Junior Doctors: Your Life In Their Hands (2011) s01e07 Episode Script

1 Summer 2010, and seven junior doctors hit the wards of Newcastle's hospitals.
Cardiac arrest.
One year later, as they're about to move on, they're getting together for one last time.
The sad thing about it all being over is, a year down the line, we are all moving apart.
They'll recall the tough times.
It was just so daunting on so many levels.
- I felt like a rabbit in headlights, to be honest.
- The fun times.
- # I really need you tonight! # - Their most memorable moments.
Someone says, "You're the girl with the toilet brush!" And I was like, "I was not WITH the toilet brush!" - That is on fire! - It was like, oh, my God, everybody, it's a fire.
And moments they'd rather forget.
Suzi is going to murder me, but there is a moment with a chip.
Cos you know, you've got What they learnt.
If you're nervous, you have to hide it as much as you can.
- Has he ever done it? - Oh, yeah, he's done it before.
The nurses are our lifesavers.
And where they're going next.
I think it's time to go back to Hong Kong, where I come from.
Just to not messing up too badly.
August 2010, and these seven junior doctors were about to embark on one of the most challenging times of their lives.
They were joining thousands of other junior doctors across the UK who were starting work on the wards for the first time.
One year on, they're coming together for the last time.
I'm doing a little bit more in terms of seeing patients and making decisions.
Now I do feel more like a doctor than I did.
At the end of the year you're like, I kind of know what's going on.
I know what I'm supposed to do and I know how to do it.
I've changed loads.
It's completely different - from the start of the year.
- I feel more like a doctor, but I think that's because as I've improved throughout the year people are treating me more like one.
Maybe you just give the wrong impression.
I think we've all learned a lot about medicine and a lot about ourselves and how we deal with situations, - and that's all really good experience.
- Yeah.
Has anyone mastered the art of being in four places at once yet? - No, I think you eventually - Eventually, you'll have a junior doctor underneath and you can.
You can delegate that.
12 months earlier, they were far less confident.
I just keep telling myself that there's literally tens of thousands of people in exactly my position that will be going on the wards and at least one of those people at least one of those people will make a worse mistake than me.
Fresh out of med school were the first years Adam, Lucy and Katherine.
It's the sort of profession where people don't want to know if you're a beginner.
You'll never be ready.
You have to deal with it.
Sharing a house with them were second years, Andy, Suzi, Jon and Keir.
I'm absolutely scared witless as well.
And they'd already had a year's experience on the wards.
You can make mistakes and people can die.
And that's scary.
Scares me quite a lot.
Day one.
Adam, Lucy and Katherine had only graduated a few weeks before.
Would it be possible to take that blood from you? One of their first responsibilities was to take blood.
Just tap on you to see if I can get them to stand up a bit better, OK? When you first start to take blood, you pray for somebody who's got veins you can see from the other side of the room and can practically get with a dart.
That's kind of how I feel and how I felt when I first started taking blood on the wards.
You dreaded the time the nurses said, they're difficult to get blood from.
And first year Katherine was about to encounter such a case.
The arm's quite swollen.
I think it'll be quite difficult.
I just can't see or feel the vein at all.
If you're nervous, you have to try and hide it as much as you can.
I don't think it helps the patient if if it looks like you don't know what you're doing.
I don't want to take it out of that arm.
I could do your foot.
- I can see a little one here.
- If you put a tourniquet on Yeah.
I'll put a tourniquet on.
It's quite small.
I don't know if I can make it bigger, though, with the tourniquet.
I'm really not convinced this is going to work.
'When you've been lying in bed with your feet up for three days 'it's not so easy to get blood out of.
' No, that's not going to go.
Sorry about that.
It's quite embarrassing to say I can't get blood.
She was actually, um, a nurse herself, so she completely sympathised with me and so, you know, obviously I felt awful about it but I tried not to beat myself up too much about it.
I think Katherine demonstrated one example of something that we all struggle with at some point.
And if it's not blood taking, it might be something else.
First year Adam HAD managed to take blood.
Bit of a bruise, sorry.
But struggled in other areas.
Do you know what Addison's disease is? Do you know what the original Addison's disease was? Um I'm trying to think of whether it was ac Is the original AddisAddison's disease from, er, the pi - No, it's a primary, isn't it? - Yeah.
Do you know what I'm thinking of? Um, anyway, never mind.
Another endocrine.
Go on.
So, it's primary adrenal failure and what did Addison describe on postmortem in the adrenal glands? What was actually causing adrenal destruction? - Was it an au was it an autoimmune? - No.
- It was TB - TB's - .
.
of the adrenal glands.
- .
.
the most worldwide.
I'm sure I could talk about that in length now.
However, at the time, I was under so much pressure to make a good impression, it just went straight out of my head.
If I am asked on my first day what is Addison's disease, I will tell that it's something that Dr Biani does not know what it is.
I didn't come out with it and it didn't sound right and I looked like a fool.
I just felt like I'd made a really bad first impression.
- I think you're too harsh on yourself.
- Am I? Oh.
Second year Suzi might have had a year's experience on the wards, but her new placement was in A&E and she was scared.
I woke up that day and I felt terrible and I just thought, I do not want to go in today and start in A&E.
First days are petrifying and I think in our job, it's just a million times worse.
A&E lived up to its reputation.
Suzi's first case was a cardiac arrest.
It was like, "Go! "Cardiac arrest, go!" And I was like, "Ahhhh! A&E!" BEEPING We're waiting for a cardiac arrest call to come in so everyone's just waiting, ready to go.
I'm just trying to get all my bits and pieces gathered.
'Inside I just thought, oh, this is just the scariest thing.
' - Suzi, are you happy to pulse check? - Yeah.
- Yeah, OK.
Are you happy to shock? - Can do.
- I haven't shocked anyone before.
- You haven't? - No.
- OK.
All right, we'll show you, then.
OK.
Looking back, it seems just getting through A&E felt like a very long time.
Like a lifetime! SIREN WAILS He arrested in an ambulance.
The paramedics shocked him out of ETAC, he's now in sinus rhythm with a blood pressure of 114/82, but he's he remains unconscious.
We're in.
I haven't got much blood off.
I'll get some more on the other side as well.
The patient was unconscious, but his body was writhing because of the shortage of oxygen to his brain, a difficult first case for Suzi.
If you come round to that side, the cricoid ring is underneath the Adam's apple.
When he starts to go to sleep, direct pressure backwards into the bed.
HE GROANS All right.
You're all right, well done.
OK.
30 minutes in, the patient was stabilised and Suzi had passed her first big challenge.
I guess it's better to be thrown in at the deep end, because you think, if can do that on my first day, I can do anything.
I think Suzi did really well, you know, kept a cool head, did things expected of her and she did them well.
But I was glad that not every day was as tough as my first day.
Some of them were, but others weren't as bad, thankfully.
Some nice deep breaths in and out through the mouth.
Second year Jon's new role was stressful too.
I'm Dr Barclay, I'm one of the doctors at the Emergency Admissions Unit at the RVI.
As well as working on one of the most demanding wards in the hospital, he was also part of the hospital's crash team.
That's scary because the first couple of minutes of a cardiac arrest are important.
Cardiac arrest! If his alarm went off, it meant a medical emergency and he had to get there quickly.
This time, the patient had gone into cardiac arrest and her heart was failing.
The patient had no pulse.
Jon started chest compressions to keep blood flowing around the body.
Yeah, 29, 30.
But with no heartbeat, time was running out.
The team had done everything they could.
Thanks, guys.
You go through a range of emotions.
There's obviously, sadness, that someone's passed away, and someone's life's ended.
Frustration that you have all this training and there's thousands and thousands of pounds have been invested in you as a doctor and nothing that you can do or, you know, think about, will be able to change the outcome for this patient.
You get your first experience of failing to save somebody very quickly and very abruptly.
First year Lucy was about to learn this herself, working with some acutely ill patients on the gastro ward.
I am quite a sensitive and emotional person and I saw some lovely patients who were really unwell and I found it very difficult in my first job.
As part of her ongoing training, Lucy would accompany consultant Dr Gun on the ward round.
And what is it you've been noticing? First of all I completely lost my appetite.
- I think I've lost at least a stone and a half.
- OK.
Your tummy then, when did that start to swell up? I'm not sure, but it's got increasingly worse.
The patient had a number of tests to determine the problem.
Lucy helped Dr Gun assess the X-ray.
Bowel-wise there looks like gaseous dilation on the left-hand side.
But here, there's this this sort of central dilated small bowel.
And we know she's obstructing radiologically, and clinically, cos she's acutely distended.
So, she's in trouble.
I need to assess her clinically, but my gut feeling is, we should be conservative - this is only going to get worse.
There isn't an operation to help with this, palliative or otherwise.
Dr Gun made the final diagnosis - pancreatic cancer.
In this case, the condition was terminal.
The patient was just a lovely, lovely lady.
She was cheerful, happy, and we were about to literally destroy that glint in her eye.
I put myself in her shoes and thought, how do you deal with someone telling you that information? Dr Gun had to break the news, and Lucy accompanied her.
This poor lady we've seen today has been told some of the worst news well, the worst news that she's ever going to hear, ever.
Her life has literally been taken away from her like that.
And she's just been told, right, you're going to go home to die.
It's awful.
So Yeah, anyway Is there anything else you want me to do for her today? Is it all sorted? - You all right? - Yeah.
Fine.
Sure? I know, it's sad, isn't it? She'sshe's got good family support, which helps a lot, and we'll get her feeling better.
The most important thing now is quality of life, which we can definitely improve.
I'm fine.
I know, it's horrible, and the difficulty is I was all right and suddenly it sort of just came over me.
That's all right and I won't be nice cos that'll make it worse.
All right.
- Thank you.
But that's it for today? - Yeah, thanks, Lucy.
Brilliant, OK, no problem.
It's all right.
What I hoped was I would perhaps be able to hide my emotions a bit more at work.
You don't expect your doctor on the wards to get upset or to cry over you or over their patients, but at the same time we all have those emotions and we all really care.
That's why we do the job.
Are you OK? Just knackered and had a shit day.
It's one thing caring within yourself and it's another thing actually showing that and, you know, you could just hug and kiss Lucy when you see her crying about a patient, you know, cos she's sincere with it.
It just left me completely drained.
I sort of sat there and I was just like So, anyway, that was my day.
Do you need a hug? Maybe.
Thanks.
I honestly think it should get to you.
I know it sounds weird but I think the day that you stop being affected by the amount of suffering that's going on around you is probably the day you should leave.
With more experience of kind of death and dying and people being unwell you never accept it, but you find better coping mechanisms.
So, you It's not that you care less, it's that maybe you deal with it better.
I now understand more that, you know, medicine isn't about being a superhero.
It's about being a good doctor and doing the best you can for someone, even if eventually that means, unfortunately, you can't save their life.
Being a junior doctor is a very stressful job.
They worked hard and they played hard too.
We work weekends and evenings and things like that so the time we do have off is quite precious and we like to use it wisely.
And no-one played harder than Jon.
The thing is, right, Jon Barclay is a rugby player.
And he's a drummer.
He's always on an adrenaline rush.
Jon Barclay is a horse's arse.
THEY CHEER I tried to fill my spare time, as it was, with as many extracurricular activities as I could.
Rugby kind of has a bit of a niche for people of my size and with my abilities.
It can be hard to fit in with my schedule sometimes.
The time constraints of the job make it hard, but my job's my job, but this is kind of my fun.
Jon Barclay You suffer from morbid obesity And you're gonna die young Jon Barclay! On top of a jam-packed social life, Jon also had to revise.
I'm studying at the moment for my first part of my surgical exams.
I've got a pretty thick book to revise from, and I've got two of these to get through.
But Jon also worked on one of the most demanding wards in the hospital, the Emergency Assessment Unit.
He needs bloods, he needs bloods, he needs bloods, oh.
The combination of hectic social life, revision and a week of night duty meant one thing.
Jon was exhausted.
The time is now quarter to four in the morning.
Really, it was kind of my decision as to how far I thought I could push myself, how much I thought I had left in the tank as to how much extra stuff I could fit in.
I booked my exam before I knew what my rota was and that was the pro that is the risk you take and it came back to bite me in the ass a bit, really.
Right, I'd better see this lady.
Where is she? Left.
Hello.
My name's Jon, I'm one of the doctors.
This has been the busiest three days I've had as a doctor, I think.
In just a few days, Jon would be facing his surgical exam, but even that didn't stop him.
In three hours' time I've got rugby training and then I've got my last night.
So, I'm pretty tired.
I might just go and fall asleep.
Exam results.
There was a price to pay for Jon's ethos of work hard, play harder.
Right, I didn't pass.
Priorities have shifted.
I'm not captain any more, so that takes a bit of pressure off.
But then my relationship with my girlfriend's now pretty serious so maybe any free time that I could have generated by not doing rugby now I'll spend with her, so I'm always I'm always finding stuff to do.
He might have failed the surgery exam first time around but Jon's not giving up.
I think the future for me, I'm still hoping to become a surgeon, so I'll try and do orthopaedics, which is broken bones and, you know, mangled knees and things like that.
And do that for a year and see where that takes me.
Although most of the housemates knew one another before the series, living together cemented their friendship.
Ultimately, one of the most important traits in any doctor is maturity.
Take that off.
I think we all got on really well in the house, actually.
You're gross.
Oh! I think the most likely person to keep everyone entertained in the house is Keir.
I was thinking of opening a bottle of fizzy.
I think you'd have to say Jon! Probably a combination of Keir and Jon together.
Yeah, yeah, Keir and Jon together, cos Keir alone's one thing, Jon alone he'll just sit down and eat something, but then when they're together, singing, piano.
- They're a double act.
Yeah.
- They're a double act.
Turn around Every now and then I get So, it's like Laurel and Hardy, you know.
Yeah.
Hale and Pace.
Yeah, Trinny and Susannah.
Turn around, bright eyes Every now and then Oh, sorry, sorry.
That's one for the outtakes.
Jon actually is a very talented singer.
Yeah, and he's a pretty good pianist as well.
He carried my awful singing.
We'll only be making it right I really need you tonight And it seemed that Adam wanted to get to know one of the housemates better than the others.
How does this girl, who was never in my life previously, now still not really in my life.
I think I had good chemistry with Suzi.
I think she's a nice girl, she had a good personality, I got on with her well, and she's an attractive girl.
- Can I have your number? - Can you have OK, I've already got it.
- You've already got my number.
- Can I have a kiss? Suzi is, you know, bubbly and cute and good looking and outgoing, so that helps.
Suzi is going to possibly murder me for bringing this up, but there is a moment with a chip.
Oh, look at that.
Which looks a little bit Lady and the Tramp.
I love pepper.
Dirty laundry.
Public.
Don't look at me.
- Well, I just - Don't say Adam and look at me.
- Well, I don't know because, you know, you've got - Don't feed me things! Just because I ate a chip out of Adam's hand, - I got the rumour mill spinning around.
- Oh, I know.
Nothing happened with me and Adam.
I'm sorry to disappoint everyone.
Adam's lovely, but he's just not my kind of guy.
But it wasn't discussions of Suzi's love life that took up most of the time.
It was discussions about the state of her bedroom.
Suzi is a delight to live with, an absolute delight, as long as you don't go anywhere near her bedroom.
I mean, I have seldom seen anywhere that has been "tidied" and is as suitable for animal habitation.
There'd be stuff on the floor that wouldn't move because it was superglued to the floor because it had been there for so long, it had moulded into the floor.
Bombsite.
You can't see your feet.
Yeah, it was like a pink version of Basra.
Her parents tidied if for her.
I haven't had time to tidy.
Da-daa! Oh, Suzi.
Oh, Suzi.
Right, bin liner and skip, Suzi.
I'm just wondering why I can't find anywhere to walk.
I've done I was up till one o'clock tidying last night.
Wash, wash.
- What's this here for? - I was cleaning a surface.
You keep telling us that normal life is impossible.
Normal life IS impossible.
Last week I worked five 14-hour shifts and two 12-hour shifts.
I then came home, went to sleep, got up, had a shower, ate, like, some chocolate and then went back to work again.
- I'm a messy person, OK.
- Yes, you are.
Yes, you are.
And I can accept that I am messy and untidy at home.
I can assure everyone that at work, I'm very organised.
If I had to choose whether to be organised at work or at home, I'd rather be organised at work, so my excuse - Can you not choose whether to be organised or whether to be disorganised? - No! - That's the decision I made.
- My mum can't understand how I can be one and not be the other.
- But it's true.
- I'm on her side.
- You're on my mum's side? Thank you.
- Yeah, I'm sorry.
Oops.
Can I just get back into bed for the rest of the day? Your room looks like you've spent the last week in bed anyway.
I don't want you to overdo it today.
I don't want you to get stressed out.
- Let's go and crack this egg open.
- Right, Suzi, coffee time.
I'm messy but I've always been messy and I know that I've had lots of people comment on it and go, "Oh, my god, you're so messy! "I can't believe that you're that untidy.
" I am.
People need to just get over it! Even though some of them were living like teenagers the first years were getting grown-up salaries for the first time.
The average junior doctor gets paid about £30,000 a year, so it is quite nice to be paid, as shallow as that sounds.
Please be paid, please be paid.
I'm the only one who hasn't received a pay slip.
I think that I gave them the wrongthe wrong National Insurance number.
Yes, I got paid! Sweet.
Having actually £99 in credit was just awesome.
I was like, I've not been in credit for years.
This is brilliant.
I have more debt now than I finished medical school with.
Because as your gains increase, your expenditure increases as well.
As fully paid up doctors, they had to learn to be professional at all times, whatever they encountered.
Tell me about what's been going on, then.
Basically, I went to the bathroom about 2.
30, - 3 o'clock this morning.
- Yep.
I've just moved into the property so I haven't got carpets throughout.
My bathroom floor was a bit wet, I slid off the toilet seat.
Right next to the toilet seat was a toilet brush and I've landed literally on it.
The patient said he's slipped in his bathroom and landed on the toilet brush, which was now stuck up his bottom.
Have you been able to get any of it out? Has any of it broken off at all? No, right.
And you just tried kind of pulling at it and things? Tried easing it in the shower.
But it just seemed it was catching and HE GROANS IN PAIN I'm sorry.
Back up again, all right? - It brings tears to your eyes, I tell you.
- I'm sure it does.
I'm sorry to embarrass you today, ladies.
- Don't be silly, it's fine.
- I'm more embarrassed myself.
Back in a second, all right.
I'll get you some painkillers.
There was a danger that the toilet brush had torn a hole in his bowel and if this wasn't treated, he could have died.
Really fast, James.
This man, he's had some PR bleeding around it.
- Toilet brush stuck up - I can't see how much more of it there is.
- Do we give him an X-ray first? - Is it? Right - Is it actually poking out the end? - Mmm.
Can you see the? - It's like - I think that probably needs referring to the surgeons.
That's fine, that's what I thought.
Someone needs to pull it out, but if it's been bleeding - I would refer it to them and let them take it out.
- That's fine.
Looking back, keeping a straight face was so hard but, you know, it's my job to sort out what's going on with that patient.
- We need to get you an X-ray done, OK? - Right.
To make sure that there's no hole in the bowel.
But it was so hard for him to come into A&E.
'It would have been mean to laugh in his face.
' So, if I leave you to get sorted and then I'll come back and then we'll get a porter to bring you round to X-ray, OK.
- Champion.
- Is that all right? 'I haven't had anything else kind of embarrassing happen.
' But there's worse things I could have done in my career, I think.
Potentially.
But for first year Adam, who always wanted to be a doctor, the thrills of A&E seemed a long way away.
I was jealous of Suzi in the thick of it in A&E.
As a first year doctor, I was doing simpler tasks.
Oh, God, what's the dose of that? I forgot what she said.
I had massive ambition and I wanted to, you know, save the world and do all that kind of stuff and I was doing paperwork.
Um One gram.
OK, so that's TDS.
TDS means three times a day.
It felt like I was drowning in it.
At one point, I think I was in a back room for eight hours just doing discharges.
Mm And I did not see a patient all day.
And that's when I wanted to quit! 60 to 70% of the job's probably paperwork, I reckon.
I think people watch Casualty and ER and Holby City and think, you know, the life of a junior doctor is running round saving lives and actually, most of what we do is pretty mundane.
And when Adam wasn't doing paperwork, he was taking blood.
Bloods or paperwork? Back at the house, Adam let off steam.
Guys, I don't think being a doctor's all it's cracked up to be.
It's just being, you know, like a ward bitch.
You're saying that you feel experienced enough to be a doctor.
Do you feel ready to give somebody the diagnosis - that they've only got three weeks to live? - Yes.
Are you sure you can tell someone they've only got weeks to live, because that took me a long time to actually have the courage to say that to somebody.
It's not easy.
There's nothing more I can do without actually being a doctor, so yeah, I do feel ready.
I need the experience now to hone my skills and to.
.
I think it's quite dangerous, in a sense, to have that that understandable confidence that says, I'm ready to be a doctor.
These are the sort of things that you only get fromdecades of experience.
That is on fire! It was just a hilarious moment where Keir was like, "You think you can tell someone that they have days to live?" And, "Oh, my God, it's a fire! Everybody, it's a fire!" Everybody, flap, flap, and then he just came with this fire blanket and just threw the fire blanket on the sizzling piece of paper.
It was just the worst and best timing ever.
A year on, Adam has been doing jobs in intensive care, doing all sorts of procedures on very critically ill people and learning an awful lot about complex medicine.
Now I do the same amount of paperwork, but my job's really different and I feel like I have a lot of clinical responsibilities and, you know, that's really nice, so I don't mind.
It's just the amount of the day it took up and the fact that I was rubbish at it as well.
Whilst Adam came to terms with the realities of the job, all of the junior doctors were beginning to realise the benefits of working as a team.
The nurses are your best friends and they have to be.
They are life-savers, to be honest.
They were there to support us, they were there to give you advice.
I always make a point of saying, "I know you're new, "it must be horrible.
"If there's anything you're unsure of, ask.
" - Did you know you could get medical degrees off iPhones? - Um SHE LAUGHS I think any way you can build rapport with the people that you work with is good because you need to build relationships to kind of work effectively as a team.
Get your bloods done? But good communication skills didn't come naturally for second year Andy.
I found that I didn't fit in immediately in the beginning and it took me a while to understand.
We work well on here cos we work as part of a team and we expect good communication, and if you're not prepared to communicate and work within the team then you get pretty short shrift, particularly if it's busy.
When it came to treating his patients, Andy knew what he wanted to do and had to consult his seniors.
But he sometimes left the nurses out of the loop.
What's your plan for him? My current plan is to get bloods and get X-ray.
- Have you spoken to orthopaedics? - Not yet.
I'm asking our reg to have a look at him first and see what he thinks.
Then orthopods would ask for an X-ray before they would.
'I like to have a good idea of the characters around 'before I interact with them.
' It, in strange way, helps me be professional.
Andy tries to come over as very professional and, for him, professionalism is kind of being slightly detached.
Sometimes you've got to grab him by the scruff of the neck and say, "For goodness sake lighten up!" The nurses on Andy's ward didn't give up on him and devised a plan to make him part of the team.
We're having a ward night out and we just wondered if you'd fancy joining us, Andy? - You made it sound more scary than it should be.
- No, it's not scary.
No, not just me and you on a night out.
An actual ward night out.
- I got that bit.
- There's nothing to be scared about.
- Yes, I would love to.
- A really nice bonding session to get to know you.
And then you can see what we're like when we're out socially.
'The ward is very social but he's not been out with us yet.
' We're going to take him round town and get him into the mood of things.
Working on a ward is all about building relationships and whether you do that with a pen in your hand or a drink in your hand - is neither here nor there.
- I'll be in a bad state tomorrow, but yeah, what the hell.
And after a few drinks, a very different Andy emerged.
It's great having Andy out.
A good character.
He's having a great laugh and I think we're getting to know the real Andy.
I think you had some impressive dance moves there, Andy.
All I think is, now the whole nation knows I can not dance.
Andy obviously has his own style, which we appreciate, and that's something we'll just have to improve on in the future.
The night has been amazing.
I never knew how much fun the people I work with are outside work.
- OK, one drink.
- One drink.
Andy has now finished his junior doctor training in Newcastle and has decided to make a big move.
I've lived in Britain for 12 years now.
I love the country, but I think it's time to go back to Hong Kong, where I come from.
I don't think I'll ever leave medicine.
I just can't think of a career that I would enjoy more than what I'm doing right now.
You're cold? Well, can I open up this blanket a bit for you so it's a bit more round you? A few months into their rotations, the junior doctors were starting to find their place in the team and even forge relationships with some of the longer-term patients.
One of the challenges I faced when I first got onto the wards was learning how to communicate with patients.
You have to learn quickly.
Margaret, where are you going with your table? - Just down there.
- I'll take it back for you, if you like.
'We had a lovely lady on Ward 48 when I was on there called Margaret 'who had come in with various things but had a background of dementia.
' Oh, Margaret, come on.
Away.
Come on.
He's not breathing.
'Some days she was really confused and quite distressed.
' My husband hasn't had anything to eat today, as far as I know.
'Other days she was clear in her thinking 'and quite aware of everything that was going on.
' It's hard to change the way you are with somebody on a day-to-day basis.
You tailor communication with a patient to how they are on the day.
Aren't they wonderful pictures? Who brought these in for you? Your daughter? She brought them in.
Is this you? That's me, yes, when I was 18.
- Look at your hair.
- Loads.
- Amazing, isn't it? You're opened up and let into someone's life.
You've been a part of something difficult with them and it's such a privilege, really is.
- Thank you for showing me these.
Gorgeous.
- Lovely, aren't they? Like Adam and Katherine, Lucy's staying in Newcastle and will get a chance to try out specialities as a second year junior doctor.
I've enjoyed everything I've done so far and I love learning new things.
I don't know where I'm going, but in ten years' time I still will be working as a doctor.
Hello.
How are you? In A&E, second year Suzi also developed a good rapport with her patients.
But she was learning there were times to put down boundaries.
When did this happen? Probably, like, four hours ago now.
I've been sat here for ages.
That's A&E for you, I'm afraid.
I've literally never had so much fun in hospital before.
Well, that's good.
- Are you a student doctor? - No.
Fully qualified.
Just look over that door handle, please.
I'm going to shine this into your eyes.
Where is it most sore, if it's sore anywhere? Nose.
Nose, yeah, just there.
- Is it broken? - I think it probably is, yeah.
- Are you going to break it back for me and put it into place? - No.
- Why? What we do here is you get seen at the Freeman after the swelling has gone down.
Give them a call and they'll do it for you.
All right? Do you have any other questions about anything? Can I have your phone number? - You can't have my phone number.
No, sorry.
- Ahhhh! This has ruined my A&E experience.
- I'm sorry, I'm sorry.
- Is that your phone number? No.
This is the number that you call about your nose.
Patients that flirt with you is a weird thing to have to deal with.
It's very flattering and I kind of thought, wow, you know, it's in the middle of the night and I'm wearing scrubs and I've been stuffing my face with loads of food and someone thinks I'm not like the back end of a bus and that's nice, you know.
- But it's hard.
I didn't know what I should be doing.
- You look lovely tonight.
Suzi, you're the best doctor ever.
You're the best trainee doctor ever.
No, not trainee doctor.
You're the best freshly 16-month qualified doctor ever.
OK.
That's very kind.
Thank you.
Yeah! Oh, bless him.
Thank you.
Yeah! I think now sometimes I choose carefully if I say that I'm Suzi or if I'm Dr Bachelor.
I think with some patients, I think I feel as though I need to kind of show that, you know, I know more than they do about what's going on.
As she finishes her time at Newcastle, Suzi's moving on to a new job in South Shields.
I'm going to be doing adult medicine cos I think it's interesting.
I've got a couple of exams since filming so I'm kind of part way there to doing that anyway now.
It's a job that I can't wait to get stuck into and things.
Excited! It'll be good.
First year Katherine has another year in Newcastle.
The past 12 months have increased her confidence.
One of my patients came in to basically have his little finger stitched up.
And when I took a history, he mentioned he was getting some pain.
Feel the pain since yesterday morning but I think it's just through work.
I think it's just muscle pain.
It's quite a problem, having this pain now? It's just heavy lifting.
- Did it come on suddenly or gradually? Do you remember? - Just gradually.
- Do you smoke at all? - Yeah.
- Do you drink at all? - Yeah.
How many units would you say a week? I'm not sure.
Um Probably about 60 pints a week.
- 60? - Yeah.
I don't know what that is.
- Sorry, 16 or? - 60.
- 60.
- Mm-hmm.
Katherine decided to investigate further.
I'm just going to tap down from this end now.
OK.
I mean, I - From the history, I'm not worried at all about your heart.
- Yeah.
- The pain's sort of more round there.
- Mm-hm.
- Do you know if you've ever had any tests done on your liver before? - No, I haven't.
- OK.
Just cos when I wasfeeling, I thought maybe your liver was slightly enlarged.
99% of your day is just doing, you know, the jobs like taking bloods and filling in forms.
'So, it does feel quite nice to be able to say, '"I think I know what's wrong with you and it's this.
"' I might just ask one of my senior colleagues what they think.
If you pop back to the day room - Just come with me.
- Cheers.
I went to see this guy, I think that's his Don't know where his notes are.
This guy, and I think he's got an enlarged liver.
60 pints a week is 120 something units, good spot.
You don't want patients to be ill and you don't want them to be sick but when you're the one that spots what's wrong with them, it is quite satisfying.
As she faces the start of her second year, Katherine knows where she wants to end up.
When I started my first year as a junior doctor, I wanted to do surgery.
In the past few months I've passed my first set of surgical exams, which I'm excited about, so I'm on track to make applications in a few months' time.
While Katherine's confidence was starting to grow, Adam finally got the chance to prove himself.
I felt my first chance to make my mark was during my first on-call.
That was hugely different to the day job.
He was covering up to 170 patients over five wards.
BEEPING Hello.
He was called to see 85-year-old Lester, with a lung complaint.
Hello.
His condition had deteriorated.
Lester was already very, very poorly but when I got called to see him, he looked ghastly.
Honestly, I thought he was on the verge of dying.
He's not well.
He's not well at all.
Adam decided to investigate further and ordered a new X-ray to compare with the first one.
I could be convinced the new one's worse, actually.
I think it's the heart that's the problem and it's backed up into the lungs.
Yeah, I think the new one's definitely worse.
Definitely.
Adam thought the patient should be on additional medication, but needed to clear this with the senior doctor.
Do you think I can give him furosemide, or is it not a decision I should be making? - His renal function - If you're comfortable and you know what you're doing.
Cool, sweet.
OK Can we start furosemide? 40 I'll hand it over and she'll come over.
- Thanks very much.
- This was the first time as a doctor Adam had made a diagnosis.
Yeah, I'm going to give him furosemide.
I knew it was I knew it.
Goddamn right.
- Furosemide.
- Yes, I'm going to give him furosemide! I'm sure everybody knows now.
I'll get taken the piss out of for it.
Now, that is different from the day job.
That's why you're a doctor.
The next day I came back and he looked well.
- I'm so happy about that.
- Seriously, good job.
'The staff were nice and he was nice.
'It was like one big Care Bear moment.
It was just amazing.
' Hello.
How are you feeling today? I feel much better than what I did yesterday.
- OK, good.
I'm glad to hear it.
- I do, and so am I.
'I'll never forget that.
' It just doesn't happen like that in medicine very often.
Just doesn't.
And it was just great, it was a great moment.
As he enters his second year, Adam is learning that responsibility will come in time.
I see now that I need the transition to go through, but I'm about to start A&E myself in a month, and I'm really looking forward to it but still really apprehensive, even after a year's training.
I definitely, in hindsight, wouldn't have gone onto it straight away, you know.
I think it's wise to have at least a year under your belt before you go onto something like A&E.
Hello, it's Keir on call for plastics.
Wheee, you're flying! Do you want to shake my hand? Keir had a big decision to make about the direction he wanted his career to take.
When you start off as a junior doctor, you think, right, I've made it, this is the end, I've sat my exams, I am now a doctor.
And then suddenly, 14 months later, someone turns to you and goes, "Do you want to be a chemical pathologist or a psychiatrist?" I don't know what a chemical pathologist is! Keir had to decide whether to become a medic and treat with medicine or become a surgeon and wield the surgeon's knife.
- Hello.
- You OK? - Yeah.
- My main problem with this is the nail.
So, we need to remove the nail and then flap the skin over the top.
- Is it? - Yep.
- I've never done this before.
I'm quite excited and a little trepidatious at the same time.
When he was in plastic surgery, Keir had the opportunity to assist in operating theatres, which gave him real hands-on experience.
So, have a go.
- That's the bone.
- Mm-hmm.
And we're just literally nibbling, like that.
- What I'm hoping to do is preserve a little bit of the joint.
- Mm-hmm.
The operation was performed on a conscious patient so he could go home on the same day.
The bone in his finger was shortened with a bone nibbler.
- Are we down to that, then? Oh, fantastic.
- Wow, look at that! AUSTRALIAN ACCENT: That's not a bone nibbler, THIS is a bone nibbler.
- Right.
- You don't mind us talking, do you? - Oh, no.
- That's all right.
At the end of the operation, Keir stitched up - the tip of the patient's finger.
- Lovely.
Well done.
Grand.
But it didn't really help Keir come to a decision.
People say that that decision's the easiest one.
I find it the hardest one.
Major choice.
Surgeon or medic? And you can't tell, can you? Cos you like both.
Boy did good.
Just what I expect.
He has natural ability.
It'd be a shame to lose him from surgery.
Obviously surgery is a lot more practical.
You are physically removing bits of people that have gone wrong.
So, I can see what I'm dealing with now.
'Looking at a healthy patient and saying, "I did that", is fulfilling.
' See you a bit later.
'Whereas in medicine, you're trying to identify lots of difficult patients' with lots of different things wrong with them so solving that puzzle is attractive.
Ultimately, you have to make your career decisions based on experience.
Right, hello.
- OK, let's have a look, then.
- Let's take them off for you.
- That's grand, thank you.
As part of his training, Keir also treated some of Newcastle's youngest outpatients.
- Is it hurting all the time? It is.
- When I move it, it really hurts.
It's hurting most when you move, OK.
That's cool.
What we do need to do is clean it, OK? Are you feeling a bit dizzy and queasy and rotten? No? Excellent.
- I'm just really hungry.
- You're really hungry! One year on and Keir has made his decision.
But I've finally made my mind up.
I'm now going down to Great Ormond Street to do children's medicine, which is kind of mydream, as it were, so I'm confident I've made the right decision.
Plus, I think if/when I have kids, - I would love Keir to be my kids' doctor.
- Aw! Because, I mean, watching him on television and things with kids, you put kids at ease so well, you're good at talking to patients and I just think that you'll be great at it.
I'm just immature! That's it.
BLOWS RASPBERRY - How old are you, Alicia? - Six.
- Six.
Are you a bit frightened? Yeah.
There's no need to be frightened, OK? She's gorgeous.
You're the cutest patient I have had all day.
He says that to all the girls! - See you later, guys.
- See ya.
Six months into the job, the junior doctors had a whole new experience to face.
The programme hit the air and they started to be recognised.
- Is that why you've cut your hair, so that people don't know who you are any more? - No.
- That's what the theory is.
- I've heard this theory.
"You know Lucy? She's cut her hair since the show.
"She's trying to go under the radar.
" Not a day goes by when someone goes, "You've had your hair cut!" The one that I get the most is, "Have you passed your exam yet?" Or, "Do you still play rugby?" I get, like, toilet brush a lot, especially at work.
"You're the girl with the toilet brush.
" I was like, "Wait a second, I was not WITH the toilet brush!" I happened to be there, dealing with the toilet brush but it was nothing to do with me.
Tonight is the last time the seven junior doctors will all be together before they go their separate ways.
- We might not see each other again for a long time.
- Mm.
You're going down to London.
You're going to Hong Kong! It'll be more difficult to visit you.
Out of everything that we've been through, what do you reckon you'll be remembered for? Me crying, definitely.
- No doubt.
- It's a good thing to be remembered for, for actually having emotions.
- Well, for me, it's the other way round.
No emotions.
- Yeah! - Do you still want to save the world? - Well, I have good intentions.
What about you, Katherine? I certainly felt, at some times, quite isolated and overwhelmed.
It's important to remember you're not the only person to have gone through that.
You have to remember as you go from being a first year to a second year, having someone underneath you, - they're feeling exactly how you used to feel.
- Yes.
When we were all round the table at the start of the year, I think some of us were worried about potential disasters and we've managed to get through the year without anything too bad going wrong.
So, cheers to not messing up too badly.
- Cheers.
- To not being struck off.
LAUGHTER It's finally hit us, you know.
We're actual doctors now.
'I'm really glad my first year's almost over.
'Don't get me wrong, I've really enjoyed the year, but I'm hoping the next few years' are going to be less and less kind of, you know, painful.
'I think I've still got a long way to go' and I think I still have a lot that I've got to learn.
But I feel ready to move on to the next stage.
To the left or right? Which way? There aren't many other jobs that you can go home from at the end of the day and feel like you've really made a difference in someone's life.
'It's weird, because that first day 'and those first experiences almost feel alien to me now' because being a doctor and working as I am just feels to be part of me.
The most important thing I learned in the last two years is how to be professional.
But I think letting your guard down often, from time to time, is important.
When I say letting the guard down, I don't mean just go absolutely bonkers.
The best thing about being a doctor is actually seeing people with problems, putting them right.
That is, by far, the most amazing thing that I could ever imagine doing in my life.
Take a chill pill, count to ten.
Even for all the bad hours, you know, and the difficult patients, I would not trade in this job for anything else, honestly.
MUSIC: "Lie Down In Darkness" by Moby No more No more No more, hmmmm No more The sun Will be no more.