24 Hours in A&E

Fifty two year old Mark is rushed to St George’s by air ambulance after a road traffic collision that threw him from his motorbike and left him suffering a cardiac arrest. Emergency doctors fight to keep him alive and when he arrives in A&E, Consultant Paul escalates his condition to ‘Code Red’ giving him an emergency blood transfusion. His wife Jacquie was at their home in Kent when police arrived to inform her of the accident and rush her to hospital: ‘We just felt they were getting us up there as quickly as possible really just to say goodbye to Mark.’ Jacquie talks about how her relationship with Mark slowly blossomed from a friendship into a romance. When Mark proposed at the top of a ski slope, Jacquie skied off, making him wait until the bottom to give him her answer “but there was never any doubt what the answer would be.” Now, married with two teenage sons, will the love of his family be enough to inspire Mark through his battle for survival? Twenty five year old Kayley is brought to St George’s after being thrown from her horse. On arrival, she has one leg longer than the other and doctors are worries she has a severe hip dislocation and other internal injuries. Her mother, Gail was at the scene of the accident, and describes the pain of seeing her daughter injured doing the thing she loves: ‘I’ve always been aware of the risks of the sport, riding has been so important to her if it was taken away from her she wouldn’t be the same.’ Whilst doctors await the results of Kayley’s scans, Gail explains she was forced to move from the tight knit community of the North East when the shipyards closed and her husband lost his job. She describes the poverty in the area at that time ‘There were long queues of men looking for work, there were long queues of women trying to buy provisions.’ The desire for a better life for her young family motivated her to ‘follow the work’ and move south. The risk paid off with Kayley pursuing her passion for animals, running a successful dog grooming business and buying a horse. Finally, Kayley’s scans confirm a severely dislocated hip and she’s rushed for emergency surgery to give her the best chance of walking normally again. Meanwhile, 23-year-old Receptionist, Melissa is having trouble hearing, and books an appointment with Emergency Nurse Practitioner, Craig. St George’s is like a ‘family business’ to her, with her mum, her sister, her cousin and her best friend all working on Reception at the hospital. Her dad was a paramedic, and met her mum whilst attending St George’s. Melissa explains that one day her father was admitted to resus in a critical condition while she was on shift. Despite the shock of dealing with such a personal tragedy at work, Melissa vowed to return to ensure she was there for other patients and their families in similar circumstances.

Eighty-year-old Frances is rushed to St George’s by air ambulance after she fell from a height of three metres into her empty swimming pool while gardening. Consultant Rathan is concerned that a significant wound to her head caused by the depth of her fall may conceal a bleed on her brain that could have life changing consequences. Frances had managed to call her son Clive and he called 999. He rushed to the scene, “I’ve never seen mum that broken before. There are twenty year olds who wouldn’t have survived that fall.” Clive talks about how his eighty year old mother is fiercely independent, continuing to mow the large lawn on her tractor and even re-felting the garden shed roof. He reminisces about happier times in childhood summers spent around the family swimming pool, his mum “swimming for hours, up and down, up and down, with incredible stamina.” As the medical team work quickly to identify France’s injuries, her independence appears in danger: “we wanted them to fix the hole on her head and get her back on her feet, give her some Savlon and send her home. It didn’t quite turn out like that.” Eighty six year old Ruth IS about to go on a cruise but brought to A&E with her heart beating at three times the normal rate. She arrives complaining of shortness of breath and tightness in her chest that feels “as if someone is pressing on it.” Consultant Rathan is concerned that her heart is only pumping out small amounts of blood: “a person isn’t going to last very long with a heart rate like that.” Doctors work quickly to address Ruth’s heart condition with fast-acting medication. Ruth talks about how she was born in Germany but grew up in Poland during the Second World War. Soon after the war ended Ruth and her mother we’re taken from their home in the middle of the night to prison and then to a labour camp. Some of the people she was imprisoned with didn’t survive. One of her tasks was to feed the other inmates and she talks about how the women who ran the kitchen would feed the children first before supplies ran low. Even in a place like that, “you always find kind people if you look for it.” Meanwhile twenty-year-old students Jerry and Sakille arrive in A&E after Jerry crashed the car on their way home from a party. Deciding to stay sober so she could drive her friends home, Jerry thinks she briefly fell asleep at the wheel. It’s a rite of passage for her as she concludes that having a full time job and partying until 5am on week nights might not be sensible anymore. Social media addicts, both Jerry and Sakille document their social life and their time in A&E on snapchat: “it’s basically like reality TV… but unedited!”

84 year old John is rushed to St George’s after losing control of his car and crashing into a road sign. His wife Gwynaeth was having a meal out with the WI when she was told the news of his accident “I was asked to go to the desk to see somebody, and the somebody was this police officer”. After bullseyeing his car windscreen, John’s blood pressure drops dangerously low and doctors declare a “Code Red,” giving him an emergency blood transfusion. Gwynaeth talks about how they met in a youth club aged just 11 and 13, where mutual friends were convinced they could predict the future “they thought we were going to get married eventually, but I said ‘no we’re just friends.’ ” It was only when John was sent away for National Service that Gwynaeth became aware of how close they really were “that’s when it really struck home, I missed him a lot more than I realised.” As doctors discover that John has a broken pelvis and will need emergency surgery, Gwynaeth talks of how she’s leant on John over their years of marriage. “I don’t think I know anyone else who I could rely on who could get me over the humps.” 66 year old Christine is brought to A&E with her husband Paul after the left side of her body collapsed whilst making her way to work at a local supermarket. Doctors suspect she’s suffered a stroke and Neurology registrar Anil is sent to Resus to assess her symptoms, “one moment you’re functioning normally and just suddenly, you can cruelly have the loss of the ability to do some things we really take for granted.” Christine is sent to CT and whilst doctors conduct further tests Christine talks about her upbringing on a farm in rural Ireland “I used to get up at 6 in the morning and go out and pull the hay, on a frosty morning your hands would be falling off you”. With no work in Ireland, she moved to London aged just 16 and was shocked when she arrived in Paddington Station to find the streets full of revellers “people were sitting on the side of the road drunk and happy, it was the next day I found out what was really going on ...England had just won the World Cup!” Worryingly, Christine’s CT scan shows no obvious sign of a stroke and doctors begin to suspect her symptoms may be the result of a tumour in her brain and admit her for further tests. Her husband Paul talks of how Christine’s strength and resilience helped him and their family through redundancy “that’s typical Chris, any problems that come up, she’s always really listened so that we get through it.” 7 year Reggie comes to A&E after hurting his arm whilst doing a cartwheel to celebrate England’s victory against Wales in the European Championships. As doctors examine his injury his Mum Hayley talks about how she always knew she wanted to be a Mum “some of my friends at school had these career plans to be journalists and doctors and dentists, no I just want to meet someone and have babies.” An X ray reveals that Reggie has broken his arm that will need emergency surgery, Hayley talks of how her own parent’s separation shaped her approach to parenting “we never really spoke about it, it was happening and we just dealt with it, like a protection thing, if you don’t speak it’s not actually going on” but is determined to be open with Reggie and his younger brother Alfie “you need to show your feelings and how much you love people, because they’re your family.”

61 year old Nicky is airlifted to St George’s by helicopter after a car mounted the pavement and ran her over whilst out walking. Doctors work quickly to get her into the CT scanner to ascertain the full extent of her injuries. Junior Doctor Raj explains “When you know a patient has bullseyed the front screen, it’s one of those cases you always know the pedestrian is on the losing team.” Nicky’s daughter Annie was on her way back from a horse competition when she found out about her Mum’s accident “as soon as I knew she was going to St. Georges, my whole idea of the accident changed. I thought we could lose her”. Whilst is being scanned, Nicky’s husband Richard talks about how when he first met Nicky she was going out with one of his friends, it was only after they split up that he got the chance to woo her in style “I wined and dined her for a couple of evenings, before being told the news that she was actually going out with someone else.” It was only weeks later his luck changed when she returned to tell him “I missed you, you made me laugh”. Daughter Annie, is the first child to arrive at hospital tells us how her mother has always been there for her “Mum gave up work when we were born, so she was the one that was there, every single time”. Richard tries hard to reassure and calm everyone, whilst Annie struggles to come to terms with her mother’s accident “how could this be happening to the one person I love most in life?” The results of Nicky’s scans show she has a fractured shoulder blade and spinal fractures. She is admitted to a ward for further observation. Meanwhile, 91 year old Sam arrives in Resus with a suspected stroke. He is accompanied by doting wife Roshan. Sam is unresponsive and doctors need to work quickly to get to the root cause of his symptoms. As Sam is assessed, we learn that he used to be a Pilot in the Royal Indian Air force, and met Roshan when he started work on commercial airlines “he started on the spitfires and ended on the jumbos”. Roshan describes meeting Sam when she worked as an Air Hostess, with Sam being 23 years older than her, her parents “were not at all pleased” with the age difference. Roshan talks of their life together and how when they first moved to London with Sam’s work “We used to walk around on foot and just admire all the old buildings and all the lovely history” We discover how Sam was diagnosed with Alzheimer’s and Roshan talks bravely about the impact it has had on their lives “it strips a person of all their personality and their dignity” but glimmers of his cheeky demeanour still shine through. Meanwhile 4 month old Teddy has fallen out of his car seat face first onto concrete. Distraught Mum Lauren describes the scene: “his skin was going all blue and black from his feet up”. Teddy is struggling to move his neck, so Consultant Rhys is concerned he could have damaged his spine. Whilst Teddy has his x-ray we hear how Lauren has always wanted to be a Mum and how she went through a devastating miscarriage before having Teddy. Lauren’s Mum reflects on that tragic time and explains how children look to you to make things better “but sometimes you just can’t”.

Seventy-year-old George is rushed to A&E with a piece of driftwood stuck in his left eye. He was bailing out rainwater from his boat moored on the Thames when he fell and impaled his eye on a piece of driftwood. His partner Irene received a call from George “it didn’t sound like George, it was a muffled groan.” She rushed to the scene to find paramedics attempting to stem the flow of blood from George’s eye: “I nearly fainted a couple of times, it was like something out of a horror movie.” Irene talks about how when she became a divorcee, she thought she’d never find another companion. She reminisces how during a night out in Teddington she noticed George walk in to the pub: “he stood in the threshold and glowered” he was “this huge blokey bloke with a battered face, such a presence.” She plucked up the courage to talk to him and George drove her home in his black taxi. As Doctors carry out tests on George’s eye, they become increasingly concerned about the damage behind the eye and whether he could lose sight in one eye. Irene tells us driving is more than just a job for George, it’s his life. At Heathrow Airport, he spends time in the taxi drivers’ canteen, “playing cards, telling jokes… and if they’re lucky, getting a couple of fares. If he lost his ability to work, it would be devastating for him.” Fifty nine year old Debby arrives in A&E after cutting her hand in her lawnmower whilst removing some grass cuttings. A keen gardener, she won’t let her husband Stephen near the lawn mower: “it’s one of the things I won’t let Stephen do, he doesn’t make straight lines and it drives me crazy.” Debby talks about how she became distracted when mowing the lawn by thinking about her son’s upcoming wedding: “whether my pink hat matched the rest of my pink outfit, whether pink was right anyhow, there’s so much to think about.” She then talks about her other son, Simon who has recently transitioned and is now called Sophie: “there could not have been a bigger challenge that any one man could take.” Debby says that it took time to adjust but that it’s important to accept that “I was his mum, I’m her mum now… I’m still mum.” Eight-year-old Phoebe is brought to St George’s with a pair of scissors stuck in her thigh. She had been cutting up stickers when she sat down on the scissors after accidentally leaving them upright in an armchair. She’s accompanied by her mum Natalie, a mother of four other children, who talks about how she’d always wanted to be like her own mum and have a big family. Squeezed into their small three-bedroom house, Natalie and her partner Brian sleep on a sofa bed in their front room – “we just put up with it and wouldn’t change it, I love being a mum.”

60 year old bricklayer Phil is rushed to A&E in a critical condition after falling just two feet off a ladder at work and suffering multiple injuries. Paramedics took him to a local hospital but his injuries were so severe he needed to be transferred to the Major Trauma Unit at St George’s. His friend and business partner Paul was working on another site when he heard about the accident “it just goes to show how easy it is for an experienced builder to slip up, it takes a second to make a mistake and your life’s changed forever.” On shift in resus, Consultant Manny explains how falling from a relatively low height can have serious implications “It doesn’t always correlate to how high they’ve fallen. Some people, having not fallen very far, will break a lot of bones and have a lot of injuries.” Initial results show Phil has fractured his spine, wrist and ribs and doctors need to CT scan him urgently to check for any internal injuries. Fellow bricklayer Paul talks about how he first met Phil on a building site in Hammersmith over 28 years ago. But it was only when Paul took on a big job and asked Phil to help him, that they realised how compatible they were as a team “one left handed, one right handed.. you’ve got a trowel in one hand and bricks in another, so you can work towards each other and never get an awkward bit!” As doctors assess the severity of Phil’s spinal fracture, Paul talks about how it was more than just work they had in common “over the years we’ve always had more laughs than arguments… we was coming home from a job one day and he said something and we had to pull over and physically laugh for 10, 15 minutes until we’d calmed down enough to be able to drive off.” But as specialist doctors review Phil’s scans, Paul talks about how, despite the bravado of the building site, Phil one day confided in him about how he’d dealt with the death of his son before they met. “It was hard for a long, long time” but Paul supported him both on and off the building site. 93 year old Violet was getting ready to go out for lunch with friends when she fell and seriously fractured her leg at home. Her friend Bob and his wife Sylvia, were the first to arrive at her home “there was quite a lot of blood on the floor, it looked as though something was sticking out her leg….but in fact it was the shin bone poking out.” Doctors work quickly to realign the bones in an attempt to restore the blood supply to Violet’s foot. Bob talks about how important Violet’s social life is to her independence; she regularly joins them for Scrabble evenings and organises an annual Christmas lunch for Marks & Spencer retirees “I think she’d find it very difficult to come to terms with sitting in a chair watching television all day” says Bob. As she’s taken to CT to assess the damage to the nerves and blood vessels in her foot, Violet talks about how much she’s needed her friends since her husband passed away on Christmas Day several years ago “I probably wouldn’t survive if I didn’t have people like Sylvia and Bob.. you just need friends, very much so.” 18 year old dance student Shiana has come to A&E with her Mum and best friend Briony after slipping over and hurting her ankle during a rehearsal. Shiana talks about how her and Briony met by knocking into each other at nursery aged just three years old and became inseparable shortly afterwards “we basically became friends from bumping heads.” Shiana talks about how her love of the stage was cemented at an early age by performing songs from Greece for their Mums, but it was only with Briony’s encouragement that she decided to pursue it as a career.

27 year old Corey is rushed to St George’s after suffering a cardiac arrest during a game of ice hockey. His teammates administered CPR for 25 minutes on the ice before doctors and paramedics finally managed to get a pulse. His wife of 7 days, Alice, was watching him play when he collapsed, “they rolled him over and I could quite clearly see that he was starting to go blue and I just started screaming that somebody needed to do something.” As Emergency Care nurse Liz helps the team prepare for his arrival, she talks about how dangerous cardiac arrests are in young people “you’ve kind of got in the back of your mind, this may not end well.” As he arrives in Resus, the medical team learn that Corey’s brain has been deprived of oxygen for over 25 minutes and doctors have put him in an induced coma to prevent further damage to his brain and major organs. As he’s taken to CT, London-born Alice talks about how she first met Canadian Corey whilst studying at the University of Toronto “I felt like I’d known him forever…he was so genuine”. Alice remembers how for their first date, Corey took her ice skating and was surprised when she struggled to stay upright, exclaiming “don’t you skate in England?” As doctors wait for the results of his CT scan, Alice describes how Corey proposed during a weekend away in Budapest and they decided to get married in Sicily. She talks of how nervous she felt on their wedding day but when she saw Corey “he was just standing there smiling and so that made me feel better.” With Corey still in an induced coma, Alice is brought to his bedside, and she talks about how marriage has changed their relationship “it makes you feel the same, but so much better, it’s just knowing that you’ve always got someone.” The initial results of Corey’s CT scan reveal no clear sign of a blood clot or abnormality that may have caused his heart to stop and cardiac specialists decide to keep him in an induced coma to monitor his progress over the next few days. As they prepare to take him to the ward, nurse Liz talks about the difficulty in predicting the long term outcome of cases like Corey’s “until the patient has woken up, you’ve got no idea how this has affected them, how badly brain damaged they’ve got, how they are going to function.” As he leaves resus, Alice talks about how the event has affected her outlook “you realise what a good life you’ve had, nothing else seems important.” 55 year old John is airlifted to St George’s after falling 10 feet whilst taking down scaffolding at home. The medical team are concerned that he may have multiple injuries and he’s taken for an immediate CT scan. As doctors assess his scans, his wife Penny talks about how they met as teenagers “it was quite a whirlwind really, we’d got engaged, we’d bought our house and we were married with twins by the time I was 26.” Scans reveal John has a complex ankle fracture and orthopaedic doctors are called to assess the break ahead of emergency surgery. Penny talks about how John has supported her through sickness and bereavement during their long marriage “I said my vows meaning every single word and I think every single one of them over the last 30 years has probably come true.” As John is taken for emergency surgery to save his foot, Penny reflects on her feelings “we all think that we have loved, but it’s not until you meet the right person that you know what love is, it’s a rather lovely feeling to have tucked in your heart.” 4 year old Beatriz is in A&E after getting a gem sticker lodged in her ear. As doctors attempt to remove it, her Mum Sarah talks about how the arrival of children changed her and her husband’s relationship and ultimately brought them closer together.

54 year old Michelle is airlifted to St George’s after being involved in a car crash with her husband in Surrey. Their daughter Toni had just left them when she heard about the accident “we ran over but we got pushed back as they were trying to cut my Mum out of the car. She wasn’t in a good way at all”. Michelle was given a blood transfusion at the scene and as Anaesthetist Tom prepares for her arrival he explains how serious such collisions can be “potentially the internal organs are travelling at that speed as well and suddenly stop… internal injury or bleed can be very serious”. Doctors work quickly to get Michelle to CT to ascertain the full extent of her injuries. Daughter Toni talks about her childhood “she wasn’t a strict Mum, she was quite a laid back and chilled” and how her Mum has supported her over the years. Toni describes how she became pregnant at 16 and how her Mum was there for her when her friends found out “it was scary, I would get judged by people because they were sitting their GCSEs and going onto work and college and I was having a baby.” As Doctors assess Michelle’s scans for signs of internal injuries and bleeding, Toni talks about how growing up she always knew her Mum was different but it was only when she was diagnosed with depression, anxiety and split personality disorder that they fully understood the reason, “it was like we’d lost a part of her”. Toni explains that it “was only as we got older they started opening up a bit more about the illness, she wouldn’t do half the stuff that she would before”. She describes how her Dad, Paul gave up work to become Michelle’s full time carer “my Dad jumped into my Mum’s role”. As Paul talks about his care for Michelle, he bravely says “it’s fulfilling it is, to know I can do that for her”. 41 year old Derren comes to A&E after fracturing his ankle whilst out trampolining with his 12 year old daughter Macie. Doctors are concerned that the injury may have affected the blood supply to his foot and need work quickly to realign his ankle. As he arrives in Resus, he talks of growing up as “an average street kid, chasing the girls all over the shop” but always had an undeniable bond with his Mum. Derren talks of how, as a teenager, he got in with “a lively lot” and one day accidentally set fire to the back of his Mum’s house whilst she was away on holiday in Clacton, “it gutted the whole house completely!” After realigning his ankle, doctors need to scan his foot to check whether or not the blood vessels in his foot have been permanently affected. Derren talks about how he dealt with his Mum’s death after watching her battle long-term illness and how he looks forward to making the most of life with his daughters. Retired Nurse Monica has come to A&E with chronic hip and leg pain. As Doctors try work out what’s causing her discomfort we hear about Monica’s early life in Trinidad and how her ambition brought her to the UK “I wanted to be a Nun and to be a Nun, you had to travel.” Arriving in London after a two-week boat journey, she found work as a Nurse and quickly settled in to life in the UK where she met the love of her life, Noel. Monica talks of how, as a mixed-race couple, they experienced vicious racism but didn’t let it affect their love for one another. When reflecting on what life has taught her she says “be kind, it doesn’t matter what they do to you, be kind.”

64 year old Mohammed is rushed to St George’s after being hit by a pizza delivery motorbike. Consultant Will is concerned he may have a pelvic fracture, which could seriously affect his mobility and if the fracture hits a major artery, can be life threatening. His son Tom went to see his father at the scene of the accident and followed his father to St Georges to be by his side. Tom reflects ‘when you are younger you think your Dad is superhuman. When this happens, you realise he isn’t invincible…’ As Mohammed is sent for an emergency CT scan, Tom talks about his Dad being from Somaliland, a breakaway state of Somalia and how he is from one of the first Somali families to come over to the UK. Mohammed achieved success, and sent Tom to private school, where he always came to support Tom at rugby matches: ‘he was always coming to the games… he was the only black guy on the side of the pitch.’ Tom recounts the story of how when he visited Somaliland, he realised his dad’s humble beginnings: ‘I am in complete awe of him- someone who has been successful, starting from scratch.’ As doctors wait for the full results of his scans, Mohammed tells the story of his father, who was a stoker in the merchant navy, bringing him and his mum to the UK in the 50s. Mohammed was ‘chiselled in the East End’ as a young lad and how his parents ‘even though they couldn’t read or write, had a fierce sense of ambition for me. My father used to take days off to go and interrogate my headmistress.’ 90 year old John comes to St Georges with his wife Iris and daughter Joan after his GP picked up on his abnormally low heart rate. As doctors conduct a series of tests to establish the cause of his abnormal heart rate, John tells us that he has been married to his wife for 65 years, after meeting her in the telephone office where they worked together. He took her on their first date 70 years ago.’ Now, she has dementia, and John is coping with seeing the woman he loves have her good days and her bad days: ‘it’s sad. But I mustn’t be greedy, we’ve had a good life together… If I had my life over again, I’d want her as my partner.’ Eight year old Clementina comes to St Georges with her dad Jim, after falling off her scooter and hurting her knee. She enjoys asking her questions of her dad, and says ‘it’s important I ask questions to get better at stuff. Otherwise I’ll never learn anything.’ She is very keen to be a midwife when she grows up and likes all things medical: Dad Jim tells us Clementina wants a diabetes testing kit for Christmas. We hear how her mother was diagnosed with breast cancer earlier this year and is going through chemotherapy. Her parents decided it was best to be honest with Clementina, who is understanding that process through asking lots of questions. Doctor Will reflects on the family bonds he sees in A&E every day ‘I think with any illness, your support network is vital. It is almost as important as the medicine we supply… the support that comes from the patient’s loved ones.’

31 year old Aaron is rushed to St George’s after overturning his car onto metal railings during a high speed collision. His twin brother Alvin was at home when the accident happened “I jumped in the car and during the entire time, I was thinking about the worst.” As the medical team prepare for his arrival, nurse Anna talks about the potential for life threatening injuries in a car crash “that patient could have. a possible head injury, bones being fractured, all of their organs inside you’re worried about, their heart, their lungs. Time is crucial to the whole thing.” Aaron arrives in Resus with a serious laceration to his face where he landed one of the metal spiked railings, narrowly missing his eye socket. During his initial assessment it becomes apparent that Aaron’s memory has been affected as he struggles to remember the day of the week and has no recollection of the accident. Doctors suspect a brain injury and as he’s taken to CT, Aaron’s brother Alvin talks about life growing up as a twin “we had our own language, so we didn’t actually really speak properly until quite late in life. That’s really common amongst twins, once you’ve already got your friend there, you don’t want to hang out with anyone else.” Doctors are also concerned that the impact may have caused serious internal injuries and send Aaron’s CT scans to radiologists for further assessment. As Alvin and his girlfriend Aneta arrive at St George’s, Alvin talks about Aaron’s single life and his hopes for the future. “I think he’s unlucky in love, he hasn’t met someone who truly appreciates him.” The initial scan results show a small laceration to his spleen and doctors decide to admit him a ward for further observation. 65 year old Fiona is rushed to St George’s after falling over in a restaurant and cutting her knee during her friend Evelyn’s birthday party “it was my 70th birthday and we went to this restaurant… we had a wonderful time and everybody was leaving and she tripped off two steps.” The impact caused a deep wound to her knee and doctors are concerned that she may have damaged a major artery. As doctors work to stem the bleeding from her laceration, Evelyn talks about how they met over 40 years ago as air hostesses and reminisces about their adventures together “I remember being in Bugis Street in Singapore… all the lady boys were there, we had to dress up because they sometimes looked prettier and in nicer frocks than we looked!” As Fiona is taken to X-ray to check for fractures to her knee, she talks about how their lives took different paths after Fiona left her job to start a family and Evelyn continued her single life as a stewardess. Fiona explains how in more recent years however, Evelyn has supported her through a divorce and they are now enjoying a new lease of life together. 37 year old superyacht Marketing Consultant Caroline is in A&E after falling on rocks on a beach in Spain and hurting her ankle. As nurse practitioner Craig assesses her injury, Caroline talks about her life as a single woman and her pursuit of love.

84-year-old Neil is rushed to St Georges after falling down the stairs at home. His wife Jenny describes finding him at the bottom of the stairs and reflects on the shock of realizing their life may never be the same again. Orthopaedic Registrar Rob is called to resus to assess Neil’s injuries and is concerned that he has a severe shoulder dislocation. Dr Rob highlights the difficulties of treating elderly patients because of their physical vulnerability. He tells us that the lesson he has learnt is ‘when treating trauma in the elderly, expect the unexpected.’ As Neil is sent for emergency scans to determine the extent of his injuries, Jenny tells us about their early life together. She explains that Neil has always been a lover of nature- he was the Horticultural Officer for London and would woo Jenny with flowers when they were first dating. They soon got married and had children and whilst Jenny was busy working as a Mayor, Neil took well to being a father. He loved to share his passion for nature with them. His daughter Jane tells us of precious time in the garden with her father, a place she could really talk to him and confide in him. As doctors become increasingly worried about Neil’s shoulder and an underlying heart condition, we hear how Neil carved out a long career for himself as one of London’s leading Tree Officers. Jane tells us ‘his job was to protect the existing trees where possible.’ She tells us how, in the 1960s, Neil fought for a preservation order to save a Mulberry tree that was under threat from being ripped up as a new housing estate was being built. Jane tells us of the pride she feels when she sees the trees he’s saved, and the legacy he has left for London. 25-year-old Danny is rushed to A&E after a road traffic collision where he has been knocked from his motorbike. Orthopaedic Registrar Sadia is concerned about a serious leg fracture and that Danny may have other hidden internal injuries. Danny’s girlfriend Angy tells us about their relationship which saw them expecting a child very quickly: they were a year and a half into their relationship when Angy fell pregnant and had never considered children. Now, they have a healthy 10-month-old baby and a happy life together which Angy fears losing: ‘Every minute he is on that bike I worry. I just think ‘how is my child going to grow up without a dad?’ 23-year-old Adil comes to St Georges after twisting his knee playing badminton. His friend Sibby brings him in, and tells us of how Adil is renowned as accident-prone. Emergency Nurse Practitioner Craig sends Adil for an x-ray, and as his results come in, Adil tells the tale of being born with Dextrocardia, a rare congenital condition which means his heart is unusually located on the right side of his body.

34 year old Niki is airlifted to St George’s after crashing into another rider during a charity bike ride between London and Brighton. He was found unconscious and unresponsive by race volunteers, his friend Chris was ahead of him in the race when the accident happened “when I got to one of the stopping points…I heard about the accident…I was thinking this has got to be one of the worst things that could possibly ever happen, he was unconscious and he’d been airlifted off to hospital.” As Niki travels to St George’s by air ambulance, Consultant Paul prepares the team and talks about what they expect when a patient is airlifted to them “if you hear that a HEMS call is coming in, you know that this is going to be one of the most sick patients you are going to see.” As doctors quickly assess Niki’s injuries, it becomes obvious that his memory has been affected by the impact as he struggles to recall details of the crash, Paul explains “if [patient’s] have lost part of their memory, that suggests that their brain has taken a big impact and that immediately alerts you.” As Doctors conduct his CT scans, the staff at St George’s are still trying to contact Niki’s wife Phil, who is almost 300 miles away at their home in the North-East of England. As radiologist assess Niki’s brain for signs of permanent damage, Phil talks about how her and Niki bonded over a mutual love of Monty Python after a night out in Redcar “he was just really easy to get along with, we sat and talked about nerd stuff all night.” Phil explains how losing her parents at a young age meant she moved to Redcar to live with her Grandmother “if anything had have happened differently I wouldn’t have met Niki. I wouldn’t change anything, because I’d rather have him than what I could have had”. As doctors wait for the results of his CT scan, Phil talks about how Niki’s size had always been part of his identity but in recent years he had struggled with his weight “he’d be really depressed for days…and then cheer himself up by eating cake.” It was only after their son James was born and Niki went to the doctors for a routine check up and was diagnosed with Type II Diabetes that he decided to change his lifestyle and set about losing weight once and for all. Phil explains “it took Niki 10 years to put the weight on, and one year to take it off… he went from 26 stone to 13 stone.” 90 year old Peter is rushed to A&E with severe blood poisoning. He had been undergoing treatment at a local hospital but his condition had deteriorated so much doctors decided to transfer him to St George’s. As he arrives at hospital his daughter Vivian recalls how the family had enjoyed a day out only a day before “we went to his favourite watering hole where he had a roast with the family...it had been a really good fun day…I had that sense of well at least the last day was a good one.” As doctors conduct tests to determine whether or not Peter has any damage to his internal organs, Vivian reflects on his time in the RAF during World War II and the bond between him and her Mother, Edna, 21 year old Guiseppina comes to A&E with her Mum after falling down stairs and hurting her foot. With a long awaited weekend away approaching, she hopes a broken foot won’t get in the way of her plans.

Sixty three year old Valerie is rushed to St George’s having fallen from a horse. Her daughter Vikki was riding with her at the time, “the next minute I turned and saw mum crashing down on her head.” Leading the trauma is Consultant Will. He is concerned about potential spinal and head injuries, “your neck isn’t designed to take your body weight from the direction of your head…if there’s damage to the nerves in the spinal cord, we can’t fix those.” Vikki has accompanied her mum to A&E and as she’s whisked off for emergency CT scans she recalls, “all I could think was I’m going to lose her”. Vikki recalls how her mum introduced her to horse riding when “mum was nine months pregnant with me in her belly still” and as she grew up horses and animals were an integral part of their lives. With no father around and no brothers or sisters, mum Valerie has been the one person “who taught her about life….mum and dad rolled into one” and she’s “the one person she would trust with her life. As doctors assess Valerie’s CT scans, Vikki recalls how at just 17 years of age she found her grandmother after she had a suffered a stroke and how they both looked after her until the day she died. When she sees her mum in resus, “she felt like she was 17 again seeing nan but it was mum….I can’t imagine her not riding the horses again. It would break her heart as it’s all we know. “ Sixty-six-year old Lisa is travelling by ambulance to St George’s with a suspected injury to her prosthetic hip. Her husband Tony found her lying on the kitchen floor and is travelling with her, “she’d been to a school reunion with her best friend….and she was lying across the kitchen floor, unable to move…” Doctors quickly send her for X rays to assess the damage to her hip and whether she will need emergency surgery. Lisa reveals how she struggled with anxiety and agoraphobia as a young girl “nobody really understood what being anxious was about then” and how she spent a year and half in her bedroom, “if I had an amputated leg everyone would feel sorry but it’s very difficult when you have something in side your head for people to understand about it.” But with medication and psychiatric help, Lisa “got out of that room and met boys” which led her to find her “soulmate” of forty years, Tony, “we never talked about it as a illness but more a constraint of what she could do in life”. Meanwhile 30-year-old Natasha is in A&E with her friends after an accident whilst trampolining at her son Taelan’s eighth birthday party, “I don’t know if I was showing off but I did bite off more than I could chew”. Doctors are concerned about the injury to her knee and send her for a CT scan. Natasha recalls how as a single mum, her and Taelan benefit from the support of her mum and her gran as well as an extended network of friends “they are like my sisters”. Scans reveal a serious break in her leg and while doctors realign and plaster her leg Natasha reflects on her work criminal rehabilitation, “You see the flip side people don’t have much family and much support and you can see the road you could go down if you don’t…my friends have been really, really supportive of me and I really think it’s extremely important for Taelan that he’s got support from myself as well as his extended family and my friends.”

53 year old Pam is rushed to A&E after suffering a suspected heart attack. Her daughter Meg was woken up when her younger sister raised the alarm. “It was a Friday night, we’d been out for dinner with my Dad…everything was fine and then at about half 12 my younger sister woke me up.. all I saw was Mum… and she was completely red in the face, gasping for breath.” As Pam travels to St George’s, Registrar Simin explains why the symptoms of a heart attack are so concerning “regardless of how fit you are, it is still one of the things that can actually kill you, its like handling a ticking bomb.” As she arrives in resus, doctors decide to take emergency blood tests and Simin explains why it’s important to act quickly when a patient arrives with chest pain and a racing heart “you can be talking to a patient one minute and they can deteriorate so quickly, that’s why you need to be ready for anything.” As doctors bring Pam’s heart rate under control with medication, they are still unsure as to whether an underlying condition or a heart attack has caused her chest pain. As doctors monitor her heart rate, her daughter Meg talks about how her bond with her Mum has strengthened over the years “she’s kind of my best friend.. we literally can read each others minds.” Meg reminisces about holidays spent with her Mum, Dad and two sisters on the coast in the Witterings. She reveals how she helped her Mum when her parents decided to get divorced “I felt like I had to be support to her just as she was support to us.” As Simin waits to find out whether or not Pam has suffered a heart attack, Meg reveals how her Mum recently lost her own father to a heart attack and how difficult it was the be facing the same fate again. 10 year old Cora is rushed to St George’s after being thrown from a horse into the low hanging branches of a tree. Her Mother Sharon was informed of the accident by her riding instructor and rushed to the scene “she was on the floor under this big tree, she had blood all over her face.. and…this piece of wood sticking out just under her eye.” As she arrives at the scene doctors work quickly to assess whether or not she has also injured her neck, spine or brain. After Cora is transferred to the specialist paediatric emergency department, Sharon talks about how Cora’s birth was even more joyous than usual as it came at the end of a testing period of IVF. 8 year old Ruben has come to St George’s with his Mum Manuela after falling over and cutting his head whilst playing with his dog. As medics treat his wound, Manuela talks about how she made a surprising career change to give her more time with her children.

51-year-old painter and decorator Gary is rushed to St George’s A&E after falling ten feet from a ladder whilst at work painting a ceiling. His friend and work-mate John was working nearby when he heard about the accident, “you fear the worst. I thought he’d broken his back” Gary’s parents Don and Gill are first to arrive at St George’s and Dr Rob sends Gary for urgent CT scans. As radiographer’s carry out the scans, we hear from Don how he and Gary worked in the local foundry and in their spare time shared a love for fishing. But whilst Gary enjoyed a big catch as an angler, he was never so lucky in love after two engagements were broken-off, “it broke his heart and he’s never been with anyone since”. Best friend John reflects on the importance of Gary’s friendship, “he’s a member of the family, he’s seen my daughter born… never misses out on anybody’s birthday.” But when Gary’s scans arrive, Dr Rob becomes increasingly concerned about fractures in his back, pelvis and coccyx, “the worst case scenario….is that anything below the injury will stop working permanently.” A concern shared by Gary’s best friend John, “if he doesn’t go back to work…it would be terrible for him”. Meanwhile, 5-year-old Beatriz has been brought to A&E by her parents Cristiane and Alessandro with symptoms of a fever. It turns out she suffers a rare kidney condition that lowers her immune system making her vulnerable to infection. In her first year, she was admitted into hospital about 38 times. But despite her condition she’s still determined to enjoy a normal life as a child, “she is very curious….she wants to be an astronaut and explore the solar system…and likes sports and swimming”. But a trip to the swimming pool can result in an infection and more hospital treatment. “It’s draining,” says mum Cristiane but a stay in hospital has become a regular routine, “nowadays we pack our stuff as if we’re going on holiday.” As doctors carry out further tests, there’s a concern that Beatriz might need to stay in hospital again so doctors can help her fight the infection. 84-year-old Eileen is brought to A&E suffering from stroke like symptoms. Her daughter Catherine travelled with her in the ambulance, “she was almost paralysed on one side of the face…and started talking in a strange language…I know this could be something more permanent.” As Specialist Doctors take Eileen for scans and carry out further tests, Catherine tells us that her mum wasn’t from a well off background but “she was very ambitious to be educated.” Through hard work Eileen got a degree and became a social worker, “I always remember her writing and being very busy and being able to argue with the best of them.” But in recent years Eileen has suffered from dementia, “she started to call me a lot during the day say six or seven times …there have been occasions where she’s been out on buses and forgotten where she’s going or where she lives and I’ve had calls from strangers saying she’s with them”. The diagnosis was a shock to Catherine, “I think for someone who is so intelligent and articulate, I couldn’t believe that could be the case.” To help care for Eileen, daughter Catherine asked her mum to move in with her, “caring for someone with Alzheimer’s makes you very upset and down and the person you would go to with those sort of feelings is your mother and you can’t. You have to be a stronger person…if you look at it with so much seriousness you wouldn’t get through it.” Dr Rob reflects on his own experience after being diagnosed with cancer and how colleagues, family and friends helped him overcome his illness.

40 year old Adrian is escalated from majors to Resus after colliding with a car on his bike ride to work. Adrian recently moved back to London to set up a new life for his family but at the time of the accident, his wife Lili and daughter Luna are still 1,400 miles away at their home in Montenegro. Lili always worries about him cycling in London and about him being so far away. “It was difficult for me not being there,” she explains. “I felt like I was letting him down because I wasn’t there for him.” Consultant Melissa is in charge of Resus and she is concerned Adrian may have a serious chest injury so he is sent for a full CT scan. Melissa also highlights the difficulties of being separated from loved ones and details her own experience of being in South Sudan with Medecins Sans Frontieres when her father fell ill: “It was horrific I had no phone and no internet and it took me 4 days to get home. It’s very hard when you’re far away from home.’ Whilst doctors wait for the CT report to determine the extent of his chest injuries, Adrian’s wife Lili talks about how they only dated for a year before they got married and moved to her native Montenegro where they lived for 8 years. It was only once their daughter Luna started school that they decided to move back to London. As concern grows that Adrian has a collapsed lung and may need emergency surgery, he makes a heartfelt phone call to Lili in Montenegro. A tearful Adrian tells his wife that he doesn’t want their daughter to know about the accident as he doesn’t want to upset her. Lili tells us that Luna was born on Adrian’s birthday so she was the perfect gift for him: “She’s a daddy’s girl. Daddy’s her hero.” 49 year old Steve was encouraged to go to A&E by his wife Julia when his heart rate more than doubled over the course of an hour whilst he was preparing supper. As doctors run blood tests to determine the cause of his racing heart, Brazilian Julia tells us how she was late for her own wedding and by the time she walked down the aisle, the whole congregation was drunk on caipirinhas. Julia talks about how their 15 years together have been filled with fun, laughter and two wonderful daughters but that there have also been difficulties. Whilst doctors try to determine whether Steve’s accelerated heart is connected to his recent stroke and whether he is at risk of having another, the picture is complicated by family medical history. Julia reveals that Steve’s mother died of a heart attack when she was 42 and his brother had a heart attack at 44. Whilst waiting for the blood results, Steve develops a migraine and Julia reflects on the future: “I think something will happen. I’m always thinking something is going to happen to Steve. Everything could change but I kind of put this to the back of my head.” 54 year old Graham has come to A&E after stubbing his toe trying to avoid treading on Pickles, his friend’s black cat. And he doesn’t even like cats. As Emergency Nurse Practitioner Ali examines his foot, Graham admits he is definitely accident prone having broken both wrists, both legs, his ribs four times and his nose three times. Following an x ray which confirms that he has indeed broken his toe, warehouse worker Graham explains how he lived the high-life for over 20 years, organising trips and travelling with the Royal Family of Dubai and then how, overnight, he lost it all.

20-year-old Antonio is rushed to A&E after a motorcycle accident. Dr Shafi explains: ‘When you hear there has been a motorcyclist that has been involved in a collision, you are thinking about multiple injuries to every system of the body.’ The medical team quickly discover Antonio has a severe fracture to his leg and are concerned about a potential arterial bleed. As he is undergoing a CT scan, Antonio’s mother Dawn tells us: “I wanted to be a mum quite young, I thought if I had my children young I could grow up with them and do things together.’ But having children wasn’t without it’s challenges and she explains how Antonio as a child was hyperactive and struggled at school, with teachers unable to cope with his behaviour. As he’s grown up, motorbikes have managed to capture his attention and give him focus: ‘It’s the freedom- the bike has given him independence.’ Antonio’s leg starts to swell and doctors become concerned about long term damage to his leg. As they prepare him for emergency surgery, Dawn tells us about her own childhood, growing up in an adopted family. ‘If you’re adopted, it’s almost as if a part of you is out there, missing… But my children are the ones that give me joy.’ We hear the story of Dawn’s search for her birth family that when she finally found them, gave her ‘closure.’ 40-year-old Karen comes to St George’s after falling off her horse, which then trampled on her. Karen’s friend Annie tells us of the moment she discovered her at the horse yard: ‘As I was walking up the driveway, I saw something lying in the middle of the road and realised it was Karen. I knew there was something seriously wrong, because she was curled up and couldn’t move.’ Doctor Rathan tells us: ‘When someone falls off a horse you have to expect the worse case scenario… If they have fallen onto their chest, they could have broken ribs, collapsed lungs and can bleed into their chest cavity.’ As doctors investigate the damage to Karen’s chest and lungs, we learn of her life-long passion for horses and how her late granny provided the inspiration to do what she loves and get her first horse. 29-year-old Hayley comes to St George’s with her wife Emma, after experiencing an infection and low immune system. We hear of how they met after bumping into each other in the queue to see Legally Blonde. Emma tells us ‘I was almost 30, and I’d never even thought about being with a woman.’ Their relationship slowly developed and five years later, we learn that they got married in New York. Four months after their wedding, they had some unexpected news after Hayley went to the doctor feeling unwell. She was sent to A&E and diagnosed with leukaemia: ‘my world absolutely turned upside down.’ As doctors carry out a series of tests, Hayley explains us that the process of chemo has brought her and Emma closer and although life feels on hold for now, they’re hoping the future will be brighter: ‘I think the odds are 70:30. So we’ll hope for the 70.’

52-year-old long distance lorry driver Neil is rushed to St George’s after falling backwards off a ramp onto a concrete floor. His family is 200 miles away in Middlesbrough and unaware of his accident. Consultant Rathan is concerned that Neil has sustained serious injuries to his head and neck and is at risk of a bleed on the brain. “Just because a patient can talk does not mean that there is no danger, “ Rathan explains. “He could have a really nasty break to the spine and the neck that could paralyse. Any damage to the brain could not only be life-changing it could be life-threatening.” Whilst Neil is sent for an urgent CT scan, Neil’s ex-wife Heather describes the night they first met in a pub and how he used to get up and sing Abba on the Karaoke, stone cold sober. “I did fancy him straightaway…” she says smiling. “He had more hair then…” After 20 years of life together and two wonderful children, Heather goes on to explain that she and Neil began to drift apart and they eventually separated. Nevertheless, she admits that she will always be there for him: “You can’t walk away. I couldn’t turn my back on someone and not support them -- it’s just not in me.” The CT scan shows that Neil has not sustained any serious injuries from his fall but unexpectedly, it does reveal a large tumour on his brain. Neil reflects on the shock of the news - “but for an accident I would never have known” – on the uncertainty of his future and on his fears for his young family. “I lost my father when I was very young… I know the affect it can have on children… I just don’t want that to happen.” 29 year old Ben is brought to A&E after dislocating his shoulder in a cycling accident. Whilst doctors re-locate his shoulder, his girlfriend Karen explains how they have only been together for a year and that she’s nervous at the prospect of speaking to Ben’s mum for the first time. “The boyfriend’s mum is always a significant point in any girl’s relationship calendar,” she says. “It was a responsibility I really didn’t want to mess up.” After a successful re-location, Ben continues to experience acute pain so he is sent for further X rays to uncover the cause of his on-going discomfort. Whilst waiting for the results, Karen and Ben both describe their difficult experiences of growing up with divorced parents and how it impacted on their view of love. “Experiences with my family have shown how devastating the break up of a relationship can be,” says Karen. “I became hugely guarded after my parents divorced. Didn’t want to get married, didn’t want to go through that hurt… but meeting Ben has changed my mind.” 73 year old Wendy is in Resus with a severe open ankle fracture after falling at home. As Wendy’s leg is examined, she tells us in no uncertain times about her views on the world. “I like who I like and who I don’t like, I ignore.” As Wendy enjoys the gas and air given to help her cope with the pain – “I’ll be as high as a kite” - she tells us that she’s been married twice but that her first husband was unfaithful. “His name was Keith but he liked to be known as Dave. Everything was fine until ‘Cynth the Nymph’ came on the scene…” Not wanting to be “second best” Wendy promptly divorced him. X ray results reveal a severe fracture to Wendy’s leg that can only be fixed with surgery. While waiting for the operation, Wendy talks lovingly about her second husband Bill, about spending 40 wonderful years together and the grief of losing him three years ago: “I still talk to him at night,” she says looking towards the sky, “‘Goodnight Bill… I’ll be up there with you soon.’”

30 year old Chris is being rushed to St George’s hospital after being injured in a shooting. He has a wound to his abdomen. His mum Mandy has been made aware of the accident but doesn’t know the detail that her son has been shot. “It was all very vague. I imagined all sorts of terrible things could have happened.” says Mandy On arrival at the hospital, it becomes clear that Chris has been injured with an air rifle during a game with his friend Jack. Jack fired the inside shaft of a biro pen deep into Chris’ abdomen. The wound could lead to a life threatening hemorrhage if it isn’t dealt with quickly. The medical team rushes to survey the extent of Chris’ injuries by taking him for a CT scan. Consultant Sunil suspects that Chris’ bowel is damaged and leaking internally. “If it’s not treated quickly enough people can die.” He says. Meanwhile, in the waiting room 19 year old college student Lennon has come in to A&E with his friend Jeremy. He has a head injury after jumping into a door frame whilst kicking a balloon. His dad Mark is on his way from home to join him at the hospital. “My first thought was that it was typical of Lennon. He wasn’t even supposed to be at college that day. He’d gone back for a birthday party.” Whilst Lennon and Jeremy entertain themselves in the waiting room and await treatment from the Emergency team, Mark muses about fatherhood, growing up and his special relationship with his son. “The moment he was born I felt really connected to him.” Says Mark “He was really cool, he slept through, he had loads of character… Even though me and his mum weren’t together we maintained that parenting responsibility together…on the whole I think we kept things settled and safe for him. And he loved having two bedrooms” Later on, the red phone rings to announce the arrival of an adult priority call. 74 year-old Stafford is on his way to St George’s because his internal cardiac defibrillator, attached to his heart, keeps shocking him. His wife Cathie has been informed of the situation and is on her way to see Stafford. “I always knew that there was a chance he could die because the heart is the heart and if the heart fails the heart fails. So It really brought it back to me that this could be the end” Doctors have to try to work out whether the issue is with Stafford’s heart or with a faulty defibrillator. While the team in Resus treats Stafford his wife Cathie talks about their marriage, their children and their shared belief in God.

8 year old Billy is rushed to St George’s after being crushed by falling bricks that were being stored on his front drive. As he travels to St George’s, his Dad Shaun recounts the horror of finding out about the accident…”I was in the back garden..I heard a scream and I wasn’t too sure if it was Billy, when I ran out there it was just horrible, absolutely horrible.” As he arrives in A&E, Orthopaedic Registrar Niv is called down to resus to assess the extent of the damage the bricks have done “anything is possible at that stage, you just don’t know.” Niv is concerned that the impact of the bricks falling on him may have caused a serious fracture to Billy’s femur that has damaged the nerves or blood vessels in his leg and needs to X ray him immediately. Whilst doctors assess the X ray, Shaun talks about Billy’s presence in the family ”He’s got this thing about him that he seems to just make someone happy when they’re sad, and that’s what makes him, Billy.” When the X ray reveals that Billy has indeed fractured his femur he’s transferred to the specialist paediatric emergency department. Doctors need to put his leg in traction ahead of emergency surgery to give him the best chance of walking normally again. 6 year old Luther comes to A&E with a metal washer stuck on his finger. After doctors unsuccessfully attempt to ease it off with cream, they decide to try to cut through the washer. As doctors tackle either side of the metal ring, Senior Healthcare Play Specialist Tracy, who’s role is to comfort and distract children during their treatment in A&E, talks about how close she feels to the patients she sees in A&E and how vital her role is to both children and their parents. 83 year old Audrey comes to St George’s with her grandson Lee after falling whilst on holiday. As doctors assess the damage to her wrist she talks about her life growing up during the war and how much she relies on Lee after her husband of 60 years passed away recently.