Surgery is like one big pyjama party. I was woken at five to eight by Clara, a surgical house officer whom I find rather dishy, bouncing up and down on my bed in the on-call doctor's room, and shouting: "Wakey-wakey, Dr Sleepyhead. Your ward round awaits." After a routine check that my genitalia have not fallen out of the front of my theatre blues (a hazard of using them as pyjamas) I spring up and pull on a white coat for the morning round.
You cannot begin to imagine the pain and misery of a night on call, followed by a day at work. If you could, you probably wouldn't all keep coming in at three in the morning with that bit of tummy ache that has been troubling you for six months.
On the whole, I am not terribly impressed with your pain thresholds; not to mention common sense. "Go back to bed," I am tempted to write in the notes as my clinical plan, "and leave me alone." But that is not what they want: they want hospital lights, and hospital beds, and hospital hysteria.
"Ooh, I was up at that hospital the other night," you can hear them saying, after being sent packing next morning. "Accident and Emergency it was. They had me on one of them drips and everything. They still never found out what it was."
Yes we did. You had tummy ache. Now go to bed and be good. You know for sure that they wouldn't do it if it wasn't free of charge.
At least in this job we get a cosy on-call room on a staircase near the wards. In my last job we had to sprint 100 yards across open gangland territory in central London at three in the morning when the cardiac arrest bleep went off. And, of course, now I've got this new job, now I'm a surgeon, I don't have to do too much thinking because you only ever see the same five things over and over again and because thinking isn't butch enough for surgeons. Surgeons stand in theatre looking hard, and calling their house officers "big girls" for not being able to hold retractors for hours on end. They don't like to think. It makes their willies hurt.
So, after I flourished my sleepy way through the new admissions (two lots of appendicitis, one sub-acute obstruction and three tummy aches), we stumbled across an patient I had seen, who was "short of breath" and coughing up goo overnight. Needless to say, without pausing for breath I had instituted the patented Foxton Triple Therapy for chest symptoms: antibiotics in case it was an infection, diuretics in case it was heart failure, and a salbutamol nebuliser, partly on the off-chance that she had a bit of chronic lung disease, and partly because those big see-through masks with clouds of mist coming out of them look fabulously pneumatic and Victorian, an aesthetic our elderly patients often seem to appreciate.
The registrar was not impressed. Deciding for the first time in his life to take an interest in the medical management of our surgical patients, he held his hand aloft theatrically. "It is as if," he said, with a grandiose smile, "you had walked into a darkened room filled with flies, and started firing rounds from a machine gun at the walls."
We all peered at the silver pan of poo that the nurse had brought for us. It contained a puddle of green and red semi-formed stool, which smelled metallic and vegetal in the way that only antibiotic-induced pseudomembranous colitis does. I was definitely not guilty: she had only been on the drugs for 12 hours. "Well done, doctor. And with which 10 drugs will you be attacking her bowel to reverse the effect?"
The Evil Sister on Ward 7B stared at me. I froze, immobilised by the injustice of it all, and the complex damage limitation analysis running through my brain. Should I mention that it was his 12 days of cefuroxime and metronidazole which had trashed her bowels? "Blink if you can hear me, Dr Foxton." Clearly not. Should I chance a matey comment to defuse the atmosphere? Something implicitly sexist, perhaps? They seem to like those ones.
He walked over and put his mouth menacingly close to my ear. Shit, I thought, he's going to bite my ear off. He smiled and whispered into it. "You're obviously mistaking me for someone who gives a shit, Dr Foxton. She has been incontinent and doolally in a nursing home for six years. I can't believe you even got out of bed."
He returned to his usual bark. "Right, well done, I'm going to theatre. Sort out the social sitters and stop being such a big girl."
And I was alone once more.
