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WOMAN: Ambulance.
What's the emergency?
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00:00:02,800 --> 00:00:04,016
WOMAN 2: Quickly.
We're at Southport.
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00:00:04,040 --> 00:00:05,480
OK. Southport.
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00:00:05,600 --> 00:00:09,120
NARRATOR: The Gold Coast,
where the lights burn bright
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00:00:09,240 --> 00:00:11,520
and the sunshine never ends.
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00:00:11,640 --> 00:00:13,960
While many Aussies call it home...
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00:00:15,440 --> 00:00:18,480
..every year, 12 million tourists
come to play
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00:00:18,600 --> 00:00:21,480
on this stretch of golden coastline.
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00:00:21,600 --> 00:00:25,960
WOMAN: He was surfing when he got
bitten on both legs by a shark.
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00:00:26,080 --> 00:00:27,960
I don't think
I'm going in the sea again.
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00:00:28,080 --> 00:00:31,080
But the good times...
WOMAN: We need some medical staff!
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..can often turn ugly.
Pelvic binder on him, OK?
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00:00:34,680 --> 00:00:37,560
And when they do...
Maybe you've had a heart attack.
14
00:00:37,680 --> 00:00:40,320
..these are the people
you want on your side.
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00:00:40,440 --> 00:00:45,360
This is Princess Charlotte, so we've
got her a room with a view. Good.
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00:00:45,480 --> 00:00:48,160
If this guy doesn't die,
there's a good chance
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00:00:48,280 --> 00:00:50,120
he's gonna end up with
a horrible brain injury.
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00:00:50,240 --> 00:00:52,280
Whether you're just visiting...
Love you.
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00:00:52,400 --> 00:00:54,640
..or you live here...
This got attacked by a buffalo.
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She's biting me.
(GROANS)
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Are we getting any
sort of a blood pressure?
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00:00:59,640 --> 00:01:02,440
He could still lose his leg.
..these are the real stories
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00:01:02,560 --> 00:01:04,000
You OK?
Yep.
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00:01:04,120 --> 00:01:06,040
..of the cutting-edge
medical teams...
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00:01:06,160 --> 00:01:09,240
Do not move your head.
We need to get that clot out.
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00:01:09,360 --> 00:01:11,200
Good work, guys.
..who pick you up...
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OK, let's get moving.
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00:01:12,720 --> 00:01:15,240
You may get some chest pain.
We're inflating the balloon now.
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..patch you up...
Superpower!
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00:01:18,440 --> 00:01:22,440
The fairy dust, it's very magical
and it fixes all sorts of things.
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..and put you back in paradise.
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00:01:24,960 --> 00:01:27,760
Where else would you rather be?
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00:01:30,360 --> 00:01:32,960
Tonight, on Gold Coast Medical,
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top surgeons take on a challenge...
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We often do cases together.
It's a concert.
36
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It's a concert without a conductor.
Yeah. (LAUGHS)
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..to perform a life-changing miracle
on this gentle giant.
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00:01:45,680 --> 00:01:47,840
A police officer watches over surgery
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00:01:47,960 --> 00:01:51,200
to see what this man
has inside his body.
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00:01:51,320 --> 00:01:54,040
WOMAN: OK, I need whoever
took the bullet out
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to actually give it
to actually the policeman
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00:01:57,000 --> 00:01:59,360
in a pot as chain of evidence.
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00:01:59,480 --> 00:02:02,800
And a new life...
Want me to catch it?
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00:02:02,920 --> 00:02:06,240
..that doesn't start as planned.
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00:02:11,200 --> 00:02:14,120
('WILDEST DREAMS'
BY TAYLOR SWIFT PLAYS)
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As the Gold Coast has grown from
holiday town to big, bad city...
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00:02:22,760 --> 00:02:24,216
MAN: Ambulance.
What's the town or suburb?
48
00:02:24,240 --> 00:02:27,240
WOMAN: Surfers Paradise.
Tell me what's happened.
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00:02:27,360 --> 00:02:29,000
She's been stabbed.
50
00:02:29,120 --> 00:02:32,120
..sadly, so has its rate
of violent crime.
51
00:02:35,520 --> 00:02:36,520
This morning,
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00:02:36,560 --> 00:02:39,640
the hospital's Director of Trauma
Services, Dr Martin Wullschleger,
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00:02:39,760 --> 00:02:43,520
is leading a team trying to
save the life of the latest victim.
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00:02:43,640 --> 00:02:48,320
There is a 31-year-old that's
got a gunshot to his upper abdomen.
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00:02:48,440 --> 00:02:50,400
He's not doing very well.
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00:02:50,520 --> 00:02:53,480
He's unstable so we have
to go to theatre straightaway
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00:02:53,600 --> 00:02:55,120
and fix him up.
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00:02:55,240 --> 00:02:58,240
The man was shot at close range
in the stomach.
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00:02:59,440 --> 00:03:01,400
Now he's on the operating table
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00:03:01,520 --> 00:03:04,120
in front of trauma surgeon
Dr David Parker.
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00:03:04,240 --> 00:03:06,640
As soon as he arrived, we got him
up to theatre very quickly.
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00:03:06,760 --> 00:03:10,160
And then,
once we had him stabilised,
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00:03:10,280 --> 00:03:13,400
we performed a laparotomy,
which means we opened his abdomen.
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00:03:13,520 --> 00:03:16,440
The bullet is still inside somewhere.
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00:03:16,560 --> 00:03:19,520
But finding it
isn't the first priority.
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00:03:19,640 --> 00:03:21,760
When we got in,
we found about two litres of blood,
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00:03:21,880 --> 00:03:24,920
and then it was a case of just what
we call 'damage control surgery',
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00:03:25,040 --> 00:03:28,040
where we just try and pack things
and try and stem the bleeding.
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00:03:28,160 --> 00:03:31,200
The man has lost two
of the five litres of blood
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00:03:31,320 --> 00:03:34,800
that an adult male
typically has in their body.
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00:03:34,920 --> 00:03:37,720
Right now, the only thing stopping
him from bleeding out
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00:03:37,840 --> 00:03:40,520
is a constant supply of transfusions.
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We had to go looking
for the actual bleeding.
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00:03:44,600 --> 00:03:47,840
If the team can't find and stop
the source of bleeding,
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the man will die.
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00:03:49,680 --> 00:03:51,880
With bullets, you never know
where they go in the body.
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00:03:52,000 --> 00:03:56,440
Because we didn't have an exit, we
didn't really know where it went to.
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00:04:15,280 --> 00:04:16,920
While most people on the Gold Coast
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00:04:17,040 --> 00:04:19,160
lap up the sunshine
whenever they get the chance,
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00:04:19,280 --> 00:04:22,520
one man is covering up
and sticking to the shadows.
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00:04:24,440 --> 00:04:29,440
51-year-old Ronnie suffers from
a rare disease called porphyria.
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00:04:29,560 --> 00:04:33,280
Porphyria is the basis
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00:04:33,400 --> 00:04:35,840
of the history
of the legend of the vampire.
84
00:04:35,960 --> 00:04:38,000
I actually have vampire disease.
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00:04:38,120 --> 00:04:41,920
Just like the vampires
in horror stories,
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00:04:42,040 --> 00:04:46,480
for Ronnie, sunlight on his skin
causes him unbearable agony.
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00:04:48,320 --> 00:04:49,720
Hey, Fiona.
How are you?
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00:04:49,840 --> 00:04:52,360
It's been a bit of a hard week.
Has it?
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00:04:52,480 --> 00:04:54,880
Ronnie meets with
pharmacist Fiona Clark
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00:04:55,000 --> 00:04:57,360
and Dr Stuart Aitken for treatment.
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00:04:57,480 --> 00:05:00,160
Good morning.
Ah, Ronnie. Have a seat.
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00:05:00,280 --> 00:05:04,160
Our bodies make a group of chemicals
called cytochromes.
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00:05:04,280 --> 00:05:06,840
We use them for things
like our liver enzymes
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00:05:06,960 --> 00:05:08,040
and for haemoglobin.
95
00:05:08,160 --> 00:05:10,320
Bit of a closer look
at what's happening.
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00:05:10,440 --> 00:05:13,040
But Ronnie's body
can't convert these chemicals
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00:05:13,160 --> 00:05:15,760
so a build-up of toxins occurs
on his skin.
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I can feel there's a blister coming
up underneath it already.
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'Cause I can feel
when they're starting.
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In Ronnie's case,
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00:05:24,000 --> 00:05:27,480
the chemical that's accumulating,
when it reacts with sunlight,
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00:05:27,600 --> 00:05:30,000
it becomes very toxic
and burns his skin.
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00:05:30,120 --> 00:05:33,280
There's another blister
just coming up under here.
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And here. And that corner.
Then this one.
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For Ronnie,
it's personally horrifying.
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This is a really horrible disease.
It's quite disfiguring.
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00:05:45,480 --> 00:05:48,680
And it's certainly made a big impact
on Ronnie's life.
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It started all with
just one tiny, little blister
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that proceeded to then spread.
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And then, over the period of a week,
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it proceeded to take over
most of my hand.
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00:06:02,160 --> 00:06:04,080
How are you going with
staying out of the sun?
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00:06:04,200 --> 00:06:07,320
I'm hating you. (LAUGHS)
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The more time that porphyria
sufferers spend in the sunlight,
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00:06:10,920 --> 00:06:13,120
the more horribly disfigured
they will become.
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That's that whole vampire thing -
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the blood from the mouth,
the wounds, the sores,
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the not appearing in the sun.
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Not having mirrors because they
didn't wanna see themselves.
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00:06:25,160 --> 00:06:29,600
So, Ronnie, if I can get you
to pop your arm out for me.
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In past centuries,
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vampires would drink blood
to make themselves feel better.
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00:06:33,720 --> 00:06:36,760
And the modern treatment for Ronnie
is just as ghoulish.
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00:06:36,880 --> 00:06:39,480
Ronnie, are you ready?
No.
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00:06:40,560 --> 00:06:42,960
Three, two, one.
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Appointments are Robina Hospital's
breast cancer clinic
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00:07:01,040 --> 00:07:02,560
are always in high demand.
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00:07:02,680 --> 00:07:05,160
WOMAN: The bottom line is that
one in eight Australian women
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00:07:05,280 --> 00:07:08,440
is going to get breast cancer,
which is 12.5%
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00:07:08,560 --> 00:07:10,920
So the vast majority of
breast cancer that you see
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00:07:11,040 --> 00:07:12,856
is what we call
'bloody bad luck' breast cancer.
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(LAUGHS) In other words,
it just happens.
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We just got a whole bunch of
interesting patients today.
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00:07:20,080 --> 00:07:21,640
We've got a lot, hey?
We've got 14.
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00:07:21,760 --> 00:07:25,440
Dr Rhea Liang started
the breast clinic seven years ago,
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driven not only by profession,
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00:07:27,320 --> 00:07:30,320
but also a very personal connection
to breast cancer.
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00:07:30,440 --> 00:07:31,920
There's breast cancer in my family.
139
00:07:32,040 --> 00:07:36,440
So my grandmother, who's now 103 -
turns 104 next month -
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00:07:36,560 --> 00:07:38,320
she had breast cancer.
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00:07:38,440 --> 00:07:40,240
I have an aunt who
also had breast cancer.
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00:07:40,360 --> 00:07:43,720
And my aunt had it around the time
I was coming through medical school.
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00:07:43,840 --> 00:07:46,376
No, the funding has actually
changed. It's back with the GPs now.
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00:07:46,400 --> 00:07:51,240
It strikes young, old, rich, poor,
any race, any group.
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00:07:51,360 --> 00:07:52,840
You know, it's just indiscriminate.
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00:07:55,040 --> 00:07:59,280
Every day, women like
46-year-old Kirsty come to the clinic
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to begin treatment for this
all-too-common disease.
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00:08:02,200 --> 00:08:05,840
So your waiting area today
is down by 19-27.
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00:08:05,960 --> 00:08:07,080
Oh, OK.
150
00:08:07,200 --> 00:08:09,200
Fortunately,
Kirsty's cancer was picked up
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00:08:09,320 --> 00:08:11,280
before she even had any symptoms.
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I went for a routine mammogram and
I got a call about four days later
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to say that they had found something
in my right breast.
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And they wanted me to go back in.
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What the mammogram found
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is an early form of breast cancer
that grows fast.
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00:08:28,720 --> 00:08:30,600
Hello, Kirsty.
Hi.
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I'm Rhea. I'll be your surgeon.
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00:08:33,120 --> 00:08:34,480
Come and take a seat.
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00:08:34,600 --> 00:08:38,320
So Kirsty's at the hospital today
to begin her treatment with Dr Liang.
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Now we've received...
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Breast cancer is different
from a lot of other cancers.
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There's no other cancer
that I can think of
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that threatens a woman
in so many ways.
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The breast is a sexual organ,
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it's part your
physical characteristic
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that identifies you as a woman
when you go out in public.
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It's an organ of nourishment
for babies.
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But just up there is where
you've been feeling the tenderness?
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00:09:00,800 --> 00:09:02,320
Just kind of in...
171
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So there's that very complex
mix of things
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00:09:04,680 --> 00:09:06,280
when they first come to clinic.
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00:09:06,400 --> 00:09:09,160
I'll give you the beginner's guide
to breast ultrasound.
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00:09:09,280 --> 00:09:10,280
Thank you.
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00:09:10,320 --> 00:09:11,960
And you feel a particular connection
176
00:09:12,080 --> 00:09:14,280
with the women
who are suffering from it
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'cause you could so easily imagine
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that it was your
mother or your sister,
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00:09:17,600 --> 00:09:19,520
or in my case,
my aunt or my grandmother.
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00:09:19,640 --> 00:09:21,200
So that's what breast tissue
looks like.
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00:09:21,280 --> 00:09:23,136
See that honeycomby stuff?
That fluffy white stuff?
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Today, Rhea is hoping Kirsty
doesn't add her name to the list.
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00:09:26,840 --> 00:09:30,000
As we scan around here,
you'll notice something else pop up.
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That's your cancer.
Oh.
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00:09:33,920 --> 00:09:36,120
Mmm.
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00:09:56,680 --> 00:10:00,440
51-year-old Ronnie is suffering
from a rare disease called porphyria
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00:10:00,560 --> 00:10:04,440
that causes painful lesions on his
skin when it's exposed to sunlight.
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00:10:04,560 --> 00:10:08,120
RONNIE: Porphyria is the basis
189
00:10:08,240 --> 00:10:10,280
of the history
of the legend of the vampire.
190
00:10:10,400 --> 00:10:12,480
I actually have vampire disease.
191
00:10:12,600 --> 00:10:15,360
Extreme sensitivity to sunlight
192
00:10:15,480 --> 00:10:18,400
is the latest in a long history
of health problems for Ronnie,
193
00:10:18,520 --> 00:10:20,280
caused by HIV.
194
00:10:20,400 --> 00:10:24,920
I've actually contracted by HIV
when I was 23
195
00:10:25,040 --> 00:10:28,520
so, basically, it's been
predominantly my whole adult life.
196
00:10:28,640 --> 00:10:32,280
I was part of the initial onset.
197
00:10:32,400 --> 00:10:34,720
I lived inner-city Sydney then.
198
00:10:34,840 --> 00:10:37,960
And, basically,
it was horrific in those days.
199
00:10:38,080 --> 00:10:39,960
I lost most of my friends.
200
00:10:40,080 --> 00:10:44,560
Nearly three decades of potent
medications has kept Ronnie alive,
201
00:10:44,680 --> 00:10:47,920
but taken a toll on his liver.
202
00:10:48,040 --> 00:10:51,440
I've been a guinea pig
for some trials that were horrific.
203
00:10:51,560 --> 00:10:54,480
I still don't know what half the
things that went in my body then.
204
00:10:54,600 --> 00:10:58,600
But indirectly or directly,
they've affected my liver.
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00:10:58,720 --> 00:11:02,920
So, Ronne, if I can get you
to pop your arm out for me...
206
00:11:03,040 --> 00:11:06,280
Porphyria sufferers
often become anaemic
207
00:11:06,400 --> 00:11:08,800
because the iron in their blood
collects in the liver.
208
00:11:08,920 --> 00:11:13,640
In the past, the best way
to top up your iron levels
209
00:11:13,760 --> 00:11:15,440
was to drink animal's blood.
210
00:11:15,560 --> 00:11:17,520
OK.
Ronnie, are you ready?
211
00:11:17,640 --> 00:11:19,680
No.
212
00:11:19,800 --> 00:11:22,480
Three, two, one.
213
00:11:22,600 --> 00:11:25,000
For Ronnie, the modern treatment
is the opposite.
214
00:11:25,120 --> 00:11:27,440
He's having his blood drained.
215
00:11:27,560 --> 00:11:30,880
The way we treat Ronnie is by
removing some of his blood.
216
00:11:31,000 --> 00:11:35,440
By doing that, we're removing.
The iron stores from his liver
217
00:11:36,960 --> 00:11:42,040
The build-up of iron in his liver is
worsening this underlying process.
218
00:11:42,160 --> 00:11:44,320
So we're improving
his liver function,
219
00:11:44,440 --> 00:11:46,040
it's improving his liver's ability
220
00:11:46,160 --> 00:11:48,440
to clear some of those
toxic compounds.
221
00:11:48,560 --> 00:11:51,280
Ronnie has had weekly bleedings
222
00:11:51,400 --> 00:11:53,880
over the two months
since he developed the condition.
223
00:11:54,000 --> 00:11:56,360
We've been treating him
quite aggressively,
224
00:11:56,480 --> 00:11:59,880
more aggressively than usual, 'cause
he's had quite severe disease.
225
00:12:00,000 --> 00:12:02,840
If we continue
as aggressively as this,
226
00:12:02,960 --> 00:12:04,576
we're going to cause Ronnie
to become anaemic,
227
00:12:04,600 --> 00:12:06,000
we'll take too much blood.
228
00:12:06,120 --> 00:12:09,840
So we're sailing the fine line
between controlling his porphyria
229
00:12:09,960 --> 00:12:12,040
and not causing him anaemia.
230
00:12:12,160 --> 00:12:13,976
We're sort of approaching that stage
at the moment
231
00:12:14,000 --> 00:12:15,880
so we've gotta go
very, very carefully.
232
00:12:16,000 --> 00:12:19,720
At the limit of his ability
to cope with the blood loss,
233
00:12:19,840 --> 00:12:23,720
Ronnie must now hope his
agonising lesions begin to heal
234
00:12:23,840 --> 00:12:26,440
so he can come out of the shadows.
235
00:12:35,520 --> 00:12:37,960
I'll give you the beginner's guide
to breast ultrasound.
236
00:12:38,080 --> 00:12:39,080
Thank you.
237
00:12:39,120 --> 00:12:42,920
46-year-old Kirsty has been referred
to the Robina Breast Clinic
238
00:12:43,040 --> 00:12:46,400
after a routine mammogram came back
with abnormal results.
239
00:12:46,520 --> 00:12:49,120
There's a little bit of fat there.
240
00:12:49,240 --> 00:12:52,560
And it doesn't take long for Dr Liang
to confirm the findings.
241
00:12:52,680 --> 00:12:54,760
That's the skin stripe, the fat,
242
00:12:54,880 --> 00:12:58,400
this fluffy stuff all round it
is the breast tissue,
243
00:12:58,520 --> 00:13:03,520
and then in amongst the breast
tissue, you can see this lump,
244
00:13:03,640 --> 00:13:05,600
which isn't supposed to be there.
245
00:13:07,600 --> 00:13:09,000
That's your cancer.
Oh.
246
00:13:09,120 --> 00:13:10,320
Mmm.
247
00:13:12,000 --> 00:13:14,240
Already 2.5cm across,
248
00:13:14,360 --> 00:13:17,720
Kirsty opts to have the lump
taken out as soon as possible.
249
00:13:17,840 --> 00:13:19,720
I don't want to wait.
250
00:13:19,840 --> 00:13:21,680
I just want to get it
over and done with.
251
00:13:21,800 --> 00:13:26,240
Typically, around the 2cm to 3cm
mark is where women start to feel it
252
00:13:26,360 --> 00:13:28,360
as a separate lump
from the rest of their tissue.
253
00:13:28,480 --> 00:13:30,120
And more likely than not,
254
00:13:30,240 --> 00:13:32,480
the tumour would have
started spreading by then,
255
00:13:32,600 --> 00:13:34,040
gone to the lymph glands.
256
00:13:34,160 --> 00:13:36,080
And once it goes to
the lymph glands, of course,
257
00:13:36,200 --> 00:13:38,080
it starts going elsewhere -
liver, lungs, bone.
258
00:13:38,200 --> 00:13:41,680
By the time it reaches that
sort of stage, we can't cure it.
259
00:13:41,800 --> 00:13:44,800
Right now, we have to
save your life first, and...
260
00:13:44,920 --> 00:13:46,560
Kirsty has done everything right
261
00:13:46,680 --> 00:13:49,920
but it's still possible that this
cancer may be life-threatening.
262
00:13:50,040 --> 00:13:52,880
The most important prognostic factor
263
00:13:53,000 --> 00:13:54,880
is whether the cancer
has started travelling.
264
00:13:55,000 --> 00:13:57,720
And we'll know that after surgery.
265
00:14:07,760 --> 00:14:09,240
Down in the operating theatre,
266
00:14:09,360 --> 00:14:12,360
a trauma team is trying to save a man
from bleeding to death
267
00:14:12,480 --> 00:14:14,480
after a close-range gunshot wound.
268
00:14:15,600 --> 00:14:18,720
An X-ray reveals the slug that
entered through the man's belly
269
00:14:18,840 --> 00:14:21,280
has lodged right near his spine.
270
00:14:21,400 --> 00:14:23,840
When the bullet went in
from the front,
271
00:14:23,960 --> 00:14:25,760
it must have hit something harder -
272
00:14:25,880 --> 00:14:27,960
most likely here
at the vertebral body -
273
00:14:28,080 --> 00:14:29,840
and just blew up a bit.
274
00:14:29,960 --> 00:14:33,040
The bullet tore a path
of destruction.
275
00:14:33,160 --> 00:14:36,560
The bullet actually
ruptured the bowels.
276
00:14:36,680 --> 00:14:38,840
One piece was nearly fully ruptured.
277
00:14:38,960 --> 00:14:42,840
And the other, the small bowel, just
two holes, an in and an out hole.
278
00:14:44,200 --> 00:14:47,880
Dr Wullschleger is able to pass his
finger right through the bullet hole.
279
00:14:48,000 --> 00:14:51,920
Because it's high energy,
you can't salvage this bowel,
280
00:14:52,040 --> 00:14:53,560
so we took that off.
281
00:14:53,680 --> 00:14:58,040
But even with the damaged sections
of the bowel removed,
282
00:14:58,160 --> 00:15:00,560
the blood continues to pool
inside the abdomen.
283
00:15:04,520 --> 00:15:06,760
Vascular surgeon
Dr Mark Jackson arrives
284
00:15:06,880 --> 00:15:09,400
to help stem the life-threatening
flow of blood.
285
00:15:14,600 --> 00:15:18,360
There's a laceration on the aorta
behind the pancreas.
286
00:15:18,480 --> 00:15:21,520
So we just need to get
some control of the artery.
287
00:15:30,200 --> 00:15:32,120
It turns out there's not
one big bleed,
288
00:15:32,240 --> 00:15:34,280
but lots of smaller ones.
289
00:15:34,400 --> 00:15:37,880
The bleeding was coming
from deep down in his abdomen,
290
00:15:38,000 --> 00:15:39,760
the area that we call
the retroperitoneum.
291
00:15:39,880 --> 00:15:43,040
And essentially, the bullet had
hit a number of big veins
292
00:15:43,160 --> 00:15:46,320
that come from - big veins and
arteries that supply the bowel.
293
00:15:46,440 --> 00:15:49,360
The bullet is still lodged
near the man's spine.
294
00:15:49,480 --> 00:15:51,560
But before they can
try and remove it,
295
00:15:51,680 --> 00:15:54,800
the team must first close off every
leaking blood vessel.
296
00:15:54,920 --> 00:15:58,320
We clamed the aorta
and that gave us good control
297
00:15:58,440 --> 00:16:00,560
and enabled us to
suture the bleeding
298
00:16:00,680 --> 00:16:02,480
and get control of the bleeding.
299
00:16:02,600 --> 00:16:06,400
What's his pressure, Simon?
Pressure is 110 systolic.
300
00:16:06,520 --> 00:16:09,480
Yeah... (SPEAKS INAUDIBLY).
301
00:16:09,600 --> 00:16:11,160
Yeah, the clamp's fully off.
302
00:16:11,280 --> 00:16:14,360
The open tummy gets packed with
absorbent towels
303
00:16:14,480 --> 00:16:16,080
and temporarily closed.
304
00:16:18,080 --> 00:16:21,120
It's now time to deal with the most
precarious part of the surgery -
305
00:16:21,240 --> 00:16:25,600
to remove that bullet lodged
right near the young man's spine.
306
00:16:35,320 --> 00:16:38,200
Which arm are we doing?
The left's better.
307
00:16:38,320 --> 00:16:40,360
Over the past three months,
308
00:16:40,480 --> 00:16:42,960
Dr Stuart Aitken has been draining
Ronnie's blood weekly
309
00:16:43,080 --> 00:16:46,480
to stimulate liver function so his
body will get rid of the toxins
310
00:16:46,600 --> 00:16:49,760
caused by the vampire disease
porphyria.
311
00:16:49,880 --> 00:16:52,200
His blood tests show that his bloods
312
00:16:52,320 --> 00:16:54,640
are getting almost
perfectly into the area
313
00:16:54,760 --> 00:16:56,280
where we want them to be.
314
00:16:56,400 --> 00:17:00,520
It's his last day of treatment,
but despite the liver improving,
315
00:17:00,640 --> 00:17:02,280
there's some bad news for Ronnie.
316
00:17:04,080 --> 00:17:06,200
Getting rid of the disease
is going to take
317
00:17:06,320 --> 00:17:09,200
a few months of absolutely
no exposure to the sun.
318
00:17:09,320 --> 00:17:11,920
I recommend gloves when you go out.
319
00:17:12,040 --> 00:17:13,040
Gloves?
Mm-hm.
320
00:17:13,160 --> 00:17:16,480
I'd recommend not going out in
direct sunlight at all.
321
00:17:16,600 --> 00:17:18,520
And if you do, gloves.
322
00:17:18,640 --> 00:17:21,200
Every time you have
any sun exposure,
323
00:17:21,320 --> 00:17:23,120
those lesions will get worse.
324
00:17:23,240 --> 00:17:25,440
Until they're gone?
Yeah.
325
00:17:25,560 --> 00:17:28,480
And then?
And then the gloves can come off.
326
00:17:28,600 --> 00:17:32,640
I didn't really wanna hear that.
Mmm. Yeah.
327
00:17:32,760 --> 00:17:33,760
OK.
328
00:17:33,800 --> 00:17:37,920
Any sun exposure
and the skin will blister.
329
00:17:38,040 --> 00:17:39,040
OK.
330
00:17:39,080 --> 00:17:40,680
It's understandably upsetting.
331
00:17:40,800 --> 00:17:44,840
I'm sure that any of us, if we had
to wear hats, long sleeves, gloves
332
00:17:44,960 --> 00:17:47,960
every time we went out into the sun,
it would get to you.
333
00:17:48,080 --> 00:17:51,240
You'd probably be able to do it for
a few days without much of an issue,
334
00:17:51,360 --> 00:17:53,600
but after it goes on
for months and months,
335
00:17:53,720 --> 00:17:56,240
that would get very annoying,
336
00:17:56,360 --> 00:18:00,400
and would have to affect your
psychological state and your mood.
337
00:18:00,520 --> 00:18:05,560
Ronnie has bravely battled health
conditions related to his HIV
338
00:18:05,680 --> 00:18:07,360
for 28 years.
339
00:18:07,480 --> 00:18:11,680
But to be denied access to sunshine
is perhaps the cruellest setback yet.
340
00:18:13,200 --> 00:18:18,120
No sun, sit inside, no work,
can't be too active,
341
00:18:18,240 --> 00:18:19,840
I may as well get in a box.
342
00:18:19,960 --> 00:18:21,360
Do you know what I mean?
343
00:18:21,480 --> 00:18:23,376
That's how it's feeling
with just that last statement.
344
00:18:23,400 --> 00:18:27,920
You know, like, that vampire disease
makes it really feel real.
345
00:18:28,040 --> 00:18:30,280
It feels like I should
just go lie in a coffin.
346
00:18:32,520 --> 00:18:34,200
There's a gloomy few months ahead
347
00:18:34,320 --> 00:18:36,560
but at the end of it,
unlike a vampire,
348
00:18:36,680 --> 00:18:39,520
Ronnie will be able to get back
out in the sunshine
349
00:18:39,640 --> 00:18:41,400
and get on with life.
350
00:18:41,520 --> 00:18:45,560
Ronnie's a battler.
Ronnie doesn't give up.
351
00:18:45,680 --> 00:18:51,880
The big picture. It's got to be done
so I accept that, you know?
352
00:18:52,000 --> 00:18:54,000
Like, as in, that's what it is.
353
00:18:54,120 --> 00:18:57,640
So it's just another little hurdle
but I'm jumping
354
00:18:57,760 --> 00:19:00,920
and, you know, as the Olympics
of health are going,
355
00:19:01,040 --> 00:19:02,840
I think I'm doing marathons.
356
00:19:02,960 --> 00:19:05,160
So all good.
357
00:19:12,040 --> 00:19:13,720
When it comes to cosmetic work,
358
00:19:13,840 --> 00:19:17,360
the hospital's Director of
Plastic Surgery, Dr Raja Sawhney,
359
00:19:17,480 --> 00:19:18,800
is an artist.
360
00:19:18,920 --> 00:19:22,000
But his real interest lies
in improving patient's lives
361
00:19:22,120 --> 00:19:24,080
with reconstructive work.
362
00:19:24,200 --> 00:19:25,720
My biggest interest
in plastic surgery
363
00:19:25,840 --> 00:19:28,200
has always been hand surgery
and upper limb surgery
364
00:19:28,320 --> 00:19:31,880
and I find that
extremely rewarding too.
365
00:19:32,000 --> 00:19:33,400
Just a few months ago,
366
00:19:33,520 --> 00:19:36,800
world-renowned hand and upper limb
specialist Dr Randy Bindra
367
00:19:36,920 --> 00:19:39,680
joined the international team
on the Gold Coast.
368
00:19:39,800 --> 00:19:43,920
I think the hand surgery
involves more finesse.
369
00:19:44,040 --> 00:19:47,760
And I enjoy doing finer things.
370
00:19:47,880 --> 00:19:50,600
So he had some trapezial or
trapezoidal injury there as well.
371
00:19:50,720 --> 00:19:54,000
Dr Raj and Dr Randy
make an expert double act
372
00:19:54,120 --> 00:19:56,160
in the operating theatre.
373
00:19:56,280 --> 00:19:57,720
We often do cases together.
374
00:19:57,840 --> 00:20:00,520
We enjoy working together 'cause
we're both hand surgeons.
375
00:20:00,640 --> 00:20:04,240
I do more soft tissue work.
Professor does all the bony work.
376
00:20:04,360 --> 00:20:06,120
It's just better when you have
377
00:20:06,240 --> 00:20:09,560
people with more experience in
parts of it all working together.
378
00:20:09,680 --> 00:20:12,720
You end up with better results
for your patient, better outcomes,
379
00:20:12,840 --> 00:20:15,520
and it's nicer for the surgeons too.
380
00:20:15,640 --> 00:20:19,240
It's a concert.
It's a concert without a conductor.
381
00:20:19,360 --> 00:20:21,480
Yeah. (LAUGHS)
382
00:20:21,600 --> 00:20:24,600
The next concert the pair play may
just change the life
383
00:20:25,600 --> 00:20:27,000
of single dad Mahmood.
384
00:20:28,200 --> 00:20:30,160
This is Randy.
Hey, Raj.
385
00:20:30,280 --> 00:20:32,080
Good to see you.
386
00:20:32,200 --> 00:20:35,480
I have one son and one daughter.
387
00:20:35,600 --> 00:20:38,760
Um, I love them. (LAUGHS)
388
00:20:38,880 --> 00:20:41,800
Mahmood lost his right eye and
damaged his hand
389
00:20:41,920 --> 00:20:45,080
in a fireworks accident in Iran
more than 20 years ago.
390
00:20:45,200 --> 00:20:48,760
He's been an electrician in Iran
and he's tried to get work
391
00:20:48,880 --> 00:20:50,160
but because of these injuries,
392
00:20:50,280 --> 00:20:53,040
some people have thought
that he looks a bit scary
393
00:20:53,160 --> 00:20:55,560
and worry about whether there's
394
00:20:55,680 --> 00:20:57,600
a criminal background
or something because of it.
395
00:20:57,680 --> 00:21:03,040
All the people think, "This man is
really danger man," or like this
396
00:21:03,160 --> 00:21:05,120
but I'm not, I'm not.
397
00:21:05,240 --> 00:21:07,640
I'm very... I'm very peaceful.
398
00:21:07,760 --> 00:21:09,160
That's great.
He's a gentle giant.
399
00:21:09,280 --> 00:21:10,720
Yeah.
(LAUGHS)
400
00:21:12,480 --> 00:21:14,880
A gentle giant with a working
opposable thumb
401
00:21:15,000 --> 00:21:17,720
will be able to go back to working
as an electrician
402
00:21:17,840 --> 00:21:21,440
and make a better life in Australia
for himself and his two kids.
403
00:21:21,560 --> 00:21:26,760
I'm very thankful
of all the doctors,
404
00:21:26,880 --> 00:21:30,320
also all the Australian people
and government.
405
00:21:30,440 --> 00:21:33,560
They're... 'cause they provide this.
406
00:21:33,680 --> 00:21:37,600
I'm really respectful to them,
thankful to them.
407
00:21:37,720 --> 00:21:39,160
Returning function to the thumb
408
00:21:39,280 --> 00:21:41,960
won't just be good
for Mahmood and his family,
409
00:21:42,080 --> 00:21:45,880
Raja and Randy will enjoy every
minute of it too.
410
00:21:46,920 --> 00:21:49,520
I like these ones.
I got no ears so...
411
00:21:49,640 --> 00:21:52,280
I wear.. I don't have ears.
Here, use this... Oh, OK.
412
00:21:52,400 --> 00:21:55,360
(BOTH LAUGH)
413
00:21:55,480 --> 00:21:57,840
I don't think I ever operated
with a turban on.
414
00:21:57,960 --> 00:22:00,640
No, I don't think I ever did.
Gets a little hot.
415
00:22:00,760 --> 00:22:03,520
But at least when you bang your head
on the lights, it don't hurt.
416
00:22:03,640 --> 00:22:05,480
(LAUGHS)
417
00:22:19,440 --> 00:22:22,680
Anna and Steve are expecting their
third baby tomorrow.
418
00:22:25,200 --> 00:22:27,840
And they are determined
the baby will arrive on time.
419
00:22:27,960 --> 00:22:31,600
I've got an appointment
with Pauline for 12:30.
420
00:22:33,040 --> 00:22:36,040
I'm due tomorrow,
which is my dad's birthday.
421
00:22:36,160 --> 00:22:37,960
All of our children have been due
422
00:22:38,080 --> 00:22:39,640
on one of their
grandparents' birthdays.
423
00:22:39,720 --> 00:22:43,200
So we're hoping that the baby will
arrive on its due date
424
00:22:43,320 --> 00:22:46,040
but the other two didn't so that
probably won't happen.
425
00:22:46,160 --> 00:22:49,640
Not wanting to have history repeat
itself on the eve of her due date,
426
00:22:49,760 --> 00:22:52,280
Anna is going to try
every non-medical way
427
00:22:52,400 --> 00:22:53,960
of getting labour going,
428
00:22:54,080 --> 00:22:56,800
starting with a cervical stretch
and sweep.
429
00:22:57,880 --> 00:22:59,280
(LAUGHS)
430
00:22:59,400 --> 00:23:01,000
Alright, so just drop your bottom.
431
00:23:01,120 --> 00:23:03,280
Relax your legs.
432
00:23:03,400 --> 00:23:07,520
OK, and just look at your man's face
and he can keep you occupied.
433
00:23:07,640 --> 00:23:10,280
OK, so stretching now,
stretching now.
434
00:23:10,400 --> 00:23:12,760
And just another sweep.
435
00:23:12,880 --> 00:23:15,560
I've got the shortest fingers
in midwifery.
436
00:23:15,680 --> 00:23:17,440
Yeah.
437
00:23:17,560 --> 00:23:19,760
There's no guarantee this
circular action in the cervix
438
00:23:19,880 --> 00:23:21,520
will bring on labour.
439
00:23:21,640 --> 00:23:24,000
And Anna is not taking any chances.
440
00:23:24,120 --> 00:23:25,600
Hi. How are you?
441
00:23:25,720 --> 00:23:28,080
So next up is some
pregnancy pampering.
442
00:23:28,200 --> 00:23:30,000
With her bump buddy Abby.
443
00:23:30,120 --> 00:23:33,720
Oh, is this on, this chair?
444
00:23:33,840 --> 00:23:36,400
Rumour has it a pedicure
could do the trick.
445
00:23:36,520 --> 00:23:39,640
Yeah, they said that
it can stimulate labour.
446
00:23:39,760 --> 00:23:41,800
So I'll have it on, yeah.
447
00:23:41,920 --> 00:23:44,280
While the girls feet
are being made fabulous,
448
00:23:44,400 --> 00:23:48,280
they make sure they've covered every
baby-bringing method in the book.
449
00:23:48,400 --> 00:23:50,080
Yeah, I had a friend telling me
450
00:23:50,200 --> 00:23:52,120
how she got one of
her labours kick-started
451
00:23:52,240 --> 00:23:53,880
was walking up and down
stairs sideways.
452
00:23:54,000 --> 00:23:55,880
(BOTH LAUGH)
453
00:23:56,000 --> 00:23:58,240
I've been eating dates.
Oh, have you?
454
00:23:58,360 --> 00:24:00,360
Yeah.
Did you do that last time at all?
455
00:24:00,480 --> 00:24:02,760
Yeah.
(BOTH LAUGH)
456
00:24:02,880 --> 00:24:06,080
They do say being intimate
with your partner, of course.
457
00:24:06,200 --> 00:24:08,320
Yeah, it comes out
the same way it got in.
458
00:24:08,440 --> 00:24:11,600
Yeah, I don't think that works.
(LAUGHS)
459
00:24:11,720 --> 00:24:14,280
But before she heads home,
there's one more stop for Anna.
460
00:24:14,400 --> 00:24:16,040
And that's acupuncture.
461
00:24:16,160 --> 00:24:17,680
Hi, Anna Hi, how are you?
462
00:24:17,800 --> 00:24:20,416
I've heard acupuncture works, but
it didn't in my last two pregnancies
463
00:24:20,440 --> 00:24:21,840
so maybe third time lucky.
464
00:24:21,960 --> 00:24:24,120
Haven't had a baby
in this room before
465
00:24:24,240 --> 00:24:26,120
but, you know, you go right head.
466
00:24:26,240 --> 00:24:29,280
Nice and relaxing atmosphere.
467
00:24:34,200 --> 00:24:35,480
So far, so good?
468
00:24:35,600 --> 00:24:40,480
It'd be nice for the baby to share
its birthday with my dad tomorrow.
469
00:24:40,600 --> 00:24:44,480
The last two women I've treated
have laboured overnight.
470
00:24:44,600 --> 00:24:45,760
So...
That night?
471
00:24:45,880 --> 00:24:46,880
Yes.
472
00:24:47,000 --> 00:24:48,880
Tonight, Anna will be keeping
everything crossed
473
00:24:48,920 --> 00:24:52,000
in the hope that tomorrow brings
a double celebration.
474
00:25:02,920 --> 00:25:05,960
It's just a few days since
46-year-old Kirsty
475
00:25:06,080 --> 00:25:11,760
discovered she has a 2.5cm cancer
growing quickly in her breast.
476
00:25:11,880 --> 00:25:15,440
Today, she will have a large section
of breast tissue taken out
477
00:25:15,560 --> 00:25:18,960
by Dr Rhea Liang
and her all-female surgical team.
478
00:25:19,080 --> 00:25:21,480
More often than not,
we are female predominant.
479
00:25:21,600 --> 00:25:24,040
This is Maddy, who's my intern.
480
00:25:24,160 --> 00:25:27,200
And we've got Kim,
who's the registrar... scrubbing.
481
00:25:27,320 --> 00:25:29,240
So we've got an all-girl team
for Kirsty today.
482
00:25:29,360 --> 00:25:31,360
It almost sits just behind
the nipple, doesn't it?
483
00:25:31,480 --> 00:25:35,000
Treating breast cancer is
one medical specialty
484
00:25:35,120 --> 00:25:37,120
that attracts
a much higher proportion
485
00:25:37,240 --> 00:25:40,120
of female doctors and nurses
than any other.
486
00:25:42,080 --> 00:25:44,000
Does it make a difference
to the women?
487
00:25:46,000 --> 00:25:47,920
It may sounds sexist
but I think it does.
488
00:25:48,040 --> 00:25:52,640
I think it is innately more
comfortable to talk to a woman
489
00:25:52,760 --> 00:25:54,040
about your womanly bits.
490
00:25:54,160 --> 00:25:56,280
I think that women
make really lovely surgeons.
491
00:25:56,400 --> 00:25:59,440
You know, just the delicacy with
which they hold the tissues
492
00:25:59,560 --> 00:26:02,216
and their sort of natural feeling
for how to communicate with people,
493
00:26:02,240 --> 00:26:04,960
dealing with the emotional
and social aspects.
494
00:26:05,080 --> 00:26:08,240
I just think that women do that just
a little bit better than the blokes.
495
00:26:08,360 --> 00:26:10,760
Not biased at all. (LAUGHS)
496
00:26:12,800 --> 00:26:15,400
She just went for a mammogram.
She's got no symptoms at all.
497
00:26:17,640 --> 00:26:20,760
But, you know, in the end, that'll
probably end up saving her life.
498
00:26:22,680 --> 00:26:25,960
Rhea will remove the lump and enough
fatty tissue around it
499
00:26:26,080 --> 00:26:28,080
to make sure
she hasn't missed anything.
500
00:26:28,200 --> 00:26:30,960
But there is another procedure
to do first.
501
00:26:31,080 --> 00:26:34,200
What we need to know is whether
the cancer has started spreading.
502
00:26:34,320 --> 00:26:37,720
And the first place to check is
in the lymph glands under the arm.
503
00:26:41,440 --> 00:26:43,600
A blue dye injection will show Rhea
504
00:26:43,720 --> 00:26:46,560
which of Kirsty's lymph nodes
is most at risk.
505
00:26:46,680 --> 00:26:50,080
Pop the tracer dye in and we massage
that into the breast
506
00:26:50,200 --> 00:26:53,320
and it follows the same pathways
that the cancer travels down.
507
00:26:53,440 --> 00:26:55,800
And so we follow those down
into the armpit
508
00:26:55,920 --> 00:26:59,400
and take out the first one or two
nodes that the dye hits.
509
00:26:59,520 --> 00:27:00,880
There she blows.
510
00:27:01,000 --> 00:27:04,280
That's good.
So you can see it just down there.
511
00:27:04,400 --> 00:27:06,400
Yeah. (SPEAKS INDISTINCTLY)
512
00:27:06,520 --> 00:27:10,600
Rhea removes the dye-injected node
and sends it to the pathology lab.
513
00:27:10,720 --> 00:27:12,560
OK, that's cool.
514
00:27:12,680 --> 00:27:14,160
Sentinel node can be sent.
515
00:27:19,560 --> 00:27:21,176
Those nodes get sent down
to the pathologist,
516
00:27:21,200 --> 00:27:23,056
the pathologist looks at them
under the microscope
517
00:27:23,080 --> 00:27:24,480
and gives us a phone call
518
00:27:24,600 --> 00:27:26,520
to tell us whether there's
cancer in them or not.
519
00:27:26,640 --> 00:27:28,320
I'll grab that off you. Thanks.
520
00:27:28,440 --> 00:27:31,040
A positive test result will mean that
521
00:27:31,160 --> 00:27:35,280
the cancerous growth in Kirsty's
breast has already started to spread
522
00:27:35,400 --> 00:27:39,480
and she'll be facing a long difficult
fight for her life.
523
00:27:49,360 --> 00:27:52,320
A trauma team hard at work
on a gunshot victim
524
00:27:52,440 --> 00:27:54,240
have stopped his internal
haemorrhaging
525
00:27:54,360 --> 00:27:58,000
and now they're going after
the bullet lodged near his spine.
526
00:27:58,120 --> 00:28:01,080
We knew that the bullet is just
under the skin on the back
527
00:28:01,200 --> 00:28:03,960
so that's why we decided
to just roll him quickly -
528
00:28:04,080 --> 00:28:05,440
he was stable now -
529
00:28:05,560 --> 00:28:07,480
roll him quickly,
get the bullet out.
530
00:28:07,600 --> 00:28:11,000
The bullet entered the man's stomach,
531
00:28:11,120 --> 00:28:14,000
tore a path of destruction
all the way through his body,
532
00:28:14,120 --> 00:28:15,520
ricocheted off his spine,
533
00:28:15,640 --> 00:28:18,000
and stopped just under the skin
of his back.
534
00:28:20,920 --> 00:28:22,680
With the X-ray to guide him,
535
00:28:22,800 --> 00:28:26,360
Dr Wullschleger is able to open
a small incision near the bullet
536
00:28:26,480 --> 00:28:27,800
and pop it out.
537
00:28:32,400 --> 00:28:35,040
WOMAN: OK, I need
whoever took the bullet out
538
00:28:35,160 --> 00:28:38,840
too actually give it
to the policeman, in a pot,
539
00:28:38,960 --> 00:28:41,040
as chain of evidence, OK?
540
00:28:44,400 --> 00:28:47,680
The instant it's out, a detective
from Queensland Police Service
541
00:28:47,800 --> 00:28:50,040
is waiting to collect the evidence.
542
00:28:51,720 --> 00:28:54,240
It's not every day a police officer
is in the operating theatre.
543
00:28:54,320 --> 00:28:57,960
And Dr Wullschleger must personally
hand him the slug.
544
00:29:00,640 --> 00:29:04,560
Today's surgery has got the man out
of danger of bleeding to death.
545
00:29:04,680 --> 00:29:07,680
But there's still plenty more
work to do on his injuries.
546
00:29:07,800 --> 00:29:10,240
The plan from
the surgical point of view
547
00:29:10,360 --> 00:29:13,400
is to take him back
tomorrow or the day after
548
00:29:13,520 --> 00:29:15,280
because we didn't close the abdomen.
549
00:29:15,400 --> 00:29:17,240
So we have to have another look.
550
00:29:18,400 --> 00:29:20,400
If there is more bleeding,
stop that bleeding,
551
00:29:20,520 --> 00:29:22,200
clean it out, wash it out well.
552
00:29:22,320 --> 00:29:26,120
Then we have to anastomose
the bowels back together
553
00:29:26,240 --> 00:29:28,920
and then probably close him up.
554
00:29:29,040 --> 00:29:32,760
The man will spend tonight under
police guard in intensive care.
555
00:29:34,400 --> 00:29:36,760
It will take more than a month
of surgeries and recovery
556
00:29:36,880 --> 00:29:38,680
before he's released from hospital.
557
00:29:51,560 --> 00:29:53,000
Relax your legs.
558
00:29:53,120 --> 00:29:55,080
OK, just look at your man...
559
00:29:55,200 --> 00:29:58,360
There's not much Anna didn't try
yesterday to bring on labour -
560
00:29:58,480 --> 00:30:03,280
cervical sweep, massage, pedicure
and acupuncture -
561
00:30:03,400 --> 00:30:05,840
and it seems to have worked.
562
00:30:08,400 --> 00:30:10,681
It's one in the morning in
the hospital's birthing centre.
563
00:30:12,200 --> 00:30:14,680
Anna, her husband, Steve,
and Anna's mum, Lizzy,
564
00:30:14,800 --> 00:30:16,600
who's flown in especially
from the UK,
565
00:30:16,720 --> 00:30:19,520
are all hoping the baby
will be born today
566
00:30:19,640 --> 00:30:21,760
so it will share a birthday
with Anna's father.
567
00:30:22,920 --> 00:30:25,720
It's been like this now for about an
hour and half - every two minutes.
568
00:30:25,800 --> 00:30:28,360
That's a head.
That's definitely a head.
569
00:30:28,480 --> 00:30:30,680
She had very quick births
with her last two babies,
570
00:30:30,800 --> 00:30:32,280
um, four hours long.
571
00:30:32,400 --> 00:30:33,840
We'll see what happens this time.
572
00:30:33,960 --> 00:30:35,960
I reckon it will be good
this time as well.
573
00:30:36,080 --> 00:30:38,720
No drugs. You can do it.
574
00:30:40,600 --> 00:30:42,760
Anna's waters
haven't actually broken yet
575
00:30:42,880 --> 00:30:46,720
but she's determined to have this
baby without the use of medication.
576
00:30:48,600 --> 00:30:50,560
Right, where are we going walking?
577
00:30:50,680 --> 00:30:52,160
Right, so you can walk here.
578
00:30:52,280 --> 00:30:55,840
Sometimes it's just that walking and
stretching your pelvis...
579
00:30:55,960 --> 00:30:58,560
That's it. Good.
(BOTH LAUGH)
580
00:30:58,680 --> 00:31:01,600
But as the night wears on,
Anna keeps trying.
581
00:31:01,720 --> 00:31:05,280
Clearly, the baby didn't get the memo
about the arrival time.
582
00:31:05,400 --> 00:31:06,560
Start.
I did.
583
00:31:06,680 --> 00:31:07,680
Alright.
584
00:31:07,800 --> 00:31:09,400
And the contractions timing app
585
00:31:09,520 --> 00:31:12,160
calculates that she's still
a long way off.
586
00:31:12,280 --> 00:31:14,560
It's just a waiting game.
587
00:31:16,520 --> 00:31:18,320
Jump on your mat there. On your mat.
588
00:31:18,440 --> 00:31:21,480
It will start happening soon
and then...
589
00:31:23,160 --> 00:31:24,160
We'll see.
590
00:31:24,240 --> 00:31:26,120
I'm falling asleep.
591
00:31:27,200 --> 00:31:29,040
Let's just watch
over the next half hour
592
00:31:29,160 --> 00:31:30,856
and see what's happening
with these contractions.
593
00:31:30,880 --> 00:31:33,120
And as dawn breaks
over the Gold Coast,
594
00:31:33,240 --> 00:31:36,960
there's no sign that baby is going
to share a birthday with Grandpa.
595
00:31:45,840 --> 00:31:48,960
Dr Rhea Liang
has just removed a lymph node
596
00:31:49,080 --> 00:31:52,200
from under the arm
of breast cancer patient Kirsty.
597
00:31:52,320 --> 00:31:54,160
Sentinel node can be sent.
598
00:31:54,280 --> 00:31:55,640
I'll grab that off you.
599
00:31:55,760 --> 00:31:58,480
The node has gone for a cancer cell
check at the lab
600
00:31:58,600 --> 00:32:02,440
while Rhea gets on with removing the
cancerous lump from Kirsty's breast.
601
00:32:02,560 --> 00:32:03,880
Lovely.
602
00:32:04,000 --> 00:32:06,360
So you may as well
keep hold of those
603
00:32:06,480 --> 00:32:08,880
'cause now we
chase the cancer top-side.
604
00:32:09,000 --> 00:32:10,120
There it is.
605
00:32:11,120 --> 00:32:12,480
Lovely. Alright.
606
00:32:12,600 --> 00:32:17,120
Dr Steven Weinstein is responsible
for assessing the sample,
607
00:32:17,240 --> 00:32:19,720
with a bit of help from his
technician, Brendan.
608
00:32:21,440 --> 00:32:24,240
So, what Brendan is doing,
he receives the node fresh,
609
00:32:24,360 --> 00:32:26,920
and then I come in
and cut that in half,
610
00:32:27,040 --> 00:32:28,800
put it in a little plastic boat,
611
00:32:28,920 --> 00:32:31,160
then Brendan puts it
on the cryostat,
612
00:32:31,280 --> 00:32:33,640
which is a frozen
section instrument.
613
00:32:33,760 --> 00:32:36,520
It's -20 degrees
or something like that.
614
00:32:36,640 --> 00:32:40,560
The idea is to take
what they call a section,
615
00:32:40,680 --> 00:32:46,880
which is just a very thin piece that
we can attach to the slide,
616
00:32:47,000 --> 00:32:48,320
and then we'll stain it.
617
00:32:48,440 --> 00:32:51,120
So when you stain it,
it'll show up the cellular features.
618
00:32:51,240 --> 00:32:53,840
It'll show up the tissue
that's in the lymph node
619
00:32:53,960 --> 00:32:56,200
and if there's any tumour there.
620
00:32:56,320 --> 00:32:57,920
It's come up pretty good.
621
00:32:58,040 --> 00:33:00,600
If the team in the lab find signs
622
00:33:00,720 --> 00:33:02,600
that Kirsty's cancer
has been spreading,
623
00:33:02,720 --> 00:33:06,720
then her chances of surviving
this scare take a massive hit.
624
00:33:06,840 --> 00:33:10,480
So we're kind of three-quarters
of the way around.
625
00:33:11,680 --> 00:33:15,040
And I just need to get
this last little bit here.
626
00:33:16,800 --> 00:33:19,320
Working in medicine
came very naturally for Rhea.
627
00:33:19,440 --> 00:33:21,480
I've come from
a long line of doctors.
628
00:33:21,600 --> 00:33:24,720
Yeah, my father, my grandfather
and my great-grandfather.
629
00:33:24,840 --> 00:33:27,240
Almost there.
630
00:33:27,360 --> 00:33:32,120
So I grew up in one of those
households where there was a feeling
631
00:33:32,240 --> 00:33:35,240
that medicine was a calling,
a service
632
00:33:35,360 --> 00:33:37,000
that you do to help other people.
633
00:33:38,120 --> 00:33:42,200
(PHONE RINGS)
Ooh! Is that the pathologist?
634
00:33:47,360 --> 00:33:49,480
Just as Rhea
gets the lump section out,
635
00:33:49,600 --> 00:33:51,440
Dr Weinstein rings with the results
636
00:33:51,560 --> 00:33:54,080
of his cancer check
on Kirsty's lymph node.
637
00:33:54,200 --> 00:33:55,720
Hello?
638
00:34:12,320 --> 00:34:15,240
(PHONE RINGS)
Ooh, is that the pathologist?
639
00:34:17,000 --> 00:34:19,920
Just as Dr Rhea Liang
removes a cancerous lump
640
00:34:20,040 --> 00:34:21,520
from Kirsty's breast,
641
00:34:21,640 --> 00:34:24,880
she gets a call from the pathologist
with the results on the lymph nodes.
642
00:34:26,680 --> 00:34:28,360
Hello?
643
00:34:29,520 --> 00:34:32,680
It's good news.
There's no sign of cancer cells.
644
00:34:32,800 --> 00:34:35,840
Oh, that's fantastic.
Thank you so much.
645
00:34:35,960 --> 00:34:37,176
We're super happy
about the sentinel node.
646
00:34:37,200 --> 00:34:39,760
The fact that it's come back
negative is really good news for us.
647
00:34:39,840 --> 00:34:41,360
So that's a win. Yeah.
648
00:34:41,480 --> 00:34:42,760
Bye now.
649
00:34:42,880 --> 00:34:45,960
Negative.
Excellent.
650
00:34:46,080 --> 00:34:47,080
Hooray!
651
00:34:47,200 --> 00:34:48,680
Let's move on.
Yeah.
652
00:34:48,800 --> 00:34:50,200
So let's mark the specimen now.
653
00:34:50,320 --> 00:34:54,200
Kirsty will lost about one cup size
from her breast in today's procedure,
654
00:34:54,320 --> 00:34:57,160
and for the next five years,
she'll be monitored closely
655
00:34:57,280 --> 00:34:59,480
for any recurrence of cancer.
656
00:34:59,600 --> 00:35:03,800
Her decision to have a routine
mammogram, and Dr Rhea Liang,
657
00:35:03,920 --> 00:35:06,000
have saved her from
a life-threatening illness.
658
00:35:06,120 --> 00:35:08,240
Lovely. There we go.
659
00:35:08,360 --> 00:35:12,600
KIRSTY: Oh, Dr Liang is awesome.
She's just fantastic.
660
00:35:12,720 --> 00:35:17,600
And she's done a fantastic job.
The scar's very small and neat.
661
00:35:17,720 --> 00:35:21,000
And, uh, I'm very thankful.
662
00:35:28,600 --> 00:35:32,680
36-year-old single dad Mahmood
lost the function in his right thumb
663
00:35:32,800 --> 00:35:35,560
in a fireworks accident
when he was just a teenager.
664
00:35:35,680 --> 00:35:40,560
Doctors Randy and Raja have cut away
the scar tissue in Mahmood's palm.
665
00:35:40,680 --> 00:35:44,160
Now they're preparing a transplant
of tissue to fill the gap.
666
00:35:45,720 --> 00:35:48,400
Randy frees up a spare tendon
from the index finger
667
00:35:48,520 --> 00:35:51,960
that will be used to give movement
back to Mahmood's thumb.
668
00:35:52,080 --> 00:35:54,400
This is my tendon. See it?
669
00:35:54,520 --> 00:35:56,560
So we're gonna pull it through
back here now.
670
00:35:56,680 --> 00:35:58,680
There we are.
671
00:35:58,800 --> 00:36:03,440
So you've got the tendon here. You
can see it's still attached to him.
672
00:36:04,880 --> 00:36:06,720
I've gotta get it back over here.
673
00:36:08,000 --> 00:36:11,440
I don't wanna go in a pocket.
I wanna go deep. Here.
674
00:36:11,560 --> 00:36:14,360
Making the tendon
pull the thumb closed
675
00:36:14,480 --> 00:36:16,840
means tunnelling it to the front.
676
00:36:16,960 --> 00:36:18,080
OK.
677
00:36:19,800 --> 00:36:21,800
(SPEAKS INDISTINCTLY)
678
00:36:23,920 --> 00:36:25,560
Yep.
Good. Hold the hand for me.
679
00:36:25,680 --> 00:36:28,520
Grab it. Gently pull it through.
680
00:36:28,640 --> 00:36:31,560
With the tunnel made,
Randy feeds the tendon through
681
00:36:31,680 --> 00:36:34,400
and connects it to the loose end
of the tendon in the thumb.
682
00:36:34,520 --> 00:36:37,480
So I've gotta secure the tendon
into this tissue here
683
00:36:37,600 --> 00:36:39,320
so it can pull on the thumb.
684
00:36:40,480 --> 00:36:43,400
Some temporary pins are put in
to hold the joint steady
685
00:36:43,520 --> 00:36:45,240
while things heal.
686
00:36:45,360 --> 00:36:47,920
And then Raja moves his
big skin graft into place.
687
00:36:52,240 --> 00:36:54,440
Now, you can see how that's
just fitting in nicely
688
00:36:54,560 --> 00:36:57,560
to fill in that defect.
689
00:36:59,800 --> 00:37:03,360
Now, the good thing with this tissue
is you can see it's expansile
690
00:37:03,480 --> 00:37:06,800
so when he stretches open,
it can stretch with it
691
00:37:06,920 --> 00:37:10,320
and it's a nice surface
for his flap.
692
00:37:10,440 --> 00:37:12,440
That'll do him well.
693
00:37:14,120 --> 00:37:16,800
You can see that tissue there's
quite bulky at the moment
694
00:37:16,920 --> 00:37:18,680
and that will stay bulky
for a while.
695
00:37:18,800 --> 00:37:20,800
But down the track,
I'll do some liposuction on it,
696
00:37:20,840 --> 00:37:24,080
depending on how it looks,
and contour it more if need be.
697
00:37:24,200 --> 00:37:25,600
But we'll do that down the track.
698
00:37:25,720 --> 00:37:28,000
But that will allow him
the opening up his web,
699
00:37:28,120 --> 00:37:29,480
which is what we wanted to do.
700
00:37:29,600 --> 00:37:33,160
Prof's done all the rest,
as we spoke about,
701
00:37:33,280 --> 00:37:36,000
with the tendon transfer
and ligament reconstruction.
702
00:37:36,120 --> 00:37:39,080
So this will give him a good chance
of getting some decent function back
703
00:37:39,200 --> 00:37:41,640
and the idea is
now he can open his hand
704
00:37:41,760 --> 00:37:46,360
he should be able to grasp and,
hopefully, grab a can of beer.
705
00:37:46,480 --> 00:37:49,480
If all goes well
with Mahmood's recovery,
706
00:37:49,600 --> 00:37:52,440
he may be able to land his first job
as an electrician
707
00:37:52,560 --> 00:37:55,200
since leaving Iran four years ago.
708
00:37:55,320 --> 00:37:56,600
(LAUGHS)
Nice one.
709
00:37:56,720 --> 00:37:58,400
I'll see you on the weekend,
I'm sure.
710
00:38:07,240 --> 00:38:10,880
After two previous births
involving doctors and drugs,
711
00:38:11,000 --> 00:38:13,760
Anna and Steve are hoping for
a drama-free delivery
712
00:38:13,880 --> 00:38:15,360
for baby number three.
713
00:38:16,880 --> 00:38:18,640
But after eight hours of labour,
714
00:38:18,760 --> 00:38:20,640
midwife Pauline
and Anna's mum, Lizzy,
715
00:38:20,760 --> 00:38:23,600
can't see any sign
that baby is about to be born.
716
00:38:23,720 --> 00:38:26,240
Was that contraction
a bit different?
717
00:38:26,360 --> 00:38:28,840
No.
No. Same as before?
718
00:38:28,960 --> 00:38:31,680
Basically, she's
had her waters broken.
719
00:38:31,800 --> 00:38:34,320
Now her contractions
are coming more frequently.
720
00:38:34,440 --> 00:38:36,840
She's now had some gas.
721
00:38:36,960 --> 00:38:39,280
Another contraction?
(SPEAKS INDISTINCTLY)
722
00:38:39,400 --> 00:38:43,200
So just give us a push down.
Sorry, sweetie.
723
00:38:43,320 --> 00:38:45,800
Are you feeling as if the baby's
pushing down on your cervix?
724
00:38:45,920 --> 00:38:48,640
No, just it hurts.
OK. Relax.
725
00:38:50,800 --> 00:38:53,360
Oh! (SPEAKS INDISTINCTLY)
726
00:38:53,480 --> 00:38:55,720
OK, so you've still got
cervix there.
727
00:38:55,840 --> 00:38:58,360
And what I'm trying to figure out
is how much.
728
00:38:58,480 --> 00:39:02,320
OK, so you're about 7cm.
729
00:39:02,440 --> 00:39:03,840
(WHIMPERS)
Yep.
730
00:39:03,960 --> 00:39:06,640
I really need you
to stay with me, OK?
731
00:39:06,760 --> 00:39:10,280
Anna is disappointed
that she's only 7cm dilated
732
00:39:10,400 --> 00:39:12,040
after 10 hours of labour.
733
00:39:12,160 --> 00:39:16,440
It could be many more hours before
she finally delivers her baby.
734
00:39:16,560 --> 00:39:19,040
So Pauline suggests
a change of plans.
735
00:39:19,160 --> 00:39:22,480
Oh! Oh!
736
00:39:22,600 --> 00:39:24,800
OK, just breathing in and out.
737
00:39:24,920 --> 00:39:29,120
So basically because we've been
contracting all night, alright,
738
00:39:29,240 --> 00:39:31,040
and we're getting
where we need to be -
739
00:39:31,160 --> 00:39:33,440
I think the baby's just turned
in a funny position -
740
00:39:33,560 --> 00:39:35,920
um, so, what I need to do now
741
00:39:36,040 --> 00:39:39,040
because it's getting to the point
where we've tried everything,
742
00:39:39,160 --> 00:39:42,560
I think what we need to do is get
the doctors to come and have a chat.
743
00:39:42,680 --> 00:39:45,400
(SPEAKS INDISTINCTLY)
744
00:40:01,600 --> 00:40:03,520
This is how we get our
daily exercise, hey, guys?
745
00:40:03,640 --> 00:40:06,360
On his rounds this morning,
Dr Randy Bindra drops in
746
00:40:06,480 --> 00:40:09,440
to see how Mahmood and his
rebuilt right hand are doing.
747
00:40:11,360 --> 00:40:13,280
(LAUGHS) Good to see you, mate.
748
00:40:13,400 --> 00:40:16,160
You're smiling. That's great.
Yeah.
749
00:40:16,280 --> 00:40:19,120
Honestly, I feel, changed my life.
750
00:40:19,240 --> 00:40:21,880
I feel they absolutely
changed my life.
751
00:40:22,000 --> 00:40:26,120
To... better life.
752
00:40:26,240 --> 00:40:30,000
The key to the reconstruction was
giving Mahmood an opposable thumb
753
00:40:30,120 --> 00:40:34,200
that will allow him to grasp things
and pick up small objects.
754
00:40:34,320 --> 00:40:38,040
What do you think? How may percent
thumb can move in the future?
755
00:40:38,160 --> 00:40:39,960
Before, you had no movement, OK?
756
00:40:40,080 --> 00:40:44,200
If everything heals well, I think
you'll have, like 60%, 70%.
757
00:40:44,320 --> 00:40:46,160
70%?
60%, 70%, yeah.
758
00:40:46,280 --> 00:40:47,280
Awesome.
759
00:40:47,360 --> 00:40:48,520
Absolutely awesome.
760
00:40:48,640 --> 00:40:50,960
Good.
Thank you so much.
761
00:40:51,080 --> 00:40:54,520
I think the most satisfying is if
somebody comes to the clinic
762
00:40:54,640 --> 00:40:57,120
and says, "Thank you.
763
00:40:57,240 --> 00:41:01,520
You've... I feel much better now
than I have in a long time,"
764
00:41:01,640 --> 00:41:08,320
or, "Thank you, I never though that
I would be able to do this again,"
765
00:41:08,440 --> 00:41:09,680
or, "play golf again,"
766
00:41:09,800 --> 00:41:12,520
or "do my knitting again, but now,
thanks to you, I can do it."
767
00:41:12,640 --> 00:41:16,040
I think a simple thankyou is what
makes it all worthwhile. For sure.
768
00:41:23,840 --> 00:41:25,640
In the birthing centre,
769
00:41:25,760 --> 00:41:29,240
third-time mum Anna has been hoping
for a drug-free water birth.
770
00:41:29,360 --> 00:41:32,440
But an extended labour
has forced her to reconsider.
771
00:41:32,560 --> 00:41:33,960
Please, give me morphine.
772
00:41:34,080 --> 00:41:36,080
OK, so just let's see
what's happening.
773
00:41:36,200 --> 00:41:37,720
OK.
774
00:41:37,840 --> 00:41:41,360
Owww!
775
00:41:41,480 --> 00:41:44,360
After a long night of contractions
but little progress,
776
00:41:44,480 --> 00:41:48,360
Anna was given an inducing drug,
and it seems to be working.
777
00:41:48,480 --> 00:41:52,000
Ahhh!
778
00:41:54,680 --> 00:41:56,720
OK, good job.
Want me to catch it?
779
00:41:56,840 --> 00:41:59,400
While the Irish are normally known
for their humour,
780
00:41:59,520 --> 00:42:02,680
tonight, Steve's jokes
are falling a little flat.
781
00:42:02,800 --> 00:42:05,320
Oh!
Right, just keep it going.
782
00:42:05,440 --> 00:42:08,680
Anna, really important you keep
things nice and calm.
783
00:42:08,800 --> 00:42:11,600
Breathing in and out.
784
00:42:11,720 --> 00:42:13,160
Oh, Anna, good on ya.
785
00:42:13,280 --> 00:42:14,640
In and out.
786
00:42:14,760 --> 00:42:19,440
Well done.
Oh, baby... (SPEAKS INDISTINCTLY)
787
00:42:19,560 --> 00:42:21,440
Oh, yes.
Good.
788
00:42:21,560 --> 00:42:24,320
Ow, ow, ow, ow, ow!
Well done, Anna.
789
00:42:24,440 --> 00:42:26,080
Oh!
790
00:42:26,200 --> 00:42:30,920
Anna's baby boy is out but she can't
relax until she knows he's OK.
791
00:42:31,040 --> 00:42:32,960
I can't hear crying.
No worries, yeah?
792
00:42:33,080 --> 00:42:35,520
Yeah, your baby's moving, Anna.
793
00:42:35,640 --> 00:42:37,880
He's... he's moving!
794
00:42:38,000 --> 00:42:40,480
He's moving.
795
00:42:40,600 --> 00:42:45,000
The long and difficult birth is not
what Anna and Steve were expecting,
796
00:42:45,120 --> 00:42:47,360
and it's left everyone
feeling exhausted.
797
00:42:47,480 --> 00:42:50,400
(TEARFULLY) Sorry.
798
00:42:50,520 --> 00:42:52,200
What are you sorry for?
799
00:42:52,320 --> 00:42:53,880
I don't know.
Don't be sorry.
800
00:42:54,000 --> 00:42:57,600
Don't be sorry. Well done.
801
00:42:57,720 --> 00:42:59,920
Sorry...
What are you sorry for?
802
00:43:00,040 --> 00:43:01,120
I don't know.
803
00:43:01,240 --> 00:43:03,520
(SIGHS)
804
00:43:03,640 --> 00:43:05,960
You're alright.
805
00:43:06,080 --> 00:43:08,320
Oh, wow.
806
00:43:16,160 --> 00:43:20,240
Anna's mum, Lizzy, came all the
way from England to be at the birth.
807
00:43:20,360 --> 00:43:22,480
Far more traumatic than
I thought it would be.
808
00:43:22,600 --> 00:43:25,520
Yeah. It was a lot more traumatic
than the last two.
809
00:43:25,640 --> 00:43:30,760
It was just a bit more complicated
and... yeah, just, ooh... terrible.
810
00:43:36,840 --> 00:43:39,640
Hello. Your biggest birthday present
has arrived.
811
00:43:41,800 --> 00:43:43,160
You've got a little grandson.
812
00:43:45,040 --> 00:43:47,280
Despite baby Romeo's
difficult arrival,
813
00:43:47,400 --> 00:43:50,080
he shares Anna's dad's birthday
as planned.
814
00:43:50,200 --> 00:43:53,800
And Anna is keener than ever
to keep growing her family.
815
00:43:55,880 --> 00:43:59,200
In fact, soon as she's rested
after delivering number three,
816
00:43:59,320 --> 00:44:03,400
Anna starts planning to have four,
five, six and seven.
817
00:44:03,520 --> 00:44:05,920
It wasn't quite
the candlelit water birth
818
00:44:06,040 --> 00:44:07,440
that I'd said I was gonna have.
819
00:44:07,560 --> 00:44:10,640
But never mind. Next one.
820
00:44:10,760 --> 00:44:14,920
I'd like seven, but... uh...
821
00:44:15,040 --> 00:44:16,880
Don't know...
(LAUGHS)
822
00:44:17,000 --> 00:44:18,120
I'm too easy going, you see?
823
00:44:18,200 --> 00:44:20,400
No, they're too lovely.
Look at them.
824
00:44:20,520 --> 00:44:22,200
I know. That's it.
825
00:44:22,320 --> 00:44:25,800
If Romeo does end up
with six brothers and sisters,
826
00:44:25,920 --> 00:44:29,360
at least he'll be able to say that
he's the first in the family
827
00:44:29,480 --> 00:44:31,400
to share a birthday
with Grandpa Johnny.
828
00:44:31,520 --> 00:44:34,520
Next time we see you,
goodness knows.
829
00:44:34,640 --> 00:44:37,600
I know. You're gonna be
running around, probably.
830
00:44:37,720 --> 00:44:40,640
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