I Feel Privileged to Be A Pediatrician | Confessions of a Junior Doctor | Only Human

We can put her into one. Hello Lenny, my name's Morgan. I'm one of the doctors. There are over 63,000 junior doctors working in Britain's hospitals. You squeeze my hand if you understand what I said. As young as 23, they are the foot soldiers of the NHS. And how are your bowels and waterworks? Yeah, it is not glamorous. It is not glamorous. Hey baby, hey. They'll welcome us into the world. Aw, awesome. Do we have a pulse? No, no. They will be there at the end. Should I stop? I've yet to rest on find and board. Emergency. Alright, don't worry. But they are working in hospitals that are treating more patients than ever before. We are utterly, utterly full. We've got just no room, no beds, no space. Everything is stretched. We haven't got a lot more to give and something needs to change. These doctors have become a symbol of the state of the NHS. We are doing our best. We are working our hardest. But it's just not enough. Filmed in one regional hospital at the height of the junior doctor crisis. This series is about the young doctors who are the future of our health service. To survive as a junior doctor, you must have courage. Courage to cope with what we see day in, day out. Courage to deal with people at the very worst moments of their lives. And courage to work in a system that can't cope with the pressure it's under. Every day in Britain, over 6,000 children are admitted into hospital. Some will arrive by ambulance, others on foot. But almost all will end up in the care of a hospital's paediatric department. Oh, really? I know, I know. I'm being a meanie, aren't I? It's cramped, stressful, usually hot and quite noisy. It is chaos, particularly in the waiting room area. Some of them are wandering around all over the place, crawling around the floor. It is like a zoo, but it's the zoo I like working in. For junior doctors, training in this speciality is one of the longest in medicine. Can you do a big breath for me? And every year, new recruits take their first steps onto the ward. Oh, that's fine. Hiya there. I'm Dr. Patel, one of the children's doctors. 27-year-old Fahim is a third-year doctor, just beginning life as a paediatric junior. So, um... Oh, I think he's hungry. I think he's angry. He's rooting for me. He's looking. He won't find any milk here, I'm afraid. As a medical student, the truth is I hated paediatrics. It's completely noisy. You can't think. You've got nurses shouting at you, you've got parents shouting at you, and you have the child crying. There's nowhere for you to run. But I realised, in paediatrics, you work as a detective, having to take the history, examine, and figure it all out. As a doctor, that really is the Holy Grail. Fahim is working nights in the neonatal ward. Hey, baby. No, you're not going to like this. On the bottom rung of the ladder, he's given the most junior tasks. Sorry. When you turn up to a night shift, and you're given a list of ten newborn babies that need their heels pricked tonight for a blood test, God, your heart absolutely sinks. Oh, baby, I'm sorry. All I know is, all night, I'm just going to be hearing echoes of newborns screaming. Sorry, baby. Oh, dear. See, there's no problem with your lungs. Fahim is the only junior in the neonatal ward at night. The pH is now 7.24, and the PCO2 has risen now to 8. Nurses are there, and a registrar can be called, but up to 20 sick babies are under his care. And we've stopped the vancomycin, have we? He's got one more dose. He's got one more dose. Lovely. OK, right, and baby Harper? She had a gas yesterday morning, but she's been self-ventilating since Tuesday morning, so she probably doesn't need a gas again. She's looking lovely, isn't she? She is. There's such a huge variety of complex needs that these babies have, from something like their jaundice, right through to a baby's stopped breathing, and they're going into multi-organ failure. For junior doctors that have potentially not much experience with babies, neonates, pre-term babies, being able to pick up those subtleties is a real challenge. Sats of 98%, good. Heart rate of 177. Good. Bit quick. It's the noises that really terrify you. There's lots of beeping of machines. And it's up to you, as their doctor, to first of all spot that there's a problem, as well as being able to deal with that. And that's terrifying as a junior. So we'll get those sent off as a matter of priority. Oh, ----. Oh, ----, wait. Right, red section. Three hours into a day shift, Faheem's called to theatre. A mother is having problems in labour. Sorry. This is not good. Not good, not good. Oh, dear. Sorry I'm late. When I'm in theatre and I'm there waiting at the end of the bed, thinking, God, I hope this baby's coming out OK, waiting for these obstetricians to just cut through each layer, patiently and impatiently waiting. And it's that scary moment when the waters have broken and the paediatrician reaches in to get that baby and she says, I can't get it. Then you start to panic and you start to think, God, I can really hear that clock ticking now. That baby needs to come out now. The baby is breached and not making any noise. When that baby comes out and there's no cry, yeah, your heart just stops. You're just like, oh, God, I just want this baby to cry. Please cry, baby, just cry, just cry. And you're just thinking to yourself, give me that baby now. If that baby isn't crying, I want to see that baby now. Are you ready, Ruth? Yeah. Thank you. Yeah, let's have a look. All right, I'll pick up baby if you're happy to... Yeah, I'll take the next towel off. Yep, got it. That's better. And then you hear that cry. Wow, it's music to your ears. Genuinely, it's just, the relief is immense. That's better. You are so breached. Put your legs down, lady. I want you to hold your arm. Hey, hey, hey. Dad wants to hold you. OK. That's OK. So one hand behind the head, one hand around the legs and the arm. You'll be fine, Dad. Give it a go. The head is the most important thing. That's great, that's great. I now know everything. When you present that newborn baby to that mum and that dad for the first time, you are witnessing the start of the most beautiful and enduring relationship of these three people. It's wonderful. Congratulations. It really is a privilege as a paediatrician to be able to be there. Northampton Paediatric Department looks after children from birth to the age of 16. Doing well at school? Yeah. Yeah, happy? Good. Its three wards are staffed by specialist nurses, consultants and a team of junior doctors, the most senior of whom are paediatric registrars. He's OK. Shall I listen to Teddy first? Yeah. Go on then, let's listen to what Teddy's got to say first. Right, Teddy. 34-year-old Nita has been in paediatrics for three years. She's in her first months as a new registrar. Does Mikey sound OK? Shall we have a listen? Yeah. Oh, good job. The night before you become a registrar, you're very nervous. It's this overwhelming sense of this is it. I'm going to have to see every single one of these children and sort out their problems. Hello, guys. What does your top say? Rules are made to be broken. Nita is working across every ward and in charge of over ten other juniors. Who hasn't passed the test? Hasn't passed the test. OK. As a registrar, there are times when you're the most senior doctor in the hospital. You know you've got three or four patients to review. There's also a new patient that's coming, you've got some bloods to do, A&E are ringing you about other things. You've got to be able to multitask and do all these things in the right order without letting it all fall apart. How do you think he's doing? Oh, he's a lot better than he was Thursday. Oh, he looked terrible Thursday. I'm trying to stay as calm as I can, but I can assure you that I'm absolutely... My heart is racing. I can't even hear the child's heart because my heart is going probably just as fast. BABY CRIES Children are really scary because you don't really know what's going to happen next with them. They change so quickly. One minute they're well and one minute they're not. And they are the most important thing to the parents, and you are being entrusted with their health and lives. And that scares me. Hi, paediatric registrar, how can I help you? It's 7pm, and Nita has been called to a seemingly routine Burns incident. Thank you, bye-bye. It's an 18-month-old Burns child. We've been shown quite significantly that they're finding it difficult to cannulate, so they would like some paediatric input for cannulation. On arrival, the situation proves much more acute. Go have a look at him, if that's why you hold him. A toddler has received Burns after knocking a cup of boiling Bovril onto himself. So, start from the beginning. Explain to me what's brought him in on this occasion. We were sitting on the sofa, I asked if she wanted a cup of tea, pulled the kettle, made a tea, made a bottle, walked into the living room, put the tea and the bottle on the table, went back to shut the door. As I shut the door, he grabbed the Bovril off the top of the table and went like that. When you are the registrar, your job is not just to look after that patient, but it's to look after that family. Has he ever had any problems with his breathing from birth? No. They almost want you to tell them that it's not their fault. It's OK, it's OK. And it's making those parents realise that I am going to treat your child regardless of what's happened. OK, so I need him with his legs facing... Is it granny? Yeah. Legs facing granny. Nita must inject fluids urgently to keep the child hydrated before transferring him to a specialist burns unit. Midway through the procedure, a more serious problem appears. What's this? Blood vessels in it. Hemangioma. That's the word! So hemangioma is a collection of blood vessels. If they're big, they'll be connected to bigger vessels. So if you get a burn on top of a big hemangioma on the chest wall, you need to be worried about if this burn burns the overlying skin to the hemangioma and these vessels just continually bleed. Because if that ulcerates, we will have a problem. Do you want to transfer him with blood in case, in transfer? I think we should. We've got a bit of a problem. The hemangioma, it's quite a large one. If the burn ulcerates it, it could bleed. That worries me. So in the ambulance ride over, we'll send you with some blood. So what I'm trying to do is to make sure that you guys are safe enough to get there. Before transferring the child, the burn must be dressed. It's the most painful part of the procedure. Good job. After an hour of treatment, Nita's work is complete. I'm going back up to the paediatric ward. Fingers crossed. Hopefully I won't see you again. Thank you very much. Bye-bye. Ta-ta. I think one of the crucial jobs of a paediatrician is to take that child from a place where they are unwell to a place where they are better, but also that family, from a place where they are stressed and anxious to a place where they are understood and calm. It brings with it immense responsibility. Love you! See you soon. I think I'm going to get there. It's early winter, and Northampton is in the grip of a cold snap. Can I have a listen to your breathing? Is that all right? Winter's definitely the most stressful time in paediatrics. The wards are crammed with all these small babies with bronchiolitis who need oxygen or help with feeding. We can't possibly send them home, and yet there's more coming through our doors. Right, let's do this. Whatever this may be. Nita, still in her first months as a registrar, is working in PAU, the paediatric assessment unit where all new patients are first seen. Hi, guys. PAU, in winter, it's all the sights and sounds of family life brought into a very stressful situation. OK, he tolerated 200 ml of this earlier on, but then vomited. Someone that's coming in that's not experienced that before, it's a total assault on their senses. Hi, it's the paediatric registrar. I've just been bleeped twice. Where have we got to? Who's this chappie waiting for bloods? I'm going home, going home. Operator. Numbers today are some of the highest this year. Can you send him to PAU? We'll see him here. As a new registrar, it's Nita's job to assess who needs to stay and who can go home. Where am I going next? You have to make pressure decisions very quickly to try and clear the ground, but also accurate decisions, so I don't want to just clear them out. I want to make sure they go to the right place, that they go home and they're well enough to go home, not just because there's so many people here, I need to send people home. Hi. Hi. Hi, my name's Nita. I'm one of the paediatric registrars. Start from the beginning, guys, and explain to me what brought you guys in. It's just her breathing that worries me. OK. We've been in this situation before. She was in for five days, dependent on oxygen. Wait a minute. She's doing it for you. When you first become a registrar, you are permitted to discharge patients, and that is a considerable responsibility. Can we just try and get all these loose ends sorted out so that we can get people out? So just discharge as many people as we can and then get back to me if something needs to be discussed or reviewed. Yeah. The worry is that you could be sending home someone who doesn't appear ill but will become ill at home and deteriorate and end up being readmitted or, even worse, die. And it's quite worrying, thinking, am I doing the right thing? Is it safe to do? Every patient Nita admits gets a bed. But this department has had no increase in bed numbers for 20 years, despite a soaring local birth rate. We've got no beds across Paddington. We've got no cubicles on Paddington Ward. So not that many beds. We've probably got very few beds and are probably filling them as we speak. Disney have got no cubicles. They've only got four beds. They've only got two nurses tonight and two nurses tomorrow. So that's that. So I've potentially got maybe one bed, one cubicle to work with. No, just one cubicle. Midway through her shift, Nita has only one bed left and there are still people waiting. Maximillian. So, blood and poo is the problem. It's been going on for a little while, about two weeks now. Have you got pictures? Yeah, I've got a picture. I like poo pictures. Everybody's got them on their phone. That was yesterday as well. I think we definitely need to investigate a little bit further. But we're waiting for a bed. Now I need to discuss with you what we're going to do between now and tomorrow. My feeling is that I send you guys home, but you're not actually technically discharged. How's that sound? Yeah, a bit scary, but yeah. I don't know what's going on. And I know it's scary. But I think we should find out what's going on. Thank you, guys. Are we free to go now? Yeah, just give me like two minutes, OK? Thank you. If you decide to give her some ibuprofen, make sure she's eaten something first. OK, yeah. OK, it's OK. Can I get a saturation probe? Yeah. Can we get him on a bed? Can we have a bed? Is there a bed? In the waiting area, a child has unexpectedly started fitting. Can I get some oxygen? OK, OK, OK. You're all right. Come with me, Mum. Can I get some oxygen, please? No, I haven't. We are about two minutes, but I haven't got a... OK, OK. Come in, Mum. What's his name? Ryan. Let's give him a little bit of time, OK? There is pressure. You can hear it and you can see it and you can feel it, but you need to be able to put on a face that says, don't worry, I've got this. Even if sometimes you don't know what you're doing. Is he all right? He's fine. On this occasion, it was very in keeping with the febrile convulsions, so when children get hot, their seizure tolerance level is really low, so they tend to fit. And unfortunately, that's what Ryan's going to do every time he's hot until he grows out of it. But they do grow out of it. Bear with me a second. I'm just going to let him cool down. When you become a registrar, you've got to perform. You have got to perform in a performance that you've never been in before. Can we send this one home? It's like one of those cartoons, you know, where they're walking along and then they fall into a hole. I want to speak to the surgical registrar. All of a sudden, you are in a different environment, in a different situation that you have to become adaptable to. So you can't be, you know, not on your game. You've got to be able to respond to that situation very quickly. Excuse me, please. That's mine. Across on the neonatal ward, Fahim has completed his first months as a paediatrician. Hi, guys. We need to admit one to our unit, so it's a baby that's just been born now, 35 weeks. Many of his shifts have been at night. The long hours are beginning to take their toll. I am suffering at the minute with those night shifts. The tiredness really sets in. You can barely keep your eyes open. Every part of your body aches. Your mind feels like it's in a vault and you can't think. You worry about missing something and that child is going to become poorly because you've misread something in your blurred haze of tiredness. It was an induced labour, actually, at 35 weeks because of static growth. And that delivery. And the baby was born in good condition. I got to a stage this morning where I was just so tired. Just absolutely exhausted. I could barely finish my own sentences. I could barely even just... ..barely move. Junior doctors in particular, they're working very long shifts, often no breaks. The exhaustion manifests itself in sometimes poor decisions. In paediatrics, you absolutely have to be 100% all the time because of the subtleties of what we do. Just got our new admission. I'm just going to take him into the treatment room for his cannula. It's 2am on a night shift and Fahim has been called to a sick newborn. This baby was born prematurely. He's only about 1.7kg. And also, mum's waters had broken for about a day. This puts this baby at significant risk of developing an infection. At this stage, they have a very immature immune system and so they won't be able to fend off infection. So we need to give antibiotics before baby gets sick. Ideally, we need to get these antibiotics in within the next 15 minutes. Is he the one that was induced earlier today? He was. Fahim must insert a cannula into the baby's arm to administer the drugs. Doing a cannula on a newborn baby, especially one that's preterm, is incredibly difficult. It's the most important thing I'll probably do tonight. Very nervous. It's like cutting thread through the eye of a needle. This baby has a tiny little vein. It's so fragile. The margin of error is millimetres or less. Fahim hits a blood vessel, but it's not big enough to take the antibiotics. I'll have to put another cannula in. It's bleeding well, but it's not going to stay. We'll try again. There's a vein next to it anyway. OK. Got it? Yeah. I cannot believe that just happened. It got hooked on something, and as I pulled back, it fell out. I cannot believe that just happened. Fahim's 15-minute window for giving antibiotics is now closing fast. Your heart just, you almost can feel it in your chest. Your hands are so sweaty. The glove starts to stick to your fingers. Yeah. It really is, yeah. This will be my last attempt. It just feels like everything is conspiring against you. That vein's gone. All right? Good. Before calling a registrar, the neonatal nurse has one attempt. Another good fine hair, but... Oh, brilliant. Got it? Well done. Brilliant. Excellent work. Thank you. All right. Thank you. All right. I'm not used to failing. I breathed through school. I got into med school, which was really competitive. I'm usually very successful at everything I do, and dealing with failures, it's just... It's a horrible feeling to have to admit to yourself, actually, on this occasion, I just wasn't that good. You do start to doubt yourself and sometimes even your suitability for this career. For all paediatricians, treating children is a demanding job. Their patients need close care around the clock. Finding a balance between work and life is a challenge every junior must face. Alongside being a registrar, Nita is also a mum herself. So this is Smith's playroom. It's so full of toys, because every time I'm at work and I feel a little bit guilty about leaving him, I buy him something. So when I come in here, although I see a great room for us to play in, I do sometimes see the amount of times I've left it. Yes, there's guilt. There's immense guilt. Being a registrar and a mum, it's brought new challenges for me, largely because the responsibility I have to my patients is quite immense. I have to be the first one there. I have to be the last one to leave. Come here, Baba. Mummy's going to get to work now. No. It's OK. Mummy's going to come back. She'll come back later. Mummy will come back. Oh, Baba. Smith, look, Mummy will come back, OK? She'll come back later. Mummy will come back. Come here. Nita's rota means she works night as well as some weekends. Say bye-bye, Mummy. Yes, it is interesting, isn't it? Because it's well demarcated. Have we got a report? Tonight, she's in charge of the emergency arrest team. Yes. Dr Smith might have the A&E referral bleep. Neonatal team to labour ward theatre one. Neonatal team. I run faster for a neonatal first bleep than I've ever ran ever, that I could possibly run, because the baby on the other end really needs you. The labour ward is going to do some sort of delivery. You may be the most senior person there when you get there. And all those unknowing parents believe that that person that they're going to get at the end of that bleep is going to know what they're doing, and it's going to save my child. Becky! Where am I needed? At your door. Baby came out. Cried. So where are we going now? Back to recess. Did you actually need to... Run? Yes, of course I did. It's a baby. Every minute I slow down, every second I slow down, that's potentially a breath that baby didn't take. And I've got a junior on, who I trust implicitly, but is still quite junior. OK, tell me about them. In one night, Nita is bleeped over 40 times, never knowing what she will find when she arrives. Hi, Josh. Peds is emotionally draining. I think it's because I quite frequently relate to the situations that are going on. What if this was my child? In this situation, how would I feel? And then in addition to that, medicine is not predictable. I don't know what time I'm going to come home. I don't know what time children are born. I have no control over that. You need to give him the steroid at about 11 o'clock. Your whole life revolves around how much you care for this job and for other people and for the profession. In order to be a good doctor, I believe that you have to give 100% to what you're doing. And that's what I was doing until I had Samir. And then I gave 100% to being a mum. And now I don't have 200%. It doesn't work. And sometimes I feel like I'm not doing a very good job in either place. Oh, excuse me. That baby's chilling, eh? Across on the neonatal ward, Fahim is also finding paediatrics all-consuming. I might need a hand in a minute, if that's OK. Just because he's quite fidgety, so I might struggle to get the line on. At the moment, if I'm honest, there isn't much of a work-life balance. OK, lovely. I'm sorry. Work just starts to take over your life, and it has to because you're the lifeblood of the system. You are keeping the wheels turning. For support, Fahim has his faith. As a practising Muslim, he prays five times each day. Having religion really helps me to get through the hard times because I remember that I trust God, and I trust that if I dedicate my life to helping people and to doing good things, hopefully God will have plans for me. Being a Muslim, to help people is a form of worship. And as a doctor, I get to help people every day, and actually that's an expression of my faith. Despite his struggles, Fahim's training means he's taking on ever more complicated work. Today, he has to take spinal fluid from a baby with suspected meningitis. This will be my second lumbar puncture in this age group. If you completely mess this procedure up, you could effectively cause paralysis. Last time it was fine. The sample's a tiny bit blood-stained, which does happen, it's technique-related sometimes. So I'm hoping on this occasion we get something we call a champagne tap, clear fluid, rather than blood. Fingers crossed, eh? Fahim is supported by a nurse and senior registrar. Are you sure you're happy there? It looks a little bit low, but you're happy with it? It's in line with your eyelid crest, yeah? Let me check the space there. OK. So you want to be nice and level, aim towards the umbilicus. OK. That's it. Feel good? OK. That's it, don't go too far. All right, let's have a look and see what we've got. OK. No, I think we've got too much blood, haven't we? I think you've unfortunately clipped a blood vessel. OK. Oh, man. Fahim has missed the spinal canal. This time, he only has one more attempt. I see scared junior doctors on a frequent basis. They're just so overwhelmed by the pressure that is on them. And sometimes they have to make mistakes to learn from that. Blood's there. Come out a little bit, see if it clears up. Yeah, we've run out of gauze. Keep that needle away. Yeah, I've got it, I've got it, yeah. On his second attempt, Fahim is successful. Good job. Oh, thank God you were here. Thank you. That was absolutely exhilarating. Nerve-wracking. I can't tell you how fast your heart is beating into your mouth when you're doing that procedure. There was quite a lot of blood, but got there in the end. Got the sample, so there we go. It's moments like these, it really hits you that there's a limit to my ability, there's a limit to my skill, a limit to my experience. Special delivery for you. She was absolutely lovely with us. She was really calm and settled up until the point we had to hold her, which she hated, but she was absolutely lovely, you know. I need more time. I think that's what I've learned. I think I need more time to get the experience and to get better at what I do. Thank you very much. Bye, Fahim. Bye. Thanks. OK, baby girl. Baby girl. Yeah. Happy birthday, baby girl. By the end of 2016, Fahim's been a paediatrician for five months. Slippy baby. All right, lovely. His confidence is slowly growing. Lovely, hi. I'll just come to the baby check if that's OK. Yeah, five fingers, five toes, a good start, isn't it? Yeah. Tonight, he's on a night shift and has been called to a baby with breathing difficulties. Good evening, hi. This is Teddy. Yeah. Has she been coughing? Yeah, like a really loud, kind of piercing cough. Just going to have a listen to your chest, sweetheart, if you're going to let me. We need to keep an eye on her, actually. Yeah. Just to be on the safe side. If I were to offer you admission to stay overnight, would you stay with us? Yeah, definitely, yeah, I'll stay. So, Teddy's got croup, which is a swelling of your upper airways. So, if that airway, which is normally that size, gets swollen from infection, from this virus, it gets tighter and tighter and tighter, and what you're hearing is, with that stridule, is that the airway's tight. That's dangerous. Over the next four hours, as Fahim monitors her, Teddy deteriorates. So now she's got reduced air entry and now her breathing is much harder than it was. Fahim calls on Nita for support. She's got a significant stridule. Oh, God, it's gotten much worse since we left her. So I'm going to put her in HDU. Yeah, HDU, Jesus. Are you all right sorting this out? Of course, yeah, yeah, yeah. She's actually taking a turn for the worse. She's now getting to a critical stage where her airway can close off and she may collapse. We're going to move her to the high-dependency unit because this is an airway emergency. Fahim must prescribe the correct steroid dosage. Page 128, come on, come on, come on. That was it? 400 mikes per kilo, max 5 milligrams, 400 mikes per kilo. She's 8.9. I still worry a lot. I worry that I've done things wrong. I worry that I've said the wrong things. You worry about every little thing, and I've learned, as a paediatrician, you have to worry. Times 8.9, 3.56. If you're a bit too calm, a bit too casual, the chances are you have missed something. This time, Fahim has got it right first time, and the steroids calm Teddy's breathing. Just let her get settled with it. Hey, honey. It worked. Her airway is now wide and open. She's no longer got that stridor sound, that every time she was breathing, it's all disappeared. She's really calm, she's really settled. I'm really happy. Over the past couple of months, I've started to care for these little ticking time bombs a little bit more, actually. They all have their own personalities, despite sounding all the same with their screaming. Hey, hey. Yeah, yeah. They've fallen in love with them. Fahim's first five months are only a small step on the eight years of training that lie ahead of him. It sounds really far-fetched at the minute, but I want to be the complete paediatrician. I want to be that go-to doctor that people will know of and people will hear of and say, well, that's Fahim. He came and sorted my child out. It's going to look like I'm dropping him, but I'm not. Despite all the low moments, this is definitely what I want to do, and it's only through failure do you learn to win. Oh, wow. Hello, paediatric registrar, how can I help you? Across on the assessment unit, Nita is facing another busy shift. So we've got a plan, got a plan, got a plan. Today, they are several staff short. What do you want me to do? Just hold his head. One more time. I'm sorry if he's sick. The rotor has always got gaps on it, but it's not anything new. People step up and do shifts that they are not normally rated for. We all ship in, we all help. Just continue and I'll come over to you as soon as we can. No problem. Nita's stepped up to being a registrar seamlessly. And is beginning to find a balance between work and the rest of her life. Before I had a son, my world was paediatrics. I ate, breathed, slept paediatrics. I will never be that doctor that I was before. But I hope that the doctor I've become is a better doctor. Can I have a feel of your tummy, young man? Where does it hurt? I think about smear all the time. It's difficult. I like your Superman pyjamas. I had a very poorly child come in to me in A&E. And the child was wearing the same pyjamas as Samir's got. In fact, the same pyjamas that I left him in before I came to work that day. And all I could think about was Samir. Hello, baby. Are you okay? Samir? I'm playing with daddy. Are you playing with daddy? Oh, that's good. Seven years after she became a doctor, Nita's now working part-time. I've got a card for you. You've got a card for me. That's nice. It will take her four extra years to become a consultant. Mummy's going to come home from work soon, okay? Bye. I love you. I love you too. I think that I've now come to terms with it. That I do my absolute best at what I do. And when I'm with Samir, I'm 100% his mum. But when I'm at work, I'm 100% a doctor. Because I know that what I'm doing is worthwhile. And I know that what I'm doing will make him proud of me. And he won't remember that I never saw his first steps. But what he will remember is that his mum fixes poorly babies. Bye-bye, guys. Next time, junior doctors are working in the competitive world of surgery. There's one more before you, and you're going after that. It's not easy. Not everybody can be a surgeon. We're like Top Gun. Can we have the hat down a little bit, please? Young trainees have little room for any mistakes. There is always a fear of messing something up that you can't fix. Click on screen for more videos of extraordinary humans.