TV Scope: All doctors take actions which can affect, to some extent, patients' lives for better or worse, and we are often accused, sometimes with good reason, of playing God.
Surgeons, in particular, come in for such criticism, but nowhere else in medicine is the patient's life as acutely and literally in the hands of the doctor as in surgery, as life or death can depend so crucially on the slip of a scalpel or a carelessly tied suture.
This programme is the latest manifestation of a medical reality series which has been appearing intermittently since 1958 and the current series focuses on complicated, state-of-the-art surgery where previously hopeless lives can be salvaged and sometimes steered towards normality.
Nigel Heaton is director of the liver transplant unit in King's College Hospital, London. The plight of two of his patients is highlighted. Irishwoman Lizzy has auto-immune liver disease, in which her own body continually attacks her liver. She has had five liver transplants to date, her current liver is failing and she needs another transplant urgently. Three-year-old Omar from Lebanon has a congenital liver disease which will kill him within a year. His parents have sold their home and business and clocked up debts of half a million pounds to get treatment.
Both patients must suffer the ordeal of waiting for suitable donors, and of beds becoming potentially available and almost immediately being reallotted in the lottery of acute emergency care.
Lizzy's chance comes with someone else's tragedy when a suitable liver becomes available after a road accident. In a most dramatic scene, the brown and shiny transplanted liver, which looks as if it has come straight from the butcher's, turns pink once the blood supply is restored during the operation. Lizzy still has a long way to go: once she is out of intensive care, she must undergo chemotherapy to destroy her antibody-producing bone marrow in order to have a bone marrow transplant from her brother.
She loses her hair and is at severe risk of infection but is so desperate for a normal life that she will try anything. After many months, her liver function is normal and she is free to go. Sadly, a postscript tells us that she died some months later from an opportunistic infection due to lowered immunity.
Omar's search for a cadaveric donor is unsuccessful but his father, Mahmood, offers him a piece of his own liver. Such living donor surgery is relatively untried and means that a healthy person puts himself at risk for another's benefit. Happily, Omar's diseased green-tinged liver is removed and once the appropriate plumbing is complete, his new liver, formerly his father's left lobe, blushes pink. Within a month of surgery, Omar, whose growth had been stunted, has started a growth spurt. The family are now back in Beirut catching up on normal living.
My one criticism is that there was very little emphasis on the part played by anaesthetists and intensive care during and after the surgery. Anaesthetists are no longer chaps who gas patients with rags and then do the London Times crossword until it is time to wake the patient up, but are highly skilled professionals. Every operation is a surgeon/anaesthetist interdependent double act and must be recognised as such. The one cannot exist without the other.
Nigel Heaton comes across as a skilful surgeon yet humble and realistic in what he can and cannot do. Like all good doctors, he avoids getting emotionally involved in these sad and stressful situations, is glad to be of help, and carries on to the next case, as there is always work to be done. He would probably be the last to admit that he has God-like qualities.
• Dr Charles Daly is a GP practising in Co Waterford.