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Critical Between Life and Death Season 1 Episode 6
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00:00Hi, it's Tom Jackson, one of the pelvic surgeons. There's been a development with Gracie.
00:22Her heart rate has risen and her responsiveness overnight has dropped.
00:29We think that we should hold off going for surgery until we've done another CT scan of her brain.
00:39Okay, 65 seconds. Try not to worry too much and I'll speak to you later.
00:44Breathe in and hold your breath.
00:48It's just devastating. You can't believe she's gone backwards.
00:58The neurosurgeon is keen to look at her head.
01:01She's in an unstable condition. If there is anything that we feel concerned about, we would try and flag that to one of the doctors.
01:10An emergency scan, we have to ensure that there's not an evolving situation in her brain.
01:16It could be bleeding inside the brain, which may require an emergency intervention.
01:22We don't want that to evolve when I'm halfway through fixing her pelvis.
01:28The hardest part is the not knowing. You can't help but go to the darkest of places.
01:42Grace is our firstborn. The only girl out of four kids.
01:49She's a really lovely sister.
01:53She's funny and incredibly caring and will help anyone if they need help.
01:59You know, everyone just seems to love Grace.
02:05Grace started a level two beauty college.
02:07She was just thriving, doing something that she enjoyed so much.
02:13She had actually finished the course herself the Friday before the accident.
02:18But Grace agreed to model for one of her friends for makeup so she could complete the course herself.
02:24And she was coming home from doing that when she was hit on the zebra crossing by the car.
02:33You do just think, why Grace?
02:36We've heard from the neurosurgeons that Grace's head scan has been completed.
02:56Thankfully, there is no significant change.
02:59We're actually happy to proceed with her surgery.
03:06You're in a very privileged position as a surgeon.
03:10People are gifting you great faith and trust in what you're about to do to them.
03:17Grace is quite similar in age to my older daughter.
03:21As a parent, there is always a certain empathy and how that's affecting the family especially.
03:27So, three, one, two, three.
03:29What we'll do to treat Grace's fracture is insert some screws through her pelvic bone.
03:39The surgery is minimally invasive, but any pelvic surgery is a high-risk operation.
03:45OK, let's do this.
03:48X-rays.
03:50Come a bit further in, let's see if we can get both in one image.
03:52Stop there, picture.
03:53It's an operation that's entirely guided by the images we're taking.
03:58Using imaging, I'm going to insert my guide wire.
04:01Can I get the mallet?
04:06Creating the pathway that the screw is going to be safe to pass in.
04:10It's quite a tight corridor.
04:13X-ray there, please.
04:14You have to be precise.
04:16The biggest risk would really be a few millimetres the wrong direction will endanger the nerve roots.
04:23Oh, we're skiting off, aren't we?
04:24So we're going a bit posterior.
04:25So do it now on power.
04:27You got it?
04:28I have it.
04:30Back it out a little bit.
04:32So we're more at your entry point.
04:35OK, and now you should have the wiggle in the wire.
04:39I think surgery is kind of a team sport.
04:41In a sense that it's working together, having different roles and having a goal at the end of it.
04:47But the difference is we've always got to win.
04:50Losing isn't where we go when we start an operation.
04:53And it's just how long it takes to win.
04:55X-ray.
04:57Just above the level of the pelvis, the spinal column becomes myriad nerves that then travel out down your legs.
05:05That we call the horse's tail.
05:07The risk of damaging the horse's tail is that you can damage the nerve coming out of L5 and get paralysis in your foot.
05:16Or we can damage the nerves that control bladder and bowel function.
05:20So you can end up with incontinence.
05:23In Grace's case, as a young person, both would be pretty catastrophic.
05:27Go a centimetre more.
05:32Stop.
05:34We might be a bit close.
05:39Reverse.
05:41Reverse.
05:42I think it's not quite right.
05:43We're just getting closer to where the nerve it's going to exit.
05:46There's no margin for error.
05:53OK, holding it.
05:54I am.
05:57OK.
06:00X-ray.
06:01We're not careful.
06:02We can suddenly push it further and cause a deformity.
06:10Better, right?
06:11That looks perfect.
06:13OK, so I just want you to do a couple of centimetres, right?
06:15Now, the journey may have various paths.
06:19Keep going, keep tracking.
06:21But it's really rewarding.
06:23At the end of that case, thinking, great job, we've achieved our goals, and the patient's going to be better as a result of that.
06:30How does that feel?
06:31Nice.
06:32On the face of it, it's a really bizarre, bizarre job we have.
06:37But I can't deny it, it's fun.
06:44Well done, guys.
06:46It's like delivering minor miracles to people.
06:49That went really nicely.
06:53It's Friday, fish and chip day.
06:56We've managed to complete Grace's pelvic surgery, which is excellent.
07:01So now it's just about seeing whether or not her brain injury recovers.
07:05Whether there'll be any long-reaching consequence, we just don't know yet.
07:09Can I stay calm? I know it's difficult.
07:20And has she been fully alert since the injury?
07:24So he's laying on the floor.
07:26What's happened?
07:27Is he talking to you?
07:31We'll get someone down to help you, OK?
07:32Just stay exactly as you are.
07:39What?
07:47If they take it off, just keep the finger in your purse or something.
07:50Oh, my good God, is he having a laugh?
07:52You want me to walk around with your finger in my bag to show them?
07:55And they'll be like, yeah, it wasn't just a cut.
07:57Thank you very much.
07:59Shall I put the ring on it as well?
08:03I'd sit in my bedroom and get a phone call to say,
08:06Teddy's walked out of school rather than get a phone call to say,
08:08I've jumped over a fence and cut my finger off.
08:11But they found his ring.
08:12The caretaker went and found it,
08:14and it was still attached to the pole that took his finger off.
08:18I'm finishing school this week.
08:20I miss out on Believers Day, Prom, all the rest of that.
08:24So it, like, ruined my whole summer.
08:27I feel like you're more upset about missing a summer than the finger.
08:30Yeah, I am.
08:31Teddy underwent a ten-hour surgery where we reattached the finger
08:43and reconnected all the structures, including blood vessels.
08:48We rely on blood flow, first of all, to keep that body part alive.
08:53It's now just over 72 hours since his operation's finished.
08:59So today will be a case of seeing what the colour of the finger is like.
09:04Morning, Teddy.
09:05I'll pinprick the tip of the finger.
09:08Start by unravelling you.
09:11And if it's bright red, this is good.
09:14If it's a darker red, then not enough blood is being drained from the finger.
09:18I need to be sure there is blood flowing to and from it,
09:23so that the tissues don't die.
09:24So the colour to the fingertip is dark.
09:33It appears like the finger's struggling.
09:36It did.
09:42I think it's certainly deteriorated.
09:46And you're definitely not out of the woods completely yet.
09:50OK.
09:52If the amount of blood that's reaching the finger
09:55is too much for the veins to drain the finger,
10:00then that finger can become congested.
10:02There's too much blood there,
10:04and that can lead to the finger not surviving.
10:07Just bear with me. I'll speak to the nursing team.
10:09We have one more trick up our sleeve.
10:11We have one more trick up our sleeve.
10:21They look ugly, alright.
10:23But they are a good organism.
10:26They are very helpful.
10:28Leeches are anti-coagulant.
10:30They are antimicrobial.
10:32They are little amazing suckers, as a matter of fact.
10:35I thought it was a joke.
10:36I thought it was a medieval medicine.
10:38I didn't think they could use leeches still.
10:41It wasn't happy at all.
10:43What is that, Dad? What is that?
10:45He didn't know what a leech was.
10:47I think it's not a leech was.
10:49Medicinal leeches are a recognised form of treatment
10:54in plastic surgery, particularly in microsurgery.
10:56We still often rely on methods which have been used since medieval times.
11:05It's time for me to do my leech in place.
11:08Sure, sure, sure.
11:10So, today, what will happen is that the leech will help draw the blood to that end.
11:19Then the leech will suck the blood and release the excess blood,
11:23which is causing the congestion from the region.
11:28Can you feel it, Teddy?
11:30No, don't feel anything.
11:32The saliva of the leech contains analgesics,
11:36which helps prevent any pain to the individual when applied.
11:43Why don't you look at it?
11:45No, I don't want to look at it.
11:48Yeah.
11:50It's lighter a bit, isn't it?
11:54As a team, we'll apply the leech every three hours.
11:59Stop now.
12:04This one's just not feeding.
12:09You often get a lazy leech,
12:11but seeing as it's been quite a few now that haven't done too much,
12:16maybe it's a bit too congested,
12:18maybe the blood is not free-flowing enough
12:20to make it a nice, easy meal.
12:24It's really scary to think that we are literally waiting to see
12:27whether or not these leeches work,
12:29whether or not that's going to save his finger or not.
12:31Come on, Grace, time to wake up, darling.
12:33Come on, baby girl.
12:37Come on, Grace, time to wake up, darling.
12:48Come on, baby girl.
12:53Come on, knock.
13:01Knock, knock.
13:03Hi.
13:05So, from our perspective, it's gone as well as we possibly could.
13:08Yeah.
13:09But it's just been nice to see her wake up so we can take the tube out.
13:12Yeah.
13:13That's not been as nice.
13:15OK.
13:16They're trying to wake her up now, but she's not really...
13:18Responding yet.
13:19Responding yet.
13:21It's been a hard day.
13:25Just keep her to wake up.
13:26Yeah.
13:28Absolutely.
13:29Hopefully you are going to do soon, Grace.
13:37The brain injury is the most concerning thing
13:40because you can't help but think,
13:43is she going to be Grace anymore?
13:52Right here with you, OK?
13:55And you are safe.
13:57There's no real medical evidence that shows
13:59that holding somebody's hand or speaking to them
14:02changes their outcome.
14:05There's also no evidence to say that it doesn't.
14:08I don't think that everything is explainable
14:11by medical science as yet.
14:13Miracles can happen.
14:19I was born with a hole in my heart.
14:22They told me that I'd always have to carry around a card
14:26saying that I had a heart defect.
14:29And I was under follow-up for that for several years
14:32before my parents took me to their local church
14:35and prayed for me.
14:39Then they took me back for one more appointment.
14:44And the doctors said that I couldn't be the person
14:47that had been born with this thing
14:49because there was no evidence of it.
14:51And so, from my perspective,
14:53I think it's incredibly important that we have hope,
14:57that we have belief that things are going to get better.
15:00And I think the support of the loved ones that we have is really important.
15:05London ambulance service.
15:15RTC motorbike versus tree.
15:19Just down from the M25.
15:21Oh, that sounds bad.
15:22There's an unconscious RTC in TW7 Isleworth.
15:27It's an adult male motorcyclist.
15:29It's got an abdominal injury.
15:30St. Mary's.
15:32Adult.
15:34Adult.
15:3614.
15:38We've got a 38-year-old male coming in.
15:42He was driving his motorcycle this morning
15:44and he's clipped a kerb and come off into a central reservation.
15:51AB 60.
15:53Can I have a blue call to St. Mary's?
15:55ETA will be 10 minutes.
15:57Received.
15:58Patient's going to be transported to St. Mary's,
16:01and you'll be there in 10 minutes.
16:04Most cycle incidents can be really serious.
16:08That transfer of energy can cause significant injuries.
16:12And these injuries can become critical
16:15if we don't act on them quickly enough.
16:19Everyone ready?
16:21This is Abdi.
16:22It's a 38-year-old male.
16:24He was riding a motorcycle.
16:26He's hit the kerb and gone over.
16:28He's got a right tumoral fracture.
16:29There is a large laceration to his left leg,
16:33down to the bone,
16:34and he has pain all down the right-hand sides
16:36and round to his back as well.
16:39Could you give him two grams of TXA as well?
16:42Abdi, how are you?
16:44My name is Mohammed.
16:45I'm one of the doctors in here.
16:47Alhamdulillah.
16:49Where are you from?
16:50Somalia.
16:51Somalia.
16:52OK, I'm from Jordan, OK?
16:54Just relax.
16:55I'm going to just view your neck.
16:56Check your central areas patterns.
16:59Look at me.
17:01Good.
17:03So I'm going to feel your tummy.
17:04If you feel any pain anywhere,
17:05press, just tell me, OK?
17:07Here.
17:08It's mainly all up here.
17:09All up there.
17:10OK.
17:11We're going to take him to the CT.
17:13One, two, three.
17:21He's got multiple injuries.
17:22The main thing that we're concerned about
17:24is that he's got some active bleeding in his liver.
17:28He's also got an injury to his spleen.
17:30Thank you very much.
17:32Right, let's go.
17:34Abdi's injuries have the potential to be life-threatening.
17:38We need a trauma surgeon to come and assess him,
17:40so I'm going to call my colleague, Marion.
17:42Have you guys been told about the man that's down in recess?
17:45Oh, I'm done.
17:46Yeah, perfect.
17:47I'll see you in a sec.
17:55When you're part of the trauma team,
17:56you're there as your best.
17:58You're there as your Usain Bolt moment all the time.
18:03The adrenaline just kicks in,
18:04so you have no choice but to give it your all.
18:08So he's on his way to work.
18:10His motorbike was?
18:11Motorbike.
18:12He's clipped a curb and come off.
18:15Teamwork is crucial,
18:17but when it comes to the decision-making,
18:19you have to make a decision before you make an incision.
18:22It is very much, you know, on you.
18:26Hi, I'm Marion.
18:27I'm the trauma consultant.
18:29It's going to have a gentle feel, OK?
18:32Just let me know if it bothers you anywhere I press, all right?
18:36The problem is the hematoma is getting worse,
18:37so that needs to be resolved quite quickly.
18:39Yeah.
18:40You have significant injury to your liver
18:43and also to your spleen,
18:46so that's why you're probably getting a lot of the pain here
18:48on the right side.
18:50We need to speak to our interventional radiologists
18:52and they'll try and stop the bleeding.
18:55Is there anybody you want us to call?
18:56If you've spoken to everybody you want to speak to? Yeah?
18:57OK.
18:58These guys are going to take you up now.
18:59Thank you, guys.
19:00Thank you all.
19:01Thank you all.
19:02Thank you all.
19:03So, trauma patient, urgent procedure to get into the artery.
19:06and embolitis, bleeding, tributary.
19:07Well, you've got to get into the artery.
19:08You've got to get into the artery.
19:09You've got to get into the artery.
19:10You've got to get into the artery.
19:11So, if you're Pan Korean, you've got to get into the artery.
19:14So, there are only 25 pages.
19:15And it's three to 82 percent.
19:17You've got to work some more than eight percent.
19:20Yeah.
19:21Yeah? OK. These guys are going to take you up now.
19:24Thank you, guys. Thank you all.
19:29So, trauma patient, urgent procedure to get into the artery,
19:33an emboliis, a bleeding, pubertary.
19:35We are pinhole surgeons.
19:38And our plan is to navigate a tube and a wire up through the aorta,
19:43the main artery of the abdomen.
19:44We are then going to use a directional catheter
19:47to get into this artery here
19:49to block that, to stop the bleeding.
19:51You're bleeding inside and you can lose a lot of blood.
19:56I work in decontamination and sterilisation.
19:59Process all the instruments these guys use to do their procedures.
20:04It's like a circle that's coming around in this.
20:09I've never been in an accident like this before.
20:14It feels like I've been hit by a truck.
20:16But what can you do in it?
20:19Eight, nine.
20:20He's going to set it up.
20:20Cool. Let's do it.
20:21Yep.
20:22OK, final question. Is everyone leathers?
20:25We're good to go now, Rob.
20:28Can I just start checking to say something?
20:30Yeah, yeah.
20:30Slow, deep breaths for him.
20:43All right, let's try and get into this.
20:45Now the wire food.
20:47This catheter's less than a millimetre in width.
20:49I'm going to try and navigate this through the blood vessel.
20:53That's great.
20:54Look at that.
20:54All the way in, straight in.
20:55There's no more blood than the distal is, aren't there?
20:59Holy moly.
21:02This is a nasty, nasty trauma.
21:05He's lucky to be alive, isn't he?
21:07The vessels are sheared off from the impact and the force.
21:14We just put some little beads down the arteries.
21:17So the beads are going to travel with the blood flow and just nestle in the very distal arteries
21:21and block those truncated vessels.
21:26Perfect.
21:27I'm happy with the liver now, OK?
21:31We've stopped the bleeding in the liver.
21:33But in motorbike accidents, you can be bleeding from multiple sites.
21:38He has to be handed over to my trauma surgical colleagues now.
21:42Ready, safe.
21:43They have to examine Abdi inside really carefully.
21:46It is risky moving someone like Abdi who is bleeding.
21:53But when it comes to trauma, it's a balance of risks.
21:59There is no perfect in medicine.
22:01It's been 24 days since Isaac was admitted to hospital.
22:22Following an alleged assault, Isaac is getting better.
22:26Oh, I need to take that off as well, don't I?
22:28I have seen glimmers of hope.
22:31Some really nice traits of Isaac before he was injured.
22:35He's very generous and he's very family orientated, which is a lovely trait.
22:46It's just part of the process and part of getting home and part of making me better.
22:53So, it's all right.
22:56I'm happy with doing it.
22:59Isaac being in a hospital has been the longest time that we've actually ever been apart.
23:04It's been really difficult not having him at home.
23:08I can see some of Isaac is coming back.
23:13Oh, my God!
23:13You can't go any quicker.
23:14Thank you for having me, do I?
23:17See you later.
23:18All right, see you.
23:19We all would want some magic tablet or magic wand where we can just make everyone better.
23:25But that's not the reality of brain injury.
23:28People's lives change.
23:30But it's encouraging the families to recognise that these really small wins are actually massive.
23:37I'm happy to be leaving here.
23:39Oh, yeah.
23:40I know that.
23:42But I'll miss everyone.
23:46I appreciate all the help they've given me.
23:50Yeah, I'm just lucky to be alive.
23:52Trauma doesn't discriminate.
24:00Rich, poor, it can touch anyone.
24:06And nobody's expecting it.
24:09The biggest challenge I see is the patient not returning to who they were.
24:15And that's really difficult for families.
24:22Grace is squeezing my hand.
24:29She's turned her head to my voice.
24:31But she's still so out of it.
24:40Grace was hit by a car.
24:42And that impact caused her to be thrown off to the side of the road.
24:47This is Grace's scan.
24:48And we can see that her brain would have rattled around in her skull, causing some bruising.
24:53And the other part of the injury is the kind of shearing forces that would have occurred in the brain.
25:00Hi, is it great in family?
25:01My name's Harry.
25:02I'm one of the neurology consultants.
25:04I work in the neuro rehab team.
25:06The brain consists of millions of neurons, which transmit information between different parts of your brain.
25:14If you tear these, you disrupt the brain's ability to do all the complex functions that it can do.
25:24Is it okay if I try and see if I can wake up Grace a bit?
25:27Yeah.
25:27My name's Harry.
25:30I'm one of the neurologists here.
25:35Grace?
25:36Can you open your eyes for me?
25:40Grace?
25:43Do you think Grace would be okay if I just feel her hand?
25:46Yeah, yeah.
25:47Is she quite sensitive to touch?
25:48She can be.
25:49Hi, Grace.
25:50Hi, Grace.
25:59Grace, open your eyes, darling.
26:02Want to wake up to the doctors?
26:06It's Mum.
26:10Grace.
26:12Hello, Grace.
26:14Hello, Grace.
26:20Seeing her open her eyes, just for that brief second, it's like all your Christmases come at once.
26:29Because you know she's in there.
26:33Hi, darling.
26:36I can feel you holding on to me.
26:38I know you're listening.
26:41After someone initially has a head injury and wakes up, they can sometimes be in this stage in which they're very confused and very disorientated.
26:47Yeah.
26:47But this will change over the next few days.
26:51And then we'll start to see a little bit more what the impact the head injury has.
26:55Yeah.
26:56For her parent, it really is this emotional rollercoaster where they feel they may have lost their loved one to knowing they're now alive.
27:04But then go through almost a kind of mourning type phase of realising that things are significantly different.
27:09And that this could be their reality for not just the next few weeks, but months to years.
27:18Abdi has had his liver embolised to try and control the bleeding.
27:43But we can see from the scans that there's still blood inside the abdomen.
27:53Every day a trauma patient comes in that is severely injured.
27:57I always feel I can relate to what people are going through because of my personal journey to get to trauma surgery.
28:08We were in our teenage times of everybody just learning how to drive.
28:18And I remember very clearly it was a Friday night and one of them rang me saying, we're going out and this person has a new car.
28:25And I was like, oh, yes, you know, I'll have to ask my mom.
28:28And I remember my mother saying, I couldn't go, you know, I was like, OK, fine, you know, I'm not going with you guys, but have fun and we'll talk tomorrow.
28:41But that was a tomorrow that I never spoke to my friends about because they were involved in a road traffic accident and one of them died.
28:54And I just could not quite comprehend or believe or accept it.
29:08Sorry.
29:10It was amazing.
29:11Her name was Mariam as well.
29:12And, yeah, she was she was always, you know, our go to person, our sort of sorter.
29:25Yeah, an incredible human being.
29:31And I wanted to do something.
29:37And so I developed a new focus.
29:40All right, start.
29:42I really wanted to be part of that, helping people as much as I can when they are severely injured.
29:53We know that Abdi's spleen is still bleeding, but it may be that there are other organs that are also damaged.
30:02Even if people do get to hospital on time, they can still die from internal bleeding.
30:07The plan for Abdi is keyhole surgery to try and stop that bleeding.
30:13We've opened up a little space just above the belly button and then we're just going to put the camera in to see what we see inside.
30:20There's probably about a liter of blood in there.
30:34There's a lot of blood in there.
30:35I can't quite see properly.
30:38Is it compromising things?
30:40We only have a certain amount of blood that's circulating within our system.
30:47So if it's being lost somewhere, there isn't enough to go back to the heart for the heart to be able to pump it.
30:52And eventually, the heart has nothing to pump and then the heart stops.
30:58There's a bit too much blood that we can't see where it's potentially coming from.
31:06The safer thing is just to convert to an open operation.
31:11Can we have a knife, please?
31:16When things are not quite right, I'm grateful that I have a very religious and spiritual aspect of my life.
31:22And I'm able to tune into that to calm my brain, my mind.
31:28Now that I've converted to an open operation, I have to be systematically looking at every organ to find out exactly what's bleeding.
31:36I mentally have a clock face in my head.
31:4212 is the middle where the breastbone is.
31:46The left colon is at 3 o'clock and then at 6 o'clock I'm looking at the rectum.
31:519 is the right colon and then going back again to 12.
31:56Walking through all the organs in the abdomen.
31:58The fact that you don't know exactly what's bleeding is primarily the problem.
32:04Every second matters.
32:07This is the small intestine.
32:10The small intestine is about 3 metres long.
32:13So far, we can't see any obvious injury.
32:17Your brain is trying to put a jigsaw puzzle together.
32:20Now the large intestine.
32:21Now the large intestine.
32:22Is that okay?
32:23Yeah.
32:24So this is the stomach.
32:25And we can't see any injury there, which is good news.
32:26Can we have a look at the spleen?
32:27Yeah.
32:28Yeah.
32:29Yeah.
32:30Yeah.
32:31Yeah.
32:32Yeah.
32:33So this is the stomach.
32:34And we can't see any injury there, which is good news.
32:36Can we have a look at the spleen?
32:37Yeah.
32:38Yeah.
32:39Yeah.
32:40Yeah.
32:41Yeah.
32:45And slightly more on the inner side of it.
32:47So we need to be really gentle here.
32:50and slightly more on the inner side of it so we need to be really gentle here
32:56so i'm going to try this special foam like gel and i can stop bleeding
33:07so we'll leave that and see if that does the trick
33:20i think it's still bleeding i need to stop it can you suture it no
33:29the spleen is part of the immune system it's very important when it comes to fighting
33:33infections so removing the spleen is always something we avoid doing unless we really have to
33:41but sometimes you have no choice we're gonna take the spleen out
33:49so that was bleeding here here and there's a cut in the middle there
34:03so start closing you're okay yeah
34:20i'm quite happy that the spleen was the source of the bleeding and now that's been controlled
34:25and we can end the operation
34:30and he has been through a lot today
34:33if he didn't get to hospital at the time that he did he could have died on
34:37the scene from internal bleeding
34:38he's still very much in a critical state so the next 24 48 hours you'll need close monitoring to make
34:50sure that there are no further complications
35:02and you can you sit there teddy so i'm just going to cut the bandage okay not anything else
35:20it's not my finger today we're seeing a young lad called teddy who's 16 and unfortunately he ripped
35:28his finger off despite best efforts of all the staff and the surgeons here at the hospital
35:34even with using some leech therapy we weren't able to salvage the finger
35:38okay do you want me to put me to look first yeah i don't think i want to see it you're all right
35:43no you're going all sweaty yeah i'm very hot you're going funny
35:48sorry again get your eyes shut
35:54what do you think it looks it looks really it looks really tidy it looks really clean
35:59will i have a dressing on it well i'm fizzy yeah i don't want to look at it it's a lot isn't it
36:05yeah since the accident teddy has probably not used or moved his hand but we do need to today
36:15start on trying to get the muscles working try and get the neural pathways connected
36:20in order to get him progressing and using his hand normally
36:24do you play playstation xbox well i do but i haven't been because yeah i haven't been able to
36:30hold the hand hold the controller you can play your playstation if you want to okay
36:37take your thumb out to the side for me are you able to get it and touch it to the bottom of that
36:42little finger excellent it's only thing you shouldn't do like go to don't get it wet after parties
36:50after prom you should avoid them yeah when is pom is it tonight friday friday yeah you're gonna go yeah
36:58yeah i'm gonna go to prom yeah but i'm trying to get i'm trying to persuade her to let me go after
37:04i mean i don't think i can tell her not to go to the after party depends what you're going to do
37:07at your after party you're not helping me right now you're going completely siding with him i'm
37:11really sorry this is definitely a lesson that i wouldn't want him to have but his attitude is
37:20it's not going to stop me from doing anything teddy when he goes to college in september he's
37:24doing an electrician course all right thank you so much see you later bye thank you i'm super proud
37:30that he's dealing with it the way he is
37:41okay so we're starting with grace let's just remind everyone grace was struck by a car on the 10th of
37:46june had a traumatic brain injury and pelvic fractures that she had fixed on the 14th
37:53grace has been with us for a few weeks now initially grace was very tired and confused but now she's
37:58doing really well really awake and able to engage in the rehabilitation recovery from a brain injury is
38:04difficult to predict however every brain is unique and everyone's recovery is unique hi grace hello
38:10already grace with regards to what brought you in did you have much chance to kind of talk or
38:18understand about that i have a brain injury you have a brain injury yeah
38:27it's variable how much it'll affect you but some things you might notice at the moment is concentration
38:31might be a little bit tricky and more complex problem solving so not doing your basic day-to-day tasks
38:37the main areas that were affected were the frontal lobes and also the temporal lobe which is often
38:43involved in actually not our verbal memory but more of our visual memory we're just very lucky and
38:49very grateful that grace is still there for the most part okay well done but she's lost probably about
38:56eight months of memory she doesn't even remember her baby brother morgan being born in february that's
39:04completely gone he doesn't remember coming to see him in hospital holding him for the first time
39:10anything like that that's just been wiped
39:16as part of post-traumatic amnesia patients like grace can have problems with short-term memory
39:22memories of events that happen before the injury can be lost it's very much akin to to the the film
39:29memento in which she's effectively living each moment without a real awareness of recollection of
39:34what happened before unfortunately we don't have medications or surgery to fix the damage really
39:44that's been done but what you can do is use visual aids so we've asked karen to bring in pictures objects
39:52from home those images and objects will act as a scaffold for her to reform those memories we're putting
40:05in pictures just you know grace with the dogs and then photos like with her friends at birthday parties
40:11and things like that hopefully the memories will come back we just don't know how long that's going to take
40:18look at the difference if you hit and then in that photo of it how you change
40:29that was your floor as well
40:30very good memory is a really complicated function but for grace youth is definitely on her side
40:39that one's from joe i know that one's from ted it's a bit bent isn't it
40:44the fantastic thing about the brain of a 17 year old is its capacity to rewire
40:49is the thing that we call neuroplasticity grace's ability to repair those connections that have been
40:55disrupted as part of this injury are so much higher which stands in a really good stead for the future
41:00so good
41:17morning good morning how's your pain i can tolerate it okay we can always give you more stuff on top of
41:24what we have okay there's there's no need to be brave i need more asked good so essentially yesterday
41:29we did try and do the operation keyhole but the spleen kept on bleeding a bit as much as we tried
41:34to sort of leave it in there so you don't have a spleen i'm afraid
41:39life is perfectly normal without it apart from having to take antibiotics
41:43i'm here breathing another day yeah just really grateful for this system that we have
41:52it's a whole village to make this operation work this has made me realize not to take anything for
41:58granted keeping people alive gives you a good feeling should i say inside
42:04i play my small parts but it's all down to a lot of people together sometimes i feel like
42:14throw my hands up in the air i know i can count on you we see people at their absolute lowest
42:23but the london trauma network has the ability to pick up the pieces and put them back together again
42:39the progress is just it's astounding you know she's there and you're gonna get her back
42:52teddy's not letting it bother him which is amazing it could be like a cool chat-up line kind of
42:57it's a journey there's highs and lows in it it can be transformative
43:01i think my prosthetic looks pretty cool definitely want to show it off to people i used to go gym with
43:16saving lives returning people to their families for their loved ones well i think the nhs is
43:21absolutely incredible welcome home we pride ourselves on pushing the boundaries of what's possible
43:34we've got the after sheffield head in place please have a look at what it looks like
43:40you realize how fragile we are yet how amazing the human body is it fascinates me every time when i
43:49operate how we put people back together again perfect they thought i might die and then after
44:02that they thought i might have brain damage the level of care i've had honestly phenomenal
44:09we're saving lives though 15 20 years ago they wouldn't survive they put me back together like
44:16humpty dumpty since they're setting up one of the major trauma system thousands of lives have been saved
44:28the city relies upon us
44:46so
45:02so
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