The Royal Marsden’s Super Surgeons: “I carry the patients I let down with me every day”

(L-R) Prof David Nichol, Prof Vin Paleri, Mr Asif Chaudry, Mr Andy Hayes, Mr Shanu Rasheed, Mr Myles Smith of the Royal Marsden
Supermen: (L-R) Prof David Nichol, Prof Vin Paleri, Mr Asif Chaudry, Mr Andy Hayes, Mr Shanu Rasheed, Mr Myles Smith of the Royal Marsden - Channel 4/Michael Wharley

There is a moment in the new series of Super Surgeons: A Chance at Life where a patient’s artery wall tears in the operating room: blood spurts upwards and to the floor, coating the clinician’s clogs. For obvious reasons, it almost didn’t make the final edit. But when Robin Hurst-Baird, theatre matron at the Royal Marsden, saw an early version of the episode, she insisted it stayed in. Those grim, urgent minutes spent trying to restore blood flow to the patient’s brain helps viewers “to gain the reality of what actually happens in theatre,” she reasoned. “When you’re in that emergency, it’s intense.”

We meet in Hurst-Baird’s office, a basement room with a window (albeit one that lets in only the artificial light of the ward). It is her job to preside over staff in the first hospital dedicated to the study and treatment of cancer, where some of the world’s most experimental surgeries take place. One hundred and seventy-three years since it opened, and two since the intricacies of what is carried out in its seven theatres each day first aired on Channel 4, the peril, ecstasy and heartbreak persists. As the surgeons involved in the Marsden’s 20-25 operations a day - some of which go on until 2:30am - make plain: “Cutting a millimetre in the wrong direction could risk someone’s life.”

The hospital has made its name taking on “untreatable” cases. “It’s really unfortunate to be at the Marsden, but also very lucky,” Hurst-Baird says. In spite of its long history, allowing the cameras behind closed doors still feels like new territory for colorectal surgeon Shahnawaz Rasheed. When he was asked to appear on the show, “I wasn’t going to say yes,” he admits. “I wasn’t that keen on it, if I’m perfectly honest. The title, Super Surgeons - I don’t think it reflecs how we work and what we do.” (A more fitting name would be “Super Teams, not Super Surgeons”, he says; producers weren’t sold.) Rasheed only agreed to participate when a patient asked him to film her surgery, and “the stars aligned”.

Beyond the GoPros on their heads, and camera operators being allowed in theatre, the surgeons say that filming days bear little difference to any other. Still, Hurst-Baird keeps a firm watch, as throwing things off-kilter “increases the risk of the standards and skills dropping, which therefore has an impact on the patient.” On one occasion, when emergency struck on the operating table and staff rushed in to stem a major bleed, “I do remember that the scrub nurse had a camera right on her face, and that wasn’t fair… [I] had to get [production staff] to remove themselves because that would have altered everybody’s decision making”.

Surgeon Vin Paleri at work
'Bad outcomes stay with me forever': surgeon Vin Paleri - Channel 4

Mercifully, such incidents have been few, in spite of the laborious procedures shown. The second series shows more intimate, intricate work: we see Rasheed perform a pelvic exenteration - one of the most radical surgeries carried out at the Marsden, which involves removal of the anal canal, part of the vagina, and the uterus. Hurst-Baird describes it, modestly, as “gruesome.” (A word that can be applied to much of the programme, which is unsparing in its close-ups of bulging tumours and blood-stained organs.) Yet the patient, 65-year-old former NHS nurse Tracy, deals with it with remarkable grace, quipping after her surgery that, with so many organs removed from her pelvic cavity, she now has a “Barbie bum”, and later: “I’ll never fart again!”

Myles Smith, a surgical oncologist, says that while the series does offer unusually close insight into he and his peers’ day-to-day work, “the truth is we’re not even remotely the most important part of [the programme]... The art and the science of medicine and surgery are more interesting, and then I think we’re very much at the end of that”.

It is true that the harrowing stories of its protagonists make for compelling, devastating television. Over the series’ four episodes we meet Rich, a 53-year-old ex-Naval pilot who has spent a decade battling cancers in his head and neck, the most recent of which requires the removal of a 16cm tumour running down from his jawline to his heart, where it has wrapped around his carotid artery. There is Anthea, an 18-year-old aspiring midwife, who has been told that a tumour in her arm will require amputation, unless Marsden surgeons can save it. And Cam, a young father dealing with recurring testicular cancer, who wakes up after another gruelling day of being cut open to find that the growth was too difficult to remove after all.

“Bad outcomes stay with me forever,” says Vin Paleri, consultant head and neck surgeon. “I can look back over the last 17 years as a consultant and I can perfectly recall the patients that I felt I let down,” he tells the programme. “I carry them with me every day.”

Rasheed had worried that turning their work into a TV show might run the risk of patients’ care being overdramatised. “But the situation itself is quite dramatic anyway,” he says (though there isn’t atmospheric music playing when cameras aren’t there...). Channel 4 has clearly found significant appetite for ready-made drama of this kind, with Super Surgeons following the likes of One Born Every Minute, 999: What’s Your Emergency? and 24 Hours in A&E. Medical drama remains enduringly popular.

As well as entertaining viewers, such shows are a useful advert for the work clinicians do. Rasheed says there has been criticism of the complex procedures the Marsden carries out: “People are saying, ‘Is it worthwhile? Is it not worthwhile?’ I felt that we needed to advocate for the patients of the future. And so it was appropriate to really demonstrate that the costs that are incurred by the NHS and by the hospital are not just worth it, they are the best option for patients going through this stuff.”

The surgeons hope too that the series proves instructive for the 3m people currently living with cancer - set to rise by another half a million next year - and the many who may go on to develop it. Produced in collaboration with MacMillan Cancer Support, it also features recordings of people calling in to talk to volunteers: a woman cries when thinking how she might tell her 87-year-old mother about her diagnosis; one man, on the cusp of treatment, fears the physical pain that treatment will bring.

“People obviously are worried about cancer and they want to see how people do, and they want to get a bit of hope and they want to get a bit of reassurance,” Smith says. “I hope that they will look at what we’re doing, and what others are doing and take some comfort from that.” While the majority of surgeries are successful, the programme makes clear that there are no guarantees. “We can’t always cure everything. But we can certainly understand things, and usually make things better.”


Series two of Super Surgeons: A Chance at Life begins on Channel 4 on Tuesday June 18 at 9pm