There is a female bay on one of the surgical wards in our hospital. 6 beds, 6 women. Usually this is fine, people get on well, they chat, they eat, they sleep, they get better and, eventually, they go home. Sometimes, however, there can be problems.

2 nights ago, one of the patients, Doris, an elderly lady with dementia, spent the night shrieking, and making a fuss. This has an impact on everyone in the bay; no one had much sleep that night.

In the bed opposite was Jean, a retired lady with all her wits about her. Sadly, she had hardly had any sleep, and spent the whole day miserable and exhausted. When we saw her on the ward round, she was very unhappy. We apologised and everyone hoped for a better night following.

The next day, we went to see Jean. She looked much brighter, and said that the night had been much better – Doris had been noisy at first, then relatively quiet. All seemed normal, until one of the nurses had a word with me…

“Last night,” she said, “We noticed the curtains around Doris’ bed were shut. We thought that was a bit odd, as none of us had done it. So we went to see why.”

“Why? What happened,” I said, with mild trepidatation, hoping that Doris hadn’t passed away in the night without any of us noticing on the ward round.

“About 10pm, Jean got up, walked across the bay, closed the curtains, and thrown a full jug of cold water over Doris!”

I walked back over to Jean’s bed. “Jean, err… was there an *ahem* incident, with a jug of water last night?” It was quite funny to see Jean’s reaction – she went bright red, like a guilty schoolgirl caught flicking elastic bands in class.

“I don’t know what came over me!”, she exclaimed. “I just couldn’t stand it anymore, it was so unfair, and I was so angry, and… I just had to do it!”

It was hard to maintain a stern manner, especially since all three doctors (myself included) started gaffawing. The shame of having to own up seemed to do the trick anyway, as she cringed and said “I was really hoping no one would ask me about it!”

With a promise from her that she wouldn’t do it again, we left her to the rest of her day. As Aristotle said, “The virtue of justice consists in moderation, as regulated by wisdom“. Fairly sure, in the circumstances, a single jug is still classed as moderation.

NB. I am thoroughly committed to being a great doctor, which includes respecting patient confidentiality. All information about patients on my website is anonymised, and often altered drastically so that whilst it still makes a good anecdote, it is unrelated in sex, time, location, age and/or ailment from the original facts.

This weekend, I worked the Freudianly named “graveyard shift” at Chesterfield hospital. Three nights, 9pm until 9am, Friday, Saturday, Sunday.

Whilst a great time to get some real hands-on experience, there is a key problem in working nights. It goes thus:

1. Most of us are not naturally nocturnal.
2. Most of us have jobs in the day time.
3. Night shifts usually only have a day’s grace between day shift and night shift.
4. It takes more than one day to completely upend your circadian rhythm.
5. Therefore, you always feel completely, exhaustedly, hungover-jetlagged-coma-after-a-trainwreck tired.

There are two methods for attempting this changover. One is to try and stay up as late as possible the night before, sleep all day, and go to work (hopefully) refreshed. I tried this. The result was that I was so tired on the first shift that I started having visual hallucinations about 4am, attempted to wear a commode around 5, and woke up the next morning completely naked in the middle of the M45.

The other method is to sleep normally the night before, stay up all day, and have a two hour nap before the start of the shift. My SHO used this method. The result was that he became so tired that he began to have paranoid delusional beliefs around 3am, attempted to order the demolition of the hospital library about 6, and woke up the next morning on a ferry to Bergen, with a new tattoo. Of the Queen. On his face.

Obviously there’s a bit of exaggeration there, and neither of us actually developed first rank symptoms of schizophrenia, but we were very tired. Aside from this, the weekend was actually fairly enjoyable. There’s a bit less red tape and paperwork on the night shift, and less distractions.

One highlight was a tired A&E clerking on Friday night from another doctor, who had written “Patient is a resident in a residential home” twice in three paragraphs. Some would say that this is not particularly useful information, even when written twice. The doctor had failed to mention that the woman was profoundly deaf, and severely demented. Which would you rather know?

My most memorable event of the weekend came at about 5:30am Monday morning. I was hungry, so I went to the vending machine to get a packet of crisps.

5:30 I put in my 45p, and selected some Prawn Cocktail Walkers. They fell out of the holder, and got stuck halfway down the machine.

5:31 I got annoyed, and tried to shake the machine. A lot. It didn’t work, the crisps remained stuck.

5:32 Rammed the machine again, and another packet of crisps fell out, Cheese and Onion this time. It also got lodged. Right next to my other packet. Nudged it again, to no avail.

5:34 Tried ringing the vending machine company, asking for a refund of my 45p. Oddly enough, no one there when its barely dawn.

5:36 Decided I *needed* crisps, so used my might again. This time a Capri-Sun fell out.

5:39 Having drained the last drop of the Capri-Sun in a contemplative manner, I hit upon an rational plan of action – purchasing the chocolate bar directly above the crisps will cause it to fall, thereby dislodging my crisps!

5:40 The Kit Kat chunky holder turned, and then the chocolate bar twisted out, began to fall and then… got stuck in the mechanism.

5:42 I finished screaming, and decided to whack the machine again.

5:43 Still whacking.

5:44 Another Capri-Sun fell out, but still neither crisp packet nor chocolate bar is released from the vending machine’s iron grip…

5:45 After a final heave, the Kit Kat fell, dislodging both packets, and I left the machine clutching half a newsagent’s in triumph. (Feeling a little guilty at my windfall, I later went to the reception desk in the hospital, who congratulated me on my honesty, but told me to keep the food!)

There ends my summation. At 9:15am Monday I left the hospital after 36 hours of attendance, with mild tooth decay and a mite more experience as recompense. Plus I think I’ll get paid at some point too, but right now I’m more excited about the Capri-Sun.

NB. I am thoroughly committed to being a great doctor, which includes respecting patient confidentiality. All information about patients on my website is anonymised, and often altered drastically so that whilst it still makes a good anecdote, it is unrelated in sex, time, location, age and/or ailment from the original facts.

Last night was a tiring, long, unsatisfying night, after we got halfway up the mountain, carrying tents, blankets, food, saucepans, etc, etc; when Mohau got called by his angry girlfriend, and we came back down. On the long walk home, I was feeling a bit depressed, as you might understand.

So this morning, I decided to have a massive lie-in. Sleep as long as I want, write off the whole day if necessary. 8:30. That was it. The latest my body could stay asleep for. To my internal clock, still adjusting from the 2 hour difference, I would still say that is around 7:30 in equivalence. Rubbish – I’m clearly getting far too mature for all this lazing around and doing nothing. I blame all the cups of tea I’m drinking out here.

I decided it was time to lay in bed, and read a book. I was gripped, so gripped that, realising I needed a shower, I walked to the bathroom and undressed, but then stood in the bathroom for half an hour reading the end of the book, naked. It was a weird thing, called “We need to talk about Kevin”. Very spooky, very frightening. I enjoyed it a lot, or rather, it deeply intrigued me. I don’t even know if I liked it. Look it up on Amazon.

I also tried to train the dogs. First I tried with Baby, who is basically a large, irritating equivalent of Heze. “Sit”, went well, as long as by “Sit”, I actually meant “Fling yourself onto your back, kicking my legs with your back feet, and try to propel yourself along through the gap between my legs in a frantic shuffling motion that, if arisen in the fifties, would have been called something like ‘The Fanny Thrust’. And then try to chew my toes”. Giving up on this, I tried “Stay”. This was a lot more successful, or it would have been, if Baby hadn’t thought I’d just said “Sit” again; running after me as I backed away, almost launching herself at my knees in order to land on her back and dutifully fulfil her interpretation of my command. At this point, I felt the day’s training had been very effective, and it was time to try Erica.

She is a lot more shy, and I was hopeful that without the endless enthusiasm that Baby displays, she might be easier to train. “Sit”, was ignored, although when I bent down near her, she did jump up at me repeatedly, snapping at my face. When forcing her down onto her back legs, to explain what the sitting position entailed, she went completely limp, lying on the back with her feet in the air. Every single time. Leaving that for another day, I moved onto “Stay”. Unlike Baby, she did this perfectly, staying exactly where she was. Proud of this victory, I called her. She completely ignored me. I called again, which felicitated a large yawn on her part. She still didn’t move though. At this point, I tied large rocks to the two of them, and threw them both in the pool.

Anyway, my day today has been very restful (Ian who I am staying with, has like 100 Clive Cussler books!!), and should be more exciting, since hopefully we will get to go up the mountain around 4. I don’t know when I will get a chance to upload this, but I do miss you.

Reading through Job at the moment in that Cover to Cover thing. It’s a powerful book – I think it was written as a play; not sure how true it is, but that doesn’t really matter.
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