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

Hospital is definitely not the place to have a hangover. We were all out last night for 'one drink', which subsequently escalated into an all-out booze-fuelled dancefest. We'd been keeping a low profile in the town for fear of bumping into patients, but with each bacardi breezer, our confidence grew, and emboldened by the alcohol, we wound up slumped over a burger joint at 2am.

Rick, one of the surgeons, thought it would be really funny to steal my glasses and so took off down the High Street with them. Enraged and passioante on account of the Malibu, I gave chase and set off in hot pursuit. Rick loped along, easily evading my blind snatches. After several near misses, I sensed an opportunity and lunged - just as Rick doubled back. Heels flailing, I sat down heavily in the middle of the road.

"Daisy, move!" yelled John, above the noise of an oncoming car. I sat there determiniedly rigid, trying not to cry.

"Good God!" grunted John, hauling me to my feet and dragging me over to the pavement.

"Er, here's your glasses," said Rick sheepishly.

I glared at him and snatched them back, setting off down the road, dragging my ankle behind me. Way to go Daisy. This morning, John is wandering aroundcomplaining of a sore arm after having to carry me back to the hospital and I am being greeted by shouts of "So, it happens to Doctors too?!" Never has the phrase 'Physician, heal thyself,' been more appropriate. I snuck into A and E and managed to half-inch a metre of tubigrip and patched myself up quite well, with the aid of John who crammed my foot back into my shoe.

I've congratulated myself on my most excellent timing, though. If you have to pick a time to bugger your ankle, the week when we have two patients is definitely the week to do it. Amos has been coming up with more and more creative attempts to spin the ward round out as long as possible, teaching us on every aspect of their conditions. He even came along to the weekly 'Social Meeting', where we have a multidisciplinary bonding sesh and the physios, nursing staff, OTs and pharmacy take on 4 frightened JHOs, one after another, in an attempt to infiltrate the system at grassroots level and hopefully impact on the socially blind Registrars. This week we had an old boy who had come in moribund with a left-sided basal pneumonia. Torn between the prospect of losing 50% of his patients and the equally unappealing vision of Mr. H's now burgeoning pressure sores, Amos was well up for fighting his corner and discharging our man.

"But he can't walk more than 10 metres!" said the physio, determinedly looking Amos squarely in the eye.

"His mobility is better than it has been in years!" said Amos. That's the great thing about being a Registrar. You can make such sweeping statements as if you've been on intimate terms with the guy for years and no-one will ever question you. "He's already got pressure sores over his heels. If we leave him any longer he's going to start decomposing in front of our eyes."

True to form, at the back of the ward, Mr. H lifted his head and then promptly sank down into the bed, once more blending miraculously into the bedsheets. Amos, of course, won the battle and so Mr. H was due to go home tomorrow, after experiencing the numerous physiotherapeutic effects available on the ward and possibly expanding his catchment area to 12 metres. However, when we went in to check up on him this morning,we noticed he was dragging his left leg behind him a bit. No matter how hard Amos tried to explain it away, Mr. H was slowly evolving a neurological lesion.

"Right!" said Amos tightly, gripping the tendon hammer. "I guess he won't be going home after all."

You could almost hear physios popping the champagne.

Charles and I, my third SHO, had completely run out of things to do. Never have 2 patients been better cared for or INRs been so carefully monitored. Amos has seized this opportunity and we are now all thoroughly proficient in the art of Warfarinisation, after the 'I sometimes think it would be better to have random number generators dosing the patients than Junior Doctors' comment uttered by one fed-up Consultant Haematologist. We had fed and watered our hangovers and had a good hours nap in the Mess. Having failed to complete the 'Sun' crossword for the third day in succession, we were feeling slightly dejected.

"Uncle Amos, we're bored!" I said plaintively.

"Now now, there's no such thing as boredom, only things whcih have not been done yet," said Amos briskly. "Why don't you do an audit?" Amos always has an answer to everything. Which is how I came to be wedged in between the revolving shelves in the basement of the hospital, feebly crying "Heeeeeelp!" yesterday, with the fire alarm resounding in my ears. I dread to think of the casualties in Records should there ever be a real fire. I had previously wondered how it could take Records so long to track down notres, and now I was beginning to appreciate why. They all have complex cryptic clues and wierd number combinations which somehow fit together into some trivia nightmare. If I couldn't do the 'Sun' crossword, the chances of completing an Osteoporosis Audit were looking fairly slim.

So Charles and I retired to the Mess again, where we came upon Darren.

"Don't you have work to do?" I said, surprised.

"Aye," he said, not taking his eyes from the screen.

Darren is so laid back he's several degrees under horizontal. He was at it again with the ladies last night. I had made it my mission to find Darren the love of a a good woman to turn him onto the straight and narrow, and so put this proposition to him.

"Ah, when you're as good-looking as I am......" he smiled, before turning and sauntering off into the distance, probably to flirt with the cute nurse on Ward 2.

Speaking of forming alliances, since our epic journey home last night, John and I have been marginally closer. We have that indestructible bond which comes from the mutual sharing of a harrowing adventure. I was sure I caught him looking at me over the muffins at the Drug Lunch today. Luckily, the Drug Rep. had come armed with customised tissues in anticipation of the -flu season, which we have used to mop up our alcohol-related nasal hypersecretion. Paediatrics are gearing up for the annual influx of bronchiolitis patients and we're all boning up on Respiratory Pathology on the Medical Side. On the Orthopaedic ward, they're already working out how many beds they can afford to set aside for all the fractured necks of femurs which are bound to come in over the winter months. Our ward are set to send in some sputum samples from Poppy, our SHO. Purulent and green, it's a chewy specimen any chronic bronchitic would be proud of. After a particularly heavy few weeks, i decided to err on the side of caution and check out my liver biochemistry. The trouble was, how to get round it without them finding out who I was.

"Daisy, what is this!" demanded Jeff, my old Registrar, as he swept into the ward one day.

"Er, time-saving?" I ventured weakly, noting my hastily scribbled blood chits in his hand.

"Yes, well the labs don't need to know about your HEAVY, PAINFUl PERIODS," he said darkly.

"Hey, at least I don't need to go to the GP now!" I said brightly, secretly delighted to note that my MCV and GGT were slap bang normal.

It was a fairly quiet day last week when my bleep went off. My first thought was 'Oh Goody, an outside line!" as if you can dodge the odd GP wanting antibiotic advice, it's usually someone fun on the other end.

"We're looking for a Daisy Dashwood," said the voice.

"That's me!" I said cheerfully. I should have noticed the others had been unusually quiet that day. I should also have known that it only takes 2 competent doctors to section a person. Once we had cleared things up and managed to get me allowed out of the ward, I gave Charles hell. No wonder morale is low in the NHS.

You never stop learning, though. Through the hectic rat race that was my 2 patient-centred day, I had taken time out to venflon John and Mary's patients. As always, it was an elderly man with an MSQ of 1, who was thrashing around wildly. I shunted a milligram of lorazepam into him and made the decision to come back in an hour's time, by which point he was out for the count, and rasping away. A venflon moment, is ever there was one! I whipped the tourniquet out and felt for a vein. Nothing there, but there was something else. He did have a very crackly hand.

"How do you get surgical emphysema in your hand?" demanded Charles, palpating suspiciously. Even Amos was stumped. We're on the lookout for a rampant Clostridium which is menacing the ward, but it looks as though Mary had just been a little too firm with the previous venflon and injected a bit of air subcutaneously.

John's patient was a dialysis guy with a fistula in his left arm and no veins in his right arm. I walked in, to be confronted with the most clinically anaemic man I had ever seen. From my position at the doorway, i squinted, momentarily dazzled by the glare. Good God, he was almost reflective! From then on, the next hour was a grim battle to extract the requisite 10mls of blood needed for a cross match, as I butterflied him zestily. That wasn't the only time I had butterflies that day, and I recounted my tale to John.

"I learnt a good trick from one of my students," he said, taking my arm. "You tap and if there's a vein, you can feel the waves transmitted down it."

"Really?" I said casually, praying that he would keep away from my radial as it was a dead giveaway, wtih the butterflies coming hard and fast on a wave of adrenaline.

"Really." he said and our eyes locked, and I knew then that he'd felt it too. Later on that night, as I wandered off home with Mary, I wondered what was going to happen next. Living together, working together.

"But you're already co-habiting!" said Amy, a JHO in the Edinburgh Royal.

"I also cohabit with Darren," I reminded her.

"You and half the ladies in Drumnadrochit!" she giggled.

"Yeah, I said," turning my attantion back to blood results. "Me and half the ladies."

"What ladies?" saiid Darren, coming into the Doctors' Room. "I don't see no ladies."

"I object to that!" said Mary indignantly. And they were off on one again. that's one thing I love about the smaller hospitals. The cameraderie, the family atmosphere. Medical School was a distant memory and all that mattered was 3 little wards and a rehab unit. Mmm, that would make for a catchy title for a film. Or an Audit...

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