Episode 1 series 34: Worlds Falling Apart
When Jeremy crashed his mountain bike, he needed a CT scan to find out the extent of his head and neck injuries. But the scan revealed something else too – a mass at the base of his skull – as you’ll see on episode one of the 34th season of Channel 4’s 24 Hours in A&E.
Filmed at Queen’s Medical Centre in Nottingham, the programme shows that Jeremy is in the safe hands of Consultant Major Trauma Surgeon John-Joe Reilly, known as JJ. We spoke to JJ to find out more about the episode.
How did you end up being filmed for this episode of 24 Hours in A&E?
JJ: I knew that cameras were at the hospital and I was initially reluctant to be involved but I thought it would be a good way of showing people what we do every day. Jeremy was one of the 600 patients we see each day in A and E. That happens in every A and E department in the country, every single day.
What was Jeremy’s eventual diagnosis?
JJ: It was a macroprolactinoma, which is a non-cancerous tumour of the pituitary gland. These benign tumours can obviously still be a big problem if they’re causing a build-up of pressure and pressing on parts of the brain. But in Jeremy’s case, fortunately, it could be medically treated.
That must have been a relief – especially after your personal experience of this disease. Can you tell us a bit about your brother?
JJ: Larry was in his 40s when he started getting headaches that just wouldn’t go away. He went to the doctor, but it wasn’t until he collapsed in the street one day that he went to hospital. He was taken to A&E where he had a scan, and they found a tumour the size of a golf ball. He was diagnosed with a glioblastoma. This was Easter time in 2001, and he died six months later on 21 October at the age of just 44.
I’m so sorry. What impact did Larry’s death have on you and your medical career?
JJ: I was working in London when I found out about Larry’s diagnosis. It changed my perspective, and I applied for medical school that December. I completed my surgical training in the East Midlands and I’ve worked there ever since. It’s a fantastic place. In medicine, you usually have the perfect job or perfect place, but I’ve been lucky to have both.
As a lad from a one parent working class village in Yorkshire, I thought people like me don’t get to become doctors or neurosurgeons. I’m practically oriented and I discovered that I prefer the acute side of things because of the variety.
In surgery there are many sub-specialists, but in trauma teams you’re a true general surgeon. The first hour of treatment after an incident is vital and I’m fascinated by the physical body’s response in those circumstances.
How did your brother’s medical care influence your own approach, your own “bedside manner”?
JJ: I know what it’s like to hear a scary diagnosis. I’ve always remembered the way my brother’s clinicians spoke to him and to the rest of the family. I could see that they found it hard telling us there was nothing they could do. More than 20 years on, that’s still the case with Larry’s type of brain tumour – it’s very difficult to treat.
How do you deliver difficult news to patients in the best possible way?
JJ: This is when being a doctor comes second to being a person. It doesn’t matter what surgical skills you’ve got it; it matters how you are as a person, how you answer questions and react.
I’ve read that if we say the word ‘cancer’, the shutters come down and the patient doesn’t hear anything we say for a while afterwards. But in practice, every patient is different so how you communicate has to be different. You really have to use your emotional intelligence. I don’t think you get taught how to do that well at Medical School, it comes from experience. If you care, it comes across in every aspect of what you do.
Many thanks to you and to Jeremy for allowing the cameras to capture your work and experiences.
How to watch 24 Hours in A&E
You can watch 24 Hours in A&E on Channel 4 from 13 February.
The series tells the stories of life, love and loss that unfold every day in one of the UK’s biggest emergency departments. Using more than 100 fixed-rig cameras, each programme follows patients who are treated in the same 24-hour period. Th series launched in 2011, featuring King’s College Hospital in South London. In 2014, it moved across the capital to St George’s Hospital before moving to its new home at Queen’s Medical Centre in Nottingham in 2021.
Data on diagnoses and the way they’re communicated
NHS data shows that almost half of people (47%) are diagnosed with a brain tumour through emergency presentation – often after repeated visits to their GP or with sudden and dramatic symptoms, out of the blue.
Responses to our Improving Brain Tumour Care surveys show that, sadly, 37% of feel their diagnosis was not explained to them sensitively either.
It’s vital that people are diagnosed in a timely way and receive the best possible care so that they have trust in their healthcare team and live longer and better lives.
There’s more information about pituitary adenomas on our diagnosis and treatment web pages.