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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.
04:33En route here, she's had one more seizure en route, with a right focus there, also tonic, her limbs stiffened
04:40also.
04:43Hey Madison, hello, hello.
04:58We're just looking for an NPA, you know, they need to bring Geo Airway for trials.
05:01I think she's still seizing to be honest.
05:03She's quite, she's a lot stiffer on this side there.
05:09I'd say we give another Laurel's there, I think she's still seizing.
05:12To a child who's having a prolonged seizure, you're fundamentally worried about any primary or secondary injuries that would be
05:18happening 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, while we give
05:25her very potent medications to help stop the seizures.
05:30As the resource team work to stabilize Madison, her parents and grandparents are waiting in the relative's room.
05:36I don't know.
05:37A nurse came out to us and said, look, 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?
05:49Is she...?
05:50And they're, they're not fixed, they're not...
05:52Yeah.
05:53Yeah.
05:54We're doing a good pressure there.
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, so you do need to
06:09introduce that idea early on, because 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.
06:28Apart card security is not the worst.
06:40Howard Grice has motor neurone disease.
06:44He is in CUH today with his wife, Yvonne, to check the progression of the condition.
06:56My name is Howard Rice
06:58I was born in Sheffield
07:00Yorkshire in 1966
07:01I moved to Towering County Cork
07:04in 1994
07:05with my partner Yvonne
07:09I have motor neurone disease
07:11it has affected my speech
07:13and swallow amongst other things
07:15as well
07:20Howard is treated
07:21by a multidisciplinary team
07:23including respiratory physiotherapist
07:25Kevin O'Sullivan
07:27I've really been without speech
07:29since about a year and a half ago
07:31so I use this app to communicate now
07:34From your point of view
07:35how is the breathlessness?
07:41A recording of my speech
07:43was made when it was deteriorating
07:45what you hear now
07:46is a repaired version of my speech
07:49it can be frustrating
07:50but you get used to it
07:51Hmm
07:54You've done this before
07:55yeah
07:57big deep breath in
07:59coffee into the mask
08:00and we're going to see how it's showing out
08:02we'll be doing three or four
08:06I'll turn away from you
08:08otherwise I'll be laughing
08:09and not about to do it
08:12When Howard laughed
08:13his whole body would shake
08:15his face would just erupt
08:17and he'd just
08:17you'd laugh with him
08:19you don't know what he was laughing at
08:20but you'd laugh with him
08:21you know
08:23It's difficult watching him
08:25and knowing what he was like before
08:27he was very talkative
08:29he was the life and soul of the party
08:32he'd be the first in
08:33and the last to leave
08:35just a top guy you know
08:39recover
08:40big breath
08:41cough
08:45The motor neurone disease
08:46it's a severe degenerative disorder
08:48of the nervous system
08:49and we don't unfortunately
08:51have a cure for it
08:53we do have
08:54limited
08:55medical therapy
08:57which is shown to slow things down
08:58but unfortunately
08:59it doesn't stop the disease
09:00from progressing
09:01My cervical spine
09:02identified a disc at C5-6
09:04but his symptoms were
09:06Consultant neurologist
09:07Aisling Rhine
09:07has been treating Howard
09:08since his diagnosis
09:11It's always difficult
09:12to communicate the diagnosis
09:14of motor neurone disease
09:14to a patient
09:16You never get used to it
09:17You try to
09:19be there for that person
09:21and be
09:22the go-to link
09:23or be the coordinator
09:24for their care
09:25for as long
09:26as you can
09:27So a small dip today
09:29compared to the last time
09:30you were in clinic
09:31OK?
09:32The most common cause
09:34that people die of
09:35finally in motor neurone disease
09:37is respiratory failure
09:38Even if your lungs
09:40are OK
09:41and you've never smoked a day
09:42and you've perfectly healthy lungs
09:43we still need
09:45innervation of our chest muscles
09:46to actually move our rib cage
09:48up and down
09:49and that
09:50slowly over time
09:51fades
09:52for patients with motor neurone disease
09:56And relax
09:57OK?
09:59I know
09:59Take a breather
10:00Give a minute
10:01so you're going to have to be doing this
10:02another two or three times as well
10:04OK?
10:05He likened it to a thief
10:07taking from you
10:08the whole time
10:09The thief has got his hand
10:10in your back pocket
10:11and he's taking everything
10:12He's taking your speech
10:13your mobility
10:16Better
10:17It's like a gradual
10:18chipping away
10:19of the person that you are
10:21I had always been
10:23a very active person
10:24and felt the threat
10:25of losing my ability
10:26to continue living
10:27as I had been accustomed
10:28to would be
10:29a very difficult challenge
10:35A lot of negative emotions
10:37Anger
10:38Fear
10:39Sadness
10:40Worry
10:40It's a head wrecker
10:44Super
10:44Well done
10:45Just a laugh
10:45OK
10:46And there's your other soft colour
10:47And that's our number
10:49on that one isn't it
10:50Yeah
10:50That's fine
10:50Just so you have it
10:51OK?
10:52We'll see you again
10:53OK?
10:53I will be in touch
10:54Bye bye
10:55Good thought
10:59Are you from Limerick?
11:00No
11:00I'm from Cork
11:01I don't know
11:03Why would you think
11:03I'm from Limerick?
11:04You have a seat
11:06Who do
11:08Do I?
11:09Yeah
11:10Thanks
11:10I don't know
11:12Is that a compliment
11:12or not?
11:13The best looking girls
11:14in the country
11:15Who?
11:16Limerick ladies
11:17are the best
11:17Oh so it's a compliment
11:19Thank you
11:20Yeah
11:21Yeah
11:21Yeah
11:25Dr. Jason Vanderveld
11:27is on duty
11:28in the emergency department
11:29and also on call
11:30for emergencies
11:31outside of the hospital
11:32I do have the golf car
11:33seven minutes out
11:34though
11:36Yeah I mentioned
11:37it's cold and stiff
11:38but I'm sure
11:38it's beyond any help
11:41now Roger
11:41now the golf car's
11:42on its way
11:42that's perfect
11:43thank you very much
11:49Dead
11:54Cyclist George Fuller
11:56has dislocated
11:57his kneecap
11:57Jason will seek
11:59to realign it
12:08I stumbled into pre-hospital care
12:10Don't know if I'll do it again
12:11I'll probably be a vet
12:12in the life
12:17I was a lifeguard
12:19beach 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
12:28I won't go
12:33use the top finger on the top
12:34to actually strengthen it
12:37and I'm going to not do anything
12:38to you for two minutes
12:38I 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
12:47in myself
12:49enabled me to go to college
12:50study further
12:52and so we're in medical school
12:53I'm going to do bigger breaths than that
12:55I think it's that community
12:56of pre-hospital care
12:57that's so special
12:58your head will swim
12:59that's fine
13:00I just want you
13:01completely intoxicated
13:02deep breaths
13:06deep breaths
13:07you're doing perfect
13:09well done
13:10you're doing perfect
13:12deep breaths
13:14and relax yourself down
13:16there we go
13:17well done
13:19deep breaths
13:20you've done
13:21magically
13:22keep going
13:23just turning the knee
13:25kneecap the right way around
13:27well done
13:28you've done brilliantly
13:30okay
13:33all straight
13:34just like an in
13:35well no
13:38thank you
13:41I'm out of here duds
13:44Jason is dispatched
13:45to a serious incident
13:46near Formoy
13:47a man has been kicked
13:49directly in the chest
13:50by a racehorse
13:52a patient is coughing
13:54and spluttering
13:55making loud
13:57blocking noises
13:58there
13:58for any of the car
13:59she's screw-headed
14:00and free
14:01human services
14:05bottom line is
14:06people do not get injured
14:07at the front door
14:09of the hospital
14:10you get ill or injured
14:12at home
14:12on the farm
14:14in the workplace
14:15on the road
14:16and our role
14:17is to bring
14:18the expertise
14:19of the hospital
14:19to where you become ill
14:21or injured
14:22to slow down
14:23hopefully hold
14:24the dying process
14:32I see a man
14:33in a farmyard
14:34he's also being kicked
14:35by a horse
14:37the big worry
14:39you've taken
14:40a full force
14:41of a massive animal
14:42kicking you
14:43into the chest
14:44that energy
14:45has to go somewhere
14:46it hits your chest wall
14:48bruises in the lung
14:50bruises to the heart
14:52I have to assume
14:54the worst
14:54at this stage
14:56here
14:58so it was just
14:59a straight forward
15:00kick into the chest
15:00and you didn't get
15:01thrown backwards
15:03you did?
15:03he did
15:04up against this
15:04one here he's at
15:05okay
15:05and did you
15:07hurt your back at all
15:08you did
15:09okay
15:10so you're in charge
15:11your own pain
15:14you've got to be
15:14very very vigilant
15:15that they haven't
15:16damaged the spinal cord
15:18bones can break
15:19they can break
15:19all the way through
15:20to your back
15:20any pain to the chest
15:23yep that's the one
15:24he was in a lot of pain
15:27no
15:28the ground here
15:29is not going to
15:29make it stable
15:30hang on
15:32hang on
15:33right I'm going to
15:34keep on
15:35and the horse
15:36was still standing
15:37between me and James
15:38so I couldn't get to him
15:39all I could think about
15:41was what damage
15:42is after being done
15:43and when I heard
15:44it was in the chest
15:45all I could think about
15:47was what's going on
15:48inside in him right now
15:51get you in the ambulance
15:52with a much much
15:53better look at you
15:54I'd knock me out
15:55I was going to do it
15:55yeah
15:56it won't be far off
15:57it's all
15:58far off it
15:59just go with it
16:00okay I'm just going to
16:01get some
16:02some scared
16:04James
16:06have a quick look
16:07at your lungs
16:07alright
16:07just while you're here
16:09mmm
16:10there we go
16:15when you see
16:15someone you love
16:17lying
16:17on a stretcher
16:19and they're
16:19pinned down to it
16:21and their eyes start to roll
16:22and the colour drains
16:23from their face
16:26is he bleeding internally
16:27I didn't know
16:28what was happening
16:29that's when
16:30we all got
16:31really frightened
16:41four-year-old Madison
16:42was rushed to CUH
16:44earlier today
16:46the team have successfully
16:47stopped her seizures
16:48but she is yet to regain
16:50consciousness
16:54we just wanted her to come around
16:56like to fire to open her eyes
16:57so she knew that we were there
17:19there's one thing
17:20seeing her have a seizure
17:21but to see her
17:22the way she was
17:23like literally
17:24out cold
17:25from being
17:26given medication
17:27to keep her comfortable
17:36and we were just talking to her
17:38and like saying
17:39come on baby
17:40like you're okay
17:40like we're here
17:43and you just want to be with your child
17:45and make like
17:45take her place
17:46so she isn't going through
17:48what she's going through
17:49it's very hard
17:49it's very very hard
17:55she's been fighting
17:56since the day she came into this world
18:00we never thought she would do anything
18:02that she's doing
18:02like now
18:04but Madison
18:05like she just surprises us
18:07every day
18:07with how like strong
18:08she is
18:09and we're just so proud
18:11of how far she's come
18:14I was only 19
18:16when I found out
18:17I was pregnant
18:17I was happy
18:20sad
18:21scared
18:22my partner James
18:23found out I was pregnant
18:24three weeks after meeting him
18:27I was like
18:28oh my god
18:28like
18:29does he want this
18:30like is he going to walk
18:31and leave me on my own
18:32but he didn't
18:32he said
18:33we did this together
18:34and
18:35there's no one going back
18:36like we'll do it together
18:38the birth was
18:39it was
18:40like it was hard
18:41but it was beautiful
18:42and I was just
18:43in awe
18:43I was so happy
18:44that like
18:45my body was able
18:46to bring Madison
18:47into the world
18:48and that I had
18:49James' support as well
18:51and then
18:52everything changed
18:53everything changed
18:58we went in
18:59with the consultant
19:00and they said
19:00Madison has been diagnosed
19:01with DYRK1A syndrome
19:04we were like
19:06so worried
19:07I was like
19:08what is wrong with her
19:09like
19:11she's the only child
19:12in the Republic of Ireland
19:13that's been diagnosed
19:14with it
19:14like I think there's
19:16like 30 something
19:17kids in the whole world
19:18with it
19:18like it's very rare
19:22Madison
19:23like can't talk
19:24she's autistic
19:25she's epilepsy
19:27feeding problems
19:28walking problems
19:29there's so many to do
19:31with her disability
19:31like she suffers from
19:33constipation
19:34reflux
19:35like there's so much
19:38I weigh very heavily
19:39on how the parent
19:40is viewing their child
19:42they'll know the condition
19:43better than I will
19:44they'll know the nuances
19:46Madison is extremely ill
19:48and will need to be
19:49closely monitored
19:50in the coming hours
19:53she's now getting oxygen
19:54to her brain
19:56but things can change
19:57at the drop of a hat
20:00Madison can start
20:01seasoning again
20:02and her oxygen levels
20:03can start going down
20:04again and her breathing
20:05can become depressed
20:06again so you maintain
20:08a holding pattern
20:14James is very
20:16he's a very caring person
20:17very kind
20:18he said
20:19no matter what
20:20we'll be the best parents
20:21and show our kids
20:23like what love is like
20:24as well
20:24like show them that
20:25like no matter what
20:26we're always going to be
20:27by their sides
20:30it is hard
20:31like it's very challenging
20:32and it's like
20:33it's around the clock
20:34like it's constant
20:35constant medications
20:37dosage
20:38dosage change
20:39hospital admissions
20:42they're entrusting you
20:44with their child
20:45so at this moment
20:46they are saying
20:47you need to come in
20:49you need to help us
20:50I couldn't imagine
20:52what it's like
20:52it's that lack of control
20:55having to give control
20:56over to the team
20:59it must be a very
21:00uncomfortable kind of
21:01feeling for the family
21:04to do that
21:06we're living it
21:07every day
21:08this is what our life is
21:09with Madison
21:10every day
21:37where's my Niamh
21:38where's Niamh
21:39Niamh's outside there
21:4049 year old
21:41James Fenton
21:42was kicked in the chest
21:43by a racehorse
21:46emergency doctor
21:47Jason is concerned
21:48he may have
21:48life-threatening chest
21:49and back injuries
21:52paramedics are preparing
21:53to move James
21:54to CUH
21:54two specific points
21:57thoracic spine
21:58upper thoracic spine
21:59and lower thoracic spine
22:02and he's also tender
22:02into the lumbar spine
22:03if you have a chest wall
22:05injury
22:06excruciatingly painful
22:07because every time
22:08you breathe
22:10it's pain
22:11I have not got a CT scanner
22:12that's going to tell me
22:13definitively that those lungs
22:15are not contused
22:16or that heart
22:17is not bruised
22:18so my first priority
22:20is just getting
22:21as much analgesia
22:22as he needs
22:23to enable him
22:24to breathe
22:25effectively
22:42he was on cloud nine
22:45I think it was the results
22:46the ketamine in his system
22:48he didn't feel like
22:50he was here with us
22:53he proposed again
22:55I love you
22:57and we'll get married
22:58we'll get married next week
22:59really?
23:00yeah
23:01yeah
23:01I was
23:03eight months pregnant
23:04trying to keep calm
23:14I was just trying to think
23:15how am I going to juggle
23:16all of this
23:17and I'm going to be on my own
23:18doing all of it
23:21what if this is more serious
23:23and that
23:25the ketamine
23:25and all the other drugs
23:26he's on
23:27are masking
23:28what he's actually going through
23:40Howard has motor neuron disease
23:43following his respiratory assessment earlier
23:45he and his wife Yvonne
23:47are waiting to see
23:48consultant neurologist
23:49Aisling Ryan
23:53hi
23:55how are you?
23:56come on in
23:59take a seat there
24:00Howard
24:00can I just get a sense
24:02of what you can do there
24:03so just arms up
24:04if you can
24:05good
24:05and keep that up against me
24:06good
24:07keep that up
24:08good
24:09maybe a little weak there
24:10push down for me
24:11nice and strong
24:11and push down
24:12nice and strong
24:12okay good
24:13he still has quite good strength
24:15in his arms and legs
24:16so he's walking
24:17he's able to be independent
24:18in many aspects
24:19but unfortunately
24:21that will change
24:22over time
24:23and then it's dealing
24:24with the challenges
24:25that that brings up
24:26and how is he going to manage
24:28how is he going to
24:29is he going to be able
24:30to walk around his house
24:32is he going to be able
24:32to dress himself
24:33et cetera et cetera
24:34and this time
24:35pull towards you
24:36pull in towards you
24:36I get fantastic support
24:38from Yvonne
24:39there are things
24:39I can no longer do
24:41for myself
24:42that she now helps me with
24:43and she's had to handle
24:45my frustrations
24:47I'm fairly good
24:48at releasing emotion
24:50I don't like bottling it up
24:51better that it comes out
24:55and just the grip strength
24:56just squeeze me tight there
24:58okay
24:58and squeeze tight here
24:59so yeah
25:00that's a little weaker
25:01in that left hand
25:01isn't it
25:02how's the strength
25:02in the leg
25:03I just like to look after him
25:05you know
25:05it's not a big deal
25:08it's just
25:08that's what you do
25:09for somebody
25:09that you love
25:10I think
25:10we have an issue
25:12with the wedding ring
25:13the fingers have swollen
25:14and we can't get it off
25:15it looks to me
25:16like it probably
25:17needs cutting off
25:17they will have a ring cutter
25:19they always have one down
25:20in the emergency room
25:21because sometimes this happens
25:22I mean it's a
25:23sort of a difficult thing
25:25to you know
25:25cut the wedding ring
25:27do you want that done
25:29today
25:29if we could organise
25:30not really
25:31do you want to think about
25:31that a little bit
25:33it's nice to just sit
25:35and be together
25:35and hold hands
25:37it's just a bit of closeness
25:40amongst all the hustle and bustle
25:42that's a precious moment
25:45maybe the next time you're coming
25:46or if that's too far away
25:47we can get it done
25:48in between
25:52we all know how it ends
25:54but the challenge
25:55is to make the most
25:56of the remaining time I have
26:00despite my deteriorating health
26:02I still feel very fortunate
26:04I have a loving family
26:07I have a lot to be thankful for
26:12I don't think about
26:13what I may miss
26:14but concentrate on
26:15what I have enjoyed
26:16over the last 20 odd years
26:18with them
26:22life's too short
26:23for all those to be worrying
26:25about how it all ends
26:26the trick is to enjoy each day
26:36what are you playing?
26:37what are you playing?
26:37yeah it was sports
26:38it was sports day
26:41everything yeah
26:42tag rugby I think
26:44first and last time
26:46I think
26:47we're giving you more medication
26:49there now Jude
27:0364 year old Tim Murphy
27:05has advanced lung cancer
27:07today doctors will attempt
27:09to surgically remove the cancer
27:11in a bid to save his life
27:19the consultant came in and told me
27:21that Tim had a tumour on his lung
27:25and it was cancer
27:30I've had two uncles that actually died of lung cancer
27:34so I just thought
27:38oh god here we go
27:40he's gone
27:43number 40
27:47I just remember Dr. Collins' initial words were
27:53oh it's a big boy
27:54was what she called the tumour
27:56what's the date of part?
27:5819th of July 62
27:59I first met Tim
28:00in the autumn of last year
28:03he would have discussed his case
28:04in our multidisciplinary team meeting
28:06and we would have looked at all his images
28:08and made a decision
28:08that actually
28:09pre-surgery
28:11chemotherapy
28:12chemotherapy with immunotherapy
28:13I suppose a regimen that we call neoadjuvant
28:16was the right way forward for Tim
28:18and the whole purpose of that
28:19would be to shrink down the cancer
28:20because as he currently was
28:23with his diagnosis
28:24he probably would have lost his entire lung
28:26if he had gone straight for surgery
28:27great
28:28we might have a quick look at the board then
28:31when I walk through the hospital
28:33there is a professional persona
28:35that kicks in
28:36but one of the hardest things that I do
28:38is
28:39when I have patients
28:41and have to tell them
28:42that this cancer
28:44is going to shorten their lives significantly
28:46that they
28:48are
28:49going to
28:50not be around
28:51for their children
28:53or their grandchildren
28:55thanks father
28:56you know
28:57we give people hope
28:58we buy people time
28:59but it is
29:00emotionally
29:01very draining
29:02it can be really hard
29:05to shake it off
29:06at the end of the day
29:07and to
29:08you know
29:08head home
29:09and pretend that I just
29:10you know
29:11put in a 9 to 5
29:12following a regime of chemo
29:15and immunotherapy
29:15to reduce Tim's tumour
29:17surgeon Kishore Doddokula
29:19will attempt to remove
29:20his cancer completely
29:21also hoping to save his lung
29:25so if we look at the differences
29:27I suppose
29:28in where we were
29:29after 12 weeks of treatment
29:32there's obviously been significant change
29:34you can see a disease
29:35big cancer here
29:36and then you know
29:37obviously much smaller now
29:38you never know
29:39till you really go in
29:40but I'll try and save
29:41but you know yourself
29:43you know
29:43unless we go in
29:44we won't know
29:47do you smoke?
29:48no
29:49so he's
29:50off them now
29:52two years since
29:52the 14th of April
29:54there was a point
29:56and now Tim doesn't know this
29:58but
29:59I felt very angry at him
30:02like initially
30:04it took everything
30:06in my power
30:07not to say
30:09you were warned
30:14he had this god awful cough
30:16sometimes he'd nearly choke with it
30:18and
30:19I just couldn't understand
30:21how
30:21he carried on smoking
30:24but
30:24you just have to try and think of
30:26where do we go from here
30:29so we'll start the pre-op
30:31they'll check your operation site
30:33later on
30:34my operation what?
30:36operation site
30:37just so we always mark
30:38where we're going to operate
30:39it's handy
30:40make sure it's the right side
30:41exactly
30:41yeah
30:42it's just a check
30:42do you know the reason
30:44for your admission?
30:46yeah
30:46lung cancer
30:47lung cancer
30:48and you're going to
30:48this is a surgical ward
30:50so you're going to have
30:51surgery on your
30:52left lung
30:53yeah
30:53is that okay
30:54and hopefully they'll be removing
30:56hopefully
30:57the tumour
30:57yeah
30:58okay
30:59to be told that the
31:00the tumour had
31:02shrunk by half
31:03was huge
31:05we knew then
31:06that he could go for surgery
31:07we just had to see
31:08what they could do
31:10who's next of kin
31:11who's next of kin?
31:11kin
31:12is it partner, wife
31:14or...
31:15partner
31:15I asked the same question myself
31:17not yet
31:19later this year
31:21yeah
31:21okay brilliant
31:22congratulations
31:24what?
31:26the goal is to get him to surgery
31:28so being able to
31:29I suppose
31:30shrink down
31:31his cancer
31:31and have it then
31:33removed by a surgeon
31:34is the best outcome
31:35and what we could hope for
31:37for Tim
31:38let's sit down here
31:39good
31:39ah no no no
31:40please sit down
31:41sure
31:41that's alright
31:41yeah yeah
31:42how are you feeling?
31:43great
31:44brilliant
31:44good
31:44the day has come
31:45yeah I heard so
31:47yeah
31:47so heading into surgery
31:49fairly soon
31:49yeah
31:50the chemotherapy
31:51and the treatment
31:51are you feeling
31:52yeah I feel good
31:53I didn't suffer badly
31:54with it at all
31:55yeah yeah
31:55just pins and needles
31:58tiredness
31:58yeah
31:58beat you up a bit
31:59in addition to beating
32:00the cancer up a bit
32:01yeah
32:01that's the plan
32:02you did that though
32:03didn't it?
32:03did yeah
32:04did a big job
32:05yeah yeah
32:05thanks for the card
32:06good
32:07the big fear
32:08for us
32:09is that
32:09you know
32:10when the surgeon
32:11goes in to operate
32:12that he doesn't get it all
32:14and Tim
32:14might end up losing
32:15the whole lung
32:16in order to try
32:17and get clearance
32:18and of course
32:18there's risks to surgery
32:20I mean
32:20having a portion
32:21of your lung removed
32:22is not without
32:23you know
32:23potential for
32:24potentially devastating
32:26impact
32:27it's just that
32:29so
32:30we are
32:31always about this
32:32I know
32:33we're getting done
32:33what we're getting done
32:34you know
32:36so
32:36can't do much more
32:37about it
32:37I think
32:48she's old
32:48the team
32:50has stabilised
32:51Madison
32:51following a series
32:52of prolonged seizures
32:53earlier today
32:54just ring me
32:56yeah
32:57she's got
32:58her body's cold
32:59Madison suffers
33:01from a rare genetic condition
33:02called
33:04DYRK1A syndrome
33:07we always said
33:08we always said
33:08from the start
33:09when we found out
33:10Madison was sick
33:10like no matter what
33:11we'll deal with it
33:12together
33:13as a family
33:15I do get lonely
33:16at times
33:17but then I have
33:18the like support
33:20of my mother
33:21my father
33:21my partner
33:23James
33:23my siblings
33:24his parents
33:24and his siblings
33:25so like we can
33:26just ring them
33:27but it's very hard
33:28to like
33:29you know
33:30kind of explain
33:30how you're feeling
33:34I'm constantly
33:35blown away
33:35just the
33:37the level of care
33:39and dedication
33:40that parents have
33:40you know
33:42their whole lives
33:42have gone down a path
33:43they
33:43they didn't think
33:45they would go down
33:46but you never see
33:48regret
33:49you only see
33:50love
33:51and
33:52and it's
33:53it's just
33:54it's
33:54it's mind-blowing
33:57Madison will be admitted
33:58to the paediatric ward
33:59so she can continue
34:01to be closely monitored
34:04she's just
34:05a lot more stable now
34:06so we're happy
34:07that we're gonna bring her back
34:08and then just kind of
34:09wait for her to come around
34:10we keep an eye on her
34:11and then
34:12Madison does have needs
34:13and that's just
34:14the way it is
34:15but she brings
34:15so much happiness
34:17to all our lives
34:18and everyone is like
34:19so happy
34:20like she puts a smile
34:20on everyone's face
34:21that she meets
34:24just looking forward
34:25to the future
34:26as our family
34:41James was kicked in the chest
34:43by a racehorse
34:44earlier today
34:45pre-hospital physician
34:47Jason Vanderveld
34:48is concerned
34:48he may have
34:49significant injuries
34:50to his chest
34:51and spine
34:54I've been there
34:54with horrific trauma
34:56when it's your own
34:57family member
34:57you know
34:58my son fell
35:00off the banisters
35:01you know
35:02from the top story
35:03down to the bottom story
35:04and literally went
35:05splat on
35:06the tile floor below
35:09having to manage that
35:10will always stick with me
35:12I live rural
35:13I live 50 minutes
35:14from the hospital
35:15so I had to switch
35:16into clinician mode
35:19did not have
35:21any other option
35:23and the one thing
35:24that I've appreciated
35:26is my colleagues
35:27the CUH family
35:28because I was able
35:29to hand over care
35:30with my severely
35:32traumatically injured
35:33five-year-old
35:34I knew he was
35:36in completely safe hands
35:37and he's multiple
35:39creptest on the left
35:40and side of the chest
35:41he's had
35:42one of Hentrox
35:44before James
35:45can be sent
35:45for a vital CT scan
35:47his pain
35:48needs to be controlled
35:52we're just going to get
35:53some local anaesthetic
35:54and we're going to get
35:56some local anaesthetic
35:57and try to take
35:58the pain that I'm here
36:03it's left side
36:04that we're blocking
36:08it's alright
36:13I seem to be very calm
36:14on scene
36:15or my parents
36:16on scene
36:16is very calm
36:17almost non-empathetic
36:18but actually
36:20I've been there
36:21and I know
36:22that the most effective
36:23way of managing
36:24somebody who's
36:25traumatically injured
36:26is to push emotion
36:27to one side
36:30and focus
36:32on the clinical
36:32on what really matters
36:35a lot of this
36:36is just the ketamine
36:36because you don't
36:37feel in control
36:38and yourself
36:40yourself being the boss
36:42normally at work
36:42you're always in control
36:43aren't you
36:45the day before
36:46James' mum
36:48had passed away
36:50to see
36:51a completely
36:52opposite side
36:53of James
36:54being so vulnerable
36:55so upset
36:55that his mother
36:57had passed away
36:57then in so much pain
36:59from getting a kick
37:00from a horse
37:01all in the space
37:02of 24 hours
37:03it was
37:04very very hard
37:06to know
37:06what to do
37:07or how to make
37:08things better
37:08and how to be there
37:09for him
37:14I know you're hurting
37:15a lot
37:16so what I'm going
37:16to be doing
37:16is getting
37:17a bit of local
37:18anaesthetic
37:20just in two
37:22around where it hurts
37:23the most
37:26you can see
37:26the bruise
37:27coming up now
37:28I'm auto-digest
37:29I know
37:29I know
37:30I want to be there
37:31for the funeral
37:35I think just one thing
37:36at a time
37:36alright
37:37because in fairness
37:38you took quite a belt
37:39of that boss
37:40alright
37:50no you're definitely
37:51not hot enough
37:51to be in hell
37:53sometimes you call
37:54this place hell
37:54but it's not
37:55it's C-U-H
38:01I'm a paediatric nurse
38:02by background
38:03I started off
38:04actually as an actor
38:05over in the UK
38:06I'm from Wales
38:07originally
38:08and I went into
38:09hospital as a play
38:10specialist
38:10working with puppets
38:11and children
38:12funny really
38:13is that a lot
38:13of the TV stuff
38:14which I did
38:15as an actor
38:16was hospital based
38:17like I was
38:17extras and casualty
38:18and a few other
38:19hospital based programs
38:21so when I first
38:22came to work
38:22in hospitals
38:23over in the UK
38:24I didn't actually
38:25like things like
38:26injections and blood
38:27so I just used to
38:27pretend I was back
38:28on set of casualty
38:34Eugene O'Leary
38:35has been brought
38:36to the emergency
38:36department
38:37following a
38:38chainsaw accident
38:41you were cut
38:42in the hedge
38:42were you
38:43yeah
38:45it needs a few
38:46stitches doesn't it
38:47I would think so
38:48yeah
38:48yeah
38:48how many cuts
38:49are there
38:49so the thumb
38:50index
38:52you wouldn't do it
38:53with a knife
38:53next time
38:53would you
38:55Eugene's hand
38:55was quite simply
38:56a mess
38:57if you have a wound
38:58there
38:58bacteria in that
38:59dirt love blood
39:01and they just
39:01grow and grow
39:02and grow
39:04it's a whole mess
39:04isn't it
39:05but there's still
39:06leaf
39:08leaf
39:09there's still
39:10leaves on you
39:10there'll be
39:11heads growing
39:12here
39:12I think
39:25one of the most
39:26mangled hands
39:27that I've had
39:27to try and put
39:28back together
39:29in a long time
39:36do you have any
39:37kids
39:38I'm not married
39:39right
39:40doesn't mean
39:41you can't have any
39:41kids
39:44no one would have
39:45me
39:45no one would have
39:46you
39:46you escaped
39:48you want to be
39:49confident with the
39:50patient
39:50and I think that
39:52by having to chat
39:52with the patient
39:53at the same time
39:54as you're
39:54doing something
39:56very important
39:56to his hand
39:57I think it feeds
39:59back
39:59it reduces his
40:00level of stress
40:01what are you
40:02doing
40:02you
40:02what are you
40:04doing
40:04you
40:04my
40:05my
40:05baba is
40:06eight months
40:07oh
40:08and my eldest
40:09eight years
40:09oh
40:10and three
40:11and five
40:13so a nice
40:14spread of them
40:14yeah
40:15all girls
40:17all girls
40:18yeah
40:18blessed among
40:19women
40:19all that
40:21you know
40:22so I'll be in
40:23big trouble
40:23later on in life
40:28that hand was
40:29properly mangled
40:30with a chainsaw
40:31there was so many
40:32little bits of skin
40:33poking out
40:35ultimately
40:36we wouldn't have
40:37got a very good
40:37closure
40:38on the wounds
40:39so he'll need
40:40more long-term
40:41definitive care
40:42under the hand
40:42surgeons
40:43which is the
40:43plastic surgeons
40:44in our hospital
40:51good afternoon
40:52CUHFM
40:53hospital radio
40:54all day
40:55every day
40:55with your classics
40:56from the 60s
40:57and 70s
40:58and the 80s
40:59do you remember
41:01this guy
41:01Harry Belafonte
41:04hey
41:04that's me
41:05I'm good
41:06I'm Dave
41:06I'll be taking
41:07upstairs there
41:07now
41:08that's a good deal
41:08Tim has advanced
41:10lung cancer
41:13surgeon
41:14Kishore Dodakula
41:15is preparing
41:15for high-risk surgery
41:17to try and remove
41:18his tumour
41:18while also saving
41:20his lung
41:22he won't know
41:23until after he has
41:24begun the procedure
41:25if that will be
41:26possible
41:28the most important
41:29thing is their life
41:31and the second
41:32most important
41:33thing is
41:34get all the
41:35cancer out
41:36any operation
41:37I suppose
41:38done by a
41:39cardiothoracic surgeon
41:40is life-saving
41:41because the
41:42stakes are very
41:43high
41:43if you take
41:44out the whole
41:45lung
41:45the risk is
41:46as high as
41:47one in ten
41:48won't make it
41:49so the priorities
41:50are three
41:50one
41:52safety
41:52so that
41:53his life
41:54is not in danger
41:55number two
41:56I want to get
41:57all the tumour out
41:58and number three
41:58I want to leave
41:59behind as much
42:00of lung as
42:00possible
42:01so that he can
42:02have a good
42:03quality of life
42:04after this surgery
42:07terrifying
42:08one of
42:10the loneliest
42:11times of my life
42:12I think
42:13I didn't want
42:13to be
42:14thinking about
42:15the reality
42:16of what could
42:17happen
42:18and I didn't
42:19want to think
42:20of my life
42:20without him
42:28I was terrified
42:30of the surgery
42:31it was just
42:32all of the
42:33risks associated
42:34with just
42:35the surgery
42:35itself
42:36outside of
42:37what they were
42:38trying to
42:39actually remove
42:48I don't remember
42:49my life
42:50before
42:51Tim
42:52I was
42:53separated
42:54I didn't ever
42:55think I would
42:56meet somebody
42:57again
42:58but Tim
42:59is the one
43:00is the only
43:01way I'll put it
43:15two hours
43:17into Tim's
43:17operation
43:18Kishore has
43:19made his
43:19decision
43:20on what
43:21to remove
43:23say this
43:24please
43:31there is a
43:32tumor there
43:36sometimes
43:37lymph nodes
43:38are involved
43:51while James's
43:52pain has been
43:53brought under
43:53control
43:54there is
43:55concern he
43:55could have
43:56severe damage
43:57to his chest
43:57and spine
43:58a CT scan
44:00has been ordered
44:00to assess
44:01the damage
44:02they gave you
44:03the ketamine
44:05it wasn't
44:06pleasant
44:07to see
44:08the reaction
44:09ketamine
44:10it was
44:13just the way
44:14you reacted
44:14to it
44:15which we were
44:15told is
44:16normal
44:16anyway
44:19your breathing
44:20it was like
44:20you couldn't
44:21breathe
44:21like you were
44:22starting to
44:22suffocate
44:23and your eyes
44:24just went
44:25completely wide
44:26and still
44:28James is
44:29turning 50
44:30this year
44:30and I'm 37
44:32but once
44:34we got to
44:34know each
44:35other
44:35it was
44:36never
44:36never
44:37a question
44:38brought up
44:38between
44:38the two
44:39of us
44:40it was
44:41evident
44:42very early
44:43on
44:43that
44:43things
44:44were
44:45going
44:45in one
44:46direction
44:49we was
44:49coming up
44:50to
44:50valentine's
44:51and he
44:51just said
44:52I hope
44:52himself
44:53is taking
44:53you out
44:53and I
44:54said
44:54no
44:54no
44:54there's
44:55no
44:55himself
44:56so
44:56he
44:57asked
44:57me
44:57if
44:57I'd
44:58go out
44:58for
44:58dinner
44:59with
44:59him
44:59on
44:59valentine's
45:01and
45:01of course
45:02I said
45:02yes
45:03and
45:04we
45:04went
45:05to
45:05Bella
45:06cafe
45:06in
45:06Fermoy
45:07but
45:08we
45:08had
45:09to
45:09go
45:09to
45:10the
45:10folding
45:10unit
45:10before
45:11we
45:11went
45:11for
45:11dinner
45:12so
45:12I
45:12was
45:12introduced
45:13to
45:13horses
45:14straight
45:14away
45:21he's
45:21very
45:22sore
45:22very
45:22specific
45:23one
45:23side
45:24of
45:24his
45:24chest
45:24we're
45:25going to
45:25get
45:25the
45:25scans
45:26done
45:26okay
45:26so
45:27Andrea
45:28is a
45:28porter
45:28we're
45:29going to
45:29go
45:29down
45:30as
45:31you've
45:31been
45:31kicked
45:31and you
45:32see
45:32visible
45:32bruises
45:33on
45:33the
45:33chest
45:33wall
45:34you
45:34don't
45:35see
45:35visible
45:35bruises
45:36in
45:36the
45:36lung
45:36the
45:37consequences
45:38of
45:38that
45:38don't
45:39happen
45:39immediately
45:39okay
45:40yeah
45:41so
45:41I'm
45:42just
45:42going
45:42to
45:42try
45:42line
45:43you
45:43a
45:43bit
45:43flatter
45:57when
45:57James
45:58was
45:58wheeled
45:59away
45:59for
46:00the
46:00scan
46:01it
46:01was
46:01then
46:01that
46:02I
46:02just
46:03broke
46:03down
46:03and
46:04I
46:04said
46:04what
46:04is
46:05going
46:05on
46:05what's
46:06going
46:06to
46:06happen
46:07is
46:07he
46:07going
46:08to
46:08be
46:08okay
46:08or
46:08not
46:30tim is
46:32in recovery
46:32following
46:32major
46:33lung
46:33surgery
46:34consultant
46:35Dervila
46:35Collins
46:36is on
46:36her way
46:36to
46:37brief
46:37tim's
46:37partner
46:38kate
46:38the
46:39best
46:39outcome
46:39is
46:40that
46:40the
46:40cancer
46:41was
46:41removed
46:41and
46:41that
46:42tim's
46:42lung
46:42was
46:42saved
46:46he
46:47was
46:47able
46:47to
46:47take
46:48out
46:48just
46:48the
46:48lobe
46:49so
46:49do you
46:49remember
46:50yeah
46:50he didn't
46:51have to
46:51take
46:51the
46:51whole
46:52no
46:52he
46:52didn't
46:53so he's
46:54left
46:54about
46:54two-thirds
46:55of the
46:55lung
46:55in
46:55alright
46:56fantastic
46:56and
46:57and
46:57has
46:57taken
46:58you
46:58know
46:58I suppose
46:59one
46:59of the
46:59lobes
46:59and
46:59a
47:00little
47:00bit
47:00just
47:01a
47:01little
47:01bit
47:01of
47:01but
47:01he's
47:02happy
47:02that
47:03he's
47:03got
47:03everything
47:03took
47:04out
47:04all
47:04the
47:04lymph
47:04nodes
47:05thank
47:05you
47:06so
47:06much
47:07I'd
47:07be
47:07just
47:08I'd
47:08be
47:08off
47:09my
47:09tears
47:09again
47:11that's
47:12my
47:12job
47:13so
47:13they
47:13send
47:14that
47:14off
47:14now
47:14to
47:14the
47:15lab
47:15sometimes
47:16we
47:16see
47:16a
47:16little
47:16bit
47:16of
47:17cancer
47:18I
47:34hope
47:34at
47:34least
47:35you
47:35are
47:35a
47:36little
47:36bit
47:36more
47:37relieved
47:39after
47:39I'm
47:40sure
47:40it
47:40was
47:40a
47:40very
47:40stressful
47:41day
47:42stressful
47:42months
47:44while it's
47:45good news
47:45that most
47:46of Tim's
47:46lung
47:47was left
47:47in place
47:47there still
47:49remains a
47:49risk
47:50that not
47:50all the
47:50cancer
47:51was
47:51removed
47:52what
47:53we
47:53want
47:53is
47:54for
47:54when
47:54the
47:55pathologists
47:56look
47:56at
47:57that
47:57cancer
47:57that's
47:57been
47:58removed
47:58under
47:58the
47:58microscope
47:59we
48:00want
48:00to
48:00see
48:00no
48:01cancer
48:01we
48:02want
48:02to
48:02see
48:02that
48:02cancer
48:03having
48:03melted
48:04away
48:04with
48:05the
48:05chemotherapy
48:05and
48:06the
48:06immunotherapy
48:06and
48:07that's
48:07the
48:07win
48:13when
48:14we
48:14were
48:14in
48:14the
48:14hospital
48:15and
48:15that
48:15we
48:15knew
48:16that
48:16it
48:16was
48:16a
48:16fracture
48:17to
48:17a
48:17rib
48:17and
48:18that
48:18his
48:18spine
48:18was
48:18okay
48:19you
48:19have
48:19to
48:20look
48:20at
48:20the
48:20positives
48:21as
48:21well
48:21and
48:21see
48:22that
48:22he
48:23was
48:23okay
48:24at
48:24the
48:24end
48:24of
48:24it
48:24but
48:25he
48:25was
48:25also
48:25extremely
48:26lucky
48:26to
48:27be
48:27okay
48:27at
48:27the
48:27end
48:27of
48:28it
48:28you
48:28get
48:28a
48:29second
48:29chance
48:30family
48:30is
48:30always
48:31going
48:31to
48:31be
48:31number
48:31one
48:32the
48:32horses
48:33will
48:33be
48:33alright
48:34but
48:35they're
48:35the
48:36hobby
48:49I'm
48:50cancer
48:50free
48:51live
48:52healthy
48:52and
48:53happy
48:54a lot
48:55to be
48:55said
48:55to be
48:56living
48:56healthy
48:56and
48:56happy
48:57what
48:57more
48:58would
48:58you
48:58love
49:46Transcription by CastingWords
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