999 The Critical List S01E01
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00:00Hi, are you bleeping emergency bleep?
00:04The patient from ED is coming in here now.
00:08Behind the scenes of every major hospital in the UK,
00:12there is an emergency list that few of us have ever heard of.
00:16The emergency list is a list of the sickest patients in the hospital,
00:20the patients who need emergency surgery.
00:24He's a sick patient who needs expediting. This critical list evolves
00:28by the hour as patients are added
00:32and prioritised.
00:34They've just booked this one also as a cat one.
00:36We weigh things up. This list is about order of priority of the sickest patients first.
00:41We follow the critical list at a time when the NHS is facing unprecedented pressure.
00:47The list is full.
00:49We see more and more people come through the door.
00:51It's the toughest time for the emergency list that I have ever known.
00:54But with patients hours away from being critically ill,
00:57staff are forced to make impossible decisions.
01:01Why is she taking priority over him?
01:03Of who goes next.
01:05Because the reality is hitting me.
01:07And who must wait.
01:09I cannot stay indefinitely in hospital.
01:12Never think that we don't think you're important to us as you are.
01:15Oh, thank you.
01:17You all right?
01:18You all right?
01:19Oh!
01:20Oh!
01:21Without the emergency list, these patients, they would deteriorate.
01:25They would be taking hospital beds up for days.
01:28They would be in critical care.
01:30These patients would probably die.
01:32Just make sure I wake up.
01:35I'm off to see a gentleman who's got a problem with his colon.
01:56He may have perforated his colon, so I'm good to see him.
01:59Unfortunately, because of ED being so busy, we've extended a corridor space for patients.
02:05Hello.
02:06Is it Kevin?
02:07Yeah.
02:08Hi.
02:09My name's Nick Hayward.
02:10I'm one of the consultant surgeons.
02:11Nice to meet you.
02:1265-year-old Kevin has had severe abdominal pains for the last three weeks.
02:16He's been waiting on the corridor since last night to be assessed.
02:21That's the side it hurts.
02:23Down there in the middle.
02:24Yeah.
02:25Has it always been there?
02:26Always been in that position?
02:27Yeah.
02:28My view is what I'm thinking is you're probably going to end up needing an operation just to
02:32fix this.
02:33I think we'll just get you up to our ward and I'll come and see you a bit later on.
02:36Yeah.
02:37Is that okay?
02:38No problem.
02:39I don't want to go into too much whilst we're in the middle of the ward down here.
02:40No, no, no.
02:41But as soon as you've got a bed upstairs, we'll get you up to us.
02:43No problem.
02:44Okay.
02:46This place is, I don't know, it's mad. They overworked over everything. It's mad.
02:55There's hundreds of people up and down sides of these corridors and that.
03:00But I had to come to hospital because it was getting that bad.
03:03I don't like hospitals.
03:04So I put it off and they knew I had to go.
03:07Why don't you like hospitals?
03:09Because some people don't come home from them.
03:11Do you know how many years you have to be here to get an extra day off?
03:2525.
03:2625.
03:2725.
03:28To get a £50 voucher.
03:29An extra day's holiday.
03:31Two pound a year, yes.
03:33I can't wait.
03:34I'll have to be here for 25 years.
03:35Yeah, you've only got another...
03:36Nine.
03:37Nine to go, yes.
03:38That's not bad.
03:39There are 11 surgical theatres at the hospital, but only one is dedicated to unplanned emergency
03:52surgery.
03:54Theatre Six.
03:56Each patient is categorised in terms of medical urgency.
03:59Hi.
04:00Bleeping emergency bleep.
04:02It's the job of theatre coordinator Nicky Tingle to keep the list moving.
04:07You can, but it's going as a category three, and I'm telling you, it will not get done today.
04:13So when I first started, 1997, we had half a day emergency list.
04:19As time's gone on, we have got busier and busier.
04:22There are times we have to cancel patients, postpone them till the next day, and it's not fair
04:28on the patients.
04:29It's the toughest time for the emergency list that I have ever known.
04:34So, we've picked up the list, and we have got seven patients on our list today.
04:40The ones who should really go next are Kevin and the female laparotomy patient,
04:47but we're going to do Freddie because he's ready to go and he doesn't need a review.
04:54Are we ready?
04:59Ready, Freddie? Let's go, go, go!
05:02Six-year-old Freddie is on the children's ward.
05:06He was brought in yesterday evening by his parents, suffering from a dental abscess.
05:11We took him to the doctors, and as soon as we walked in, they said it was orbital cellulitis,
05:20which is caused by the abscess, so he's got to have surgery.
05:26Freddie has been waiting for surgery since last night, and as the youngest child on the list,
05:32he takes priority.
05:35Good job. Nothing's going in it, nothing's going in it.
05:38I was going to tell them how brave you've been.
05:41You've been better than that.
05:44It's a bit difficult with children because, obviously, we look at clinical priority.
05:50If there was a Category 1 patient or a 2A, a realistic patient,
05:54we would do them first, they would take priority.
05:57But we'd try and do the younger children earlier because they don't understand.
06:02Plus, they're starved, they can't have a drink.
06:05It's hard because there are a lot of patients who have to wait a little bit longer.
06:10Yeah, I don't know...
06:12I don't know how I'd cope being a patient on the emergency list.
06:24All right, my friend? Yep.
06:26Right, I'm going to ask you some questions, OK?
06:28OK.
06:29Good, man.
06:30So, have you got any pain at the moment?
06:32I won't say so, no.
06:33A bit of niggly stuff going on, but know what I had when I come in.
06:36Yeah.
06:37Kevin was added to the emergency list yesterday.
06:40Full of tattoos and can't do a one little needle going in.
06:44The doctors suspect he has a perforated colon,
06:47which could be life-threatening.
06:49So, how are you feeling now, you've just been moved?
06:52Relieved.
06:54Because, believe it or not, this hospital bedroom is a palace
07:00compared to where I've been for the last day.
07:04I always thought I ate the hospitals because the crap places they've been,
07:08I don't like being like I am now.
07:11Led here, not doing now.
07:13I've got 16 grandkids and one great-grandkid.
07:19They come to the house every single day, so we never not see each other.
07:26My mum and dad passed away in hospital, you know.
07:32Scary.
07:33But what can I do?
07:41You're hungry.
07:42I know.
07:43I know.
07:44There's nothing I can do about that yet, sweetheart.
07:46I just have to wait a little bit longer.
07:49Another patient waiting for surgery is 11-year-old Isabel.
07:53She needs a diagnostic laparoscopy to investigate a pain in her abdomen.
07:59It's quite hard to diagnose Isabel because of her learning difficulties and her autism.
08:06She's hard to assess.
08:07So they're just, I think, going to edge on the side of caution,
08:10see what's going on inside her tummy, and then hopefully we'll have some answers.
08:15Whilst Isabel waits to be called,
08:17Freddie's having two teeth removed and an abscess drained.
08:22If the dental health is neglected for the kids,
08:25definitely they will have these kind of problems.
08:29Sometimes it does happen. It's spontaneous, isn't it?
08:32Yeah, spontaneous.
08:33Parents do look after the children's teeth, like if you see this young boy's teeth,
08:36they're lovely and clean.
08:38They've obviously been looked after.
08:40But we do see the teeth that are on.
08:44Here are you.
08:45How are you, buddy?
08:47After Freddie's successful surgery, Isabel is next into Theatre Six.
09:01Hi, Tanzine.
09:02Hiya.
09:03How are you doing? You OK?
09:04I'm OK, thanks.
09:05Good to see you.
09:06Good to see you again.
09:07Upstairs on the ward, 55-year-old Tanzine has just been added to the list,
09:13following an overnight wait in A&E.
09:16On the CT scan that you had last night,
09:18we saw that there was three needles in your neck there.
09:22Right, OK.
09:23Just on that left-hand side.
09:24Two of them look like they're very superficial within the neck,
09:27but there's a third one that's a little bit lower down in the neck.
09:30It's sort of just above this bone here, which is called your clavicle.
09:33All right, OK.
09:34But we're confident that we should be able to remove all three for you.
09:37Good, sure.
09:38All right.
09:39Thank you for looking out to me.
09:40No worries.
09:41Will you try?
09:42We're trying. We'll try and get out as soon as we can, all right?
09:46Tanzine is a drug user and well-known at the hospital.
09:50He's already had this procedure done on the right side twice in the last few months.
09:56And if we speak to him, you know, he says that his main complaint is stomach pain.
10:03And he's been investigated before by the stomach doctors
10:07and unfortunately they haven't been able to get a firm diagnosis for him.
10:11So he still struggles with that on a daily basis
10:14and that's why he's sort of admitted to injecting.
10:18And he's had these needles in his neck for at least a couple of weeks now
10:22and actually felt embarrassed about coming back for a third time to have them removed,
10:28which is why he's left it this long.
10:30He's telling me this morning that he has, you know, been in remission for years in the past
10:34but has relapsed unfortunately recently because of his abdominal pain.
10:39If the needles are left, there's a danger they could hit the arteries supplying blood to the brain
10:44and potentially cause a stroke.
10:46This is like a 3D reconstruction of the CT scans.
10:50And so you can see the main risk is that these needles may move further down within the layers of the neck
10:58and get closer to major vessels, which could lead to sort of major bleeds,
11:02which is why he's on the emergency list.
11:04I've got some pins in the neck, you know.
11:10When you're injecting your neck, I pulled it out, that broke in there.
11:14I think that's how it's got stuck.
11:16Yeah, it's like kind of self-arming, isn't it, you know?
11:20And do you feel like if you didn't hurt your neck, they wouldn't have looked at your stomach?
11:26Well, I wouldn't have been here. Definitely not.
11:29You know, it might be a cry for help. Who knows, you know?
11:32So would you say then, like, being here, you're less concerned with what's going on in your neck and more concerned?
11:38I'm not, I'm not at all concerned about my neck, to be honest with you.
11:42It's just the stomach.
11:44Are they misunderstood that what's actually leading me to this path,
11:49or are they just being ignorant?
11:50Oh, yes, he's a drug user, you just bob him off, do you know?
11:53That's my head, probably irrational things, irrational thoughts,
11:58because I'm not in the best of place, so, yeah.
12:08Consider this as an inflamed appendix, all right?
12:18In theatre six, 11-year-old Isabel is having keyhole surgery.
12:23Scissors, please.
12:24The source of her abdominal pain and infected appendix has been removed.
12:29Specimen coming out.
12:33With Isabel off the list, the team need to decide
12:36who is the next most clinically urgent patient.
12:39Hello, Kevin. How are you doing?
12:41Not so good.
12:43Can I have a feel of your tummy?
12:45Is it OK?
12:46So you say observations are completely fine, no temperatures.
12:49And he's on the antibiotics.
12:52If Kevin's condition has deteriorated,
12:55it's an indication that his bowel has perforated,
12:58and he'll need immediate life-saving surgery.
13:01So that's still OK, very much similar to what it was before.
13:04In your tummy down here, when I discussed the scan
13:07with the radiologist yesterday,
13:09you've got an area in your bowel
13:12which is difficult to appreciate on the scan.
13:16They're not quite sure exactly what's going on.
13:18But essentially, you've got a segment of your bowel
13:21that's got diverticular disease within it.
13:23There are a few different ways of treating this.
13:27We can either do an operation,
13:30which will undoubtedly leave you with a stoma and a bag,
13:34or we can put a drain into it.
13:37The only problem with that is if we're not 100% sure
13:40and we put a drain into that,
13:42and it's actually part of the bowel,
13:45we end up putting a drain into the bowel.
13:48But in the emergency situation in this,
13:51I suspect you'd need to have a colostomy.
13:54It wouldn't be safe to join things together.
13:56That's the worst thing that can happen, I'm on a bag.
13:59It's difficult to talk about worse things that can happen.
14:01Oh, yeah, yeah, OK.
14:02When you have abdominal surgery,
14:04any abdominal surgery like this carries risks to your life.
14:07Yeah, yeah.
14:08But you are somebody who I believe would be OK
14:13and would most likely survive an operation like that.
14:16Mm-hm.
14:17I just want to get better.
14:18If I have to be on a bag, I'm on a bag,
14:20but I don't want to be having it sorted
14:22and then further out of line coming back in to have it all done again.
14:27OK.
14:28I can send for the laparotomy.
14:30Yeah.
14:31Immediately.
14:32Perfect.
14:33With Kevin's condition currently stable,
14:36a decision has been made to call another patient.
14:39So the duty anaesthetist has been to see the lady at laparotomy
14:45and thinks that she needs doing next, so they've sent for her.
14:48So what's happened?
14:50She must be sicker than Kevin at this moment,
14:55so they have sent for her.
14:57Hi.
14:58Bleeping emergency bleep.
14:59Waiting in the surgical admissions unit is another patient
15:12who's just been added to the list.
15:14Come Sunday, I started getting a bit of pain under my groin
15:18and I just have literally crawling into work.
15:22So I ended up getting an appointment on Tuesday morning
15:25and they found an abscess.
15:27one of the most awkward places you could probably find an abscess.
15:3235-year-old Sufiam is hoping to be called next to theatre
15:37to remove a perianal abscess.
15:40Are I okay to pop a candle in, yeah?
15:42Yeah, of course.
15:43Do you want to follow me? We'll just go into the other room.
15:45I've always had a high pain threshold,
15:47but this is something that I've never experienced.
15:50It's been on a level that I've never experienced.
15:53Nah.
15:54Nah, it'll be all right.
15:56Because I've already got back conditions,
15:58my L3, 4 and 5 discs are bulging
16:02and my L5 disc is touching a nerve.
16:05So now this added to the symptoms I'm already having.
16:09They said they were going to give me morphine,
16:11but I've got my own tablets.
16:14Don't take anything just yet.
16:16Right, okay.
16:17Just in case they want to give you anything else
16:19because it will need to be on the system.
16:20Oh, okay.
16:21And then we'll get you some pain relief.
16:23I've had back pain for ten years,
16:25but over the last three to four years
16:28it's just gradually getting worse and worse and worse and worse
16:31and worse to the point where just being in constant pain
16:34do you know how long I'm looking at?
16:37I don't, but I can try and find out for you.
16:40Please.
16:41The pain has been chipping away at me for a long time
16:44and I don't blame the doctors or anything like that.
16:47Nobody understands what the job is like unless they're doing it.
16:51Now, because when I was working in care, you know,
16:53giving medication and everything takes a long time,
16:56but the reason the NHS is failing
16:58is there's not enough people in the NHS to do the job.
17:01And what I found one of the worst things
17:04about what happened with the NHS was
17:06in COVID-19 people were clapping.
17:08Where's the clapping gone now?
17:10Why has it stopped?
17:12Why has it stopped?
17:24Tansy?
17:25Yeah, that's me.
17:26Hi.
17:27Am I going down?
17:28Yes, you are.
17:29OK.
17:30Would you like to use the toilet before we go down?
17:33No, it's all right, thank you.
17:34Yeah?
17:35You've been down before, haven't you?
17:36I have, yeah.
17:37Yeah?
17:38I've been down about three or four times.
17:39Yeah, for what?
17:40For the same procedure?
17:41For the same procedure, yeah.
17:43OK.
17:44Obviously, it's been a waste of time
17:45because they've not got to the bottom of the roof,
17:48but it is what it is and I'm here and you can sort me out.
17:52Yeah.
17:53And then I'll be back again in a couple of weeks or a month.
17:57Tansy's surgery to remove the needles in his neck
18:01will likely only take an hour,
18:03so they've decided to operate on him
18:05ahead of other patients on the list.
18:08We're going downstairs to the theatre now.
18:11This is the fourth time because I don't get dealt with the issues
18:15that I should be dealt with, you know.
18:18I keep coming in to pay these guys wages.
18:22So we've got a patient on the list called Tansy.
18:24Now, this patient is on this emergency list quite often
18:27and he keeps doing the same sort of things.
18:30Now, Tansy obviously has some underlying mental health conditions.
18:33We need to get to the bottom of them, really,
18:35to stop him doing this to himself
18:37and getting to the bottom of it can take months, years.
18:41It's not an overnight fix, unfortunately.
18:45He's obviously had a lot of issues in the past
18:47to get to a state where he's a drug user
18:51and especially after going through remission
18:56and then, unfortunately, relapsing.
18:58He must have been in a really difficult place.
19:00So we have several patients
19:04who are regular attenders to the emergency list.
19:07Often they've got mental health issues.
19:10These patients, they're putting pressure on the list.
19:14They're causing other patients who are sick
19:17to have their surgeries delayed.
19:19They're taking a lot of our time.
19:21We've got the two more superficial ones.
19:25Yeah.
19:27We're just trying to find the one that's lower down
19:29and a bit deeper.
19:30Posterior.
19:32The third needle is much deeper
19:34and proving difficult to find.
19:36So Registrar George has called for a second opinion.
19:40Can I just... One second, George.
19:42Dangerous structures there.
19:43Yes, we're getting closer to major vessels,
19:46so we have to be very careful.
19:49So let's have the x-ray, actually, and find out.
19:53With Tamzim's surgery going on longer than anticipated...
20:01Hello. How are we doing?
20:03..other patients on the list must continue to wait.
20:06The plan is to have it done today,
20:09but just in case, we've booked a bed for you.
20:12Oh, OK, thank you.
20:13Because this is an emergency service,
20:15and you never know what comes through the doors.
20:18So I guess they are expecting you
20:21to be ready for theatre in two hours.
20:23Is that OK?
20:24Yeah, thank you very much.
20:25Any questions?
20:26No.
20:27Happy?
20:28Yeah.
20:29I'm sorry for that, but you understand.
20:30It's the emergency service.
20:32Good morning.
20:33Soon as it's done.
20:34Yeah, I know.
20:36OK.
20:37You have, let's say, a line-up, but it keeps changing
20:42because, as you can imagine,
20:45if something more serious needs to be done first,
20:48it goes first.
20:50So there's no fixed timeframes,
20:53but we feel for them because they are in pain.
20:56Remember, he's in pain.
20:57When I saw him, he could barely walk.
21:00The problem is what comes through the door.
21:03That's the one question that nobody can answer,
21:06so...
21:07But, hey, we're doing our best.
21:11OK, just try again.
21:13So we're just trying to put the tip of our fringes in
21:15and see how close we are.
21:16Yeah.
21:17Yeah.
21:18So according to that, it's underneath here.
21:21OK.
21:22OK.
21:23No.
21:24I cannot feel anything there.
21:26And the other ones, they were quite superficial one day.
21:29Yeah.
21:30Tanzim has now been on the table for just over two hours.
21:34So we cannot find the third one,
21:37and the more you explore, the more things can go wrong,
21:42and this can jeopardize the patient's safety.
21:45Yeah.
21:46I think we should call it a dent, actually.
21:48Yeah.
21:49So the plan is that we will do a scan tomorrow.
21:53If it's still there, we might have to come back.
21:56But first, as a doctor, it's patient safety.
22:10How are you feeling?
22:11I'm just a bit worried.
22:14It's in the best place.
22:15It's in the best hands.
22:1711-year-old Deacon has been rushed into A&E by his mum
22:21with a suspected testicle torsion.
22:23OK.
22:24Couple more really deep breaths.
22:25All the way in, all the way out.
22:28As a category one case, he must be operated on within two hours.
22:33The danger is that the testicle will die,
22:36so it will be twisted, it cuts off the blood supply,
22:39and then it turns black and dies.
22:41So we need to get in there, untwist it, and stitch it in.
22:45We're going to do a scrotal exploration and see if we can salvage the testis.
22:51That's given the highest priority over a trauma case.
22:56The hospital has a life or limb policy after midnight,
23:00and as it's getting late, all the other patients on the emergency list
23:04will be pushed to tomorrow.
23:06These patients have been waiting all day, but unfortunately,
23:09if something comes in more urgent, it's got to be done.
23:12This January has been the busiest month for the hospital's emergency department
23:18in the last five years.
23:20I don't know if it's since Covid that patients may have been unwell
23:25and never did anything, cos they end up coming into the hospital as an emergency.
23:29I don't know if it's that patients have been unwell recently
23:33and not done anything because they can't see the GP,
23:36or if patients are just sicker for some reason at this time.
23:41I don't know what it is, but we are busier than ever.
23:45PHONE RINGS
23:47Good afternoon, ESU's sister.
23:49Hi, ESU, it's theatres. Are you OK?
23:51Hi. Yes, thank you.
23:53I'm ringing with bad news.
23:55Mr Kevin Hope, we're transferring him to tomorrow.
24:00OK, I'll let the patient know and the nurse will.
24:03All right, thank you.
24:04All right, OK then, cheers. Bye.
24:07OK.
24:09Hi, are you Kevin's wife? Hiya.
24:14I've just had a phone call, unfortunately, from theatres.
24:17They're not able to do you today, but they will definitely do you tomorrow.
24:21Unfortunately, you just had a bit of bad luck today.
24:25You know, they've booked ten.
24:27Probably more important people need to sort it.
24:29No, no, it's nothing to do...
24:31You are, obviously, as important as anybody else.
24:34I know I didn't mean it like that.
24:35I meant there's people need the operation before I do.
24:37Yeah. Yeah, sometimes it's sort of...
24:39Cos I'm stable, other people might not be.
24:41Yeah, exactly, yeah.
24:43Cos I'm not blaming hospital.
24:46It's just that it's just dragging on and dragging on and dragging on.
24:50I just want to get operated on.
24:52Why, yesterday?
24:53Cos I'm worried about having operation, but I also want to get it done.
24:58I suffer from panic attacks to start with, so I'm just stressed and, you know,
25:04I might be happy, happy, happy face on, but inside I'm a bit, you know,
25:10I want to get it over and done with.
25:12You tend to yourself what, don't you?
25:13I've had enough now.
25:14You know, this waiting about...
25:16Like I say, it's not the hospital's fault, I'm not blaming them.
25:19I'm just saying, it's me, I'm a stress head and I'm...
25:22I just want to get it out of there.
25:30Testicular torsion is a major emergency in children,
25:34especially in this age group.
25:36That's why it's important to explore as soon as possible.
25:41In theatre six,
25:42surgeons are racing to save 11-year-old Deacon's testicle.
25:47It's scarier. You never know what can happen to him.
25:50You just don't know.
25:51Cos he didn't tell his teacher, he didn't say to his teachers that it hurt,
25:54but he rang me after school and he told me.
25:57If he'd have told his teachers they could have sent him home,
26:00then it could have...this all could have happened to it a lot sooner.
26:03Cos I think there's only, like, a seven-hour window
26:05from the start of the pain to the testicle dying,
26:09cos you have to act fast.
26:11HE RINGS
26:29Oh, oh, it's nice and cool.
26:33Brewtime already.
26:36It's 8am, and on the theatre corridor, senior sister Nikki is juggling another busy list.
26:44Hi, bleeping emergency bleep.
26:47As patients are added to the ones rolled over from the previous day.
26:51So we come in, the list's just full in the morning, and that's before ward rounds and admissions.
26:58Because I look at it and I get, like, tachycardia.
27:02Doesn't it bother them every day when they come in the morning that their fucking list is getting bigger?
27:06No, I think that we should operate all night.
27:08Yeah?
27:09I do everything.
27:11That's why we come into that, isn't it?
27:13We need to. Just the emergency list.
27:16Just keep them going.
27:18I think about staffing all the time.
27:22I think the government focus on the waiting list.
27:25Yeah, we've got all these timescales we've got to get waiting lists down.
27:28But they've not got any idea about A&E, what's going on in theatres.
27:33We have got areas we could make more wards, but we don't have the nurses to cover the woods that we've got now.
27:41There are already five patients on today's emergency list, including Sufyan and Kevin, who were bumped last night.
27:49We have sent for Sufyan for his perianal abscess.
27:54Sufyan's gone above Kevin because it's a quicker surgery.
28:01It's a complex abscess.
28:03This abscess turns around the anal canal, so we call it a horseshoe abscess.
28:09So it needs training usually on two sides.
28:12Right, right.
28:13Flip, please.
28:14Sufyan's surgery is underway, following an overnight wait.
28:21We've opened one side of the abscess now.
28:24And the important thing is to drain the infection.
28:27And that's what we've done.
28:29Oh, it's killing.
28:41After surgery last night, 11-year-old Deacon is well enough to go home.
28:46I'm just glad that I brought him straight in, because if we would have waited till this morning,
28:51it would have been a different story.
28:53He'd have lost his testicle and he'd have had to be removed.
29:03Hello, Joe.
29:04Hi.
29:05How are you?
29:06Rough.
29:07Tired.
29:08Hungry.
29:09In a lot of pain.
29:1133-year-old Jordan has been suffering with excruciating kidney stones for years.
29:17He's awaiting assessment to see if he'll be added to the list.
29:21Every two-year, it comes round in a cycle where I end up here, so...
29:26It's finally being operated on with sounds of it, so...
29:29Can you talk me through your tattoos?
29:31Oh, yeah, if you want.
29:32Well, my very first tattoo was this one.
29:35I've got that one because I'm a Leo.
29:38Then I've got this one because it's all about life.
29:41Life is an opportunity to benefit from it.
29:44Life is an adventure.
29:46And life is a life fight for it.
29:49Very philosophical there.
29:51It's off Google.
29:58All right, buddy.
29:59Are you ready?
30:00Ready as I'll ever be.
30:01Let's get you sorted, buddy.
30:03Kevin has now been in hospital for four days.
30:09He's finally got to the top of the emergency list.
30:12I'm just hoping that the operation...
30:16..get him sorted.
30:18Obviously, we're together all the time.
30:24Like, we're lost with each other.
30:26We hate each other, do you know what I mean?
30:28I don't know how to work with Mort and he don't know how to work washing machine,
30:31so...
30:33..we need one another.
30:3546 year this year.
30:37We're going to get married when I'm 18,
30:39but I end up getting pregnant, so...
30:42Me dad bought me a wedding dress and everything,
30:44and then he had to swap it for a pram.
30:46It means something, doesn't it?
30:49It's like sickness and health.
30:51You're there for someone, no matter what.
30:54You care for him.
30:55I'll care for him as long as I live.
30:58And he'll care for me as long as he lives.
31:04Hi, you OK?
31:05I've just come to say hello.
31:06I'm Nicola, one of the theatre nurses.
31:08We've been waiting for you for a few days.
31:10She's our boss.
31:11I've been waiting a few days.
31:12I know.
31:13Thinking nothing about operations.
31:14Starved.
31:15My blood pressure's just gone up a little touch.
31:17That's cos I'm...
31:18A bit nervous.
31:19You've got very good people.
31:22You'll be OK.
31:24Good.
31:25You've come to the best place now.
31:26Just make sure I wake up.
31:28You will wake up.
31:30Stop it, you will.
31:32Following surgery on his neck yesterday, Tanzeem needs a CT scan to find the missing needle.
31:49But he's more concerned with the underlying pains in his abdomen, which he spent the last
31:54two years trying to get diagnosed.
31:57Around about this time last year, I just drastically started losing weight.
32:01Lost three stones in space over three or four months.
32:08The pain just started getting worse and worse day by day.
32:12At that point, I had to leave my job.
32:16I had to leave all my daily activities.
32:19I just...
32:20I just could not function.
32:22Obviously, this has had a toll on my mental health, where I'm restless, I'm irritable.
32:28But I honestly have come to a point where I really, really...
32:34I really feel like giving up.
32:37And that is...
32:39That is not a quality of life that I wish on anyone.
32:45It's a complex operation, so we don't know what's going on inside until we will get in and find out.
33:01Kevin is finally on the operating table after a four-day wait.
33:06The surgeon suspects his colon is perforated and needs repairing.
33:11Kevin is in a late stage of advanced disease because he has septicemia.
33:18If we don't do any surgery, then things will get worse and worse and become more septic.
33:26There are two types of doing this kind of surgery.
33:30One of them is keyhole surgery.
33:32But we felt that the best way here to deal with this one is with the big cut,
33:38because he had a large abscess inside the tummy.
33:41I've just been into the 86 for an update.
33:45They're expecting Kevin's surgery to take at least four to five hours,
33:51so he'll probably be in there till 5pm.
33:53Luckily, we have got the use of theatre four this afternoon,
33:57so we're going to let Jordan go into there.
34:01So we'll have two emergency lifts running.
34:03That's good. That's excellent patient service.
34:12You know, the bowels get perforated due to the bad disease.
34:18What would happen if he was left untreated?
34:21He might, you know, lose his life if you don't treat it properly.
34:25Kevin has now been on the operating table for just over two hours.
34:30So these are the disease part.
34:32This is the perforation there, fingers there,
34:35and this is another perforation there,
34:37and there's where is the abscess here.
34:39So we're going to chop this there, and then chop the other part there.
34:43And the best way to give this guy a better life is to have a storm.
34:49So he's been down there for a few hours.
34:58It's a bit worrying.
35:01In fact, he should have been back by the night.
35:04He said around about 4 o'clock.
35:06I'm just thinking how it's going to affect him in the long run,
35:11you know, mentally,
35:13because he does suffer from depression and anxiety,
35:16and it's stressful, worrying, and just don't know the outcome.
35:20I don't know. All sorts go through your head.
35:23I can't...
35:29Is he all right? He's fine. Yeah, he's awake, he's alert.
35:44He's come to and everything, yeah.
35:46He still feels a bit groggy from the anaesthetic,
35:48which is completely normal. Yeah.
35:50But he's chatting to us. Oh, God.
35:52Oh, God.
35:55So, just behind this case. Oh.
35:58I'm OK.
36:00Yeah, you? Yeah.
36:02Oh, I'm glad you had it done.
36:08Oh, bless.
36:10How do you feel?
36:12Alive.
36:14You're lucky.
36:16Are you in pain?
36:18No. No, I'm in pain, no.
36:20Oh, God.
36:21Oh, God.
36:22Just...
36:23Dry mouth.
36:24Dry mouth.
36:25But I'm just glad you're back. It's been, oh...
36:27A worry.
36:31I know.
36:33I know.
36:34It has been a worry for me at all.
36:36It's over and done.
36:37It's over and done, Wayne.
36:38I just have to get you up.
36:40Get you right.
36:42Get you better.
36:43Mm-hmm.
36:44Do you realise if your tears grow on me, could you affect me?
36:49Yeah.
36:50What you like.
36:51What you like.
36:52What you like.
36:53What you like.
36:54What you like.
36:56What you like.
37:10As-salamu alaykum.
37:12How are you?
37:14I'm all right, Anastabha.
37:15Good to see you. As-salamu alaykum.
37:16As-salamu alaykum. How are you doing?
37:19Getting there slowly. Slowly.
37:21You're probably one of our fortunate patients
37:23because, you know, within
37:24two days of your admission
37:26you've managed to get yourself
37:28into the theatre.
37:30Sufyan is back on the ward recovering
37:32from his surgery. The hospital
37:34imam has come to offer support.
37:37I'm sure the fact that you couldn't
37:39fulfil your religious obligations
37:40sometimes that affects you mentally
37:43and psychologically, I guess.
37:45It affects me a heck of a lot.
37:46Sometimes I think to myself it's a test
37:48and, you know, everybody gets tested.
37:51It's a test of your faith.
37:52But then, at the same time, sometimes I think
37:53maybe I've done something.
37:54Mm-hmm.
37:55Yeah.
37:55The thing is that I've been knocked down
37:57quite a lot all over my life.
37:58I don't mind picking myself up.
38:00But this, the pain,
38:03the aches, telling yourself
38:06it's going to get better,
38:07it gets hard some days.
38:10That's all it is.
38:11Mm-hmm.
38:11Depression is just like any other illness.
38:15The fact that we have to be brave enough
38:17to then seek the treatment for it.
38:18And the bottom line is,
38:20it's not your fault.
38:21And God knows that.
38:23And so if you put Allah and your Lord
38:26in the driving seat of your life's journey,
38:29you can't go wrong.
38:30Yeah, you just follow He leads.
38:32Just follow He leads.
38:33I like that.
38:35I do like that.
38:38Sufjan is not the only one
38:40who has been struggling with his mental health.
38:43Kidney stones, does it kind of get you down?
38:46Yeah.
38:46The fact that I've done everything that I can to...
38:50That the doctors have always said
38:52through the years to change diet,
38:55try this, try that.
38:57It's just you...
38:58I've tried it, and...
39:00Here I am again.
39:02I bottle it up,
39:04so it always seems overwhelming.
39:08Five years ago,
39:09Jordan was so low,
39:11he thought about ending his own life.
39:13I just got to a point where I thought,
39:16what's the point?
39:17I put a status out on Facebook,
39:23going, like, listing everything that's going on,
39:27and basically just, like,
39:30effectively saying my goodbyes to everyone.
39:33I put,
39:34this is to all my family and friends.
39:37I'm just not strong enough to do this anymore.
39:40I'm sorry to everyone I've ever hurt,
39:43being around or not being there for when you needed me.
39:47And I'm sorry for being a failure.
39:48I've failed as a son,
39:53I've failed as a brother,
39:55and I've failed as a friend,
39:56but my time has come to an end.
40:01I've failed so many times that I can fail no more.
40:04I love you all more than you'll ever know.
40:09It's not worth it anymore,
40:11and I'm sorry.
40:14And I got 38 comments on that.
40:16People that I'd not spoke to for years,
40:21just randomly popping up and telling me they love me.
40:24If I think that I didn't put that status out,
40:27I don't think I'd be here now.
40:28I'm very thankful that I'm still here to be born.
40:36It's okay to start?
40:37It's okay to start.
40:39Since COVID, things have changed.
40:43Lots of mental health issues at the moment.
40:45Maybe just some from isolation.
40:48Some people as well who we're seeing
40:50haven't got back into the run of the world
40:53since the pandemic.
40:56They're not seeing people.
40:58They're not looking after themselves.
41:00It's a tough time at the moment.
41:03Okay, yeah, done.
41:09How long are you in here now for?
41:1527 and a half hours, not that I'm counting.
41:19Yeah.
41:20Honestly, it's next level, this toast.
41:22I've never appreciated toast
41:24as much as I've appreciated it tonight.
41:27It's only when you don't have it
41:28you realise what it is.
41:30It's mad.
41:33It's something like that.
41:34When I had one of them earlier,
41:37it was the first thing I had when I came round.
41:39And it was best tasting chocolate cake I've ever had.
41:43And I was just like, oh.
41:45And give me another one.
41:47I got another one.
41:48Did you?
41:50I know last time I were here,
41:51we had kidney stone.
41:53I think I had like two or three days
41:55where I had no visitors
41:56and everybody else were getting visitors.
41:58And I was just sat there like, wow.
42:02It's pretty boring in hospital, isn't it?
42:04And then you just sat there and you're like
42:06involving yourself in other people's conversations
42:09just to have a conversation and stuff.
42:11No, it does make it better,
42:12you know, having people on the board
42:13because even the other gent that we're here
42:15is good, you know,
42:16when you can chat to people.
42:17Yeah.
42:18Yeah, because it does get lonely, isn't it?
42:20Yeah, it passes the time as well, isn't it?
42:21Yeah.
42:22You just sat there like,
42:24and share experiences.
42:25Yeah, exactly, isn't it?
42:27It's like, you're in for a different reason
42:30to why I'm in
42:30and we're just like,
42:31oh, how was your pain today?
42:33Yeah.
42:33And you're just like,
42:35crap, isn't it?
42:45Hello, it's Royal Bateman Hospital.
42:53When are you hoping to get out?
42:55Before him.
42:55Let's talk about you ordering your Christmas dinner,
43:00never mind going and getting out.
43:01Listen to him talking,
43:03he's not going to have to do it yet.
43:05I'm doing fine.
43:07I can ween out.
43:08And I woke up this morning with a lovely surprise.
43:12A piece of poo in my bag.
43:14It was very small,
43:15but it made me smile.
43:1668 and he's laughing at a piece of poo.
43:2268?
43:23He's put three hair on.
43:27How are you feeling?
43:28Rough.
43:29Rough.
43:30You ready to go home?
43:32After successful surgeries,
43:34both Jordan and Sufiam can finally go home.
43:38See you later, boss man.
43:39See you later, buddy.
43:42See you later, boss.
43:42See you later, son.
43:43All the best.
43:44All the best.
43:45All the best.
43:45Enjoy.
43:45How are you feeling about going home?
43:55I'm not happy.
43:56No?
43:57No, they didn't do a proper treatment on me at all.
44:00Tanzim has left without being formally discharged.
44:04I came in with the stomach issue.
44:06Can we just take your hand over out?
44:08I'll pull it out myself.
44:09No, we need to take it out here.
44:11He's going to come and take it out.
44:13Pardon?
44:14He's going to come and take it out.
44:15I can't let you go with that needle in.
44:17I forgot about that, you know.
44:19I didn't.
44:20Good job, I didn't.
44:22Right.
44:22Go on.
44:23All right.
44:24Take it easy, man.
44:25Come back, all right?
44:26Yeah.
44:27What are you going to do now about your stomach?
44:30I'll have to go private somewhere.
44:34Yeah, no choices then.
44:35Tanzeem will have to return to have the third needle removed and for further investigations
44:43into his abdominal pain.
44:46This is a problem I came with.
44:47I'm going back home with that, do you know what I mean?
44:49So, yeah, basically, I've lost all my hope and faith with the NHS, to be honest with you.
44:58It's just worth the time.
45:00It's just, you know, I'm not happy at all.
45:04Afternoon, Kevin.
45:13I'm Jodie.
45:14I'm one of the stoner nurses.
45:15Bobby as well.
45:15OK.
45:17It's nearly a week since Kevin arrived in hospital.
45:20He won't be discharged until he and Bobby know how to change his colostomy bag.
45:25Because it's a colostomy, diet is normal, can eat and drink whatever really you ate before.
45:31Curry's in that, all right.
45:32Curry's now a problem.
45:33You might find you might get a bit more wind.
45:36Yeah, obviously.
45:37Yeah.
45:38That's his party trick now.
45:40Well, as I say, you've got your own balloon, haven't you?
45:43Until grandkids see him.
45:46So, yeah, because the closed bags, all you do is ease the bag.
45:50The skin away from the bag.
45:51The skin away from the bag, yeah.
45:52You mentioned that, didn't you?
45:53Yeah.
45:54Close that up.
45:56Stick it in your bag.
45:57Yeah.
45:58OK.
45:59And then all you've got to do is flip that over and seal around.
46:04Oh.
46:05And the good thing is we don't have to wait to get the toilet now, do we?
46:08No.
46:10Oh.
46:10I can sit there watching your Skysport turn up bag.
46:16If we didn't have the emergency list, the hospital would be full of very sick patients.
46:20And there wouldn't be any room for anybody else to come in.
46:24We want our patients to be operated on.
46:27We want them to be fixed and to go home before they become more unwell and ready for the next
46:33patient coming in.
46:34We've got more patients coming in than we've got going out.
46:40The list never ends.
46:41Hi, bleep in emergency bleep.
46:43We're doing all what's so great.
46:57Thanks for listening.