It's always the embarrassing ones who die. "I've taken 24 paracetamol," she mumbles, and looks at the floor of the cubicle. "My arse," I think to myself, as I skim through a fistful of casualty cards recording this girl's 19 previous attendances in A&E. There is no single occasion when she has managed to have a trace of paracetamol in her bloodstream.
So this is Munchausen's syndrome: ridiculous timewasters who come in with pretend tummyache, or unconvincingly paralysed limbs, or pathetic overdoses, and bugger us all about for a few hours. The Munch Bunch, as we like to call them. "Stop wasting my time," I say with a smile. She looks up, shocked - priming herself for a torrent of abuse. Surely somebody should think about referring this girl to the shrinks. I pull out a tourniquet and do my duty.
Other people are not so so lucky. My friend Stass is up for a coroner's in a week because someone she sent home died the next day. You know what she did wrong? She apologised. Now the family is baying for blood.
Hospital managers, we are told, get rather upset with doctors who go around apologising to patients over cock-ups. We tend to do it on the grounds that it probably makes everyone feel better and so it's just a nice way to end things.
Unfortunately there are a few of you out there who can't cope with the uncertainties of life and our failure to have magical powers, and decide to make a few quid out of it.
Stass didn't stand a chance. "She's just not quite right," they said when they brought her in. This is a common problem with elderly relatives, and you're best bet is to find out when they last saw them. "Christmas," they said. Nice way to treat your dementing mother.
So you struggle on. "In what way is she 'not quite right'?" you ask. They sneered, apparently, and pointed at her drooling. This is not such an unusual thing for an elderly woman to do when she has been abandoned by her family for 10 months.
"Well, what was she like at Christmas?" she asked.
"Not drooling," came the response, and they proceeded to be deeply unhelpful.
What can you do? She looked like she might have had a bit of a urine infection. The medics didn't want to admit her, the family said they'd take her home and look after her, so off she went with some antibiotics... and died the next day.
Moments like this make you realise that you're a grown-up. Fortunately, the Incredible Boozing Man doesn't have any family - apart from us - so there's nobody about to complain when we lose our patience and leave him at the bottom of the in-tray.
The last time he came in, I used him to teach the medical students about wound-healing: he comes in about three times a week after falling over drunk, so his head is a living demonstration model of the four stages of wound-healing, and it's all nicely slowed down by the booze. He will do anything to get booze.
I watch him sway into a cubicle, looking worse than ever, and pop down the corridor to grab a pair of gloves before examining his bloody head for the second time this week. As I walk back into the cubicle I catch him stuffing a bottle of Hibiscrub behind the trolley. He looks up at me guiltily.
"There is no booze in Hibiscrub," I tell him, authoritatively. It's an old problem: one time we even got a call from the stroke rehab ward.
"There's some bloke up here drinking the Hibiscrub. Is he anything to do with you?"
"Yup," we said. "Send him down."
So I feel my way around his scabby head, trying to see through the grit and congealed blood for the freshest injury. There are a few to choose from, but in one place there's a step down and a step up. The bastard's got a depressed skull fracture - on my shift.
An hour later he was in the scanner. After one pass they saw the massive bleed, and six hours later he was dead. Three hours after that we were in the pub, mourning our mascot, drinking like he would have. With a bottle of Hibiscrub on the table.
