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Any Given Day: Cork University Hospital - Season 1 - Episode 03
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00:00On any given day, some 800 inpatients, 800 outpatients and over 240 emergencies are cared
00:08for in one of Ireland's busiest hospitals, Cork University Hospital.
00:12It will take just one patient to come in, that just completely stops you and reminds
00:18you that, whoa, this is somebody's worst day of their lives.
00:21On any given day, some 4,000 staff come to work here, a place where life-changing decisions
00:27are made every minute, and every decision counts.
00:31Because I see a lot of sadness, I get great pleasure giving people the good news when I can.
00:39Here I am, hold my hand.
00:41You're having a heart attack.
00:43Filmed using 27 cameras, following patient journeys across the hospital, each story in
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, 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, and that's really it.
01:30Guardie, please.
01:34Guardie in Cork, yes, please.
01:37Thanks, Emilean.
01:42Hi, my name is Kate, I'm one of the CNM's here in the emergency department at CUH.
01:48Can I let you know about a patient that's after leaving the emergency department that
01:52is confused and we're concerned about?
01:55He's under the influence of alcohol at the moment, but he also has an alcohol-induced
02:02say encephalopathy, so he is confused, he does not have capacity and we are concerned about
02:08him and he is also left with an IV line in his arm.
02:16A five-year-old child is being rushed to CUH.
02:19She is barely conscious and her vitals are poor.
02:22There was a real panic there to get her in and get her seen because the man back of the
02:27ambulance was like basically trying to call her, he was really roaring to call her.
02:32She was barely responding to that, he started on the head then.
02:38We received a call from the ambulance crew, a five-year-old little girl, Fia, is coming
02:44with a complaint of vomiting and her heart rate is low and her blood sugar is low.
02:51She's still vomiting, so we need to treat all this very fast.
03:00There is a bit of a bumping bug in the house.
03:03Her older brother had the same kind of situation yesterday, but nothing at all to this extent.
03:21Fia is practically unconscious, she just looks barely breathing and there is nurses and doctors
03:31just swarming around.
03:33I feel like I am half in the way, but I don't want to be stepping back, but I also
03:40don't
03:41want to be in the way.
03:41So, like, it's just a head full of emotions there of like what, where do I go, but I don't
03:48want to go anywhere.
04:10I was with Fia all day long.
04:13And then she vomited.
04:15But, like, the fact that she was just so, so good all day long, happy out, playing and
04:22just click of the fingers and she was wiped out.
04:27She goes downhill really, really fast.
04:30It's scary just how quick.
04:34It is 1.36, pH is 7.315, bicarb is 22, sodium is 140, good girl, she's the best girl,
04:45yeah.
04:48She was becoming unresponsive.
04:51It was getting harder and harder to actually keep counting.
05:02You're okay, sweetheart, you're all right a little bit.
05:17Surgical oncologist Mark Corrigan has just started his shift.
05:21He specializes in preventative surgery.
05:25We know much more about cancer than we did 10 years ago, 20 years ago.
05:29And the different treatments that we have are really, really effective.
05:33They don't work for everybody.
05:34But for a lot of people, they do.
05:35You know, there's nothing nicer than, you know, when you give good news to somebody, you say,
05:39look, okay, you've taken them through that horrible moment of, okay, we've got a problem
05:44and we ought to do something with the problem.
05:46To that moment, maybe a couple of years later when you finish the follow-up and the surveillance
05:50and everything else, and you say, we've done what we had to do and we'll see you again.
05:55Maybe in Dunes or somewhere else, but not hopefully here.
05:59Today, Mark will operate on Antoinette O'Keefe.
06:02Hi, Jack.
06:04Six years ago, Antoinette received a diagnosis of aggressive breast cancer.
06:12I'm not a big drinker.
06:14I don't smoke.
06:15So I was thinking, like, I'm doing all the right things to prevent cancer coming to my
06:19door.
06:20And yet it still came.
06:22I went up into bed and literally, I turned and said, good night, John, I gave him a kiss
06:27and we turned and he called over and he was like, put his hand on my chest and he was
06:30like,
06:30what's that in it?
06:31And I was like, well, I don't know, I said, nothing.
06:34I said, hang on.
06:35I better check now again.
06:36So I sat up in the bed and I was like, no, that's something.
06:38I said, that's definitely, definitely something.
06:40I don't know where I'll be afterwards.
06:43Here.
06:45I'm ready for everything.
06:47That's fine.
06:50I remember being told on the Friday, the toy show was on.
06:54I had toy show bags made up.
06:56And I remember sitting there and I kept crying.
06:58I hadn't told the girls.
06:59I kept crying thinking, oh, my God, is this going to be my last one?
07:03Like, afraid it was going to happen.
07:05Something bad was going to happen.
07:07And I kept saying, like, is this going to be my last one?
07:09Oh, my God, please, can it be my last one?
07:11I haven't had enough time.
07:12Sorry, I get emotional.
07:14But yeah, that was a really hard part.
07:20You never think it's going to happen to you.
07:22And then when it turned out, it was something, obviously.
07:26The whole world changes immediately.
07:29You know, it's like somebody just turns on a switch and everything changes.
07:35You've no heart surgery.
07:36No, not like that.
07:41I had to have a full mastectomy.
07:42That was totally different.
07:45Looking down that day, you know, it's like, holy shit, like it's gone.
07:48Excuse my language.
07:49I was like, holy shit, it's gone.
07:50Like, and it's just, yeah, it was weird.
07:55To be honest, having had your surgery done recently, I expect they're fine.
08:01While the mastectomy on Antoinette's right breast cleared her cancer,
08:05tests revealed that she has a variant to the BRCA gene,
08:08which means that the chance of developing cancer in her left breast is very high.
08:13She has made the hard decision to remove that breast and is in CUH today for a mastectomy and reconstruction.
08:20Well, Antoinette.
08:22How are you?
08:23Good.
08:23All set?
08:24Yep.
08:25Yeah?
08:26All set as well.
08:27Okay.
08:27I've known Antoinette quite a long time now.
08:30And, I mean, she was very clear the minute that this was identified as a potential cause, it was no.
08:36It was, I want to take control.
08:38I want to manage my own risk.
08:39I want the information.
08:40And what are we going to do about it?
08:42The plan is today, mastectomy on the left hand side to reduce the risk.
08:45We're going to be taking the nipple and the areola.
08:48And then, Mr Chasher will be doing the reconstruction with the implant.
08:52No surgery underneath the arm today, so different to the last time.
08:55Any questions you want to ask us?
08:57No.
08:57No, just get on with it, Mark.
08:59Yeah.
09:00No.
09:01All right.
09:02All right.
09:02We'll see you inside in a little bit.
09:03Thanks a minute.
09:04All right.
09:04See you guys.
09:05This is something I get to do.
09:07I know I have this gene, so I had my tubes and ovaries removed in March.
09:13I'm taking something that I know right now is healthy.
09:15I'm taking this breast away, I'm like, and I'm going to put myself to the surgery again.
09:22I'm thinking of my kids like I'm here for a long haul, they're not getting rid of me.
09:35Oh, my God.
09:36How did the wedding go?
09:38Oh, it was great.
09:39Yeah.
09:39It was fabulous.
09:40Have you any photos?
09:41Yes, it was so long ago now.
09:42And did you go on any honeymoon or anything?
09:46I went to Italy for a week.
09:47Oh, lovely.
09:48Lovely.
09:49Let's see how ugly you are.
09:51Go on.
09:53Oh, jeez.
09:55You actually look like you belong in a movie.
10:06The pediatric allergy clinic in CUH is busy.
10:10Patients here are treated for a range of challenges, including food allergies.
10:16I was trained in Peru, then I went to Spain, and then I finished with my fellowship doing
10:22pediatric allergy.
10:24Cork has one of the biggest pediatric allergy service in the country, so I said this is a
10:28good opportunity, so I wanted to come here, and it changed my life.
10:32In 90% good things, 10% more stress.
10:36We need to sit down and tell them about the awareness of this, you know, that we are allergic
10:41and we need to carry the EpiPen all the time.
10:43OK?
10:44Yeah.
10:44Perfect.
10:4711-year-old Ciarán O'Connell was diagnosed with a severe peanut allergy at an early age.
10:54I can't eat peanuts or else I start getting sick in my throat when I start closing in.
10:59And I'll have to get like a needle in my thigh there.
11:04And I kind of have to carry around the medicine bag all the time with me, like whenever I
11:08go places.
11:10It kind of annoys me sometimes.
11:12And I won't have to check the ingredients on anything, like, because every time I have
11:17something I just have to like check it, so.
11:19And Ciarán's case, peanut, that is life and death.
11:23At 11, he's very clued in.
11:26He's very aware of it himself.
11:28He checks packaging more than us.
11:31Still, for 11, it's hard to put that into your head to say that you could potentially
11:35die from this.
11:37If ever the worst-case scenario ever came, and he went to an epileptic shock, his system
11:42started shutting down, rash forms, cough, the usual gasping for brace.
11:47So, obviously, that's when you need your auto-injecture and the shot adrenaline.
11:51He needs to be brought to a hospital straight away.
11:55EpiPens are the things that you bought in your leg if you eat a peanut or whatever you're
12:00allergic to.
12:01And they kind of, sometimes they look like this.
12:03They can be other types as well.
12:05And I have two for, like, just everywhere and then two for school.
12:10Ciarán is in CUH today for an oral food challenge.
12:13He is hoping the test will show he is no longer allergic to peanuts, which would mean no longer
12:19having to carry his life-saving EpiPen.
12:23The oral food challenge, they come to Dayward, and we will introduce them low doses of, for
12:29example, peanut until we get to an amount that is approximately between 6 to 12 peanuts.
12:35And they don't have any reactions after two or three hours.
12:39We can safely say that they have an oral food challenge negative.
12:44Are you praying?
12:46No.
12:46Okay.
12:48How are you?
12:49Good.
12:51So what are you trying today?
12:53Uh, peanut.
12:53Personally, I think today is Ciarán's last chance of maybe passing the test.
12:57For Ciarán it would be life-changing because it means he'll never have to inject himself,
13:03never have to worry about an athletic shock anymore.
13:06And he can just go on with his life, eat what he wants, and just be happy.
13:12And do you eat other nuts?
13:13Uh, yes.
13:15And this is an important question.
13:16If by any chance we're lucky and you eat peanuts and you don't have a reaction today,
13:22will you start eating peanuts at home?
13:24Yes.
13:24Okay.
13:25Crossing our fingers.
13:26Don't pray.
13:27Okay.
13:33It is going to be weird.
13:35Ciarán is physically going to take a peanut, an actual physical peanut.
13:40It's stage by stage by stage, you know, an eight of them not, a half of them not.
13:44And they're just going to try to test, push Ciarán's tolerance as much as they can.
13:50This is Murphy's Law, you know?
13:52It only takes one person to introduce it at home that has an anaphylaxis, that maybe they don't know how
13:58to use adrenaline,
13:59and has a really bad output or outcome, and then everything is a mess.
14:04So that is why it's so necessary that every challenge has to be in a hospital-based.
14:11So internet, I'm going to just wipe down, so it's okay.
14:13All right, that?
14:14Good, ma'am.
14:15Well done.
14:16Can you take a drink of water, baby?
14:18Every time that we're doing that, we're also observing them,
14:21looking if they have that minor reaction or whatsoever,
14:25because we need to look if they're going to start having an anaphylaxis,
14:29because we need to up quickly.
14:37Five-year-old Fia was rushed to CUH earlier today.
14:41Staff have worked to stabilise her, but she is still very ill.
14:45Shortly, she will be scanned so the team can investigate further.
14:58If he was born, it was just like any other birth.
15:01If he was born, and then, like, there was, like, a bit of silence in the room,
15:05like, the nurses were checking her over, and, like, we just thought it as that, like.
15:13It went really quiet.
15:15And I was thinking, what's the wrong? What's the wrong? What's the wrong?
15:18And then one of the nurses said, I think that she has Down syndrome.
15:24So, I didn't know what to say.
15:27We didn't know that in any of the checks prior to that.
15:30There was nothing they saw that indicated anyway.
15:42Very short time when Fia was born, her oxygen levels kept dropping.
15:46She had to be brought down to neonatal.
15:49And so, we had maybe 15, 20 minutes or so of Jo holding her between us.
16:00I wasn't allowed my phone in the NICU, you know,
16:03so, like, I just spent hours staring at her.
16:07And I'd be just drawing out little hearts with my fingers on her.
16:13That was, like, me just, like, just being able to touch her.
16:16I wasn't allowed, like, I wasn't able to hold her or anything, you know,
16:19because she wasn't, she wasn't strong enough for her.
16:23Lay down, Fia. I'm here.
16:25Daddy's there.
16:26I'm here.
16:27Ah.
16:28Blah.
16:34Jordan Fia's time in neonatal.
16:37To see her fight through that.
16:39And, like, from day one, just come out fighting.
16:45Good girl.
16:50Seeing what she's went through, none of us should be complaining about anything.
16:56We really shouldn't.
16:58Listen.
17:00Stay, stay still now.
17:03Stay still.
17:03If she keeps moving, is it okay if you stay with her for the x-ray?
17:07Yeah, it's fine.
17:12I might get you to see her in terms of police, because that's the good position here.
17:16Yep.
17:18B-H is like a beehive.
17:20Like, it's just, everybody's so busy, they know what they're doing.
17:23And if you don't talk bee language, it doesn't look like you know what's going on
17:28or it doesn't make sense.
17:29But everyone's working, getting it all done.
17:36And I'll ring you when she goes out to recovery.
17:38Antoinette has made a choice to have her breast removed.
17:42Although it is currently healthy, she has a harmful variant of her BRCA gene,
17:46making her more vulnerable to the risk of developing cancer.
17:52Once I have an idea of what time she'll be out, I'll be back.
17:55And again, I actually can't tell you nothing.
17:57Why not?
17:58As I say, you can take as long as it takes.
18:00John's my rock.
18:01We weren't together six months and he proposed.
18:04I think everyone thought we were insane getting engaged.
18:07Are you sure you don't even know someone after six months?
18:09John was 21.
18:10I was 24.
18:11Here we are, 17 years later.
18:14We've grown up together, really, and that.
18:17And, you know, we've built a life and, you know, we've been best friends
18:20and that all down to years.
18:23So, you know, it's been incredible.
18:27The first part of the operation will be to remove Antoinette's breast.
18:31The second part will be a reconstruction, which will be carried out by consultant plastic surgeon, Justin Chatterjee.
18:39What we're going to do, I'm going to just do some marking.
18:41Is that all right?
18:42Yeah.
18:42OK.
18:43All right.
18:44Before you do that, yeah?
18:46I'm going to get out and let you do this.
18:48Are you sure?
18:49OK, yeah.
18:49Do you have any?
18:50We'll give you a phone.
18:51I'll touch you before you leave there, OK?
18:55Oh, yeah, yeah.
18:56Absolutely.
18:57I did it.
18:57I found it hard to be inside there.
18:59Yes.
19:00One second.
19:01They were drawing the lines on her body and it was upsetting her.
19:06I didn't want it to be seen that it was affecting me as much either.
19:09You were all not there for a second.
19:11He held my hand through the whole lot of it.
19:13Every appointment, everything.
19:17Every moment of weakness that I had, the negative thought, he'd leave me wrong with it and say,
19:23OK, that's it now.
19:28He told me he's fierce too and his fear was like losing me.
19:32He's just, he's my soulmate.
19:35I went, had coffee, just took a moment and came back then and I was, you know, you need to
19:43be strong.
19:45OK.
19:46OK, dude.
19:49Great.
19:51Great.
19:58Chiron is being tested to see if he is still allergic to peanuts.
20:02A negative test will mean he is no longer at risk of a fatal anaphylactic attack.
20:07He has had two small portions of a peanut so far.
20:12They came over then to do the third part of this, which is a half peanut.
20:19I think the nurse made a joke.
20:21She goes, do you like it?
20:21He goes, they're very salty.
20:23I told him, sit back, relax.
20:24He was on his tablet.
20:26And he did give kind of one or two little small coughs.
20:30Like I was just staring at him, you know, thinking, go on, Chiron, keep going.
20:33I hope you get to stage five.
20:34I really do.
20:35I really hope you do.
20:36Yeah.
20:37Just keep picking up.
20:39Why don't you have enough?
20:40Just eat positive.
20:41I'm not eating you.
20:42And they were looking and I just went like that.
20:45I just tapped my ear like that.
20:46And they looked and you could see all these bubbles forming along Chiron's ears.
20:49And the nurse called Dr. Trulio and just pure professional came over.
20:54He goes, okay, that's the end of the testing.
20:57This is a positive reaction.
20:59And that's when Chiron obviously got very upset.
21:02I think he was gutted actually.
21:03A little bit white dots here that you're having that makes a reaction.
21:08Okay.
21:08Okay, sir.
21:09I will tell you something important.
21:11Okay.
21:11Okay.
21:13So, sometimes, ah, don't worry.
21:15No worries.
21:15Okay.
21:16This is not going to be a problem.
21:17We need to make sure that you're okay.
21:20I'm giving you that.
21:21Yes.
21:22Do you want to eat peanuts, no?
21:24Yes.
21:25You want to get a Snickers on your own.
21:29I know.
21:29It's disappointing.
21:31Yeah.
21:32I know it is.
21:33You did a really good job.
21:34I'm so proud of yourself.
21:35Yeah, I know.
21:36Give Chiron his adrenaline then and literally within, I'd say, 30 seconds, I'd say.
21:41So, the tingling was gone and joy.
21:43He just felt way better on himself.
21:45So, I really hope that's stuck in his head.
21:46What adrenaline does to his system basically just gets him back to normal.
21:51He did at home then.
21:53How his whole face changed, rash started forming his body.
21:56His ears became red and blistered in the space of minutes.
22:00His bag needs to be with him the whole time.
22:02All his injectors need to be with him, literally, the whole time.
22:05Okay.
22:07Last, last couple of things.
22:08How do you feel?
22:09Bump it.
22:11Okay.
22:12Now we know that he's allergic.
22:14And now we also know that he needs to be careful and take things seriously.
22:19Have you tried pecans?
22:21Pecans?
22:22No.
22:23Okay.
22:24How about Kinder Bueno?
22:25Do you like Kinder Bueno?
22:26Yeah.
22:27Okay.
22:28I'm happy with that.
22:29Kinder Bueno is okay.
22:30Nutella is okay.
22:31Just please, no sneakers.
22:33Yeah, no.
22:34No these kind of things.
22:35Okay?
22:35Yeah, no.
22:36Okay.
22:36We've never used the EpiPen.
22:38We have a training pen that he has practiced on himself.
22:41The only thing that you're never going to eat so far is?
22:46Peanuts.
22:46Perfect.
22:47So, if it does come to us, will he actually inject himself?
22:52And that's a massive fear.
22:53So you don't have the fear of sticking a needle into your own body.
22:56Oh, like, I know they would save my life, but, like, I think they would hurt.
23:03Take off the topless, then you push it in around there until you hear a click, and then
23:08you just hold it for 10 seconds.
23:10The medicine stops, like, my throat closing in, and it, like, stop me, like, help me to
23:19breathe again and stuff.
23:21It is life and death.
23:22That's the bottom line.
23:23It comes down to that.
23:24It literally comes down to that.
23:25It's getting power to his school.
23:27When I hand over the bag from now on, it should be aggressive.
23:30This is Ciaran's metal kit that needs to be used that will save his life.
23:34And that is the fact of it.
23:46After a diagnosis of cancer in her right breast, Antoinette had a mastectomy.
23:51Tests showed she has a mutation of the BRCA gene, increasing her chance of breast cancer
23:56into the future.
23:57She has decided to remove her healthy left breast, followed by reconstruction.
24:01We tend to focus on surgery as if there's a surgeon.
24:06And in this case, there's another surgeon.
24:08But actually, you know, you're looking at about 10 people.
24:12Two arm boards.
24:13Two arm boards, please.
24:17The role of the surgical oncologist is to perform the wrist reduction mastectomy.
24:22What we want to achieve is that we've removed as much of the breast tissue as possible.
24:27And the role of the plastic surgeon is to perform the reconstruction.
24:32And then we'll do it.
24:33There's that.
24:34Okay.
24:34And then we may have to take some of it.
24:36Can you just take it from yours?
24:37Yes.
24:37Can you just take it from yours?
24:39Can you just take it from yours?
24:45The people that we meet who come into a hospital, it's a really unique situation
24:50because you're parachuted into the middle of their lives, into the middle of their confidence,
24:54which is a huge privilege.
24:56Here, I might swap.
24:57Can I swap you?
24:58Yeah.
25:01It was never going to be an option that was going to keep my breasts and risk it.
25:05I know I have this gene, let's get ahead of it.
25:07I don't want to be in my 50s or my 60s or my 70s, or even my 80s, fighting breast
25:13cancer.
25:13And can I get two Alice's off you, please?
25:17Yeah.
25:20You are meeting people when, you know, yesterday they were on their way to work.
25:25And today, they've just got news that's completely changed that.
25:28And so the things you were worried about yesterday just are not what you're worrying about today.
25:32And on a human level, I suppose you're frequently reminded, I suppose, that, you know,
25:40for any of us, we don't know what's around the corner.
25:46It's just...
25:47Yeah.
25:48When they go home, and they're trying to process all this,
25:51and they're having a cup of tea, or they're just having a cry.
25:54And, you know, that's where you see the incredible importance of the people around them.
26:01No.
26:02No.
26:03Okay.
26:03I'll come back to it.
26:06Okay.
26:07Hi, John. Mark here.
26:09Good. Everything went very well.
26:12Yeah. No, please. Yeah, we're pleased with that.
26:14So, I suppose, Antoinette will be waking up in the theatre now in the next five minutes or so,
26:18because I promised her we'd bring in the minute we were done.
26:19So, she's only going to be coming around.
26:22Once she wakes up, she'll be able to recovery.
26:25Perfect. Perfect. That's plenty of time.
26:28Not at all, John.
26:30All right. Take care.
26:31See you. Bye-bye.
26:33Are you not going home?
26:36Oh, I'll be going at six.
26:38Oh, six. Oh, there's...
26:39Have you eaten it?
26:40I have, yeah.
26:41Good girl. Turn around.
26:43Oh, I'm just here.
26:45Sweeties.
26:45Oh, that's very nice.
26:46Let's see now.
26:48I'll have the crackers.
26:57Just 50 minutes ago, Fia was rushed to CUH by ambulance.
27:02She is now being moved to the paediatric emergency department
27:05and will continue to be monitored closely.
27:08She is stable, but remains unwell.
27:14She has any siblings at home?
27:16Yeah, she is. She's by her home.
27:17How old is she?
27:19She's six.
27:20I was at home with Finn.
27:22I do go into a panic, like, when I see her.
27:25When I see her like that, you know, it's scary.
27:29Darren can keep calm, you know.
27:34As much as you can't do anything to help it in,
27:41as a sense, other than be there,
27:43and support Bev, Bev support me, be there for Fia.
27:50To myself and Bev, family is everything.
27:54Now, her numbers are all good now.
27:57I will just send her some numbers now there
27:59and we'll come back to you, OK?
28:01OK.
28:04We'll keep an eye on her numbers there, OK?
28:07OK.
28:08Thank you so much.
28:09Perfect, thank you.
28:13Down syndrome, it's not all that she is,
28:18but to me, it's the best part of her,
28:20because, you know, I wouldn't change a thing about her.
28:23Like, she's...
28:25She's amazing.
28:27It is challenging, but it's not the end of the world.
28:32If I could say anything about it now,
28:34it's not to be scared of it.
28:38Yeah, because...
28:41She's a great girl.
29:00We're at the frontline.
29:02When you walk into the emergency department,
29:04you really can't expect what's going to be thrown at you,
29:08what you're going to face.
29:09And you don't know whose life you'll impact.
29:11That day.
29:13I got a call, and it was Christy.
29:16He said, I'm in an ambulance, and he's having a heart attack.
29:19All of a sudden, like, you're sort of...
29:21What did he tell me?
29:22What did he tell me?
29:23It's a frightening thing, you know?
29:28He's my only brother.
29:29I have nine sisters now, but he's my only brother.
29:33Christy Jacob has been rushed to CUH
29:35from University Hospital Waterford.
29:38He's had medication for pain reduction,
29:40but is having a heart attack
29:41and needs urgent treatment not available in Waterford
29:44at this time of night.
29:45Hi there. Hello.
29:48My name is Syma.
29:49I'm one of the doctors here.
29:50And what time did the chest pain start?
29:51It started about 8 o'clock.
29:528 o'clock. It's a good thing you came straight to hospital.
29:55Can we get a repeat ECG on him while he's here?
29:57Yeah.
29:58You know that you've had a heart attack?
29:59I heard that.
30:00They've told you that, yeah?
30:00What has his blood pressure been en route?
30:04Hey, Dylan.
30:05This is Dylan.
30:08Because the transfer time from Waterford
30:10to Cork University Hospital is on blue lights,
30:12is around an hour.
30:15They do have to treat it
30:16before they transfer the patient over to CUH.
30:19And the treatment which then is given
30:20is to try and attempt to dissolve the blood clot
30:23to limit the damage done to the heart muscle.
30:27Increase these cases, unfortunately,
30:28the thrombolysis had not worked.
30:31Yes.
30:32So time is key.
30:34Okay.
30:34You've almost certainly got a blocked artery in your heart, okay?
30:37We gave you some medication in the water to try and unblock it.
30:40Yes.
30:40And it hasn't really worked as well as we thought it would.
30:43Okay, so we're going to need to proceed ahead
30:45and you may need a stent.
30:47Registrar Dylan Finnerty has been in constant contact
30:49with consultant cardiologist Richard Tanner.
30:53Richard is at home but is on call for emergencies
30:56and has made a decision to activate the CAT lab.
31:00Never.
31:02Never.
31:03No.
31:03Thanks.
31:04He has 30 minutes to get to CUH
31:07along with two specialist nurses and a radiographer.
31:10Where are you looking at yourself?
31:13Healthy, what's the matter?
31:15How do you look for a thing?
31:16No.
31:17Do you smoke?
31:19How many are they?
31:22Roughly?
31:22The fish was nice and seem to be different.
31:24I'd say if I attend or whatever.
31:26Asthma?
31:26No.
31:27No.
31:28No.
31:29No.
31:29No.
31:33I don't smoke any more.
31:36You see so much in the emergency department.
31:40You see so many illnesses.
31:42You see patients at their sickest.
31:46What cause?
31:50Cholesterol.
31:51And it makes you appreciate the little things in life,
31:55you know, going back home to your family,
31:58trying to get as much out of life.
32:01You don't really know what's going to happen, you know?
32:03Even though they're treating you, you can still die.
32:07Things can change in an instant.
32:09I only want to know that.
32:10I'm going to come out to each side.
32:11Yeah, absolutely.
32:12I guess what we can say at the moment is
32:13you're having a heart attack.
32:15Yes, I was told that.
32:16If we do nothing, okay,
32:18you're just much greater risk to you.
32:20So we'll get you through.
32:21We're just waiting to go down there.
32:22Thank you very much.
32:23I really appreciate all this, what you're doing.
32:26Um, doctor?
32:28This is a very temperature.
32:31Yeah.
32:32I know, thank you only there.
32:33Mm-hm.
32:35Okay.
32:36You should make something wrong.
32:37Yeah.
32:38Do you want to go?
32:39Yeah.
32:40Do you feel the need?
32:41Yeah.
32:41Yeah, there you go.
32:43You're not allergic to anything?
32:45No.
32:45No.
32:46So what we'll do is we'll lie you flat on the table.
32:48Yeah.
32:49And we'll go through a little artery at the wrist.
32:51Okay.
32:51So, preferably we go at the wrist.
32:53Sometimes we have to go at the top of the leg instead.
32:55Alright.
32:55We'll thread a very fine wire up the arm,
32:57then into the chest.
32:58We inject some contrast dye and take some x-rays.
33:01Exactly.
33:01And we're looking for a blockage.
33:03Okay.
33:03So if we see a blockage, we're trying to relieve it.
33:06Okay.
33:08Okay.
33:08Okay.
33:08Alright, we'll get down.
33:09Take our way if you want to take care of this and get.
33:11Alright.
33:13I'll put the file in.
33:20There was one patient that came down,
33:22and we were all tipped off before he came down,
33:25that he needed to be called JC,
33:27and not by his real name.
33:28The patient himself thought he was Jesus Christ,
33:33so we had to call him JC,
33:35because if he was called by his real name,
33:37he would have gone ballistic.
33:38But unfortunately,
33:39one of the surgeons came out to meet him,
33:42and he looked down at him and he says,
33:44good morning JC, how are you?
33:46My name is Mohammed.
33:47And the patient looked up at him,
33:49and held his hand and said,
33:50I've waited all my life to see you.
33:56How's that pain in your chest there, Chris?
33:58No, I can't, boy.
33:59Still there.
34:00Christy Jacob is having a heart attack.
34:02He was treated in University Hospital,
34:05Wardford,
34:05before being rushed by ambulance to CUH.
34:08First floor will probably be quicker,
34:10if you want to just go forward and then go down.
34:15Stabilised in the emergency department,
34:17he's on his way to the cath lab.
34:22On-call consultant cardiologist Richard Tanner
34:25has made it to the hospital within 30 minutes.
34:28When an artery is completely blocked,
34:30we know that the extent of damage is dependent on
34:33the time that artery remains closed.
34:36When it remains blocked and blood supply is cut off,
34:39it can lead to extensive damage to your heart.
34:42Even if we open up the artery at that time,
34:44there's a certain amount of muscle in his heart
34:46that'll be dead and it'll be irreversible.
34:50And the consequence of that is heart failure.
34:55So time is critical in the treatment of heart attacks.
35:02You think you're invincible, but you're not.
35:06And this kind of highlights the fact that you're mortal.
35:12He's a master butcher and he loves you to meet.
35:16Fish is for cats.
35:18That's what he said.
35:20We're all guilty of overindulging and all that,
35:22but if it affects you that badly,
35:25you have to kind of stop it.
35:28Stingy had a drop of a hat and he likes women.
35:31He's never married around, so he's a single man.
35:34He's a man about town.
35:36He can do what he wants.
35:37Kind of a party animal in a way,
35:39but he's an older party animal.
35:41You kind of can't blame him until something happens to you.
35:47Can I take stent, please?
35:51To keep the artery open, we place the stent,
35:53which is like the scaffold that keeps that artery open.
35:56So that stays in your body
35:58and it'll be there for the rest of your life.
36:01No, no, no, no.
36:02Okay, almost done, almost done.
36:03All right?
36:04Almost done.
36:06So Christopher, you stent in and the artery opens up, okay?
36:11He's a kind man.
36:13We want him around as long as we can have him.
36:25Five-year-old Fiya continues to be monitored
36:28in the paediatric emergency department.
36:30She will be admitted when a bed becomes available.
36:36Okay.
36:37Thanks a lot.
36:42Maybe because of the vomiting,
36:45the white cells in the blood is a little bit high,
36:48but her CRP like a kind of infection is normal.
36:52Nothing to worry.
36:52Like because of the vomiting,
36:54the white cells are high.
36:55Okay.
36:56So anyway,
36:57they will follow up her in the water.
37:00Like, you know,
37:00they'll take more bloods there and so on.
37:03Yeah.
37:05Yeah.
37:10Her primary concern to the hospital for Fiya is now
37:14dehydration, vomiting, and sugar, hypoglycemia,
37:17not because of any cardiac issue or trisomy 21
37:20or Down syndrome she is in the hospital.
37:23The only thing, the dehydration.
37:24So we are treating dehydration now.
37:41Today, Brian Murphy is scheduled for complex surgery
37:44to try and ensure he can continue to walk into the future.
37:50For the last couple of years,
37:51he had an awful lot of problem walking
37:53because he had so much trouble with his knees.
37:56He couldn't really walk very far.
37:57And if he was walking then,
37:59she was at a snail's pace.
38:00And I'm like,
38:01will we ever get home?
38:03Oh!
38:03I played a lot of football at the bath club now.
38:09This might have nothing to do with it,
38:10but...
38:12I had terrible trouble with me knees.
38:17Eventually, I had to get him done.
38:18The pain was chronic.
38:21It still is.
38:22I think this is a bigger operation.
38:24Well, I don't know, but...
38:25Brian would be in pain every time he tries to walk.
38:28He's quite a stoic character.
38:29He's a man who doesn't complain,
38:31and I know that if he's complaining of something,
38:33he's genuine.
38:34The older you are and the frailer you are having a surgery,
38:37then the less likely you have of a better outcome.
38:40Morning, Brian.
38:41How are you?
38:41How are you?
38:42Good.
38:42Good.
38:44So, we're going to do your surgery this morning.
38:47All right.
38:47It's now causing him significant pain,
38:49and the only solution that I have to be able to reconstruct this for him
38:53is to give him a total femur replacement.
38:55I've no hearing aid.
38:56You thought I had to replace just the knee,
38:58but I have to replace the whole femur.
39:00Yeah, yeah.
39:01So, once you have to replace the entire femur,
39:03you're essentially replacing the entire knee
39:04and the entire hip in one go,
39:06and then replacing the entire femur at the same time.
39:09But I don't think you have a choice,
39:10because I think that this thing is completely loose,
39:12and you've got so much pain,
39:13you can't walk on it.
39:15So, we just have to go ahead and do this.
39:17You can say, look, I don't want to do it,
39:20but I don't think you're going to be able to walk
39:21and your pain won't go away.
39:23The challenge of trying to look after somebody
39:25with a problem that's more complex
39:27is challenging you to try and improve as a surgeon.
39:30If you do only simple things all the time,
39:32you never get better.
39:33So, you have to try and step up and do more complex things.
39:37This is a big surgery.
39:38There will be a reasonable amount of blood loss in this.
39:41Just worry how long it will take you to know.
39:44You shouldn't be worried about that.
39:46Oh, I know that.
39:47I don't know how long it's going to take.
39:49It will just take as long as I need to get it done safely for you.
39:53You put your trust in them, then for those five, six, seven year olds,
39:59whatever he does.
40:00You'll have to.
40:01It is a substantial surgery.
40:03It's going to take a bit out of you.
40:05You may need a bit of blood or something like that afterwards.
40:08People like Brian, they can lose a lot of blood.
40:10The other worries you have with people like Brian are the risk of clots.
40:16And there is the very rare patient who gets a severe clot in the lung,
40:19and that can kill them.
40:24Here.
40:26How are you?
40:30Have you eaten?
40:32Did I catch you something?
40:34I just got missing the fibros.
40:36Antoinette is recovering from her mastectomy and breast reconstruction surgery,
40:40an elective procedure prompted by discovering she has a variation of the BRCA gene.
40:48I am lucky.
40:49Yes, I have the gene, but I'm ahead of that now.
40:52So I feel I'm incredibly lucky to get this far.
40:59I get to see my kids grow up.
41:00I get to see them graduate from national school to go to secondary school,
41:04getting on with life.
41:10The gene obviously could go into the future.
41:14The girls will be checked as soon as they are 18,
41:18and they'll have consistent ISO testing and that going forward.
41:22So at least they'll always be monitored into the corners like you.
41:28I won the lotto of life.
41:30I win because I beat it.
41:34So that's really important.
41:36Yeah.
41:38I kept my word to myself that I was never going to lose to this.
41:48Surgeon James Harty is preparing for major surgery.
41:52Patient Brian Murphy requires a knee, hip and femur replacement to try and keep him walking into the future.
42:00It's a substantial surgery.
42:02You have to prepare to have a patient who's on the table for quite some time.
42:06Can the lights be put up, please?
42:08Can you put some power on those lights because they're too weak?
42:13In Brian's case, I will start at the top, remove the femoral component, put the hip cup in and then
42:18go back down and put the knee bit in and then join the two from top to bottom by putting
42:22the femur in.
42:24The question then is, can I get the hip old first? Just before I do that actually, let's just see,
42:27can I get the hip?
42:28Brian, I suppose, is the love of my life because, well, he's the only boyfriend of such really, I'd say,
42:33that I ever had.
42:34He's kind of been the one and only.
42:36If I can dislocate the hip first, it might be easier.
42:40We met through his sister, Kay.
42:42Kind of got a bit friendly with him, but, like, Brian was always very, very shy back in those days.
42:47And, like, if I'd come in the door, he was gone.
42:49Try and dislocate that hip. Try and dislocate the hip.
42:52I don't know, it was like kind of a game of chasing. I just decided, I'm going to get you.
42:57Eventually, I managed to break him down and I did.
43:00I don't know, it was kind of a mutual decision, just that we'd get married.
43:04I, like, I certainly don't ever remember him going down on one knee, that's for sure.
43:10I consider that this is a salvage type of surgery and I don't expect him to have the same function
43:15and outcome
43:16as somebody who might have a hip replacement or somebody who might have a knee replacement.
43:20OK, there's his proximal femur coming out. OK.
43:25It is a totally different procedure. The muscles don't attach to the bone
43:28and you need your muscles to be attached to your bone to be able to walk and move normally.
43:33And this implant will not allow the muscle to attach to the bone.
43:38Hit it again.
43:42Here she comes.
43:44OK, lift back now.
43:47That's it, in she goes up.
43:48My expectation for Brian would be that he would walk, he'd walk pain free.
43:52I think he'll always use sticks or crutches. He wouldn't be able to go a long distance, but he would
43:58be able to go around and do his daily activities.
44:01In she goes. Now give me the screwdriver please for that, so I can turn it in the right direction.
44:05Yeah, it's got a spin. It's got a spin 180 degrees for me there. That's it.
44:12OK, there it is. Hold it there, Sarah.
44:15She's locked.
44:16Yeah, locked in.
44:17Let's get this closed up.
44:20And we start closing the skin first.
44:33OK, you happy lads?
44:35OK, thanks a million.
44:37Lads, I'll just close the rest of it.
44:44You can't be dispassionate about the patients. You have to feel that you're giving each patient 100% when you're
44:51operating on them.
44:53So, when you've finished operating on them, you have the next patient, and you have to be just as passionate
44:58about the second one as you were for the first one.
45:02OK.
45:09Oh, when did you come? Oh, I was in Handys last week.
45:11Just last week.
45:12No better girl.
45:14You liking Cork so far again?
45:15Are you OK? You weren't coming.
45:16Yeah, I was here before and I left for 10 years, and now I'm back.
45:19Oh, good woman. You brought the weather with you.
45:22I'm going to get a few of that recess clear there. It's a bit messy. I need to stick back
45:26now.
45:26OK.
45:27Full recess gives me a bit of nerves in the morning, like.
45:31Cardiologist Richard Tanner performed an emergency procedure on Christy Jacob during the night.
45:35Now he's back to check on his patient.
45:37Hi Christopher.
45:38Richard.
45:39How are you doing?
45:40I'm doing great, all on account of you.
45:43Do you have any chest pain this morning?
45:44No.
45:45Any shortness or break?
45:46None.
45:46OK, great.
45:47And I didn't even have shortness or break before I went to hospital. It's just a pain in my arm
45:51and my chest.
45:52Yeah.
45:53Can I have a quick listen to your heart there?
45:54Yeah, of course.
45:56There was damage done to my heart.
45:57And the aorta, like, they call it the widow maker.
46:01That's the one that was blocked, but they reckon it was 100% blocked.
46:05Which is scary.
46:07Like, I said, what would have happened had I went to bed?
46:11They said you would never have woke up.
46:14So, smoking?
46:15I smoked my last cigarette before I came in.
46:18That will never, ever happen again.
46:20Never happen again.
46:21This is really important because you could be back here again.
46:23Yeah.
46:24That I don't need.
46:25OK.
46:25I mightn't get back there next time.
46:27That's the problem.
46:28Hindsight is a great thing.
46:29If I knew then what I know now, I would have changed it all those years ago.
46:35But just having a good time all the time, I kept doing it until I had heart failure.
46:43You're doing very well overall, OK?
46:45Yeah, I'm happy and I'm grateful for ye and the water staff as well for acting fast and getting me
46:53down.
46:53They did a good job looking after you.
46:54Yeah, yeah.
46:55Typically after, you know, what you've had, you're kind of three to four days in hospital.
46:59Yeah, OK.
47:00OK?
47:01Yeah.
47:01All going well, OK?
47:02That's brilliant.
47:03It's no problem.
47:04OK.
47:05Family calling?
47:06I appreciate everything you've done for me.
47:08You're very welcome, OK?
47:09The reason I do cardiology is that, you know, we had a man who came in with a heart attack
47:15which could potentially be fatal or have severe consequences for the rest of his life.
47:20And now he's, you know, sitting out of bed, had his breakfast pain-free, ready to continue his life again.
47:31All right.
47:33I'm not worried.
47:33I'm not worried they were good to me.
47:35I know.
47:35I just do it by the book.
47:37You know, you'd have your arguments and small disagreements and nothing major.
47:42But a thing like this kind of brings things into perspective.
47:46Thanks, Danny.
47:47Talk to you then.
47:48I know.
47:52Christy is lucky.
47:54He got caught in time.
47:57I hope he makes his own looking future.
48:05The relief when she comes home is, it's brilliant, like, you know.
48:12Coming home from work and just, you know, run out just really warms my heart.
48:17Like, just want to see more of that.
48:28I think, like, there is life before cancer and there's life after cancer.
48:31Like, there definitely is.
48:32There is definitely the whole things like, I live my life carefree.
48:34I love Mark.
48:36He's lovely and he's an amazing doctor.
48:38I know.
48:39I don't want to see Mark anymore.
48:40Just for him to tell me everything's going tickety by Wednesday or a grind.
49:13Well, thanks again.
49:13Thank you, guys!
49:13Thanks for having me.
49:28Transcription by CastingWords
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