ATOM 2017

A STUDY GUIDE BY KATY MARRINER

http://www.metromagazine.com.au

ISBN: 978-1-76061-020-3 http://theeducationshop.com.au

 9 x 22min
Series Run
Time

++ MIRACLE HOSPITAL
Miracle Hospital is a nine-part documentary series about the
provision of innovative and life-saving health care at St Vincents
Hospital in Melbourne and Sydney. The series offers real-life, high-
stakes emotional storytelling mixed with cutting edge science and
technology and a cast of brilliant, charismatic medical specialists.

CONTENT HYPERLINKS EPISODES:

3 CURRICULUM LINKS
3 KEY CREATIVES
1 2 3
4 SYNOPSIS
4 EPISODE SYNOPSES
4 5 6
5 PROGRAM MAKERS PERSONAL
STATEMENTS 7 8 9
6 ST VINCENTS HOSPITAL
MELBOURNE 25 RESEARCH PROJECTS
6 ST VINCENTS HOSPITAL SYDNEY 26 APPENDIX 1: GLOSSARY
6 THE MAKING OF MIRACLE 27 APPENDIX 2: COMPARATIVE
VIEWING CHART
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HOSPITAL
7 MIRACLE HOSPITAL 30 APPENDIX 3: FOCUS ON MEDICAL
TECHNOLOGY
2
++ CURRICULUM LINKS
This study guide to accompany Miracle Hospital has
been written for secondary students at all year levels.
It provides information and suggestions for learning
activities in Physical, Personal and Social Learning,
Science and curriculum projects exploring the series
key ideas at Years 7 10. For students in Years 11 and
12, the series is relevant to areas of study in Biology
and Health and Human Development. Students
undertaking vocational education courses and tertiary
courses in Health Science may also benefit from view-
ing the series. Teachers are advised to consult the
Australian Curriculum online at http://www.australian-
curriculum.edu.au/ and curriculum outlines relevant to
their state or territory for more specific information.
The activities featured in this study guide promote
student engagement and active participation via indi-
vidual reflection, class discussions, and small group
work. Multiple activities are provided to allow teach-
ers to select those that will best suit the demands
of the subject and the needs of the students. Each
of the nine episodes can be viewed as stand-alone
programs. The synopses for each episode provide
information about the content covered and links
between episodes are identified at the end of each
patient story.
In completing the tasks, students will have demon-
strated the ability to:

Miracle Hospital documents how science and technol-
ogy are revolutionising health care in Australia. As a
curriculum resource, the series expands and enriches
students understanding of how advances in science
and technology can affect peoples lives. Miracle
Hospital tells the personal stories of the patients and
their families. Teachers are encouraged to use the
series to initiate discussions about universal themes.
Through the work of the health professionals and other
experts, Miracle Hospital establishes and explores
science and technology as human endeavours. The
series provides information about and examples of the
role that hospitals, specialists and specialist teams
play in health care, as well as highlighting the place of
hospitals and hospital staff in advancing the treatment
of injuries and diseases through research and clinical
trials.
- respond to a documentary series both personally
and in detached and critical ways;
- identify how innovations in science and technology
are improving health care;
- discuss the social and ethical values of trialing
new medical treatments and technology;
- discuss the relationship between health and
wellbeing;
- research emerging medical technology and evalu-
ate its impact on the future treatment of ill-health;
- use their own written and spoken texts to explore
concepts and ideas and to clarify their own and
others understanding.
Teachers are advised to preview Miracle Hospital prior
to use in the classroom. The program contains graphic
images of medical procedures. For some students
in the class certain stories may be confronting
and upsetting. Teachers need to respect the
circumstances of these students and remain aware of
their sensitivities.

++ Key Creatives
Production Company: The Feds http://www.thefeds.com.au
Series Director: Julia Peters
Series Producer: Jenni Wilks
Executive producers: Michael Cook, Lizzy Nash & Julia Peters
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3
++ SYNOPSIS
Since performing one of the first open heart surgeries in
1959, St Vincents Hospital has become world renowned
for its ground breaking medical research and cutting edge
surgeries. It is one of the most technologically advanced
hospitals in the world, at the forefront of medical science
and innovation. Miracle Hospital takes its audience behind
the scenes at St Vincents, in Sydney and Melbourne,
where elite specialist teams use the very latest science
and technology to perform groundbreaking and life-saving
procedures every day.
The series intersects the human stories with real-life
examples of how the technology is changing and saving
++ EPISODE SYNOPSES
Episode 1
Amy and Rodney
Amy, a mother of two young children, undergoes awake
brain surgery to control epileptic seizures and Rodney be-
comes one of only a handful of people to have a life-threat-
ening aortic aneurysm repaired with a new form of stent.
Episode 2
Harry and Barbara
Harry, who is in hospital with bone cancer, has to choose
between having his leg amputated or a titanium replace-
ment of his entire femur, and Barbara has revolutionary
surgery with LASER mapping to cure her lymphedema.
Episode 3
Peter and Mavia
Peters neurodegenerative spine is causing him such
intense pain he risks cutting-edge spinal surgery to
alleviate it, and Mavia undergoes Deep Brain Stimulation to
stop the extreme tremors caused by Parkinsons Disease.
Episode 4
Bill and Melissa
Bill has end-stage heart failure and will die without urgent
treatment. To save his life he has a rare double heart pump
implanted. Melissa has multiple uterine fibroids removed
with a robotic surgical system.
Episode 5
Margaret and Ben
Margaret has shoulder cartilage cancer removed and a be-
spoke 3D printed titanium prosthesis implanted. Teenage
elite downhill skier Ben has his anterior cruciate ligament
repaired with a live donor hamstring from his father.
lives. The focus is on the patients, the specialist medical
teams and the research and technology behind the treat-
ments. Following the patients story, allows the audience
to see the journey from all sides with the human impact of
the condition playing out alongside the specialist teams as
they determine the best treatment possible.
Every episode features two different stories each show-
casing new innovative surgeries or treatments. In every
case, surgeons have allowed unprecedented access to
their busy operating theatres and consulting rooms to give
the viewer an immersive experience that shows life inside
these two leading specialist hospitals.
Episode 6
Ana and Ian
Anas lungs are full of cysts, and finally some donor lungs
have become available. Twenty-four-year-old stroke victim
Ian is immersed in a virtual 3D world, where he walks
through his own brain to improve his rehab.
Episode 7
Joseph and Phillip
Joseph has end-stage prostate cancer, which has spread
to 90 per cent of his bones. He takes the option of a new
radioisotope trial of Lutetium PSMA. Phillip has his renal
nerves zapped to reduce his dangerously high blood
pressure.
Episode 8
Dwight
Dwight has cardiomyopathy and is being kept alive by a
heart pump. After a few failed hopes at a transplant, new
technology known as heart in a box, will keep a donor
heart alive long enough for surgeons to get his damaged
heart out.
Episode 9
Peter and Andrew
Peters Multiple Sclerosis is not responding to regular
treatments so he opts to be part of a new stem cell
transplant trial. Andrew has his leaky mitral valve replaced
with a new device, which means he doesnt have to have
open-heart surgery.
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4
++ PROGRAM MAKERS PERSONAL STATEMENTS
Coming from a medical family I have always had an inter-
est in medicine and the advancements in treatment now
possible due to technology. I had a relationship with St
Vincents through another program I produced and saw
first-hand the amazing work they were doing as a result of
their commitment to research and trialing new treatments
and procedures. Further research revealed the depth and
breadth of their innovation they are truly at the frontier of
medical research and world leaders in many areas. What
fertile ground for a television series! And a series that could
showcase Australian innovation!
After many months of development, we approached
National Geographic to be our broadcast partner. Happily,
they immediately saw the potential along with our other
partners, Screen Australia and Screen NSW.
It has been a wonderfully uplifting and fulfilling experience
to guide this production. Working with such a talented
team of professionals has been very rewarding and I am
extremely proud of what we have achieved.
All the staff at St Vincents were incredibly generous,
supportive and enthusiastic ensuring we had whatever was
needed to create Miracle Hospital. Without this support
along with the patients generosity we would not have been
able to make this series.
Julia Peters, Executive Producer
As a former nurse with an ongoing interest in health and
medical documentary, I was thrilled to be asked to series
produce Miracle Hospital.
Looking at the future of medicine through emerging tech-
nology was a unique approach to a medical observational
documentary.
It was intended from the start that our stories intersect with
humanity. The application of this incredible technology
would only be important and relevant and if we considered
the enormity of what it could do for everyday people, for you
and me. This meant that as a team we needed to sensitively
and courteously tag a long for the medical journey with
the patients who generously agreed to be filmed on what
was often the most terrifying time in their life. The ensuing
relationships with the patients and families who decided to
participate in the documentary I found a great pleasure, and
a responsibility to ensure their gesture of trust was recipro-
cated by telling their stories as well as possible.
To work closely with the extraordinary doctors and medi-
cal staff at St Vincents Hospitals in Sydney and Melbourne
was simply an honor. The level of dedication, commitment,
depth of knowledge, skills in research and innovation and
the clinical applications of their work was motivation for us
to showcase their work in the most engaging way possible
to ensure the series attracts the audience it deserves.
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Jenni Wilks, Series Producer
5
++ ST VINCENTS
HOSPITAL MELBOURNE
St Vincents Hospital Melbourne is a major Catholic
teaching and research hospital providing compas-
sionate health care to almost 200,000 patients a
year. The hospital is part of St Vincents Health
Australia, the twelfth largest private company in
Australia. St Vincents Hospital Melbourne operates
from 15 sites with over 900 beds, six-thousand staff
and an annual budget of $620m. It offers complex
diagnostic services and a number of key specialties
including neurosci9ences, orthopedics, cardiac and
cancer services, as well as aged care, primary care,
correctional health and dialysis satellite centres. St
Vincents has a vibrant research program that drives
innovation in clinical care, and produced almost
800 publications in 2015.

Recommended link: https://svhm.org.au/home

++ ST VINCENTS
HOSPITAL SYDNEY
St Vincents Hospital is a principal referral and ter-
tiary, public teaching hospital. All of our staff at St
Vincents Hospital strive to deliver the highest qual-
ity of patient care and we are committed to continu-
ing the Mission of our founding Sisters of Charity
in service of the poor and disadvantaged across all
services. Our core values are compassion, justice,
integrity and excellence and through our Mission
we are committed to justice and compassionate
care for all patients, their families and carers and
the communities we serve.
Part of the NSW-based arm of St Vincents Health
Australia, the Hospital provides significant training
and research activities housing several specialty
units that are internationally recognised as centres
of excellence. These include heart and lung trans-
plantation, bone marrow transplantation, cardiol-
ogy, cancer care, AIDS/HIV, respiratory medicine,
mental health and drug and alcohol services.
Co-located with St Vincents is Sacred Heart Health
Service one of Australias largest and leading
palliative care and rehabilitation providers offering
inpatient and outpatient services. The Hospitals en-
deavours are supported by a significant investment
in teaching and research both within our facilities
but also in partnership with universities and affili-
ated research institutes.
++ THE MAKING OF
MIRACLE HOSPITAL
From the outset, St Vincents hospitals in both Sydney
and Melbourne were very helpful in facilitating our produc-
tion requirements. Initially, in order to sell the concept to a
broadcaster, I filmed a sizzle at St Vincents in Sydney.
This five-minute video proved invaluable, as I was able to
show the main doctors who we hoped would participate in
the series what the show was about. I wanted to showcase
the innovation and technology that they are renowned
for so it was important to explain the types of stories we
hoped to capture and why. I then met with the key doc-
tors to discuss the series aims and what filming would
entail. The hospitals public relations managers were also
instrumental in getting the doctors onboard and helping us
throughout the filming period.
The most important factor in producing this series was to
have good access to the doctors and patients throughout
their journey. We felt very privileged that at the most vul-
nerable of times in peoples lives, they allowed us to docu-
ment their story. And the doctors who willingly opened
the theatres to our cameras were incredibly generous with
ATOM 2017

Recommended link: https://svhs.org.au/home their time and would talk us through the operations as they
happened.

6

Once production started, it was a 24/7 proposition for
the researchers and production teams in the field. Both
Melbourne and Sydney teams had a small base within
the hospitals from which they lined up stories and film-
ing. Logistically this series was complicated and required
unique skills to firstly identify the potential stories then ob-
tain permissions from the doctors and patients, and then
follow the story to completion. More often than not a few
stories would be running at the same time. Unfortunately,
doctors and operations dont wait for film crews!
For the crew, who were on the frontline coming in and out
of patients (and familys) lives, gauging the right and ap-
propriate times to film during difficult and often extremely
emotional moments requires experience and good judge-
ment. It is also very hard for the crews when someone they
are following doesnt make it. This unfortunately happened
twice during our filming.
As the stories were being filmed our post-production team
were crafting the episodes in editing. Finding the right bal-
ance editorially between the patient and doctors journey
and the technology was in itself challenging. Added to this
was my decision not to have narration, which caused many
headaches both in the field and in the edit room.
We were able to achieve no narration, which works ex-
tremely well and adds to the drama and authenticity.
To make a program like this requires enormous team-work
and dedication. I feel privileged to have been given such
amazing access within the hospitals and to the doctors,
patients and families who without their trust this series
would not have been possible.
Julia Peters, Executive Producer
Filming in hospitals is hard. The patients and the day-to-day
hospital business take absolute priority. There is no waiting
while we change a lens or rethink a camera position when
the action is happening when its happening, its happen-
ing! There are no second chances to capture key moments.
Professors and surgeons do not have any spare time.
Arranging time with them for interviews can unravel the
best of coordinators and researchers. Asking for some
time to film at the top or tail of a surgeons already unbe-
lievably busy day often meant 4 5am crew calls for our
team. And when the crew would wrap ten hours later the
surgeons would often still be operating!
To ensure we were close to the action and built relation-
ships with staff, our team embedded themselves at the
hospital. This enabled them to be incredibly agile, as they
were on the spot with cameras to capture key story mo-
ments as they happened.
At each hospital location we had small teams of three,
a shooter/producer, sound recordist and an associate
producer/researcher. The teams were supported and man-
aged by the Series Producer. It was important to have a
small team and small cameras around the hospital to keep
the impact of their presence in the sensitive environment to
a minimum. The more inconsequential we could appear to
the hospital staff the more chance of following the unfold-
ing stories in a true observational documentary style.
Building rapport and good relationships with hospital staff
and the patients we were following was of key importance
as it enabled us to anticipate what was happening, and
therefore plan filming of the key story steps. It also secured
our privileged access of the hospitals involved, to their
Intensive care units and to their operating theatres. And it
was that access that delivered the stories.
This relationship between the divergent worlds of medicine
and filmmaking became the foundation of this important
documentary series. A series showcasing the advances
and innovation in technology and medicine that will inform,
educate, inspire, provide hope and entertain its audience.
Jenni Wilks, Series Producer
++ MIRACLE HOSPITAL
For the patients featured in Miracle Hospital, the
work of the health professionals at St Vincents
Hospitals in Melbourne and Sydney is not only life
changing, it is life-saving. As you watch Miracle
Hospital take note of those moments when the
patients, their families and the health professionals
express their opinions of the medical treatments and
technologies that are now available to treat serious
health concerns.
What is a miracle?
Why do many of the series participants liken
the medical technologies and treatments to a
miracle?
ATOM 2017
Why is this series called Miracle Hospital?
7

++ EPISODE 1
AMY
Amy, a thirty-five-year-old mother of two
young children, has been battling uncontrolled
epilepsy for most of her adult life. With her
condition worsening she is now experiencing
up to ten grand mal seizures a day.
Key terms used in this episode include:
- Dura - Seizure
- Electrode - Subdural grid
- Epilepsy - Resection
- Neurology
What is epilepsy?
Design an infographic about epilepsy. Your objectives
are to inform and raise awareness of this condition for
your selected audience.
Amys condition is known as uncontrolled epilepsy.
What are the characteristics of uncontrolled epilepsy?
Amy: What Im looking for a more simple life, and
just not have the kids having to deal with seeing mum
different to other mums. I want to just be a normal
person.
Professor Mark Cook: She really needs this to work.
How is Amys condition impacting on her quality of life?
How is Amys condition usually treated?
Amys neurologist is Professor Mark Cook. He has treated
Amys epilepsy since she was a teenager. He believes that
if the location of seizure onset is identified then it may be
possible to perform a resection of this area of the brain and
stop the seizures from occurring. Director of Neurosurgery,
Associate Professor Michael Murphy, will open Amys skull,
lift the dura and place a subdural grid of electrodes on the
surface of her brain to monitor her seizures.
What is neurology?
How do Director of Neurosurgery, Associate Professor
Michael Murphy and Professor Mark Cook technology
use medical technology to treat Amys uncontrolled
epilepsy?
Draw and annotate a diagram of the brain to support
your explanation.
Professor Mark Cook: I think Amys doing really well,
shes really hopeful it will all work out. She understands
completely I think what it involves, how shell feel and
the risks involved, so I think shes in the best position
she could be in.
What are the risks of the procedures? Explain Amys
willingness to commit to the procedures despite the
risks. How does the neurology team respond to the
challenges and complications presented by the proce-
dures? What precautions do they take to minimise the
risks of the procedures?
Awake surgery is completed to resection the area of Amys
brain where the seizures are coming from. Amy is only the
third person in the world to have this precise procedure.
Is the medical intervention a success? How is Amys
quality of life changed by the intervention?
Professor Mark Cook: Its the best part of my job, get-
ting people through epilepsy surgery like this where it
has impacted their life in this way. Especially if you can
really see that it has changed their life. I mean thats
just fantastic and that makes everything worthwhile.
Associate Professor Michael Murphy: Each time we do
this there is the sensation that youre going to be able
to turn around a persons life.
Professor Cook and his associates are the only neurol-
ogy team in the world treating epilepsy in this unique
way.
Explain the importance of the work of the St Vincents
neurology team.
Why is epilepsy research important? Write a letter to
the editor that argues for increased funding of epilepsy
research.
Amys husband Simon reflects, She can go through
this, she can go through anything.
What does Amys story reveal about resilience?
focus hospital: St Vincents Hospital, Melbourne.
Story partvicipants: Amy; Simon; Professor
Mark Cook; and Associate Professor Michael Murphy. linked
story: Episode 3 Mavia and Episode 7 - Phillip.
ATOM 2017
8
 RODNEY
After having a chest CT scan for what he thought
was a cold that wouldnt go away, seventy-one-
year-old Rodneys radiologist informed him that
he had a very large abdominal aortic aneurysm.
Left untreated the aneurysm will most likely
rupture, and Rodney will most certainly die.
Key terms used in this episode include:
- Abdominal aortic - Iliac artery
aneurysm - Polymer
- Angiogram - Stent
- Endograft
What is a CT scan? Draw a three-panel captioned il-
lustration to explain how a CT scan works.
What is an abdominal aortic aneurysm? Draw and an-
notate a diagram to support your explanation.
Why does Rodney use the metaphor a ticking time
bomb to describe his medical condition? What does
Rodneys diagnosis suggest about the importance of
regular health checks?
Vascular surgeon Associate Professor Ravi Huilgol plans
to repair Rodneys aneurysm with a new form of stent an
endograft that incorporates a polymer bag.
What is a stent? How does it work? Why is the Nellix
stent that will be used in the treatment of Rodneys
condition regarded as cutting edge technology?
The surgery required to repair the aneurysm is minimally in-
vasive but it is not without risks. While Associate Professor
Huilgol has performed thousands of aortic aneurism
repairs, Rodneys case is only the sixth time that Associate
Professor Huilgol has used the Nellix stent.
focus hospital: St Vincents Hospital, Sydney.
story participants: Rodney and Associate Professor
Ravi Huilgol . linked story: Episode 4 Bill.
Associate Professor Ravi Huilgol: Weve done five cases
already with the new technology. We just need to learn
about how it behaves, how it deploys and what technical
things are important about getting it exactly right.
List the risks of this type of surgery.
Precision is crucial in this type of surgery. What
practices do Associate Professor Huilgol and his team
implement to achieve this precision?
Drawing on the footage of Rodneys surgery, comment
on how surgery teamwork is crucial to patient care.
Rodney: Its a fairly new procedure but somebodys got
to be there to have it done so I dont mind, it doesnt
bother me. Hes a very competent surgeon so Im happy.
What does Rodneys comment suggest about the sig-
nificance of the doctor-patient relationship?
Associate Professor Ravi Huilgol: We used a new tech-
nology device in a way that I hadnt used it before and I
think his case is probably a turning point for me in terms
of understanding how to use it effectively for a variety of
different ways were going to use it in the future.
Rodney: Having this new stent is a great privilege and I
think its a modern miracle, what the doctors can do to-
day is fantastic. Now Ive been given a second chance
and I can look forward to a nice, good long future.
What are the outcomes of Rodneys surgery?
ATOM 2017
9
++ EPISODE 2

HARRY

Thirty-five-year-old Harry has been in hospital for

five months with a fractured femur caused by
osteosarcoma a rare bone cancer. He now has
to choose between a titanium replacement of his
entire femur or a full leg amputation. Harrys femur
has not been able to heal due to the presence
of a large tumor and scans now show that the
cancer in his femur has spread to his lungs.

Key terms used in this episode include:

- Femur - Prosthesis
- Orthopedics - Titanium
- Osteosarcoma

What is bone cancer? How is it usually treated?

How is Harrys ill-health impacting on his quality of life?
What does the footage of Harry interacting with his par-
ents suggest about the importance of patient support?
St Vincents Director of Orthopedics, Professor Peter
Choong and his team of specialists consider the best
treatment for Harry. Limb saving surgery is the best option.
Harrys femur will be completely removed and replaced
with a titanium prosthesis. The operation will not save
Harrys life, but hopefully it will give him the ability to walk
again.
Draw a two panel annotated diagram. In the first panel
show the structure and function of the femur. In the
second panel show the structure and function of the
titanium femur.
What is titanium? Why is titanium metal used in bone
and joint replacement surgery?
Professor Peter Choong: In the past we would be am-
putating a leg like this. To be able to offer him the ad-
vances of science, technology and engineering to give
a solution that allows him to spare his leg is immensely
rewarding, not only for Harry but also for someone like
me in my position to offer solutions like this.
How will Professor Choong use medical technology to
treat Harrys fractured femur?
Professor Peter Choong: What is the most important
thing to you?
Harry: My life.
Professor Peter Choong: Exactly. The purpose of the
operation is actually to give you a leg that works better
than it does now. It will not affect your survival.
What does this consultation between doctor and pa-
tient reveal about the significance of the doctor-patient
relationship?
Total femoral replacements are not common. The femur
resection is a three to four hour surgical procedure.
What are the risks of the surgery? How do Professor
Choong and his team respond to the challenges pre-
sented by the surgery?
Harry: Walking is definitely a good feeling.
Professor Peter Choong: Cancer surgery has to be one
of the most rewarding things I could ever do. We are
supported by science and we are supported by tech-
nology and if we can just bring these to our patients it
allows us to feel that were actually achieving some-
thing for them.
What are the outcomes of Harrys surgery?
Professor Peter Choong: When you see people like
Harry being as courageous as he is, it cant help but
encourage us. They really are our beacons of what we
should be doing. Thats why were here.
What does Harrys story reveal about courage?

focus hospital: St Vincents Hospital, Melbourne.

story participants: Harry; Harrys parents; Harrys
pastor; and Professor Peter Choong. linked story:
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Episode 5 Margaret and Episode 7 Joseph.

10
 focus hospital: St Vincents Hospital, Melbourne.
story participants: Barbara; Dennis; and Doctor
BARBARA Ramin Shayan . linked story: Episode 4 Melissa.

Three years ago, sixty-two-year-old Barbara

was diagnosed with breast cancer. She
had surgery to remove some of the lymph
nodes under her arm as well as radiation and
chemotherapy. Ten months later, she developed
chronic pain and swelling in her upper arm
caused by a condition known as lymphedema,
an obstruction in the lymphatic system.
Key terms used in this episode include:
- Laser guided lymphatic - Lymphatic system
mapping - Lymphedema
- Lymph nodes - Microsurgery
What is the lymphatic system? Make a short anima-
tion that describes the structure and function of the
lymphatic system.
What is lymphedema?
How is lymphedema impacting on Barbaras quality of
life?
Barbara seeks medical advice from Doctor Ramin Shayan,
a plastic and reconstructive surgeon who recommends
microsurgery.
ultimately successful and thats the bit that is a bit
frustrating Its pretty slow going and theres no prize for
rushing unfortunately.
List the challenges and risks associated with Barbaras
surgery.
Doctor Ramin Shayan: This is the aim of plastic sur-
gery, reconstructing not just the patient but the pa-
tients whole life as well.
What does this statement suggest about the way that
Doctor Ramin Shayan views his profession?
Doctor Ramin Shayan: Have we had a win?
Barbara: Weve had more than a win.
Is the surgery a success? How is Barbaras health and
wellbeing changed by the surgery?
Doctor Ramin Shayan: St Vincents has traditionally
taken a lead in the world on these types of diseases
involving microsurgery particularly with lymphedema.
Were happy to be in a position where were up there
leading the world.
What role do hospitals both public and private play in
medical research?

What is microsurgery?
Doctor Ramin Shayan: What we have developed is
a unique method of combining existing treatments
including high resolution MRI scans with laser guided
lymphatic mapping. Its been incredibly rewarding for
me and the whole team to be able to use our research
to develop these techniques to help the patients
who otherwise would not have a hope of beating this
condition.
How is lymphedema usually treated? How does Doctor
Shayan intend to use medical technology to treat
Barbaras lymphedema? Why are these surgical proce-
ATOM 2017

dures regarded as revolutionary?

Doctor Ramin Shayan: We dont know if we will be

11
 precisely tailor Peters operation in order to return his spine
to a neutral position.

Doctor Mark Winder: Spine surgery has the ability now

Doctor Mark Winder: The most relaxing part of my job,
Peter: Ive gone through this so I can spend more time
++ EPISODE 3
PETER
Sydney resident Peter has been living with
chronic pain for the past three years caused
by a neurodegenerative spine. St Vincents
neurosurgeon and spine surgeon Doctor Mark
Winder has diagnosed that without an operation
to correct his spine, that Peters alignment
will continue to deteriorate rapidly and that
he will be unable to walk in five years time.
to be able to give back the quality of life rather than just
see what could be a very fruitful life deteriorate quickly.
How was Peters condition treated in the past?
How will Doctor Mark Winder use new medical technol-
ogy to treat Peters condition?
without question, is when Im operating. Youre in con-
trol about what is happening, you already know what it
is that youre going to be doing.
Does the spinal surgery pose any risks? How do
Doctor Winder and his team achieve the precision es-
sential to this type of surgery?
with my children. Now Ive got my mobility back and
Ive got my ability to do a whole range of things with
them that I could not otherwise have done. So it fills
me with a great deal of enthusiasm and thirst for life.
What are the outcomes of the surgery?
focus hospital: St Vincents Hospital, Sydney.
story participants: Peter; Anika; Quinn; and
Doctor Mark Winder. linked story: Episode 6 Ian.

Key terms used in this episode include:

- Alignment - Neurodegenerative
- Angulation - Pre-operative
- Graft - Resection
- Intra-operative

Doctor Mark Winder: Peter suffers degenerative

kyphoscoliosis which means his spine has worn out.
Its shifting forward, its collapsed down. So the spine
effectively is just crumbling.
Draw a two panel annotated diagram. In the first panel
show the structure and function of the human spine. In
the second panel show the structure and function of a
neurodegenerative spine.
Peter: I first realised that I had the condition probably
three years ago. I was starting to get pain in the lower
body. It progressively got worse, in fact a lot worse.
Peters pain is described as chronic pain. What is the
difference between pain and chronic pain?
How is Peters condition impacting on his quality of
life?

Peter decides to undertake spinal surgery. Doctor Winders

ATOM 2017

plans to use state-of-the-art pre-operative and intra-

operative planning software systems that will allow him to

12
 MAVIA
Mavia was diagnosed with Parkinsons Disease
eleven years ago. In recent years the medication
she has been taking has been less effective and
she now suffers such debilitating tremors she
finds it difficult to walk or to carry out everyday
tasks. As the medication is no longer managing
her tremors, her only real hope to be able to
live a normal life is to undergo Deep Brain
Stimulation a process where electrodes are
inserted into a very precise area within her brain.
Key terms used in this episode include:
- Deep Brain Stimulation - Neuron
- Electrode - Parkinsons Disease
- Neurology
What is Parkinsons Disease?
Design an infographic about Parkinsons Disease. Your
objectives are to inform and raise awareness of this
condition for your selected audience.
How is Mavias condition and the treatment of her con-
dition impacting on her quality of life?
Consultant Neurologist Doctor Wesley Thevathasan and
neurosurgeon Doctor Kristian Bulluss perform an MRI and
a CT scan in the pre-operative stage of Mavias surgery.
What is an MRI? What is a CT scan? Explain how the
scans are used to improve the efficacy of Mavias
surgery?
Why is it necessary for Mavia to be awake during
surgery?
What is subthalamic nucleus deep brain stimulation?
Make a slideshow to demonstrate how it works? How
do Consultant Neurologist Doctor Wesley Thevathasan
and neurosurgeon Doctor Kristian Bulluss use medical
technology to treat Mavias illness?
Mavia: Id have to say Im feeling a little bit nervous but
Ive got a lot more adventures to live. So I need some
help to do that.
Explain Mavias willingness to undergo the procedure.
Mavia: Since the surgery Ive been able to do a lot
more sewing a lot more knitting, things that I enjoy
doing. From day one I havent had any tremors in my
hands at all. My quality of life has dramatically im-
proved. I even rode my pushbike own to the supermar-
ket the other day and I havent rode the bike for years.
Doctor Wesley Thevathasan: Clearly its opened up her
whole horizon about what she can now do with her
life. And thats what this is about. Its about improving
quality of life, and shedding all those restrictions and
shedding the shackles of too much medication, you
know every three hours.
How are Mavias health and wellbeing improved by the
treatment?
What does Margarets gift of a quilt to Doctor
Thevathasan suggest about the patient-doctor
relationship?
Doctor Wesley Thevathasan: Deep Brain Stimulation is
not perfect, so we are trying to improve that by devel-
oping our own method, which we think, is going to be a
step above whats currently being achieved.
How will Mavias treatment be used to help other peo-
ple who have Parkinsons Disease?
Why is Parkinsons Disease research important? Write
a letter to the editor that argues for increased funding
of Parkinsons Disease research.
focus hospital: St Vincents Hospital, Melbourne.
ATOM 2017
story participants: Mavia; Brian; Doctor Wesley
Thevathasan; and Dr Kristian Bulluss. linked story:
Episode 1 Amy.
13

++ EPISODE 4
BILL
Bill, a sixty-year-old retired business executive
with end-stage heart failure is battling for his life
in hospital. If nothing is done to save him, he
may have less than a week to live. Bill has been
unwell for fifteen years due to cardiomyopathy,
which has recently led to biventricular heart failure.
His heart is now working so ineffectively he is
breathless even at rest and has developed gross
odema, or swelling, of his abdomen and legs. He
is considered on the brink of multiple organ failure.
Key terms used in this episode include:
- Aorta - Cardiomyopathy
- Biventricular assist - Cardiologist
device - Sternum
- Biventricular heart - Ventricle
failure
What is cardiomyopathy?
How is Bills condition impacting on his quality of life?
Arthur: Its sort of hard seeing Dad who used to be a
big strong man wielding a chainsaw in each arm type
thing, to suddenly a very sort of frail little thing.
Bill: I think its tougher on the family than it is on me.
What does Bills situation suggest about the impact
that a serious illness has on a patients family?
How has Bills condition been treated in the past?
Given how rapidly Bills health has been deteriorating, his
cardiologist Associate Professor Eugene Kotlyar recom-
mends a rare life-saving operation to implant two mechani-
cal heart pumps onto either side of his heart, known as a
biventricular assist device. This is a critical step in alleviat-
ing Bills suffering and to get him well enough to become
a candidate for a heart transplant, should a suitable donor
become available.
What is the six-minute walk test? How is it used to
monitor Bills condition in the lead up to surgery?
Doctor Paul Jansz: Were about to put the second pump
in. Now this pump is not designed for this side of the
heart, so this is all a little bit made up. Theyre not de-
signed to pump into the lungs, theyre designed to pump
into the body. So we have to do a few little Magyver type
things to get it to fit in but it seems to work.
Draw a two panel annotated diagram. In the first panel
show the structure and function of a healthy circulatory
system. In the second panel show how the biventricular
assist device will facilitate the function of Bills circula-
tory system. Your diagram should explain how Associate
Professor Eugene Kotlyar and Doctor Paul Jansz have
Magyvered the biventricular assist device? Why
doesnt the manufacturer approve of this modification?
Why do Bills medical team forge ahead anyway?
What is a pulse? Why wont Bill have a pulse after the
biventricular assist device is fitted?
Doctor Paul Jansz: I think if we didnt do this hed be
lucky to see the week out. Its a risky operation and
at the end of it he could be dead so, so its all about
balancing risks.
What are the risks of the surgery? How do Doctor
Jansz and his team respond to the challenges pre-
sented by the surgery? What role does the heart lung
machine play in the surgery?
Bill: Im feeling lucky. Im feeling nervous. Im feeling,
lets get on with it. See you as a new man.
Associate Professor Eugene Kotlyar: Bills got a very
supportive family, hes got a lot to live for. Youd really
like to do as much as you can to get him through this
so he can get on with the rest of his life.
What do these claims suggest about Bills willingness
to undergo the surgery and the commitment of his
medical team?
Bill: I suppose my perspective on the importance of life
has been very well focused for the last few months. And
the longer I live and the more I benefit from the surgery in
a funny sort of way the more precious it becomes.
What are the outcomes of the operation?
Bill is placed on a waiting list for a heart transplant.
Use the internet to research heart transplants in
Australia. Drawing on your research make an info-
graphic about this subject.
focus hospital: St Vincents Hospital, Sydney.
story participants: Bill; Bills family; Doctor Paul
Jansz; and Associate Professor Eugene Kotlyar. Linked stories:
Episode 5 Ben; Episode 6 Ana; and Episode 8 Dwight.
ATOM 2017
14
 MELISSA

Thirty-seven-year-old Melissa hopes that

removing her multiple uterine fibroids with the
assistance of a robotic surgical system will
preserve her uterus and surrounding organs
and ultimately allow her the possibility of having
a child. Melissa has already had an operation
to remove large uterine fibroids in 2009.
Key terms used in this episode include:
- Gynaecology - Uterine fibroids
- Hysterectomy - Uterus
- Pelvis

What should women know about uterine fibroids and

the treatment of uterine fibroids?
How is Melissas condition impacting on her quality of
life?

When Melissa discovered that the fibroids had re-grown,

she faced the prospect of a hysterectomy. Melissas
gynaecological oncologist Associate Professor Felix Chan
believes he can preserve her fertility with the use of a robot
assisted device which allows him to operate in a minimally
invasive way.

What is minimally invasive surgery? What are the ad-

vantages of minimally invasive surgery? Are there any
disadvantages?
Melissa: There is no guarantee I guess of fertility at the
end of this but theres a lot of doctors who wouldnt
even attempt to remove the fibroids and at this stage
would be doing a hysterectomy. So the fact that Doctor
Chan is even willing to give me a chance regardless of
what that chance is, is just amazing.
Associate Professor Chan is a robotics surgeon.
How does Associate Professor Chan use the robotic
surgical system to treat Melissas condition?
What does Melissas comment suggest about
Associate Professor Chans commitment to patient
care?
How is this surgery improving womens health?
What are the outcomes of the procedure?
Melissa: I think its just amazing that, that kind of tech-
nology actually exists and what it can do for patient
care.
Working with a partner, use the internet to research
the use of robotic surgical systems in the treatment
of another illness. Use Google slides to present your
findings.

focus hospital: St Vincents Hospital, Sydney.

ATOM 2017

story participants: Melissa; Lyn; and Associate

Professor Felix Chan.
linked story: Episode 3 Barbara.
15
++ EPISODE 5
MARGARET
Melbourne grandmother Margaret is devastated
when she discovers she has a malignant
tumour growing out of her shoulder blade.
Margarets tumour is a cartilage tumour known
as condrosesarcoma. This type of tumour is
generally resistant to chemotherapy and to
radiotherapy. If there was no intervention the tumor
would grow. It would cause a lot of symptoms
for Margaret in terms of pain and distress.
Key terms used in this episode include:
- Malignant - Titanium
- Prosthesis - Scapular
- Tumour
Margaret: Ive just found out that Ive got a tumor in my
left shoulder. Its quite large. I had a sore shoulder. We
were treating it as a frozen shoulder. And we found a
little lump.
What does Margarets diagnosis suggest about the
importance of regular health checks?
What is a malignant tumour? How is it different from a
benign tumour?
Margaret: Going into this surgery, my hope is that Ill
be able to get back to a normal life with my family with
Brian, my kids, my grandchildren.
How is Margarets condition impacting on her quality
of life?
Rachel: Im used to mum always being the strong one.
Ive been through a lot and shes always been there for
me and for her to be the sick one is a bit of a scary thing.
What does Margarets situation suggest about the im-
pact that a serious illness has on a patients family?
After a consultation with Professor Peter Choong, Margaret
finds out that surgery is the only treatment that can remove
focus hospital: St Vincents Hospital, Melbourne.
story participants: Margaret; Brian; Rachel; Ella;
Professor Peter Choong; Robert Thompson (Anatomics); and
Aaron Pateras (RMIT University) . linked story: Episode
2 Harry.
the growth and save her life. The proposed operation is
extremely complicated as the tumour is growing forward
directly into the line of major blood vessels to her arms as
well as the nerves in her arm and hand. Professor Choong
proposes to cut out the growth and then rebuild her shoul-
der with a bespoke 3D printed titanium partial scapular
replacement. Margarets operation is a world first.
How would Margarets condition have been treated in
the past?
Draw a two panel annotated diagram. In the first panel
show the structure and function of a healthy scapular.
In the second panel show how the titanium prosthesis
will be fitted and how it will function.
How is technology used in the pre-operative stage of
Margarets treatment?
How is technology used in the operative stage of
Margarets treatment?
Does the scapular replacement surgery pose any risks?
How do Professor Choong and his team achieve the
precision essential to this type of surgery?
Professor Choong plays music in the operating theatre.
Why? Were you surprised? What does Professor
Choong mean when he claims Surgery is one of those
fields where you have to have your guard up the whole
time.?
Professor Peter Choong: It was a good operation. We
did what we set out to do; its always good when you
achieve what you set out to do.
Margaret: It did, it saved my life and, its got rid of the
cancer.
What are the outcomes of the operation?
Professor Peter Choong: What we are able to do these
days with new technology is perhaps edge closer and
closer towards rebuilding people as well as we can.
Working with a partner, use the internet to research the
ATOM 2017
use of 3D printing in the treatment of another injury or
illness. Use Google slides to present your findings.
16

BEN
Sixteen-year-old elite downhill skier Ben has
ruptured the anterior cruciate ligament (ACL)
in his knee while training on the slopes.
Key terms used in this episode include:
- Anterior cruciate liga- - Graft
ment (ACL) - Suture
- Dislocated - Tendon
What is an anterior cruciate ligament? What is its func-
tion in the human body?
How common is Bens injury? How are ACL injuries
usually treated?
Ben: If I couldnt ski again that, that would be terrible.
Like, Ive been skiing since I was two and its part of me.
So if I couldnt ski then there would be something miss-
ing from my life and I dont know how I would cope.
How is Bens injury impacting on his quality of life?
To repair the damaged ACL and give Ben the opportunity
to continue to pursue his goal of competing in the 2022
Olympics, orthopedic surgeon Associate Professor Justin
Roe proposes to replace the torn ligament with a graft
taken from the hamstring of Bens father Graham. This
focus hospital: St Vincents Hospital, Sydney.
story participants: Ben; Graham; Edward; and
Associate Professor Justin Roe.
Linked stories: Episode 4 Bill; Episode 6 Ana; and
Episode 8 Dwight.
procedure, pioneered at St Vincents, involves two medical
teams working simultaneously in two operating theatres
one to create a graft from the fathers hamstring and one to
use that graft to repair the sons anterior cruciate ligament.
Why does Associate Professor Justin Roe decide to
treat Bens injury in this way? Why is Graham a suitable
donor? Explain Grahams willingness to participate in
the surgery.
What are the logistical challenges of the surgical proce-
dure? Are there any risks?
What are the outcomes of the transplant?
Associate Professor Justin Roe: It gives me great
pleasure to get these young athletes back on the sport-
ing field after a devastating injury, to watch them come
through the rehab process, and then see them pursue
their dreams is a wonderful thing.
Use this statement to discuss the importance of inno-
vation in orthopedics.
ATOM 2017
17

++ EPISODE 6
ANA
After waiting nine years for a lung transplant
forty-three-year-old Ana has been admitted to St
Vincents Hospital because a donor lung has finally
become available. Ana has a rare form of lung
disease pulmonary lymphangioleiomyomatosis
a condition where cysts take over the normal
lung tissue, and in Anas case, make breathing so
difficult she can no longer continue a normal life.
Key terms used in this episode include:
- Cardiothoracic lymphangioleiomyoma-
- Perfused tosis
- Pulmonary - Ventilate
Make a short animation that describes the structure
and function of the lungs.
What is pulmonary lymphangioleiomyomatosis?
Anas condition is rare, what are common lung diseas-
es and how are they treated?
Ana: I cant remember what it feels to like actually take
a deep breath and feel that my lungs are like full, and
you struggle with every move even like taking a shower,
even just sitting down, even sometimes laying at night I
wake up because I cant breathe properly.
How is Anas lung disease impacting on her quality of
life?
How is pulmonary lymphangioleiomyomatosis usually
treated? Why is a lung transplant essential in Anas case?
Use the internet to research the lung transplant pro-
gram in Australia. Make a poster that aims to raise
peoples awareness about this program.
Doctor Emily Granger: Its like everything if you set it up
well its relatively easy.
There is a one in ten chance of something going wrong.
Why does Ana take this risk? What do Doctor Emily
Granger and her team do to minimise the risks?
Why is time of the essence in donor surgery? Make
a two column list of the challenges of this type of
surgery. In column 1, identify the challenges. In column
2, explain how cardiothoracic and transplant surgeon
Doctor Granger and the team involved in Anas surgery
respond to these challenges.
How does Doctor Granger use medical technology to
treat Anas pulmonary lymphangioleiomyomatosis?
Anas surgery is a very rare event. Only one or two opera-
tions of this type are performed each year at St Vincents.
Explain how the success of Anas surgery can benefit
other patients with pulmonary lymphangioleiomyomatosis.
Doctor Emily Granger: Im thrilled with the results that
Anas got.
Ana: I feel fantastic. Its amazing. Three months ago I
had the surgery and by now I can wake up and I can
take a shower and I can feel normal and I can feel alive.
I just feel super grateful and very, very thankful.
What are the outcomes of the operation?
Ana: Although I dont know who the donor is, I get
emotional because I am super, super grateful.
What does this episode reveal about the emotional
impacts of donor transplant surgery?
Doctor Emily Granger: Sometimes after doing a very
big operation the fact that your phone goes off and its
your six-year-old on the phone who wants to talk about
an issue with Lego or with the puppy dogs.
How does the footage of Doctor Granger after the
operation, add to the audiences understanding of the
demands of being a surgeon?
What is organ donation?
Do you know someone who is an organ donor? Do you
know someone who has benefited from organ dona-
tion? Who can be a donor? Does organ donation only
benefit the patient receiving the donor organ?
Use the internet to research organ donation.
Recommended link: http://www.donatelife.gov.au/.
*Teachers are advised to download the fact sheets and
infographics to create a classroom display.
Drawing on your research, compile a class multimedia
presentation that explores the issues associated with
organ donation. Small groups of students should take
responsibility for an issue. A list of possible issues follows:
- Cultural - Legal - Political
- Economic - Medical - Religious
- Ethical - Personal - Social
focus hospital: St Vincents Hospital, Sydney.
story participants: Ana; Ricardo; Martha; Emilo;
Doctor Emily Granger; Associate Professor Marshall Plit and
Claude. Linked stories: Episode 4 Bill; Episode
5 Ben; and Episode 8 Dwight. The activities related to organ
donation have relevance to these stories.
ATOM 2017
18

IAN
Ian, a twenty-four-year-old man from Sydney
suffered a brain hemorrhage four years ago while
playing soccer. After being given only a thirteen
per cent chance of survival, he went on to not only
regain consciousness, but through hard work and
determination to learn to speak and walk again.
Key terms used in this episode include:
- 3D virtual reality immer- - Neuroplasticity
sive technology - Rehabilitation
- Brain hemorrhage
What is a brain hemorrhage?
What are the recovery rates for patients who have suf-
fered a brain hemorrhage?
Ian: Basically I had thirteen percent chance of survival.
I couldnt walk, couldnt move, couldnt talk and thank-
fully its all come back. The only thing I cant do which
Im still working on is running.
How has rehabilitation improved Ians health and
wellbeing?
To increase Ians understanding of what happened in his
brain, and hopefully to increase Ians motivation to con-
tinue rehabilitation, Associate Professor Steven Faux has
asked Ian to participate in a trial based on 3D virtual reality
immersive technology.
Doctor John McGhee: So what the technology provides
is a whole new platform. To our best knowledge we dont
know anyone else who is doing this in the world. Rather
than looking at it through a screen or a window into their
data they can actually be inside their data.
How does 3D virtual reality immersive technology work?
List the usual applications of 3D virtual reality immer-
sive technology.
Use the internet to research the medical applications of
3D virtual reality immersive technology.
Why does Associate Professor Faux believe 3D virtual
focus hospital: St Vincents Hospital, Sydney.
story participants: Ian; Lisa; Doctor John McGhee;
and Associate Professor Steven Faux. linked story:
Episode 3 Peter.
reality immersive technology will enhance Ians recovery?
Why has Ian agreed to the trial?
What are clinical trials? Compile a fact sheet about
clinical trials. Use the questions: Who? What? When?
Where? Why? and How? to organise your fact sheet.
Learn about clinical trials in Australia online at https://
www.australianclinicaltrials.gov.au/.
*Teachers are encouraged to use the real stories to gen-
erate further discussions of clinical trials: https://www.
australianclinicaltrials.gov.au/consumers/real-stories.
Taking the data from Ians brain scans immediately after his
stroke, and working with Doctor John McGhee, Director of
3D Visualisation Aesthetics Lab, at the University of New
South Wales and 3D artist John Bailey, the team create
a virtual 3D world which allows Ian to walk through his
brain and see what happened when the brain hemorrhage
occurred, and what has happened to the neural pathways
since.
Ian: To see inside my brain was kind of weird when it first
started but it was really cool. I enjoyed the experience.
What does Ian see on the walk through his brain?
Associate Professor Steven Faux: We dont think
theres any end time to neuroplasticity. So its possible
that keeping exercising, keeping improving your think-
ing and your speech will continue to help those nerve
cells make connections.
What is neuroplasticity?
Recommended link: https://www.youtube.com/
watch?v=ELpfYCZa87g.
Lisa: It was a bit frightening but I think its, its just incred-
ible that it gives us this greater insight into what hap-
pened. Its brought a bit of closure to Ians case for us.
Ian: Seeing that 3D visualisation a few months ago
filled in all the blanks. You finally understand okay this
is what I got to do, this is how Ive got to do it and this
is where Im going. The way the brain makes new con-
nections and forms different alliances has motivated
me even more to push myself to the limits.
What are the outcomes of Ians walk through his brain?
ATOM 2017
19
++ EPISODE 7
JOSEPH
From what began as a simple nosebleed,
Sydney pensioner Joseph was devastated
to find out that he is suffering from advanced
prostate cancer, which has spread to ninety
percent of his bones. Traditional treatments
have not been able to stem the spread of
cancer, so Josephs options are limited. In
the opinion of Associate Professor Louise
Emmett, Joseph really only has weeks to live.
Key terms used in this episode include:
- End-stage - Prostate cancer
- Imaging agent - PSA
- Lutetium PSMA - Radioisotope
What is prostate cancer? What is meant by end-
stage? How is prostate cancer usually treated when it
reaches end-stage?
How is Josephs condition impacting on his quality of
life?
What does Josephs diagnosis suggest about the im-
portance of regular health checks?
The Lutetium PSMA trial in Australia is based on ground-
breaking work in Germany over the few years. Thirty
patients will be involved in the trial, fourteen of which will
be St Vincents patients. Joseph is the first St Vincents
patient enrolled in the trial. While Josephs prostate cancer
cannot be cured, Associate Professor Emmett hopes that
the treatment will improve Josephs quality of life and
prolong his life.
Associate Professor Louise Emmett: And the trial that
weve been doing is a Lutetium PSMA trial in men
focus hospital: St Vincents Hospital, Sydney.
story participants: Joseph; Associate Professor
Emmett; Doctor Kathy Willowson; and Jane Shin (Radiation
Scientist). Linked stories: Episode 2 Harry and Episode 9
Peter.
with end-stage prostate cancer. Its a completely new
therapy, which has really revolutionised the ability to
treat prostate cancer. I think this is going to give more
time to the patients than chemotherapy does.
What is Lutetium PSMA? Devise a simple animation to
show how it works.
What are the risks of Lutetium PSMA treatment? How
does Associate Professor Louise Emmett respond to
the risks associated with the treatment?
Joseph: I hope that this trial is gonna be, the answer to
all my prayers. Wouldnt that be wonderful? It would be
fantastic.
Why is Joseph willing to participate in the trial? Would
you be willing to participate in clinical research?
*See Ians story in Episode 6 for further tasks about
clinical trials.
Associate Professor Louise Emmett: Im very happy
that Josephs come on the trial. I believe its given him
more time with his family and better quality of life.
Joseph: A little bit more time. Thank God for a few
more days!
What are the outcomes of the trial for Joseph? What
are the outcomes of the trial for the other patients
involved? How may the results change the treatment of
prostate cancer?
Associate Professor Louise Emmett: Joes so sick and
hes got such a great attitude Hes such an optimist.
What does Josephs story reveal about optimism?
What is achieved by telling the audience about
Associate Professor Emmetts scooter and her online
ATOM 2017
shoe shopping?
20

PHILLIP
In Melbourne, sixty-three-year-old Phillip has
dangerously high blood pressure that is proving
difficult to control with medication. Phillip is in
line to receive renal denervation, a procedure,
which zaps the nerve endings in his kidneys,
with the aim of bringing down Phillips blood
pressure and reducing his dependency on
medication. This newer form of treatment
pioneered by Professor Robert Whitbourn
uses a catheter with four electrodes, rather
than just one as was used in the past.
Key terms used in this episode include:
- Blood pressure - Femoral artery
- Catheter - Renal denervation
- Electrode - Vascular system
Professor Robert Whitbourn: Phillip looks healthy from
the outside, the problem is he has very high blood
pressure; its been very difficult to control. And that
puts a lot of pressure on the vessels, a lot of pressure
The following morning Phillips blood pressure seems im-
proved and he is soon on his way home with a new lease
of life and a reduced medication intake.
focus hospital: St Vincents Hospital, Melbourne.
story participants: Phillip; Cathy; and Professor
Robert Whitbourn. linked story: Amy Episode 1.
on the organs such as the brain, the kidneys, the heart.
Were really concerned if we dont get control of this
that hes at a high risk of having a heart attack or a
stroke or, or even dying.
What is blood pressure? What is normal blood pres-
sure? Is high blood pressure a life threatening condi-
tion? What happens if your blood pressure is low?
Phillip: At the moment I am on nine different tablets for
my blood pressure and its still going up. A good read-
ing for someone of my age would be 135 to 40, over 75
to 80.
Cathy: Lately he has had a 24-hour monitor on him that
showed that his blood pressure was elevated most of
the time.
How is Phillips high blood pressure impacting on his
quality of life?
How is high blood pressure usually treated?
Why does Professor Robert Whitbourn intend to use
renal denervation to treat Phillips high blood pressure?
In a procedure that takes only half an hour, Professor
Whitbourn performs renal denervation on Phillip.
Explain how renal denervation reduces blood pressure.
Are there any risks to this procedure?
Phillip: The operation that I had has given me the op-
portunity to probably to have a more positive view of
my longevity.
What are the outcomes of the procedure?
Professor Robert Whitbourn: This is a procedure, which
I pioneered here at St Vincents. Uncontrolled high
blood pressure is a big problem. Internationally theres
probably about a billion people with high blood pres-
sure. So, the research that weve done, I think has had
ATOM 2017
a major impact on how we look at blood pressure and
blood pressure control, all round the world.
Explain the significance of Professor Whitbourns work.
21
++ EPISODE 8
DWIGHT
The past four years have been extremely
difficult for Dwight and his family. In 2012 he
was diagnosed with cardiomyopathy and
subsequently fitted with an artificial heart pump
to keep him alive. Now in his sixties, he has
been in a poor state of health, struggling with
mobility and unable to drive. Several attempts
at giving Dwight a heart transplant have had
to be cancelled in the pre-operative stage.
Key terms used in this episode include:
- Cardiomyopathy - TransMedics Organ
- LVAD Care System
- Perfuse
What is a heart transplant?
Why does Dwight need a heart transplant?
How is Dwights condition impacting on his quality of
life?
Evelyn: Dont be nervous, everything will be fine. Weve
been through with this for almost four years. Always
remember we love you so much.
Dwight: Im waiting for a heart for three years and
seven months already.
Katrina: Today is my Dads heart transplant and if it all
goes well and it proceeds then it could be the start of
the next phase in our familys life.
What do these claims suggest about the impacts of
waiting for an organ transplant for a patient and their
family?
What is an artificial pump? How has this artificial pump
been keeping Dwight alive? What are the limitations of
the artificial pump?
Doctor Paul Jansz: We got a call about midnight last
night there is a donor available. Now the rub is, is that
this donor doesnt have antibodies against Dwight or
the other way around which is good but the donors not
ideal, right and perhaps we may not use this heart. Its
struggling a little bit and its not what we would say one
hundred percent.
What is donor match? How are donors and patients
focus hospital: St Vincents Hospital, Sydney.
story participants: Dwight; Evelyn; Katrina; and
Doctor Paul Jansz. Linked stories: Episode 4 Bill;
Episode 5 - Ben and Episode 6 Ana.
matched? Why isnt the donor heart in Dwights case
ideal?
The emergence of new technology the TransMedics Organ
Care System or heart in a box is revolutionising donor
transplants. This new technology is the culmination of nearly
twenty years of research. St Vincents was the first hospi-
tal in the world to use the technology. Cardiothoracic and
Transplant Surgeon, Doctor Paul Jansz, is responsible for
performing Dwights life-saving operation.
Doctor Paul Jansz: This technology is called an Organ
Care System. The scientific name for it, is a Langendorff.
Its a machine that will keep an organ alive. It perfuses
the heart, so we take donor blood, we run it through
this machine, we give the blood oxygen, and then we
deliver that to the heart. So that keeps the heart alive and
functioning on this box. And that way we can nourish
the heart, and we can actually improve the heart, we can
assess whether the hearts going to work.
What is the TransMedics Organ Care System?
Recommended link: http://www.transmedics.com/wt/
page/organ_care
Using Dwights transplant surgery as an example, ex-
plain how the Transmedics Organ Care System works.
What are the unique challenges of Dwights transplant?
How is this technology changing organ donation and
transplant surgery?
Even though the surgery itself is a success, the 24 to
48 hours following Dwights transplant are crucial.
What is post-operative care? What does Miracle
Hospital suggest about the type of post-operative care
necessary for Dwights recovery?
Dwight: Im very, very grateful to the family of the donor.
What are the outcomes of the operation?
*See Anas story in Episode 6 for activities related to
organ donation. For teachers wanting to undertake
a detailed unit of study about organ donation, the
Australian Government Organ and Tissue Authority of-
fers a range of resources for students in upper primary
ATOM 2017
and secondary schools http://www.donatelife.gov.au/
school-education.
22
++ EPISODE 9

PETER

Peter is a fifty-five-year-old man with Multiple

Sclerosis (MS), a condition where his immune
system is attacking his brain and spinal cord.
His MS has been unresponsive to regular
treatments for MS and as a consequence his
mobility and eyesight have declined dramatically.
Clinical haematologist, Associate Professor
John Moore, has offered Peter the opportunity focus hospital: St Vincents Hospital, Sydney.
to participate in new stem cell transplant trial. story participants: Peter; Sharon, Associate
This trial is the result of decades of laboratory Professor John Moore; Nonie; and Alicia. linked story:
research, and aims to grow a new immune Episode 7 Joseph.
system that no longer attacks the body.

Key terms used in this episode include:

- Centrifuge - Multiple Sclerosis
- Chemotherapy - Stem cells
- Haematologist - Transfusion
- Lymphocytes

What is Multiple Sclerosis?

Design an infographic about Multiple Sclerosis. Your
objectives are to inform and raise awareness of this
condition for your selected audience.
How is MS usually treated? Is there a cure for MS?
What is the human immune system?
What are stem cells?
Explain how the stem cell transplant will allow Peters
body to re-grow a new immune system?
Sharon: We have our great days, and our not so good
days. This trial gives us really our only hope that we
can have a better life together with our beautiful four
young adult children and wider family, so thats what
were looking forward to.
How is Peters condition impacting on his quality of
life?
Peter: Theres a sense of hope. I dont know if this will
be the complete answer either but if I didnt get into
this there was basically nowhere else to go.
Why does Peter decide to participate in the trial? Are
there any risks associated with the treatment?
Associate Professor John Moore: And your lympho-
cytes, which are the cells of the immune system, have
gone from .1 up to 1. Normal is 1 to 4, so you know example of decades of laboratory research finally com-
by 6 months, it will be approaching normal. ing to fruition. We are now starting to treat patients with
Peter: I feel very fortunate to have been included in the stem cells and giving them hope for the future.
trial. It was certainly a risk taking part in this when it Learn more about stem cell transplantation by access-
was only a trial. Its not really a proven treatment and ing the Stem Cells Australia website at http://www.
one of the things I had in mind in accepting that was stemcellsaustralia.edu.au/About-Stem-Cells.aspx
that was my being in the trial has helped some other and The National Stem Cell Foundation of Australia at
people as well. http://www.stemcellfoundation.net.au/.
What are the outcomes of the procedure? Teachers can access a range of resources for second-
Associate Professor John Moore: St Vincents has a ary students online at
ATOM 2017

long history of trying new things, and the stem cell http://www.stemcellfoundation.net.au/about-stem-cells/
transplantation in autoimmune conditions is a great resources-for-secondary-teachers-and-students.

23

ANDREW
Seventy-four-year-old Bondi resident Andrew
has a leaky mitral valve in his heart, which is
making him so breathless he cannot swim,
play golf or barely even walk. The mitral valve
is supposed to open to let blood in from the
lungs to the heart and then it should close to
stop blood going backwards and back into
the lungs. Andrews mitral valve is functioning
so poorly that he is developing heart failure.
Key terms used in this episode include:
- Atrium - Mitral regurgitation
- Cardiothoracic - Mitral valve
- Echogram
Doctor Paul Jansz: A lot of these new techniques
theres no training program, we dont go to university or
train as a surgeon as a junior surgeon to do. So were
not quite making it up on the spot but we have to use
our skills from other areas to transform into this sort of
technology.
Drawing on Doctor Janszs statement and your viewing
of Miracle Hospital, compile a list of the advantages
and disadvantages of implementing new medical
technologies.
Andrew: If I didnt have the procedure well I wouldnt
be sitting here now.
What are the outcomes of the procedure?
Andrew: Im very, very grateful and all right, I was a
guinea pig but someones got to start and Im very
happy that they ah, they did.
The Australian Government National Health and
Medical Research Council has created eLearning
modules about clinical trials. These modules can be
accessed at https://www.australianclinicaltrials.gov.
au/_files/elearn/index.html.
*See Ians story in Episode 6 for further tasks about
clinical trials.

What is a mitral valve? Explain how it functions in the

human body. What happens when it is not function-
ing correctly? Draw a three panel diagram to show
your answers to these three questions. Use cap-
tions beneath each panel to provide matching written
explanations.
How is Andrews condition impacting on his quality of
life?
How is Andrews condition usually treated? Why are
Andrews treatment options limited?

Interventional cardiologist Associate Professor David focus hospital: St Vincents Hospital, Sydney.
Muller and cardiothoracic surgeon Doctor Paul Jansz pro- story participants: Andrew; Alex; Shannon; Doctor
pose a new procedure, which involves inserting a new mi- Paul Jansz; and Associate Professor David Muller.
tral valve through the apex of Andrews beating heart. Only linked story: Episode 4 Bill and 8 Dwight.
thirty or so patients around the world have had the device
inserted, but it shows good promise and will hopefully
prevent the need for Andrew to have open-heart surgery or
go onto on a heart by-pass machine during the minimally
invasive surgery.

Associate Professor David Muller: So this is an oppor-

tunity really to, to treat a group of patients for whom
there really isnt a good option otherwise. The beauty
of this is it can be done without stopping the heart,
without going onto bypass, without opening the chest.
How do Associate Professor Muller and Doctor Jansz
ATOM 2017

use medical technology to treat Andrews heart

condition?

24
++ RESEARCH PROJECTS

A.

Research the treatment of a medical condition.

You may investigate one of the medical conditions
documented in Miracle Hospital.

If you prefer, you may choose a medical condition

that you have a particular interest in because
of your health and wellbeing or because of the
health and wellbeing of people you know. Present
your findings as an exhibit that you might see in a
science and technology museum.

B.

Doctor Paul Jansz: New groundbreaking technol-

ogy today will be mainstream tomorrow.
Professor Peter Choong: Technology is moving
so quickly that we only have to ask a question
is it possible? and Im sure somewhere in the
world there is someone working on the solution
straight away.
Professor Robert Whitbourn: Were always try-
ing to look at better ways to treat people. And
so its personally very satisfying to be involved
in new technologies, new techniques, trying
new things to try and get a better outcome. So
for me its great, but my main focus is on trying
to make it better for the patient.

Your task is to research a new medical technology.

Present your findings as a feature article for a print
or online publication. The audience of the publica-
tion will influence the content, choice of language
and layout of the article.

Debate

Hold a class forum to debate the topic:

THAT AUSTRALIA SHOULD INVEST IN MEDICAL

RESEARCH AND INNOVATION.

Every student in the class is expected to express a

view based on their viewing of Miracle Hospital and
supplementary online reading.
ATOM 2017

25
++ APPENDIX 1: GLOSSARY
As you are watching Miracle Hospital, compile a glossary of medical terms.

TERM DEFINITION

ATOM 2017

26
++ APPENDIX 2: COMPARATIVE VIEWING CHART
Use the comparative viewing chart to record notes about each patients story.
Once completed, you will be able to use the chart to make links between patient stories.

PATIENT AND IMPACT OF

MEDICAL STAFF TREATMENT RISKS OUTCOMES
HEALTH ISSUE HEALTH ISSUE

Amy

Rodney

Harry

Barbara

Peter
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27
PATIENT AND IMPACT OF
MEDICAL STAFF TREATMENT RISKS OUTCOMES
HEALTH ISSUE HEALTH ISSUE

Mavia

Bill

Melissa

Margaret

Ben

Ana
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28
PATIENT AND IMPACT OF
MEDICAL STAFF TREATMENT RISKS OUTCOMES
HEALTH ISSUE HEALTH ISSUE

Ian

Joseph

Phillip

Dwight

Peter

Andrew
ATOM 2017

29
++ APPENDIX 3: FOCUS ON
MEDICAL TECHNOLOGY

Clip 1: 3D Printed Prosthesis

At St Vincents Hospital in Melbourne, Professor

Peter Choong is using 3D printed prostheses in
surgical procedures. In this clip, Professor Choong
liaises with a team of experts to build a 3D printed
titanium partial scapular.

Watch the clip and then answer the following

questions:

- What is a prothesis?
- Describe the steps that are part of the process
of build Margarets new shoulder joint.
- What does this footage suggest about the
relationship between medical and technology
expertise?

Clip 2: Organ Care System

St Vincents Hospital in Sydney is using the Organ

Care System to improve donor transplants. In
this clip Cardiothoracic and Transplant Surgeon,
Doctor Paul Jansz, explains the advantages of the
technology.

Watch the clip and then answer the following

questions:

- What is the Organ Care System?

- Describe how the Organ Care System works.
- What are the advantages of the Organ Care
System?
ATOM 2017

30
 This study guide was produced by ATOM. ( ATOM 2017)
ISBN: 978-1-76061-020-3 editor@atom.org.au
To download other study guides, plus thousands of articles on Film as Text, Screen
Literacy, Multiliteracy and Media Studies, visit <http://theeducationshop.com.au>.
Join ATOMs email broadcast list for invitations to free screenings, conferences,
seminars, etc. Sign up now at <http://www.metromagazine.com.au/email_list/>.
ATOM 2017

31