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Any Given Day: Cork University Hospital - Season 1 - Episode 02
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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
00:37can.
00:39Here I am, hold my hand.
00:41You're having a heart attack.
00:43Filmed using 27 cameras, following patient journeys across the hospital, each story in
00:49this series was captured in just one single day.
00:52Together, they tell a bigger story of any given day.
00:57I'm here for a long haul, you're not getting rid of me.
01:02I just broke down what is going on.
01:05I'm getting the chance she didn't get, so I have to grasp it.
01:09A good shift is where you come out the door happy, thinking, I made a positive difference
01:17today.
01:18And that's really it.
01:21What's the difference?
01:29Message received, thanks.
01:34Look, I am getting absolutely hammered.
01:37Hi, it's Lane over in Aeney.
01:39I'm just wondering, is that bed ready yet?
01:41You don't have no beds, but like, 4C are taking patients off of you.
01:44They're not gone yet?
01:47Yeah, does that mean you have one space?
01:52Yeah, so does that mean we give it 40 minutes, 20 minutes, 30 minutes?
01:59Okay, look, it's half as one now.
02:01Will we be over by half as two?
02:02Will the handover and the patient be up in the ward and everything like that?
02:06Fabulous.
02:17A four-year-old girl, Madison, is being rushed to hospital by ambulance.
02:22She is suffering prolonged seizures.
02:25It's a question of your airway.
02:27Robin, are you okay on drugs?
02:28Yeah, I think that would be on antibiotics and fluids.
02:31You might need a second person.
02:34Emergency consultant Rory O'Brien is leading the team in Resos.
02:38Rachel, I think access is going to be the thing.
02:40With a sick child, you need a lot of people, but you want things to be calm.
02:44You want things to be measured.
02:45Do you mind doing assessment?
02:47You want to be making the best decisions.
02:49Prolonged seizures, we know, aren't good for you.
02:5350-minute seizure, had a further one-minute seizure.
02:55The oxygen going to your brain, which is what you're trying to protect,
02:58may be reduced, which can affect brain metabolism.
03:02So, we need to stop the seizure.
03:04Madison's mother, Shannon, called the ambulance.
03:07I know what seizures are like.
03:09I just felt there was something just different about this one.
03:12We gave the rescue medication after five minutes, which I administered myself,
03:15and the jerking of the body stopped.
03:18But then the lips started twitching, and the eyes were starting to roll into the back of her head.
03:22And her breathing is starting to be affected, which had never happened with Madison before.
03:27She had a seizure this morning at approximately 29, lasting 16 minutes.
03:33When we got to her...
03:34Madison's condition has continued to deteriorate en route to hospital.
03:38Her breathing is compromised.
03:42She looked lifeless, like, as if she was gone.
03:46Just see that, like, when they're pushing the bag down and your child is, like, unresponsive.
03:51It's, it's, it's horrible.
03:54That's clearly a major concern because I'm wondering, is this a problem with her airways?
03:58Is that why she's not breathing appropriately?
04:00Is it a problem with her lungs?
04:01Is it a problem with her circulation system?
04:03Or is it a problem with her neurological system with her brain?
04:10I thought we were never going to get there.
04:14Can I get access to it?
04:16Yeah.
04:16We're here.
04:17Yeah.
04:18We're here.
04:20Yeah.
04:21We're here.
04:24We're here.
04:25We're here.
04:28We're here.
04:28We're here.
04:31We're here.
04:33We're here.
04:33We're here.
04:34I'm here.
04:35She's had one more seizure on route.
04:37We're right focused there.
04:38Also, tonic.
04:39Her limb stiffened also.
04:41Can I back up yourself, yeah?
04:42I'm not.
04:43No doubt.
04:44Hi, Madison.
04:45Hi, Madison.
04:45Hello.
04:47Hello.
04:50Hello.
04:50Sorry, is this.
04:54She's stiff there.
04:56No.
04:56No.
04:57No.
04:57No.
04:57No.
04:58No.
05:03She's quite, she's a lot stiffer on this side there.
05:09I'd say we give another lorals there, I think she's still seizing.
05:12To a child who's having a prolonged seizure,
05:14you're fundamentally worried about any primary or secondary injuries
05:17that would be happening to their brain.
05:19Do you think she's seizing?
05:20There is a very high chance that this child will need to be placed in a ventilator
05:25while we give her very potent medications to help stop the seizures.
05:30As the resource team work to stabilize Madison,
05:33her parents and grandparents are waiting in the relative's room.
05:36I don't know.
05:37A nurse came out to us and said,
05:39look, we're going to have to prepare you for the worst.
05:42She probably has been seizing them.
05:43To hear that then, it just broke my heart.
05:48What are her eyes like? Is she...?
05:50And they're, they're not fixed, they're not, yeah, yeah.
05:54We're doing good for today.
05:55Don't feel too cool.
05:56And she was stiff on the right side, so...
05:59And eyes were slightly deviated to the right, so probably seizing.
06:02There was uncertainty as to whether Madison would need to be placed on a ventilator,
06:08so you do need to introduce that idea early on
06:11because you have to prepare Madison's parents for that very possible outcome.
06:24I just said to my mum, I can't lose her.
06:26I can't lose my child.
06:41Howard Grice has motor neuron disease.
06:43He is in CUH today with his wife, Yvonne, to check the progression of the condition.
06:56My name is Howard Grice. I was born in Sheffield, Yorkshire in 1966.
07:01I moved to Towering County Cork in 1994 with my partner Yvonne.
07:09I have motor neuron disease.
07:11It has affected my speech and swallow, amongst other things as well.
07:20Howard is treated by a multidisciplinary team, including respiratory physiotherapist Kevin O'Sullivan.
07:27I've really been without speech since about a year and a half ago.
07:31So I use this app to communicate now.
07:34From your point of view, how is the breathlessness?
07:41A recording of my speech was made when it was deteriorating.
07:45What you hear now is a repaired version of my speech.
07:49It can be frustrating, but you get used to it.
07:54You've done this before, yeah?
07:57Big deep breath in, coffee into the mask.
08:00And we're going to just see how showing it out.
08:02We'll be doing three or four. Go on.
08:06I'll turn away from you, otherwise I'll be laughing and not about to do it.
08:12When Howard laughs, his whole body would shake.
08:15His face would just erupt, and you'd laugh with him.
08:19You don't know what he was laughing at, but you'd laugh with him, you know?
08:23It's difficult watching him and knowing what he was like before.
08:27He was very talkative.
08:30He was the life and soul of the party.
08:32He'd be the first in and the last to leave.
08:35Just a top guy, you know?
08:39Recover.
08:40Big breath.
08:42Cough.
08:45The motor neurone disease, it's a severe degenerative disorder of the nervous system.
08:50And we don't unfortunately have a cure for it.
08:53We do have limited medical therapy, which is shown to slow things down,
08:59but unfortunately it doesn't stop the disease from progressing.
09:01My cervical spine identified a disc at C5-6, but his symptoms were...
09:05Consultant neurologist Aisling Rhine has been treating Howard since his diagnosis.
09:11It's always difficult to communicate the diagnosis of motor neurone disease to a patient.
09:16You never get used to it.
09:18You try to be there for that person and be the go-to link or be the coordinator for their
09:25care for as long as you can.
09:27So, a small dip today compared to the last time you were in clinic, okay?
09:33The most common cause that people die of, finally, in motor neurone disease is respiratory failure.
09:38And even if your lungs are okay and you've never smoked a day and you've perfectly healthy lungs,
09:44we still need innervation of our chest muscles to actually move our rib cage up and down
09:49and that slowly over time fades for patients with motor neurone disease.
09:56And relax, okay? I know. Take a breather. Give him a minute.
10:02You're going to have to be doing this another two or three times as well, okay?
10:05He likened it to a thief taking from you the whole time.
10:09The thief has got his hand in your back pocket and he's taking everything.
10:12He's taking your speech, your mobility.
10:16Better.
10:17It's like a gradual chipping away of the person that you are.
10:21I had always been a very active person and felt the threat of losing my ability to continue living
10:27as I had been accustomed to would be a very difficult challenge.
10:35A lot of negative emotions, anger, fear, sadness, worry. It's a head wrecker.
10:44Super.
10:44Super. Well done.
10:45Super love.
10:45Super love.
10:45Oh.
10:46Okay.
10:46And there's your other soft collar.
10:47And that's our number on that one isn't it?
10:50Yeah.
10:50Yeah, that's fine. Just so you have it, okay?
10:52Okay.
10:52We'll see you again, okay? I will be in touch.
10:54Bye-bye.
10:55Good thought.
10:59Are you from Limerick?
11:00No. I'm from Cork.
11:01I am from Limerick.
11:02I am from Limerick.
11:03Why would you think I'm from Limerick?
11:05You have the features of a Limerick girl.
11:08Do I?
11:09Yeah.
11:10Thanks.
11:11I don't know, is that a compliment or not?
11:13Limerick girls are the best-looking girls in the country.
11:15Who?
11:16Limerick ladies are the best-looking girls in the country.
11:17Oh, so it's a compliment.
11:19Yes.
11:19Thank you very much.
11:21Yeah.
11:25Dr. Jason Vandervelde is on duty in the emergency department
11:29and also on call for emergencies outside of the hospital.
11:32You have the golf car, seven minutes out though.
11:36Yeah, I mentioned it's cold and stiff, but I'm sure it's beyond any help.
11:40Now, Roger, the golf car's on its way. That's perfect.
11:43Thank you very much.
11:54Cyclist George Fuller has dislocated his kneecap.
11:58Jason will seek to realign it.
12:07I stumbled into pre-hospital care.
12:10Don't know if I'll do it again.
12:11I'll probably be a vet in another life.
12:18I was a lifeguard, beach bum.
12:20Didn't do great at school.
12:23Joined the ambulance service.
12:24Really enjoyed it.
12:26Absolutely loved being a paramedic.
12:28I just won't go for it.
12:31Had to be sore.
12:33Use the top finger on the top to actually strengthen it.
12:37And I'm going to not do anything to you for two minutes.
12:39I actually want you intoxicated.
12:40And then I'm going to straighten it.
12:43Got injured.
12:44But I still wanted to carry on.
12:46And so I suppose that injury in myself enabled me to go to college, study further.
12:52And so we're in medical school.
12:54I'm going to do bigger breaths than that.
12:55I think it's that community of pre-hospital care that's so special.
12:58Your head will swim. That's fine.
13:00I just want you completely intoxicated.
13:02Deep breaths.
13:06Deep breaths.
13:08You're doing perfect.
13:09Well done.
13:11You're doing perfect.
13:12Deep breaths.
13:14And relax yourself down.
13:17There we go.
13:17Well done.
13:19Deep breaths.
13:20You've done magically.
13:22Keep going.
13:24Just turning the kneecap the right way around.
13:27Well done.
13:29You've done brilliantly.
13:31Okay.
13:33All straight.
13:35Just like an inch.
13:36Well, no.
13:38Yeah.
13:41I'm out of here, Dads.
13:44Jason is dispatched to a serious incident near Fermoy.
13:48A man has been kicked directly in the chest by a racehorse.
13:51A patient is coughing and spluttering.
13:56Making loud walking noises there.
13:58Or ear clutches.
14:00Crew heavy.
14:00It's freezing.
14:01It's freezing.
14:05Bottom line is people do not get injured at the front door of the hospital.
14:10You get ill or injured at home, on the farm, in the workplace, on the road.
14:16And our role is to bring the expertise of the hospital to where you've become ill or injured.
14:22To slow down.
14:23Hopefully halt the dying process.
14:32I see a man in a farm yard.
14:34He's also being kicked by a horse.
14:37The big worry.
14:39You've taken a full force of a massive animal kicking you into the chest.
14:44That energy has to go somewhere.
14:47It hits your chest wall.
14:48Bruises in the lung.
14:50Bruises to the heart.
14:52I have to assume the worst at this stage.
14:57Yeah.
14:58So it was just a straight forward kick into the chest.
15:01And you didn't get thrown backwards?
15:03You did?
15:04Okay.
15:06And did you hurt your back at all?
15:09You did.
15:09Okay.
15:14You've got to be very, very vigilant that they haven't damaged the spinal cord.
15:18Bones can break.
15:19They can break all the way through to your back.
15:21Any pain to the chest?
15:23Yep.
15:24That's the one.
15:25He was in a lot of pain.
15:27Nice.
15:28The ground here is not going to make it stable.
15:30Hang on.
15:32Hang on.
15:33Right, I'm going to keep up.
15:35And the horse was still standing between me and James, so I couldn't get to him.
15:40All I could think about was what damage is after being done.
15:43And when I heard it was in the chest, all I could think about was what's going on inside in
15:48him right now.
15:51I'll get you in the ambulance with a much, much better look at you.
15:54I'll knock me out, I'll get up to you.
15:56Yeah, it won't be far off, it's all right.
15:58Far off it, all right?
15:59Just go with it.
16:00Okay, I'm just going to get some, some scared.
16:04James?
16:06Let's have a quick look at your lungs, all right?
16:07Just while you're here.
16:10There we go.
16:15When you see someone you love lying on a stretcher and they're pinned down to it and their eyes start
16:21to roll and the colour drains from their face.
16:26Is he bleeding internally? I didn't know what was happening.
16:29That's when we all got really frightened.
16:41Four-year-old Madison was rushed to CUH earlier today.
16:46The team have successfully stopped her seizures, but she is yet to regain consciousness.
16:54We just wanted her to come around, like too far to open her eyes, so she knew that we were
16:58there.
16:59I'm going over this, I don't want to hold her hand.
17:07Probably.
17:11Can I hold her hand? Is that okay?
17:13Yeah, sure, sure, sure.
17:14I'm holding because it was a bit cold, so...
17:17She is cold.
17:19There's one thing seeing her have a seizure, but to see her the way she was, like, literally out cold
17:25from being given medication to keep her comfortable.
17:36And we were just talking to her and, like, saying, come on baby, like, you're okay, like, we're here.
17:43And you just want to be with your child and make, like, take her place so she isn't going through
17:48what she's going through.
17:49It's very hard. It's very, very hard.
17:55She's been fighting since the day she came into this world.
18:00We never thought she would do anything that she's doing, like, now.
18:04But Madison, like, she just surprises us every day with how, like, strong she is, and we're just so proud
18:11of how far she's come.
18:14I was only 19 when I found out I was pregnant with Madison.
18:18I was happy, sad, scared.
18:22My partner James found out I was pregnant three weeks after meeting him.
18:27I was like, oh, my God, like, does he want this? Like, is he going to walk and leave me
18:31on my own? But he didn't.
18:33He said, we did this together, and there's no one going back, like, we'll do it together.
18:38The birth was, it was, like, it was hard, but it was beautiful, and I was just, you know, I
18:43was so happy that, like, my body was able to bring Madison into the world,
18:48and that I had James' support as well.
18:51And then everything changed. Everything changed.
18:58We went in with the consultant, and they said Madison has been diagnosed with DYRK1A syndrome.
19:05We were, like, so worried. I was like, what is wrong with her, like?
19:11She's the only child in the Republic of Ireland that's been diagnosed with it.
19:14Like, I think there's, like, 30-something kids in the whole world with it. Like, it's very rare.
19:22Madison, like, can't talk, she's autistic, she's epilepsy, feeding problems, walking problems.
19:29There's so many to do with her disability. Like, she suffers from constipation, reflux, like, there's so much.
19:38I weigh very heavily on how the parent is viewing their child.
19:42They'll know the condition better than I will. They'll know the nuances.
19:46Madison is extremely ill and will need to be closely monitored in the coming hours.
19:53She's now getting oxygen to her brain, but things can change at the drop of a hat.
20:00Madison can start seizing again, and her oxygen levels can start going down again,
20:04and her breathing can become depressed again, so you maintain a holding pattern.
20:15James is very, he's a very caring person, very kind.
20:18He said, and no matter what, we'll be the best parents.
20:22And show our kids, like, what love is like as well. Like, show them that, like, no matter what, we're
20:26always going to be by their sides.
20:30It is hard, like, it's very challenging, and it's like, it's around the clock here, like, it's constant.
20:36Constant medications, dosage, dosage change, hospital admissions.
20:42They're entrusting you with their child. So at this moment, they are saying, you need to come in, you need
20:50to help us.
20:51I couldn't imagine what it's like. It's that lack of control, having to give control over to the team.
20:59It must be a very uncomfortable kind of feeling for the family to do that.
21:06We're living it every day. This is what our life is with Madison every day.
21:16CUH, it's like a big city with little villages, you know, each of our own little set group that we
21:23work with.
21:23But then we kind of called to the neighbours every now and then for a bottle of milk, you know.
21:32You okay, James?
21:37Where's my Niamh?
21:38Where's Niamh? Niamh's outside there.
21:4049-year-old James Fenton was kicked in the chest by a racehorse.
21:46Emergency doctor Jason is concerned he may have life-threatening chest and back injuries.
21:52Paramedics are preparing to move James to CUH.
21:55Two specific points thoracic spine. Upper thoracic spine and lower thoracic spine.
22:02And he's also tender into the lumbar spine.
22:04If you have a chest wall injury, excruciatingly painful.
22:07Because every time you breathe, it's pain.
22:11I have not got a CT scanner that's going to tell me definitively that those lungs are not contused,
22:16or that heart is not bruised.
22:19So my first priority is just getting as much analgesia as he needs to enable him to breathe effectively.
22:26I like Niamh. Niamh, home Niamh, of course.
22:31Ah, yes, we've got it.
22:33Everyone's there looking after everyone.
22:35I don't know if I have to give them the name.
22:37Ketamine.
22:38I'm on fucking cloud.
22:40Oh, that's good. There's no pain though.
22:42No, I'm good.
22:43He was on cloud nine. I think it was the results of the ketamine in his system.
22:48He didn't feel like he was here with us.
22:53He proposed again.
22:56I love you and we'll get married next week.
23:00Really? Yeah.
23:02I was eight months pregnant, trying to keep calm.
23:08How are you?
23:09How are you going?
23:09I'm going to follow you into the hospital.
23:11All hospital.
23:12See you here.
23:14I was just trying to think, how am I going to juggle all of this?
23:17And I'm going to be on my own doing all of it.
23:21What if this is more serious and that the ketamine and all the other drugs he's on are masking what
23:28he's actually going through?
23:40Howard has motor neuron disease.
23:43Following his respiratory assessment earlier, he and his wife Yvonne are waiting to see consultant neurologist Aisling Ryan.
23:53Hi.
23:55How are you? Come on in.
23:59Take a seat there, Howard.
24:01Can I just get a sense of what you can do there?
24:03So just arms up if you can.
24:05Good. And keep that up against me.
24:07Good. Keep that up.
24:09Good. Maybe a little weak there.
24:10Push down for me nice and strong and push down nice and strong.
24:13Okay, good.
24:13He still has quite good strength in his arms and legs.
24:16So he's walking. He's able to be independent in many aspects.
24:20But unfortunately, that will change over time.
24:23And then it's dealing with the challenges that that brings up.
24:26And how is he going to manage?
24:28How is he going to, is he going to be able to walk around his house?
24:32Is he going to be able to dress himself? Et cetera, et cetera.
24:34And this time, pull towards you, pull in towards you.
24:36I've got fantastic support from Yvonne.
24:39There are things I can no longer do for myself that she now helps me with.
24:43And she's had to handle my frustrations.
24:47I'm fairly good at releasing emotion.
24:50I don't like bottling it up.
24:52Better that it comes out.
24:55And just the grip strength. Just squeeze me tight there.
24:58Okay. And squeeze tight here.
24:59Yeah, that's a little weaker in that left hand, isn't it?
25:02How's the strength in the leg?
25:03I just like to look after him.
25:05You know, it's not a big deal.
25:08It's just, that's what you do for somebody that you love, I think.
25:11We have an issue with the wedding ring.
25:13The fingers have swollen.
25:14Oh, okay. And we can't get it off.
25:16It looks to me like it probably needs cutting off.
25:18They will have a ring cutter.
25:19They always have one down in the emergency room,
25:21because sometimes this happens.
25:23I mean, it's sort of a difficult thing to, you know, cut the wedding ring.
25:27Do you want that done today, if we could organize it?
25:30Not really. Do you want to think about that a little bit?
25:33It's nice to just sit and be together and hold hands.
25:37It's just a bit of closeness.
25:40And once all the hustle and bustle, that's a precious moment.
25:45Maybe the next time you're coming, or if that's too far away,
25:47we can get it done in between.
25:52We all know how it ends, but the challenge is to make the most of the remaining time I have.
26:00Despite my deteriorating health, I still feel very fortunate.
26:05I have a loving family.
26:06I have a lot to be thankful for.
26:12I don't think about what I may miss, but concentrate on what I have enjoyed over the last 20-odd
26:18years with them.
26:22Life's too short for all those to be worrying about how it all ends.
26:26The trick is to enjoy each day.
26:36What are you playing?
26:37Yeah, it was sports.
26:38It was sports day.
26:40It was everything, yeah.
26:42Tag, rugby, I think.
26:44First and last time, I think.
26:47We're giving you more medication there now, Jude, okay?
26:55It's almost done now.
26:57It's almost done.
26:58It's almost done.
26:59Well done.
27:0464-year-old Tim Murphy has advanced lung cancer.
27:08Today, doctors will attempt to surgically remove the cancer in a bid to save his life.
27:15That'll be 40.
27:19The consultant came in and told me that Tim had a tumour on his lung and it was cancer.
27:30I've had two uncles that actually died of lung cancer, so I just thought, oh God, here we go.
27:41He's gone.
27:43Number 40.
27:44What?
27:47I just remember Dr. Collins' initial words were, oh, it's a big boy, was what she called the tumour.
27:56What's the date of birth?
27:5719th of July, 62.
27:59I first met Tim in the autumn of last year.
28:03He would have discussed his case in our multidisciplinary team meeting and we would have looked at all his images
28:08and made a decision that actually, pre-surgery, chemotherapy with immunotherapy, I suppose a regimen that we call neoadjuvant, was
28:17the right way forward for Tim.
28:18And the whole purpose of that would be to shrink down the cancer, because as he currently was with his
28:23diagnosis, he probably would have lost his entire lung if he had gone straight for surgery.
28:28Great, we might have a quick look at the board then.
28:31When I walk through the hospital, there is professional persona that kicks in, but one of the hardest things that
28:38I do is when I, you know, have patients and have to tell them that this cancer is going to
28:44shorten their lives significantly, that they are, you know, going to not be around for their children or their grandchildren.
28:56You know, we give people hope, we buy people time, but it is emotionally very draining.
29:03It can be really hard to shake it off at the end of the day and to, you know, head
29:09home and pretend that I just, you know, put in a nine to five.
29:13Following a regime of chemo and immunotherapy to reduce Tim's tumour, surgeon Kishore Dodakula will attempt to remove his cancer
29:21completely, also hoping to save his lung.
29:25Okay.
29:26So if we look at the differences, I suppose, in where we were after 12 weeks of treatment, there's obviously
29:33been significant change.
29:34You can see a disease, big cancer here, and then, you know, obviously much smaller now.
29:38You never know till you really go in, but I'll try and save, but you know yourself, you know, unless
29:43we go in, we won't know.
29:47Do you smoke?
29:48No.
29:49So he's off them now two years since the 14th of April.
29:54There was a point, and now Tim doesn't know this, but I felt very angry at him.
30:03Like initially it took everything in my power not to say, you were warned.
30:13And he had this god-awful cough.
30:16Sometimes he'd nearly choke with it, and I just couldn't understand how he carried on smoking.
30:24But you just have to try and think of where do we go from here.
30:29So we'll start the pre-op.
30:32They'll check your operation site later on.
30:35My operation what?
30:36Operation site.
30:37Just so we always mark where we're going to operate.
30:39It's handy.
30:40Make sure it's the right site.
30:41Exactly.
30:42Yeah, it's just a check.
30:43Do you know the reason for your admission?
30:46Yeah, lung cancer.
30:47Lung cancer.
30:48And you're going to, this is a surgical ward, so you're going to have surgery on your left lung.
30:53Yeah.
30:54Is that okay?
30:54And hopefully they'll be removing?
30:56Hopefully.
30:57The tumour.
30:58Yeah.
30:59To be told that the tumour had shrunk by half was huge.
31:05We knew then that he could go for surgery.
31:08We just had to see what they could do.
31:10Who's next of kin?
31:11Kit.
31:13Is it partner, wife or?
31:15Partner.
31:15I asked the same question myself.
31:17Not yet.
31:20Later this year.
31:21Yeah.
31:22Okay.
31:22Brilliant.
31:23Congratulations.
31:24What?
31:26The goal is to get him to surgery.
31:28So being able to, I suppose, shrink down his cancer and have it then removed by a surgeon
31:34is the best outcome and what we could hope for for Tim.
31:38How are you doing?
31:38Let's sit down here.
31:39Good.
31:39No, no, no.
31:40Please sit down.
31:41Sure.
31:41It's all right.
31:41Yeah, yeah.
31:42How are you feeling?
31:43Great.
31:44Brilliant.
31:44Good.
31:45The day has come.
31:46Yeah, I heard so.
31:47Yeah.
31:48So heading into surgery fairly soon.
31:50Yeah.
31:50The chemotherapy and the treatment, are you feeling together?
31:52Yeah, I feel good.
31:54I didn't suffer badly with it at all.
31:55Yeah, yeah.
31:56Just pins and needles.
31:58Tiredness.
31:58Yeah.
31:58Beat you up a bit.
31:59In addition to beating the cancer up a bit.
32:01Yeah.
32:02That's the plan.
32:02Did that though, didn't it?
32:03Did you?
32:04Yeah.
32:04Did a big job in that.
32:05Thanks be to God.
32:06Good.
32:06Good.
32:07The big fear for us is that, you know, when the surgeon goes in to operate, that he doesn't
32:13get it all.
32:14And Tim might end up losing the whole lung in order to try and get clearance.
32:18And of course, there's risks to surgery.
32:20I mean, having a portion of your lung removed is not without, you know, potential for potentially
32:26devastating impact.
32:27It's just that.
32:30So, yeah, it is what it is.
32:32I know.
32:33We're getting done.
32:34We're getting done.
32:35You know?
32:36Can't do much more about it, eh?
32:47She's cold.
32:48She's cold.
32:49She's cold.
32:50The team has stabilized Madison following a series of prolonged seizures earlier today.
32:55Just ring me.
32:56Yeah.
32:57She's cold.
32:58She's cold.
32:59She's cold.
32:59She's cold.
33:00Madison suffers from a rare genetic condition called DYRK1A syndrome.
33:07We always said from the start when we found out Madison was sick, like, no matter what,
33:11we'll deal with it together as a family.
33:15I do get lonely at times, but then I have the, like, support of my mother, my father,
33:22my partner James, my siblings, his parents and his siblings.
33:26So, like, we can just ring them, but it's very hard to, like, you know, kind of explain
33:30how you're feeling.
33:31This is her dad.
33:33This is her dad, James.
33:34I'm constantly blown away.
33:36Just the, the level of care and dedication that parents have.
33:41You know, their whole lives have gone down a path they, they didn't think they would go
33:45down, but you never see, eh, regret.
33:49You only see love.
33:52Um, and it's, it's just, it's, it's mind-blowing.
33:57Madison will be admitted to the paediatric ward so she can continue to be closely monitored.
34:04She's just, it's a lot more stable now, so we're happy that we're going to bring her
34:08back and then just kind of wait for her to come around, we keep an eye on her.
34:12Madison does have needs, and that's just the way it is, but she brings so much happiness
34:17to all our lives, and everyone is, like, so happy.
34:20Like, she puts a smile on everyone's face that she meets.
34:23Just looking forward to the future as our family.
34:41James was kicked in the chest by a racehorse earlier today.
34:45Pre-hospital physician Jason Vanderveld is concerned he may have significant injuries
34:50to his chest and spine.
34:54I've been there with horrific trauma when it's your own family member.
34:57You know, my son fell off the banisters, you know, from the top story down to the bottom
35:04story and literally went splat on the tile floor below.
35:09Having to manage that will always stick with me.
35:12I live rural.
35:13I live 50 minutes from the hospital, so I had to switch into clinician mode.
35:19I did not have any other option.
35:23And the one thing that I've appreciated is my colleagues, the CUH family,
35:28because I was able to hand over care with my severely traumatically injured five-year-old.
35:34I knew he was in completely safe hands.
35:38He has multiple creplices down the left-hand side of the chest.
35:42He's had one pentrox.
35:44Before James can be sent for a vital CT scan, his pain needs to be controlled.
35:49I don't know.
35:52We are just going to get some local anaesthetic and try to take the pain down.
35:58All right.
36:07It's all right.
36:13I seem to be very calm on scene, or my parents on scene is very calm,
36:17almost non-empathetic, but actually I've been there.
36:21And I know that the most effective way of managing somebody who's traumatically injured
36:26is to push emotion to one side
36:30and focus on the clinical, on what really matters.
36:35A lot of this is just the ketamine, because you don't feel in control.
36:39And yourself being the boss, normally at work, you're always in control, aren't you?
36:45The day before James' mum had passed away,
36:50to see a completely opposite side of James being so vulnerable, so upset,
36:56that his mother had passed away, then in so much pain from getting a kick from a horse,
37:01all in the space of 24 hours, it was very, very hard to know what to do
37:07or how to make things better and how to be there for him.
37:10OK, I'm checking there for you.
37:14I know you're hurting a lot, so what I'm going to be doing
37:16is getting a bit of local anaesthetic,
37:20just in two, round where it hurts the most.
37:26You can see the bruise coming up now, eh?
37:28I'm going to die just now.
37:29I know, I know.
37:30I know, I want you to get up with your phone, OK?
37:35I think just one thing at a time, all right?
37:37Because in fairness, you took quite a belt of that horse, all right?
37:50No, you're definitely not hot enough to be in hell.
37:53Sometimes you call this place hell, but it's not.
37:55It's C-U-H.
38:01I'm a paediatric nurse by background.
38:03I started off actually as an actor over in the UK.
38:06I'm from Wales originally.
38:08And I went into the hospital as a play specialist,
38:10working with puppets and children.
38:12Funny, really, is that a lot of the TV stuff,
38:14which I did as an actor, was hospital-based,
38:17like I was extras in Casualty
38:18and a few other hospital-based programmes.
38:21So when I first came to work in hospitals over in the UK,
38:24I didn't actually like things like injections and blood,
38:27so I just used to pretend I was back on set of Casualty.
38:34Eugene O'Leary has been brought to the emergency department
38:37following a chainsaw accident.
38:41You were cutting the hedge, were you?
38:43Yeah.
38:45It needs a few stitches, doesn't it?
38:47I would think so, yeah.
38:48Yeah.
38:49How many cuts are there?
38:50So the thumb index...
38:52You wouldn't do it with a knife next time, would you?
38:55Eugene's hand was quite simply a mess.
38:57If you have a wound there,
38:59bacteria in that dirt love blood,
39:01and they just grow and grow and grow.
39:03Ah, it's a whole mess, isn't it?
39:05But there's still leaf on that.
39:09Leaf.
39:09There's still leafs on you.
39:11There'll be hedge growing your snark.
39:13I'll jump in there.
39:14I'll flip in there.
39:22I think...
39:26One of the most mangled hands now that I've had to try
39:28and put back together in a long time.
39:36Do you have any kids?
39:38I'm not married.
39:39Right.
39:40Doesn't mean you have any kids.
39:44no one would have me no one would have you you escaped you want to be confident with the patient
39:50and i think that by having to chat with the patient at the same time as you're
39:55doing something very important to his hand i i think it feeds back it reduces his level of stress
40:04my my father is eight months and my eldest eight years and then three and five so a nice spread
40:14of
40:14them yeah all very good all girls all girls yeah blessed among women all that you know
40:22so i'll be in big trouble later on in life
40:28that hand was properly mangled with a chainsaw there was so many little bits of skin poking out
40:36ultimately we wouldn't have gotten a very good closure on the wounds so he'll need more long-term
40:41definitive care under the hand surgeons which is the plastic surgeons in our hospital
40:51good afternoon cuhfm hospital radio all day every day with your classics from the 60s and 70s
40:58and the 80s do you remember this guy harry belafonte
41:04hey that's me i'm good i'm dave i'll be taking upstairs there now that's good dave
41:09tim has advanced lung cancer
41:13surgeon kishore dodakula is preparing for high-risk surgery to try and remove his tumor
41:18while also saving his lung
41:22he won't know until after he has begun the procedure if that will be possible
41:28the most important thing is their life
41:31and the second most important thing is
41:34get all the cancer out
41:36any operation i suppose done by a cardiothoracic surgeon is life saving
41:41because the stakes are very high
41:43if you take out the whole lung the risk is as high as one in ten won't make it
41:49so the priorities are three
41:50one safety so that his life is not in danger
41:55number two i want to get all the tumor out
41:57and number three i want to leave behind as much of lung as possible
42:01so that he can have a good quality of life after this surgery
42:08terrifying one of the loneliest times of my life
42:11i think i didn't want to be thinking about the reality of what could happen
42:17and i didn't want to think of my life without tim
42:29i was terrified of the surgery
42:31it was just all of the risks associated with just the surgery itself
42:36outside of what they were trying to actually remove
42:48i don't remember my life before tim
42:52i was separated
42:54i didn't ever think i would meet somebody again
42:58but um tim is the one
43:00it's the only way i'll process
43:02to see how we can negotiate
43:10this lobe and this lobe
43:15two hours into tim's operation
43:18kishore has made his decision on what to remove
43:31there is a tumor there
43:36sometimes lymph nodes are involved
43:51while james's pain has been brought under control
43:54there is concern he could have severe damage to his chest and spine
43:58a ct scan has been ordered to assess the damage
44:01and they gave you the ketamine
44:05it wasn't pleasant to see the reaction
44:09ketamine
44:10it was just the way you reacted to it
44:15which we were told is normal anyway
44:19your breathing it was like you couldn't breathe
44:21like you were starting to suffocate
44:23and your eyes just went completely wide and still
44:28james is turning 50 this year and i'm 37
44:32but once we got to know each other
44:35um it was never never a question brought up between the two of us
44:40it was evident very early on that
44:43things were going in one direction
44:49we was coming up to valentine's
44:51and he's just said i hope himself is taking you out
44:53and i said no no there's no himself so he asked me if i'd go out for a dinner
44:59with him on valentine's
45:01and of course i said yes
45:03and we went to bella cafe in fermoy
45:08but we had to go to the folding unit before we went for dinner
45:12so i was introduced to horses straight away
45:21he's very sore very specific one side of his chest
45:24we're going to get the scans done
45:26okay so i'm going to go down
45:30as you've been kicked and you see visible bruises on the chest wall
45:34you don't see visible bruises in the lung
45:36the consequences of that don't happen immediately
45:57when james was wheeled away for the scan it was then that i just broke down and i said what
46:04is going on what's going to happen is he going to be okay or not
46:30tim is in recovery following major lung surgery
46:34consultant dervila collins is on her way to brief tim's partner kay
46:38the best outcome is that the cancer was removed and that tim's lung was saved
46:46he was able to take out just the lobe
46:49so do you remember
46:50fantastic
46:50he didn't have to take the whole
46:52no he didn't
46:53brilliant
46:53so he's left about two thirds of the lung in all right
46:56fantastic
46:56and has taken you know i suppose one of the lobes and a little bit just a little bit of
47:01it
47:01but he's happy that he's got everything
47:03took out all the lymph nodes
47:05thank you so much
47:07i'd be just going to get i'd be off with my tears again
47:11that's my job
47:13so they send that off now to the lab
47:15sometimes we see a little bit of cancer
47:17i mean we know the stuff worked
47:18because we know from the scans we know that things looked much better
47:22and so we're really happy with i suppose the kind of the result that we went to theatre with
47:27and i think it'll just take another two weeks before we get the full information about
47:32oh i'm so relieved
47:33i hope at least you're you're a little bit more
47:36relieved
47:37relieved yeah
47:38relieved yeah after i'm sure it was a very stressful day
47:41stressful months
47:44while it's good news that most of tim's lung was left in place
47:48there still remains a risk that not all the cancer was removed
47:52what we want is for when the pathologists look at that cancer that's been removed under the microscope
47:59we want to see no cancer
48:01we want to see that cancer having melted away with the chemotherapy and the immunotherapy and that's the win
48:13when we were in the hospital and that we knew that it was a fracture to a rib and that
48:18his spine was okay
48:19you have to look at the positives as well and and see that he was okay at the end of
48:24it but he was also extremely lucky to be okay at the end of it
48:28you get a second chance
48:30family's always going to be number one
48:32the horses will be alright
48:34but really they're they're the hobby
48:37do you like to hear all the noises
48:39and you'll see what you're doing
48:41you'll see what you're doing
48:43you'll see what you're doing
48:44he he he he
48:49i'm cancer free
48:51live healthy and happy
48:54a lot to be said to be living healthy and happy
48:57what more would you want
49:01do
49:13do
49:14do
49:27do
49:28do
49:28do
49:28do
49:28do
49:28do
49:35do
49:36do
49:42do
49:44do
49:44do
49:44do
49:44do
49:44do
49:47do
49:48do
49:48do
49:48do
49:48do
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