Hospital Heroes: York Hospital consultant surgeon Ian Bradford

“We talked about moments when you get scared. This is one of them,” he says. “We’ve got to put a big tie around this blood vessel. If it starts to bleed, it will paint the ceiling. And when the roof turns red, the air turns blue!”

He’s joking, of course. With the aid of his assistant, associate specialist surgeon Mohamed Kurer, the blood vessel is neatly tied off without a problem. The ceiling doesn’t turn red, the air doesn’t turn blue.

All surgeons devise their own ways to cope with the pressure of having people’s lives in their hands, day in, day out. Some listen to music as they operate. Others work in the kind of silence where you can hear a pin drop.

Mr Bradford, a consultant colorectal surgeon at York Hospital, has a nice line in dark humour. Throughout a difficult, three-hour operation to remove a tumour from a 62-year-old woman’s bowel, he keeps up a constant patter.

He teases his assistant Mr Kurer, who is shortly to move to another hospital. “There will be a lot of broken hearts left behind!” He cracks gentle jokes. “Oops!” Pause. “Now there’s a word you don’t want to hear in theatre.”

And he keeps up a running commentary on what he’s doing. “We’re inside the body cavity now… that’s the appendix, that little tube there…. The spleen is underneath there. If it starts bleeding, it is very difficult to stop it.”

But it is also clear that he and his small operating team – Mr Kurer, consultant anaesthetist Dr Kalyan Rahma, scrub nurse Kathy Taylor and operating department practitioner Donna Sykes – trust each other implicitly. They work together seamlessly, and despite the banter, there is a calm, concentrated focus on the job at hand.

One thing a good surgeon never does, Mr Bradford says, is forget for one moment that the person on that table is a human being. They may behave as though this is all rather unremarkable, but it isn’t.

“We all know how we would feel if is was someone we loved having surgery. I try to look at every patient as someone I’m related to, and to give them the same care that you would expect for someone that you know.”

That is more than ever the case with a patient such as the woman lying unconscious on the operating table now.

She has, in Mr Bradford’s words, “been through the wars”. She has already had breast cancer. The treatment for that involved chemotherapy, and the removal of lymph nodes from her right arm. She also has a pacemaker, which means her heart will need to be constantly monitored throughout the operation.

Because of her previous medical history, getting the patient anaesthetised and ready for surgery to remove that cancerous bowel is difficult and time-consuming. Mr Bradford and I wait quietly in a nearby room as anaesthetist Dr Rahma and his team work. Time ticks by: 9.45am, 10am, 10.30am.

“I expected to be in theatre by 9.45,” Mr Bradford says. It is a classic example of how difficult it can be to keep to a tight operating schedule. Mr Bradford is due to be operating on two more patients today after this one. But with it taking so long to get this patient ready, will that still be possible? It may mean working through the lunch break, or later into the evening, he says.

Does he get nervous? I ask, as we wait. “No,” the 42-year-old says, with the trace of a South African twang – he was raised in South Africa before coming to the UK in the early 1990s. “I’m conscious of the fact that unfortunately things can occur. Events can conspire to undo your very best efforts.”

But you simply have to be confident that you are prepared, that everything is in place, that you can trust your team, and that you will act always to the best of your ability. The secret is to be calm and controlled, he says. There’s the great myth about a surgeon needing steady hands. “But no, it is the decision-making that is most important. Having a steady mind.”

Some surgeons like to listen to music, he says, others listen to the radio. But an operating theatre is not the tense place you might expect, where everybody walks on eggshells. “There is quite a calm, peaceful atmosphere in theatre. Everybody knows their role, and their contribution to the outcome of the operation.”

At last the patient is ready. She is wheeled into theatre on a trolley, and the team lift her on to the theatre table. The bright, overhead lights cast a harsh, sharp-edged glare.

There is a last check – the last of several that morning – to make sure that this is the right patient, and that the operating instructions are clear. “This is Mrs…..” says Mr Bradford. “Date of birth….” She has consented for excision of a section of cancerous bowel.

Then it is time to scrub up at a sink in one corner of the theatre. Mr Bradford soaps vigorously, several times, washing right up to the elbows and drying his hands on sterile paper. His hands are slipped into sterile rubber gloves. There is a brief, smoothly executed dance as a nurse helps him into his operating gown. Then it is time to begin.

The first cut only is made with a normal scalpel. From then on, everything is done with an electronic scalpel, a hi-tech instrument that uses a tiny, high-voltage current to cut and cauterise at the same time.

There, in front of me on the table, the woman is opened up. There is a faint smell of burning as the electronic scalpel cuts through a layer of fat and into the body cavity itself. Pink coils of intestine are exposed, loosened, separated from connective tissue, while all the time Mr Bradford keeps up his quiet running commentary and gentle teasing.

The minutes tick by, almost unnoticed.

At last, he indicates a length of glistening intestine. “This is the cancer,” he says, manipulating it expertly in his gloved hands. “It is soft and squashy, and this is a lump. It feels different, and it is a bit different in colour.”

I look, as he holds up the loop of intestine in question. It’s extraordinary, I think. I’m watching this man hold in his hands a length of cancerous bowel, while the woman to whom it belongs lies sleeping quietly on the table in front of me, her insides spread out for all to see under the harsh theatre lights. You’d think it would be horrific, but it’s extraordinary.

I leave, humbled, to allow the team to focus on cutting out the length of diseased bowel and then stitch the patient back up.

A couple of weeks later, I contact Mr Bradford again to find out how the woman is doing. She is back home, and doing well, he says cheerfully. He took out about 12 inches of bowel – and the good news is that he got all the cancer. The patient doesn’t even need chemotherapy. The lymph nodes he took out with the length of bowel were all clear.

He has time for one last quip before I say goodbye.

It was a real privilege to watch him at work, I say. He gives a little laugh. “It’s a great honour to be inside someone’s abdomen!” he replies.

Which I suppose it must be.

Fact file

A CONSULTANT colorectal surgeon such as Ian Bradford would expect to perform between ten to 15 operations a week, depending on how serious and complex they are. In any one week, he might do two operations on patients with bowel cancer, he says. Other patients he will work on include those needing gall bladder operations, or hernia repairs.

The rest of his time is taken up with clinics, ward visits, meeting with patients to get their consent – and paperwork.

Mortality rates (the number of people who die) following colorectal cancer surgery at York Hospital are very good: about 1.4 per cent, compared to a national average of about 5-6 per cent, Mr Bradford says.

In total, York Hospital has ten main operating theatres and six day unit theatres.

Last year, 9,710 procedures were carried out in main theatres, and 9,981 in day unit theatres.

There are 55 consultant surgeons employed by the trust.