TVScope: Trauma BBC 1, 7.30 p.m., Wednesdays
This 25-minute production comes to us from the A&E services of the Royal London Hospital, Whitechapel and follows the 12-hour working day of several members of staff. Doctors from the casualty department, ambulance paramedics and the crew of Helicopter Emergency Medical Service (HEMS) are shadowed, giving us an intimate insight into the highs and lows of their working lives.
The A&E department at Whitechapel is the biggest in Britain and deals with the largest number of casualty patients. Despite this, we saw many patients with serious injuries treated with the utmost speed. At the same time, those needing less urgent attention were dealt with swiftly.
First was a 59-year-old man who had fallen 12 feet while gardening. The HEMS team was with him within 10 minutes of the call and 30 minutes later he was seen by the trauma team at the hospital where an "open book" fracture of the pelvis was confirmed. Two surgical operations and four weeks later he was back on his feet with the aid of crutches.
Next up was a 19-year-old musician who had sustained a fractured rib two weeks earlier following a fall from his skateboard. Returning to the A&E department with his brother, he was pale, tired and complaining of breathlessness. An X-ray confirmed he had fluid on his lung. In order to establish what this fluid was, some needed to be extracted.
However, when the registrar withdrew some fluid he found it was frank blood - a complication of a fractured rib. The staff inserted a chest drain and extracted 1.5 litres of blood from the chest. This is a considerable amount considering we have only about 5 litres in our whole system. He stayed in hospital for a couple of days and returned home none the worse for the experience.
The paramedics working on the ambulance that particular day made 18 calls during their shift. Although some patients required transport to hospital for further treatment, others needed only reassurance. An elderly lady had been robbed and, although unhurt, she was shocked. The ambulance team examined her and reassured her that they would return if she felt unwell later in the day. Another call took them to a young child who had had a febrile convulsion as a result of a high temperature. Again she was fine but her parents were frightened and needed the reassurance of the paramedics.
The differences between this type of reality programme and a fictional representation such as ER are marked. Obviously there is no dramatic music every time the doctors and nurses look at each other over their surgical masks. The staff in the real A&E department don't scream and shout orders at each other and the patients are more frightened and subdued than those we have become accustomed to in fictional hospitals.
But the real contrast was between the services available at the Royal London and those we are used to in the Republic. Even if seriously ill, it has become the norm for Irish hospital users to be treated in less than suitable conditions. And if you should need admission, a couple of days' wait on a trolley in the midst of all the mayhem is not unknown. Inadequately staffed, many of our departments struggle to provide a first-class service with third world facilities.
Compulsive watching for anyone interested in real medicine, it could also have wider applications. In particular, the newly formed HSE and the Minister for Health could do worse than tune in to this programme for a few ideas on how emergency services here in the Republic could be improved.