The 40-Minute Seizure That Almost Destroyed His Brain | 24 Hours in A&E Season 5 Episode 6

Went from the bonnet, found face down on the floor. It's a stabbing caudre. 25 feet from a ladder, onto his back. He's really unwell, I think anaesthetics need to see him before he goes to theatre. Daphne? Daphne? How is everybody then? Chilling? King's A&E, how can I help? King's College Hospital, London. I've got a stab. I know, it's a night in. On my head. One of the busiest A&E departments in the world. I want top to toe, head, chest, abdomen. A place where love, I love you. life and loss Don't bloody die. I love you too much for you to die. unfold every single day. All the patients you're about to see were treated in just one 24 hour period. A&E is always like a traffic jam. Can we get a trolley? You've got to realise that there's awful things that can happen to you. I'm so sorry. Life is unpredictable. So it's important that your nearest and dearest know that you love them. You have to tell them that you love them. You must get better and come back to me. I don't want to lose you. Because there may come a time when you're not around to tell them. Obviously not tree bark extra strong. Kit Kat? No, come on no. Mars no way. Caramel I think has got to be a no. Why do we sit in front of the vending machines? We could go by a process of elimination. Okay, that's the plan. We'll rule out the first three shelves and the bottom shelf. Let's go from left to right. I don't want any of nature's table, thank you. Drift of the maybes. Not tonight. I've got shoes on though. No, that's a lot. No, I'll take my shoes off, hang on. I've got loads of stuff on. I've put on three kilograms. They're so bad because they're supposed to be like energy, aren't they? So there must be so many calories. No, that's the one with guarana. Yeah, but it's still called a boost, isn't it? It's only 150 for half. When anything's 100 calories, it doesn't count. Shut up, you know that's a lot. Yeah, but it's not really anything. Cheers. So I'd be quite concerned about subarach. So her blood pressure's slightly up as well. Dr Ling has just started her eight-hour shift as one of the registrars in the emergency department. When you start that first day, your first job, in any department, and you're suddenly like, oh my God, I'm a doctor now, all these people's lives are in my hands. If it was affecting the cerebellum, that would cause dizziness, or usually it's vertigo. Yeah. Along with your other cerebellum signs, like your nystagmus and dysarthria and unsteadiness, and that's from your posterior circulation. You kind of have this concern that, yeah, you might just be found out as being a complete fraud. What the hell are you doing? How can you be a doctor? What are you talking about? You're just this, you know, this little girl who doesn't have a clue about anything. I need the metal thing that sticks it on, which I don't know where it is. Maybe that's something that a woman feels maybe more than a man as well, that kind of constant self-doubt. You just have to draw back on the fact that actually, you know, I've got nine years of experience, I do know what I'm doing. Hello, how can I help you? Yep. OK. OK, lovely, thank you. Bye. She's got three, 20 mils a dozen pounds. She's been brought 20 minutes. 27 minutes, she said. OK. Let me show you five minutes. Five minutes, five minutes. A 23-year-old man is being brought to King's after seizing uncontrollably for the last 30 minutes. He was found on the floor at home by his friend and housemate who has accompanied him to hospital. Have we got some more diazepam, just in case? Diazepam, yeah. It's likely we'll need phenytoin as well, but we'll get some diazepam first. This is the second time the patient has been brought to resus in the past two weeks. You've got a line in? Yeah, we have a line in. OK. He is stage 23. He is known to have complex partial or cuticle seizures. This seizure started at 17 minutes past. He's had a previous seizure today that lasted for 19 minutes, self-terminating. He's had a recent change of medication, we don't know what to, and he has had a spout or repeated complex partial seizures over the last three weeks. Somebody who continues to fit and doesn't stop, usually anything over half an hour, we will become very concerned. Anything going for how long now? We're now looking at 41 minutes. OK. If someone's fitting, they don't tend to be breathing, they clench their teeth. All of our cells in our body need oxygen to survive, so if we don't have oxygen, they slowly will die off. Brain damage is a concern. So there's a real pressure to get on top of the situation quickly. Also their heart going into a funny rhythm and the worst-case scenario even going into a cardiac arrest. Through your mind, you're running through all these different causes of it and how you're going to investigate them. Is there any other medical problems, do you know? Yeah, there's a bag of medication there on the side. Oh, is there? If they are an epileptic, have they been taking their medication? So he's on citalopram, Tegretol. Definitely no OD or... No, drugs are out. In your mind, you know this patient's not responding, I need to do something now. As he is unresponsive to drugs, Ling has requested an anaesthetist to put David into an induced coma. Oh, OK, I can't answer it now, so I thought it was anaesthetics. I'm just with someone who's... All right, if I just hand you on to someone. OK, sorry, it's just I thought it was anaesthetics. Oh, hi there, it's Ling here, I'm the A&E reg, and I've got a 22-year-old who's in status. He'll be fitting around half an hour now. So give us some diazepam, it still hasn't worked, and phenytoin is going to be going in shortly, but it's probably going to need a tube. As a doctor, you do live in this constant fear that you are going to make the wrong decision and that there is going to be something bad that happens to somebody, because this is not why you go into medicine, is it? You go into medicine to help people and to save lives and to do the best for somebody. OK, just give him a bit more diazepam now. You really do think, this is a person's life on my hands. It's been 40 minutes since 23-year-old care worker David was found having a seizure at home. Right, diazepam's not done very much, has it? Let's just try and get some more blood stuff in, and gas and stuff, just to see where we're going. He has failed to respond to drug treatment since arriving at King's. An anaesthetist is on her way to put him into a medically induced coma. When a fit has been going on for a certain length of time and you've tried everything that you can try, then really the last attempt is to anaesthetise somebody, put a tube down, and then you know that they're going to have to be on intensive care for a certain length of time and may have a prolonged recovery, and it's possible that their brain may not recover fully from that. As the seizure continues, David's body is deprived of oxygen and the risk of permanent brain damage increases. David's friend and housemate Mike has accompanied him to King's after finding him having a seizure and calling 999. I came into the living room and he'd already begun to have a seizure and it was really, really violent. I'd seen quite a few seizures before. This was different. The convulsions were more frequent than usual. They were just... It was relentless. It just went on and on and on. When you're in an emergency ward and you actually see that, actually, no, people coming in here are potentially going to die, this is a serious place. That's scary. That's really scary. The possibility of me not leaving with Dave did cross my mind. What's the BM? 5.8. OK. Violated, aren't they? You've got... Listen, I told you already. Come here. Your mum's packed you with all your goodies, look. I want these ones. These are very healthy. These are the healthy options, look. Come here. These are healthy. 100% apple juice. Good boy. Here you go. Ready? That's it. Good boy. In he goes. 49-year-old Suzette and her grandson, Azario, have come to King's after Suzette was knocked over by a cyclist. Azario and myself go anywhere at all. We're so inseparable, you know, we really are. I got apple juice. Initially, I didn't want children. I must admit, I didn't want children at all. But my daughter came by sheer accident. I'm afraid to say I much prefer being a grandmother. Wash your hands, please. Good boy. Can we wash your hands, please? Let his parents tell him that. Anyway, come on. But having a grandson is like having a second child. But with Azario, it's like double trouble. Hi, cutie. Heyo. Wash your hands, people. Azario, Azario, Azario. Come here. They're adults. They can read the sign. I'm telling you to wash your hands. You're not their mummy. You're not their daddy, Azario. My daughter came down from uni and I was taking her out for a meal in Battersea. So I decided to take the brolly along with me. She had her headset and I put the music in my ears. We were standing at the bus stop and I was doing a dance and I said, this is how you dance when you go out because you never go out anyway, so I'm going to show you how to dance. And I pulled her towards me and she had this black jumper on and when I pulled her towards me, it just basically just flicked back, opened up and I saw a tiny, tiny little bump. Mummy. Yes, darling? Come here. I want to play toys. You want to play with the toys? Yeah. Might as well. And I said, I'm not going to pretend and lie to you. I'm very disappointed and, you know, you should have told me. When I saw the actual scan and I saw it was a boy, you know, for the obvious reasons, I cried. I think I cried. I think I cried. On us. That's what we got on our body. And I just looked at my daughter and I just said, you know, this is going to be all right. It's going to be all right. It's going to really be all right. I'm back. Are you 699? Yeah. I'm Ling. I spoke to you on the phone. An anaesthetist has arrived in resus to administer the drugs that will stop David's seizure but leave him unable to breathe without assistance. He seems to be on Teglutal and Keppra, has complex partial seizures and has had them increasing in nature recently and today and has been sort of in this, like, odd sort of sleeping fashion for around 40 minutes. He's not really settling at the moment, so I'm pretty sure he's going to need to... People's are reactive now, he said. OK. OK, that's good. Heart rate's actually pretty good, considering. Hello, David. It's nice. Hello, David. Oh, OK, is he settling? He does. In King's Hospital, he's been seizing for the last hour. He's only just settled down. David's seizure has stopped moments before he is anaesthetised. Hi there. I'm Ling, I'm one of the doctors. Nice to meet you. You're just in the hospital, OK? You just rest there. I'm going to send him round for a CT, cos that was a long time to be in status for. He's come round reasonably well, considering he was out for a while. OK. A CT scan will reveal whether there is a more sinister reason for David's prolonged seizure. OK, thanks. Jacinto Blanco? Motorbike courier Jacinto has come to King's after being knocked off his bike. Hello. Hello. Come through. When I was growing up, my family always used to joke that they thought I was probably, like, the least sympathetic, least kind of caring kind of person. And they wondered why I wanted to do medicine. Yeah, no bed. Come and have a seat for me. My name's Clara, I'm one of the doctors. I'm sorry about the wait. I started working when I was 14 and I worked in restaurants and then when I was old enough, bars and stuff, so I guess I've always worked in the kind of, what you would describe as the service industry. So tell me a bit about what's happened. Yeah, I stopped in the red light. Big truck behind me and the green one coming and I think he didn't see me. And started driving. OK. And pressed me in my back. OK. And fell off the floor and... So the bike landed on your leg? No, don't land, but I'm, like, supported. Yeah, OK. And... I see, yeah. It was, like, in the move and stopped. I think there's probably a lot of similarities between your average pub customer and your average A&E attender. Do you think you can take these off so that I can examine you? Yeah, I can. OK. Yeah. After I first qualified and when I started my first job, I think every day I had that thought of, oh, my God, I'm a doctor and there is some kind of responsibility. Yeah, that's fine. Fine, all right. OK. So whereabouts is it painful in here? If I feel up here, it feels OK? No, it's OK. OK. And it feels OK round here? Yeah, it's OK. Is it more sore over here? You know, little things, like the first time someone asked me to prescribe paracetamol and I looked at the drug chart and I was like, I don't know how to prescribe it. I mean, I know how to take it, I know how much to take, but I don't know how I put it down on this chart so that someone else can do it. Feels OK here? Yeah, just here. Feels OK over here? OK, yeah. OK, if you bend it slightly for me, if you push back, is it painful at all? No, click. OK, all right. It doesn't sound like the kind of mechanism that would do anything to bones, which is good. So I don't think there's any need to do any X-rays, OK? Yeah, yeah. X-rays, no. No, I think it's probably just a little bit bruised and a little bit sore. I am just 50 years old now. I don't have more like a crash, crash every day, no. Injury every day. But that's fine. OK, take care. Thank you, darling. OK, no problem. So is that your experiment going to be? Yeah, those are the cream eggs and the cupcakes. And there's a difference. Best friends Celine and Maria have come to King's after Celine cut her hand whilst de-stoning an avocado. I like your idea of having it... In layers, yeah. Yeah, it's two very different flavours, isn't it? I'm half Turkish. Maria's half Greek-Cypriot. The Greek-Cypriot-Turkish thing was probably why we got on in the first place. We both have really hairy arms, which I think is, you know, it's nice to find a kindred spirit in that sense. Cos you used to hate her when you were younger, though. Of course. And even Josh was like, hey, you've got hairy arms. I was like, so? He was like, you should shave it. I was like, I'm going to go shave it. Do you know how gross they'd grow back? And how white my arms would be? I'd look like a ******* uncooked piece of chicken. We just met at school and then sort of stayed in touch cos we both then went to the same drama school for a year. I think we were cast next to each other in a Chekhov play, so it wasn't the most exciting first thing to go into and be like, what are we doing? Celine didn't live in London, so at weekends she'd often stay at my house or a friend's house so that you could just always hang out all the time because school wasn't enough. You had to spend every minute together. My mum thinks she's getting, er... Dementia? Yeah, early onset. She sort of was saying, you know when you can't find the word for something? I was like, you need to keep your brain active. She was like, no, I already take a break. A what? I already take a break. I was like, I'm not being funny. But they're not exactly the hardest mental challenges, are they? Oh, it's hurting now. It's getting annoying. 23-year-old David endured a 40-minute epileptic seizure. He's being sent for a CT scan to check whether a new event has occurred in his brain to trigger such a long seizure. You all right, Rich? How you doing, mate? You all right? They're just taking him off to have a CT scan now. He's just unconscious, having a sleep. Yeah. It was a biggie, though. It was a biggie. They were talking, like, 35, 40 minutes. Like, really bad. I have now... OK, now. Ready, steady, slide. OK, just going to do a quick scan. Just lie down. We're just going to move you into a bit of a headrest. OK, dog. OK, dog. Thanks for calling, mate, before. Sorry, sorry, I missed it. Yeah. Yeah. See you, bud. Bye-bye. We've been friends for just over two years. Close friends, just good friends. When we started living together, it unfortunately coincided with a really, really bad time and the seizures. The contrast between when Dave was having four or five a year and when he now has four or five a day, it's night and day. It's so different. He was incredibly chirpy and he's always been so energetic. Almost sort of on the point of brimming with energy now that they've really started to batter him down, I think, and he's really feeling it. When you've read the literature on epilepsy and you know that when it goes on for over an hour, that that's the danger zone, the main thing going through your head is, God, I hope he doesn't die. Another friend of David's has arrived at King's after hearing about his seizure. Hi, Richard. Just sitting down for about four hours. How long have you been here? What time did you come in? I can't remember. It was 17 minutes past something that the seizure started. I think it was 5, though. I think it was 20 past 5. 20 past 5. OK. He hasn't had a consultation yet cos he's been unconscious. David. Open your eyes up for me a sec. You need to shine me a torch in your eyes. Make sure your pupils are... ..round the other way. Then I can leave you alone for a bit. There we are. That's all right. David? David? David? I've laddered all my tights through. I think she's stirring things. I'm so hungry. I've got some fish cakes I need to eat out. I'm going to cut this a bit more round here. I'm getting cold. Want some fish cakes? 21-year-old history student Rory has been brought to King's by his best friend Niall after he injured his arm playing rugby. Is it getting sore? Yeah, I can feel it in my shoulder now. Do you want me to ask to get you some codeine or some painkillers? Or are you just going to wait? Give me a laughing gas, man. Thank you. Shh! I'm sorry, man. I don't... I feel really... I feel bad about it. I think it was just a dodgy tackle, wasn't it, really? I don't think it was a... It wasn't... I'm not sure it was too hard either. Hello. Yeah. Where's your footing, please? Yeah, there. It's so important to be there for somebody when they come round, I think. Hello. Hi. It's such an alien environment, very brightly lit and lots of people running around and saying things that you don't understand. It's nice to have someone there that makes you feel comfortable. It's important. Nothing makes you feel more comfortable than home, so someone from home is probably a good thing to have. Dave? David? Hello. Sorry, mate. What? What have you done now? Um... It's all right. I gave your mum a little call. She's going to call you in the morning and see if you want her to come up. I think you're stronger than me, Azario. Right. Go this way. I don't think I can take it too far out, Azario. No, no, no. No, no, because you're going to the people who are well and we'll be in trouble. Dave? Yeah? Shall I push you? Yeah, push again. I'm the invalid. I'll push you. Yeah, be careful. Now, listen, take your time and don't forget my foot's already injured. Ready? Straight. I want to push you that way. Go on, then. Say, Nanny, Nanny, you know, when I get older, I'm going to look after you, I'm going to get a big car, Nanny, and I'm going to drive you around, and I'm going to make sure you're all right, and I'm going to feed you, you know, and I'm going to give you lots and lots of money. You're going the wrong way. No. He's strong, Josie. That way. He's just turned four, that's it. He's actually helped me to actually stay a lot younger, however, cos I think I would have matured a lot faster, a lot quicker, but having Osario, it's made me... made me still stay, like, childlike. Stay, stay, stay. I'm going to play tight. Thank you. Yeah. 99% of the time, I do treat him as a little man, you know, as a little grown man. But in certain circumstances, I can see that he is a child. Help! Oh, could you let the little boy out? He's just trying to get out. Please help! Thank you. Come on, Osario. Be careful, Osario. I know we're in a hospital. Come on in. Thank you so much. Thank you. And whatever you do, don't go into my foot, OK? I'm not. Right, at least we'll hope... I'm not going to wait for the X-ray, darling. I've been here far too long now, all right? If you don't mind, OK? OK. I've got one over. OK, my name's Clare. Hi, Clare. Hi, Clare. The bus stopped for me... Yeah. ..before it got to light, and the... and the cars stopped for me. Yeah. And then, right, sandwiched in between them... And the bike stopped. It was a crazy guy on a bike here. OK. The cyclist went into you and then you fell over? Yeah, his front wheel went into me foot, then he couldn't stop himself and then he went toppling onto me. OK, that's fine. Yeah, you're right, you don't need an X-ray. I don't. Minors is definitely a different kind of mindset to somewhere like majors or recess, but, you know, it's nice to be able to fix things quickly and to give, you know, to make an intervention and then for it to make a difference and then for you to be able to send the patient home. It's just... Oh, God, yeah, you can feel the bone. Oh, right there, it's right on the bone and that's all I've got is bone. It's a bit sore here. It's just right here, here. Is it sore when you walk? Yeah, yeah. It's just, I told you, it's just like, it's just cos I've been knocked. OK. I've been knocked in donkey's ears. OK. Not in that way, but, you know, knocked in... Good, and you're not allergic to anything? Yeah, men. Anything, any medication for that? It's quite nice, you know, just to be able to say, you know, no, it's OK and for the person to feel better because you've said it's OK. Best thing is to take your painkillers regularly. OK. When you get home, some ice will help, so something wrapped in a tea towel. Oh, brilliant, and just stick it there. Yeah, and it will settle down. Thank you so much. Sorry for wasting everybody's time. No, no problem at all. It's better to get checked out. Right, then let's go and bring back their stuff, don't you worry? Yeah, yeah, it's just there. Thank you so much. All right, no problem. Are you going outside? I don't think so. I might do, but... I've got a presentation to do tomorrow. Yeah, see that teacher we saw as we were walking down the stairs? Yeah. I volunteered for a presentation for him yesterday. Oh, what's that one? Reasons against NATO's involvement in Kosovo. Against it? Yeah. And what are those reasons? I don't know. I have no idea. They're going to put... She's going to inject my fingers and then stitch. Oh, then you won't feel it. Yeah, but I can't... That's so cool. She'd love to have stitches. You're like a superhero. Friends, in times of need, can be sometimes even better than partners and definitely better than family, because I think you can be... You're at your most vulnerable around, say, your loved ones and your family, and you... I know I can react in sort of a... You get annoyed at them and you're irritated and you wish they weren't there. Flip the bird. I can't really... I can, but... For some reason, it's OK to do that to your family. But with a friend, especially, like, girlfriends, you're always... You've got your own relationship, and I think it's nicer in those situations. We'll do both sides of the finger. It's going to sting a little bit when it goes in. OK. All right. OK, well done. Good job. Now we just need to wait five minutes for that to work. She's really good at gauging what sort of mood someone's in. There'd be so many times when I'd walk into the flat and I'd be in a horrible mood, like, really, really bad. But she's not the kind of person that takes that personally and kind of, you know, tries to be a bit passive-aggressive or kind of pushes you to talk about something. She's always the first person to just kind of go, well, shall we go to the pub? Do you want to have a drink? Or do you want to have a cookie? It's actually really strange because I can feel it tugging. You feel it tugging, but it's nice and numb. It doesn't hurt. Yeah. I just thank you for making it not hurt. There's the drama queen element about it. Not that she is a drama queen, but... Yes and no. And so, you know, to be more... Not highly strung, but highly strung. Then I can be the one that's like, nah, calm down, it's fine. I think that should do it, actually. Just put two in. Two. Well done, soldier. Opposites do attract and we go well together. Very good. Thank you very much. Take care. Oh, yeah, it goes out that way. Thank you. OK, bye. M'lady. Hello. Cold spray as well. That's why you should just go... Yeah, exactly. And then, you know, it was one of those ones that isn't that satisfying anyway. I've known Claire for just really this past year that I've been working at King's. So after all that, there's not that much. But you know sometimes it can be really... Yeah, definitely. I've done those. And you're just like, oh, it's only blood. There's no parsley. We're both half Chinese. We've both got fathers who are GPs. We actually went to the same university and we've got the same mutual friends. Claire! Relationships with people that you work with are definitely important. I don't remember it, so it didn't happen. If you form good friendships with people you work with, it's always really nice because, you know, you can talk about things more. You can vent. And it also spares your poor other half or other person who maybe doesn't understand exactly what you're going through at that particular point from having their ear chewed off by you every evening. I'm basically stitching someone's finger on mine. And my hands are going like this. I think we're quite similar sort of characters. A little bit kind of hyperactive and like to talk quite quickly and get overexcited by things. Finished my paperwork nearly forever. That's brilliant. Excellent. Well done. Yay! You certainly have to be a problem solver if you want to do medicine. My father, he was always really keen to get us thinking about different problems and outside the box. And every Christmas we'd get puzzle books of mazes and various problems within it that we had to solve. A lot of people ask me about doing medicine and say, oh, you must be really clever or you must be really good at science. And I always say no to both of those questions because to me it's an art and in medicine I don't think there are any black and white answers to be honest. Oh, he looks so cute and sleepy. I want to shave bluebirds into his beard. He'll love that. I got on the bus and I was like, oh, I didn't get his toothbrush, oh, I didn't get this, I didn't get that. And I was like, he's not going to want his toothbrush when he wakes up. Ah! Ah! Tooth clean. David's friends, Richard and Mike, are waiting for the results of his CT scan. He's trying to be polite to his mum when we used to go out as like exoskeletons. It's all right, love, you can say that. Yeah. She's great like that, actually. Why do I stand by him? To do otherwise would be horrendous. That would be... That's an evil person's path. That is. He's a friend and he's ill. I say I'll go up. See if he wakes up. Say hello. Thanks for coming out, I appreciate it. Yeah, not at all. I know you would anyway, obviously, but... It's default setting. I remember once I took him somewhere and it was like five in the morning or something by the time we were talking to someone and I didn't have a clue what they were on about. Like, does that mean he's all right? Or... All I want to know is, can he still walk, doctor? How long has he got? Oh... 80 years max. No! I wanted his Nintendo. Right. Got to stay by him, that's the point. If we don't have that, what do we have? Come on, darling. Suzette hasn't broken any bones after her collision with a cyclist, but will need to rest at home. Take care. Bye-bye. Bye-bye, Zoe. Bye. Bye, everybody. Take care, all. Bye. See you soon. Press the button. If anything was to happen to me, then I know that it would... He's only four, but it's like I'm his whole world and he's mine. We have such a bond, such a strong bond. I'm not putting any pressure on him. I said, Zario, every morning you wake up, say, I want to be a genius. And every morning from that day, this was a few months ago, he said, I want to be a genius. I want to be a doctor. You want to be a doctor? And make people better. He says he wants to be a paramedic. He's always said that. I hope that he does follow his dream, you know, because, as I said, he's a helper, he's a giver, and he's very loving. David? David? David? OK, I'll let him sleep a bit longer, but all the tests so far have been fine. But we are going to keep him in overnight just to observe. Check he's OK, so obviously if you want to go, that's fine, because he won't be here for a while waiting for him to wake up. David, open your eyes up. David? The initial results of David's CT scan show no bleeds or other new symptoms that could explain his long seizure. He'll be closely monitored until he's fully conscious. How are we feeling, pretty boy? He's always been here. How are we doing? I've put on my weight. I'm finishing at 12, so I'm just looking for small things to do. Do you want me to put a line? Would you? No, I'm finishing at 12, so I just wanted to do a couple of small things. I guess you always know more than you think, and inside you're still the same person that qualified, you know, seven, eight, nine years ago, and you don't necessarily feel that you've progressed from there, so you're always slightly surprised that people are turning to you for advice or that they need you to step up. I think everyone has that kind of feeling, don't they? I've done my paperwork. I've finished sorting it out. Forever? No. This year? Forever. If I've had a difficult day at work, now I will try and go for a drink with a friend, another medical friend, and we'll talk about what we've seen and what we've done and offer opinions. I guess, yeah, it's just encouraging to know that someone else in your same situation would make the same choices. You got the email from Claire that we're going for drinks tomorrow evening. If you don't examine yourself and think about what it is that you know or what you don't know, then I think that you're not a very good doctor. If you get to the point where nothing throws you or nothing surprises you, then you've probably been doing it too long. Whenever I cut an avocado, it's silly. This is really just what goes through and I guess I do remind her of that. You texted me the other day, didn't you? Yeah. You texted me saying, every time I cut an avocado, I think of you. He reassures me 100% of the time. You're going to be fine, nanny, and you're not getting old. You're not getting old, nanny. He'll tell everybody how old I am. My nanny's 49 and she's going to be 50 soon. So I was in a pub and I was attempting to chat up this girl and I went into a seizure and the ambulance came and had to give me rectal diazepam in the middle of the pub to get me out of the seizure which was incredibly embarrassing especially as I'm semi-aware during my seizures so I knew exactly what was going on which was not cool at all. I'm sorry. I did get her number.