Wife Donates Organ To Save Husband s Life UK Hospital Documentary Full Episode

This is Ming Theatre Admissions. Imperial College Healthcare NHS Trust performs over 500 operations across 19 different surgical specialities every week. I've got probably about 12 hours worth of operating on this system. At least. Sixteen. Yeah. How's your morning been? Er, pretty stressful. The big case that I was supposed to be doing this afternoon we've had to move and cancel because of this trauma patient that we've got to get done. Hip and Pelvic Specialist Angus Lewis works across two of the Trust's five hospitals. There is only two pelvic surgeons here and one of those is away on annual leave at the moment so it's just me. We are a bit stretched. So you need more surgeons? I'm doing another ten. We're not going to get that. I've finished here at Charing Cross so I'm coming over. So hopefully by then the theatre's ready and we can crack on. I'll see you over there. Alright, bye. Today, Angus is needed in St Mary's, five miles away to operate on a man with a shattered pelvis. We are constantly battling with elective service and the trauma service and our trauma service is getting busier and busier by the year. So hopefully timing-wise the operating theatre at St Mary's is going to be vacant by the time I get there on a motorcycle. It's a bit of a rush but it's just the way it is at the moment and we're just going to have to get our skates on. It was a rough night. It's very painful at the moment. Angus' patient is 52-year-old hairdresser Reno. At the moment what they're trying to do is to keep the ball of my leg out from the socket as far as it can by putting the weights at the bottom because they say if it goes up it can cause more damage. I cannot move at all, just my toes I can move a little bit as far as it goes. Reno fractured his pelvis in a motorcycle accident. He's been waiting four days for an operation to repair it. The way the doctor explained to me that the whole socket is shattered. It's about seven or eight pieces and I'm actually sitting on it. Give me some other medication. Every five minutes I get a 15ml, it's like a morphine. Do you want us to get a nurse? There's nothing they can do. I just can't find the right sweet angle. To make time for Reno's surgery, Angus has cancelled another patient's pre-planned hip operation. This is a very bad injury. The socket of his left hip joint is in quite a lot of pieces which need to be put back and it's therefore going to take quite a long operation. Four to five hours and it's not a fracture we can leave. The longer you leave it, the more difficult it is to fix it. I don't really want to wait any longer with this gentleman. The problem we've got is the case that was meant to finish hasn't finished yet. They won't let us start now at three o'clock. Right, and then tomorrow we've only got half a list. We will talk about it when I've calmed down. It's none of your fault. It's not your fault, I'm just pissed off because I've now got to find another slot for this guy. The consultant who was doing this operation, you know, was trying to get me into theatre on time and unfortunately we failed. And it's just, you do all these things to try and get these things slotted in, a lot of which is out of your control. You do what you can and then it all just goes to pot. And that's where we are at the moment. OK, I'm going to have to go and tell him. I don't know, can you, if you speak to Ian and just say, look, there's another two hours left on this list, if we can get something done. We've now pushed aside an elective case which, when you look back on hindsight, you wish you hadn't. And then you end up doing nothing. I hate doing this. It doesn't get any easier. Hello. Well, I was better. I am going to tell you that, Ian. I know. And I know the disappointment you're going to have. I have just tried to shift mountains today to try and get you done and I've failed. I'm sorry. The case that was in that theatre has gone on longer than the surgeon expected, which is not his fault either. But it has run-on effects on what we need to do. And I'm really sorry. It's very frustrating. Now, Friday is the next slot. I have you top of the list. I'm not having this again. All right. I'm sorry. OK. I'll be in touch. Reno is one of more than 300 patients at St Mary's who've had their orthopaedic surgery delayed in the past year. It would be frustrating. And I don't feel for the doctor because he was more frustrated than me. Or the surgeon. They've got their hands tied up. It's not their fault. It's really the system. It's not their fault. Friday now. Because I've got two more days of just pain. Good morning, everyone. So St Mary's went out on red this morning. It's the job of site director Lesley Powells and her team to make sure there's enough beds at St Mary's for its patients. Unplaced electives. This is a little bit of a moveable feast this morning. We're on hold at the moment for anything except for day cases and inpatients in the correct beds. An elective patient is a planned patient. So it's a patient who knows they're coming into hospital for surgery. The first thing that happens when we have bed pressures is we review our electives. And what we tend to do is prioritise then our urgent electives, so our electives who need cancer surgery, and patients who've been waiting considerable lengths of time. So this morning we have got only two beds in the hospital. So all electives. So she's about to ring theatres. They're going to go on hold for the time being. I'm trying to be helpful, but I have a feeling they probably will be cancelled. One of the surgeons hoping to operate today is gastric bypass specialist, consultant Mr Ahmed Ahmed. Rona, hi, how are you? Do you know what the bed status is? I've spoken to Fendi and I've explained to her that we need two beds for the bypasses. Yeah. And you're telling me that at the moment we have one bed? I don't have any bed at the moment. 41-year-old Daniel is one of five patients today on Mr Ahmed's list. There's a little bit of me in the back of my mind which is anxious, but fingers crossed we've got a bed and we can get this done. I don't think I can go through another being sent away and having to wait for another appointment again. Daniel has been waiting a year and a half for his weight loss surgery. I am 27 stone and I have a BMI of just short of 50. Family history has not been great, so all our parents are no longer with us. So they've all passed away through one ill health or another. So if I can sort of increase my chances of a longer life and a healthier life, it's got to be good. I don't want to be another statistic where my girls are growing up without their dads. I don't want them to be saying goodbye to me at 45. Daniel's surgery is scheduled to take place in St Mary's £10m Surgical Innovation Centre. It has its own dedicated weight loss operating theatre and oversized beds for clinically obese patients. Hi Mandy, how are you? When St Mary's is close to capacity, the weight loss beds are regularly redeployed to higher priority patients from across the hospital. Where does bariatric surgery kind of sit in the pecking order at St Mary's in terms of who gets cancelled? Well, unfortunately it's low down on the priority list. It's often our patients that get cancelled because there's a lack of beds. The beds will first go to patients that are coming in through accident and emergency and then lastly it will be elective surgery like bariatric surgery and other specialties as well. I don't want to say that mine is the only one that's suffering this problem. Any kind of elective non-cancer surgery gets hit. When the centre opened in 2012, Mr Ahmed and his team performed 750 operations. Last year, they completed just 150. If you look at the number of patients who meet our national NHS criteria for bariatric surgery, we should be doing about 1.5 million operations a year in this whole country. But I can tell you last year we probably only did about 9,000. The last time it got cancelled was one of the most difficult days that I've had in quite a long time. We have this endless number of patients that's building up that don't get their surgery because there's actually no beds in the hospital. That is our 82nd complaint from a lady patient of ours. I was referred for bariatric surgery at St Mary's in April 2015. On calling the team at Mary's, I was informed I would only possibly get a date February next year, 2017, putting aside the growing desperation to get my surgery done and the stresses this is causing. This is influencing my ability to make decisions on my career because I'm in limbo. This journey has taken the better part of four years. Can you please help? The waiting list for bariatric surgery is one of the longest in the trust. I think generally there's a feeling that we're victimising them and not giving them... we're withholding surgery. What I try to get across is that it's not personal, but that there is... I think there is a stigmatisation against obesity and that that's part of the problem, that we're not prioritising this operation. Because in general there's a perception that obesity is not as big a problem or somehow a lifestyle problem that people have caused themselves. It's sad to say, but we get a fair amount of complaints and there is a common theme, which is basically that people who struggle with this disease have to wait so long to get treatment. How many patients do we have tomorrow coming for surgery? There's four. All right. So they're 28-day cancellations? Fourth time coming in. Fourth time? Yes, the other two are third time coming in. Third time coming in. So it's two three-day, three-time cancellations and a fourth-time cancellation. So that's ten cancellations on the list tomorrow already happened previously. Unbelievable. All right. If Daniel's operation goes ahead today, he'll need to recover for two days afterwards on the ward. We're going to just pop over to the Linda Wing, which is the private unit of St Mary's Hospital. With no beds available, Mr Ahmed has a plan to ensure Daniel's operation can happen. We were able to have a negotiation which has allowed the NHS part of our hospital to buy two beds for after surgery for two of my patients. The Linda Wing is a 39-bed private hospital owned and operated by Imperial Trust. Profits from the Lindo are reinvested into the Trust and used to support its NHS services. It's one of the primary private units in London. So, I mean, it's very popular. I mean, you obviously remember, you know, Prince George and Princess Charlotte were born here not so long ago. So, yeah, it's very important. Hello. Oh, there she is. Are you going to take two of my patients today? Yes, I am. We're ready for you. All right, perfect. The Lindo can accommodate Mr Ahmed's NHS patients today because it's not currently full of private clients. The costs of nursing them in the private Lindo during their recovery from surgery will be borne by Mr Ahmed's NHS bariatrics budget. The alternative, which is not to use these private beds, would be for us not to do any surgery, and that would be a complete waste of money because it costs the NHS, I think, roughly about £20 a minute to run an operating room. So you can imagine with all the team and the staff that's there, and if we don't operate, that's costing a lot of money and a lot of wastage. So at least by paying a little bit and getting these extra beds so that these two of our cases don't get cancelled, you know, I think that's a great idea. What have you got elective-wise, Linda? Oh, we've got nine for surgery. We use the Lindo wing beds when they have free capacity, but what that means is when we do that, we in effect stop Lindo being able to use those beds for a paying private patient. The Lindo wing is part of Imperial, and the money that the Lindo bring in, we use to fund NHS work. For me, if we've got an empty bed anywhere on this site, I will make sure that we use it, because it's really important to get our patients treated, irrespective of how the money for that bed comes in. Which two of these beds can I have? Colorectal surgeon George Rees is also scheduled to operate this morning. Hi, morning. So there's two patients on my list today, two ladies, who should have been booked for HDU, I think. Are you likely to have any discharges? Do you know? They haven't done the round yet, but... OK, we'll wait. Before he can start, Mr Rees needs to find an HDU, or high-dependency unit bed, for his patient, 84-year-old Betty. Were you up very early? Yes. Crack of doom! Betty was diagnosed with bowel cancer a month ago. She is accompanied by her two sons. I think the worst thing is not hearing the news yourself, but telling your relatives and those close to you. I can't quite believe that I've actually got it. It doesn't seem possible. I don't know, you expect to have some feeling that there's that beast in you, but apart from having an occasional pain, there's nothing extraordinary about it. Quite tough? Are you quite brave? No, no, I'm a registered coward! But pull the plug if I'm going to be... Yeah, as long as they're not filming, I'll do that, yeah. Yeah. OK. They're going to come and talk to you, apparently. They will shortly, but I think we've got a slight blockage in the management system. We're going to do a day case whilst we find out if we're going to be allowed to do any operating at all today, because the bed situation is worse than we had first thought, and we may not even get a bed for our cancer case, apparently. Any help in negotiating a bed would be appreciated. I'm texting our divisional manager, and I'm also going to send the same message to his boss, just really for some leverage. Everyone's doing what they can, but I don't like being in the dark, because things were so bad for such a long time that all of the previous ways we had of negotiating beds have been exhausted, and there isn't a way any more. The site manager says there's a bed, there's a bed, or they don't, and then there isn't. OK. Daniel, good to see you. How are you? Welcome back to the hospital for attempt number two. At the moment in our hospital, we're having a huge problem with beds on the NHS side. So, in fact, we don't have any beds for you, but I have got a bed for you in the private side. So you're going to be looked after after the surgery, not in this building, but the one across the street, which is the private building for private patients, and we've actually done a deal, so we basically brought a bed for you there so your operation doesn't get cancelled. You'll have your own private room and your ensuite bathroom, so it's a bit more luxurious. Daniel's obesity has led to type 2 diabetes, sleep apnea and high blood pressure. And the amazing thing that we will hopefully see, and we see that in 80% of cases, is your diabetes will begin to melt away within hours of the operation. So all these drugs you're on at the moment, hopefully we'll be able to switch them all off one after the other. If you take Daniel's case, poor guy's suffering from diabetes on five different drugs. How much money does that cost the NHS? I would say just tablet treatment for diabetes would probably be costing the NHS close to £8,000, £9,000 a year every year for the rest of his life. So people who have diabetes will get heart disease, they'll get strokes, they'll get problems with their eyes, they'll get amputations, they'll get kidney damage. And I'm not even costing in the cost of treating those health problems from diabetes. So one operation that's going to cost the NHS close to £6,000 will in fact pay for itself within a year or two. All right, great, see you in a bit. Oh, I'm sorry it's such a long time. I thought you'd be going... Betty needs a post-operative high-dependency bed, which is still not available. There is one potential short-term solution. We can do the cancer if we're prepared for her to stay in recovery. I understand, although I've got permission to send, she's going to have to spend, you know, probably at least a couple of days in recovery. Of all the ladies I've had for these cancers, this is really not a good person to leave in recovery indefinitely. Recovery is a 12-bay holding area adjacent to the main operating theatres. It's designed for patients to wake up from their anaesthetic before being moved and cared for on the appropriate ward. What it means is that because our recovery isn't set up as a ward, it is supposed to be somewhere that people spend no more than four hours, there are not the normal facilities you need to get people up and going after an operation, and it's not staffed to nurse unwell post-operative patients for long periods of time. We know that there are some operations where we just really struggle to be able to postpone it. And we look for what's the next best option. And often the next best option for that patient is recovery. A last resort is cancelling. It's the next best option. Hi. Sorry to disturb you. Thank you. And everyone said that I'm allowed to do the cancer case and she can stay here and stuff, but I'm just not totally sure if she's the right person to stay here. She's 84, she's quite frail, and it might not be the nicest or safest place for her to recover for more than a minimum period of time. How are we staffed if we do decide to do this now? So today the only patient I know that is going to stay overnight... Yeah, would be her. If you're well-staffed and she'll be the only one, then that should be OK. OK, thank you. We'll go ahead with Betty's operation after only three and a half hours of wrangling. So we're going to send for Betty. We're going to send for Betty Wu. Oh, thank you. Bye for now. Thank you. I think you've witnessed a lot of the frustration we've had this morning, trying to do operations and being told, no, you can't start in case there's no bed later, and then after hours of not doing anything, they find a bed. Bowel cancer is the fourth most common cancer in the UK, with over 100 new diagnoses each day. Bowel cancer is curable, and if people report symptoms to their doctors early, then they have better results. Until we've got the final pathology, I can never say never, but I would imagine that we would consider it definitive treatment. Betty will stay in recovery until an HDU bed becomes available. After 18 months of waiting, Daniel is having his gastric bypass surgery. It's only going ahead because the Trust's private Lindo wing is providing him with a bed. This is the first time we've done this. Is it a long-term solution? I don't know. That's something we'll have to ask our managers. How long can they carry on funding these private beds? It's hard to know. But it's one way to get through the work and make sure our patients get the surgery they need so much. Mr Ahmed will use keyhole surgery to reduce the size of Daniel's stomach by 80%. So this is the size of his new stomach, his neo-stomach, and we're joining on the lower bowel. So this is the small intestine being pulled up, so his initial weight loss will come all internally. All this fat that we see here will melt away in the next few weeks. It'll start to go very, very quickly for him. The surgery, it returns life expectancy back to normal. It reduces the risk of getting cancer by about 40%. People who were previously perhaps not working on unemployment benefit will hopefully, after losing weight and getting their health back, will go back to work. So I can't think of any other surgery that's as beneficial both to the individual and to society. Daniel's operation is completed. He'll spend two nights recovering in St Mary's private Lindo wing. Ah, there she is. Not quite what I expected would have came up. They're just waiting for a bed in the high dependency. She's always been the one that looks after us rather than anyone else looking after her. You can go back to sleep if you can. After seven hours in recovery, a bed becomes available for Betty in the high dependency unit. It's Leslie at St Mary's. Have we got Hammersmith? Yeah. Renal are you on the line? Yeah, no problem. We have two beds. Marvellous. Three miles west of St Mary's is the Trust's renal unit at Hammersmith Hospital. Renal will work really hard to ensure that there is a bed if they have something like a transplant coming up. And they're protected because what they do is very, very special. Surgeons here are specialists in live kidney transplants where organs are harvested from healthy donors. You are seeing the best of the best. It's kind of the jewel in Imperial's crown, really. Can we do a group hug? So, busy day today. We have... Head of transplantation, Frank Door, conducts around 35 live donations a year. People are still not aware that they can save a life by donating a kidney. It is one of the most beautiful things to do. As you will see, it's just lovely to do an operation knowing that people will actually get a second life and knowing that the donor will do well as well. So let's concentrate on the live donor first and everything else according to the protocol. Hi, how are you? Yeah, all right. Good. 31-year-old Jen, a mother of two, is donating one of her kidneys to save her husband's life. In my mind, it's very black and white to give my kidney away. For me, it's not a selfless thing that I'm doing. We are ready. My husband gets his life back. My kids get their father back. Jen's husband, Elliot, has a rare autoimmune disease which has left him with just 5% kidney function. I had kidney failure and I had to go straight on to dialysis. He is kept alive by regular four-hour dialysis sessions. The last eight months have been pretty tough, not being able to work full-time and going to dialysis three times a week. We've got a young family and we've got kids and we explained to them that everybody has two kidneys and both of Daddy's kidneys weren't working and that he needed a new one. At Imperial, without a live donor, kidney patients typically wait three to five years for an organ to become available from the deceased donor list. There's great studies that show that overall 50% of dialysis patients don't survive five years. So this is very serious and a kidney transplant can prolong life with decades. Forget about the whole circus and focus on each other and we will take care of the rest. OK, excellent. See you around. See you later. Bye-bye. I knew I wanted to be a donor. There was never a second of doubt in my mind that this is something I wanted to do. We're both going to have an operation on the same day so it's quite nice to go through that together, I think. They're a very close, tight little unit and they're there for each other. It's not like Elliot would have said to her, will you do this for me? It was just right away, I will give you my kidney, as anyone that you love would do. Where's my dad? OK, I love you. Have a good flight home. Bye, Dad. Be good. I'll see you when you're awake. Love you. You know, this is about him and this is saving his life. I love you. Good luck, OK? His operation means a lot more to me than my operation because his has to be OK, it has to work. He needs that kidney to work. Jennifer, what operation are we doing? Kidney transplant. So what operation are you having? Donor nephrectomy. Can I just make the famous arrow so that you're still awake and still remember that we're going to take your left kidney out? As soon as Frank Doar harvests Jen's kidney, an intricate chain of events will be set in motion. I was unable to donor directly to him as I wasn't a blood type match. When I found out, that was devastating. Jen's blood type means she can't donate directly to Elliot, so the couple are taking part in a pioneering kidney sharing scheme. Jen will donate to someone else in the UK and Elliot actually gets a kidney from somewhere else in the UK. She ensures he gets a kidney transplant. Four times a year, a group of specialist renal centres, including Hammersmith, unites in a kidney swap initiative called Paired and Pooled. So I'll be coordinating for the day with my other colleagues in the other centres, making sure everything is OK with our donor-recipient pair, and we're happy to proceed, and everything has to happen at the same time, basically putting the patient to sleep at the same time and the operation starting at the same time. And that's no problem, so we communicate constantly for the day, hoping that everything goes smoothly, there's no last-minute cock-ups, one mistake can screw up or mess up the whole thing. All the pre-transplant work is anonymous. For now, no-one knows to whom he is donating and from whom she is receiving. You know, to help improve someone else's life, it's really important, having been through and seen how Elliot suffers. No-one should be suffering like that. For Jen to be able to do that for a complete stranger is, you know, it's admirable. OK, so are you happy for us to put our donor to sleep? Thank you. Bye. So it's a yes? Yes. Great. I'll get started. Good news! We can start! Oh, my God! Jennifer, squeeze my hand, I don't mind. He's really strong. It makes you feel a little bit black-headed. We'll do some heart-arm wrestling. How's it going? Are you OK? Do you know which room my patient's in? Weight-loss patient Daniel is recovering from yesterday's operation to reduce the size of his stomach. Right, there he is. How are you? I'm great, thank you. Good to see you. How about the drinks? Are they going down OK? I've had a small mouthful, and I think on one occasion it actually felt like it was too much. So this feeling of fullness you're getting, that's part of a consequence of the surgery we did. When was the last meal you ate before the surgery? Was it on Sunday night? It was Sunday night, and it was around... finished about 6.30. Do you feel hungry today? Not particularly. Isn't that amazing? We went through all of Sunday night, all of Monday yesterday, and then nothing to eat. And then until now, all you've been having is a bit of water, a bit of soup. So for most of us, we'd be famished right now. But the amazing thing is that you don't feel hungry. And that's the effects of the surgery. OK? Definitely. Thank you. Take care. Bye-bye. This is the newest way forward for bowel-reaction surgery. What, bring them in the private sector? Actually, I didn't ask Daniel what he thought of the ward, but he seems pretty happy. We'll see. At the moment, we have no beds on the NHS, and this is one practical solution so that, you know, my surgeons can do their work and we don't get any minimiser cancellations. So this is a nice anatomy lesson, guys, for the students. And, of course, what you see here is a bit magnified. Transplant surgeon Frank Door is about to remove Jen's healthy kidney as part of a unique kidney swap scheme. Can we zoom in there, Sam? This is the kidney, still covered, but you can see the shape of a kidney bean. That's why it's a kidney bean. And it's a beautiful, beautiful kidney that we see. And, of course, it makes it beautiful because we know that it's going to save Elliot's life. So I'm just going to expose the kidney. It's an operation with finesse. And that's what's necessary. There is a small risk. There is no operation without any risk. The risk of dying is about... is reported to be 1 in 3,000. If something goes wrong, obviously, and I can't stress it enough, this is a person that doesn't need this operation, and basically we only can do things wrong because she's perfect now, in good health. I'm going to make a few small incisions in her that's going to change her body forever. And, of course, she's taking some risks by having a vital organ removed. So the kidney is almost free. Is the stapler ready? Shh, shh, shh, please. Just let me think a second. The staplers did not fire. We have a thing there. Can we please all be quiet? Sam, if you hold this. Okay, another stapler. Now scissors. Just cut it. Okay, kidney back. Nothing wrong with the kidney, and nothing wrong with Jen, which is, of course, most important. Okay. It's like delivering a newborn baby. That's how I see it. This kidney's coming out, and we look at it and think, wow, this is so brilliant. Science has evolved, and eventually this is going to save someone's life and give them a good quality of life. So it's all exciting now. Okay, lights on. It's a beautiful kidney, and, you know, it's going to change someone's life in another centre. So that is a good feeling. Jen's healthy kidney is one of many that have been harvested simultaneously across the country. As hers is couriered to its recipient, her husband Elliot's new kidney should now be on its way to Hammersmith. Jen, you've only got a minute. I'm so proud of her as a mother. I just think what she's doing is just incredible. You know, you couldn't ask for a bigger show of love, could you, to somebody? Stay asleep. You've just saved someone's life. So it's gone to a very good place. Bye. Love you. Nearly there. One down, one to go. Go back to sleep. Rest. What's it like to see, honey, your daughter-in-law giving away a kidney for your son? It's going to cost him a lot of Chanel handbags, for sure. Your eyelashes look good. Two people, two members of your closest family to be operated on the same day is just really, really tough. All yours. Thank you. Elliot's new kidney arrives from its anonymous donor. If the transplant is a success, he will be able to come off dialysis immediately. Please God, if the kidney works, then it'll be a new life for him. See you. Thank you. You can't really plan, you know, 5, 10, 15 years in advance. You just have to take this one and live a completely normal life and hope it lasts a long time. Elliot's operation will be performed by Imperial's head of renal surgery, Vasilios Papalois. The kidney looks beautiful, actually. It's very nicely procured. The anatomical structures have been protected, so this is a very good start. The clock is ticking, and we cannot wait, we cannot simply wait. It's an amazing feeling, I mean, to be able to help people that are in this very difficult situation, and especially the living donor operation is absolutely amazing, actually, because not the life of an individual, but the life of the whole family changes dramatically. But it's equally important to remember that a kidney transplant adds years of life, as well. So we are basically ready to start. As you can see, the kidney is gray because all the blood has been flushed out and has been replaced by a very expensive preservation solution. But it's a nice and healthy kidney. You put your hand in here to protect the kidney. Here. It must not go on the floor. Quite soon we're going to be coming up to a fairly crucial part of the operation, is when we take off the clamps on the vessels which supply the transplanted kidney, and the transplanted kidney will fill up with blood. It's a miracle, and it's happening in front of your eyes, and it's something that was practically dead, an organ in an icebox without blood, and it's coming back to life. You can see the ureter start making urine. See that? It's urine. It's already working. That's the transplant section. It looks good, actually. Nice and pink, and both arteries are buzzing, which is excellent news. Thank God it went very well. Very pleased. All I thought about is what it's going to be like, you know, spending time with the kids normally and being able to go swimming and all those things that you take for granted. Elliot will be monitored closely over the next few days to make sure his body doesn't reject the donor kidney. It's a lovely morning today, the operation day. I feel much better. The good night rest. This young lady here is my beloved wife, Marina. Without her, I don't think I would be where I am now. It is quite extensive damage that he's done to his pelvis, and it'll be a while before he's better. I'm sure he thought he was going to be up and about in a couple of weeks, and going back to his dancing and to his CrossFit and standing up ten hours a day at work, and I think this surgeon kind of made him realise that actually he won't be doing a lot of that stuff for maybe a year. The problem will be probably when I get him home, but then hopefully his mother will come and she'll look after him at home, and then I'll just be out of the house working all day. See you later. Thank you. Two days after the operation to repair his shattered pelvis was postponed, Reno is finally called to theatre. I've rearranged a few things today so I can come over here. So the main thing is he's getting done. This is a very bad injury. You can see the number of fragments that we're now dealing with. There is one assistant who's pulling on the leg, which is actually one of the most important jobs. It helps the surgeon to hold the fracture in the position he wants it. Then, once we've worked out how it's all going to go back together again, the next stage of the operation is trying to hold it there with plates and screws. Can I have the screwdriver please? That's fantastic. That looks great. It's reconstituted his socket, which was just... I mean, it was just in pieces earlier. We're now going to close up and we're done. So, you know, this guy's got his operation completed. So, shall we go and see her? Good morning. Very nice to see you again. How are you feeling this morning? A bit ropey. Yes, I'm not surprised you feel a little bit ropey. Betty has spent the past three days recovering from her bowel cancer surgery on a high-dependency ward. It's very, very important to sit you out of bed and to get you out and get you moving and to get you breathing deeply. We'll keep a very close eye on you. All right, then. Bye-bye. She's obviously had her confidence hit a bit, which is perfectly natural, perfectly expected given the circumstances. So, I'm trying to build up that confidence and try and get into her head that she's going to be going home after the weekend because I think that's probably roughly when she'll be fit. We think it's going to be the middle of next week. It seemed pretty fast to us, but she's got a good support network so someone will always be with her once she does come home. I have to think that at my age you're really hanging on to bed space when perhaps two or three or even more people could be treated in that same time. I'm in a difficult position because I think perhaps I should be making way for younger people who've got longer lives and more things to fulfil. It seems a bit greedy of me. Good morning, Jen. Hi. Good morning. Sleeping in today? Elliot and his wife, Jen, are recovering well, following their respective kidney operations. People probably think you've done an amazing thing, I hope. I don't know about that, but just making sure Elle's OK. I was in contact with the transplant surgeon in the other centre yesterday. And even up to late in the evening we texted each other. Oh, good. So, yeah, he was very happy with your kidney. Good. And your kidney turned out to be a perfect match. Oh, my God. So this is a one-off event. Oh, I'm really happy to hear that. That's what I thought. Really happy. OK, good. She is not a patient. I normally don't call live donors a patient. She is healthy. She comes in. She feels a bit worse, of course, afterwards by having one kidney and having had an operation that she didn't need. The most important thing is that Jen can live with one kidney for the rest of her life. And we know that there is a slight increased risk for getting end-stage renal disease herself. However, if we do a thorough follow-up and act upon things that arise early, we may actually provide her a very safe and healthy life. Bye-bye, Jen. See you very soon. Last year, there were over 1,000 living kidney donations in the UK. Frank Doerr wants live donors like Jen to be able to go to the top of the transplant waiting list, should they themselves experience kidney failure in the future. So thanks to be able to present on an issue related to live kidney donation. This is more a general ethical issue or dilemma that I'm facing actually every day. He brings the issue to Imperial's Ethics Committee, consisting of staff volunteers and members of the public. It meets once a month to review and debate the moral and ethical implications of the Trust's work. None of these people are actually involved in my field of expertise and represent the broader public actually, rather than just me talking to my colleagues who might think more like me. First, I need to tell you that, of course, live kidney donation for the recipient, if you get a transplant from a live kidney donor, it gives the best outcome. And it is spectacular. If this would be cancer, it would be Nobel Prize winning, I'm sure. So I think our duty as people who take out kidneys for the benefit of others goes for the rest of their lives. And that's why I think we have some obligation at least to give them at least perhaps some priority even, if I think about it. I'm quite conflicted because I had a live kidney donor who's my brother and, of course, on a human level, I'd like to say, fantastic, if he suffers renal failure later in life, he should get preference because he's done such a wonderful thing. The truth is, we don't give priority to anybody but the reality is, if we are to give live donors a bonus number of points, how do you set that and who do you disadvantage? Even though I'd really want to see my brother have that priority, I'm really not sure that I can ethically morally justify it. I'm very mindful of your relationship with these live donors but I do take very seriously the idea of introducing value judgments and if you introduce value judgments, where does that stop? However admirable it is to donate a kidney, what you potentially describe sounds like an unequal two-tiered system. We do not treat people differently, whether they're a policeman, a fireman, a drug dealer, a child, it doesn't work like that. Everybody receives care equally and that's how the NHS has evolved and worked to function. I think every time you have an ethical discussion, especially in a broader group, it helps you enormously and at least you can bring these dilemmas that you're facing every day in your job to the table. No one is saying, oh you're doing it wrong or you have the wrong opinion because everyone is giving an opinion and there might be consensus but there might not be consensus so it's just giving me input and that's really great. I've never come down this way until the morning of the operation. Hi! How are you? I'm fine, how are you? Good to see you, you alright? I'm good, how are you? The day I came out of hospital it felt like the world had lifted off our shoulders instantly. So you look well but how do you feel? I feel well, I feel really good. Would you do it again? Yes I would. Unfortunately we can't right? No. Thank God for that. Do you need your dialysis? No, no dialysis. I can now have a shower, I can go swimming, I can do normal things again but having lived quite a restricted life for such a long time I feel like a new person now. It means so much to us that not only did you get fixed but someone else has got fixed as well. Happy? Very, very, very happy. Yeah it shows. Shall I see you around? Good man. Hi Betty, how are you? How are you feeling? Eleven days after her operation Betty is well enough to go home. We just wanted to chat about your results which we got back. Oh good. It's not as dramatic as it might feel at the moment, it's all good news. The general consensus is that you don't need any more treatment. It's all done. Fantastic. Your good work, thank you. It's a pleasure. So in actual fact we probably don't need to follow up the cancer at all. Oh. It's probably gone. We're very pleased. Hopefully you are too. I'm very, very pleased. What can I say but thank you? It's a pleasure. You don't need to thank me at all. It's my pleasure. I'll see you in four weeks. It's so difficult to find the words to say thank you because there aren't enough words and I just love him anyway. Across the six weeks you've been here I think you will have seen the absolute best of us and the worst of us at times. And I think it's really important that the public and our patients can see how hard we work to really try and make it right. I think there needs to be a shift in the expectation of what people want the NHS to deliver because you can't keep on pulling and pulling on this system. We're all a bit tired and we all have to dig kind of deep within at times to find that extra bit of strength. We're all only humans at the end of it, aren't we?