Most programmes focusing on the NHS are, unsurprisingly, frantic. From 24 Hours in A&E to Ambulance, viewers, much like the medical staff, are presented with patient after patient, and trauma after trauma. These documentaries effectively convey the sense that there is never quite enough time. Thankfully, Surgeons: At the Edge of Life (BBC2), which focuses on astonishingly complex surgical procedures at the Queen Elizabeth Hospital Birmingham, is able to take its time. This is a pared-back version of the usual rapid-fire hospital doc, seeing only two patients through surgeries that are as astounding as they are unvarnished.
Each episode has a subtitle, establishing the theme, and, in this episode A Risk Worth Taking has a double meaning. It shows surgeons assessing the risk to the patient and the patients assessing the risk to themselves – these procedures are so impossibly complex that they may cause paralysis or death – as well as the financial implications for the NHS. It is galling to hear patients discussed in terms of their immediate and long-term cost, as if they are investments. But that is the crude reality right now, and it is important to hear how jarring it sounds. The care these doctors take, to press for expensive procedures that could change the lives of people who are suffering, is heartening, and the show itself takes a more philosophical and measured approach to what suffering means and the value of a person’s quality of life.
Chris is a former butcher in his early 60s whose back pain has become so debilitating that he is barely able to get out of bed. His wife, Sandra, says he has endured “four years of hell” and three previous surgeries have failed. Navin Furtado (pictured, above) is a spinal surgery specialist who corrects spinal deformities, and his final suggestion is a radical and brutal one: he will take out a wedge of bone in Chris’s spine and pull it into an upright position, using metal pins and rods. The irony that Chris was a butcher is lost on no one. Those of a squeamish persuasion may wonder if they could watch this through open fingers, looking away at the gruesome bits, but almost all the bits are gruesome. It is bloody and gory and completely frank. If you have ever wondered what a spine looks like when the flesh around it is pulled to either side like curtains, Surgeons has the answer.
Meanwhile, as a result of lymphedema, Judy has a distended abdomen filled with fluid that is known in medical parlance as an apron. “It’s like carrying another person,” she says, sadly. Her belly button sits at her knees, and the flesh reaches her ankles. She no longer leaves her house because people stare. Sunil Thomas is the consultant plastic surgeon who will detach it; it is the largest ever attempted at this hospital. He talks eloquently about compassion: “As surgeons, we are here to help our patients, not to judge them,” he says. The surgical team has a sweepstake on how much the apron will weigh once it has been taken away from Judy’s body. But what might seem frivolous, as Thomas puts it, is important and human. It is to unite the team during a potentially lengthy and risky endeavour. It boosts morale. Again, this is not for the faint of heart. To remove such an enormous part of her body is a staggering feat; the sight of it on a table, completely detached, is surreal and unforgettable.
There were a series of comments in Surgeons that should make any patient pleased that, for the most part, we are unconscious when these incredible experts are tinkering around inside our bodies. I started mentally ordering them into which I would least like to hear: “Terribly bloody, isn’t he?” was one; “Mallet, please,” was another. Surgery, it turns out, is not nearly the delicate act one might expect it to be. Chris has his spine bashed with a hammer to stimulate bone regrowth. Judy must have 30kg of flesh resting on her chest while the process of detachment is figured out. That people can do this, and that others can survive it, is consistently amazing.
So, too, is the scale of everything Surgeons shows: the size of the teams involved, the cost of it all, the waiting, the care, the sheer weight of every tiny fraction of a decision. It is not pretty, or easy to look at, but it is quite awe-inspiring.
