24 Hours in A&E

In a shocking, random act of violence, a young woman is knocked to the ground, after being punched in the face by a stranger on her way home from work. Lying in the street, she’s fighting for her life when Andrew, a passer-by, finds her and calls 999. A&E doctor Des has worked at King’s for over five years and is rarely shocked by what he sees, but when the unidentified young woman arrives in Resus with life-threatening swelling on her brain, the impact is felt by him and the entire department. “People are unfortunately capable of doing the most awful things to one another, but people are also capable of doing some of the nicest and kindest things that you would never imagine would happen in a busy, urban area like Kings,” says Des. “So sometimes it’s the acts of kindness that surprise me more than the acts of cruelty.” Also in Resus is 12-year-old Tom. Hit by a car on his way home from school, he is airlifted to King’s by HEMS, the helicopter emergency medics. His mum Anna faces an agonizing wait as A&E Consultant Emer assesses the extent of damage to her son’s brain. “Children are inherently fit strong little creatures,” says Emer. “Children’s little bodies will compensate for a long time and they will hold it together and hold it together and hold it together and then crash…” Meanwhile, 90-year-old ex-circus performer Frank is in A&E after collapsing at home. News of his colourful past – including training bears and lifting horses - quickly travels amongst the staff as they try to determine what brought him to King's. 24 Hours in A&E is a powerful, intimate - at times humorous, but ultimately heart-warming - portrait of modern Britain in all its diversity.

80-year-old Rose has fluid on her lungs and is having trouble breathing. Her three daughters Christine, Sandra and Debbie put on a brave face around their mother’s bedside, convincing her that everything will be all right, but in the relatives’ room there is high emotion as they tearfully contemplate life without her. Debbie wants to get the grandchildren to the hospital before it’s too late, but older sister Sandra thinks all the family by the bedside will make their mum think it’s her last rites. Sister Claire, who is looking after Rose, knows only too well the torment the families go through around end of life decisions: “As doctors and nurses, we have to accept we can’t change everything and there’s not always a miracle cure,” she says. “Once you accept it is happening you have to get it right. You can’t get dying wrong”. Also in Resus, is Kevin, a 55-year-old trucker who jack-knifed his lorry, ‘bullseyed’ the windscreen and rolled down a verge. He was trapped in the wreckage for an hour before being cut free and air lifted to King’s by the Kent air ambulance. He has injuries to his pelvis, neck and head. His wife Janet waits anxiously for news about the seriousness of the injuries. “Modern medicine is perhaps a victim of its own success,” says consultant Malcolm. “Some people’s lives are prolonged in an uncomfortable, undignified state because doctors try and play God sometimes…but we’re not gods”. 24 Hours in A&E is a powerful, intimate - at times humorous, but ultimately heart-warming - portrait of modern Britain in all its diversity.

Father-of-three John, 53, was on his way to work when he came off his motorbike and struck a bollard, injuring his shoulder. Frances, his partner of twenty-four years, is abroad and John doesn’t want to spoil her holiday – she worries about him going out on his motorbike every single day – so he asks their son not to tell her he’s in hospital. “I'm a psychologist,” says John. “Some of the work I do is with pain management and I teach particular skills to my clients - none of those skills were of any use to me at that time.” Consultant Graham, who’s looking after John, decides his patient’s pain is so bad that he will give him Ketamine – a sedative so strong it’s also used as a horse tranquiliser. Gary is in King’s with a bleed on the brain and a suspected stroke. His partner Tracy is at his side to support him. They met at a biker’s rally in Kent ten years ago and are still deeply in love. Despite appearances, Gary is a secret softie. 84-year-old Ronald has been bitten by his dog Benjie while playing with a ball. Ronald’s wife Cathy passed away after fifty years of marriage and Benjie is his constant companion – as well as being very contrite since the accident. 24 Hours in A&E is a powerful, intimate - at times humorous, but ultimately heart-warming - portrait of modern Britain in all its diversity.

47-year-old Chrissie was crossing the road near her home when she was hit by a motorcycle. The side of Chrissie’s face took the brunt of the impact and the main concern is potential bleeding behind the eye or in the brain. Her husband Tim struggles to get to the hospital - ironically he’s stuck in the traffic jam her accident has caused. Chrissie and Tim first met over twenty years ago. It was love at first sight and Tim proposed almost immediately. But three weeks before the wedding, Chrissie changed her mind, Tim moved out and never came back. However four years ago Chrissie got in touch looking for closure and they decided, finally, to get married. But could Chrissie’s accident put their second chance of happiness in jeopardy? John is in Resus with a suspected stroke - luckily for him, King’s specialises in caring for stroke patients. He’s confused and doesn’t know what year it is. But in spite of his fears about memory loss, John’s irrepressible sense of humour shines through. Meanwhile Benedict, 22, a gifted musician, has come into King’s because of his drinking problems – he drinks over seventy units of alcohol a day. Damian, Benedict’s dad, finds it difficult to watch the destructive nature of his son’s alcoholism - but can a father’s unconditional love overcome such a terrible disease? “When somebody that you've brought up and been proud of is an alcoholic, I think there aren't enough words really to describe the intense sorrow and pain that one can feel,” says Damian. “I don’t think there’s a stereotype, it can happen to anybody, at any time.” For consultant Liz, it’s the patients’ families who carry the weight of responsibility after an illness or accident. “It’s a marathon, it’s not a sprint,’” says Liz. “Long after the hospital has discharged them the process of getting well may still be going on and it’s the relatives that carry the burden of that.” ‘24 Hours in A&E’ is a powerful, intimate - at times humorous but ultimately heart-warming - portrait of modern Britain in all its diversity.

Eight-year-old Abby hit her head after falling from the steps of a high diving board. The medical team need to scan her head and neck to check for serious injuries. “Head injury in children always makes me worried,” says Paediatric Intensive Care Consultant Tushar. “Seeing her getting drowsy was not good, her brain could be under pressure from a blood clot.” Abby’s mum Nikki is at her beside, but dad Scott is away in Scotland having missed the last train home. “I had no passport so I couldn’t fly. I just remember sitting on the floor just trying to figure out some way that I could possibly get down to London right away, “ says Scott. “It’s worse than agony. I just wanted to be there.” Mum Nikki is putting on a brave face and trying to hold things together for her daughter, but like every parent whose child is injured, inside she’s terrified. “I had to say to her you’re going to be fine, you’re doing really well, just to get through it,” says Nikki. “I noticed the sheer look of panic and that bottled-up emotion that every mother has when they're scared,” says consultant Tushar. “Wanting ‘please tell me this is going to all be all right’. And I can't, because I will not give false hope.” Meanwhile, the hospital security team deals with over fifty incidents every month in A&E, ranging from verbal abuse to assault. Anne and Holton are both working the night shift dealing with a variety of challenging patients in the hospital. “Sometimes I go home and I think about what I've seen that night, or I speak to my wife about it. I do fear for the younger ones 'cause I know how horrible the world we live in can be,” says Holton. “My mum says I'm overprotective, but my daughter, she gets a little bump on her head, I feel like I want to wrap them up in cotton wool.”

26-year-old Nicholas has been punched in the face in a random attack – his jaw is fractured and dislocated and he can’t close his mouth or speak. Consultant Craniofacial Surgeon Rob, a world-renowned specialist, puts Nicholas’s jaw back in place with his ‘magic thumb’. With Nicholas is his long-term girlfriend, Holly. “He’s definitely not the fighting type. When I first met him, for sure, he was a boy,” she says. “Sometimes I feel a bit like a mum – ‘Can you slow down? Don’t run or you’re going to hurt yourself!’.” Tyrell has damaged his big toe playing football. The 17-year-old’s blackened toe-nail needs removing and his dad, Adrian, uses the opportunity to lecture him that experiencing pain is what separates men from boys and about the importance of knowing his family tree as well as he knows Spanish football. Ho, 26, has brought his 78-year-old grandma Amoui to King’s after finding her collapsed in her flat. Amoui came to Britain during the Vietnam war and she’s been like a mother to Ho. The thought of losing her is almost too much for her grandson to bear. “It was a shock when I found my grandma…I’ve never seen her so fragile before,” he says. “She’s a tough lady, she’s like Margaret Thatcher. She looked after me always and so I felt I have the responsibility to go and look after her.” Consultant Rob, the first person in his family to go to university – “or, for that matter, to do an A level” - recalls his own rite of passage to becoming a man, with his father, who left school at thirteen to work in a brick yard to support his family. “There is a time in your life that is unspoken, when your responsibilities change from your parents to you,” he says. “I remember standing at the side of my father’s car and he gave me the car keys… and something in that unspoken act said that was the transition.”

47-year-old Gary was on his motorcycle when he had a head on collision with a car. The single father of two is a code red trauma and is being flown fifty miles to King’s by air ambulance. He’s on life support with serious head, chest and limb injuries and has been put in a medically-induced coma to reduce the risk of brain damage. A&E consultant Chris is leading a trauma team of twenty and her immediate concern is keeping Gary alive: “You’re thinking what will kill him first…you’re always thinking of the chances of survival,” she says. “You’re wondering what the impact speed was, whether the patient was thrown a distance, whether they hit the windscreen, what other objects they could have hit when they were thrown off.” In minors, 69-year-old charmer Steve has a fishbone stuck in his finger. It happened while he was preparing supper for a female friend. “I was showing off my skills in cooking fish,” he says. “I got somewhat distracted by her beauty, I just got complacent and that’s when it happened.” His fear of pain and needles make it a challenge for the nurse to anaesthetize his finger and remove the bone. A year ago, 58-year-old Terry was diagnosed with lung cancer and given two weeks to live. But Terry’s a fighter and will not give up easily. He’s in A&E with his friend and carer Sandy who looked after Terry’s identical twin brother, Tom, during his last months and promised she would do the same for Terry. “Terry’s not the sort of person you can say ‘Oh, I do feel sorry for you’,“ says Sandy. “You say ‘You know you’ve got it, you know how far it’s progressed, you know how to deal with it now and if you can’t deal with it on your own, I’m here to deal with it with you. But I’m not going to sit there and wallow in self-pity with you, we are gonna fight whatever comes along’ and this is what we’ve done…I get more angry than I get upset.” Senior sister Leanne epitomizes the ‘seize the day’ approach to life. “When you do this job every day and realise how short your life can be, literally nothing is taken for granted,” she says. “You know it can just end like that - you’re not going to waste a day are you? You’re just gonna do it.”

32-year-old scaffolder Thomas has been struck on the back of the head by a six metre tube at a building site in South London. He lost consciousness and was convulsing at the scene. Doctors are concerned he may have fractured his skull, spine or neck. Thomas is on his own in A&E, but his dad is due to visit later in the day. “My dad just thinks he’s dropping off a toothbrush,” says Thomas. “He doesn’t realise that I’m grateful to have my dad there…there’s a lot of people in this world who haven’t got anything or anyone.” Hilton has diabetes and is worried about his swollen legs. At 85, he lives on his own and looks after himself, but he’s come to King’s with his cousin Earl. Hilton keeps busy putting the world to rights and quipping with his cousin and Nancy, the nurse looking after him. “I feel as young as ever, I’m quite happy,” says Hilton. “Never married yet, I don’t want nobody to have me pinned down to them. I like to be free.” Retired architect Edgar comes in after suffering an asthma attack. He’s struggling to breathe, but A&E doctor Des realises that it’s not just asthma that’s troubling the 79-year-old. Edgar confides in Des that his wife of forty-five years, who was a nurse, passed away only a few months earlier. He’s grieving for her and has no-one to turn to, so Des tries to get him some support. “There is a phenomenon called ‘broken heart syndrome’ and I think that once your partner and your anchor is gone, then why are we here?” says Des. “I find it difficult to know that there’s an aspect of my patients’ care that I can’t sort out, because that’s why I’m here…I’d love to wave my magic wand and make everything fantastic, but life’s not like that.” And in the waiting room two older women make friends, talk about their life, love and loss and exchange jokes with each other. As one of them points out philosophically: “Laugh and the world laughs with you, cry and you sleep alone.”

A 28-year-old with a dislocated his shoulder, a 24-year-old with Behçet’s Syndrome, and a 30-year-old dad of four is found unconscious.

94-year-old Douglas is a highly decorated Second World War veteran who served in an elite commando unit. He’s been brought in to A&E by his youngest daughter Sylvie because his breathing has deteriorated. Sylvie, who’s an amputee herself, has been his full-time carer for the last twenty years. Douglas has four children, seventeen grandchildren, nineteen great grandchildren and a cheeky sense of humour. “He’d do silly things,” says Sylvie. “We couldn’t go on holiday, we didn’t have the money for that, so he’d take us on a long bus ride and we’d literally be going round in circles. But we really thought we’d been on a good trip!” Sylvie’s sister agrees: “Dad’s a very brave man and, as they get older, they go to the garden party at Buckingham Palace. He had a good old conversation with the Princess Royal when he went and I just think to myself ‘Oh gosh, I hope he didn’t tell her any jokes!’.” Laura, the nurse in charge of Resus today, is looking after Douglas as well as another nonagenarian, Hector. The 97-year-old has been brought in by ambulance with life-threatening problems - his airway is in danger of collapsing and his blood pressure is dangerously high. Hector is on his own and keeps asking for his grandson, Glen – his only living relative. “He reckons that the key to long life was to live a decent life and make sure you eat your porridge,” says Glen. “If my sons are half the man he was I’d still be happy.” Meanwhile 69-year-old Steve has fallen off a chair and fractured his shoulder. He worked as a plumber until four years ago, when he was hit by a motorbike while crossing the road. “The accident took everything away from him. He’s only a shell of the man he used to be. On top of that he’s got dementia,” says his partner Una. But she still remembers the good times. “He used to dress really well, he stood out. He was a right old charmer – charm the birds off the trees, he would.” Nurse Laura takes just as much care of patients at the end of life as she does those at the beginning. “There is a massive spectrum in the way you can die. It can be very peaceful and comfortable. I think that’s the nicest way you can go - and that’s very difficult to recreate in an A&E department.”

Scott is the senior nurse in charge of a very busy shift in Resus today. All the beds are full, a trauma has just arrived and an air ambulance trauma is on its way. “When you’ve got a full Resus where you’re completely rammed, but something else is coming in, you need to fit that in and you’ve got five minutes to do it,” says Scott, who has worked at King’s for thirteen years. “You’ve really got to fire off a lot of big decisions in a very short period of time.” 56-year-old Pauline has had a fall at home, hitting her head on a table. She smashed her teeth, but the main concern is injury to her spine and neck. Pauline’s proneness to accidents is a constant worry for her husband, John. “She tripped on a manhole and broke her foot,” remembers John. “She ran across the road, tripped and fell onto the pavement and fractured her wrist and broke her elbow…I hold her hand more often now when we go out.“ Soon after, the air ambulance brings in satellite and aerial-fitter David from Sussex. The 62-year-old has fallen 30 feet - head first - from a roof. He has life-threatening injuries to his head, chest and abdomen. His wife Pam is being blue-lighted into London by the police. Finding her husband in a coma on life support certainly puts things into perspective. “We all moan about our partners,” she reflects. “But you don’t realise it until something like this happens.” And opera critic John and his wife Gudrun are in minors. John injured his leg on a skiing holiday and has pain in his ankle. The couple have been together for 48 years and John admits the longevity of their relationship probably comes down to his wife being in charge. “She probably wears one and a half legs of the trousers,” he says. Meanwhile former window cleaner Alfred, who still works at the age of 78, has had to come to terms with life without Peggy, his wife of nearly sixty years, who recently died in a nursing home. With his wife suffering from dementia he had to look after both of them when she was at home. “I can cook, sew, iron - all the jobs that a woman can do,” says Alfred. “The times that I’ve heard somebody say ‘I wish I had you for a husband’. I said ‘You can’t have me, I’m spoken for!’.”

35-year-old Sarah has had a blistering headache for the past four days. She’s finally come in to A&E worried that a recurring brain tumour she first had as a teenager has returned. “I've always been told it won't come back and then it has three times,” she says. “My parents put on a brave face. I can see how distraught they were. As a parent, when something goes wrong all you want to do is put yourself in their shoes and take it away from them. I guess as parents they felt very helpless. “I sort of made a vow to myself then that I would do as much as I could to never let them know how I was feeling,” continues Sarah. “I thought if there was something I could do for them it would be to put on a brave face, put on a smile and just not ever let them see how upset or how scared or how worried I was.” Sarah’s concerns are even more heightened now that she has a young son of her own. He’s being looked after by her dad – who has never changed a nappy before – while she’s in A&E. “Now that I am a mum, the thought of going through it again whilst I have Elliot is a hundred times more scary.” 47-year-old mum Helen has come in with her 10-month-old son James who has been vomiting since the morning. With two older boys already, Helen decided to have another child and James was conceived after three courses of IVF. The pregnancy was difficult and James was born prematurely with a hole in his heart and one kidney and spent his first thirteen weeks in hospital. So Helen is worried that it could be something more serious than a stomach bug. “With that history you can imagine I would be very protective,” says Helen. “There was absolutely no way that I was taking any chances with him.” And Wayne, a 28-year-old glazer, has been stabbed twice in the leg as he tried to stop someone stealing his girlfriend’s mobile phone outside a pub. His mum Joan reflects on her son’s wayward youth and how he has turned his life around for the better. “It doesn’t matter what they’ve done and what you’ve gone through, you’re always going to be protective about them, “ says Joan. “And here’s something happening that you have absolutely no control over.”

11-year-old Archie has tripped and fallen up a step at the school library and has badly cut his lip. Archie’s worried about stitches, but he’s also concerned about his rumbling tummy - he hasn’t had his favourite dinner of chicken and chips. Staff nurse Emily is on duty in Resus: “We get a lot of falls. People climbing trees, people being drunk, falling out of windows…People can fall off anything can’t they? Horses, night-club stages,” says Emily. “So men fall off ladders and women fall off stages, thinking that they’re dancing like Beyoncé.” Kevin, a 57-year-old tree surgeon, has fallen off a step ladder landing heavily on a sharp metal bar and he’s struggling to breathe. His wife June knows that he will never be a classic ‘sitting in the armchair reading a book’ kind of guy, but it’s hard for her to see him in pain and the doctors are concerned he has punctured his lung. Alcohol can also be a major issue for A&E. “Everybody thinks that it's the weekend and the night, but actually it's all the time,” says staff nurse Emily. 53-year-old John has fallen down a flight of steps at the hostel in south London where he lives. He has been drinking heavily and has a deep wound on the top of his head. John has hit hard times in recent years, including drugs and living on the streets, but music is still his first love. “My favourite passion is drumming - started off with me mum’s Tupperware and knitting needles,” says John. “I was in a band called The Reducers. Had a single made once ‘Man With A Gun’, John Peel played it a couple of times.” Meanwhile 31-year-old barman Ross has fallen and smashed his head against a wall. He was leaving a club after an alcohol-fuelled work’s night out. He’s fractured his eye socket and has a possible bleed on his brain. The full extent of the damage won’t be known until Ross sobers up. Ross’s work colleagues Mark and Adam stay with him all the way through. “Didn’t really want him waking up on his own in A&E thinking ‘Where am I? How did I get here?’,” says Adam. “When you see one of your friends hurt, it’s instantly sobering,” says Mark. “You just go into autopilot.”