by Adam Kay
I buy the least hideous card they have in the hospital shop and leave it with the nurses to pass on to the baby’s mum. I say how glad I am that their story had a happy ending. I give her my phone number and ask her to text me a picture of the baby every now and again. It is against all the rules, but I’m prepared to break them for this one. And she did text me.
Wednesday, 22 March 2006
It’s 3 a.m. Patient RO is twenty-five years old and thirty weeks into her first pregnancy. She complains of a large number of painless spots on her tongue. I inform her they are taste buds.
Monday, 3 April 2006
My night shift is strangely quiet so I go and stare at Facebook for a bit. I comment on how cute a friend’s latest ugly baby looks. This comes easily to me, as I spend much of my working day doing the same thing to total strangers. I always find it funny that sensible adults manage to convince themselves that their slimy, squished baby’s face is beautiful.
I’m just going through Facebook profiles to make sure everyone I’ve ever dated is fat and miserable without me, when I see a post pop up. It’s from Simon, a school friend’s younger brother. His post reads: ‘Goodbye everyone. I’m done.’
I realize I might be the only person reading this at 2 a.m. on a Monday. I don’t even know Simon that well, but I send him a private message to ask if he is OK. I tell him I’m awake. I remind him that I’m a doctor and I give him my mobile number.
He calls me, drunk and crying. He and his girlfriend have just split up.
I have as much training in this area as I do in laying bathroom tiles. But Simon seems to trust me and that’s good enough for both of us.
Two hours later, we’ve had a good chat. He is going to get a taxi to his mum’s house and see his GP in the morning. When we hang up, I get the same rush I feel after any medical emergency. I’m tired but positive and feel like I’ve done a good thing. I might have made more of a difference to Simon than to any of my patients tonight.
I answer a call from the ward and head down to see a pregnant woman who wants me to look at a mild rash. It’s 5 a.m. ‘I thought you would be less busy now than in the morning,’ she says.
Monday, 19 June 2006
I respond to an urgent call about a woman who has been put into labour because her baby is late. The patient has just been to the toilet and the midwife is extremely worried. The toilet contains an explosion of red and brown liquid. It looks like very bad news for the patient and even worse news for the person who has to clean it up.
I spend the next few hours looking into every possible cause. The baby seems fine and the patient isn’t in any pain. In the end, I put in an urgent call to another doctor for advice and the patient goes off for a scan.
Later in the day, the results come back from the specialist doctor. It turns out that the nightmare in the toilet bowl was in fact due to the two large jars of beetroot the patient had eaten the night before. The specialist doctor suggests that next time I want to send him a patient who has the same problem, I taste the contents of the toilet first.
Friday, 21 July 2006
I am called to the ward at 5 a.m. to write up the notes for a patient due to go home in the morning. It should have been done during the day by her own doctor. But if I don’t do it, the patient will not be able to go home. I sit down and get on with it, plotting how to get revenge on my colleague.
On my way out, I see that the light is on in a side room, so I pop my head in to check that patient CR is OK. I saw her in A&E last week and have been on night shifts since, so have not heard her news. It turns out she has cancer, and only a few months left to live.
When I saw her in A&E I thought the signs were there but didn’t say it. I was taught that if you say the word ‘cancer’ even once, it is all the patient then remembers. It doesn’t matter what else you say or do, to them it feels as though you have said ‘cancer cancer cancer’ for half an hour.
You never want a patient to have cancer, of course, but I really didn’t want CR to have it. She was friendly and funny and chatty. It was as if we were two old mates.
She bursts into tears. Her son will graduate from university and she won’t be there. Her daughter will get married and she won’t be there. She will never meet her grandchildren. Her husband will never get over it. ‘He doesn’t even know how the boiler works!’ She laughs, so I laugh with her. I don’t really know what to say. I want to lie and tell her everything is going to be fine, but we both know it won’t.
We talk about boring practical things and, as she tells me her worries, I can see it’s helping her. It occurs to me that I might be the first person she’s been able to open up to about all this. On the way home I phone my mum to tell her I love her.
Wednesday, 2 August 2006
I have started at a new hospital. Junior doctors have to move to a different hospital every six to twelve months. Just as you are getting used to one hospital and making friends with the people who work there, you are moved away to a place full of strangers. It’s like the first day of school every time. All junior doctors change hospitals on exactly the same day as each other, which is known as Black Wednesday.
It is a known fact that death rates go up on Black Wednesday. This really takes the pressure off, so I’m not trying very hard.
Wednesday, 16 August 2006
As I delivered a baby today, the midwife on duty with me said I seemed more experienced than I actually am. But her nickname is ‘Dangerous Dawn’ so I’m not sure she is the best judge.
A phone call from Mum to say my sister Sophie has got into medical school. I send Sophie a text to say well done, then send her a photo of me giving the thumbs-up. ‘This will be you in six years!’ I write. I crop out the bloodstains on my clothes.
If the call had come at the end of the shift, my text would have said, ‘RUN LIKE THE FUCKING WIND.’
Monday, 21 August 2006
I’ve been carrying a Post Office ‘Sorry you were out’ card around with me for the last two weeks. I keep taking it out and looking at it like it’s a photo of my first child. I would not have time to get to the Post Office and back in my lunch hour, even if I had a lunch hour. Which of course I don’t. But I’ve been hoping I might get off work early one day. Like if the hospital burns down. Or if war breaks out.
The Post Office can only hold on to items for eighteen days, every one of which I’ve been at work. So the parcel has now been sent back and H won’t be getting a birthday present tomorrow.
Wednesday, 27 September 2006
I’m off sick for the first time since I became a doctor. I don’t think they will be sending me a Get Well Soon card.
‘Oh, for fuck’s sake,’ said my boss when I called. ‘Can’t you just come in for the morning?’ I explained I had a bad stomach bug and was vomiting so much that I could barely leave the bathroom. ‘Fine,’ he said. ‘But phone around and find someone who’s on leave to cover for you.’
I don’t know of any other job where you have to arrange your own sickness cover. The North Korean army maybe? How ill would I have to be before someone else had to arrange my cover? A broken leg? A coma?
I always thought that if I ended up off sick, it would be work that caused it. Maybe as a result of getting beaten up by a patient’s angry relative, or falling asleep and crashing my car into a tree after yet another night shift. But it was actually because of a lasagne brought in by a patient’s mother. I know it can’t have been anything else. I was so busy that it was the only thing I had time to eat all day.
Saturday, 7 October 2006
I have now spent six months as Simon’s mental health helpline since that first Facebook post. I’ve told him he can ring me any time he starts to worry, and he does. I’ve also told him several times to keep seeing his GP, but he doesn’t seem to listen to that bit.
Not knowing when the phone is next going to ring with bad news is stressful, and a bit too much like being at work for me. I also know Simon could get better help from someone who didn’t
have to google ‘what to say to someone who wants to kill themselves’. But it seems talking to me is better than nothing. I’m glad he’s still here. I panic if I get a missed call from him. What if I call back too late and he’s killed himself? Does that make it my fault?
We spoke again this evening. I listened and told him the way he feels will pass. We seem to have the same chat every time, but perhaps it doesn’t matter. Simon just wants to know someone cares. I guess that’s a big part of what being a doctor is.
Monday, 9 October 2006
Today I heard about a problem so absurd, I looked around the room for hidden cameras. A patient’s husband tells me that he can’t find any condoms that will fit him. After a long talk I realize this is because he pulls them right down over his balls.
Tuesday, 10 October 2006
I didn’t hear what the argument was about but I saw a woman storm out of the room. ‘I pay your salary!’ she screamed at the nurse. ‘Can I have a raise then?’ the nurse yelled back.
Tuesday, 31 October 2006
I’m leaving work at 10 p.m. rather than 8 p.m. because a patient had major blood loss after her baby was born. I am meant to be going to a Halloween party but now I don’t have time to go home and change into my costume. Would it be so wrong to go straight to the party? After all, I am dressed as a doctor and covered from head to toe in blood . . .
Monday, 29 January 2007
My favourite patient died a couple of weeks ago. I can’t stop thinking about her. She was eighty years old and had been on the cancer ward for as long as I’ve worked here. So I knew it was going to happen at some point.
She was only five feet tall and had bright, smiling eyes. She loved to tell long stories, but she would become bored with telling them just as soon as they got interesting. Almost all of them ended with her saying ‘blah, blah, blah’ and giving a wave of her hand.
Best of all, she hated my boss. She called him ‘old man’ every time she saw him, even though he was about fifteen years younger than her. I’d always look forward to seeing her on my shifts. We’d have a good chat and I felt like I’d really got to know her.
Over the months I had met all her children, as well as the many friends who came to visit her. ‘NOW they like me!’ she would say. Despite the joke, you could see why everyone did.
I was really upset when I heard she had died. I decided to go to the funeral. It felt like the right thing to do. So I swapped my shift with another doctor and let my boss know.
He told me I couldn’t go. I know doctors aren’t meant to get too close to their patients, but from his tone you would think I was going along to try and sleep with her grandchildren. I guess the real reason doctors aren’t meant to go to their patients’ funerals is the blame or shame around it. Like the doctor has lost or failed if a patient dies.
Of course, I went to the funeral anyway. I’d already had my suit dry-cleaned, plus I knew how the patient felt about my boss. It was exactly the ‘fuck you’ she would have wanted. It was a beautiful service and I was glad to be there, for me and for the friends and family I’d met on the ward. Plus, I was able to sleep with one of her grandchildren. (Just kidding!)
Sunday, 4 February 2007
I know everyone moans about how much they get paid and thinks they deserve more. But I really don’t think the sums add up for a junior doctor. Your job means making life-and-death decisions every day. You go to medical school for six years. Then you become a doctor, but you have to keep taking exams. You often work over one hundred hours a week. Today I realized that the parking meter outside the hospital is on a better hourly rate than I am.
Monday, 12 February 2007
Today I had to give a patient the morning-after pill. She said, ‘I slept with three guys last night. Will one pill be enough?’
Monday, 9 April 2007
I got my exam results today. I have somehow passed the next stage of my medical training and I am in the pub with Ron to celebrate. Sadly, I am only drinking orange juice as I have to head straight off afterwards to do a night shift. They tend to frown on doctors who turn up drunk.
Ron passed his own set of exams last week, so we compare notes. The bank he works for cut down his hours so he could study, but I had to squeeze in as much as my tired eyes would allow after work. Ron had a full month off before the exam. I asked for a week off, but a gap in the rota meant I had to work. Ron had all his exam fees paid for by his company. I had to spend around £300 on books, £500 on a course and £400 on the exam itself. The only upside was I was able to steal the pencil I used to fill in the paper.
Passing his exam means Ron will get a pay rise. All mine means is that I can now enter the next set of exams.
‘No,’ Ron says wickedly. ‘All it means is that you spent over a grand on a pencil.’
Saturday, 5 May 2007
Because I don’t get paid enough, I have invented my own bonus. I take home spare uniforms to wear as pyjamas, and sometimes I steal hospital food. It’s 1 a.m. I’m very hungry and now is my only chance to get some food for the next seven hours. I head to the kitchen on the ward.
There’s a new sign up on the fridge warning staff that meals are for patients only. I ignore it. But then I see the meal tonight is ‘Mince with Sultanas’. It’s as though they invented the most horrible food they could think of. I’ll just take my chances and let nervous energy and Red Bull keep me going.
Tuesday, 12 June 2007
It’s five minutes until my shift ends and I need to get away on time to go out for dinner. So, of course, I am asked to see a patient. The midwife looking after her tells me she hasn’t been signed off to give the patient the kind of stitches she needs.
Me: ‘I haven’t been signed off to do them either.’
Midwife: ‘You don’t need to get signed off to do things – you’re a doctor.’ (Sad but true.)
Me: ‘Isn’t there another midwife who can do it?’
Midwife: ‘She’s on her break.’
Me: ‘I’m on my break.’ (Not true.)
Midwife: ‘You don’t get breaks.’ (Sad but true.)
Me (begging in a voice I have never heard myself use before): ‘But it’s my birthday.’ (Sad but true.)
Midwife: ‘It’s labour ward – it’s always someone’s birthday.’
Tuesday, 26 June 2007
I have been in trouble with H for days now. We were at H’s friend Lucy’s house. Lucy is pregnant and, just before dinner, she showed us the photos of their recent 3D scans. I think there is no point to 3D scans apart from making the 3D-scan company rich and boring the pants off dinner-party guests. I had a feeling this opinion would go down like a cup of cold sick, so I had a polite look through the pictures along with everyone else.
‘Does everything look OK to you?’ Lucy asked me. I wanted to say, ‘Looks the same as they all fucking do,’ but I just smiled. I handed the photos back and said, ‘She looks perfect.’ There was an icy silence and murder flashed across Lucy’s eyes. ‘She? SHE?’ Oops.
It turned out they had wanted the sex of the baby to be a surprise. This is the first time I’ve made this mistake. Worst of all, she’s a friend, not a patient. Dinner felt like it took a week.
It didn’t help that things were already tense at home. Two weeks ago it all went wrong with the flat we were trying to buy. The owners have decided not to sell it after all. I suspect it’s more that they don’t want to sell it to H and me, but to someone with more money instead.
The whole process has already cost us several thousand pounds in legal fees and surveys. I know more about this flat than I do about any of my closest relatives. But I will never set foot in it again.
By an amazing twist of fate, the couple who own the flat turned up in my clinic today. I had not met them before, but I noticed the address on their notes. The same address that has caused so much stress. If only there was a way I could get my revenge. If this were an action movie, this would be the part where I produce two samurai swords and give a ten-minute speech
about honour and respect, before chopping off their heads.
But back in the real world, doctors have to treat you as well as they can, whoever you are. Through gritted teeth I gave them the help they needed. I did the scan and showed them the baby’s heart beating. ‘It all looks normal,’ I said. ‘Look, there’s an arm. That’s a leg. There’s his penis . . . Oh, didn’t you know? It’s a boy.’
Saturday, 30 June 2007
There is a news story in the paper about a hospital porter who has been sent to prison for pretending to be a doctor for the last few years. I have just finished one of those shifts when I wished I could get away with pretending to be a porter.
Monday, 23 July 2007
I tell a patient she can have sex again as soon as she feels ready, but to use protection until her next period. I nod at her husband and say, ‘That means HE has to use a condom.’ I can’t work out why they both look at me in shock. What have I said? It’s good advice. I look at them both again and realize the man is her father.
Wednesday, 8 August 2007
Three years into the job, I have now been promoted. When I started out I thought the doctors in this position were always right, like God or Google. I tried never to bother them. As I moved up, I turned to them when I got stuck or needed some wise words. And now the person to turn to is me.
