’24 Hours in the ER’ – BBC America Has Unprecedented Access at London’s King’s College Hospital
via press release:
24 HOURS IN THE ER – BBC AMERICA HAS UNPRECEDENTED ACCESS AT LONDON’S KING’S COLLEGE HOSPITAL
Life and death decisions revealed by the unsung heroes of the medical profession
“Everyone should walk through an Emergency Room at least once in their life, because it makes you realize what your priorities are…It’s the people you love, and the fact that one minute they might be there, and one minute they might be gone.”
Liz Hobbs, ER Chief of Staff, King’s College Hospital
This Fall, BBC AMERICA unveils a major new 14-part observational documentary capturing the daily life-or-death dramas that take place in one of London’s busiest Emergency Rooms. Filmed by a BAFTA-winning team, around the clock over 28 days, with 70 specially rigged remote cameras, 24 Hours in the ER tells the intimate, emotional stories of the patients needing urgent medical attention and follows up with those lucky enough to recover to hear of life post-ER. The documentary follows the actions of the ER’s medical staff whose decisions within the first 15 minutes of an arrival determine whether someone lives or dies. The U.S. premiere of 24 Hours in The ER begins with a two episode back-to-back special on Tuesday, September 27, 9:00p.m. ET/PT.
Every day 60,000 people walk into an ER department in the UK. Around 350 of them are treated at King’s College Hospital, London. With a staff of 140, it is one of the busiest ER departments in the country. The hospital is a major trauma centre, which means it sees some of the most serious cases in London, ranging from stabbings and shootings to car crashes and major accidents. But it’s also a community hospital with its fair share of boils, cut fingers, hemorrhoids and splinters.
With unprecedented access to the hospital, the production team rigged over 14 miles of camera cable with 70 remote cameras strategically placed around its major trauma department. The installation had to cause the minimum disruption to patients and staff. Filming took place 24 hours a day for 28 days, capturing 4200 hours of footage. One hundred and sixty-eight people worked on the production team. The result is a raw, revealing and captivating narrative that captures life in the trauma ward, from the perspective of both patients and the medical staff, in a way that has never been done before.
Series Producer/Director, Anthony Philipson says: “The rig allowed us to film amazingly intimate and heart-warming stories of real courage, love and dedication that captured our imagination. The drama which unfolded before us every day was far more powerful than any work of hospital fiction could hope to be.”
Each episode focuses on patients who were treated within the same 24-hour period and captures the joy and heartache faced by them and their loved ones, as well as the split second life and death decisions made by ER staff. Footage is interspersed with interviews of those involved in each case, and offers an honest insight into their experience of the emergency ward, and the harsh lessons of life that they have had to learn.
Richard De Croce, Senior Vice President Programming says: “24 Hours in The ER is a truly remarkable documentary series that is unique from anything else I’ve seen in the U.S. With unprecedented access to the ER ward, the program observes what really happens – the life and death decisions, the happy and heartbreaking moments, as they naturally unfold.”
From life-threatening traumas to embarrassing mishaps, 24 Hours in the ER is an intimate, powerful and sometimes comic insight into life – and death – on the frontline of the UK’s National Health Service and a unique portrait of human life.
Executive Producers Nick Curwin (One Born Every Minute, The Family)
Magnus Temple (One Born Every Minute, Murder on the Lake)
Series Producer/Directors Amy Flanagan (The Hospital, Feltham Sings)
Anthony Philipson (Coppers, Ross Kemp on Gangs)
24 Hours in ER is produced by The Garden Productions.
BBC AMERICA delivers U.S. audiences high-quality, innovative and intelligent programming. Established in 1998, it has been the launch pad for talent embraced by American mainstream pop culture, including Ricky Gervais, Gordon Ramsay, Graham Norton, and successful programming formats including ground-breaking non-scripted television like Top Gear and top-rated science-fiction like Doctor Who. Owned by BBC Worldwide, the commercial arm of the BBC, BBC AMERICA has attracted both critical acclaim and major awards including an Emmy, four Golden Globes and ten Peabody Awards. The channel attracts one of cable’s most affluent and educated audiences and is available on digital cable and satellite TV in more than 68 million homes. It broadcasts in both standard and high-definition, with content available On Demand across all major digital platforms. Online, www.bbcamerica.com is the place to go to dig deeper into pop culture with a British twist.
Series Producers/Directors – Amy Flanagan, Anthony Philipson
24 Hours in The ER offers a unique insight into the Emergency Room thanks to the unique way it’s filmed – 70 remote cameras filming round the clock. But what was it like to make a major documentary series in such a challenging environment?
What do you think the series does differently compared to other documentaries about ER departments?
Amy: One big difference with the series was that it was filmed using a ‘fixed rig’ of 70 cameras. Each camera is about the size of a small soccer ball, fixed in place and the team could control them by remote control from a mobile gallery parked outside to turn and zoom in any direction. They give you an amazing sense of intimacy and ability to follow stories across the department without camera crews getting in the way.
Anthony: The other aspect is that each program features people treated at King’s in a 24-hour period. That throws such different stories together – you might have someone clinging to life, while another person has sprained their ankle. But every story reveals so much about human life and that’s what is so interesting.
What was the appeal of filming in King’s College Hospital?
Anthony: The ER department at King’s College Hospital is an incredible place and a real privilege to experience first-hand. It’s one of the busiest hospital ER departments in the country, with 350 people treated every day, and they see injuries from broken bones through to gunshot wounds.
There’s an incredible team there. We obviously spent a lot of time with them and really got to know and respect them. They do an amazing job in very challenging circumstances and we were constantly struck by how hard-working and professional they were, as well as being incredibly caring to everyone. We all came away humbled by the job they do.
What was involved in filming a series like this?
Amy: We spent two months before filming even started researching in the hospital and observing, towards the end, 24 hours a day. The most important thing was to build trust with the core staff of 140 people who work in the ER, from porters, cleaners, nurses, doctors to the paramedics who come in all the time.
We wanted to find out how the department ran, what kind of patients come and where the real human stories lay – we also needed to know who among the staff was happy to be filmed and who we were most interested in.
Two weeks before the shoot, work started on installing the cameras. This was one of the most crucial parts of pre-production. We installed over 14 miles of camera cable and 70 cameras were fixed to the wall. Work had to take place often in the middle of the night or the early hours of the morning in a department that was fully operational day and night – including in Recovery where the most seriously ill patients are treated – causing absolutely minimum disruption to patients and staff.
We filmed 24 hours a day for 28 days, capturing 4200 hours of footage. There were 168 members of the production team, ranging from sound mixers, gallery directors and a team in charge of consent.
Are there extra challenges filming in a hospital with busy staff, seriously ill patients and their loved ones?
Amy: Of course it’s a pressurized environment and our first concern was to keep out of the way and respect people who were often in very difficult and emotional situations. One of the key issues was getting consent from patients and families, so that we would know who to film and who to avoid.
During the shoot, several members of the team were based in every area of the department – one person in each area – 24 hours a day, asking patients for consent, changing radio mics and communicating to the mobile gallery, built in the hospital car park, who could and couldn’t be filmed. They also liaised with staff, addressing any issues. The consent team followed a detailed filming protocol, worked out over several months with the hospital, to ensure that patients’ privacy and dignity was respected at all times.
What are the benefits of filming with fixed cameras?
Anthony: Filming with fixed cameras from a gallery allows you to follow multiple stories in the department at any one time without lots of camera crews and camera equipment getting in the way. It meant that we could be flexible, discreet and capture intimacy that would be impossible with a camera crew.
Each program is filmed over a 24 hour period. How was that different from a normal documentary?
Anthony: Filming in this way allowed us to capture an extraordinary snapshot of a place where somebody who’s critically ill could be only 10 yards away from someone with a splinter in their finger. We wanted to reflect the extraordinary range of human life and stories that come through the ER doors every day. From the joyful to the tragic, and the moving to the frustrating, staff see it all. Like them, during the shoot, we had no idea who was going to arrive through the doors and when they would arrive. We just knew that there would be about 10,000 of them over the four weeks we were there.
Amy: We stuck to the rule that in each program we would only include the stories of patients who were treated in the ER within the same 24-hour period. To tell their stories fully and more effectively we sometimes included treatment that happened before or after that period, and had to move the stories around, but the principle rule was always rigidly adhered to.
We use a clock in the program simply to remind viewers that they are watching a single, confined period of time. The clock reflects the time of the story that follows.
Producer Lucy Morgan
Pretty much everyone has spent some time in a hospital waiting room, whether for themselves or with a friend or family member, and we all have a story to tell of the traumas, accidents and embarrassing mishaps that took us there. But making a series in one of London’s biggest emergency departments was to be an eye-opening experience for everyone involved.
Although a technically complex production – putting 70 fixed cameras into one of London’s busiest ER departments and filming for 24 hours a day for 28 days – some of the real challenges came from the stories and emotions that we encountered.
The ER staff have to be prepared for anything at any time – so the production team had to be as well. The aim of the series wasn’t just to cover the major traumas but the joy and heartache faced by patients and their families, the humor and sadness of their stories, and the daily work of staff facing the never-ending queue of people who need mending, from the waiting room to Recovery, where the most serious cases are treated.
We wanted to capture the scenes that hospital documentaries usually don’t – the scenes that make up hospital life. For patients it’s the boredom of the waiting room and time spent in the relatives’ room waiting for news; and for staff there were cameras to tell the story of the back office and the nurses’ station.
King’s treats a varied community and in the waiting room you see people from all walks of life and all ages waiting together side by side. Some come alone, some bring their best friend and use the time to gossip or people-watch and some are surrounded by anxious family. Wherever you look there is a deeper story to tell – even if a patient has only come in with a cut on their finger. It can be humorous or heartbreaking.
Once the shoot started, it was down to the 168 production staff involved to ensure that things ran smoothly. With teams working around the clock and the cameras offering 24-hour access, maintaining patient confidentiality and privacy was essential, and we took our lead from the doctors and nurses working at the time as to whether it was suitable to film or not. We are incredibly grateful to those who chose to share their experiences with us.
With the stories unfolding in front of us – dramatic, gruesome or very human – everyone at some point felt challenged by what they were seeing. Spending so much time in a place where emotions run high and the atmosphere is constantly charged is fascinating but also allowed us look beyond the flashing blue lights to give a more authentic picture of the department.
For the staff, dealing with serious accidents and bad news is an unavoidable fact of their job. For the production team, seeing the worst day of someone’s life unfold was humbling and saddening in equal measure. Meeting inspiring patients and seeing the remarkable work of the King’s staff made what sometimes seemed like an impossible production a remarkable and revelatory project to work on. In a world that deals with extremes of life you find yourself laughing with characterful patients one moment and in tears the next.
Message board quotes in the UK
“Amazing, inspirational documentary, as a medical student if I’m half as good as that main consultant [chief of staff] I would be proud.”
“This documentary is fantastic… Not necessarily because of the jobs…but how it manages to capture everything else that goes on. From the day to day workings of the staff to emotions and real life problems that exist. The production is fantastic and I think everyone should watch it…”
“This program is beautifully shot, balance between action shots and interviews with some really interesting, sometimes hilarious characters and perfectly matched and blended in soundtrack.”
“Not everything they do is brilliant, but they do the best with what they have got. The nurses…are by far the best I have seen at what they do for a long time, treating their patients with kindness, care and compassion, plus with the utmost professionalism. They deserve medals.”
Chief of Staff Malcolm Tunnicliff and his team face a battle to save a ‘Code Red’ – a patient with potentially fatal injuries – brought into the ER by helicopter.
Thirty-three-year-old Greek student Theodore Chatziapostolou was dragged under a bus while crossing the road at a major intersection in South London. He was trapped and literally folded in two with his ‘nose touching his toes’.
Hovering between life and death, he has multiple serious injuries, including a shattered pelvis. Tunnicliff has 15 minutes to keep him alive so he can find out what’s wrong with him and work out how to save him.
Other emergency cases coming to the ER include 78-year-old Tom Gibbs, who fell head-first off a ladder while painting his daughter’s house, and a confused cyclist with a severe head injury.
The ‘red phone’ from the ambulance service rings, signaling the imminent arrival of a seriously ill patient. Thirty-one-year-old motorcyclist, Brendan, has had a head-on collision with a car, ‘bulls-eyeing’ the windscreen.
Brendan’s broken both his wrists, but he’s most worried about injuries to his testicles – he’s so bruised that his penis looks like a ‘purple carrot’. And he’s decided to hang up his bike keys.
Teenager Alex turns up with nasty injuries to his hand after punching through a window. Will he learn a lesson once he’s been patched up by the ER staff?
Meanwhile, sisters Pat and Alice are concerned about when they can get a sandwich from the ER’s food cart.
And after the Recovery team struggle to revive two patients in their eighties, they discuss what they would want done for them in a similar situation.
Eleven-year-old Kofi is rushed into the department, critically injured after being hit by a van. His father, Wayne, sits by Kofi’s bedside praying for his recovery: “I remember when Kofi was born I counted all his fingers and toes and held him in the air.”
Meanwhile, seventy-three-year-old Roger Jackson is coming to terms with his own mortality. A member of The Tornados, the first British group to top the U.S. chart in the ‘60s, Roger confesses that, despite having cancer, he wouldn’t give up his rock ‘n’ roll fame for his health.
Back in the trauma ward, Chief of Staff Chris Lacy is tested to the limit when three trauma patients arrive in quick succession: one has been shot in the face, another has been stabbed in the chest and a third has been knifed in the head. As armed police arrive and a gang gathers outside ER, tempers flare and Chris calls for calm as Kofi fights for his life.
The Emergency Department is besieged by Saturday night drunks. Alcohol is one of the biggest causes of injury seen at King’s ER – on an average weekend half the cases will be alcohol-related.
Thirty-nine-year-old Sean has had one too many and has tripped, fallen and broken his neck. The medical team have attached blocks to the sides of his head to stop him from moving and prevent him from paralyzing himself, but it’s a struggle to persuade him to leave them there.
Andrew, twenty-six, has been arrested after a day of heavy drinking. “To be honest with you I can’t remember too much about it,” he says. The police have brought him to King’s because he’s cut his hand putting it through a window. It takes two officers to hold him still, and, after he refuses to co-operate, three to lead him away to the police van waiting outside.
And fifty-six-year-old David is a long-term alcoholic who’s collapsed in the street and bashed his head. When he was two, he survived a plane crash that killed his mother. “That may have started it, I don’t know,” he says.
He drinks a bottle of brandy in the morning and another in the evening. “Booze has ruined my life,” he adds. “I’ve basically wasted my life.”
Senior Nurse Claire has seen the consequences of drink. She says: “I’ve looked after somebody that has drunk so much they actually bled to death in front of me.”
Sixty-five-year-old taxi driver Charlie Brown is making his second visit to King’s in a week. Two days previously he crashed his cab and ‘bulls-eyed’ the window with his head.
He was stitched up and discharged, but Charlie’s not been the same since, reading the newspaper upside down and becoming uncharacteristically chatty. Dr Tian is concerned that this may be as a result of a brain hemorrhage caused by his accident. When a scan shows a large dark patch on the left side of Charlie’s brain, his fears seem well-founded.
Also in ER is eighty-nine-year-old Peggy Pierce. Her husband Derek woke to find her slumped semi-conscious over the bed and she’s been rushed into King’s with a suspected stroke. This isn’t the first time Derek’s had to take an emergency trip to the hospital with his wife, so he’s braced for the worst.
King’s is a specialist Stroke Centre, treating on average three cases a day, and doctors know time is of the essence. “It’s terrifying”, says stroke specialist Dr. Kumar. “It’s like a heart attack. It’s a brain attack.”
Meanwhile, in the waiting room, Sally is comforted by her ex-boyfriend Ben while she awaits treatment for a cut finger, and two boisterous friends entertain themselves with an impromptu ride around the department in a wheelchair.
Senior Nurse Jen’s nightshift kick-starts as stabbing victim, Colin Richards, thirty-five, is rushed in by ambulance with injuries to his lung, arm and liver. He’s accompanied by his nineteen-year-old girlfriend, Esther, who was lying in bed next to him when they were awoken at gunpoint.
Esther lovingly watches over Colin, who admits he was no angel a few years back. “I just felt like he just needed hugs and like smiles and me telling him he was gonna be okay,” Esther says. “I just felt like I had to really be there for him when that happened.”
Jen says: “A lot of people don’t have anybody to look after them, to love them, I think that’s sad… I think everybody deserves to be looked after and loved and cared for.”
While Esther cradles her boyfriend in Recovery, Jen tends to Nancy Shirley, eighty-seven, who has spent her life alone and fell over at home. “If you’re happily married and got a family you know it must be very nice for people; I’ve always thought that,” says Nancy. “When I would have been courting the war was on and all the men were away.”
And in the minor trauma section, former international lawyer Robert Knutson is patched up after collapsing on the street, drunk. He has lost his wife and family after years of alcoholism.
“I don’t have a home… the bed in the hospital is the nicest bed I’ve been in, in a long time… I’m sorry but that’s the state of Robert Knutson,” he says. After being treated with care and compassion, Robert decides to make a change.
The team face a 12-hour night shift treating young men with stab wounds, as their friends gather in the ER waiting room and tension mounts.
Seventeen-year-old Levi is the first stab victim to arrive after a fight on the street. His injuries aren’t life-threatening, but he needs extensive stitching and an overnight stay. His mum is distraught, but Levi doesn’t want to speak to the police about the attack.
When two young men from different areas come in with stab wounds from the same fight, the staff know trouble is brewing and groups of friends soon arrive.
Other patients in this episode include a young woman who’s been punched in the face and knocked to the ground, and a man who has had too much to drink at the House of Commons – the home of British Government.
And porters Brian and Kevin, responsible for moving patients, collecting bloods and taking specimens to the labs – as well as taking bodies to the mortuary – explain their passion for the job.
The medical team, patients and their families face up to the meaning of life and death.
Former motorbike racer John, 77, has been sent to the ER with his wife Brenda after a routine health screening revealed a potentially-deadly ‘Triple A’ (abdominal aortic aneurism) – a dramatic swelling of the main artery that could burst at any moment, making him a ‘walking timebomb’.
The only option is major surgery, which could be dangerous at his age. Meanwhile, ninety-two-year-old widow Eileen has been brought into hospital after falling and spending the night on the floor. Chief of Staff, Liz, is worried Eileen may have broken her hip and wants to keep her in overnight to make sure she’s fine.
“Lots of times there’s nothing I can do,’” says Liz. “We are meant to grow old, we are meant to get ill and we are meant to die. I can fiddle about at the edges of that, but there’s no sort of magical response in this hospital that can change that.”
Among the other patients is Claire. A year ago, her boyfriend, a medical student, was killed instantly while cycling to lectures, and now she’s been injured on her bike.
Meanwhile, emergency medical technician Amanda and food cart worker Pritpal talk about the roles they play in helping people to get better.
The medical team faces a range of sport and drink-related injuries on a busy Saturday. But things turn darker when a family party goes horribly wrong, leaving a father and son with life-threatening injuries.
Every year 750,000 people are treated at the ER for injuries suffered during recreational activities, mostly at weekends. Ball games account for 300,000 of those, with soccer the number one culprit, closely followed by rugby.
But as evening approaches, sporting injuries begin to make way for the results of another favorite British recreational pastime – drinking. It’s a huge issue: there were three million alcohol-related admissions to the ER last year, with half of the patients under 25.
Two nineteen-year-old girls are waiting for treatment after falling when the bar they were dancing on collapsed, while bricklayer Colin has been badly cut by someone trying to mug him.
But the evening takes a dramatic turn when a father and son, Morris and Jamie, are rushed into the ER badly injured after being attacked by gatecrashers, one armed with a Samurai sword, at a family birthday party.
Construction worker William has been trapped under a boom lift, breaking his leg in three places and crushing his chest. Nick has fallen from a high ladder onto concrete, landing on his head, resulting in a severe brain injury. It’s a matter of life and death and his brother, Nigel, waits nervously at his bedside.
Darren has fallen through a window while trying to clean it, cutting his arm badly. It’s not the first time he’s been seriously injured – he had head injuries as a teenager when he was knocked over by a moped.
Meanwhile Wilfred, who lives alone after his wife died, has had a nasty accident with a sharp knife while cutting vegetables. And good-natured Alex, who once dived onto a railway track to save a woman, has been head-butted by someone trying to steal his wallet and mobile phone.
Seventy-eight-year-old Reginald is dangerously ill. He woke up with severe stomach pain, and the ER team has concluded that his condition is life-threatening. But can they save him?
A retired dock worker who is now his wife’s carer, Reginald suffers from diabetes. King’s doctors Firas and André suspect that part of his gut may have died and that without immediate surgery he won’t survive.
There are risks, but, as André says: “Compared to your risk of dying without it, that risk pales into insignificance in my view.” Firas recently qualified as a Chief of Staff at King’s: “It’s a bit clichéd but, yes, I have always wanted to be a doctor – ever since I had my tonsils out at the age of five and my parents bought me a doctor’s kit.”
Reminded of his own father passing away, Firas becomes increasingly concerned about his patient. “It is hard when you see a strong man who’s suddenly become very vulnerable,” he says.
Meanwhile, other patients include Richard, who has twisted his knee moon-walking in a club, and a young cyclist brought in unconscious after falling off his bike.
Eighty-eight-year-old Omar is brought in after suffering severe stomach pains and a suspected abdominal aortic aneurism, also known as a triple A. The news that Omar now only has a 50% chance of surviving the operation he urgently needs comes as a huge blow to his son, Talit, who says: “I thought, I don’t think I’ve ever said to my father I love you.”
Thirty-three-year-old Hanny is rushed in after attempting to take his life with a lethal cocktail of drugs. And during the hectic few hours when the ER is inundated, staff fight to save an 18-year-old who’s been stabbed in a street fight and lost a life-threatening amount of blood.
This episode also reveals what happens when the open doors of ER lead to a department flooded with patients, and what working life is like for the porters, receptionists, cleaners and security guards who also experience the traumas and pressure alongside their medical colleagues.