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Hello?

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Hi, it's Tom Jackson,
one of the pelvic surgeons.

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There's been a development with Grace.

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Her heart rate has risen,

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and her responsiveness overnight
has dropped.

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We think that we should hold off
going for surgery

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until we've done
another CT scan of her brain.

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Okay. 65 seconds.

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Try not to worry too much,
and I'll speak to you later.

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Breathe in and hold your breath.

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It's just devastating.

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You can't believe she's gone backwards.

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The neurosurgeons are keen
to look at her head.

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She's in an unstable condition.

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If there is anything
that we feel concerned about,

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we would try and flag that
to one of the doctors.

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In the emergency scan, we have to ensure

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that there's not an evolving situation
in her brain.

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There could be bleeding inside the brain,

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which may require
an emergency intervention.

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We don't want that to evolve

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when I'm halfway through
fixing her pelvis.

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The hardest part is not knowing.

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You can't help but go
to the darkest of places.

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Grace is our firstborn.

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The only girl out of four kids.

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She's a really lovely sister.

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She's funny, and incredibly caring,
and will help anyone if they need help.

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You know,
everyone just seems to love Grace.

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Grace started Level 2 Beauty at college.

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And she was just thriving
doing something that she enjoyed so much.

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She had finished the course herself
the Friday before the accident.

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But Grace agreed to model
for one of her friends for makeup

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so she could complete the course herself.

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And she was coming home from doing that

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when she was hit
on the zebra crossing by the car.

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You do just think, "Why Grace?"

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We've heard from the neurosurgeons

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that Grace's head scan has been completed.

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Thankfully,
there is no significant change.

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We're actually happy
to proceed with her surgery.

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You're in a very privileged
position as a surgeon.

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People are gifting you
great faith and trust

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in what you're about to do to them.

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Grace is quite similar in age
to my older daughter.

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As a parent, there is always
a certain empathy

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and how that's affecting
the family especially.

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So, on three. One, two, three.

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What we'll do to treat Grace's fracture

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is insert some screws
through her pelvic bone.

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The surgery is minimally invasive,

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but any pelvic surgery
is a high-risk operation.

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Okay, let's do this.

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X-rays. Come a bit further in.

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Let's see if we can get both in one image.
Stop there. Picture.

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It's an operation that's entirely guided
by the images we're taking.

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Using imaging,
I'm going to insert my guide wire.

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Can I get the mallet?

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Creating the pathway that the screw
is going to be safe to pass in.

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It's quite a tight corridor.

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X-ray there, please.

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You have to be precise.

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The biggest risk would be

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a few millimeters the wrong direction
will endanger the nerve roots.

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Oh, we're skiting off, aren't we?

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We're going a bit posterior.
Do it now on power.

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-You got it?
-I have it.

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Just back it out a little bit
so we're more at your entry point.

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Okay. And now you should have
the wiggle in the wire.

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I think surgery is kind of a team sport

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in a sense that it's working together,

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having different roles,
and having a goal at the end of it,

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but the difference is
we've always got to win.

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Losing isn't where we go
when we start an operation.

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It's just how long it takes to win.

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X-ray.

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Just above the level of the pelvis,
the spinal column becomes myriad nerves

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that then travel out down your legs
that we call the horse's tail.

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The risks of damaging the horse's tail

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is that you can damage the nerve
coming out of L5

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and get paralysis in your foot.

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Or we can damage the nerves
that control bladder and bowel function,

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so you can end up with incontinence.

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In Grace's case, as a young person,
both would be pretty catastrophic.

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Go a centimeter more.

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Stop.

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We might be a bit close.

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Reverse. I think it's not quite right.

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We're getting close
to where the nerve root's going to exit.

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There's no margin for error.

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-Okay. Holding it?
-I am.

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Okay.

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X-ray.

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If we're not careful, we can suddenly
push it further and cause a deformity.

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Better, right? That looks perfect.

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Okay, so I want you to do
a couple of centimeters, right?

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Now, the journey may have various paths.

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Keep going. Keep tracking.

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But it's really rewarding,
at the end of that case, thinking,

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"Great job. We've achieved our goals,
and the patient's going to be better

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as a result of that."

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-How does that feel?
-Nice.

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On the face of it,
it's a really bizarre job we have.

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Um… but I can't deny it is fun.

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Well done, guys.

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It's like delivering
minor miracles to people.

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-That went really nicely.
-One, two, three.

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It's Friday, fish-and-chip day.

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We've managed to complete
Grace's pelvic surgery,

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which is excellent.

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So now it's just about seeing
whether or not her brain injury recovers.

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Whether there'll be any
long-reaching consequence,

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we just don't know yet.

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Try and stay calm. I know it's difficult.

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And has she been fully alert
since the injury?

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So, he's laying on the floor.
What's happened? Is he talking to you?

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We'll get someone to help you.
Just stay exactly as you are.

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If they take it off,

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you should keep the finger
in your purse or something.

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Oh my God, is he having a laugh?

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You want me to walk around
with your finger in my bag?

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And then be like, "Yeah, it wasn't
just a cut, thank you very much."

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Shall I put the ring on it as well?

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I'd rather get a phone call to say,
"Teddy’s walked out of school,"

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rather than get a phone call to say,

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"I've jumped over a fence
and cut my finger off."

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But they found his ring,
the caretaker found it,

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and it was still attached to the pole
that took his finger off.

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I'm finishing school this week.

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I'll miss out on the leavers' day prom,
all the rest of that.

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It's just, like, ruined my whole summer.

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You're more upset about
missing the summer than the finger.

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Yeah, I am.

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Teddy underwent a ten-hour surgery

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where we reattached the finger

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and reconnected all the structures,

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including blood vessels.

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We rely on blood flow, first of all,
to keep that body part alive.

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It's now just over 72 hours
since his operation's finished.

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So today will be a case of seeing
what the color of the finger is like.

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Morning, Teddy.

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I'll pinprick the tip of the finger.

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Just start by unravelling you.

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And if it's bright red, this is good.

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If it's a darker red,

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then not enough blood
is being drained from the finger.

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I need to be sure there is blood
flowing to and from it

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so that the tissues don't die.

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So, the color to the fingertip is dark.

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It appears the finger's struggling.

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Is it dead?

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It's certainly deteriorated.

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And you're definitely
not out of the woods completely yet.

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Okay.

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If the amount of blood
that's reaching the finger

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is too much for the veins
to drain the finger,

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then that finger can become congested.

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There's too much blood there,

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and that can lead to the finger
not surviving.

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Bear with me.
I'll speak to the nursing team.

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We have one more trick up our sleeve.

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They look ugly, all right?

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But they are a good organism.
They are very helpful.

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Leeches are anticoagulant.
They are antimicrobial.

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They are little amazing suckers,
as a matter of fact.

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I thought it was a joke.
I thought it was medieval medicine.

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I didn't think
they actually used leeches still.

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He wasn't happy at all.

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"What is that, Dad? What is that?"
He didn't know what a leech was.

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-I did know what a leech was.
-Such a liar.

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Medicinal leeches
are a recognized form of treatment

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in plastic surgery.
Particularly in microsurgery.

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We still often rely on methods

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which have been used since medieval times.

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It's time for me
to do my leeching, please. Sure.

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Yeah.

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So, Teddy,

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what will happen is that the leech
will help draw the blood to that end.

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Then the leech will suck the blood
and release the excess blood

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which is causing the congestion
from the region.

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Can you feel it, Teddy?
No, don't feel anything.

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The saliva of the leech
contains analgesics

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which helps prevent any pain
to the individual when applied.

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Why don't you have a little look, Ted?

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No, I don't want to.

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It's gone a nicer color.

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Mm-hm. It's lighter a bit, isn’t it?

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As a team, we would apply the leech
every three hours.

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Knock, knock.

191
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This one's just not feeding.

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You often get a lazy leech,

193
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but seeing as it's been quite a few now
that haven't done too much,

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maybe it's a bit too congested.

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Maybe the blood is not free-flowing enough
to make it a nice, easy meal.

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It's scary to think
that we are waiting to see

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whether or not these leeches work,

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whether or not
that's going to save his finger or not.

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Come on, Grace. Time to wake up, darling.

200
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Come on, baby girl.

201
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Knock, knock.

202
00:13:03,320 --> 00:13:04,200
Hi.

203
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So, from our perspective,
it's gone as well as we possibly could.

204
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It'd be nice to see her wake up
so we can take the tube out.

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That's not been as nice.

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They're trying to wake her up now,
but she's not really…

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-Responding yet.
-…responding yet.

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It's been a hard day.

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-I just need her to wake up.
-Yeah.

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Which, hopefully,
you are going to do soon, Grace.

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The brain injury
is the most concerning thing

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because you can't help but think,
"Is she gonna be Grace anymore?"

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Right here with you, okay?

214
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And you are safe.

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There's no real medical evidence
that shows that holding somebody's hand

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or speaking to them changes their outcome.

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00:14:05,320 --> 00:14:07,680
There's also no evidence
to say that it doesn't.

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00:14:08,800 --> 00:14:12,960
I don't think that everything
is explainable by medical science as yet.

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Miracles can happen.

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I was born with a hole in my heart.

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They told me that I'd always
have to carry around a card,

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saying that I had a heart defect.

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And I was under follow-up for that
for several years

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before my parents took me
to their local church and prayed for me.

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Then they took me back
for one more appointment,

226
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and the doctors said
that I couldn't be the person

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that had been born with this thing
because there was no evidence of it.

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And so, from my perspective,

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I think it's incredibly important
that we have hope,

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that we have belief
that things are going to get better.

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00:15:01,160 --> 00:15:05,360
And I think the support of the loved ones
that we have is really important.

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London Ambulance Service.

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RTC, motorbike versus tree.

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Just down from the M25.

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That sounds bad.

236
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There's an unconscious RTC
in TW7, Isleworth.

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00:15:26,640 --> 00:15:31,280
It's a adult male motorcyclist.
And he's got an abdominal injury.

238
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St Mary's.

239
00:15:34,840 --> 00:15:38,240
Adult Trauma Team.

240
00:15:39,280 --> 00:15:42,280
We've got a 38-year-old male coming in.

241
00:15:42,360 --> 00:15:44,360
He was driving his motorcycle
this morning,

242
00:15:44,440 --> 00:15:48,360
and he's clipped a curb
and come off into a central reservation.

243
00:15:51,840 --> 00:15:54,320
AB60, can I have a blue call to St Mary's?

244
00:15:54,400 --> 00:15:56,200
ETA will be ten minutes.

245
00:15:57,280 --> 00:15:58,120
Received.

246
00:15:58,200 --> 00:16:01,000
Patient's gonna be transported
to St Mary's Major Trauma Center,

247
00:16:01,080 --> 00:16:03,360
and you'll be there in ten minutes.

248
00:16:04,880 --> 00:16:07,400
Motorcycle incidents
can be really serious.

249
00:16:08,040 --> 00:16:12,040
That transfer of energy
can cause significant injuries.

250
00:16:13,040 --> 00:16:16,680
And these injuries can become critical
if we don't act on them quickly enough.

251
00:16:19,080 --> 00:16:20,240
Everyone ready?

252
00:16:20,960 --> 00:16:23,680
This is Abdi. He's a 38-year-old male.

253
00:16:23,760 --> 00:16:25,480
He was riding a motorcycle.

254
00:16:25,560 --> 00:16:27,280
He's hit the curb and gone over.

255
00:16:27,360 --> 00:16:29,520
He's got a right humeral fracture.

256
00:16:29,600 --> 00:16:33,400
There is a large laceration
to his left leg down to the bone,

257
00:16:33,480 --> 00:16:36,080
and he has pain all down
the right-hand side

258
00:16:36,160 --> 00:16:37,800
and round to his back as well.

259
00:16:37,880 --> 00:16:38,720
Thank you.

260
00:16:38,800 --> 00:16:41,880
Could you give him
two grams of TXA as well?

261
00:16:42,480 --> 00:16:46,160
Abdi, how are you? My name is Mohammed.
I'm one of the doctors in here.

262
00:16:46,240 --> 00:16:47,200
Alhamdulillah.

263
00:16:47,280 --> 00:16:48,120
Alhamdulillah.

264
00:16:48,640 --> 00:16:50,040
-Where are you from?
-Somalia.

265
00:16:50,120 --> 00:16:52,560
Somalia? Okay. I'm from Jordan, okay?

266
00:16:53,080 --> 00:16:53,960
Just relax.

267
00:16:54,040 --> 00:16:56,280
I'm gonna just feel your neck.

268
00:16:56,360 --> 00:16:59,040
Trachea is central. Airway is patent.

269
00:16:59,640 --> 00:17:00,800
Look at me.

270
00:17:01,520 --> 00:17:02,400
Good.

271
00:17:02,480 --> 00:17:04,000
So, I'm gonna feel your tummy.

272
00:17:04,080 --> 00:17:07,720
If you feel any pain anywhere I press,
just tell me, okay? Here?

273
00:17:07,800 --> 00:17:09,400
It's mainly all up here.

274
00:17:09,480 --> 00:17:10,560
All up there?

275
00:17:11,160 --> 00:17:13,160
We're gonna take him to the CT.

276
00:17:13,240 --> 00:17:14,360
One, two, three.

277
00:17:21,160 --> 00:17:22,880
He's got multiple injuries.

278
00:17:23,400 --> 00:17:27,400
The main thing that we're concerned about
is active bleeding in his liver.

279
00:17:28,000 --> 00:17:30,320
He's also got an injury to his spleen.

280
00:17:30,400 --> 00:17:31,600
Thank you very much.

281
00:17:32,160 --> 00:17:33,160
Right, let's go.

282
00:17:33,840 --> 00:17:37,160
Abdi's injuries have the potential
to be life-threatening.

283
00:17:37,960 --> 00:17:40,320
We need a trauma surgeon
to come and assess him.

284
00:17:40,400 --> 00:17:42,800
So, I'm gonna call my colleague, Maryam.

285
00:17:42,880 --> 00:17:45,760
Have you guys been told about the man
that's down in resus?

286
00:17:45,840 --> 00:17:46,800
I'll come down.

287
00:17:46,880 --> 00:17:48,520
Perfect. See you in a sec.

288
00:17:55,200 --> 00:17:58,680
When you're part of the trauma team,
you're there as your best.

289
00:17:58,760 --> 00:18:01,640
You're there as your Usain Bolt moment
all the time.

290
00:18:03,040 --> 00:18:04,520
The adrenaline just kicks in,

291
00:18:04,600 --> 00:18:07,120
so you have no choice
but to give it your all.

292
00:18:08,800 --> 00:18:10,160
He's on his way to work…

293
00:18:10,240 --> 00:18:12,000
-It's motorbike, motorcycle?
-Motorbike.

294
00:18:12,080 --> 00:18:14,840
He's clipped a curb and come off.

295
00:18:14,920 --> 00:18:18,800
Teamwork is crucial,
but when it comes to the decision-making,

296
00:18:18,880 --> 00:18:21,800
you have to make a decision
before you make an incision.

297
00:18:21,880 --> 00:18:24,240
It is very much, you know, on you.

298
00:18:25,840 --> 00:18:28,360
Hi. I'm Maryam, the trauma consultant.

299
00:18:29,560 --> 00:18:31,600
I'm just gonna have a gentle feel, okay?

300
00:18:32,240 --> 00:18:35,360
Just let me know if it bothers you
anywhere I press, all right?

301
00:18:35,880 --> 00:18:37,600
The hematoma is getting worse,

302
00:18:37,680 --> 00:18:40,240
so that needs to be resolved
quite quickly.

303
00:18:40,840 --> 00:18:45,360
You have a significant injury
to your liver and also to your spleen.

304
00:18:45,960 --> 00:18:49,320
So that's why you're getting
a lot of the pain here, on the right side.

305
00:18:49,400 --> 00:18:52,280
We need to speak
to our interventional radiologist,

306
00:18:52,360 --> 00:18:54,320
and they'll try and stop the bleeding.

307
00:18:54,400 --> 00:18:56,120
Is there anybody you want us to call?

308
00:18:56,200 --> 00:18:57,720
Could I just call my mum?

309
00:19:01,080 --> 00:19:02,040
Hello, Mum.

310
00:19:02,120 --> 00:19:04,680
While I was heading to work,
I fell off of the motorbike.

311
00:19:04,760 --> 00:19:06,360
What are your injuries?

312
00:19:07,680 --> 00:19:11,600
Do not worry, Mum, okay?
If you will do anything, just pray for me.

313
00:19:13,480 --> 00:19:16,440
They're waiting for me, Mum.
I will call you later, okay?

314
00:19:18,240 --> 00:19:20,800
Have you spoken
to everybody you want to speak to?

315
00:19:20,880 --> 00:19:23,080
Yeah? Okay.
These guys are gonna take you up now.

316
00:19:24,960 --> 00:19:26,720
Thank you, guys. Thank you all.

317
00:19:29,800 --> 00:19:30,960
So, trauma patient.

318
00:19:31,040 --> 00:19:34,920
Urgent procedure to get into the artery
and embolize a bleeding tributary.

319
00:19:35,520 --> 00:19:37,440
We are pinhole surgeons,

320
00:19:38,920 --> 00:19:42,880
and our plan is to navigate a tube
and a wire up through the aorta,

321
00:19:42,960 --> 00:19:44,640
the main artery of the abdomen.

322
00:19:44,720 --> 00:19:47,560
We are then going to use
a directional catheter

323
00:19:47,640 --> 00:19:51,760
to get into this artery here
to block that to stop the bleeding.

324
00:19:51,840 --> 00:19:54,640
You're bleeding inside,
and you can lose a lot of blood.

325
00:19:56,520 --> 00:19:59,400
I work in decontamination
and sterilization.

326
00:19:59,480 --> 00:20:03,320
Process all the instruments
these guys use to do their procedures.

327
00:20:04,480 --> 00:20:05,680
So, it's like a…

328
00:20:06,480 --> 00:20:08,880
It's like a circle
that's coming around on itself.

329
00:20:10,040 --> 00:20:13,360
I've never been in an accident
like this before.

330
00:20:14,000 --> 00:20:16,280
It feels like I've been hit by a truck.

331
00:20:16,360 --> 00:20:18,920
But what can you do, you know?

332
00:20:19,440 --> 00:20:20,760
He's consented.

333
00:20:20,840 --> 00:20:22,360
-Cool, let's do it.
-Yep.

334
00:20:22,440 --> 00:20:25,160
Okay, final question. Is everyone leaded?

335
00:20:25,240 --> 00:20:27,480
-We're good to go now, Rob.
-Thank you.

336
00:20:28,600 --> 00:20:30,240
I just want to say something.

337
00:20:30,320 --> 00:20:31,160
Yeah.

338
00:20:37,560 --> 00:20:39,080
He just wants to say a prayer.

339
00:20:40,480 --> 00:20:42,400
Nice, slow, deep breaths for me.

340
00:20:43,080 --> 00:20:44,840
Let's try and get into this.

341
00:20:44,920 --> 00:20:46,440
Can I have the wire, please?

342
00:20:47,360 --> 00:20:48,960
It's less than a millimeter in width.

343
00:20:49,040 --> 00:20:52,080
I'm gonna try and navigate this
through the blood vessels.

344
00:20:53,600 --> 00:20:56,000
That's great. All the way in, straight in.

345
00:20:56,520 --> 00:20:58,480
Is there more bleeding distally as well?

346
00:20:59,080 --> 00:21:00,040
Holy moly.

347
00:21:03,000 --> 00:21:05,240
This is a nasty, nasty trauma.

348
00:21:05,840 --> 00:21:07,400
He's lucky to be alive, isn't he?

349
00:21:10,800 --> 00:21:14,080
The vessels are sheared off
from the impact and the force.

350
00:21:14,600 --> 00:21:17,400
We just put some
little beads down the arteries.

351
00:21:17,480 --> 00:21:19,880
So the beads are gonna travel
with the blood flow

352
00:21:19,960 --> 00:21:23,800
and just nest in the very distal arteries
and block those truncated vessels.

353
00:21:26,400 --> 00:21:27,320
Perfect.

354
00:21:27,840 --> 00:21:29,920
I'm happy with the liver now. Okay?

355
00:21:31,320 --> 00:21:33,880
We've stopped the bleeding in the liver,

356
00:21:33,960 --> 00:21:37,400
but in motorbike accidents,
you can be bleeding from multiple sites.

357
00:21:38,360 --> 00:21:42,200
He has to be handed over
to my trauma surgical colleagues now.

358
00:21:42,280 --> 00:21:43,520
Ready, steady, slide.

359
00:21:43,600 --> 00:21:46,720
They have to examine
Abdi inside really carefully.

360
00:21:48,600 --> 00:21:52,320
It is risky moving
someone like Abdi who is bleeding,

361
00:21:53,000 --> 00:21:55,960
but when it comes to trauma,
it's a balance of risks.

362
00:21:59,560 --> 00:22:02,000
There is no perfect in medicine.

363
00:22:18,080 --> 00:22:21,400
It's been 24 days
since Isaac was admitted to hospital

364
00:22:22,080 --> 00:22:24,000
following an alleged assault.

365
00:22:24,520 --> 00:22:26,400
Isaac is getting better.

366
00:22:26,480 --> 00:22:29,280
I need to take that off as well, don't I?

367
00:22:29,360 --> 00:22:31,280
I have seen glimmers of hope.

368
00:22:31,360 --> 00:22:34,880
Some really nice traits of Isaac
before he was injured.

369
00:22:35,480 --> 00:22:39,320
He's very generous
and he's very family orientated,

370
00:22:39,400 --> 00:22:40,680
which is a lovely trait.

371
00:22:46,480 --> 00:22:50,280
That's just part of the process,
and part of getting home,

372
00:22:51,080 --> 00:22:53,520
and part of making me better.

373
00:22:54,480 --> 00:22:57,640
So, it's all right.
I'm happy with doing it.

374
00:22:59,320 --> 00:23:01,880
Isaac being in hospital
has been the longest time

375
00:23:01,960 --> 00:23:03,720
that we've actually ever been apart.

376
00:23:04,920 --> 00:23:07,840
It's been really difficult
not having him at home.

377
00:23:08,520 --> 00:23:11,920
I can see some of Isaac is coming back.

378
00:23:12,840 --> 00:23:15,360
Oh my gosh, he can't go any quicker. Go.

379
00:23:15,960 --> 00:23:18,120
-Thank you for having me.
-See you later.

380
00:23:18,200 --> 00:23:19,320
All right, see ya.

381
00:23:20,040 --> 00:23:23,080
We all would want
some magic tablet or magic wand

382
00:23:23,160 --> 00:23:25,240
where we can just make everyone better,

383
00:23:25,840 --> 00:23:28,560
but that's not
the reality of brain injury.

384
00:23:28,640 --> 00:23:30,080
People's lives change,

385
00:23:31,320 --> 00:23:34,160
but it's encouraging
the families to recognize

386
00:23:34,240 --> 00:23:37,280
that these really small wins
are actually massive.

387
00:23:37,880 --> 00:23:40,640
-I'm happy to be leaving here.
-I can imagine.

388
00:23:40,720 --> 00:23:42,080
I know that.

389
00:23:42,160 --> 00:23:44,680
But I'll miss everyone.

390
00:23:46,320 --> 00:23:49,120
I appreciate all the help
they've given me.

391
00:23:50,640 --> 00:23:52,720
Yeah, I'm just lucky to be alive.

392
00:23:57,680 --> 00:23:59,720
Trauma doesn't discriminate.

393
00:24:00,240 --> 00:24:03,160
Rich, poor. It can touch anyone.

394
00:24:06,560 --> 00:24:08,760
And nobody's expecting it.

395
00:24:09,880 --> 00:24:14,240
The biggest challenge I see is the patient
not returning to who they were.

396
00:24:14,920 --> 00:24:18,440
Um… And that's really difficult
for families.

397
00:24:26,240 --> 00:24:28,640
Grace is squeezing my hand.

398
00:24:29,160 --> 00:24:31,360
She's turned her head to my voice.

399
00:24:31,440 --> 00:24:33,880
But she's still so out of it.

400
00:24:40,920 --> 00:24:42,320
Grace was hit by a car,

401
00:24:42,400 --> 00:24:46,440
and that impact caused her
to be thrown off to the side of the road.

402
00:24:47,760 --> 00:24:49,080
This is Grace's scan,

403
00:24:49,160 --> 00:24:52,240
and we can see that her brain
would have rattled around in her skull,

404
00:24:52,320 --> 00:24:53,320
causing some bruising.

405
00:24:53,400 --> 00:24:55,800
And the other part of the injury

406
00:24:55,880 --> 00:24:59,240
is the kind of shearing forces
that would have occurred in the brain.

407
00:25:00,200 --> 00:25:01,680
Hi. Is it Grace and family?

408
00:25:01,760 --> 00:25:04,400
My name's Harri.
I'm one of the neurology consultants.

409
00:25:04,480 --> 00:25:06,240
I work in the neuro rehab team.

410
00:25:08,120 --> 00:25:11,680
The brain consists of millions of neurons
which transmit information

411
00:25:11,760 --> 00:25:14,080
between different parts of your brain.

412
00:25:14,160 --> 00:25:17,040
If you tear these,

413
00:25:17,120 --> 00:25:20,920
you disrupt the brain's ability to do
all the complex functions that it can do.

414
00:25:24,560 --> 00:25:27,240
Is it okay if I try and see
if I can wake up Grace a bit?

415
00:25:27,320 --> 00:25:28,360
Yeah.

416
00:25:29,800 --> 00:25:32,720
My name's Harri.
I'm one of the neurologists here.

417
00:25:35,080 --> 00:25:36,080
Grace.

418
00:25:36,800 --> 00:25:38,720
Can you open your eyes for me?

419
00:25:40,160 --> 00:25:41,200
Grace.

420
00:25:43,920 --> 00:25:45,920
Would Grace be okay
if I just feel her hand?

421
00:25:46,000 --> 00:25:48,640
-Yeah.
-Is she quite sensitive to touch?

422
00:25:48,720 --> 00:25:49,960
She can be.

423
00:25:52,720 --> 00:25:55,280
Let me hold your hand
if that's okay, Grace.

424
00:25:57,800 --> 00:25:58,760
Hello, Grace.

425
00:25:59,280 --> 00:26:01,000
Grace, open your eyes, darling.

426
00:26:02,920 --> 00:26:04,480
Want to wake up for the doctors?

427
00:26:06,040 --> 00:26:07,040
It's Mum.

428
00:26:09,960 --> 00:26:10,800
Grace.

429
00:26:12,720 --> 00:26:14,240
-Hello, Grace.
-Hello, Grace.

430
00:26:20,800 --> 00:26:24,960
Seeing her open her eyes
just for that brief second,

431
00:26:25,480 --> 00:26:28,120
it's like all your Christmases
come at once.

432
00:26:29,400 --> 00:26:31,320
Because you know she's in there.

433
00:26:33,520 --> 00:26:34,600
Hi, darling.

434
00:26:36,320 --> 00:26:39,480
I can feel you holding on to me.
I know you're listening.

435
00:26:41,800 --> 00:26:44,000
After someone
who has a head injury wakes up,

436
00:26:44,080 --> 00:26:46,600
they can be in this stage
in which they're very confused

437
00:26:46,680 --> 00:26:48,080
and very disorientated.

438
00:26:48,160 --> 00:26:50,800
But this will change
over the next few days.

439
00:26:51,680 --> 00:26:54,800
And then we'll see a little bit more
what impact the head injury has.

440
00:26:54,880 --> 00:26:55,720
Yeah.

441
00:26:55,800 --> 00:26:59,560
For her parents,
it really is this emotional roller coaster

442
00:26:59,640 --> 00:27:03,600
where they feel they may have lost their
loved one to knowing they're now alive.

443
00:27:04,120 --> 00:27:06,800
But then go through
almost a kind of mourning-type phase

444
00:27:06,880 --> 00:27:09,320
of realizing that things
are significantly different.

445
00:27:13,480 --> 00:27:17,360
And that this could be their reality
for not just the next few weeks,

446
00:27:17,440 --> 00:27:18,640
but months to years.

447
00:27:39,160 --> 00:27:43,640
Abdi has had his liver embolized
to try and control the bleeding.

448
00:27:45,680 --> 00:27:48,040
But we can see from the scans

449
00:27:48,560 --> 00:27:51,440
that there's still blood
inside the abdomen.

450
00:27:53,880 --> 00:27:58,640
Every day a trauma patient comes in
that is severely injured,

451
00:27:58,720 --> 00:28:04,040
I always feel I can relate
to what people are going through

452
00:28:05,120 --> 00:28:08,440
because of my personal journey
to get to trauma surgery.

453
00:28:12,480 --> 00:28:18,120
We were in our teenage times
of everybody just learning how to drive.

454
00:28:18,200 --> 00:28:21,160
And I remember very clearly
it was a Friday night,

455
00:28:21,240 --> 00:28:23,400
and one of them rang me
saying we're going out

456
00:28:23,480 --> 00:28:25,720
and this person has a new car.

457
00:28:25,800 --> 00:28:28,240
And I was like, "Oh, yes.
I'll have to ask my mum."

458
00:28:32,600 --> 00:28:36,360
And I remember
my mother saying I couldn't go. Um…

459
00:28:36,440 --> 00:28:39,320
You know, I was like, "Okay, fine.
I'm not going with you guys,

460
00:28:39,400 --> 00:28:42,240
but have fun and we'll talk tomorrow."

461
00:28:44,320 --> 00:28:47,880
Uh… but that was a tomorrow
that I never spoke to my friends about

462
00:28:48,600 --> 00:28:51,720
because they were involved
in a road traffic accident.

463
00:28:52,240 --> 00:28:54,400
And one of them died.

464
00:28:56,400 --> 00:29:00,760
I just could not quite comprehend
or believe or accept it.

465
00:29:02,120 --> 00:29:03,120
Um…

466
00:29:08,720 --> 00:29:10,080
Sorry. Yeah.

467
00:29:10,720 --> 00:29:14,000
It was amazing. Her name was Maryam
as well.

468
00:29:14,080 --> 00:29:18,880
Um… and… and yeah,
she was always, you know,

469
00:29:19,880 --> 00:29:23,080
our go-to person, our sort of sorter.

470
00:29:25,240 --> 00:29:27,000
Yeah, an incredible human being.

471
00:29:31,200 --> 00:29:34,080
And, um, I wanted to do something.

472
00:29:37,640 --> 00:29:39,480
And so I developed a new focus.

473
00:29:41,280 --> 00:29:42,600
All right to start.

474
00:29:42,680 --> 00:29:47,160
I really wanted to be part of that,
helping people as much as I can

475
00:29:47,240 --> 00:29:49,240
when they are severely injured.

476
00:29:53,360 --> 00:29:56,880
We know that Abdi's spleen
is still bleeding,

477
00:29:56,960 --> 00:30:00,800
but it may be that there are other organs
that are also damaged.

478
00:30:02,720 --> 00:30:04,680
Even if people do get to hospital on time,

479
00:30:04,760 --> 00:30:07,400
they can still die from internal bleeding.

480
00:30:09,040 --> 00:30:13,040
The plan for Abdi is keyhole surgery
to try and stop that bleeding.

481
00:30:13,880 --> 00:30:17,080
We've opened up a little space
just above the belly button.

482
00:30:17,720 --> 00:30:20,880
Then we're going to put the camera in
to see what we see inside.

483
00:30:23,920 --> 00:30:25,240
Large intestines.

484
00:30:27,080 --> 00:30:29,680
This is all the abnormal blood
that's inside.

485
00:30:31,480 --> 00:30:34,680
There's probably
about a liter of blood in there.

486
00:30:36,160 --> 00:30:37,760
I can't quite see properly.

487
00:30:38,800 --> 00:30:40,600
Is it compromising things?

488
00:30:41,880 --> 00:30:44,360
We only have a certain amount of blood

489
00:30:44,440 --> 00:30:47,040
that's circulating within our system.

490
00:30:47,120 --> 00:30:49,360
So if it's being lost somewhere,

491
00:30:49,440 --> 00:30:53,360
there isn't enough to go back to the heart
for the heart to be able to pump it.

492
00:30:53,880 --> 00:30:57,400
And eventually,
the heart has nothing to pump,

493
00:30:57,480 --> 00:30:59,040
and then the heart stops.

494
00:31:00,520 --> 00:31:04,840
There's a bit too much blood, so we can't
see where it's potentially coming from.

495
00:31:06,880 --> 00:31:09,240
The safer thing is to convert
to an open operation.

496
00:31:11,440 --> 00:31:12,880
Can we have a knife, please?

497
00:31:17,080 --> 00:31:19,240
When things are not quite right,
I'm grateful

498
00:31:19,320 --> 00:31:22,600
that I have a very religious
and spiritual aspect of my life,

499
00:31:22,680 --> 00:31:27,200
and I'm able to tune into that
to calm my brain, my mind.

500
00:31:28,840 --> 00:31:31,320
Now that I've converted
to an open operation,

501
00:31:31,400 --> 00:31:34,120
I have to be systematically
looking at every organ

502
00:31:34,200 --> 00:31:36,200
to find out exactly what's bleeding.

503
00:31:36,280 --> 00:31:39,160
I mentally have a clockface in my head.

504
00:31:42,320 --> 00:31:45,480
Twelve is the middle
where the breastbone is.

505
00:31:46,000 --> 00:31:48,520
The left colon is at three o'clock.

506
00:31:48,600 --> 00:31:51,120
And then at six o'clock,
I'm looking at the rectum.

507
00:31:51,200 --> 00:31:55,840
Nine is the right colon.
And then going back again to 12.

508
00:31:55,920 --> 00:31:58,840
Walking through all the organs
in the abdomen.

509
00:31:59,840 --> 00:32:03,720
The fact that you don't know exactly
what's bleeding is primarily the problem.

510
00:32:04,320 --> 00:32:06,240
Every second matters.

511
00:32:06,960 --> 00:32:08,680
This is the small intestine.

512
00:32:10,520 --> 00:32:12,880
The small intestine
is about three meters long.

513
00:32:14,040 --> 00:32:16,400
So far, we can't see any obvious injury.

514
00:32:18,080 --> 00:32:21,160
Your brain is trying
to put a jigsaw puzzle together.

515
00:32:23,280 --> 00:32:25,000
Now, the large intestine.

516
00:32:28,320 --> 00:32:30,240
-Is that okay?
-Yeah.

517
00:32:31,080 --> 00:32:32,720
So this is the stomach.

518
00:32:34,280 --> 00:32:37,920
And we can't see any injury there,
which is good news.

519
00:32:38,000 --> 00:32:40,520
-Have a look at the spleen?
-Yeah.

520
00:32:44,240 --> 00:32:45,600
This is the spleen.

521
00:32:46,280 --> 00:32:48,240
This is the area that's bleeding.

522
00:32:50,440 --> 00:32:52,800
And slightly more on the inner side of it.

523
00:32:52,880 --> 00:32:55,040
So we need to be really gentle here.

524
00:32:56,200 --> 00:33:00,160
So I'm going to try
this special foam-like gel,

525
00:33:00,240 --> 00:33:02,000
and that can stop bleeding.

526
00:33:07,240 --> 00:33:09,960
So we'll leave that
and see if that does the trick.

527
00:33:20,160 --> 00:33:21,560
I think it's still bleeding.

528
00:33:22,360 --> 00:33:23,800
We need to stop it.

529
00:33:24,800 --> 00:33:26,320
Can you suture it?

530
00:33:26,400 --> 00:33:27,240
No.

531
00:33:29,440 --> 00:33:31,280
The spleen is part of the immune system.

532
00:33:31,360 --> 00:33:34,400
It's very important
when it comes to fighting infections.

533
00:33:34,960 --> 00:33:39,120
So removing the spleen
is always something we avoid doing

534
00:33:39,200 --> 00:33:40,760
unless we really have to.

535
00:33:41,840 --> 00:33:43,800
But sometimes you have no choice.

536
00:33:45,160 --> 00:33:46,880
We're gonna take the spleen out.

537
00:33:57,720 --> 00:33:59,160
-Thank you.
-Okay.

538
00:33:59,240 --> 00:34:03,880
So that was bleeding here, here.
And there's a cut in the middle there.

539
00:34:11,640 --> 00:34:13,480
So, start closing.

540
00:34:14,280 --> 00:34:16,000
-You okay?
-Yeah.

541
00:34:20,480 --> 00:34:23,840
I'm quite happy that the spleen
was the source of the bleeding.

542
00:34:23,920 --> 00:34:27,880
And now that's been controlled,
and we can end the operation.

543
00:34:30,040 --> 00:34:32,040
Abdi has been through a lot today.

544
00:34:33,760 --> 00:34:38,680
If he didn't get to hospital at the time,
he could have died from internal bleeding.

545
00:34:43,280 --> 00:34:45,640
He is still very much in a critical state.

546
00:34:45,720 --> 00:34:49,640
So the next 24, 48 hours,
he will need close monitoring

547
00:34:49,720 --> 00:34:52,840
to make sure that there are
no further complications.

548
00:35:16,040 --> 00:35:17,520
If you sit there, Teddy.

549
00:35:17,600 --> 00:35:20,760
So I'm just gonna cut the bandage, okay?
Not anything else.

550
00:35:20,840 --> 00:35:22,640
-Not my finger.
-No.

551
00:35:23,520 --> 00:35:26,640
Today, we're seeing a young lad
called Teddy, who's 16.

552
00:35:26,720 --> 00:35:29,160
Unfortunately, he ripped his finger off.

553
00:35:30,000 --> 00:35:33,960
Despite best efforts of all the staff
and the surgeons here at the hospital,

554
00:35:34,040 --> 00:35:38,840
even with using some leech therapy,
we weren't able to salvage the finger.

555
00:35:39,440 --> 00:35:42,720
-Do you want me to look first?
-I don't think I want to see it.

556
00:35:42,800 --> 00:35:44,640
-You all right?
-No.

557
00:35:44,720 --> 00:35:46,040
You’ve gone all sweaty.

558
00:35:46,120 --> 00:35:47,240
Yeah, I'm very hot.

559
00:35:47,320 --> 00:35:49,680
-You going funny?
-Just lie down, Teddy.

560
00:35:49,760 --> 00:35:51,200
Keep your eyes shut.

561
00:35:54,400 --> 00:35:55,720
What do you think?

562
00:35:56,240 --> 00:35:59,160
It looks really tidy.
It looks really clean.

563
00:35:59,840 --> 00:36:02,560
Will I have a dressing on it
while in physio?

564
00:36:02,640 --> 00:36:04,120
I don’t wanna look at it.

565
00:36:04,200 --> 00:36:05,920
-It's a lot, isn't it?
-Yeah.

566
00:36:10,160 --> 00:36:14,080
Since the accident, Teddy has
probably not used or moved his hand.

567
00:36:14,160 --> 00:36:17,880
But we do need to today start on trying
to get the muscles working,

568
00:36:17,960 --> 00:36:20,440
try and get the neural pathways connected

569
00:36:20,520 --> 00:36:23,240
in order to get him progressing
and using his hand normally.

570
00:36:24,640 --> 00:36:28,080
Do you play PlayStation, Xbox?

571
00:36:28,160 --> 00:36:30,160
-I do, but I haven't been 'cause--
-Yeah?

572
00:36:30,240 --> 00:36:32,520
I haven't been able
to hold the controller.

573
00:36:32,600 --> 00:36:35,880
You can play your PlayStation
if you want to, okay?

574
00:36:37,440 --> 00:36:39,760
Take your thumb out to the side for me.

575
00:36:40,360 --> 00:36:43,920
Are you able to get it and touch it
to the bottom of that little finger?

576
00:36:44,480 --> 00:36:45,560
Excellent.

577
00:36:46,080 --> 00:36:48,280
Is there anything he shouldn’t do?
Like go to…

578
00:36:48,360 --> 00:36:49,360
Don't get it wet.

579
00:36:49,440 --> 00:36:50,720
…after-parties, after-prom?

580
00:36:50,800 --> 00:36:53,080
He should avoid them, yeah?

581
00:36:53,640 --> 00:36:55,120
When is prom? Is it tonight?

582
00:36:55,200 --> 00:36:56,840
-Friday.
-Friday.

583
00:36:56,920 --> 00:36:59,120
-Yeah.
-You're gonna go, aren't ya?

584
00:36:59,200 --> 00:37:01,200
-I'm going to go to prom.
-Yeah.

585
00:37:01,280 --> 00:37:04,400
But I'm trying to persuade her
to let me go after-party.

586
00:37:04,480 --> 00:37:08,360
I can't tell him not to go. Depends
on what you're doing at your after-party.

587
00:37:08,440 --> 00:37:11,640
You're not helping me.
You're going completely siding with him.

588
00:37:11,720 --> 00:37:13,760
I'm really sorry.

589
00:37:15,560 --> 00:37:19,280
This is definitely a lesson
that I wouldn't want him to have,

590
00:37:19,360 --> 00:37:22,920
but his attitude is it's not gonna
stop him from doing anything.

591
00:37:23,000 --> 00:37:26,000
Teddy goes to college in September.
He's doing an electrician course.

592
00:37:26,080 --> 00:37:28,440
-Thank you so much.
-See you later. Bye.

593
00:37:28,960 --> 00:37:31,960
I'm super proud
that he's dealing with it the way he is.

594
00:37:41,440 --> 00:37:43,680
Okay, so we're starting with Grace.

595
00:37:43,760 --> 00:37:47,040
Just to remind everyone,
Grace was struck by a car on 10th June,

596
00:37:47,120 --> 00:37:49,440
had a traumatic brain injury
and pelvic fractures

597
00:37:49,520 --> 00:37:51,480
that she had fixed on the 14th.

598
00:37:52,960 --> 00:37:55,240
Grace has been with us
for a few weeks now.

599
00:37:55,320 --> 00:37:59,240
Initially, Grace was very tired
and confused, but now she's doing well,

600
00:37:59,320 --> 00:38:01,560
awake and able to engage
in the rehabilitation.

601
00:38:02,880 --> 00:38:05,720
Recovery from a brain injury
is difficult to predict, however.

602
00:38:05,800 --> 00:38:08,680
Every brain is unique
and everyone's recovery is unique.

603
00:38:08,760 --> 00:38:09,960
-Hi, Grace.
-Hello.

604
00:38:10,040 --> 00:38:11,120
Morning, Grace.

605
00:38:13,880 --> 00:38:16,280
With regards to what brought you in,

606
00:38:16,360 --> 00:38:19,640
did you have much chance
to kind of talk or understand about that?

607
00:38:21,240 --> 00:38:23,080
I had a brain injury, didn't I?

608
00:38:23,160 --> 00:38:25,600
You have a brain injury, yeah.

609
00:38:27,080 --> 00:38:29,240
It's variable how much it'll affect you,

610
00:38:29,320 --> 00:38:33,040
but some things you might notice
is concentration might be a bit tricky,

611
00:38:33,120 --> 00:38:36,840
and more complex problem-solving,
so not doing your basic day-to-day tasks.

612
00:38:37,560 --> 00:38:40,960
The main areas
that were affected were the frontal lobes

613
00:38:41,040 --> 00:38:42,880
and also the temporal lobe,

614
00:38:42,960 --> 00:38:45,640
which is often involved in actually
not our verbal memory,

615
00:38:45,720 --> 00:38:47,080
but more of our visual memory.

616
00:38:47,880 --> 00:38:49,800
We're just very lucky and very grateful

617
00:38:49,880 --> 00:38:52,120
that Grace is still there
for the most part.

618
00:38:52,200 --> 00:38:54,120
Okay. Well done.

619
00:38:54,200 --> 00:38:58,080
But she's lost probably
about eight months of memory.

620
00:39:00,120 --> 00:39:03,680
She doesn't even remember her baby brother
Morgan being born in February.

621
00:39:03,760 --> 00:39:05,920
That's completely gone.

622
00:39:07,240 --> 00:39:09,360
Doesn't remember
coming to see him in hospital,

623
00:39:09,440 --> 00:39:11,720
holding him for the first time,
anything like that.

624
00:39:11,800 --> 00:39:13,480
That's just been wiped.

625
00:39:16,920 --> 00:39:19,000
As part of post-traumatic amnesia,

626
00:39:19,080 --> 00:39:22,480
patients like Grace can have problems
with short-term memory.

627
00:39:22,560 --> 00:39:25,840
Memories of events that happened
before the injury can be lost.

628
00:39:26,360 --> 00:39:29,880
It's very much akin to the filmMemento,

629
00:39:29,960 --> 00:39:34,120
in which she's effectively living
each moment without a real awareness

630
00:39:34,200 --> 00:39:36,320
or recollection of what happened before.

631
00:39:39,520 --> 00:39:42,200
Unfortunately,
we don't have medications or surgery

632
00:39:42,280 --> 00:39:44,840
to fix the damage,
really, that's been done.

633
00:39:45,440 --> 00:39:47,960
But what you can do is use visual aids.

634
00:39:48,040 --> 00:39:53,320
So we've asked Karen
to bring in pictures, objects from home.

635
00:39:56,400 --> 00:40:01,600
Those images and objects
will act as a scaffold for her

636
00:40:01,680 --> 00:40:03,240
to reform those memories.

637
00:40:04,560 --> 00:40:08,760
We're putting in pictures,
just, you know, Grace with the dogs,

638
00:40:08,840 --> 00:40:12,880
and then photos like with her friends
at birthday parties and things like that.

639
00:40:14,640 --> 00:40:16,440
Hopefully, the memories will come back.

640
00:40:16,520 --> 00:40:18,800
We just don't know
how long that's gonna take.

641
00:40:24,160 --> 00:40:27,720
Look at the difference of you here,
and then in that photo up there.

642
00:40:27,800 --> 00:40:28,880
How you've changed.

643
00:40:29,920 --> 00:40:32,600
-That was year four as well.
-Very good.

644
00:40:33,600 --> 00:40:36,200
Memory is a really complicated function.

645
00:40:36,280 --> 00:40:39,040
But for Grace,
youth is definitely on her side.

646
00:40:39,760 --> 00:40:42,080
That one's from Joanna.
That one's from Ted.

647
00:40:42,160 --> 00:40:43,320
It's a bit bent, innit?

648
00:40:44,080 --> 00:40:47,360
The fantastic thing
about the brain of a 17-year-old

649
00:40:47,440 --> 00:40:49,840
is its capacity to rewire.

650
00:40:49,920 --> 00:40:51,520
We call it neuroplasticity.

651
00:40:51,600 --> 00:40:55,080
Grace's ability to repair
those connections

652
00:40:55,160 --> 00:40:57,280
that have been disrupted
as part of this injury

653
00:40:57,360 --> 00:41:00,640
are so much higher, which stands her
in really good stead for the future.

654
00:41:00,720 --> 00:41:02,840
-She was so drunk.
-She was very dr…

655
00:41:17,680 --> 00:41:19,520
-Morning.
-Morning.

656
00:41:19,600 --> 00:41:20,880
How's your pain?

657
00:41:20,960 --> 00:41:22,280
-I can tolerate it.
-Okay.

658
00:41:22,360 --> 00:41:24,880
And we can give you more stuff
on top of what we have.

659
00:41:24,960 --> 00:41:26,520
Okay, there's no need to be brave.

660
00:41:26,600 --> 00:41:28,120
-If I need more, I'll ask.
-Good.

661
00:41:28,200 --> 00:41:29,960
So, essentially, yesterday we did try

662
00:41:30,040 --> 00:41:33,200
and do the operation keyhole,
but the spleen kept on bleeding a bit

663
00:41:33,280 --> 00:41:35,600
as much as we tried
to sort of leave it in there.

664
00:41:35,680 --> 00:41:37,720
So you don't have a spleen, I'm afraid.

665
00:41:39,640 --> 00:41:43,400
Life is perfectly normal without it,
apart from having to take antibiotics.

666
00:41:46,120 --> 00:41:48,560
I'm here breathing another day.

667
00:41:48,640 --> 00:41:51,760
Yeah, just really grateful
for this system that we have.

668
00:41:52,360 --> 00:41:55,160
It's a whole village
to make this operation work.

669
00:41:55,680 --> 00:41:58,840
This has made me realize
not to take anything for granted.

670
00:42:00,360 --> 00:42:01,720
Keeping people alive

671
00:42:01,800 --> 00:42:04,400
gives you a good feeling,
should I say, inside.

672
00:42:06,480 --> 00:42:09,040
I play my small part,

673
00:42:09,880 --> 00:42:13,000
but it's all down
to a lot of people together.

674
00:42:13,080 --> 00:42:17,000
Sometimes I feel like
Throwing my hands up in the air

675
00:42:17,840 --> 00:42:21,240
I know I can count on you

676
00:42:21,320 --> 00:42:23,640
We see people at their absolute lowest.

677
00:42:25,960 --> 00:42:29,560
But the London trauma network
has the ability to pick up the pieces

678
00:42:29,640 --> 00:42:31,120
and put them back together.

679
00:42:40,920 --> 00:42:42,920
I made him smile. Look.

680
00:42:43,840 --> 00:42:46,320
The progress is just astounding.

681
00:42:46,400 --> 00:42:50,000
You know she's there,
and you're going to get her back.

682
00:42:50,080 --> 00:42:51,400
You've got the love

683
00:42:52,120 --> 00:42:54,880
Teddy's not letting it bother him,
which is amazing.

684
00:42:54,960 --> 00:42:57,680
It could be like
a cool chat-up line, can't it?

685
00:42:57,760 --> 00:43:00,160
It's a journey.
There's highs and lows in it.

686
00:43:00,240 --> 00:43:01,680
It can be transformative.

687
00:43:01,760 --> 00:43:04,040
You've got the love

688
00:43:05,000 --> 00:43:07,440
I think my prosthetic looks pretty cool.

689
00:43:07,520 --> 00:43:10,360
Definitely want to show it off
to people I used to go to gym with.

690
00:43:11,520 --> 00:43:12,800
There we go, son!

691
00:43:16,400 --> 00:43:20,480
Saving lives, returning people
to their families, to their loved ones.

692
00:43:20,560 --> 00:43:22,560
I think the NHS is absolutely incredible.

693
00:43:23,160 --> 00:43:24,880
Welcome home!

694
00:43:24,960 --> 00:43:26,720
-You all right, Mum?
-Yeah!

695
00:43:27,240 --> 00:43:28,600
Welcome home.

696
00:43:30,640 --> 00:43:33,920
We pride ourselves on pushing
the boundaries of what's possible.

697
00:43:34,600 --> 00:43:36,640
We've got the artificial forehead
in place.

698
00:43:37,440 --> 00:43:39,320
Shall we just see what it looks like?

699
00:43:40,120 --> 00:43:43,440
You realize how fragile we are,

700
00:43:43,520 --> 00:43:46,960
yet how amazing the human body is.

701
00:43:47,640 --> 00:43:50,120
It fascinates me
every time when I operate,

702
00:43:50,200 --> 00:43:52,960
how we put people back together again.

703
00:43:53,640 --> 00:43:54,680
Perfect.

704
00:43:54,760 --> 00:43:58,040
I know I can count on you

705
00:44:00,440 --> 00:44:01,680
They thought I might die,

706
00:44:01,760 --> 00:44:04,720
and then after that,
they thought I might have brain damage.

707
00:44:05,240 --> 00:44:08,040
The level of care I've had,
honestly, phenomenal.

708
00:44:09,360 --> 00:44:13,280
We're saving lives that 15, 20 years ago,
they wouldn't survive.

709
00:44:14,120 --> 00:44:17,080
They've put me back together,
like Humpty Dumpty.

710
00:44:24,200 --> 00:44:26,680
Since the setting up
of London Major Trauma System,

711
00:44:26,760 --> 00:44:28,360
thousands of lives have been saved.

712
00:44:28,440 --> 00:44:31,080
The city relies upon us.

713
00:44:31,160 --> 00:44:34,080
But you've got the love
I need to see me through

713
00:44:35,305 --> 00:45:35,646
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