Episode 6 - Tuesday 1 May
The sixth and final episode of ‘Hospital’ is all about the life and death decisions in the Major Trauma Centre and our care for emergency patients.
Fifty-one-year old Ruth has a thoracic disc pressing on her spinal cord, which if left untreated, could cause paralysis. It’s a very rare condition, affecting just one in a million people. Her operation has been cancelled once before due to a lack of a critical care bed.
The trauma team deal with two patients who have been involved in a serious road traffic accident. Ravi, 29, has been run over by the side of the road as he came to the aid of George, 89, who had himself been involved in a serious crash. Both have potentially life-threatening injuries.
Joe, 75, needs an urgent operation to remove part of his pancreas which has a suspected tumour. It is among the highest risk operations; one in 20 patients do not survive. Joe’s daughter Stephanie, supports his decision to go ahead with the high risk surgery but is still extremely concerned, “It goes over and over in your mind, have we made the right choice”
Meet the team from Episode 6
The spinal fellowship at Nottingham Hospitals is the key reason I came to the UK in 2007 as the opportunity to work at a hospital which provides leading regional spinal surgery, is one many in my field aim to do.
Having completed my medical training in Germany with electives spent in South Africa and USA, I qualified as a Neurosurgeon in 2003; I then embarked on a period of specialist spine surgery training before taking on a role as Consultant Spinal Surgeon at NUH.
Spinal surgery is a very exciting specialty as there is a broad spectrum of conditions that are treated using this technique; very few surgical specialties treat conditions from the base of the skull to the pelvis, including access to the front and back of the spine. We work closely with several specialty areas throughout the procedure and the department treats patients from children to adult including tumor, trauma and degenerative conditions.
The reason I do what I do is because my role is very satisfactory and rewarding and the procedures we do change people’s lives. There are procedures that can reverse partial paralysis in patients and many of the smaller procedures can help patients with pain relief, it’s not just about treating the condition it is also about improving the patient’s wellbeing, their self-image and their life perspective.
Working at NUH during what has been reported as one of the toughest winters for the NHS has been a heartbreaking experience, staff have felt the ultimate pressure to help all our patients however have not always been able to do so, due to the pressure and having to prioritize clinically urgent and cancer operations. People plan their lives around these procedures and when patients are not able to access the services it is heartbreaking. The challenge with cancelling procedures which are not clinically urgent is that we know we have people who are already struggling to live their lives because they need this surgery and it is difficult to have to prioritize patients – as all of these operations are essential.
On a good day when we have all our medical and surgical teams working together, going above and beyond to find the right solution for patients – nowhere beats here (NUH). It is always a fantastic feeling and credit to our staff when we pull together to achieve these complex surgeries that we provide to our population.
Some of my career highlights include being Nottingham Hospital’s Head of Service for Spinal Surgery, for five years and being instrumental in implementing many features the department is a regional leader for, including the East Midlands hub for complex deformities spinal surgery. During my time here it has been a significant achievement for the department to achieve GMC sponsorship status and the Spinal Surgery Fellowship at NUH was the first unit in the UK to be approved by the Royal College of Surgeons (RCS).
Having been at Nottingham Hospitals for the last 12 years I have worked with such a fantastic mix of people with a variety of clinical skills and know-how. Professionally it is a very satisfying experience to see different teams and expertise working together and looking for ways to optimize the outcomes of patients.
In May Bronek will be moving to Germany after 12 years at Nottingham Hospitals, to take on a position of Head of Service for a Spinal Surgery unit for the Artemed Group in Tutzing just south of Munich, with his wife and two daughters joining him.
You can see Bronek in Tuesday’s episode of Hospital on BBC Two from 9pm.
Adam Brooks trained in General Surgery, Hepatobiliary Surgery, Emergency Surgery, Trauma and Critical Care in the UK, USA, Australia and South Africa and joined Nottingham University Hospitals NHS Trust as a Consultant Surgeon in 2005.
His specialist interests are liver surgery, surgical management of hepatobiliary biliary disease and major trauma. He is the Director of the East Midlands Major Trauma Centre, one of the largest Centres in the UK, based at Queen's Medical Centre.
Adam has significant surgical education experience. He developed the Specialist Skills Course in Emergency Surgery & Trauma for Surgical Trainees held at the Royal College of Surgeons of England and has taught trauma surgical skills around the world including the USA, Australia, Norway, New Zealand and the UK.
Adam's story in 'Hospital'
Joe, 75, needs an urgent operation to remove part of his pancreas; he has a suspected tumour. Known as a Whipple Procedure, it is among the highest risk operations. One in 20 patients do not survive. Joe’s daughter Stephanie, supports his decision to go ahead with the high risk surgery and Adam and the surgical team provide all of the information so that Joe and his family can make the right choice for them.
It’s an operation that does carry some significant risk. It’s the biggest abdominal operation there is. The risk of not surviving the operation is about 5% so one person in 20 won’t survive. I don't know how you feel about that but even the, your very big operations, cardiac operations and other operations, people normally quote a, a risk of about 1 in 100 of not surviving the operation so it is significantly more than the vast majority of big surgery.