Dead babies. There are times when I despair. So I was just about to see this lady who had walked in with a sprained ankle, and who had clearly mislaid her copy of the Reader's Digest Guide to Commonsense Obviousness About Your Health because she hadn't taken any painkillers, when in came a blue baby, in the arms of a screaming woman.
I like to imagine that nothing much can choke me up these days. Babies in general don't really do it for me. Terrified, screaming, desolate mothers, of course, are a whole different, gut-wrenching story.
When I cry (places hand nobly on chest), I cry for the human condition. And here it comes. "You said I was next." Excuse me, I say, trying not to sweep the sprained ankle out of the way too obviously. "No," she says, and moves to block me. I try not to look too shocked and duck to the right. "You said I was next," she starts shouting. "I've been here for eight hours." She screams. I stare. "Eight hours!"
An entire A&E department is converging on the resuscitation room. A man on oxygen and a large bleeping box is being wheeled out in a hurry. Someone has done a swift prioritisation on the dead baby. Someone else hasn't.
"Eight hours!" I feint to the left, but duck to the right; she blocks, and catches me in the corner of the door frame by the nursing station. I look inside for help, but all I can see is an agency nurse with minimal English who has clearly just called the wrong number for the paediatric crash team. It's only 15 seconds since the blue baby arrived in casualty, but this ankle is more than a pain in the arse. I gently lever her against the wall and call 222.
"Paediatric crash team to casualty, please," I say, in my most urgent doctor voice. I listen to Tom put out the crash call over the bleep system, in his favourite urgent hospital switchboard operator's voice. "Thanks Tom." "That's all right Mick, pleasure mate," he says. "Anything else I can do you for? Free call to your sister in Australia?" "Thanks," I say. "But I'm in the middle of a paediatric crash call." "So you are." The ankle glares at me.
You'll have to go back to the waiting room, I say. And that is why it takes so long to get to see us in casualty. That and people who call ambulances for funny tingly feelings in their hands when they've got a hangover. That and years of underfunding. "I'll see you as fast as I can," I have often wanted to say. "In the meantime, could you please fill out this form detailing every voting decision you've made over the past 30 years to show exactly how much you deserve it."
My consultant, like all consultants in A&E, is the hardest man in the world. Once, he took a man who had been bullying the receptionist about waiting for several hours into the resuscitation room and showed him five beds full of five exceedingly ill patients, and demanded to know: "Which of these five people would you like me to boot out so we can urgently deal with the lump on your wrist?"
After the baby is pronounced dead (and God it is so screamingly awful) I go and smoke a cigarette outside on my own, and miss his touchy-feely pep talk. He catches me on the way out, and passes me a fraternal look. I whinge about the ankle. "Why can't people get over the idea that we have an open-ended commitment to them even for their flakiest conditions?"
"We can't get rid of the open-ended commitment," he smiles. "It's where we derive our immense moral high ground." I go back inside and get on with my night. There are no more dead babies.
At half past five in the morning, astonishingly, unprecedentedly, it all goes quiet, and I lie down on a trolley for half an hour, to be woken up by a woman who has had a sprained ankle since the previous afternoon. "I came now because I knew it would be much quieter." Thanks a bundle, I think. And smile benevolently.
