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00:02Surgeons they can change your life forever as they tread the line between life and death. We got a bet
00:11What's it really like to hold someone's life in your hands? It's miracles and disasters nothing in between
00:17Let's get this bugger out. And how do you balance the needs of others with the needs of your family
00:24home sweet home?
00:25You take care and have a good sleep. Oh, I will do love your mom
00:31Now we go behind the mask to find out just what it takes you late been hit by bus
00:39To live life as a surgeon a rollercoaster. Oh, right. Yeah, it all went really well
00:46Professor all my race number one
01:03The idea that somebody is going to operate on your brain is a huge thing
01:07You know, it's it's who you are. It's where you carry your memories. It's where you form your new memories
01:11It's your personality. It's who we are. It's our consciousness
01:1745 year old Omar Patmonaavan is a consultant neurosurgeon at Salford Royal Hospital in Greater Manchester
01:27He's been operating on people's brains for the last 20 years
01:34As clinical director Omar and a team of leading surgeons are responsible for over 3,500 brain surgeries every year
01:45Morning
02:13Hi
02:15Hello
02:22I'm here
02:23I'm here
02:24I'm here
02:25All right
02:25Thank you
02:26Now the tumour needs to be removed if it isn't it will continue to grow and eventually kill him
02:32All right
02:35How have you been?
02:36It's sometimes like a little bit of business and everything but overall is okay. Yeah, okay good
02:44The couple live in Manchester with their three daughters
02:52She's told me we are going to refer you to neurosurgeon and I was saying why and I say it's
02:58like brain tumour and I said oh my goodness
03:00That's a big word tumor
03:04Yeah, it was it was scary. Yeah, it was
03:08So this is your brain stem you can see that there's a difference between the two sides
03:13Can you already at this point and that's because we're seeing this epidermoid cyst and that's why you've been getting
03:19the balance problems
03:20The dizziness you've gone deaf in that ear. Yeah, that's why because of the effect of this epidermoid cyst
03:27Okay
03:29Um in terms of risks from the surgery so bleeding
03:34Okay
03:36Stroke
03:37Yeah, okay
03:39How is happening? What's going to happen? This tumor is going to kill me what they are going to do?
03:45She's in a GCSE. She's in a
03:48Primary school, so anything happen and I'm die who's going to look after my family
03:55very tough
03:58We're gonna take good care of you and you know my anticipation is that that you know you're going to
04:02be good
04:04Aditya hopes he'll get the hearing back in his right ear
04:06So it's going to recover or not like can I hear a hundred percent?
04:11It's a good it's a good question and
04:13It's not something I want to promise to you
04:15But it's possible there could be some recovery
04:17But I think you should consider it a bonus if you get some recovery because it's been quite a long
04:22time that that's been gone now
04:23Okay
04:26Yep
04:28No, I'm very positive about the surgery. It should be give me
04:33Good longer life. I think so better life
04:36Hopefully hopefully improve the quality long term. Yeah. Yeah
04:41You never want to take away somebody's hope. I mean hope is is a basic fundamental requirement for people
04:50Sometimes if you don't get that balance in the conversation quite right or even if the patient is not quite
04:56in the right place yet
04:57All right, thank you. Thank you. Those are the most challenging of discussions
05:20Aditya and his family have arrived at hospital for his surgery
05:25Across the uk over a hundred thousand people are living with brain tumors
05:30So adi's tumor is about the size of a tangerine
05:34And it sits in a space that would normally only be a few millimeters wide
05:38And it's insinuated itself in between all the nerves and the blood vessels that sit in that area normally
05:45And it has compressed his brain stem and it's compressed his cerebellum
05:50And that's what's caused him to lose his hearing his balance and to develop facial pain. So over the last
05:5845 46 years this has been slowly accumulating over time
06:02Until it's got to the point where his functions have started to decompensate because they can't cope anymore with the
06:09level of pressure and
06:11Tension that they're being put under by this cyst
06:15Any issues with your hearing?
06:17Yeah, I can hear
06:20I think sometimes it is hard for patients to
06:24Get their head around the fact potentially after surgery they can feel worse than they do now before they get
06:30better
06:30So for Adi for instance, he lost his hearing some time ago as part of this process
06:35And we certainly can't guarantee to him that we'll be getting any hearing back for him
06:42Hello
06:42Hello
06:43Hello
06:43Hi
06:44Hello
06:45Hello
06:45Hello
06:45Hello
06:46I'm going to get you to the theatre
06:48Okay
06:50Okay
06:51Yeah
06:52Can I hug her?
06:53Yes, of course
06:53Of course
06:54Yeah
07:16I think patients want us to be superheroes
07:22Particularly when they're facing the most serious consequences and the most serious diseases that could change their life forever
07:30But sometimes the decisions we make the advice that we give
07:34Can make you a villain in the same breath that you can be a hero
07:41I hope the next like 10 hours also go like super quick
07:45It's a big surgery we know
07:47But
07:49Yeah, he'll be fine
07:51He will bring him back
07:54Adichas life is now in surgeon omar's hands
08:13This morning neurosurgeon omar patmanabhan is about to begin life-changing brain surgery on dad of three adichia
08:26Adichas tumor is between the brain stem and the cerebellum which helps coordinate movement and balance
08:33Omar will cut through the skin and nearby muscle and then the bony section of the skull behind adichas right
08:40here
08:42Once he's reached it he will cut away the tumor to release pressure on the cranial nerves
08:48Which control hearing balance and facial functions?
08:54Operating in this area of the brain is high risk
08:57One wrong move could lead to irreversible damage causing a stroke or paralysis
09:03It could even be fatal
09:06Good okay pins going in
09:10The tumor is causing a ditcher pain dizziness imbalance and loss of hearing
09:24I'll just go straight down to bone here now
09:28First of all adichas skull needs to be opened then muscle must be cut to get to the brain tumor
09:36So we're doing the initial exposure down onto
09:40the bone just behind the mastoid which is the bony prominence just behind
09:47Adi's ear
09:48So to do that we have to get through some really big tough muscles
09:54and soft tissue to get down to this bit because we've got lots of attachments of muscles
09:59onto the skull at this point
10:06Something that's always struck me is the sharp contrast between the sort of brutality of using
10:13powered instrument drills and
10:16steel to get through this
10:19bone and then the delicacy and serenity of the brain that's underneath it
10:37So
10:38Scissors please
10:40You can start to see some pearly pellets
10:43We call them pearly tumors
10:45because it looks like mother of pearl and we're starting to see a piece of mother of pearl appearing there
10:51After nearly an hour and a half of drilling
10:54Omar can see the tumor which is buried deep inside a ditcher's brain
11:00You can see why he's gone deaf can't you?
11:05Yep
11:08As Omar begins cutting out the tumor he has to be extremely careful
11:13It's crucial he avoids harming any of the nerves
11:17Any damage could cause life-changing complications
11:21So we're we're in the space that sits between
11:25The cerebellum a bit of brain that controls
11:28movement coordination
11:30And the brain stem which is a obviously a critical structure the stalk which connects the brain to
11:37The spinal cord and the rest of the body
11:40So we're looking currently
11:43At the lower cranial nerve so these nerves control your voice
11:47You're swallowing
11:49Prior to coming down here. We've just found the seventh and eighth cranial nerves and those are responsible for
11:55facial expression the seventh nerve facial nerve
11:59And then we'd found
12:01The eighth nerve which supplies hearing and balance
12:04And they were really really very compressed by this lesion
12:08Which explains why he's had such difficulties with balance
12:12And why he's gone deaf in that ear
12:16Even if Omar manages to remove the tumor
12:20There is no guarantee that a ditcher's hearing will return
12:25He's been deaf because of this for a number of years so it's probably quite unlikely
12:29But I have I have had cases where hearing has been restored or improved at least
12:35It would be a big bonus if you've got a hit any hearing back
12:39Because it's wrapped up in that capsule stuck down
12:42The
12:44Faucet the fine tube faucet. I'll do the blockage. Yeah, so this is a two-man job as we start
12:50to remove that bit of tumor
12:52Okay, a bit of suction on that piece now
12:55Watch this watch this side of the suction counter on your nerves
12:59Okay, good
13:00And we need to be careful about how we remove the tumor because this particular type of epidermoid cyst
13:06wraps itself and insinuates around these nerves so you can find
13:11the nerves and the vessels within this the structures that you're removing with the lesion you're removing
13:18Gradually parts of the tumor begin to be released
13:22That's around it's welded as you'd expect after
13:29Over four decades getting on for five decades of being slowly insinuated into this space, but
13:36It's coming bit by bit
13:41It's stuck to the veins here
13:43I'm just going to debulk it initially
13:48Some of the pressure off that nerve forceps please
13:53Thank you
13:54So we're getting a view of some of that more classically pearly pearlescent
13:59Material there that we see which is quite quite beautiful actually
14:06So this is the part of the tumor that's been causing adi's facial pain
14:13This is trigeminal nerve which is the nerve supplying sensation to the face
14:21Sarah just working around the trigeminal nerve
14:25On occasions we can cause the heart to stop by manipulating the nerve scissors please
14:34We have to be careful that we're not damaging the facial nerve that would paralyze his face
14:49We're just picking away at the few little remnant bits
14:55So we've been able to give him an excellent clearance and hopefully
15:00Very little chance that he's going to ever need another operation for this in his lifetime, hopefully
15:13Yeah
15:16Back into the cerebellum, the hemp peduncle there
15:22Some loose bits floating but nothing solid is it?
15:25Okay, that's great. Thank you
15:29Right, let's wash it out with two liters of warm wash
15:33So we've removed the the epidermoid cyst
15:36And then we'll be making sure there's no bleeding
15:41And then closing up
15:43Three hours in and Oma has removed all of the tumor
15:49Another boring day at the office is all we'll want
15:57Yeah, that's good
15:59There we go
16:01Not much more than a haircut
16:03Sources
16:05Right
16:06This is the worst
16:08Bit of time for me now waiting to see how he does
16:12Not very optimistic he's going to get any hearing back
16:16We have to wait now to see that he wakes up well
16:21Hi Adi
16:22Everything went really well
16:24All went exactly as we wanted it to
16:27Okay, you're just coming around now, so I'll talk to you again in a bit
16:31But it all went really well
16:41Now only time will tell if any of Aditya's hearing will return
17:01Neurosurgeon omar lives in cheshire with his wife annabelle who is also a surgeon and their three children all under
17:0816
17:12I think that we're constantly juggling so many balls and dropping various ones
17:19I think I think we're just putting one foot in front of the other one like everybody else
17:23Morning one band
17:26We were in the same halls in the first year of university so we met then but we didn't really
17:31know each other
17:32We knew each other just sort of in passing
17:35He's noticeable on the dance floor
17:37He really clears himself for space
17:41I got that he's shaking that ass award didn't I when we left medical school
17:48Computer are you ready for you we've got two minutes yeah
17:51Yeah, I'm coming
17:52Okay, cool computer
17:55Off
17:56We think that we know a lot about each other's specialties you in particular you think you could do my
18:00job
18:01I think yeah, I think I think I've got a damn pat now
18:05How are we doing for you?
18:10Good day love you sorry dipped my hair in your bowl
18:15Yeah, it's a pretty even split I think I'd like to think
18:21He constantly tells me I have no idea how much he does
18:25Yeah, you're right
18:30Have a good day
18:31Have a good day everybody see you later
18:34I think it's it's still the case that you take you take more of the burden here
18:41What we coat on where's my bed it's stuck behind you
19:02Good morning everyone, how are you?
19:03Good morning mate
19:07Fabulous
19:09Yeah, all right brilliant. Thanks very much. Cheers. Thank you. Bye. Bye
19:18We got a bed we got a bed
19:22Do you want to just let um Dr. Sebastian know?
19:24No
19:27Exactly tell him he's got some more work to do
19:29Um good
19:3345 year old service manager emmanuel
19:36has a rare type of tumor that started in his nose before spreading towards his brain
19:41He's here with his wife corkul knock knock
19:45Good morning
19:47Hello
19:48Good to see you
19:49Good to see you
19:50Hello
19:50We haven't met nice to meet you
19:52I've been a van your surgeon
19:53This is Adi our fellow as well
19:56Okay, take a seat take a seat
19:58The tumor is cancerous and due to its size and position
20:02Emmanuel needed over 36 rounds of chemotherapy and radiotherapy to shrink it
20:08It's now small enough for omar to safely operate on
20:11You know, I said to you before that everything on the day is positive energy now
20:14We've done all the consent forms and everything else
20:17But have you got any questions about about that?
20:20Anything we went through?
20:21I want to say a big thank you to you and your team
20:24I'm trusting you do your very best as you do always
20:29Thank you very much
20:30We're going to take good care of you
20:32And we hope that it will improve the length of time you've got
20:36But we can't promise that
20:38Okay
20:39All right
20:40Okay
20:44Okay
20:44All right nice to meet you and see you again soon
20:48Bye
20:49Yeah
20:51The reality is turning on me
20:59It's been amazing
21:02Always thanking her for that
21:04She
21:05She
21:05That's support
21:06And this actually gives the true meaning of for better for worse
21:12And she's giving meaning to that she stayed with me in my difficult and trying moments
21:18She's been there for me
21:20We can't wait to get to the end
21:22I think we are nearly there
21:24Nearly there
21:25We can't wait to get to the end of the day
21:31You ready?
21:33Let's go
21:33Baby
21:34Come on
21:39All the best
21:40See you
21:42Go
21:46Yeah
21:47Yeah
21:47Yeah
21:48Yeah
21:48Yeah
21:51Emanuel's surgery is a joint case with ear, nose and throat specialist Raj Bala
21:56So between May and October so quite considerable sort of shrinkage
22:02Yeah
22:03Emanuel's got a rare type of cancer that started in his nose and then grew up to involve the border
22:09between the nasal passages in the brain
22:12We are operating around all the most important sensors
22:15Okay
22:16So we're operating around where you get your sense of smell
22:20We're operating around your vision
22:22We're operating around the blood supply that supplies the brain
22:24And we're operating around the base of the brain
22:28Where you've got some of your most important functions
22:31With lots of potential risks from operating in that area
22:34The tumour is involving the olfactory bulbs which are the nerves which carry all of the smell from your nose
22:43into your brain
22:44And when he wakes up he will not have smell again
22:48We want to achieve a high quality of life
22:53But at the same time achieve a better duration of life
22:58For him
22:59Right Emanuel
23:01You do have a brain
23:03It's a good start
23:04Okay
23:05Right
23:05So there's a good start
23:07Emanuel is in a really good frame of mind this morning
23:12Patients feeling positive and and good just before they go into surgery is really important
23:17So everything looks perfect
23:20And what we'll do is start drifting off to sleep
23:33Okay
23:37Emanuel's cancerous tumour will be removed in three phases
23:42Known as the approach
23:43Resection and finally reconstruction
23:47So that is all the preparation
23:50Let's scissors and forcep to discard please
23:53ENT surgeon Raj will gain access to the tumour through Emanuel's nose
23:59Preventing surgery through his face
24:03Next Omar will carry out the resection
24:07Meaning he'll cut out the tumour and the olfactory bulbs
24:11Causing Emanuel to lose his sense of smell
24:15Finally using tissue from Emanuel's scalp
24:18Omar will reconstruct the seal between his nasal cavity and the brain
24:26Okay room lights down please folks
24:28Reg patties with adrenaline going in
24:33One more please
24:36Raj and his team begin phase one of the operation
24:40Creating access to the base of Emanuel's skull through his nose
24:45Okay, and then we'll come up into the roof of the nose the vault of the nose
24:50And we'll make a vertical incision
24:52Okay, just down to there
24:54Okay, then we'll go back up into the roof of the nose
24:58And then do the same on the nasal septum
25:03Blood pressure okay, you happy?
25:05Yeah, yeah
25:07Okay, so I've just communicated those two flaps
25:15I'll take the suction again just the fenestrated suction if you've got it now please
25:19Okay, so just up into the roof of the nose now
25:25This will allow a shri now okay to get to the posterior table here okay
25:33This is drilling through the base of the skull
25:36After just over two hours the base of Emanuel's skull has been successfully reached
25:42Okay, so now I'm just starting to thin the bone
25:45to the base of the skull
25:48We're starting to expose dura
25:52I'll be there just two ticks Raj
25:55With a clear route to the tumour Omar can now take over and start to remove it
26:02And I'll take it bipolar please
26:06Thank you
26:08The team won't know if Emanuel has suffered any further damage until the tumour is out
26:15The undersurface of the frontal lobe is looking healthy which is good news
26:20We weren't sure if it was going to look potentially like there was invasion
26:26Beautiful isn't it?
26:30There we are, there's the frontal lobe on the right
26:36Still instinctively a little bit shocking to see the brain through the nose isn't it?
26:43There we go, final bit
26:45And there you can see this is the olfactory bulb
26:51Here so this is the nerve that would be carrying all the smell from your nose and the outside world
26:57into your brain
26:58Unfortunately here is as you can see running directly into all of this tumour
27:04We're going to be removing that and sadly also with it his sense of smell
27:12It's the right-sided olfactory bulb
27:15Smell nerve
27:17There's always a certain amount of sadness that comes with dividing a nerve
27:22But it needs to be done in this case
27:25Right olfactory bulb
27:27Yep
27:29So all of the tumour
27:31You can see it's quite a challenge to fight this bulk as we're dissecting and removing the tumour
27:37But we're battling on at the moment to see if we can achieve this
27:40en bloc
27:42Removing the tumour means emmanuel will no longer be able to smell anything
27:55There's a lot going through my mind right now
27:59I've been waiting for five hours already
28:03I hope it's over soon
28:06He's my world
28:07He's a good dad
28:10And he's my love and life partner
28:12So yeah
28:14I need him back because there's so many things we need to do together
28:19And when we are together we are a team
28:29So now it's just hampering at progress
28:33Omar has managed to loosen the tumour and can now start to bring it out through the nose
28:39Free isn't it?
28:40Let's have the ball probe
28:43So now the challenge is going to be whether or not we can actually remove this large piece
28:49Through the nose or not
28:57There's parts of it
28:58part of the septal part
29:01He's removed the first part
29:03Now he needs to get the rest out
29:05Oh, maybe
29:08Coming
29:13There we go
29:15The tumour
29:18Tumour
29:20Yep
29:30The next step is to start the reconstruction
29:33So I'm going to put a ruler in now so we'll be able to see the size of the defect
29:39With the tumour now all out
29:40The gap that's been made between the top of Emmanuel's nose and his brain
29:45Now needs to be repaired
29:49Yeah, it looks perfect
29:52This is a fibrin glue
29:54That we're going to use now to secure that onto the edges of the dura
30:01To fill the gap
30:02Omar needs to add a layer of fresh tissue with a strong blood supply from Emmanuel's scalp
30:08A bit of local adrenaline going
30:14So Adi's going to make a cut down here
30:17I'm going to assist him from this side
30:25There we go
30:26Good healthy scalp
30:28And the layer that we're going for is the layer that sits right on top of the skull
30:33The pericranium we call it
30:35It's a lovely robust layer of tissue
30:40With a fantastic blood supply
30:43And it's going to give us some nice healthy tissue to place down to repair the defect
30:50The team must carefully remove the layer of tissue
30:54Any damage caused to the tissues blood supply could mean serious complications
31:00We want to take this flap of tissue all the way down to the rim of the orbit so just
31:05above the eyes
31:07And what we'll do is we'll make an opening then once we've raised this flap in the bone just over
31:13the glabella into the frontal sinus
31:15And that will allow us to post this tissue from his scalp into his nose to use for the reconstruction
31:23You know I actually look at this and see hope
31:27Because I look at although it's a huge thing to put somebody through and it it seems
31:33You know to
31:35To the outside eye this seems somewhat grotesque to be exposing somebody's skull in this way
31:40But this gives us the ability to do something that otherwise
31:44He would not have been able to have and he would not have had this opportunity
31:48He had a potential
31:51Extended life good quality of life
31:55Without this tissue so I look at this and I see
31:58A fantastic piece of tissue that's going to help him survive
32:04Next omar will need to attach this tissue to the gap between emmanuel's brain and nose
32:10This is critical in order for the operation to be a success
32:19So
32:19I'm going to take a look at this
32:26Neurosurgeon omar and his team have removed a tumour from emmanuel's brain behind his nose
32:33Next thing we're going to need a drill so we put the light source inside the nose
32:39So this is a manual skull and then as we come back down we're seeing the frontal sinus and this
32:43is our window now
32:44Where we're going to enter through into the nasal space to pass our flat
32:48All right
33:01Raj is just putting a stitch in and we'll feed that stitch through and then he'll come into the nose
33:06and bring it down using that stitch
33:08Really good. Okay, stop stop pulling that in for me first. Yep. Yep. Yep. Go on pull. Yep. Keep pulling
33:17Keep going keep pulling keep pulling
33:21pull pull pull
33:21Thank you. It's nice isn't it? It's beautiful
33:28You can see that lovely pink healthy tissue with blood supply now really helpful
33:34And we're using that to create a vascularized so a piece of tissue with a blood supply
33:39To help this heal
33:42Once we've done this we'll put some some support within the nose to help secure all of this and then
33:48we'll close the scalp
33:50Um, and then that's it
34:00Yeah, you should never see the brain through the nose should you
34:05We're done
34:07We're done
34:08The most stressful part of an operation is when the operation is done and you're waiting for the patient to
34:14wake up
34:14It might only take it five fifteen twenty minutes
34:18It feels like forever
34:21Because until you see your patient wake up even if everything's gone perfectly well in an operation
34:26You don't know how they're going to do you don't know for sure that they're going to wake up as
34:30you want them to wake up
34:49It is yeah 10 minutes after the operation finished
34:54Emmanuel comes round
34:56Where's your hand? Give me and
34:58Everything went really well
35:01Went fantastic. Thank you so much. Oh, you're very welcome. We went exactly as we wanted it to go, okay
35:07So I'm really pleased
35:10Okay, so now it's over to you to get better. All right, you rest now
35:15Shall I go and let the boss know that you're doing okay? She'll be pleased to hear I think won't
35:20she
35:22Are you ready for a drink?
35:24Yeah, water
35:30Hello hello, is that Coco? Oh my goodness. Are you done?
35:34Yes, we're all done and Emmanuel's awake. He's just woken up. He's woken up
35:39He's in the recovery area and he's doing really well. Oh my goodness. Thank you
35:44And everything went exactly as we hoped it would
35:46He wanted to hear your voice. I'm in the room with him
35:49I can hear you. Are you close to Emmanuel?
35:53Yeah, Coco. Thank you so much.
35:55Yeah, hi. Are you okay? I'm okay by the grace of God
36:00I am awake. I'm so glad. I can't wait to see you. I'm coming about to see you
36:05All right. I'll see you soon. Thank you
36:07It won't be long before you can come up and see him. Okay. Okay. All right. Thank you so much.
36:12Thank you
36:13Okay, bye-bye. Thank you. Thank you
36:34I'm relieved now that we've been able to perform the surgery and that we said we would for him, but
36:40there's going to be another step now
36:42To get him through his recovery and he's going to be at risk now for a few weeks of things
36:48like cerebrospinal fluid leak meningitis
36:51And we've got to give him time and hope that the combination of treatments we've given him now will keep
36:56things under control
36:58But he's got a very aggressive cancer. So the long-term outcome, you know remains remains open for him
37:17Having undergone extensive radiotherapy chemotherapy and brain surgery
37:22Emmanuel will now remain in hospital until he's well enough to be discharged
37:39I'm praying and hoping that this is the very final lap
37:43And then we can have our lives back. Yeah, because we have a lot planned for end of year and
37:49next year
37:51We can't wait to do it together
37:53We can't wait to do it together
37:58Pedic
37:59Don't worry. I'm here for you. Yeah. Thank God. Yeah, well
38:16It's the end of the week
38:18And omars mum and and his aunt and her partner have come for dinner
38:2515 year old Theo is cooking it
38:28It doesn't look like a bomb that's it does it when you're finished doing
38:33All the cooking it does
38:36I think i'm probably a dosing dad. I probably let them get away with too much, but
38:43uh, yeah, i'm i'm i'm a i'm a relaxer i think
38:51It's lovely fabulous very good
38:54To the chef
38:59My dad left um when i was about 10 weeks old
39:02And and so I didn't have a father figure in my life
39:09I had an amazing mum who filled that easily
39:12And was my role model growing up
39:15But I did not want to embark on
39:19Being a parent unless I was going to make a commitment that I would be there and be present
39:25Because I did you know it's I did feel that I
39:30Would have liked to have had that presence in my life when when I was at that age and and
39:35I didn't want that to play out again
39:37in another generation
39:40When I met my father in my 20s, it wasn't straightforward
39:46There's an expectation
39:49That you will have a father-son relationship, but actually that doesn't just
39:55Magic itself out of nowhere
39:57It was hard to
40:00Realize that you're never going to rebuild what you haven't had and then to
40:06Just accept and have peace with the fact that you can't rewrite
40:10history
40:11But you can start again from where you are now
40:27It's been 24 hours since omar operated on a ditcher
40:32Knock knock
40:33It's still unknown whether his hearing has returned
40:37How are you?
40:39Feeling all right?
40:40Yep
40:40Good well done
40:42Well done
40:43Feel like you've been hit by a bus this morning
40:45Yeah
40:45Yeah
40:46You're looking really well actually considering what you what you had done yesterday
40:50Yeah
40:50Yeah
40:51And you probably won't remember but it was very very stuck to your facial nerve
40:55So I'll just just show me your smile
40:57Fabulous
40:58Okay, you can relax this that's good
40:59What about hearing?
41:01I wasn't
41:02I can hear
41:03You can hear on that side now
41:06That's amazing
41:06Well, that's very positive
41:08I wasn't necessarily expecting that because it had really stretched your hearing and balance nerve
41:15And was stuck so I wasn't surprised that you'd lost your hearing
41:18But but that's a that's a great sign if you've already got some hearing back
41:21Currently there is no tightening nothing
41:27Everything goes well
41:28All right, got to take it easy when you get home
41:31Hey, I have to be treated like a prince when he gets home
41:34Yeah
41:34Oh, yeah
41:37Okay, we'll leave you to it for now
41:38Thank you so much
41:40Bye, have a good one
41:41Thank you
41:42Okay
41:45She's actually got some hearing back in that ear
41:53Dr. Omar said now treat him like a prince for the next three months
41:58You've never heard of prince treatment princess treatment
42:01We'll see
42:03Feeling good
42:04Professor Omar is number one
42:06I can hear again on my this ear
42:10It's amazing it's miracle for me
42:13It's clear
42:15Even no tightening no
42:18Dizziness nothing right now
42:21I really appreciate whatever the dr. Omar done for me
42:27It's really medical
42:43I absolutely love my job
42:47You need a significant level of confidence to be able to be a surgeon
42:52There is a difference between being egotistical and having a level of confidence and striving to be the best that
43:01you can be
43:02How are you?
43:02How are you? Nice to see you here
43:04Nice to see you too
43:04Nice to see you
43:05Good to see you again
43:06Yeah, good
43:06I like to get to know my patients as well as I possibly can
43:12I think that you are under more pressure when you're emotionally invested
43:16Because you really care about what matters to them
43:20Makes you better at what you do
43:24Neurosurgery is miracles and disasters
43:26Nothing in between
43:29Okay, it started
43:38I'm happy you are still here with me
43:47Go
44:00Heart surgeon inda carries out life-saving surgery
44:04We've got the a team with us today
44:07The trickiest moment is going to be at the end
44:10Will this heart work?
44:13Will we do?
44:17Go
44:17Go
44:17Go
44:17Go
44:17Go
44:17Go
44:17Go
44:45Transcription by CastingWords
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