Fed Up • 2014

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An examination of America's obesity epidemic and the food industry's role in aggravating it.

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Specialist maxillofacial surgeons Tim Martin and Sat Parmar prepare for a marathon operation on 53-year-old Teresa. Four weeks ago, Teresa was diagnosed with a fast-growing cancerous tumour in her face and she will die within weeks unless it is removed. The procedure involves radical surgery to the entire right-hand side of her face, and means she will lose both her upper jaw and right eye. It is an enormous undertaking for Teresa, and for Tim and Sat, too. Using 3D imaging, the team plan how to remove the tumour and, most importantly, how they will rebuild Teresa's face. Tim and Sat are all too aware that whilst removing the tumour will save her life, it will be devastating if she is left disfigured and unable to face the world. To give her the best possible outcome, they intend to fill the cavity left in Teresa's face with a section of bone and muscle removed from her hip, using a 3D-printed plastic guide that helps them cut out the correct shape bone.

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Two procedures so formidable, they would not have been attempted even a few years ago. Surgical teams at the Queen Elizabeth are constantly pushing the limits of what is possible. But despite state-of-the-art diagnostic scanning, sometimes cancer surgeons don't know exactly what they are up against until they open the patient up on the operating table. Even with the most meticulous planning, sometimes they must resort to taking critical decisions live in the theatre. 74-year-old Jasmine Harkness has been referred to the specialist sarcoma unit with a vast tumour in her abdomen, weighing more than three stone - a third of her total body weight. It is consuming her, displacing organs including her stomach and liver. Unless it can be removed, she has just four weeks to live. Sarcoma specialists Sam Ford and Professor David Gourevitch can't be sure whether they will be able to save Jasmine until they open her up and inspect her anatomy. Such is the risk of this surgery - five years ago they would not have embarked on this intervention. Sue Sinclair, lead anaesthetist and matriarch of theatre, keeps the others in check - working alongside them as they battle to detach the tumour from Jasmine's organs and blood vessels, and remove it intact. Whenever it presses heavily on vital blood vessels, Jasmine's blood pressure plummets, placing her life in grave danger. It will take unwavering focus to keep her alive. The tumour has grown so invasively that it has crushed and displaced Jasmine's internal organs. Sam and David have a puzzle on their hands to identify what and where everything is. At times, dark humour is the only way to release the tension as they grapple with blood, guts and mind-boggling complexity.

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