeah, that's...
10:06We knew it was shocking and very, very scary.
10:08So I didn't sleep for those two weeks, to be honest with you.
10:11So the plan today is to fix your aneurysm
10:14using what's called an endovascular stent graft.
10:17Yeah, I understand.
10:18So what that is, is it's a series of stents
10:20that are all slightly different shapes and sizes
10:23that are assembled into 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.
10:37The mortality, it's like you don't think about it
10:39until it starts happening
10:41and then you have, like, friends
10:44that, you know, are 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?
10:59No, he's staying.
10:59I think for a few days, they said.
11:01Peter's complex and life-saving surgery
11:03is scheduled to take three hours.
11:06Bye.
11:07The one's open.
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
11:29to try and correct his cleft lip.
11:33Cleft lip is when there's been a failure of fusion
11:35of elements of the face in the womb
11:37and this can leave gaps in the lip.
11:40It's very traumatic in actual fact
11:42and some people are very shocked at its appearance
11:46and there's a grieving process
11:47through which most parents go.
11:49I remember walking into the anatomy scan
11:53and my personality is always like,
11:55it's going to be fine
11:56and Connor was like,
11:57are you nervous?
11:58And I remember saying to him,
12:00about 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
12:13the nose and lip a few times.
12:16So before she even said it,
12:17I remember saying,
12:19is there an issue?
12:19Can you see something?
12:20And then she did say,
12:22there's a gap here that I'm concerned about.
12:30It's unusual to see a baby that age
12:33make 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,
12:46so 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 will be ready to go down
12:55as soon as theatre are ready.
12:56That's good.
12:57Great.
12:58All ready for it.
13:00You go through probably all the emotions.
13:03You go through, you know,
13:05disappointment
13:05and then you're angry
13:07and you're wondering,
13:08is it yourself?
13:09But I suppose
13:09even the fact of being able to find out
13:11in the anatomy scan
13:12did allow me that time
13:14to kind of process before he was born.
13:16My husband, he said,
13:17he was like,
13:18does he need it done?
13:19And I was like,
13:20when he's in college,
13:20he'll definitely be like,
13:21why didn't you get that done?
13:23Very mean.
13:24Yeah.
13:26Yeah.
13:28Lorraine, I'd watch these too
13:29because I might steal your baby.
13:31Yeah.
13:33You mind yourself now.
13:35Bye.
13:37Yeah, really, really good on that.
13:39We sure did.
13:41Yeah.
13:42Bye-bye.
13:43Bye-bye.
13:44That's my favourite.
13:45Oh, thank you.
13:47Bye.
13:48Isn't it amazing
13:49that your name is Rose Higgins
13:51and my name is Frank Higgins?
13:53You might be related to me.
13:56We might.
13:58Have you the white stocking on?
14:00No.
14:00No.
14:01Peter Crisp has an aortic aneurysm
14:04that has grown significantly
14:05and the hospital team
14:06must intervene before it bursts.
14:08Very straightforward.
14:10You both want better than me
14:11in this morning.
14:12Perfect.
14:13Yeah.
14:15My dad is from England.
14:16All his friends in England
14:18were of either Irish descent
14:19or Nigerian or Jamaican.
14:23I've got one little sticker.
14:26All right.
14:29When he came over here,
14:30he felt part of the community
14:31and more welcomed.
14:33That's how he came along
14:34and got together.
14:36So we're just going to do
14:37a trial deployment
14:39using the simulator.
14:40CUH is a training hospital.
14:42The surgical team today
14:43will include young surgeons
14:45in training.
14:46So that's going to be the marker
14:47for the top of your fabric
14:48on the stent graft.
14:49We know that Peter's distance
14:52from his lowest renal
14:53to his aortic bifurcation,
14:56which is the key distance.
14:57It's about 90 to 100 centimetres.
15:00So off you go.
15:01See if you can put it in there.
15:05I need people
15:06that are going to look after me
15:07when I'm old.
15:08Well, actually, I am old,
15:09but when I'm older.
15:10Okay.
15:11So just rotate your gate there.
15:12I was very fortunate
15:13when I was a young doctor
15:14that I worked with
15:15some phenomenal people
15:16who spent the time and effort
15:18helping me to be able
15:20to do this job.
15:21So the least I can do
15:23is try and replicate
15:24for this group of doctors
15:25in training
15:26what those people did for me.
15:27Advancing the graft there.
15:29So what we're going
15:29to be looking at here
15:30is just stop for a second.
15:33You're going to be looking
15:33at these two markers here,
15:34which we want to try
15:35and move over
15:36towards the left side.
15:37So you can see
15:38on the device
15:39those markers represent
15:40the top of the fabric.
15:42So there's obviously
15:42fabric and metal below this.
15:46We won't be covering them.
15:47Specialist registrar
15:48Niamh Hallinan
15:49hopes to execute
15:49a critical part
15:50of today's surgery,
15:51a first for her.
15:53Right, so you're going
15:54to start to deploy.
15:56If you look at
15:56how medicine is going,
15:57there are more females
15:59coming into medical school.
16:02Maybe in surgery.
16:03We haven't caught up yet,
16:03but we are catching up.
16:05Surgical training
16:06is hard for everybody,
16:07whether you're male or female.
16:09Pursuing current surgery
16:10is difficult.
16:13It's a competition
16:14from the get-go.
16:15Getting 600 points
16:16of your leaving search
16:16isn't good enough.
16:17You need to have done
16:18all the extracurriculars.
16:19You need to have
16:19a bit of research done.
16:20Keep a little bit
16:21of forward pressure on there.
16:23So back, pace back then
16:24and you'll see it spring.
16:26There you go.
16:27Even now I'm thinking
16:28about what's the next competition
16:29and that's, you know,
16:30consultant job.
16:32And you're thinking
16:34who's going to be looking
16:35for the same job as me
16:37in eight or nine years
16:38and what do I need to do
16:39to make myself
16:41the best candidate.
16:42If you sit on your laurels,
16:44you're going to be left behind.
16:47Let's go.
16:48Let's go.
16:53Let's go.
17:03Let's go.
17:04Iobami, which is joy meets me.
17:06Then the variations I've heard is
17:08I owe, you know,
17:11I owe you a fibre.
17:13Oh yeah.
17:15Which is, you turned it
17:17the other way.
17:18How?
17:24Three hours ago,
17:25Patricia was rushed
17:26to the CUH emergency department
17:28with severe breathing difficulties.
17:32She is critically ill.
17:34He's told today
17:35she's only 50% of her lungs
17:37actually working properly.
17:39Yeah, FBC is, yeah, yeah, yeah.
17:42Yeah, no, no,
17:43we have his lectures as well.
17:45Yes, you know, we know.
17:46She still unfortunately
17:47had wheeze
17:48despite the fact
17:48she got steroids,
17:50despite the fact
17:51that she got antibiotics,
17:52nebulizers,
17:53medications,
17:54salbutamol,
17:55for example,
17:55to open paris
17:56and she still was
17:56profoundly wheezing.
17:57And at that point,
17:59I was quite concerned
18:00and I actually asked
18:00the intensive care unit doctors
18:02to come down
18:02to see Patricia.
18:08How long has it been
18:09sore like that?
18:11Since Monday.
18:12Since Monday?
18:13Since seven.
18:14Patricia has been
18:15in ill health
18:16in recent years,
18:16dealing with
18:17the respiratory conditions,
18:18COPD,
18:20vocal cord problems
18:21and bowel issues.
18:22She's in an operation
18:26in January.
18:29Trish was caring
18:30for people.
18:31She's a healthcare worker.
18:32She was good
18:32at what she did.
18:33You'd meet offspring
18:34of people she looked
18:36after today
18:36and they'd meet her
18:37and say,
18:38you know,
18:39you were very good
18:39to ma'am or dad
18:41or whatever
18:42and, you know,
18:43she always looked
18:43after people that way
18:45and she has
18:46that caring thing
18:47I suppose
18:47as far as I come into it.
18:49She looks after me too
18:50I have to say.
18:51Now,
18:51is your abdomen
18:52hurting you now?
18:54Is it sore?
18:56As my colleague said,
18:57the general surgery
18:58will see you
18:59to make sure
19:01everything is okay?
19:02Yes.
19:03The team are trying
19:04to find the source
19:04of Patricia's
19:05acute breathing problem
19:06and will investigate
19:07all possibilities
19:08including her abdominal pains.
19:12She acts to be strong
19:14but she's not as strong
19:15as that at times
19:15and she has said to me,
19:18Trish says to me
19:18from time to time,
19:20I'm sick of being sick.
19:47I don't want you to go
19:48for me.
19:49I don't want you to go
19:50for me.
19:59Patricia's breathing
20:00continues to be challenged
20:01and she is placed
20:02back on the BiPAP machine
20:03to keep her lungs functioning.
20:08From being what she was
20:10and what she is today,
20:12there's no comparison
20:13in one sense.
20:14She's not able to
20:16to do as much
20:17as what she was able to do.
20:18Jeez,
20:19we walk miles every day.
20:21We've been in proses
20:23and we were able
20:24to walk into cities
20:25and walk all our own cities.
20:27Like we were in different,
20:28we were in Monte Carlo,
20:29we were in Barcelona,
20:31different cities like that
20:32that we'd never been
20:35and we had fun
20:36and we had a great crack there
20:37and every night
20:38there was music there
20:40and you could hear her
20:40singing away to the music
20:42and stuff like that.
20:44We haven't been on a cruise
20:45since she got sick,
20:46to be truthful.
20:48Trish was out for anything,
20:49she'd probably go
20:50two nights a week at least
20:52with her buddy.
20:53They were always following music,
20:55they wanted music
20:56and there was a karaoke
20:58once a week.
21:05She got sick and stuff like that,
21:06people are coming up to me
21:07and asking me,
21:08how's Trish,
21:09we heard she's sick,
21:10is she sick again?
21:12And you know,
21:12I'm trying to say,
21:13yeah, look,
21:14she'd be alright.
21:18It's tough,
21:19and there's no other way,
21:20it's tough on her
21:20and it's tough on us.
21:22It's tough on everyone,
21:23to be honest with you about it,
21:24because we have grandkids
21:26here local to us.
21:28You know,
21:29it's tough on them,
21:30as well,
21:30not being able to see her
21:31for maybe two or three weeks
21:33and she's just,
21:34you know,
21:35she can't do
21:36what she could do.
21:41Patricia remains
21:42on critical oxygen support
21:43while the team
21:44continues to investigate.
21:54That's about a centimetre and a half
21:55above the crease,
21:56which is nothing
21:56where you want to go,
21:57you really don't have to go,
21:58like,
21:59you don't?
22:00Peter is having
22:01a large aortic aneurysm fixed.
22:03It's a complex operation
22:05led by vascular surgeon
22:06Greg Fulton.
22:08Registerer Niamh Hallinan
22:09hopes to perform
22:10a critical part
22:11of the procedure.
22:12Okay,
22:13I'll actually live again.
22:13I'll catch on you.
22:14I'll catch on you.
22:15I'll catch on you.
22:16It's stressful.
22:17I mean,
22:17it would be something
22:19like,
22:20that I may be worried about
22:21as part of my training,
22:22that's something
22:22I need to learn
22:23to deal with,
22:24but at some point
22:25in the future,
22:26I'm going to be
22:26the leader in the room.
22:28Just follow it down
22:29until you get to the ligament.
22:30Yep.
22:31You've ultimately got
22:32patient to look after
22:33and you want to look after them
22:35the same way
22:35that I would expect
22:36or hope,
22:37you know,
22:37somebody belonging to me
22:38looked after.
22:40So it is stressful.
22:41You want the best outcome
22:42for them.
22:43Okay.
22:44So just go
22:46south of that there.
22:52My dad is like
22:53a walking encyclopedia.
22:56We call him
22:57the Oracle.
22:58He's been getting
22:59like the National Geographic
23:00since 1961
23:03and he's kind of
23:04instilled in us
23:05the love of
23:07different cultures
23:08and we've always traveled
23:10and we're always
23:10very adventurous.
23:11My dad bought a van.
23:14One of the most
23:15crazy holidays we went
23:16was 1986
23:17during the communist times.
23:20So we drove in the van
23:22from Ireland to Poland.
23:24We witnessed communism.
23:25We witnessed people
23:26having to queue up.
23:28We saw like amazing
23:29things as children.
23:31But my parents
23:32they see the joy
23:33in everything.
23:34They kick out of things.
23:36They're always laughing.
23:38Like I was coming
23:38and like the two of them
23:40would be laughing
23:40and I'm like
23:41what did he do now?
23:42And they can't tell me
23:43because they're laughing
23:44so much.
23:44I'm like all right
23:45I'm walking out here.
23:49So you can see
23:52the top mark there
23:55so if you look at the mark
23:56that's moving on the device
23:57it's at the second lowest mark
23:59and it's now up at the top mark.
24:01So we want you to just
24:03start about there
24:04okay
24:06and you use your left hand
24:09to sort of push slightly
24:10in 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
24:20as the simulator
24:21you just deploy it
24:22all the way out
24:23until the gate is out
24:25you watch the top dots
24:26and as soon as it's out
24:27you stop it
24:28you fix it
24:29and then we deploy
24:31the top cap
24:31and then we deploy
24:32smacked in like that
24:33yeah
24:35the most dangerous
24:36part of the surgery
24:37is the deployment
24:38of the main body stent
24:39so you need to be
24:41really careful
24:41when you're deploying
24:42that stent
24:43to make sure
24:43that you do not
24:44cover the patient's
24:45renal arteries
24:46or the artery
24:47supplying their kidneys
24:48the twist
24:50hold on a second
24:51let's get screaming
24:52overlay on
24:53it's check
24:55after check
24:55after check
24:56to make sure
24:57that it's okay
24:58if you deploy
24:59the stent
25:00and you've
25:00covered the kidneys
25:02it's a total disaster
25:04so one quick movement
25:05breast movement
25:06with the black
25:07pull
25:08black
25:10well done
25:11well done
25:13fantastic
25:14okay
25:14the biggest point
25:16of jeopardy
25:16would either be
25:17putting your device
25:17in either too low
25:19or too high
25:21and this will be
25:21just the last
25:22confirmation
25:23if you are indeed
25:24in the right place
25:26hold on
25:29yeah
25:31that proves
25:31that the balloon
25:32is inside the graft
25:33and therefore
25:34our wire is inside
25:35the graft
25:35and therefore
25:36we're in the right place
25:37very good
25:38so I think
25:38it's jobs a good one
25:40so we get ready
25:41to go home
25:42all right
25:43that was the first time
25:44I deployed a main body
25:45stent
25:46Ian I was like
25:47why am I happy to do it
25:48if you're happy
25:48to let me do it
25:49and he's like
25:49yes you need to be well able
25:51I've seen it done
25:52a hundred times
26:01are you okay
26:02to be in the room
26:03you're not squeamish
26:04or lightheaded
26:04or anything like that
26:05once it's not me
26:05I'm fine
26:06once it's not me
26:07you're good
26:08and you're okay
26:09to have her in the room
26:10yeah yeah
26:10good at you
26:11perfect
26:11I just have to ask
26:18round to here
26:22now we wait
26:23yeah
26:24I know
26:26we can do not
26:28this but wait
26:2964 year old
26:31Sue Cleary
26:31has advanced ovarian cancer
26:33it's her second diagnosis
26:35of the disease
26:36she is in CUH
26:37today for chemotherapy
26:39not too bad actually
26:40good
26:41I didn't think
26:42I'd get another
26:43cancer scare
26:43certainly not
26:44I thought
26:45I've had my breast cancer
26:46I've had the mastectomy
26:48that's me done
26:49then this one came along
26:52and that was a bigger shock
27:00I was getting very bloated
27:03in the tummy
27:03I said to the doctor
27:05that I can't stand this anymore
27:08I said
27:08I can't sleep at night
27:10with this tummy
27:11I said you have to do something
27:12and he said
27:13I'm going to send you into the A&E in Cork
27:16and was seen
27:17the next morning
27:18I had x-rays and scans
27:23and he brought us both into a little room
27:25and that's when he told me
27:26that I had the ovarian cancer
27:31now Sue I'm just going to check
27:33and see if there's a nice blood return
27:34here in the forest
27:35and I 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 sort of stunned
27:54you know just shot silence really
28:01Sue's consultant is clinical director for cancer
28:04Dervila Collins
28:05Sue has unfortunately stage 4 high grade serous ovarian cancer
28:10Hi
28:11Hello
28:11Hi Sue how 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
28:18I might as well forget it
28:19I suppose they're one of the most vulnerable groups of patients
28:22that we have in healthcare
28:24a lot of times they have a diagnosis
28:27that's going to you know shorten their lives
28:29the ability to be able to give people you know hope and time
28:33was one of the things that I was really drawn to
28:35in the week after it
28:36like how how washed out are you feeling?
28:39pretty washed out
28:40I suppose good days are when you know
28:42my patients give me a huge hug
28:44and you 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
28:51you have to tell people that the treatments aren't working
28:54or the treatments aren't right for them
28:56and that they have you know
28:59I suppose significantly limited time
29:01they are the devastating days
29:04but you're looking after her
29:05will any of that fair play it to you?
29:06that's the hard part of what we do
29:08and you know it's tempered by you know
29:12the good days and you know
29:14the good news and the good results
29:15but there is unfortunately sometimes in the clinic
29:18more bad news than good news
29:21and who brings you up the cup of tea?
29:22oh you bring me up the cup of tea
29:24but that doesn't mean I'm sleeping in
29:25I mean you're bringing up my tea at 8 o'clock
29:27I mean that's not sleeping in is it?
29:28oh that's lovely
29:29how long have you been delivering the tea in the morning?
29:34I suppose since her diagnosis
29:36yeah
29:36yeah
29:37it 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
29:47one thing probably led to another
29:49because she had been separated
29:52from her husband at that particular stage
29:54and you know she was attracted to me
29:58and likewise I was attracted to Susie
30:01so we set her to date
30:03as 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
30:15putting it mildly has knocked us all for six
30:18you know
30:18I actually I like to be a bit ignorant about this
30:21because if I knew all the facts
30:24it would be too frightening
30:28later today Sue will have a further consultation with Durvila
30:31she's hoping to receive positive news about a new cancer trial
30:42I mean I'd love to be around long enough
30:45well I hope I'll be
30:46I mean my daughter's got another year to go at college
30:49and 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
31:20and know what he was going through
31:22your initial instinct is to just stay with him
31:26I just had to go away and just trust in that
31:30they were all going to look after him and do their best
31:33good boy
31:35oh yeah that's good
31:36okay my mind
31:37okay all right
31:38I have your number and we're going to give him a kiss there
31:41bye bye
31:42good boy
31:43good boy
31:45I know
31:46bye bye
31:48every time a mother hands their baby over
32:21to us it is a big responsibility to take on
32:22enough weight that journey I saw was quite difficult
32:26it's coming in about 11 millimeters 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 and you know
32:39nobody wants anything to be wrong with their baby
32:45we take multiple measurements and look at multiple landmarks including the width of the nostril on the normal side and
32:55the height of where the nostril starts where it meets the side of the lip
33:01it'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
33:26if anything it's low
33:28if we pull the lip in too far
33:30it will push it up a bit
33:31so we just have to get it right
33:33can I have an 11 blade now please
33:43Peter has been in recovery for five hours post-surgery for his aneurysm
33:48surgeon Greg Fulton and registrar Niamh Hallinan delivered the good news
33:53we managed to put the stent up through the aneurysm and exclude it from the top and the bottom
33:58that's all dealt with now
34:00so 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
34:13and if you did a poll of surgeons I'd say most people would tell you they love it like
34:19we'll be keeping a close eye on you over the next day or two
34:23we obviously hope there's no problems but our job is to try and anticipate those and deal them if they
34:28arise
34:29the kind of satisfaction for that lasts about five minutes
34:34because you know that you've got either that afternoon or the next day
34:39you've got another problem
34:40or 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
34:47thanks
34:48okay take care
34:49bye
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 it worries look what do I do tomorrow morning and nobody here
35:15you know
35:20that I'm not even thinking about I'll be very honest
35:23I'm not that's not even coming into play it's
35:27it's not going to happen to possibly me
35:34it's not going to happen in the story
35:37I'm older and so I go first
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
35:53sure sir
35:54I know you're uncomfortable
35:56and unfortunately I have no pain
35:58at the moment we need a higher level care bed
36:01and the hospital to be honest
36:02alright is that okay with you
36:24I do get a great sense of satisfaction working in theatre when you go in with a trauma case
36:31or at an RTA the amount of people from anaesthetics to portraying to surgeons inside the theatre
36:36that are there just for that one person
36:39just to keep that person alive on the table
36:41it's such a kind of an uplifting experience that you say to yourself
36:47geez look if that happened to anyone
36:49this is the effort that's been put in to keep that person alive
36:52huge huge and I'm part of this
36:58baby she is having an operation to correct his cleft lip
37:02slightly more anterior there
37:04that's it
37:09I remember coming home in the car and thinking
37:12god I'm going to have to tell my mum
37:14that you know
37:15my baby has cleft lip
37:18and I didn't want to start crying
37:20you know straight away in front of the kids
37:22sure she could empathise straight away
37:24she'd been through that
37:25even though she only found out when my brother was born
37:29and the fact of being able to find out in the anatomy scan
37:32did you know
37:33allow me that time to kind of process before he was born
37:38it's still quite different doesn't it
37:43it's just that it's the bulk of this
37:45it's just hard to
37:46hmm
37:47it can be quite frustrating because you're trying to match unequal sort of elements
37:58so this is the sewing machine technique
38:02the sewing machine technique is like an invisible stitch
38:05it's just a trick to get a stitch into deep tissue
38:08without having to go through the skin on that side
38:11and 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
38:29she was a week overdue
38:32we had chosen not to find out the sex
38:34but I was so convinced it was a boy
38:36that I had even booked a baby boy in for Santa in Blarney
38:40that's how sure I was it was going to be a boy
38:42so I knew it
38:45first thing that struck me was
38:46the head of black hair
38:48and that he looked like Conor
38:49I think I just thought he was beautiful
38:51and that was his face
38:54and he was in great form because he slept
38:56and he wasn't that hungry
38:58so
38:58nearly better at it than at home
39:03yeah
39:10it's actually super glue
39:11it is real super glue
39:13same thing
39:14it's going to be too much longer now
39:19I'd say before we get called
39:21and how long do you spend when you go down there?
39:24this is actually them calling there
39:26hello?
39:26no matter how well you think you do the surgery
39:29there are elements that are going to be out of 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
39:40yeah great
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?
39:52no what are you too old?
39:54no I'm 34
39:55I know I'm okay
39:56it's just me and I haven't had any
39:57so no I don't think you do
39:59I think you're too young to have two kids
40:02sometimes I think with my first child
40:04we're actually brother and sister
40:05as opposed to
40:06do you know what I mean?
40:08oh I was 25
40:09I wasn't exactly
40:10do you remember my leaving?
40:11but that's what I tell people
40:13so they think that I'm really young
40:14that's nice
40:15do you remember my leaving?
40:21it's been 16 hours
40:23since Patricia was rushed to CUH
40:25with severe breathing difficulties
40:26she remains critically ill
40:30nice to meet you
40:31my name is Kevin Deese
40:32one of the respiratory doctors
40:33a precautionary scan
40:35has ruled out
40:35Patricia's abdominal pains
40:37as 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?
41:0523 weeks
41:06okay
41:06I know
41:08Patricia has been in ill health
41:09in recent years
41:10as well as her COPD
41:12she previously had operations
41:14on her vocal cords
41:16any change in your voice
41:17over the last week or so?
41:19I know you've got a problem
41:20with your voice normally
41:21anything new
41:22I can't speak
41:23yeah
41:24no voice
41:24you get periods
41:26where you can breathe okay
41:27and then suddenly it gets worse
41:28again
41:28it gets very bad
41:33she's an outgoing person
41:34and she's always talking to people
41:36you know
41:37if they're at the meal for a night
41:39I'd say to her right
41:41stop talking
41:42you know
41:43and she'd be explaining
41:44what happened the night
41:45that night
41:45stop
41:47stop
41:47tell me tomorrow
41:49because I can hear it in her voice
41:50that she's straining
41:52she thinks that
41:53she should be still talking
41:54the way she always was
41:57when's the last time you had your vocal cords looked at?
42:02hospital
42:03hospital
42:03hospital
42:04hospital
42:04literally
42:05treatment
42:05the very same
42:06she wanted to communicate
42:08wasn't able to
42:10wasn't telling
42:12that you know
42:12her breathing wasn't as good
42:14as it should be
42:14which it wasn't
42:16and
42:17stuff like that
42:18you 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 recollected this
42:23because of the lungs
42:24and sometimes you can be recollected this
42:25because of the vocal cords
42:27or your trachea
42:28okay
42:28so I'm wondering if there's something up here
42:30that's going on
42:31professor D has got worse and worse
42:33we've had seen that
42:34but she's a fighter
42:36and a big fighter
42:40yes
42:41and they said that
42:42and they said it yesterday
42:44which we remember saying
42:45we get us after
42:46here
42:47this is why
42:47this is here
42:48get us after
42:49and we walk from there
42:51everything else is
42:52we will forget about everything else
42:56just you know
42:57she's not going to give up by no means
42:59but
42:59it's very unfair
43:00I suppose in one sense
43:02to go from being very
43:03very lively
43:04being out
43:05going
43:05to this
43:09socks
43:12pillow
43:18and the other little bits
43:19I suppose
43:19that you see
43:20being picked away at times
43:22I suppose
43:25it's hard the times
43:26all right
43:26those little things
43:27but Ian
43:29nice
43:45Good morning
43:47Sue has stage 4 ovarian cancer
43:51though receiving chemotherapy
43:53her tumor 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,
44:05you can see a large tumour mass 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.
44:18Dervila has identified a new drug that could potentially help soon.
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.
44:40We don't expect it to unfortunately cure her cancer.
44:44Have a seat.
44:46As you know, we've got a clinical trial open here in CUH.
44:51This 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.
45:27Well, I'm looking forward to having a go at this and see if it works, you know.
45:31Okay.
45:31I want Sue to be able to access this, you know, mervituximab, sorbentansine, this, you know, impossibly named treatment,
45:38and 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.
46:13And so this is information for you.
46:15Okay, that's great.
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.
46:36That's the one thing I would say to anybody.
46:40Never, ever give up.
46:43It could be worse, I suppose.
46:44I'm not going to.
46:50This is Anna.
46:52She's our therapy dog.
46:54Mum is a golden retriever and Dad's a poodle.
46:57I think she has her mum's hair.
47:01I like pustache.
47:04I don't want to live next to you.
47:09Hi, Mum.
47:10There he is.
47:11Hi.
47:13I'm hungry, young man.
47:15Baby Shea is in post-op recovery, following a procedure to correct his cleft lip.
47:20Nice and happy with the anaesthetics.
47:22No matter when it's all right, there's no reaction to it or anything else.
47:26All right.
47:27It was like my initial instinct was he was crying, that I just wanted to comfort him and feed
47:33him, so to, and I asked the nurse straight away, would I be able to feed him, so I just
47:38tried to breastfeed him straight away as a kind of a comfort measure.
47:44Yeah.
47:46I don't think he's doing any drinking.
47:48He'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.
48:05What they can do for cleft lips now, it's really, you know, brilliant.
48:09His life won't be any different.
48:13Here you go, baby.
48:16Here.
48:16I know.
48:18I'm not taking it away from you, okay?
48:20Here, dolly girl.
48:22Hey, 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.
48:45Get your breath.
48:46Get your breath.
48:47She's a fighter.
48:48We're not going to give up.
48:49I promise that.
48:50I promise that.
48:51It's been tough on him.
48:53It has been tough on him, like.
48:55But he's my rock.
49:18toyenza.η»ε ΄
49:20Eine. It has
49:45been tough on him. It has
49:45been tough on him. You need
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