Junior Doctors: Your Life In Their Hands (2011) s02e07 Episode Script
Series 2, Episode 7
1 Summer, 2011.
Eight junior doctors hit the wards of the Chelsea and Westminster Hospital.
One year later, as they're about to move on ALL: Cheers.
.
.
they are getting together to look back on the most testing year of their lives.
You don't just develop professionally but actually you develop quite personally as well.
They'll talk about the hard times Starting on nights was shocking.
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the wild times CHAMPAGNE CORKS POP CHEERING THEY SING .
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the things they remember Ready? Go.
PATIENT CRIES IN PAIN Sharp, spiky thing goes in and sharp, spiky thing come out.
BOY CRIES .
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and those they'd rather forget.
- Get off my hand! Get off! - Alfie, Alfie, Alfie, Alfie.
Alfie.
Alfie, Alfie.
Alfie.
Boom, there's a needle in your face.
.
.
what they learnt There's this myth that doctors make a lot of the decisions.
- Nurses run the show, don't they? - Yeah, the nurses do run the show.
.
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and where they're going next.
I'm really interested in helping patients who have disorders of the skin.
I've seen the impact it has on their lives.
12 months ago, these eight young people were about to take on the biggest challenge they'd ever faced: becoming junior doctors.
They were joining thousands of other juniors across Britain, starting work for the first time.
One year on, they're coming together for the last time.
ICE CLINKS You don't really appreciate how much you've grown and developed in that short space of time.
Now you go in and the patients are, "Oh, you know, are you any good at this?" And I'm, like, "Yeah, I am good at it.
" Do it first time and they are, like, "Oh, that was really good, "some people are rubbish at this.
" I think we've accomplished so much.
We've learned a lot.
Just about practising medicine.
Until you have to do it and it's your responsibility, it's completely different.
It's just very satisfying.
Going to a procedure and knowing you are good at it and you can do it.
12 months ago it was a very different story.
If they work out that you're useless in the first few days then it's not a good place to be, is it? 24-year-old Priya and 26-year-old Milla were fresh out of med school.
Until you are actually a doctor, you're not a doctor.
You see what I mean? As were their fellow colleagues, Aki, Andy and Lucy.
I've got an awful memory, and that really is honestly something I have to work around.
- Make sure you write everything down.
- I do, but then I lose my paper! Sharing a house with the first years were second years Amieth and Ben.
How did you guys feel on your first day, in your first week? Petrified.
It's terrifying.
And then the first set of nights, they are horrible.
Oh, no! I'm not going to ask you any more questions! PHONE BEEPS AND VIBRATES With little experience, all the junior doctors were about to head into the unknown.
See you later.
And anxious about what the day would bring.
- You're new doctors? - Yes, my name is Lucy.
You go straight in.
Boom.
Go save that patient's life.
It's not that easy.
At just 22-years-old, Andy was the youngest.
Going in to the first day, yeah, it was really nerve wracking.
And straightaway he came face-to-face with an age-old challenge.
Fitting a device called a cannula.
Hello, Mister Straw.
OK, so I'm going to have a go at doing a cannula, if that's all right? The procedure involves first finding a vein.
OK, so sharp scratch coming up.
Then threading a hollow needle through it.
A common task but a nerve-wracking one.
HE TUTS Right, that's not in.
Let's have a look at this arm, shall we? Basically, he had to endure your lack of skill.
Yeah, yeah, I wasn't very good at cannulas.
- Are you all right there? - Yeah, fine.
- Good.
All right, two goes, yeah? All right.
Mister Straw was a lovely gentleman who took it for the team, I have to say.
Andy's pincushion.
So I get one more go? Yeah? He was just on the wrong end of someone who wasn't very good at doing cannulas.
I felt for Andy.
I could really understand his position.
But my God I was, like, that poor man, having to go through all of that just because we're crap.
- Well, I'm crap.
- No, we all were.
HE SIGHS Yeah, didn't manage to get it in again so that's kind of annoying but I guess I'm glad I persisted because you've just got to do it and I'm going to get one of the others to come and have a go.
And then, yeah, hey, next time.
I think he took it really well.
It could be the beginning of a downward slope but I think you took it on the chin, picked himself up and went on.
I basically can't walk around the hospital without getting cannula jokes everyday.
No, you can't! It wasn't only the first year doctors who were struggling.
- Who's your favourite Star Wars character? - Darth Vader.
Second year Ben was about to meet a young patient called Alfie.
- All right there, Alfie? - Hi.
- Hiya.
Have you still got that magic cream on? - No.
- No, it's all gone, good.
Working with children was Ben's dream job.
So he needed to prove he had a winning way.
I'm going to spray this on your arm, OK, it's just cold spray.
Ready? It will make it go numb in a minute.
Alfie was a young boy who needed a big operation on his bowels, so he needed part of his intestines taken out.
I essentially had to put a cannula in him.
What's that? It's a little needle I need to put in your hand so we can give you some medication.
Do you want to hold mummy's hand and lie back as we do it? - It's cold.
- Just put this down, OK.
So you've got the cream on so it shouldn't hurt, it should be all right.
Look at mummy, there we go.
Alfie.
I can't do it! HE CRIES Can't do it! Get off my hand! Alfie, Alfie, Alfie.
Alfie, Alfie.
Alfie, Alfie, Alfie.
Alfie.
Boom, there's a needle in your face.
I don't want it on there.
I don't want it! Alfie, we'll do it very quickly, we'll get it over and done with.
It was a nightmare.
It was late at night, end of an on-call.
I just did it badly.
Don't be silly.
I don't like it here.
I know, but come here and me and you will go for a walk.
Rather than make sure he was completely still, I should have found a vein, had him calm and just gone ahead and done it.
He's got local anaesthetic on his hand, he's not going to feel it anyway so just do it.
Mum.
I'm not doing it.
Nowadays I'd just go ahead and put the cannula in the back of his hand and that would be that, rather than build-up to it and him get stressed.
- It's all right, we're not putting any needles in you today.
- Why? Maybe he needed that one experience where he had that difficult child and all the future Alfies he has to put the big needle in, he'll know exactly how to deal with them.
See you later, Alfie.
Alfie, Alfie.
All anyone ever bloody says to me is Alfie, Alfie, Alfie, Alfie.
Alfie, Alfie, Alfie.
All junior doctors have to manage the transition from textbook knowledge to practical application, and it's not easy.
I had it for a second there.
Learning how to put it into practice is a whole new ballgame.
It's terrifying to encounter that for the first time.
I think your scariest moments are when people expect you to be able to manage and you feel for the first time that you're on your own.
I was quite confident with my medical knowledge but what I perhaps was less confident in was how you actually then apply it in real life.
First year Aki tried to brace himself by doing some last-minute swotting up.
I'm going to be a little bit nervous on the first day so I just want to make sure that I'm prepared.
At the start of the year I wasn't very confident at all.
I was really worried about not doing my job right.
Pissing all my colleagues off.
SECURITY LOCK BEEPS Harming patients.
I don't think her blood tests are back or she might have not had them done this morning.
Just hours into his first shift, Aki got a grilling by a senior doctor.
Before we do that, which trial evidence do you know of for use of atorvastatin in acute coronary syndrome? Erm There was a time when I knew so many studies.
- I know this doesn't help.
- When was that time? About two months ago.
That time has come and gone already.
It's only your first day.
No one knows that stuff.
No one.
I know now.
I happen to have a friend who's quite interested in becoming a cardiologist and he didn't even know about it until afterwards.
It's an apprenticeship so you get asked by your seniors about, do you know how to do this, do you know what drug you're supposed to give this kind of condition.
You are constantly tested.
As well as working together, the eight junior doctors shared a house in south-west London.
It was a bit like being back in university halls.
It was a very interesting experience living with the guys in the house.
It was a complete range of different characters.
When I'm ill I know I get really princessy and moany.
When you're ill? SHE LAUGHS I loved moving in with seven people.
It made the whole thing very entertaining.
It was like a sitcom.
Living together allowed the juniors to chew over pressing issues.
Lucy, if it was your last day on earth, who would you sleep with? You could all relate to each other.
We knew what each other was going through.
Just being able to discuss your day and laugh at things, I think that was a massive boost.
And just to see you weren't alone in feeling completely inadequate.
It was really nice.
Men should stay at home and do the cooking and women should go out and become good doctors.
No two colleagues got on better than Andy and Aki.
It's been really hectic on the surgical unit.
- Are you, like, down on men, manpower, as in are people away? - No! Yeah, no, we've been really busy.
We haven't been down on men, I certainly haven't been down on any men.
Aki and Andy's bromance was beautiful.
You're just too good to be true When I was at school, I was in this pop punk band.
Really? That's hilarious.
Same.
No, bullshit! Andy and Aki have a special relationship, don't you? - I wouldn't say it was a special relationship.
- I would.
- Just a friendship.
- I would say it was special.
- It's a friendship.
- Aki.
- What? Screw being a doctor, let's become rock stars! - You definitely had a bromance with Aki.
- You reckon? - Yeah.
Oh, wow! - Dude you look - What? It's good, we did good.
- Within the house, Andy and I got on very well.
- Yeah.
Shall I go blazer or leather jacket? - There's a lot of man love.
- Well - There is.
- Is there? - Yeah.
- All right, take it.
We didn't touch each other if that's what you're asking.
- You look good.
- Thanks.
Let's get our game on, bitches.
Whilst live at the house may have been fun, their jobs were demanding and stressful.
PHONE RINGS Chelsea.
And none more so than for second year Amieth.
Laid-back by nature, he was working in A&E, where quick decisions are vital.
Could you tell me what happened to you today? - I fell down about 15 or 20 stairs.
- Really? He ran through the standard checks and decided on a course of action.
I had wanted to get a CT scan on him to look for any bleeding into the brain because there were lots of risk factors for that and he had some slightly alarming clinical signs.
Yeah, I think so.
Yeah.
All right, shall we stitch first then? Can I do it? I think we'll be able to make you pretty again.
MAN CHUCKLES So now we just have to make small talk for a few minutes.
It's very difficult starting off as a doctor and you need to do everything you can to make your job easier.
Using the nurses and their experience is just one way of making the job much easier.
It didn't take long for the junior doctors to realise how much they needed the nurses.
Can I possibly borrow you? - Am I right or not? - That's right.
It's twist and pull, isn't it? There's this myth that, you know, doctors make a lot of decisions and they do a lot of things.
- Nurses run the show, don't they? - Yeah, the nurses do run the show.
What enema do you tend to give? And we'll prescribe the one that you tend to use, because we're both new.
- Usually phosphate.
- Just a phosphate enema, OK.
And we're just like their minions.
We'd go to the nurses a lot in those first few days.
Maybe I wasn't clear enough verbally.
I thought I said but No, but nurses should still be reading the notes.
- Don't blame yourself.
- All right.
I am referring, not I would like to refer, I AM referring.
Make an enemy of a nurse at your peril.
They'll make your life miserable if you start to piss them all off.
But I don't think that happens that often.
Well, not that often.
Don't get too friendly with them either.
Even with the support of a team, the days were taxing.
But more daunting were the nights.
First to run the gauntlet was Milla.
It's not like the daytime when you have your colleagues around you and it's a lot easier to ask for help.
All doctors on call are given a crash bleep, which alerts them to medical emergencies.
Milla hadn't used one before.
But you just double-press the green button.
- And it's definitely going to go off? - It will definitely go off.
- OK.
- Or you'd be very lucky if it never went off.
- So this is how it begins? - This is how it begins.
BEEPING OK.
OK.
Starting on nights was, for me, shocking.
BEEPING Oh my God, I'm not going to get my jobs done! You're not supported by an entire team so you start on your own and you have to deal with all the emergencies.
BEEPING This is my new best friend, Mr Beep.
He basically doesn't stop bothering me.
BEEPING It's just one bleep after another.
Mr Bleep still goes off all the time.
You can't get away with it! I now go to the supermarket and from the check out I literally think a bleep's going off somewhere.
To run off and answer ten million beeps.
BEEPING And Milla's difficult night was only just beginning.
Somebody called me up to come and certify, I think, a death.
I had to do some, I think, really quite challenging things.
Things that I would never have experienced before, including sort of having to certify a death.
I mean, it's my first night.
If you can help me out, I'd be most grateful.
He was still warm.
So I think that's kind of It's probably part of the really scary bit because you kind of You expect them to have a pulse, so it's quite weird.
Yeah, just to look into his eyes and stuff So, yeah, quite shocking actually.
I guess I didn't really expect that on my first night.
And Milla's stress levels were about to go up a notch.
That's it.
Fantastic.
OK.
'Cardiac arrest.
A&E Resus.
Cardiac arrest.
' Oh my God, I don't have a card.
Shit! When your crash bleep goes off you literally see yourself running to the crash call and you look up in the corridors in the hospital to see whether there's anyone else running.
A patient was in cardiac arrest.
but Milla was four floors up on the other side of the hospital.
Hello, Milla.
How's it going? Hello.
Good, you let me know if you need me to do anything.
Milla arrived just in time to help Amieth and the A&E team.
Point 99.
PTO twos.
She was given the job of monitoring the patient's heart rate.
Basically says minus 24.
- I still need to continue.
- Are you happy in your job? - Yeah, I am, thank you.
- It's the most important job going.
And after an hour she had helped stabilise them.
- Anything else I can do? - No, thank you very much.
- Thanks very much.
You can't take those first few nights back, you'll never experience them again.
But I don't think that I did anything that I would do differently now but I think that I can now deal with things much quicker.
At the front line of this intense job, it was crucial to switch off.
But the junior doctors soon realised that their chosen career was going to have a big impact on their personal lives.
It's really difficult to plan a social life around this rota.
You're supposed to finish at a certain time but you rarely ever do.
Hello, I've just been bleeped.
It's Lucy.
Hi, it's Ben, I was just bleeped.
Well, in every job, when you start, you have days where you're just like, "This is awful, I hate it, I'm miserable.
" And it's now 2am, so this is my cereal.
Unfortunately, I think I've lost my life completely in the last year.
I got four bleeps just then.
I just think you get completely immersed in work and you forget what's outside of it.
I'm already sleepy.
- Can I hand over this patient to you? - Yeah, of course, man, no worries.
I just I think that I'm so tired now after the ten days.
It's a very conscious effort to maintain your life outside of work.
So when they did get a chance to go out they really went to town.
- I've been looking forward to tonight so much.
- Going to get trashed? That's the biggest balls up you've made in the last 12 days! And I think it's absolutely crucial, especially in a job like ours, to have things to look forward to.
Cos we know how hard we work.
THEY SING KARAOKE When it came to party planning, Chelsea girl Milla led the way.
Hello.
Hi.
Thank you for coming.
- Oh, do you remember the bhaji thing? - I do.
- Thank you so much for organising that.
- Oh, you're welcome.
CHEERING She bestowed upon us the honour of teaching us this amazing skill.
Across the bottle.
Priya, come on! CHEERING It was a completely bizarre party with the champagne and the swords and Milla beingMilla.
Work life balance is hard.
You can end up in hospital all the time, go home, you carry on working actually and end up going a little bit crazy and it is hard to balance.
- Ready? - Yeah.
I wouldn't say I've got the work- life balance right just yet, no.
The doctors were bonding with each other.
On the wards they also had to build relationships with patients.
It doesn't look like there's any wax or cotton in there.
It felt as if someone had taken me lungs out, given them a good kicking and put them back in.
Can you point to where the pain was? And from day one it was clear that Lucy was a natural when it came to bedside manner.
I just feel like I need to get older because, at the moment, when I'm talking to 80-year-olds and telling them what they should be doing, I feel quite young.
Lucy was based in the General Medical Ward where she treated mostly older patients.
You're 97 and doing everything on your own.
Can't complain.
I shall be 100 soon.
'I think my first job offered me what I enjoy, 'so just the nature of the job' meant there was a lot of elderly people that had very long stays in hospital.
At just 25, Lucy had to give advice and support.
I wonder whether I'll be able to manage when I get home.
That's exactly why I want to talk to you.
I manage to kind of foster relationships with people that actually, they give you quite a lot of slack, so as a first job, people were very patient with me.
- Do you know where my eyebrows are? - Do I know where they are? - Yeah.
- I think I can probably guess.
'But you slowly gain confidence 'and the fact that you'd go in and people would know you' and they enjoy seeing you and you would enjoy seeing them and that kind of stuff I am a completely softy for really.
I just really enjoyed it.
I'll draw the curtain round and have a listen to your breathing.
We've taken him off his oxygen to see what he's saturating at so he's been a bit better.
From her first day, Lucy cared for a 92-year-old patient called Robert Beck.
He was suffering from a chest infection.
- Stick your tongue out.
Did you have breakfast this morning? - Not yet.
- Oh, you haven't had any breakfast? - No.
- Not even a cup of tea? - I had a cup of tea, yes.
- OK, that's what medical students are for.
Would you mind getting some tea and biscuits for Mr Beck, please? - Thank you.
How do you take your teeth? - Milk, no sugar.
- Well done.
- No sugar.
- OK, it's coming up.
Robert Beck was a patient that was there for a long time during my first job.
Over that time you get to know things about people, and he would tell you about Well, he'd tell me about his insecurities and about his worries and you can't help but really grow very fond of somebody and empathise with them.
Do you? Let me shut the curtains and we'll have a proper chat.
I'm a bundle of nerves.
Are you? What are you nervous about? What's just round the corner? I don't think so.
I know it's a little bit miserable being in here.
It's just a matter of keeping going.
And you look good.
You do.
The secret is, Robert, I like having you here and we want to keep you.
But I certainly don't want you to be nervous.
I know.
I know it's human nature.
I don't think it's pleasant for anybody, being in hospital.
I'm sorry it's been like that.
I know you do.
You've been in here now though for about two and a half weeks and because you've been in for that long I want to carry on and make sure that you get home and you stay at home and you're well.
Because I think we can do that.
Honestly I do.
Yeah.
I feel very privileged when people put their trust in you, actually.
I think it's such a privilege.
I think it still touches me now, actually.
I still think, God, it's a great job for that.
People are in hospital and that is the worst time of their lives and we forget that.
Oh, yeah, especially when you've got 20 patients.
We just waltz in and waltz out.
You don't have to scratch the surface very far at all with most patients and they do have massive insecurities and worries and concerns and stresses and I think they always appreciate it if you just spend a bit of time.
And are you warm enough? Because you feel quite cold.
My friend asked me, "If my mum becomes sick, can you make sure Lucy looks after her?" If my mum's sick, I'll make sure I would pay Lucy to look after her.
- And I'll see you later.
You enjoy that tea.
- OK, love.
I'm honoured to be her friend.
Like Lucy, Milla was learning the art of putting patients at their ease.
In Dermatology, she saw a patient with severe psoriasis.
It's quite smelly, isn't it? A skin condition which needed treatment with coal tar.
How often do you have this done? - So you had psoriasis for that long? - Yes.
He was just the most loveliest man who had dealt with this condition for so many years and I think more shockingly he obviously was, you know, was struggling dealing with it.
How does it affect you physically? You said both physically and mentally.
- And so 40 years, you said? - Yeah, about 40 years now.
- Wow.
And you're still smiling.
- Yeah, I'm still smiling, yes.
Yeah.
It was really quite upsetting, some of the things that he shared with me regarding his wife and regarding his children.
I think sometimes we don't realise how much different medical conditions affect people and their lives.
And Milla has decided that dermatology is going to be her chosen career path.
- OK? - Is that all done? - No, not yet, that was just the anaesthetic.
- Oh, right.
But that was it, I promise you that was the worst bit, you shouldn't feel anything else now.
The fact that it's something that people can see and it's something that, you know, we can do something about Because a lot of these conditions are really debilitating for people because they are visible.
And we can do something about it.
As well as rewarding, patient contact could also be challenging.
Starting out as a junior doctor is very daunting and there's lots of trepidation about what's going to happen and how you deal with things as they occur.
And Sameer was about to meet a patient who would test his bedside manner.
I will.
I will talk to you first.
So just to introduce myself - I'm Sameer, I'm one of the doctors.
So where's the pain? So does anything make the pain worse or better? I just need to make sure I've got the whole story.
- But I will be as quick as I can.
- Of course.
'I knew you'd need to have difficult conversations with patients.
' There's always going to be a couple of patients that you're not going to You know.
Perhaps not enjoy talking to, but they're going to be difficult.
I want to talk a bit about the drug use.
How long have you been using and what kind of drugs have you? It's just It would be helpful It's just questions we ask everyone.
Well, no, there's a reason for it.
No, no, it's because I-I OK.
Don't worry, we don't have to talk about it in that case.
OK, can I just move on to? 'He did take me on a ride a bit and he was quite difficult with me 'and I did feel a bit uncomfortable on the inside,' but I think sometimes that part of the doctors' job is to keep control of the situation.
That patient was trying to engage with him and was just been very challenging.
And he stayed quite calm, and I think he managed him as well as anyone could have done, to be honest.
'I know exactly what to say now if that were to happen again,' but I guess I didn't when that did happen.
A lot of the time, difficult patients are being difficult because of anxiety and fear about being in hospital and being unwell.
And once you kind of get past that and you address their particular concerns, then they become a lot easier.
Um, it is something that I'm becoming a bit more used to, but there are always certain patients that you just find you don't quite make that connection with.
.
.
a test to a blood stent, please.
For all the junior doctors, new experiences were coming thick and fast.
Chest drains are quite nasty, OK? So really keep anaesthetic, all right? OK.
Just so you know, I haven't done this before.
- I will talk you through it.
- OK.
Yep.
Aki was asked to carry out an advanced and difficult chest drain.
- My God.
- What's that? - Chest drain.
Have you done one? - Yeah.
You'll love it.
I'm sure I will(!) Thanks, see you tomorrow.
I think was really nice that I was given the opportunity to do something a bit exciting really early on, because it kind of sets you up for the whole year, really.
The crucial thing was to put the patient at ease.
I'm going to really honest with you, this is I don't want to scare you - This is the first time you've done this? - Yes.
"I don't want you to worry, but I've never done this before.
" "Oh, well, that's fine then, I feel completely at ease about it.
" "It's extremely dangerous and you might die.
"But I've never done it before but it's fine.
" Aki had to pierce the chest from behind, avoiding vital organs.
So Put that in, and then with your needle, you are going to go straight in, perpendicular to the skin.
- Like that.
- Mm-hm.
- We're going to give it a try now.
- Can you feel that? - No.
Hold the needle, remember not to let go of that guard.
Push it through, twiddle, twiddle, twiddle.
- Sorry.
- How are you doing there? - It's hurting a bit.
- Is that bearable? - Just.
- OK.
Take a big breath in for me please? You can see it's swinging, yeah? Good.
Well done.
- Congratulations.
- Thank you very much.
- Your first drain.
It was my first drain.
I'm really, really proud of Aki, he did really, really well, and actually the patient was really comfortable as well and that's really satisfying, so, no, job well done.
I wanna sing That wasreally cool.
I wanna scream till the words dry out Job done! 'When everyone else is wondering around, 'filling in bits of paper, looking lost,' you're there, sticking bloody great needles into someone's chest, and walking around like you own the place! I think every year I have a moment where I think, "Oh, my God, this is the best job ever.
" I think Aki was somewhat of an excited puppy dog, wasn't he? - After he'd done that chest drain! - SHE LAUGHS - How are you? - I am exhausted, - but I'm really happy, I just put a chest drain in! - Oh my gosh, wow! That's exciting.
'I was very surprised, slightly jealous,' because, you know, it's quite a challenging procedure.
- I haven't done one since.
- No.
Take the opportunity when you get it! So when I go into my second year, in a new hospital, everyone's going to be like, "Oh, Aki, chest drain.
"Standard, right? Just whack one out, why don't you?" I'll be like, "I've never done one since.
" I think Aki dealt with the situation really well.
It's difficult.
It's nerve wracking.
We've all been in that situation, where you are doing a procedure for the first time.
Yet you have to exceed confidence otherwise your patient doesn't have confidence in you.
'It's coming up to a year, now, of being a doctor.
' Some things repeat itself.
And the more you do it, the more confident you become.
'It's a positive spiral.
' And I just hope that continues.
As they gained more experience, the junior doctors' confidence started growing.
In A&E, Amieth now had a few months under his belt.
PHONE RINGS Hello, A&E resus.
Just as well, given the case he was about to face.
A waitress had been admitted to A&E - her hand had been impaled with a spike.
Make sure you keep all the receipts.
I was going to say, are these the chits or just the counter slips? Oh, no, they'll need them for their records! - I liked your joke as well, "Keep the receipts.
" - It wasn't a joke.
- OK.
I actually wanted You know, I thought they might be important.
'And if you just throw them away, the whole business goes under,' so not only is she out of a job, she's also got a spike in her hand.
You can just take this out.
OK.
What we'll do is get a decent pair of pliers.
It's very deep, though 'I'd actually anticipated sending her to the operating theatre 'to do that, and then the registrar turned around' and said "Oh, no, you can do it, just go and get some pliers.
" Get further down and a bit more in the middle, that's it, right, now I'll tell you when Ready? Go.
PATIENT MOANS Sharp spiky thing goes in and sharp spiky thing comes out.
- You've taken it out? - I managed to get it out, yeah.
Oh, my God, well done, you! I've certainly learnt to work on my own a lot more this year, and I'm certainly much more comfortable in dealing with many different sorts of problems.
- PRIYA: - 'The funny thing is you and I are both doing A&E next year,' - and I don't know how - I know.
You get faced with anything and everything.
That's what we've seen with Amieth.
We've seen Amieth go through it, we've learnt a few things from him.
You have to be so versatile.
You have to adapt to the situation and, you know, get out the toolkit and just get on with it.
Right, let's run through this list, cos I want a good day.
Like Amieth, Andy was being given more responsibility on the night shift.
My SHO, he was like, "We're going to get a bit of sleep "and then you can run the show," so I'm just a bit like, "Oh, God!" Ah, thank you.
Cheers.
On his patient list was 22-year-old Cristobel.
So tell me what's been going on then? At five o'clock today, some cramps started.
If I move or if I cough, or if I laugh or anything like that, then it really hurts.
- Point me exactly where? - The middle, just here.
Underneath the belly button, around here.
I need to have a feel of your tummy now.
She had severe abdominal pains.
- Ow.
- Sorry.
- Ow! That's painful there, is it? It could have been appendicitis or just some non-specific pain.
BEEPING The patient I saw earlier has fainted.
But a few hours later, her stomach pains had taken a turn for the worse.
Hi.
She just looked awful, and I thought, you know, "There's really something seriously wrong here.
" So we need some gel infusion, get some oxygen as well, please.
That's when the sort of real training kicks in.
OK No, what's been happening with your chest? OK, can we get an ECG as well? Thanks.
'I think the moment where I realised 'that I did have some responsibility there' was when the nurses have done their bit, they've got her into bed, called the doctor, and they're standing, waiting for you to make that decision, "What do we do now?" Then you think, "Right, I'd better get on and do something to help this girl.
" Andy suspected an internal bleed, and called his senior for back up.
She's had a faint and her blood pressure's dropped, she's looking very pale, I just thought I'd call you sooner rather than later about this because I think she looks quite ill.
If Andy was right, the condition could have been fatal.
'So he gave her fluids, he got her comfortable, 'he gave her pain killers, and actually stabilised her 'so that the gynaecology surgeons could come in' and deal with the problem in a sort of more definitive way.
Based on Andy's diagnosis, a specialist surgery team took over her care.
I don't think he realises what he's done there, like, what he's achieved, because he's being really nonchalant about it, but that was pretty cool, what he did.
After three months of living together, the junior doctors were starting to feel like a family SHE LAUGHS .
.
and really getting to know each other's quirks.
There's quite a variety of characters in there.
I think I've only noticed that on reflection.
- No, you definitely mentioned it all the way through.
- Did I? - Yeah.
But now OK, well I had an unusually high tolerance level over that time.
Sameer is somewhat quirky.
He's rather awkward.
If you weren't doctors, what would be your ideal job? Um, I'd be Batman.
He completely recognises what he's saying is a bit odd or, you know, a bit satirical, but who cares, he doesn't care.
The stuff he comes out with is magical.
And why, Sameer? Why would you be Batman? I went into medicine so I could help people from disease, and if I couldn't do that, I'd like to help them from save them from organised crime.
Right.
While Sameer kept the house amused, Priya kept the house fed.
My mum tends to cook a lot of food for me and send it down to London.
Priya could never eat all of it, so she always gave it to us, and we appreciated that, so thank you, Priya, and thank you, Priya's mum.
I hope you enjoy my curry attempts.
- LUCY: - This looks so nice.
Priya is so conscientious, can sometimes be a little bit ditzy, but that combination's lovely.
I think this is my road.
Parking wasn't one of Priya's strong points.
- Oh, man! - Are you still going to park it there? I always thought, when I was a child, that I've got very good spatial awareness.
You're quite far away from the curb, Priya.
Maybe my mirrors aren't set right.
You need to go that way a bit and get flush with the curb.
- I don't know what that means.
- Right, OK, turn the wheel a bit.
- Which way? - That way.
- You're looking behind, yeah? - Yeah.
OK.
Stop! - Good work, team.
- Good work, Andy.
High five.
- Yeah.
I'm just not very good.
But parking was the least of Priya's problems.
On the wards, she was about to be given an even bigger test of agility I'm going to ask her if she's had bloods.
.
.
by taking blood from a patient with notoriously small veins.
OK.
Right.
Throughout their early months, most of the junior doctors found taking blood a surprisingly difficult task.
When you learn how to take blood, you learn it on models.
You do it a few kinds at medical school, and then you're expected to go out - and do it for real on patients aren't you? - Yeah.
And you know, the models you have at medical school, the veins are literally like - Like drainpipes.
- Yeah, drainpipes, it's impossible to miss.
And then when you get into the real world you realise that patients are elderly, they're sick, they're shut down, you're not going got find veins that easily.
Let's go.
But the juniors were no longer fresh out of med school, and Priya had to prove herself as a doctor.
She's so difficult to get blood from that the phlebotomists, who are the trained experts in getting blood, they would often say to her, "If I get blood from you today, "you have to take me out on a date.
" We've all been in that situation where patients either have very, very tiny veins or you can't even see them.
I was basically set up for failure.
A sharp scratch.
- You OK? - Ooh.
- OK? - Egads! - Oh.
- It's all right.
- What happened? - Keep going.
- No, no, no, no.
- You're not stopping it.
- I withdrew it.
- Why? You moved a little bit and you screamed! - Don't be a quitter, cos I'm not quitting.
- OK, I will try again.
A sharp scratch.
- Let me know if it hurts too much.
- No, it's fine.
Still fishing.
- Have you got it? - I've got some.
Oh, well done! Yes! - Isn't she wonderful? - YOU'RE wonderful.
For tolerating having a needle stuck Did you get enough, though? Yes, I did.
I've got more than enough.
'At that time, it felt like a good achievement,' simply because everyone else was struggling.
I mean, right now I look back at it and think that it was just a simple, mundane task, but, at that time, it felt rewarding and I felt like I was winning for once.
I just did what is the impossible, I managed to take blood from Mrs Tristholt.
'Probably one of the most conscientious doctors that' I know of, actually.
She's good.
She really is good.
But, however, you'll never see me parking in a straight line, ever, that's one promise I can never make.
Priya's latest placement is in Dermatology.
If you feel any pain let me know, I'll stop straight away and I'll put a little bit more local anaesthetic to numb it, OK? It's the area she's decided to specialise in.
'I'm really interested in helping patients 'who have disorders of the skin,' because I've seen the impact it has on their lives.
It's just a little hole, it looks a bit unsightly now, but what we'll do is we'll put a stitch in it and in time it will heal over, OK? Like Priya, second year Ben had made some big decisions about the future too.
Probably best if we get you holding her.
After getting a chance to work with children, Ben wanted to make his dream of specialising in paediatrics a reality.
Hey there.
Sorry! Sorry.
- That was easier than expected.
- Yep.
All built up for it to be a nightmare! I think you can see his real passion for the job, I think when you see somebody do that, you just think, "THAT'S why you should do something that you love.
" But he still needed to stand out to get ahead in this highly competitive field.
Quite a big deal for me, but it's also terrifying.
So he put himself in the limelight, presenting new research to an audience of top paediatric surgeons.
'I remember Ben having to make a presentation to 'sort of a national conference with lots of different consultants,' and I just thought, "Wow, that must be really, really exciting.
" Anaesthetising a neonate has a suggested high risk than anaesthetising an older child, making it even more prudent to try and avoid a second operation in this patient population.
Thank you very much.
APPLAUSE This helped land Ben the recognition that enabled him to clinch a place on a prestigious surgery training programme.
The next step for me is starting what we call an academic clinical fellowship, in Oxford, in paediatric surgery.
BABY BURBLES It's essentially the dream job, this is the best job I could have hoped for, it combines paediatric surgery and further training.
Hopefully it'll take me through to consultancy in 20 years' time.
It's scary that you're making such a long-term decision, and it's something that we'll all have to do in a year's time.
While some of the juniors know exactly which fields they want to pursue, as they come to the end of their 12 months, others are still undecided.
I don't know what kind of doctor I want to be, it's, um to be announced.
Hello, sir.
Hello again.
I think I learnt over my first job how much I value patient contact.
I just need to take a blood test today, just to make sure that your clotting's OK.
During her year, Lucy found that her key talent was really connecting with patients.
- There you go, all good.
- That's an English rose.
That's for you.
Lucy came across great, she's open, honest and they trust her, and actually she spent a lot of time going the extra mile to help them, and that makes a massive difference.
- Thank you very much.
Bye! - Bye.
In terms of long-term, I've not really got a plan, I'm just going to see how it goes.
Now I'm on surgery, one of the doctors at Chelsea tells me that surgeons are born and not made, and I think that's absolutely true, I was not born a surgeon, I think I was born a medic.
At the end of their first year, Andy and Aki have brought their bromance to the work place.
- Have you seen them, Aki, today? - Not yet.
- Not yet? You serious? They're working together on the same ward.
It's been fun, apart from Aki's managed to avoid spending any time with me, by constantly being on call.
So basically he's a guy who's got end-stage heart failure.
So me and Aki are doing the ward round today, so we're basically just going round all of our 18 patients.
Big breaths.
'Generally just' .
.
saving lives.
Don't say that.
Please don't say that again.
THEY LAUGH Now, with much more to prove than their early days, the junior doctors have to show they can go it alone.
.
.
pitting oedema in the knees, but I think that's improved.
I feel a lot more confident at assessing a patient.
We're fine with you medically, it's just making sure that you're safe at home.
Making a decision on their management.
I'm just going to check your chart.
What was his weight? It's just, isn't it? The more you do it, the better you get.
- Which one of you is coughing? MEN: - Me.
Both of you are coughing? 'Quite incredible what a year can do to you, 'I mean, looking back to the first couple of weeks at work,' you know, it was a complete nightmare, I didn't know my left to my right, but now I actually feel like I can look after the patients a lot better and in a more confident manner.
Bye.
And, for Andy, there's one basic procedure he's happy to have finally conquered .
.
the cannula.
I'd like to think I'm a bit better now after a lot of practice, you know, I can do them, I do them, you know, fairly regularly now.
Probably done a good few hundred this year.
Just keep that on, I'm just going to stick that down now.
Everyone knows who we are, it's very weird.
It's going to be sad to go to a new hospital because suddenly everyone won't, or they will and they'll think, "You're shit at cannulas, don't come anywhere near me.
" THEY LAUGH 12 months on, all the doctors are leaving to take new positions around the country.
If I had to describe this year in one word, it would be busy.
This is the last time they'll be together.
It almost feels like I'm looking through a dream or something, it's just so different to how it is now, and you go into shifts now and it's just like going to work, it's routine.
Even the hardest times actually turn out to be quite a fond memory, even those night shifts where you're like, "Gosh, it was awful.
" I look back on them now and I almost think, "Actually, that was pretty great.
" I've learnt to work on my own a lot more and trust my own judgement a lot more.
Ben, where do you see yourself in ten years' time? - Be outrageous.
- "Be outrageous"? - Great Ormond Street.
- Do you? - Yeah.
As Professor Allin? Well, not in ten years' time - I'll only just be a registrar! So we're probably won't see each other for a while again.
All going on different directions, to different parts of the country and scattered all over the place.
Aw, I'm going to miss you all.
To the future.
This year has been probably the most challenging years of my life.
- Get off my arm! Get off! - Alfie, Alfie, Alfie, Alfie.
I've grown in confidence out of any sort of recognition from a year ago.
Yeah, didn't manage to get it in again, so it's kind of annoying.
Definitely feel I can go into the job day to day and know what I'm doing, and it's not as stressful as before.
I feel a million times more confident now.
That's still not the confidence level that I should be at, but I am a lot more confident.
PATIENT MOANS I think I have improved because I've gained a lot of experience in the last year.
It would just be helpful It's just the questions we ask Our shared experience was starting off at a new hospital for the first time, and those challenges actually brought us together.
CHEERING The people that you work with inevitably become a huge part of your life.
Oh, my God, that is amazing! To suddenly have to move on and detach yourself from that.
You're quite far away from the curb, Priya.
Truly and sincerely, I'm sad to be leaving because I've sort of made it my home.
CHEERING - ALL: - CHEERS! Yeah, I'd definitely do it all again, I mean it's been an amazing experience.
Eight junior doctors hit the wards of the Chelsea and Westminster Hospital.
One year later, as they're about to move on ALL: Cheers.
.
.
they are getting together to look back on the most testing year of their lives.
You don't just develop professionally but actually you develop quite personally as well.
They'll talk about the hard times Starting on nights was shocking.
.
.
the wild times CHAMPAGNE CORKS POP CHEERING THEY SING .
.
the things they remember Ready? Go.
PATIENT CRIES IN PAIN Sharp, spiky thing goes in and sharp, spiky thing come out.
BOY CRIES .
.
and those they'd rather forget.
- Get off my hand! Get off! - Alfie, Alfie, Alfie, Alfie.
Alfie.
Alfie, Alfie.
Alfie.
Boom, there's a needle in your face.
.
.
what they learnt There's this myth that doctors make a lot of the decisions.
- Nurses run the show, don't they? - Yeah, the nurses do run the show.
.
.
and where they're going next.
I'm really interested in helping patients who have disorders of the skin.
I've seen the impact it has on their lives.
12 months ago, these eight young people were about to take on the biggest challenge they'd ever faced: becoming junior doctors.
They were joining thousands of other juniors across Britain, starting work for the first time.
One year on, they're coming together for the last time.
ICE CLINKS You don't really appreciate how much you've grown and developed in that short space of time.
Now you go in and the patients are, "Oh, you know, are you any good at this?" And I'm, like, "Yeah, I am good at it.
" Do it first time and they are, like, "Oh, that was really good, "some people are rubbish at this.
" I think we've accomplished so much.
We've learned a lot.
Just about practising medicine.
Until you have to do it and it's your responsibility, it's completely different.
It's just very satisfying.
Going to a procedure and knowing you are good at it and you can do it.
12 months ago it was a very different story.
If they work out that you're useless in the first few days then it's not a good place to be, is it? 24-year-old Priya and 26-year-old Milla were fresh out of med school.
Until you are actually a doctor, you're not a doctor.
You see what I mean? As were their fellow colleagues, Aki, Andy and Lucy.
I've got an awful memory, and that really is honestly something I have to work around.
- Make sure you write everything down.
- I do, but then I lose my paper! Sharing a house with the first years were second years Amieth and Ben.
How did you guys feel on your first day, in your first week? Petrified.
It's terrifying.
And then the first set of nights, they are horrible.
Oh, no! I'm not going to ask you any more questions! PHONE BEEPS AND VIBRATES With little experience, all the junior doctors were about to head into the unknown.
See you later.
And anxious about what the day would bring.
- You're new doctors? - Yes, my name is Lucy.
You go straight in.
Boom.
Go save that patient's life.
It's not that easy.
At just 22-years-old, Andy was the youngest.
Going in to the first day, yeah, it was really nerve wracking.
And straightaway he came face-to-face with an age-old challenge.
Fitting a device called a cannula.
Hello, Mister Straw.
OK, so I'm going to have a go at doing a cannula, if that's all right? The procedure involves first finding a vein.
OK, so sharp scratch coming up.
Then threading a hollow needle through it.
A common task but a nerve-wracking one.
HE TUTS Right, that's not in.
Let's have a look at this arm, shall we? Basically, he had to endure your lack of skill.
Yeah, yeah, I wasn't very good at cannulas.
- Are you all right there? - Yeah, fine.
- Good.
All right, two goes, yeah? All right.
Mister Straw was a lovely gentleman who took it for the team, I have to say.
Andy's pincushion.
So I get one more go? Yeah? He was just on the wrong end of someone who wasn't very good at doing cannulas.
I felt for Andy.
I could really understand his position.
But my God I was, like, that poor man, having to go through all of that just because we're crap.
- Well, I'm crap.
- No, we all were.
HE SIGHS Yeah, didn't manage to get it in again so that's kind of annoying but I guess I'm glad I persisted because you've just got to do it and I'm going to get one of the others to come and have a go.
And then, yeah, hey, next time.
I think he took it really well.
It could be the beginning of a downward slope but I think you took it on the chin, picked himself up and went on.
I basically can't walk around the hospital without getting cannula jokes everyday.
No, you can't! It wasn't only the first year doctors who were struggling.
- Who's your favourite Star Wars character? - Darth Vader.
Second year Ben was about to meet a young patient called Alfie.
- All right there, Alfie? - Hi.
- Hiya.
Have you still got that magic cream on? - No.
- No, it's all gone, good.
Working with children was Ben's dream job.
So he needed to prove he had a winning way.
I'm going to spray this on your arm, OK, it's just cold spray.
Ready? It will make it go numb in a minute.
Alfie was a young boy who needed a big operation on his bowels, so he needed part of his intestines taken out.
I essentially had to put a cannula in him.
What's that? It's a little needle I need to put in your hand so we can give you some medication.
Do you want to hold mummy's hand and lie back as we do it? - It's cold.
- Just put this down, OK.
So you've got the cream on so it shouldn't hurt, it should be all right.
Look at mummy, there we go.
Alfie.
I can't do it! HE CRIES Can't do it! Get off my hand! Alfie, Alfie, Alfie.
Alfie, Alfie.
Alfie, Alfie, Alfie.
Alfie.
Boom, there's a needle in your face.
I don't want it on there.
I don't want it! Alfie, we'll do it very quickly, we'll get it over and done with.
It was a nightmare.
It was late at night, end of an on-call.
I just did it badly.
Don't be silly.
I don't like it here.
I know, but come here and me and you will go for a walk.
Rather than make sure he was completely still, I should have found a vein, had him calm and just gone ahead and done it.
He's got local anaesthetic on his hand, he's not going to feel it anyway so just do it.
Mum.
I'm not doing it.
Nowadays I'd just go ahead and put the cannula in the back of his hand and that would be that, rather than build-up to it and him get stressed.
- It's all right, we're not putting any needles in you today.
- Why? Maybe he needed that one experience where he had that difficult child and all the future Alfies he has to put the big needle in, he'll know exactly how to deal with them.
See you later, Alfie.
Alfie, Alfie.
All anyone ever bloody says to me is Alfie, Alfie, Alfie, Alfie.
Alfie, Alfie, Alfie.
All junior doctors have to manage the transition from textbook knowledge to practical application, and it's not easy.
I had it for a second there.
Learning how to put it into practice is a whole new ballgame.
It's terrifying to encounter that for the first time.
I think your scariest moments are when people expect you to be able to manage and you feel for the first time that you're on your own.
I was quite confident with my medical knowledge but what I perhaps was less confident in was how you actually then apply it in real life.
First year Aki tried to brace himself by doing some last-minute swotting up.
I'm going to be a little bit nervous on the first day so I just want to make sure that I'm prepared.
At the start of the year I wasn't very confident at all.
I was really worried about not doing my job right.
Pissing all my colleagues off.
SECURITY LOCK BEEPS Harming patients.
I don't think her blood tests are back or she might have not had them done this morning.
Just hours into his first shift, Aki got a grilling by a senior doctor.
Before we do that, which trial evidence do you know of for use of atorvastatin in acute coronary syndrome? Erm There was a time when I knew so many studies.
- I know this doesn't help.
- When was that time? About two months ago.
That time has come and gone already.
It's only your first day.
No one knows that stuff.
No one.
I know now.
I happen to have a friend who's quite interested in becoming a cardiologist and he didn't even know about it until afterwards.
It's an apprenticeship so you get asked by your seniors about, do you know how to do this, do you know what drug you're supposed to give this kind of condition.
You are constantly tested.
As well as working together, the eight junior doctors shared a house in south-west London.
It was a bit like being back in university halls.
It was a very interesting experience living with the guys in the house.
It was a complete range of different characters.
When I'm ill I know I get really princessy and moany.
When you're ill? SHE LAUGHS I loved moving in with seven people.
It made the whole thing very entertaining.
It was like a sitcom.
Living together allowed the juniors to chew over pressing issues.
Lucy, if it was your last day on earth, who would you sleep with? You could all relate to each other.
We knew what each other was going through.
Just being able to discuss your day and laugh at things, I think that was a massive boost.
And just to see you weren't alone in feeling completely inadequate.
It was really nice.
Men should stay at home and do the cooking and women should go out and become good doctors.
No two colleagues got on better than Andy and Aki.
It's been really hectic on the surgical unit.
- Are you, like, down on men, manpower, as in are people away? - No! Yeah, no, we've been really busy.
We haven't been down on men, I certainly haven't been down on any men.
Aki and Andy's bromance was beautiful.
You're just too good to be true When I was at school, I was in this pop punk band.
Really? That's hilarious.
Same.
No, bullshit! Andy and Aki have a special relationship, don't you? - I wouldn't say it was a special relationship.
- I would.
- Just a friendship.
- I would say it was special.
- It's a friendship.
- Aki.
- What? Screw being a doctor, let's become rock stars! - You definitely had a bromance with Aki.
- You reckon? - Yeah.
Oh, wow! - Dude you look - What? It's good, we did good.
- Within the house, Andy and I got on very well.
- Yeah.
Shall I go blazer or leather jacket? - There's a lot of man love.
- Well - There is.
- Is there? - Yeah.
- All right, take it.
We didn't touch each other if that's what you're asking.
- You look good.
- Thanks.
Let's get our game on, bitches.
Whilst live at the house may have been fun, their jobs were demanding and stressful.
PHONE RINGS Chelsea.
And none more so than for second year Amieth.
Laid-back by nature, he was working in A&E, where quick decisions are vital.
Could you tell me what happened to you today? - I fell down about 15 or 20 stairs.
- Really? He ran through the standard checks and decided on a course of action.
I had wanted to get a CT scan on him to look for any bleeding into the brain because there were lots of risk factors for that and he had some slightly alarming clinical signs.
Yeah, I think so.
Yeah.
All right, shall we stitch first then? Can I do it? I think we'll be able to make you pretty again.
MAN CHUCKLES So now we just have to make small talk for a few minutes.
It's very difficult starting off as a doctor and you need to do everything you can to make your job easier.
Using the nurses and their experience is just one way of making the job much easier.
It didn't take long for the junior doctors to realise how much they needed the nurses.
Can I possibly borrow you? - Am I right or not? - That's right.
It's twist and pull, isn't it? There's this myth that, you know, doctors make a lot of decisions and they do a lot of things.
- Nurses run the show, don't they? - Yeah, the nurses do run the show.
What enema do you tend to give? And we'll prescribe the one that you tend to use, because we're both new.
- Usually phosphate.
- Just a phosphate enema, OK.
And we're just like their minions.
We'd go to the nurses a lot in those first few days.
Maybe I wasn't clear enough verbally.
I thought I said but No, but nurses should still be reading the notes.
- Don't blame yourself.
- All right.
I am referring, not I would like to refer, I AM referring.
Make an enemy of a nurse at your peril.
They'll make your life miserable if you start to piss them all off.
But I don't think that happens that often.
Well, not that often.
Don't get too friendly with them either.
Even with the support of a team, the days were taxing.
But more daunting were the nights.
First to run the gauntlet was Milla.
It's not like the daytime when you have your colleagues around you and it's a lot easier to ask for help.
All doctors on call are given a crash bleep, which alerts them to medical emergencies.
Milla hadn't used one before.
But you just double-press the green button.
- And it's definitely going to go off? - It will definitely go off.
- OK.
- Or you'd be very lucky if it never went off.
- So this is how it begins? - This is how it begins.
BEEPING OK.
OK.
Starting on nights was, for me, shocking.
BEEPING Oh my God, I'm not going to get my jobs done! You're not supported by an entire team so you start on your own and you have to deal with all the emergencies.
BEEPING This is my new best friend, Mr Beep.
He basically doesn't stop bothering me.
BEEPING It's just one bleep after another.
Mr Bleep still goes off all the time.
You can't get away with it! I now go to the supermarket and from the check out I literally think a bleep's going off somewhere.
To run off and answer ten million beeps.
BEEPING And Milla's difficult night was only just beginning.
Somebody called me up to come and certify, I think, a death.
I had to do some, I think, really quite challenging things.
Things that I would never have experienced before, including sort of having to certify a death.
I mean, it's my first night.
If you can help me out, I'd be most grateful.
He was still warm.
So I think that's kind of It's probably part of the really scary bit because you kind of You expect them to have a pulse, so it's quite weird.
Yeah, just to look into his eyes and stuff So, yeah, quite shocking actually.
I guess I didn't really expect that on my first night.
And Milla's stress levels were about to go up a notch.
That's it.
Fantastic.
OK.
'Cardiac arrest.
A&E Resus.
Cardiac arrest.
' Oh my God, I don't have a card.
Shit! When your crash bleep goes off you literally see yourself running to the crash call and you look up in the corridors in the hospital to see whether there's anyone else running.
A patient was in cardiac arrest.
but Milla was four floors up on the other side of the hospital.
Hello, Milla.
How's it going? Hello.
Good, you let me know if you need me to do anything.
Milla arrived just in time to help Amieth and the A&E team.
Point 99.
PTO twos.
She was given the job of monitoring the patient's heart rate.
Basically says minus 24.
- I still need to continue.
- Are you happy in your job? - Yeah, I am, thank you.
- It's the most important job going.
And after an hour she had helped stabilise them.
- Anything else I can do? - No, thank you very much.
- Thanks very much.
You can't take those first few nights back, you'll never experience them again.
But I don't think that I did anything that I would do differently now but I think that I can now deal with things much quicker.
At the front line of this intense job, it was crucial to switch off.
But the junior doctors soon realised that their chosen career was going to have a big impact on their personal lives.
It's really difficult to plan a social life around this rota.
You're supposed to finish at a certain time but you rarely ever do.
Hello, I've just been bleeped.
It's Lucy.
Hi, it's Ben, I was just bleeped.
Well, in every job, when you start, you have days where you're just like, "This is awful, I hate it, I'm miserable.
" And it's now 2am, so this is my cereal.
Unfortunately, I think I've lost my life completely in the last year.
I got four bleeps just then.
I just think you get completely immersed in work and you forget what's outside of it.
I'm already sleepy.
- Can I hand over this patient to you? - Yeah, of course, man, no worries.
I just I think that I'm so tired now after the ten days.
It's a very conscious effort to maintain your life outside of work.
So when they did get a chance to go out they really went to town.
- I've been looking forward to tonight so much.
- Going to get trashed? That's the biggest balls up you've made in the last 12 days! And I think it's absolutely crucial, especially in a job like ours, to have things to look forward to.
Cos we know how hard we work.
THEY SING KARAOKE When it came to party planning, Chelsea girl Milla led the way.
Hello.
Hi.
Thank you for coming.
- Oh, do you remember the bhaji thing? - I do.
- Thank you so much for organising that.
- Oh, you're welcome.
CHEERING She bestowed upon us the honour of teaching us this amazing skill.
Across the bottle.
Priya, come on! CHEERING It was a completely bizarre party with the champagne and the swords and Milla beingMilla.
Work life balance is hard.
You can end up in hospital all the time, go home, you carry on working actually and end up going a little bit crazy and it is hard to balance.
- Ready? - Yeah.
I wouldn't say I've got the work- life balance right just yet, no.
The doctors were bonding with each other.
On the wards they also had to build relationships with patients.
It doesn't look like there's any wax or cotton in there.
It felt as if someone had taken me lungs out, given them a good kicking and put them back in.
Can you point to where the pain was? And from day one it was clear that Lucy was a natural when it came to bedside manner.
I just feel like I need to get older because, at the moment, when I'm talking to 80-year-olds and telling them what they should be doing, I feel quite young.
Lucy was based in the General Medical Ward where she treated mostly older patients.
You're 97 and doing everything on your own.
Can't complain.
I shall be 100 soon.
'I think my first job offered me what I enjoy, 'so just the nature of the job' meant there was a lot of elderly people that had very long stays in hospital.
At just 25, Lucy had to give advice and support.
I wonder whether I'll be able to manage when I get home.
That's exactly why I want to talk to you.
I manage to kind of foster relationships with people that actually, they give you quite a lot of slack, so as a first job, people were very patient with me.
- Do you know where my eyebrows are? - Do I know where they are? - Yeah.
- I think I can probably guess.
'But you slowly gain confidence 'and the fact that you'd go in and people would know you' and they enjoy seeing you and you would enjoy seeing them and that kind of stuff I am a completely softy for really.
I just really enjoyed it.
I'll draw the curtain round and have a listen to your breathing.
We've taken him off his oxygen to see what he's saturating at so he's been a bit better.
From her first day, Lucy cared for a 92-year-old patient called Robert Beck.
He was suffering from a chest infection.
- Stick your tongue out.
Did you have breakfast this morning? - Not yet.
- Oh, you haven't had any breakfast? - No.
- Not even a cup of tea? - I had a cup of tea, yes.
- OK, that's what medical students are for.
Would you mind getting some tea and biscuits for Mr Beck, please? - Thank you.
How do you take your teeth? - Milk, no sugar.
- Well done.
- No sugar.
- OK, it's coming up.
Robert Beck was a patient that was there for a long time during my first job.
Over that time you get to know things about people, and he would tell you about Well, he'd tell me about his insecurities and about his worries and you can't help but really grow very fond of somebody and empathise with them.
Do you? Let me shut the curtains and we'll have a proper chat.
I'm a bundle of nerves.
Are you? What are you nervous about? What's just round the corner? I don't think so.
I know it's a little bit miserable being in here.
It's just a matter of keeping going.
And you look good.
You do.
The secret is, Robert, I like having you here and we want to keep you.
But I certainly don't want you to be nervous.
I know.
I know it's human nature.
I don't think it's pleasant for anybody, being in hospital.
I'm sorry it's been like that.
I know you do.
You've been in here now though for about two and a half weeks and because you've been in for that long I want to carry on and make sure that you get home and you stay at home and you're well.
Because I think we can do that.
Honestly I do.
Yeah.
I feel very privileged when people put their trust in you, actually.
I think it's such a privilege.
I think it still touches me now, actually.
I still think, God, it's a great job for that.
People are in hospital and that is the worst time of their lives and we forget that.
Oh, yeah, especially when you've got 20 patients.
We just waltz in and waltz out.
You don't have to scratch the surface very far at all with most patients and they do have massive insecurities and worries and concerns and stresses and I think they always appreciate it if you just spend a bit of time.
And are you warm enough? Because you feel quite cold.
My friend asked me, "If my mum becomes sick, can you make sure Lucy looks after her?" If my mum's sick, I'll make sure I would pay Lucy to look after her.
- And I'll see you later.
You enjoy that tea.
- OK, love.
I'm honoured to be her friend.
Like Lucy, Milla was learning the art of putting patients at their ease.
In Dermatology, she saw a patient with severe psoriasis.
It's quite smelly, isn't it? A skin condition which needed treatment with coal tar.
How often do you have this done? - So you had psoriasis for that long? - Yes.
He was just the most loveliest man who had dealt with this condition for so many years and I think more shockingly he obviously was, you know, was struggling dealing with it.
How does it affect you physically? You said both physically and mentally.
- And so 40 years, you said? - Yeah, about 40 years now.
- Wow.
And you're still smiling.
- Yeah, I'm still smiling, yes.
Yeah.
It was really quite upsetting, some of the things that he shared with me regarding his wife and regarding his children.
I think sometimes we don't realise how much different medical conditions affect people and their lives.
And Milla has decided that dermatology is going to be her chosen career path.
- OK? - Is that all done? - No, not yet, that was just the anaesthetic.
- Oh, right.
But that was it, I promise you that was the worst bit, you shouldn't feel anything else now.
The fact that it's something that people can see and it's something that, you know, we can do something about Because a lot of these conditions are really debilitating for people because they are visible.
And we can do something about it.
As well as rewarding, patient contact could also be challenging.
Starting out as a junior doctor is very daunting and there's lots of trepidation about what's going to happen and how you deal with things as they occur.
And Sameer was about to meet a patient who would test his bedside manner.
I will.
I will talk to you first.
So just to introduce myself - I'm Sameer, I'm one of the doctors.
So where's the pain? So does anything make the pain worse or better? I just need to make sure I've got the whole story.
- But I will be as quick as I can.
- Of course.
'I knew you'd need to have difficult conversations with patients.
' There's always going to be a couple of patients that you're not going to You know.
Perhaps not enjoy talking to, but they're going to be difficult.
I want to talk a bit about the drug use.
How long have you been using and what kind of drugs have you? It's just It would be helpful It's just questions we ask everyone.
Well, no, there's a reason for it.
No, no, it's because I-I OK.
Don't worry, we don't have to talk about it in that case.
OK, can I just move on to? 'He did take me on a ride a bit and he was quite difficult with me 'and I did feel a bit uncomfortable on the inside,' but I think sometimes that part of the doctors' job is to keep control of the situation.
That patient was trying to engage with him and was just been very challenging.
And he stayed quite calm, and I think he managed him as well as anyone could have done, to be honest.
'I know exactly what to say now if that were to happen again,' but I guess I didn't when that did happen.
A lot of the time, difficult patients are being difficult because of anxiety and fear about being in hospital and being unwell.
And once you kind of get past that and you address their particular concerns, then they become a lot easier.
Um, it is something that I'm becoming a bit more used to, but there are always certain patients that you just find you don't quite make that connection with.
.
.
a test to a blood stent, please.
For all the junior doctors, new experiences were coming thick and fast.
Chest drains are quite nasty, OK? So really keep anaesthetic, all right? OK.
Just so you know, I haven't done this before.
- I will talk you through it.
- OK.
Yep.
Aki was asked to carry out an advanced and difficult chest drain.
- My God.
- What's that? - Chest drain.
Have you done one? - Yeah.
You'll love it.
I'm sure I will(!) Thanks, see you tomorrow.
I think was really nice that I was given the opportunity to do something a bit exciting really early on, because it kind of sets you up for the whole year, really.
The crucial thing was to put the patient at ease.
I'm going to really honest with you, this is I don't want to scare you - This is the first time you've done this? - Yes.
"I don't want you to worry, but I've never done this before.
" "Oh, well, that's fine then, I feel completely at ease about it.
" "It's extremely dangerous and you might die.
"But I've never done it before but it's fine.
" Aki had to pierce the chest from behind, avoiding vital organs.
So Put that in, and then with your needle, you are going to go straight in, perpendicular to the skin.
- Like that.
- Mm-hm.
- We're going to give it a try now.
- Can you feel that? - No.
Hold the needle, remember not to let go of that guard.
Push it through, twiddle, twiddle, twiddle.
- Sorry.
- How are you doing there? - It's hurting a bit.
- Is that bearable? - Just.
- OK.
Take a big breath in for me please? You can see it's swinging, yeah? Good.
Well done.
- Congratulations.
- Thank you very much.
- Your first drain.
It was my first drain.
I'm really, really proud of Aki, he did really, really well, and actually the patient was really comfortable as well and that's really satisfying, so, no, job well done.
I wanna sing That wasreally cool.
I wanna scream till the words dry out Job done! 'When everyone else is wondering around, 'filling in bits of paper, looking lost,' you're there, sticking bloody great needles into someone's chest, and walking around like you own the place! I think every year I have a moment where I think, "Oh, my God, this is the best job ever.
" I think Aki was somewhat of an excited puppy dog, wasn't he? - After he'd done that chest drain! - SHE LAUGHS - How are you? - I am exhausted, - but I'm really happy, I just put a chest drain in! - Oh my gosh, wow! That's exciting.
'I was very surprised, slightly jealous,' because, you know, it's quite a challenging procedure.
- I haven't done one since.
- No.
Take the opportunity when you get it! So when I go into my second year, in a new hospital, everyone's going to be like, "Oh, Aki, chest drain.
"Standard, right? Just whack one out, why don't you?" I'll be like, "I've never done one since.
" I think Aki dealt with the situation really well.
It's difficult.
It's nerve wracking.
We've all been in that situation, where you are doing a procedure for the first time.
Yet you have to exceed confidence otherwise your patient doesn't have confidence in you.
'It's coming up to a year, now, of being a doctor.
' Some things repeat itself.
And the more you do it, the more confident you become.
'It's a positive spiral.
' And I just hope that continues.
As they gained more experience, the junior doctors' confidence started growing.
In A&E, Amieth now had a few months under his belt.
PHONE RINGS Hello, A&E resus.
Just as well, given the case he was about to face.
A waitress had been admitted to A&E - her hand had been impaled with a spike.
Make sure you keep all the receipts.
I was going to say, are these the chits or just the counter slips? Oh, no, they'll need them for their records! - I liked your joke as well, "Keep the receipts.
" - It wasn't a joke.
- OK.
I actually wanted You know, I thought they might be important.
'And if you just throw them away, the whole business goes under,' so not only is she out of a job, she's also got a spike in her hand.
You can just take this out.
OK.
What we'll do is get a decent pair of pliers.
It's very deep, though 'I'd actually anticipated sending her to the operating theatre 'to do that, and then the registrar turned around' and said "Oh, no, you can do it, just go and get some pliers.
" Get further down and a bit more in the middle, that's it, right, now I'll tell you when Ready? Go.
PATIENT MOANS Sharp spiky thing goes in and sharp spiky thing comes out.
- You've taken it out? - I managed to get it out, yeah.
Oh, my God, well done, you! I've certainly learnt to work on my own a lot more this year, and I'm certainly much more comfortable in dealing with many different sorts of problems.
- PRIYA: - 'The funny thing is you and I are both doing A&E next year,' - and I don't know how - I know.
You get faced with anything and everything.
That's what we've seen with Amieth.
We've seen Amieth go through it, we've learnt a few things from him.
You have to be so versatile.
You have to adapt to the situation and, you know, get out the toolkit and just get on with it.
Right, let's run through this list, cos I want a good day.
Like Amieth, Andy was being given more responsibility on the night shift.
My SHO, he was like, "We're going to get a bit of sleep "and then you can run the show," so I'm just a bit like, "Oh, God!" Ah, thank you.
Cheers.
On his patient list was 22-year-old Cristobel.
So tell me what's been going on then? At five o'clock today, some cramps started.
If I move or if I cough, or if I laugh or anything like that, then it really hurts.
- Point me exactly where? - The middle, just here.
Underneath the belly button, around here.
I need to have a feel of your tummy now.
She had severe abdominal pains.
- Ow.
- Sorry.
- Ow! That's painful there, is it? It could have been appendicitis or just some non-specific pain.
BEEPING The patient I saw earlier has fainted.
But a few hours later, her stomach pains had taken a turn for the worse.
Hi.
She just looked awful, and I thought, you know, "There's really something seriously wrong here.
" So we need some gel infusion, get some oxygen as well, please.
That's when the sort of real training kicks in.
OK No, what's been happening with your chest? OK, can we get an ECG as well? Thanks.
'I think the moment where I realised 'that I did have some responsibility there' was when the nurses have done their bit, they've got her into bed, called the doctor, and they're standing, waiting for you to make that decision, "What do we do now?" Then you think, "Right, I'd better get on and do something to help this girl.
" Andy suspected an internal bleed, and called his senior for back up.
She's had a faint and her blood pressure's dropped, she's looking very pale, I just thought I'd call you sooner rather than later about this because I think she looks quite ill.
If Andy was right, the condition could have been fatal.
'So he gave her fluids, he got her comfortable, 'he gave her pain killers, and actually stabilised her 'so that the gynaecology surgeons could come in' and deal with the problem in a sort of more definitive way.
Based on Andy's diagnosis, a specialist surgery team took over her care.
I don't think he realises what he's done there, like, what he's achieved, because he's being really nonchalant about it, but that was pretty cool, what he did.
After three months of living together, the junior doctors were starting to feel like a family SHE LAUGHS .
.
and really getting to know each other's quirks.
There's quite a variety of characters in there.
I think I've only noticed that on reflection.
- No, you definitely mentioned it all the way through.
- Did I? - Yeah.
But now OK, well I had an unusually high tolerance level over that time.
Sameer is somewhat quirky.
He's rather awkward.
If you weren't doctors, what would be your ideal job? Um, I'd be Batman.
He completely recognises what he's saying is a bit odd or, you know, a bit satirical, but who cares, he doesn't care.
The stuff he comes out with is magical.
And why, Sameer? Why would you be Batman? I went into medicine so I could help people from disease, and if I couldn't do that, I'd like to help them from save them from organised crime.
Right.
While Sameer kept the house amused, Priya kept the house fed.
My mum tends to cook a lot of food for me and send it down to London.
Priya could never eat all of it, so she always gave it to us, and we appreciated that, so thank you, Priya, and thank you, Priya's mum.
I hope you enjoy my curry attempts.
- LUCY: - This looks so nice.
Priya is so conscientious, can sometimes be a little bit ditzy, but that combination's lovely.
I think this is my road.
Parking wasn't one of Priya's strong points.
- Oh, man! - Are you still going to park it there? I always thought, when I was a child, that I've got very good spatial awareness.
You're quite far away from the curb, Priya.
Maybe my mirrors aren't set right.
You need to go that way a bit and get flush with the curb.
- I don't know what that means.
- Right, OK, turn the wheel a bit.
- Which way? - That way.
- You're looking behind, yeah? - Yeah.
OK.
Stop! - Good work, team.
- Good work, Andy.
High five.
- Yeah.
I'm just not very good.
But parking was the least of Priya's problems.
On the wards, she was about to be given an even bigger test of agility I'm going to ask her if she's had bloods.
.
.
by taking blood from a patient with notoriously small veins.
OK.
Right.
Throughout their early months, most of the junior doctors found taking blood a surprisingly difficult task.
When you learn how to take blood, you learn it on models.
You do it a few kinds at medical school, and then you're expected to go out - and do it for real on patients aren't you? - Yeah.
And you know, the models you have at medical school, the veins are literally like - Like drainpipes.
- Yeah, drainpipes, it's impossible to miss.
And then when you get into the real world you realise that patients are elderly, they're sick, they're shut down, you're not going got find veins that easily.
Let's go.
But the juniors were no longer fresh out of med school, and Priya had to prove herself as a doctor.
She's so difficult to get blood from that the phlebotomists, who are the trained experts in getting blood, they would often say to her, "If I get blood from you today, "you have to take me out on a date.
" We've all been in that situation where patients either have very, very tiny veins or you can't even see them.
I was basically set up for failure.
A sharp scratch.
- You OK? - Ooh.
- OK? - Egads! - Oh.
- It's all right.
- What happened? - Keep going.
- No, no, no, no.
- You're not stopping it.
- I withdrew it.
- Why? You moved a little bit and you screamed! - Don't be a quitter, cos I'm not quitting.
- OK, I will try again.
A sharp scratch.
- Let me know if it hurts too much.
- No, it's fine.
Still fishing.
- Have you got it? - I've got some.
Oh, well done! Yes! - Isn't she wonderful? - YOU'RE wonderful.
For tolerating having a needle stuck Did you get enough, though? Yes, I did.
I've got more than enough.
'At that time, it felt like a good achievement,' simply because everyone else was struggling.
I mean, right now I look back at it and think that it was just a simple, mundane task, but, at that time, it felt rewarding and I felt like I was winning for once.
I just did what is the impossible, I managed to take blood from Mrs Tristholt.
'Probably one of the most conscientious doctors that' I know of, actually.
She's good.
She really is good.
But, however, you'll never see me parking in a straight line, ever, that's one promise I can never make.
Priya's latest placement is in Dermatology.
If you feel any pain let me know, I'll stop straight away and I'll put a little bit more local anaesthetic to numb it, OK? It's the area she's decided to specialise in.
'I'm really interested in helping patients 'who have disorders of the skin,' because I've seen the impact it has on their lives.
It's just a little hole, it looks a bit unsightly now, but what we'll do is we'll put a stitch in it and in time it will heal over, OK? Like Priya, second year Ben had made some big decisions about the future too.
Probably best if we get you holding her.
After getting a chance to work with children, Ben wanted to make his dream of specialising in paediatrics a reality.
Hey there.
Sorry! Sorry.
- That was easier than expected.
- Yep.
All built up for it to be a nightmare! I think you can see his real passion for the job, I think when you see somebody do that, you just think, "THAT'S why you should do something that you love.
" But he still needed to stand out to get ahead in this highly competitive field.
Quite a big deal for me, but it's also terrifying.
So he put himself in the limelight, presenting new research to an audience of top paediatric surgeons.
'I remember Ben having to make a presentation to 'sort of a national conference with lots of different consultants,' and I just thought, "Wow, that must be really, really exciting.
" Anaesthetising a neonate has a suggested high risk than anaesthetising an older child, making it even more prudent to try and avoid a second operation in this patient population.
Thank you very much.
APPLAUSE This helped land Ben the recognition that enabled him to clinch a place on a prestigious surgery training programme.
The next step for me is starting what we call an academic clinical fellowship, in Oxford, in paediatric surgery.
BABY BURBLES It's essentially the dream job, this is the best job I could have hoped for, it combines paediatric surgery and further training.
Hopefully it'll take me through to consultancy in 20 years' time.
It's scary that you're making such a long-term decision, and it's something that we'll all have to do in a year's time.
While some of the juniors know exactly which fields they want to pursue, as they come to the end of their 12 months, others are still undecided.
I don't know what kind of doctor I want to be, it's, um to be announced.
Hello, sir.
Hello again.
I think I learnt over my first job how much I value patient contact.
I just need to take a blood test today, just to make sure that your clotting's OK.
During her year, Lucy found that her key talent was really connecting with patients.
- There you go, all good.
- That's an English rose.
That's for you.
Lucy came across great, she's open, honest and they trust her, and actually she spent a lot of time going the extra mile to help them, and that makes a massive difference.
- Thank you very much.
Bye! - Bye.
In terms of long-term, I've not really got a plan, I'm just going to see how it goes.
Now I'm on surgery, one of the doctors at Chelsea tells me that surgeons are born and not made, and I think that's absolutely true, I was not born a surgeon, I think I was born a medic.
At the end of their first year, Andy and Aki have brought their bromance to the work place.
- Have you seen them, Aki, today? - Not yet.
- Not yet? You serious? They're working together on the same ward.
It's been fun, apart from Aki's managed to avoid spending any time with me, by constantly being on call.
So basically he's a guy who's got end-stage heart failure.
So me and Aki are doing the ward round today, so we're basically just going round all of our 18 patients.
Big breaths.
'Generally just' .
.
saving lives.
Don't say that.
Please don't say that again.
THEY LAUGH Now, with much more to prove than their early days, the junior doctors have to show they can go it alone.
.
.
pitting oedema in the knees, but I think that's improved.
I feel a lot more confident at assessing a patient.
We're fine with you medically, it's just making sure that you're safe at home.
Making a decision on their management.
I'm just going to check your chart.
What was his weight? It's just, isn't it? The more you do it, the better you get.
- Which one of you is coughing? MEN: - Me.
Both of you are coughing? 'Quite incredible what a year can do to you, 'I mean, looking back to the first couple of weeks at work,' you know, it was a complete nightmare, I didn't know my left to my right, but now I actually feel like I can look after the patients a lot better and in a more confident manner.
Bye.
And, for Andy, there's one basic procedure he's happy to have finally conquered .
.
the cannula.
I'd like to think I'm a bit better now after a lot of practice, you know, I can do them, I do them, you know, fairly regularly now.
Probably done a good few hundred this year.
Just keep that on, I'm just going to stick that down now.
Everyone knows who we are, it's very weird.
It's going to be sad to go to a new hospital because suddenly everyone won't, or they will and they'll think, "You're shit at cannulas, don't come anywhere near me.
" THEY LAUGH 12 months on, all the doctors are leaving to take new positions around the country.
If I had to describe this year in one word, it would be busy.
This is the last time they'll be together.
It almost feels like I'm looking through a dream or something, it's just so different to how it is now, and you go into shifts now and it's just like going to work, it's routine.
Even the hardest times actually turn out to be quite a fond memory, even those night shifts where you're like, "Gosh, it was awful.
" I look back on them now and I almost think, "Actually, that was pretty great.
" I've learnt to work on my own a lot more and trust my own judgement a lot more.
Ben, where do you see yourself in ten years' time? - Be outrageous.
- "Be outrageous"? - Great Ormond Street.
- Do you? - Yeah.
As Professor Allin? Well, not in ten years' time - I'll only just be a registrar! So we're probably won't see each other for a while again.
All going on different directions, to different parts of the country and scattered all over the place.
Aw, I'm going to miss you all.
To the future.
This year has been probably the most challenging years of my life.
- Get off my arm! Get off! - Alfie, Alfie, Alfie, Alfie.
I've grown in confidence out of any sort of recognition from a year ago.
Yeah, didn't manage to get it in again, so it's kind of annoying.
Definitely feel I can go into the job day to day and know what I'm doing, and it's not as stressful as before.
I feel a million times more confident now.
That's still not the confidence level that I should be at, but I am a lot more confident.
PATIENT MOANS I think I have improved because I've gained a lot of experience in the last year.
It would just be helpful It's just the questions we ask Our shared experience was starting off at a new hospital for the first time, and those challenges actually brought us together.
CHEERING The people that you work with inevitably become a huge part of your life.
Oh, my God, that is amazing! To suddenly have to move on and detach yourself from that.
You're quite far away from the curb, Priya.
Truly and sincerely, I'm sad to be leaving because I've sort of made it my home.
CHEERING - ALL: - CHEERS! Yeah, I'd definitely do it all again, I mean it's been an amazing experience.