I'm beginning to work out what's so wrong with all these TV hospital dramas: the characters are never on their own. When they're not flirting over the defibrillator pads, they're fighting out some burning ethical issue behind the nursing station, or tenderly consoling each other over a cup of vending machine soup.

On the whole, they tend not to depict junior doctors on ward cover at three in the morning, wondering what the hell to do with a patient who's spiking a temperature that's been ignored all day, and on unfamiliar wards staffed by bank nurses who have no interest in even looking at you, let alone showing you where the patient is.

Incidentally, most hospitals have now abolished that nice big white board behind the nurses desk that has the patients names on it, because they anticipated several months ago (bizarrely) that it might infringe human rights legislation on privacy. This costs me, and anyone else who sees patients on unfamiliar wards, an average of one minute's faffing per patient seen, adding up to four minutes an hour, or one hour in a shift, or a fifth of my projected sleeping time on an average night of ward cover. I've been performing these iterations compulsively on every aspect of my life since I started work, and believe me, I could bore for England on the subject.

To be fair, I rather enjoy pootling around the wards on my own, sorting people out here and there and acting as a unilateral medical force (especially since it's the only time I feel like a doctor rather than a paperwork clerk). But your average TV scriptwriter would have to work pretty hard to derive any narrative tension from my little wanders, particularly now I have perfected my air of inscrutable, calm professionalism, in the face of nauseous exhaustion. Perhaps that's why no one takes me seriously when I whinge about being tired: or maybe it's just over exposure. Perhaps that's why nurses will chirpily say: "You chose the hours when you chose the job." Even the nice ones.

Empathy, it must be said, is a problem which cuts in both directions. So, last night I was called to see a patient who was pretty obviously about to die. Having established this ballpark diagnosis (largely by exclusion), and anxiously double-checked it with my senior, I shared the unhappy news with the family. It was, if I say so myself, a moment of which even our appalling communication skills lecturer would have been proud, and compared favourably to my previous "breaking bad news" moment, when I had just been called from bed and was wearing theatre trousers and a borrowed T-shirt which read "Sheffield Medics at your Cervix".

I retreated to the wards, leaving the family to do their business (and let's not forget, a lot of the stuff in the final hours is business), and five hours later I was bleeped to be told that she was dead. Now, of course, my heart skipped: I don't know if it's because I watched too many cop shows when I was a kid, but for some reason I can't shake the idea that a dead body is somehow a legal issue until proven otherwise. For each corpse there should be an attendant explanation, legitimising or permitting death, and in this case it was me. No one else much had seen this woman alive, except her adoring family who had noddingly swallowed the improvised platitudes I had downloaded onto them on my way to lunch. "Christ," I thought, for one fleeting moment, "I've got a fucking corpse on my hands."

Now for times like these, there is always an entry in the Hands on Guide for House Officers (holy tome). Truly, the weirdest learning curve of becoming a doctor must be that words in books translate into actions in the real world, which themselves translate into tangible impacts on the mortality of the person lying in bed in front of you, a chain of causation which has only recently begun to seem plausible.

I look up death and am pleasantly surprised to find one definitive entry. After a string of platitudes about not letting it freak you out (at the time I thought I had no time for such nonsense, but looking at what I've just written that seems hasty), it turns out that all there is left to do is the pronouncement of death. Which all looks pretty easy: I put it to the back of the queue and start working through my backlog of bleep calls.

So you're waiting for the punchline? Nothing more than an act of crass thoughtlessness, I'm afraid. After six hours that felt like five minutes, running between crappy half pneumonias and writing up interminable IV fluids, I'm bleeped again and finally make it up to the ward to find an entire family waiting expectantly for me to place the seal on their mum's death. And for a fleeting, exhausted moment, would you believe I was even miffed that they'd been impatient?