On Call : Dr. Daisy Dashwood writes........

I wandered miserably down to the Geriatric Wing, scuffing my shoes on the ground. It was one of the days where I was not carrying the cardiac bleep and therefore had mysteriously ended up wearing sensible shoes. Cardiac bleep days were invariably accompanied by wearing high heels. Someone would always arrest on the furthest away ward when you wore your stilettos.

I had more reason to be miserable than most JHOs. Not content with messing up any potential relationship I might have had with John Jones, Dr. Flett had also got in on the action somewhere along the line and was quite obviously and vocally displeased with me. How else could I explain his behaviour regarding the alendronate? Surely he couldn't be that keen on adhering to the SIGN Guidelines? Dr. Flett stuck rigorously to these proclamations, veering never to the right or left where drug prescription was recommended.

"Psst! Daisy!" It was Dr. Flett, hiding surreptitiously behind the sluice door.

"Dr. Flett?" I said in surprise. Perhaps he wanted to beat me up about the Didronel?

"Daisy!" he hissed urgently. "In here!"

Risking a quick glance behind me, I sidled into the sluice.

"Gosh, it's just like Mission Impossible, Dr. Flett!" I said excitedly.

"Yes Daisy," he said. "Anyway, I just felt I ought to apologise for my behaviour back on the ward. It really was quite inexcusable, not a winner, no-no."

"Er, that's OK Dr. Flett," I said in surprise. A Consultant apologising to a JHO? What next? Amos baking scones for his juniors? A vision of Amos clad in a frilly apron, bending over and proffering scones swam into my mind. I shook my head and focussed on Dr. Flett instead. Some things were just not meant to be.

"I feel I owe you an explanation Daisy," he said, gesturing with his hands. I always felt that Dr. Flett would have been ace on the piano. He had great expression with his hand movements.

"You might have felt I was a bit hasty with my words, Daisy," he continued. "I must admit that such language is not my normal turn of phrase. But I felt that I had to get you away from Dr. Jones, Daisy. I thought that shock would be the only way."

"You sure figured that one," I said chummily, punching him tentatively on the triceps. "But Dr. Flett, what I don't understand is, why would you want me away from John? He's a nice boy. I mean, I know I probably don't stand a chance with him, but he's not the type to hurt a girl."

Dr. Flett paused for a moment and wiped his patriarchal domed forehead.

"Daisy, you must understand that some things are a lot more complicated than they seem," he began. "It all goes back a long way, to my boyhood days."

Right enough, I could just about see him in a cap, bowling a hoop along through the streets.

"I used to have a good friend at school," he started. "We did everything together. Lived together, ate together, played together, even slept together."

I decided that sweet old Dr. Flett did not know the modern-day connotations of that particular phrase.

"We went onto become buddies at Medical school," he continued. "Even shared the same cadaver. I'll never forget the day he hooked the right main bronchus under my shorts and I trailed that blasted lung halfway through the dissection room before I realised I was leaking. Ah, such japes!"

Here, he paused to wipe a tear from his eye.

"We were partners all the way through medical school," he carried on. "Until our final year. There was a gold medal up for grabs and three of us wanted it. We began spending more and more time studying and less time playing bridge. On the final day," here he stifled a small sob, "we sat opposite each other and he glared at me. I never forgave myself for having let John Jenkins beat him. He never should have won that medal. He should have lost on purpose!"

"Who's John Jenkins?" I enquired, intrigued.

"The cleverest boy in our year," answered Dr. Flett, a far-away look in his eyes. "Looking back, he was a dead cert."

"But where do I come into this, Dr. Flett?" I asked frustratedly, hopping from one foot to the other. I was desperate for a wee but I was damned if that was going to stop me.

Dr. Flett turned and faced me squarely.

"Daisy," he said. "There's something you should know."

"Don't let me be related to John; Don't let me be related to John!" I prayed silently.

"My boyhood friend, Daisy," he said solemnly, one hand on my shoulder. "He was your father."

"Dad?" I said incredulously. "You knew my dad at Medical school?"

"All that and more," he said sadly. "I knew I couldn't let his daughter go steady with a boy with the same name as John Jenkins. I knew it would upset him too much. That's why I felt I had to get you out of there."

"That's really sweet of you, Dr. Flett," I said, reeling. "But I think you've been spending too much time in Nursing Homes. Dad never thinks of the past. He wouldn't mind."

"I'd watch out, Daisy," said Dr. Flett gravely. "But I thought I'd let you know. It was your time."

"Thanks, Dr. Flett," I said, equally gravely. "I'm glad we share a common bond."

"Never forget that bond, Daisy," he said, gripping my shoulder earnestly.

"I'll never forget, Dr. Flett," I said fervently. "Not ever."

**********************************

"Come on guys!" yelled Chuck, skidding to a halt outside the Doctor's Room. "They've got a wifie in the WRVS with an MSQ of 3 and everything's 50p!"

"Yeah," said Amos, getting to his feet. "I reckon they owe me at least 793 packets of pastilles. How they can charge £2.30 for a tube of reconstituted glucose is beyond me."

"Why don't you say something?" asked John. "It's not like you to hold back where holding back isn't indicated."

"Ah, you see," said Amos, "I already have a reputation for being a bit of a bastard, but the thing is, I need to keep in with the WRVS ladies. They overheard me complaining to Poppy one day about the length of time it took to make a cup of coffee and now I reckon they're just spinning it out as long as they can. One day I'm going to get a DVT just waiting by the WRVS counter."

"Man, I'd love to see the look on Dr. White's face when you hobbled into Radiology!" said John enthusiastically.

John had a bit of a thing for the Radiologists. He both loved and feared them. He also needed them psychologically; it was the fear which kept him going.

"Anyway," said Amos. "We ought to take our chances whilst the going's good. With a bit of luck, she'll be slowly dementing too and the Trust can put it down to a rogue manic episode."

"You feel so much empathy with the Trust, Amos," I said in wonder. "Have you always been like this?"

"Actually, no," admitted Amos ruefully. "Once, I saw the Trusts for what they were; misguided beaurocrats bound in red tape who were out to screw you for everything you had. Every venflon, every 10ml tube of saline had to be accounted for."

I thought back to my pre-JHO days and shuddered at how much I had probably cost the Trust in cannulation issues.

"And when you think about it," continued Amos, "I'm nowhere near as empathetic as Dr. Flett is with his patients. He is such a typical Geriatrician, he just keeps on trying to get into the skin of his patients."

"It's baggy enough," muttered Poppy. "He won't have to try very hard."

"You can really see Dr. Flett trying to feel how these old grannies think," said Amos with passion. "I can just see him as an old woman, falling over every now and then, hitting himself off the drip stands for maximum empathy."

"And at night, in one of those draughty old NHS nighties," added Chuck. "Lying there, doubly incontinent, just……..wet. Wanting to get up but unable to bring himself to do it as he really needs to feel what these people are going through."

"Yuk," I said.

"Well, he needs to understand their pain," argued Chuck. "And it just wouldn't be realistic if he didn't lie there for at least 3 hours whilst waiting for the Nurses to answer his buzzer."

"I can almost see him in one of those oversized pink fluffy quilted dressing gowns," mused Amos. "He has that kind of cheery face. I can really see it happening one of these days, instead of the usual white-coated figure, nodding benevolently, we'll see a pink and fluffy apparition doddering about behind the ward trolley."

"Sorry I'm late, dudes," said Dr. Berkley, slipping in between the tables. "I was up somebody's rear end."

We were all sitting around, comparing blood results and seeing who won the 'Most dehydrated Patient' Prize.

"Lovely, Dr. B," said Chuck sarcastically.

"Lay off, guys," protested Dr. Berkeley. "You have to take a chill pill. Listen, I'm in a bit of a tight spot with the old social life."

Nobody said anything. Most likely, it was all going to end with Dr. Berkley scoping someone and from the judicious use of the word 'tight', we could all guess what kind of scope that would be.

"You see," he went on, "I was wanting to take time out and play a bit of golf but it was raining so I got out my putter and set it up on the living room carpet."

Images of broken vases and Dr. Berkley caught up in a curtain flashed across my mind.

"Only I go and hit the bloody dog," he complained. "Now the wife's not speaking to me. And she made me take it to the vet."

We all made sympathetic noises and Angie patted him on the shoulder in the manner of one who has children.

We were disturbed by a flurry of activity by the door.

"Did you take the last orange juice, you little bastard?" demanded Poppy, clipping John over the head.

"No," said John in a scared voice, puffing out his abdomen so that she wouldn't see it behind him.

"Look, Toblerone!" cried Janey, pointing. Poppy's thirst was quickly distracted as she swivelled to track down the chocolate.

"I wonder if Dr. Flett role-plays with the Occupational Terrorists?" pondered Amos.

"They're the people behind all the delayed discharges!" exploded Chuck. "Not the Trust, it's the OTs. Step away from the kitchen, I repeat, step away from the kitchen. You've made your hot drink, now leave. Senna. Lactulose. Whatever! I'll give you what you want. Just let him home to his family. He has kids."

"They are 60," pointed out Mary practically.

"They're still his kids," said Chuck, defiantly.

"I know!" chimed in Amos. "You ask for a home visit and you get a reply next week saying they should be able to fit you in in July 2004. I only got what I wanted the other week because I said I was Dr. Flett."

"Amos!" scolded Angie.

"Well, it's the only way," said Amos belligerently. "I reckon we should all get in on the act. With a bit of make-up, I think Laurence could pass for Dr. B."

Dr. Berkeley preened. Laurence was actually quite good-looking.

Dr. Berkley was a bit of a character. Eccentric and lively, and with his chance of Nobel Prize fame lying at the bottom of the sea, he would alternate between skulking in the background, playing a twisted game of hide and seek with his JHO, and sneaking into A and E on the sly, simultaneously clerking, venflonning and taking the patient to theatre before the JHO had had a chance to get down there.

Dr. Berkeley was a very JHO-friendly tutor, as far as staff went. There was one Nurse on the Psychiatric Ward, whom Gordon had nicknamed 'Big Jim'. Big Jim was a large man with a mullet and a perma-tan whose torso was covered in assorted tattoos in muted autumn shades and who wore heavy fake gold jewellery under his Nurse's Uniform. Gordon once saw his left biceps as he was undressing for theatre and had seen the heart with the word 'Mummy' running through it. Gordon would swear blind that Big Jim had caught him staring and had given him a nasty half-smile as he crunched his knuckles. Ever since, Gordon had been convinced that Big Jim had it in for him and that it was only a matter of time before he ended up in a loch in 7 pieces.

"That Big Jim," said Amos, shaking his head. "That mullet. He gets away with murder."

"He probably has," said Gordon gloomily. "He's probably not even a nurse. I'll bet they just hire him and make him walk through the Ward every morning, just to keep the patients on their toes. It'll be like one of those urban myths, where they tell the patients "If you don't stop that screaming, Big Jim'll get you." Gordon visibly flinched.

"He probably stands there, threatening the patients," said Gordon. "You must not listen to the voices, you must listen to me! To me! To me! Mwah-ha ha ha! Mwah-ha ha ha!"

"Are you sure you're not getting a little obsessed with this man," said Mary concernedly.

"He's going to get us!" said Gordon, rocking back and forth. "He'll get you. And you. And you!"

"Yep," chimed in Amos. "Big Jim'll fix it for you, Gordon!"

"Noooooo!" wailed Gordon.

His experience with the mentally deranged was obviously taking it's toll on him.

******************

"At-choo!" sneezed Poppy.

"That's atopy for you," said Chuck, matter-of-factly. "With your asthma and my bronchiectasis, we could have some really revolting children. They'd just be a seething mass of raw, heaving flesh, hocking up sputum right, left and centre."

"Isn't a lot of atopy self-induced?" asked John quizzically.

"Is that the case for most of medicine?" answered Amos innocently. "You sneeze, you spit, you wheeze. Big deal. Like you're the first person to ever hock up a lump of phlegm. I had a patient with an IgE so big that it was off the map. He literally couldn't sleep at night, his sinuses were so impacted. Honestly, it was the manual evacuation of all sinuses. Somebody needs to invent some Senna for noses. Anyway," he continued, sensing our interest drifting, "he really couldn't get to sleep at night. He'd do the usual. Get up, get himself a few beers. Buy a new lawnmower."

"Another closet B and Q addict," said Chuck knowledgeably. "They all come out in the end."

"If only some of our patients would come out," sighed Amos longingly.

Everyone's head snapped round to face him and we all immediately thought the same thing: Is Amos gay?

"I'm not gay," said Amos hastily. "In fact, I'm the most heterosexual person I know. It's all my Latin genes. Just ask Mrs. Maradonnna. Why, only last night, when I arrived home we had this huge…….."

"Amos" screamed Mary, covering her ears with her hands. "I'm young and innocent and I don't understand these things."

"Sorry," said Amos sheepishly. "Anyway, I was only wishing that some of them would go home. Take Mr. Potts, for example."

Mr. Potts was a retired farmer from Rothes who had decided to spend his dotage by the shores of Loch Ness. This consisted of smoking as many cigarettes as he could humanly puff his way through and perfecting his sideburns. The food fairy had endowed him with a generous portion of adipose tissue and he spent his days clockwatching from breakfast to lunch, from lunch to dinner, punctuated by the occasional gruelling battle with Dr. Sinclair over his erratic BMs. You could almost hear his coronary arteries screaming 'Oxygen! We need oxygen! Somebody haul the GTN quick!'

"Some hope of Mr. Potts self-discharging," said Amos wistfully. "It would take him a week, crawling along on his forearms, waiting for some misguided Good Samaritan to lift him down the stairs."

**************************

"She doesn't think anything's the matter with her legs," I argued.

"She's wrong!" said Amos emphatically.

"But she's known her body for 74 years," I shot back. "Why can't she be right?"

"Because I'm the Registrar!" said Amos. "And I'm always right. Now go and clerk in the pacemaker patients."

"Don't want to," I said sulkily.

"Oh Amos, go easy on Daisy," said Angie sympathetically. "Does anybody even check the pre-pacemaker bloods?"

"Well, no," admitted Amos. "We found that out when that guy with the coagulopathy slipped through the net and went onto be paced anyway. Turned out he had Factor 12 deficiency"

"Something to tell the grandchildren," said Darren.

"A coagulopathy never killed anyone," said Amos dismissively. Ah, go on up with the chit anyway. Maybe you'll meet a phlebotomist."

"But they're not due in for another 3 hours," I argued.

"Who? The phlebotomists?" said Amos, startled. "Bloody hell, that would explain why the bloods never come back till late evening."

"Er, no," I said. "They start at half eight each morning."

"Losers," muttered Amos.

"It's the pacemaker patient who aren't due in yet," I said.

"Ah go on anyway," said Amos persuasively. "It'll give them the chance to lose the chit earlier."

It had been a long week at the Royal Scottish Hospital. My mind was racing as I tried to think how to broach the boyhood friendships of my father. And John. Would I ever stand a chance with him now? So much seemed to stand in our way. We were both acting as though nothing had happened, making idle chit-chat about the weather and length of Mr. Pott's sideys. Would we ever get together? Would my father try to stand in our way? Would our children ever know their grandfather? Oh damn, forgot to prescribe that Alendronate!

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