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alice roberts our hospital through time s01e03
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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.
01:41St 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 bae, two, bae, whatever.
01:52And you just go through the double doors.
01:54Its specialist wards have room for almost 300 patients to stay at the hospital.
01:58See this one here? Just go and put a bridge 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.
02:25But 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 and looking for patients.
02:56And 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, there were regular outbreaks of the plague.
03:14Finding the sick and bringing them into the hospital was the job of certain officers called Beedles.
03:21In the mid-1500s, BARTs was employing a team of Beedles, officers who would go out into the streets of
03:29London looking for people who needed treatment in the hospital.
03:33Almost 500 years ago, there were only three surgeons at BARTs, yet the demand for medical care was so great
03:40that 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, but I really don't want
04:00you to infect any of my other patients.
04:02I can't allow contagion into BARTs. So 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, especially if what you had was catching.
04:23She's definitely infectious. Look at this. There are pustules all over her hands and her forearms and all over her
04:32face as well.
04:34I think I'm looking at the face of pox. I can't take you in, I'm afraid.
04:40I can't let pox into BARTs. Too much of a risk for the other patients.
04:46People with contagious diseases would have been sent to the hospital's outhouses beyond the city.
04:53Thankfully, today, the doors to BARTs are always open, with the staff providing world-class care 24-7.
05:01But patients may not realise how close the hospital came to collapse in the 1500s,
05:07thanks to our most infamous monarch, King Henry VIII.
05:12Henry had turned the country upside down, divorcing his first wife and marrying Anne Boleyn.
05:19He broke from the church in Rome, and he seized land and cash from monasteries, including St Bartholomew's Priory.
05:27Although BARTs effectively stayed open as a hospital, Henry had taken away its property, leaving it penniless.
05:36BARTs struggled on for seven years.
05:40Eventually, the citizens of London persuaded Henry to restore its property,
05:45pointing out that sick people were littering the streets and BARTs could solve that eyesore.
05:51Henry was convinced, and a new charter was drawn up.
05:57Amazingly, this extraordinary treasure still survives.
06:00It's enormous.
06:02This almost 500-year-old document is so precious, it's kept under lock and key.
06:09But today, archivist Kate Jarman is letting me have a look.
06:13This is the actual Tudor re-foundation document.
06:17That's right. This is the charter issued by someone whose signature is right up here at the top above the
06:22main document.
06:23Yeah.
06:24Henry R, that's his signature. Henry 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, because it was only granted a few weeks
06:38before his death.
06:39Really? Wow, 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, that there are sick people around the city who need
07:01to 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, this is when, in 1547, the role
07:16of 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.
07:28OK, my dear, when you've had your treatment, someone will come and take you back up to the water, OK?
07:32Look after yourself, OK?
07:33James 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, so my nickname is Rocket.
07:52We're going to go in a quick way.
07:53That's the way I am.
07:55It's got to be fast and furious all the time.
07:59He's fast.
08:00Time to catch him up.
08:05Every day, James moves up to 30 patients and covers five buildings, playing a vital role in keeping the hospital
08:12running.
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.
08:20Are 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? No.
08:25You sure? Yeah. OK.
08:26James' 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 and was in charge of checking who came in and out.
08:40By the 1800s, the job had grown to managing the water pumps and coal supplies,
08:46and ensuring all the hospital lamps were lit at night.
08:51No, it's all right. Thank you. Thank you very much.
08:55As a modern-day porter, James 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, from the blood transfusion unit.
09:13Hello. Come to get a platelet, please.
09:17Thank you much. Thank you.
09:20All 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, because 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.
09:52But 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.
10:29Across a lifetime, a human heart will beat an incredible two and a half billion times.
10:35From the first contraction in the womb at around four weeks to the very last pulse at the end of
10:41a life.
10:42The heart is a dependable workhorse.
10:46But when it does fail, Bart's is here to help.
10:51Over its long history, Bart's has been the birthplace of some pioneering medical discoveries.
10:58Especially in understanding how our hearts function.
11:03For centuries, people tried to work out how the heart and the circulation worked.
11:08And they came up with all sorts of weird and wonderful theories.
11:11They had ideas that the arteries carried air, not blood.
11:15That there were tiny holes and the blood flowed from one side of the heart to the other.
11:20Or that the heart pumped out blood and then somehow blood was magically regenerated in the liver.
11:26So, all this confusion.
11:29And then suddenly, there was a breakthrough.
11:34This breakthrough happened around 400 years ago, courtesy of Bart's most famous doctor, William Harvey.
11:42In the early 1600s, when William Shakespeare was writing the likes of Hamlet and Macbeth,
11:49Harvey was away in Italy studying medicine.
11:52He was obsessed with discovering how blood moved around the body.
11:57When he joined Bart's in 1609, he was experimenting on live animals.
12:03Dogs, eels and even wasps to watch the heart pumping.
12:11Fortunately, today we have less brutal ways of observing a living heart.
12:15So, I'm going to be a guinea pig.
12:17So, today we're going to do the scan of your heart.
12:20With some help from cardiac physiologists Delphine Encarnacion and Florence Lorenzo.
12:26It's just going to be a bit cold.
12:28All right.
12:29Florence is going straight to the port chamber images.
12:32Straight in. There's my heart.
12:35Invented in 1953, 375 years after William Harvey was born, an echocardiogram uses sound waves to create moving images of
12:46the heart and blood vessels.
12:48It's something Harvey could only have dreamed of.
12:51This is the right side of the heart and the left side of the heart.
12:54And the apex is at the top of the image.
12:56Correct, yeah. And then the, your right atrium here.
13:00Yeah.
13:01Despite having worked as a doctor and an anatomy lecturer, looking at my own heart gives me a thrilling glimpse
13:08of this incredible organ in action.
13:10Four chambers pumping away with valves to keep blood flowing in the right direction.
13:17You know, I know this anatomy so well, but there's something really quite mesmerising and impressive about seeing it in
13:25real time.
13:26And I bet William Harvey would have loved to have seen this.
13:29I mean, my goodness, it would have blown his mind.
13:33But Harvey wasn't just interested in the heart.
13:36He wanted to find out how blood moved around the body.
13:41He knew that veins had valves in them, and he thought that might be to keep blood flowing in one
13:47direction.
13:48So he conducted some experiments on beefy farm workers who had big veins.
13:53He saw that by putting pressure on their veins and then releasing it, the blood flowed in one direction towards
14:00the heart.
14:02After a decade of painstaking research, in 1628, William Harvey finally published his revolutionary discoveries.
14:11I've come to the Royal College of Physicians to see a truly extraordinary treasure of medical history.
14:19Oh, there's something extremely special in this box then.
14:25And it is a first edition of Harvey's book.
14:30I lift it up very carefully.
14:32This always feels like such an amazing privilege.
14:37Published in 1628.
14:43And at this point, he's worked as a physician at Barts.
14:48He's worked as an anatomy lecturer, rather like me, although I never made a breakthrough like this.
14:57Oh, look at that.
14:59So here's one of the most famous illustrations from this book.
15:03And Harvey's demonstrating that if you empty the veins just by the pressure of a finger on the vein,
15:09you can work out which way the blood is flowing along that vein.
15:13So he's working out that the blood is coming from the tips of the fingers back up the arm.
15:19This is absolutely crucial.
15:23It's about the motion of the heart and the blood.
15:29It may seem simple, even obvious to us nowadays, but Harvey's work overturned theories that had held sway for centuries.
15:38So this is really important because he's saying that the blood is constantly circulating.
15:44It's a phrase that we just throw out now as though we've always had that knowledge that the circulation is
15:52circular.
15:54I would like to have met William Harvey.
15:57I would love to just travel back in time to the 17th century and walk into Barts Hospital and go
16:04and talk to him.
16:06He's there at such an interesting time in medicine, you know, people are really starting to challenge all those classical
16:11ideas of medicine.
16:13And I think there's something really, really important in this book, which is about the fact that if you want
16:19to understand the human body, you can read what other people have written.
16:25But if you really want to know, you've got to look at the body itself, you've got to see this
16:31with your own eyes.
16:33It's so powerful to see the real thing.
16:36But yeah, I would love to have met him.
16:42Flash forward 400 years and today, William Harvey's amazing discovery is making operations for patients like 65 year old Edith
16:51Pugh possible.
16:53Two months ago, while out and about, Edith experienced a sudden and sharp pain in her chest.
16:58It was caused by a large tear in the main artery carrying blood from her heart.
17:04It's a life threatening condition.
17:06She's travelled from Belfast with her family, including son Will.
17:10She's a go getter, like the woman never stops.
17:13She's always on the go.
17:15She loves her hill walking.
17:16She loves shopping.
17:17She loves just being out and about.
17:20So, it's something that none of us will ever expect and it just, it's a shock to the system, for
17:25all of us.
17:28Today, Edith will undergo an incredibly complex operation that could take up to 10 hours.
17:35Her consultant is Professor Ong Wu, a world renowned heart surgeon and clinical lead at Barts.
17:43Hello.
17:44This is you?
17:45Yes.
17:46How are you?
17:47Professor Ong Wu is one of only a handful of people in the world with the expertise to treat such
17:53a challenging case.
17:58Edith has a tear in her aorta, the largest artery, carrying oxygen rich blood from the heart to the rest
18:05of the body.
18:06This damaged section supplies blood from the heart to the kidneys, liver, stomach, bowel and spinal cord.
18:13So, it's vital it's repaired quickly.
18:16Professor Ong Wu's plan is to replace the torn aorta with a synthetic substitute.
18:23It is a very dangerous operation. It's one of the most complex operations that you can perform in the aortic
18:29surgery.
18:30Too many things can go wrong with these operations.
18:33So, it is a big privilege as well as a big pressure on my shoulder.
18:39Good morning, everybody.
18:41These operations are quite long operations.
18:43And you need to prepare mentally.
18:48All ready to go?
18:50Ready.
18:50Playing a vital role in this incredibly complex procedure is Pete Reeves, a perfusionist.
18:57My colleagues, they just say, where's Pete the pump?
19:01Today, Pete the pump is using a heart-lung machine.
19:06The machine will divert Edith's blood out of the left side of her heart, bypassing her damaged aorta and allowing
19:14Professor Ong Wu to remove it.
19:16Pete will then pump the blood back into Edith's body through the femoral artery in her leg.
19:23This whole miraculous process is only possible if you understand how the circulation works.
19:29Thanks to pioneers like Harvey, it makes it possible for Professor Ong Wu to replace her aorta.
19:35Basically, we're here to supply the surgeon with a clear bloodless field in which to work.
19:41Edith is now under general anaesthetic and after two hours of prep, the surgery can begin.
19:47Trying to remove the tiny bit of a stingray off.
19:50With the blood flow to the lower body and spinal cord being provided by the perfusionists, Professor Ong Wu can
19:57start the procedure.
19:58Plumping the lower thoracic.
20:00Lower thoracic.
20:01Opening the aorta.
20:03Maybe a bit of blood.
20:07This will be the artificial aorta to replace her.
20:10This synthetic aorta is made from a type of polyester material that's also used in upholstery and soft toys.
20:18Replacement aortas date back to the 1950s when the first synthetic grafts were successfully used in surgery.
20:28In modern medicine, doctors often need to get blood into a patient.
20:33But historically, they were just as concerned with getting blood out of them.
20:39Bloodletting, intentionally removing blood from a patient, was believed to help rid the body of excess blood to rebalance it.
20:47It's been done for thousands of years and was practiced up until the late 1800s as a way to prevent
20:53or cure illness.
20:55Including here at Barts.
20:57And one of the most common tools for extracting blood used to be found in a long forgotten corner of
21:03the hospital.
21:04Just around here was where the apothecary shop was, where you could pick up various remedies, pills, medicines and something
21:13a bit more alive.
21:16I'm meeting archivist Ginny Dore Woodings to investigate the bloodsuckers of Barts.
21:24Ginny, that's got to be among the largest books that you've got in the archive, surely.
21:28It's definitely up there.
21:30A count of drugs, it says.
21:31Yeah.
21:32So this covers the 1860s to the 1890s.
21:34OK.
21:34And it's got big lists of everything that you might need to run a pharmacy shop.
21:39So it includes all your herbs, your alcohols.
21:42Brandy.
21:43More brandy.
21:44More brandy.
21:45A lot of brandy.
21:47All very intriguing, but I'm looking for something more wriggly.
21:51So Herudo Medicinalis is the medical leech.
21:54Absolutely.
21:55So yeah, and this is where you start to see the amounts they're buying per week and how much they're
21:59paying and the dates that they're buying them on.
22:01That's strange that they're listed in the pharmacy.
22:03In the way that you would give someone some pills, you might give someone some leeches to treat them for
22:07various things.
22:08Leeches were used to treat a wide range of conditions, from inflammation to headaches.
22:14And the word leech itself goes back even further.
22:17It comes from the Anglo-Saxon word for doctor.
22:22So where did they come from?
22:24In the 1700s, you would buy them off people who, particularly women and children, who'd go and wade in boggy,
22:29marshy areas and get them attached to their legs and then bring them and they'd sell them.
22:33People were wading into rivers as bait themselves.
22:36Yep.
22:37So how many leeches? Hundreds actually, each of these orders is a hundred.
22:41Yep, every couple of weeks and buying a hundred a dime.
22:44So 1,100 leeches in 1891.
22:47It might seem like a lot, but 50 years earlier they were using much, much more.
22:51Really?
22:51Yes.
22:52Letters from the hospital treasurer reveal the height of Bart's leech mania.
22:57By 1837, you're getting 96,300.
23:01No, in one year?
23:03Yep.
23:03So almost 100,000 leeches being used every year.
23:07By the late 1800s, this love affair with leeches had come to an end.
23:12But I'm keen to see one in action.
23:14So I'm meeting medical historian Leslie Smith.
23:17So you've got the leeches and I've got their dinner.
23:20You have.
23:21Right.
23:22So...
23:22Got some tweezers.
23:23Let's see what they do when we drop it in.
23:26Here's a nice piece of liver for you little leeches.
23:33Absolutely nothing.
23:34Look.
23:35Oh, no.
23:36What's he doing?
23:36I think he's feeding.
23:37He is.
23:38He's attached.
23:38Yeah, he's on it already.
23:40Yeah.
23:40Look, this one's thinking.
23:41How do I get there?
23:43Oh, here he comes.
23:43Look, he's making his way over.
23:46A leech has around 100 sharp teeth across three circular sets of jaws.
23:53Fortunately for the patient, having a leech latch on is pretty painless as their saliva contains substances that numb the
24:01area.
24:03I think they've actually sucked the blood out of it.
24:05Shall we stick in another piece?
24:06Then we'll be able to see.
24:09Oh, it's much pinker.
24:10Yeah, look at that.
24:10Look at that.
24:11Difference in colour.
24:12And apparently they can take five to ten millilitres of blood.
24:16And if you think about a medicine spoon, you know, it's usually five mil.
24:20Well, they can take up to twice that amount, which considering their size is remarkable.
24:24It is.
24:25That was a very good experiment.
24:27It worked.
24:28There.
24:30Coming up.
24:31Now we're going to remove this clump.
24:34Five hours into Edith's operation and her new aorta is in position.
24:38Okay, moving the distal clump.
24:40Okay.
24:41A life-saving donation from a son to his mum.
24:44He feels quite proud he's doing it, I think.
24:46And my needlework is put to the test.
24:49Okay, so we've made a start.
24:51As I learn all about the origins of suturing.
24:54What have I done?
24:56Right, I'm starting again.
25:02Saint Bartholomew's Hospital in central London is home to the world leading Barts Heart Center.
25:10Two days ago, 65-year-old retired mental health support worker Edith flew over from Belfast.
25:16The patient's doing fine. They're quite stable throughout the neuromonitoring.
25:23After five long and challenging hours in theatre,
25:27Edith's torn aorta has been replaced with a synthetic one.
25:30I know it's been a long day for everybody.
25:33Now Professor Wu needs to check whether it will function correctly.
25:37Now we're going to remove this clump at the lower end,
25:40allow the blood to come back into the graft and see any bleeding from this joint.
25:44OK.
25:47Now off the heart-lung machine,
25:49Edith's heart is pumping blood through her new aorta and around her body.
25:54Centuries of medical discoveries have come together
25:57to provide this life-saving treatment for Edith.
26:00Everybody has a role to make sure this operation is successful.
26:05As one of only a few experts pioneering this cutting-edge surgery,
26:10Professor Wu has learned ways to cope with the responsibility of his role.
26:13The job that I do involves quite a lot of high pressure,
26:17so it is important to have a time where you can rest and relax
26:23and having some solitary moment to reflect and then rejuvenate to carry on.
26:31Professor Wu was born in Burma, now Myanmar.
26:35His father was the country's first heart surgeon.
26:38He followed in his footsteps, but also learned a valuable skill from him.
26:43My father was very keen for meditation, and then he asked us as children to start meditation quite early on.
26:51As you get older, I understand that the value of it, I can concentrate in the middle of all the
26:59things going on,
27:00with all the noises and all the stressful kind of scenario going on,
27:04and then focus my mind and then complete the task without having to be distracted a lot.
27:10The surgery has gone well, but it will take the team another two hours to stem any bleeding and close
27:16up Edith's chest.
27:18Let's see whether I can.
27:19Meanwhile, Professor Wu calls Edith's family.
27:22So the operation was successful, everything went fine as we expected, so we would let her sleep.
27:30Whenever a patient has an open wound, whether it's the result of complex surgery like Edith's,
27:36or from a minor injury, the tissue usually needs to be stitched together to allow it to heal.
27:44Stitching wounds, or suturing, is something I did back when I was a doctor.
27:48It dates back thousands of years.
27:52The first mention of suturing comes from the world's oldest known surgical textbook,
27:57the Edwin Smith Papyrus, written over 3,500 years ago in ancient Egypt.
28:03It describes how to treat a variety of wounds, drawing the edges together by stitching.
28:09Over 1,000 years later, in the 6th century BCE, pioneering Indian surgeon Shashruta wrote a guide to suturing techniques.
28:19One way involved using large ants to bite the edges of a wound together like staples.
28:26I want to learn more about these ancient methods, and maybe even have a go myself.
28:31OK, so it's rather a long time since I've done any suturing, so I think I need a bit of
28:35a refresher.
28:36Glad to help.
28:38Cardiologist Stephen Hampshire is on hand, and I'm hoping there are no ants involved.
28:43Suturing's been around now for many, many, many years, using, like, hair of horses and things like that along the
28:49way.
28:49But obviously, trying to get into the wound, they had to use many different types of needles.
28:53Yeah, yeah.
28:53Including things like bone needles, which are very used for a long time.
28:56Oh, they're chunky.
28:57Yeah.
28:58I wouldn't like to be stitched up using one of those.
29:00No, so over time got much smaller.
29:04Almost 2,000 years ago, the Roman physician Galen described using needles like this, and something called catgut, to stitch
29:12the wounds of gladiators.
29:13The use of catgut survived until the 1990s, but no cats are actually involved.
29:20It's basically the byproduct or the gut of large animals such as cows.
29:25So it is gut?
29:26It is gut.
29:27It's just that it's not cat?
29:28It's not cat.
29:28OK.
29:29The reason behind why it was so good is the body actually absorbs it back into itself, so it will
29:35dissolve in the patient itself.
29:37Nowadays, sutures are mostly made from synthetic polymers.
29:40But despite advances in materials, many of the methods described by Galen are still used by surgeons today.
29:48Time for me to have a go.
29:49So this is the kind of suture that Galen would have done going back 2,000 years?
29:53Exactly the same as he proposed.
29:54What we're going to do is do a continuous suture from this end of this cut all the way down
29:58to the other end.
29:59OK.
30:00Nice bit of skin.
30:01Go down.
30:02Use your forceps to the other side to take off the needle.
30:05And pull through.
30:09OK.
30:10Perfect.
30:11So we've made a start.
30:12We've made a start.
30:13Now what we need to do is make sure that is secure.
30:15So what we're going to do is a surgical knot.
30:17Used since at least the first century, surgical knots are vital for keeping stitches in place.
30:23There are several different types of knots and tying one is a skill that can take years to master.
30:28It's part of every medical student's training in the UK.
30:33And this is why, Stephen, I became an anatomist.
30:37What have I done?
30:38Right.
30:38I'm starting again.
30:40Pull it through.
30:43So now, that is nicely stuck.
30:46So now we can get the needle back in our forceps.
30:48And now go diagonally across and just go through like we did before.
30:53Out the other side.
30:56And pull through.
31:01Oh, it pulled through.
31:02It pulled through.
31:03Look.
31:03Yes.
31:04I've gone too close to the edge.
31:05And it's pulled straight through.
31:07What do I do now?
31:08So the choices are...
31:09Clearly, I'm a little rusty.
31:11But it's extraordinary to imagine gladiators 2,000 years ago being sewn up with these very same techniques.
31:1726.
31:18Have I passed?
31:19You've passed.
31:19Not bad for the first time in how many years now?
31:2226.
31:22Not bad at all.
31:23Thanks very much.
31:26Okay, just going on the ground floor.
31:28Just a nice smooth ride.
31:30At Bart's Hospital, ancient medical techniques sit alongside very modern ones.
31:37Bart's is a centre of excellence for treating blood cancer.
31:40A disease that 40,000 of us are diagnosed with every year.
31:45Dr. Heather Ockovey is a consultant haemato-oncologist leading Bart's pioneering department.
31:51Hello then.
31:52How are you today?
31:53I'm right.
31:54So I look after patients with a variety of different blood cancers.
31:57The cells you collected yesterday will probably be the same volume.
32:01So we've had great fortune in haematology over the last few decades,
32:05whereby we've been able to make massive improvements in patient care
32:10because of scientific advancements.
32:13How long have we been looking after you here?
32:1415 years.
32:16Yeah.
32:17But it's the best hospital going.
32:21One of Heather's patients is Lorraine Gunn.
32:25She'd been feeling unwell for a few years.
32:28I had aches and pains.
32:30You know, you were sure, could it be menopause?
32:32Could it be this?
32:35But, um...
32:35Yeah, I wasn't expecting cancer really.
32:38So I've been on a bit of a roller coaster since then.
32:40Hi Lorraine, how are you today?
32:42Not too bad, thank you.
32:43So Lorraine has a condition called myelotisplastic syndrome.
32:45The bone marrow cells do not make blood properly.
32:49Bone marrow is the soft tissue inside our bones.
32:53Much of it is yellow and is mostly fat.
32:56But some bones around the centre of the body contain red bone marrow,
33:00which makes blood cells.
33:03But Lorraine's bone marrow makes faulty blood cells,
33:06and she's at high risk of developing leukemia.
33:08Have you had your chemotherapy yet today?
33:10I'm having it at the moment.
33:11Heather's plan is to destroy Lorraine's bone marrow
33:14and then use cells from a donor to help her make healthy blood.
33:19The process is known as a bone marrow transplant,
33:22and it has its roots in World War II.
33:25Doctors studying radiation sickness
33:27discovered that high levels of radiation damaged bone marrow
33:31and that a transplant could restore the blood cells.
33:35The first successful bone marrow transplant was done in 1956
33:40by Edward Donald Thomas on a leukemia patient
33:43with their identical twin as a donor.
33:47Usually we'd use a fully matched sibling,
33:50but Lorraine didn't have a suitable fully matched sibling.
33:53But fortunately, Lorraine's 27-year-old son, James,
33:57who works for the Crown Prosecution Service, is a good match.
34:04James is feeling a bit trepidation,
34:07and I think he thought if it goes wrong, it's something to do with him.
34:10So we've been trying to sort of say to him,
34:11it's nothing to do with that.
34:12You've given me a chance.
34:14You know, you've given me hope.
34:15Let's try to relax.
34:17The first stage in the process involves James giving blood.
34:21Among the many cells in blood are some very special ones called stem cells.
34:26These have the ability to transform into many different cell types.
34:31So far, so good.
34:34Lorraine's daughter, Catherine, is supporting her mum and brother.
34:37We don't know how this is going to go.
34:39We can hope for the best.
34:40And we are hoping for the best.
34:42We've also not really had cancer in our family before,
34:45so it's quite, yeah, a shock in that sense.
34:48I mean, James doing this as well.
34:51We always laugh that he's a bit of a mummy's boy,
34:53and I think now he'll definitely get the spot as the favourite child.
34:58James's stem cells are transferred into Lorraine's bloodstream.
35:02They'll move into her marrow and start producing healthy blood cells.
35:06I'm quite excited, really.
35:08It was a very nice thing that he's doing for me.
35:11So, yeah, great gift, really.
35:15But he feels quite proud he's doing it, I think.
35:19Yeah, nearly done, isn't it?
35:21Woo-hoo-hoo!
35:28St Bartholomew's Hospital is known for its world-class care
35:32and state-of-the-art facilities.
35:35But much of this modern hospital exists inside buildings
35:39that date back centuries.
35:43The Grade 1-listed North Wing, designed in the 1720s,
35:47has never had a medical function.
35:50It housed the hospital clerks and meeting rooms.
35:54For the past 18 months, it's been undergoing major restoration.
35:58And that's included the most spectacular part of the building.
36:03The Great Hall.
36:07The Great Hall was the jewel in Bartz's crown.
36:10It was a venue for lavish events to tempt generous benefactors
36:15into donating to the hospital.
36:17To bring the hall back to its former glory,
36:20the team have carefully repaired the panelling,
36:23meticulously restored the plasterwork
36:25and re-guilded the ornate ceiling.
36:30Its 36 sash windows dating back 300 years
36:35have also undergone conservation work.
36:39Steve Logan is one of the restoration specialists.
36:42The process of each window basically is to get the new wood to look old
36:47and the old wood to look a bit newer.
36:50Now, when you look at this, you can see those are brand new.
36:53That's actually a brand new bit of oak.
36:56So we've got to condition that so it looks as if it's 300-year-old.
37:01So it's filling, it's rubbing down, it's coating up.
37:04So you're coating on each window between eight coats of paint,
37:08outside and inside.
37:10It's great getting a hold of something
37:12that somebody else would put in a skip
37:14and you do the job that you do it
37:16to get it looking like that again.
37:18I absolutely love it. I love my job.
37:20I absolutely love my job.
37:23The Great Hall's windows filled the space with daylight,
37:26but in the 1700s that light came at a premium.
37:29King William III began taxing people according to how many windows they had.
37:36The tax was aimed at the wealthy owners of bigger houses.
37:40To avoid paying up, homeowners bricked up their windows,
37:44a site that can still be spotted today.
37:47And this tax may have inspired the phrase daylight robbery.
37:52Luckily for Bartz, with its many windows,
37:55the tax was repealed in 1851.
37:59Coming up...
38:00Wow!
38:01Yeah.
38:01Isn't it fantastic?
38:03The most treasured window at Bartz scrubs up nicely.
38:06The faces are incredible actually,
38:08especially looking at the face of Henry VIII himself.
38:11Edith's on her way home.
38:12Let's go.
38:13That's cool.
38:14It's her first time actually getting a bit of sunshine,
38:17getting a bit of air under the lungs.
38:18But the road is not quite so smooth for Lorraine.
38:22She had a nasty bacterial infection during her transplant.
38:32St. Bartholomew's Hospital in the heart of London
38:35admits around 248 patients a day onto its 20 wards.
38:41As well as doctors and nurses to look after all those patients,
38:45essential services and utilities have always played a vital role.
38:49A hospital needs a water supply.
38:53And Bartz was ahead of its time.
38:55In 1433, it had its own piped water.
38:59The water flowed through wooden pipes into a cistern.
39:03And in fact, it was a bit unreliable.
39:05So then a well was dug right here in the centre of the courtyard.
39:10And a pump was installed in the 1700s.
39:13So you can imagine that this would have been a very busy space
39:16with people coming to collect their water.
39:18But not everyone was a fan of this pump.
39:21Charles Dickens wrote about it.
39:22He said,
39:23In the centre of this space, there's an ugly circular pump.
39:27It looks like a slice of an old worn-out steam boiler with a lamp on top.
39:33And in 1859, this ugly pump was torn down
39:37and replaced with this rather beautiful fountain.
39:42The courtyard with its fountain became a place for patients to convalesce.
39:47And it's still a focal point of the hospital.
39:52Paying it a visit today is Edith.
39:55She's accompanied by her son, Will.
39:59First time in four weeks, can I say?
40:01Let's go.
40:03A month since undergoing major surgery, Edith has made remarkable progress.
40:09The last time she was here, she was just coming out of the ambulance,
40:11so it's her first time actually getting out and getting a bit of sunshine,
40:15getting a bit of air under the lungs.
40:16In two days' time,
40:17Edith and her new aorta will be travelling home to Belfast.
40:21Can't wait to get home.
40:23It's been a long journey, but we've got here finally.
40:26Like, the hospital is just incredible.
40:30Like, the staff, everything, we've treated so well since she got here.
40:33Like, it gave us peace of mind too,
40:34knowing that she was here and she was being well looked after.
40:39Across the courtyard in Bart's historic Great Hall,
40:43specialist conservators continue repairing the windows.
40:47One of them, the charter window, is so precious and complex,
40:52it was taken off-site for several months for restoration.
40:56Ready?
41:00That's the charter window.
41:01Oh, wow!
41:02Yeah.
41:03Isn't it fantastic?
41:04It's beautiful.
41:05I'm so lucky to be one of the first to be let into the Great Hall
41:09to see how it's been brought back to life.
41:11It's so luminous.
41:13Yes, it's been away for a year as well on its conservation journey.
41:18Heritage and Health Engagement Manager Caroline Hampson is decoding it for me.
41:23And there he is handing a document down.
41:27That is the Royal Charter.
41:29So that's the re-founding charter, which is how the window gets its name.
41:34Oh, that's amazing.
41:35The charter window is a 17th century depiction of one of the most important moments in Bart's history.
41:43Henry VIII closed Bart's Priory, taking away the hospital's income.
41:48Fortunately, he was persuaded to return its money-making property,
41:51and in 1547, a new charter protecting the hospital was drawn up.
41:57And it's got his great seal, hasn't it?
41:59That's his great seal hanging down underneath it.
42:01Yes.
42:01That's amazing.
42:02He looks quite healthy there, doesn't he?
42:05With his son next to him there on the right-hand side.
42:09So that's Edward.
42:10Oh, yes.
42:10And his purple cloak.
42:11You can see it's been repaired quite a few times.
42:14Absolutely.
42:15Henry did have two large pieces of lead work across his face, which distorted the image.
42:21So if you can just see on his left eye there...
42:23There is a crack coming down.
42:25So they removed that old lead, once they were sure that it wouldn't obviously damage the glass,
42:31and fixed that back together so he just looks beautiful.
42:34The faces are incredible, actually, especially looking at the face of Henry VIII himself.
42:38He does look very benevolent.
42:40He does look very benevolent.
42:42I mean, it's very lovely of him to re-found the hospital, having confiscated all its lands to begin with.
42:49Yes.
42:50But he did give it back, and it has been serving the community for the last 900 years.
42:57Back in the King George V building, there's been some good news for blood cancer patient Lorraine.
43:04Today I'm going home.
43:05Yay!
43:06After a month and two days, I'm going home.
43:09All the best.
43:10Thank you very much.
43:10Yeah?
43:11You're welcome.
43:12I'm quite overwhelmed, actually.
43:14Yeah.
43:15I've been quite cool all the way through it, but yeah.
43:18Yeah.
43:20It's actually behind me.
43:24Since receiving her son's stem cells, it's been a touch and go recovery.
43:29Lorraine's blood count recovered a few days ago, having been very low for a week or so.
43:34She had a nasty bacterial infection during her transplant, but she's completed her quite long course of antibiotics for that.
43:42So she's well and good to go home today.
43:45Sore's open.
43:47It's always good to go home, isn't it?
43:48Own bed.
43:49And food, yeah.
43:50Be lovely.
43:55Next time, I discover the uncomfortable truth of what happened when the plague came to Bart.
44:01The two physicians just left town.
44:03Who is left running the hospital?
44:05And I reveal how the work of a pioneering World War One surgeon...
44:09He's gradually restoring his face. Look at that.
44:13...paved the way for cutting edge operations at Bart's today.
44:17The very last stitch is going in, so I'm happy with how she looks.
44:39To be continued.
44:41To be continued.
44:43To be continued.
44:47To be continued.
44:49...
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