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

"Why does it always seem to be us who get stuck in this bloody hospital?" I grunted, glaring at Gordon.

"I don't know Daisy," he mtttered, shoving the bed viciously with his left shoulder.

"Whoever heard of a hospital with no Porters?" I said vociferously, kicking the doorframe.

"Maybe the same one that decided to do away with the weekend phlebotomy service?" said Gordon bitterly.

Actually, in all fairnness, we do have a weekend phlebotomy service. It's just that it tends to run exclusively between the hours of 8am - 12pm and if you don't manage to make it within this window of time, well, you're basically screwed for the rest of the day. Likewise with the portering service, which is how Gordon and I came to be shunting a septic man from Ward 7 into ITU at 9pm.

Yeah, Gordon and I ended up on yet another weekend together. Don't get me wrong, Gordon and i just love working together. It's just that if we end up on the same weekend together, something always goes wrong. It's like saying the Q word. It all goes pear-shaped then.

All in all, it was a pretty traumatic weekend. 8.30am Friday morning until 8.30am Monday morning, covering the 4 teams. We had 2 nasty arrests, both of which occurred when I was carrying the cardiac arrest bleep, a rather dashy affair with the words 'Cardiac Arrest' emblazoned over it in Red Cross red and white, only partially obscured by the 'Biohazard' tape which somebody has wound around its bottom.

When you're on at a weekend, there's less cover and more scope for responsibility. But, as they say, with great responsibility comes great potential for screwing up. We split it so that Gordon covered A and E and I sashayed aroubnd the hospital, like some kind of stressed-out Florence Nightingale, ministering to the sick and the nurses in equal parts.

"Daisy," said Dr. Sinclair, the consultant on call. Dr. Sinclair is about 5 foot nought and looks like Kylie. "Daisy, can we get a couple of CT heads on these men please?"

My blood ran cold. If she had said, "Daisy, please cut off your own arms and feed them to Edward," I would have been marginally less terrified. This request would most definitely necessitate a trip to Radiology. Feared by medical students and House Officers the land over, Radiology Departments all over Sotland have long enjoyed a malicious sense of power over the Junior Doctors. I remember one communications skills scenario they made us do in Medical School, where we had to pretend to be the duty JHO on nights, attempting to rouse the on call Radiographer. Not one of us managed to get through it courteously without the conversation escalating into an all-out slagging match. There's just something about Radiographers that seems to stir House Officers' blood.

We have 2 Radiologists, Dr. White and Dr. Neil. By the end of day 1 we had all quickly learned that no radiology chit would be accepted unless it had A) correct patient details, B) a full patient address C) a valid GP and D) a fantastic story, as recounted by the House Officer.

"2 CT heads?" hissed Dr. Neil down the phone. It was a Saturday afternoon and he was probably gearing himself up for a game of golf or a picnic in the park, or whatever off-duty Radiologists do on their weekends off. Actually, given the preferred occupation of the majority of the population in this part of the world, he was probably still recovering in bed.

"Er, yes, that's right, Dr. Neil!" I said brightly. "Dr. Sinclair would like you to have a look at these 2 patients please?"

"Oh she would, would she?" I could almost hear him challenging me down the phone.

"Why?" he barked.

"Um, patient one is a man who was on the Orthopaedic Ward and has subsequently developed a left sided weakness and an expressive dysphasia."

"Bloody surgeons," growled Dr. Neil.

"Er, yes," I said, not sure whether to agree or not. "Patient 2 is a man with carcinoma of the lung who has become a bit confused and headachey lately."

"And has Dr. Sinclair authorised this?" he asked menacingly.

"Well, no actually," I felt like saying. "I just really like the adrenaline rush I get from hauling you out of bed on a Saturday and playing cat and mouse down the phone."

"Yes," I said meekly.

"I'll do them this afternoon," he said grudgingly, and rang off.

Radiology requests are scary stuff, which is why we tend to save them up, hoarding them for the weekly X-Ray meeting on a Tuesday lunchtime. Then we can go as a team and have more chance of deflecting the rapid-fire questions deftly put to us by the Radiologists, who work as a sadistic team behind the X-Ray monitor.

"Is it indicated?" demanded Dr. White, from his chair. It was a Monday morning and I was standing in his office with a request for a CT chest.

"Um, Dr. Sinclair would like one," I whispered.

"Is it indicated?" he demanded.

"Er, well, I suppose it would help show us her progression," I fumbled.

"How much change do you think there will be since the last one in July?" he asked, getting into his stride. He knew he was going to win now and so was in full flow. Damn, I wished I knew the patient better.

"We could better assess the cause for her pleural effusion?" I said defiantly. Might as well be hanged for a sheep as for a lamb. Which is why I ended up swinging from the metaphorical gallows, as I was sent packing to write out a chest-X-Ray chit instead.

The first man was almost completely devoid of speech and so we were nestled together over a pen and paper, trying to communicate by the medium of writing. So far, we were not having much success.
He picked up the pen and gave it another shot.

"Will..........my...........sheep.........crack............back?" he wrote and looked up at me.

Well, there was a question.

"Is that what you wanted to say?" I asked gently. He thought for a moment and then scored out the sentence.

"Will.........my......sheep..........come......back?" looking at me plaintively, like some kind of bearded Bo Peep.

"Do you have pet sheep?" I enquired synpathetically. "Have they run away?"

He rolled his eyes manically and pointed at his mouth.

Oh horror! What an awful situation to be faced with.

"Are you worried someone might have eaten them?" I asked, shocked. He pointed more insistently at his mouth and at the paper.

"Will.........my..........sheep..........come......back?"

"Sheep.....oh, speech! Will your speech come back?"

What a question. How do you tell a previously well 40 year old that he might be severely dysphasic, if not aphasic, for the rest of his life. As it was the weekend and there was no-one else around (well, unless you counted Gordon and his seven overdoses in A and E) I was going to have to do it as we couldn't leave the poor man waiting 2 days.

"You've had a stroke," I said, drawing it out on paper so he could see. "Sometimes, part of the arteries that go to bits of the brain get blocked and we can't get anough oxygen to them and so that bit of the brain dies."

He picked up the pen again.

"Will..........I......drive?"

"Well, you're pretty weak just now," I said. "But there's bound to be a lot of inflammation and some fluid pressing on your brain just now. We'll be able to make a more accurate assessment of your prognosis in a couple of days time when the swelling goes down. But not for now, no."

"Is.....it......cancer?"

"No, God, no," I said quickly. At least that was one thing I could set his mind straight on. "No, it's not cancer so it won't spread. If you're worried that it might happen again, then yes, there is a risk of that. But we know that you've had this stroke and now we can put you on some drugs to try to stop it happening again."

"Is........there..........a...........cure?"

If only there was, I thought sadly, as I sellotaped our 'conversation' into his notes. I looked at him, staring fixedly ahead. What must he be thinking? His whole life must seem to be over. I found it heard to comprehend what it must be like to potentially lose your job, your social life and your communication all in one fell swoop.

Yet another SHO changeover has occurred and Team Sinclair now consists of myself and Angie, who works part-time and has 2 children under 3. Consequently, childcare is a bit of a problem and Angie spends much of her time trying to enveigle potential cildminders to mind her offspring for tempting sums of money. I had had a rather traumatic mortuary experience that day and was still a bit shaky - lets' just say that I'm going to learn to thoroughly work out how to use the machinery in there for next time - which prompted Angie to recollect her own days as a House Officer.

"I'd been a JHO for a few weeks when I was called to certify a patient," she said, absently staring into space. I remembered all too well the first certification I'd done and felt an instant wave of sympathy. "Of course, back in those days,k they didn't have body bags; they used to shroud the patients instead."

Angie's 2 offspring and the way that childcare plans work these days mean that she has been an SHO since before I was a medical student.

"I carefully unwrapped her shroud," she continued, "being ever so careful, 'cos you're really respectful to the dead at that point. She was still warm, bless her soul, and I began to listen for her heart sounds."

Here, she paused dramatically.

"Boom boom, boom boom. Heart sounds."

Heavens above!

Angie lowered her voice and gazed intensely into my eyes.

"The lady was still alive!" she hissed.

"No!" I said incredulously.

"Damn right she was," said Angie, emphatically. "So I said to her, 'Mrs. T, how are you feeling?'"

"Oh, awfully nice and warm, dearie," she replied.

"Ddn't you think that the nurses had wrapped you up a bit tightly there?" said Angie, not sure whether to laugh or to cry.

"Oh, they're ever so nice, dearie," said the old lady, graciously. "They attend to your every need."

"But didn't you think it was a bit strange that they had the sheet over your face?" said Angie, by now seriously worried as to the mental state of the nurses.

"Oh no, dearie," said the old dear. "They were just tucking me in."

Angie walked over to the Nurses' Station.

"That lady," she said, pointing at the corpse in question. "She's not dead."

"Sure she is," said one of the nurses, peering over the obligatory Nurses' Station Quality Street.

"She most certainly is not!" said Angie indignantly. "I suggest you take a look for yourselves and then see if you think she's still dead."

So they did. The lady in question, free from the constraints of the shroud, continued to reperfuse and pinked up nicely, while beside her, propped up against her pillows, was another old lady, dead as a doornail.

"And they wonder why the NHS gets so much bad press?" said Angie, mopping her brow.

The Medical Family is going from stength to strength and I'm beginning to forget what my real father looks like. We all try to go down to the canteen together and sometimes, the Consultants even join us.

"Uuuuurgh," groaned John.

"You," Darren informed him, "look like shit."

"Yeah!" chimed in Sally, our Medical Student. "Was it 3 words you said on the Ward Round today? Yes, yes and yes!"

"I don't think I've eevr checked as many blood results," moaned John, looking a deathly grey. "Any excuse to sit down."

That's the thing about being a proper Doctor. You can't slope off home when you have a hangover.

"Poor John," I said demurely. "You must be feeling awful. I really feel for you," whilt battling the waves of nausea which came from one too many glasses of Chardonnay. At my end of the table, I was fighting a losing battle with one of the industrial-strength oranges which they keep in stock.

"Here," said Amos, reaching over. "Let your Uncle peel it for you."

"Thank-you Uncle Amos," I said gratefully, handing over the offending piece of fruit.

Amos has saved my bacon more times than I care to remember whilst I've been here. I've got kind of used to having him around. After leaving Cardiology and Dr. Park, I'd moved onto Dr. Sinclair, who didn't have as much input from Amos. And after Dr. Park went on annual leave for a fortnight, this left Amos with very little to do apart from intensively rehabilitate his 2 patients and mooch around, kicking tin cans off the walls.

"Do ya miss me?" I asked, bouncing up to him on one particularly quiet morning.

"Well," he said, with his head on one side, evidently weighing up the question. "I don't really have any reason to miss you, Daisy."

"I'm sure he means clinically, Daisy," said Edward kindly.

"No," said Amos evenly. "I meant I really don't miss her." However, the Sun horoscope had predicted that he would be feeling a bit down and as my star sign advised me to 'talk to R' I worked on a bit of PRHO-Registrar bonding.

God, I wished I'd had Amos that weekend.

"D you know how long we've been waiting?" screeched the old lady, eyes wide and nostrils flaring.

"Why don't you tell me?" I said, from my corner on the Orthopaedic Ward where the entire family had me hemmed in.

"2 hours!" she yelled. "2 hours! Do you know how disturbing that is for the menfolk?"

Menfolk? Who says that these days?

"I'm terribly sorry," I said to the lady in question, taking care to keep my voice level. "But I had to go to a cardiac arrest and I've been kept really busy down there."

"Still, 2 hours!" she hissed, her face in mine. "It's a disgrace."

"Well, I'm here to tell you that you can go home now," I said cheerfully. That ought to make her happy.

"I'm not finished yet!" she said forcefully. "You kept Mavis waiting too!"

As if on cue, Mavis looked up from the neighbouring bay.

"Mavis and I are neighbours," announced the first lady.

Dear God, I thought wildly, looking around, my eyes settling suspiciously on the woman opposite them, who resisted my gaze. Might she turn out to be the Milkman?

"I'm ever so sorry I took so long......." I began, before being swiftly cut off.

"In all my experience........" she spat, "I was a nurse for 30 years and....." Aha. That explained it.

"Ex -nurses are fucked up!" said Gordon viciously, as we staggered, broken, by yet another ear-bashing from an ex-nurse relative.

"Ah, the worst ones are the ex-Oncology nurses," said Amos. "They all want to palliate their relatives, even if they're not at the palliative stage."

Amos and I will be standing in the middle of the ward when an incensed relative will suddently pop up from the middle distance and demand to know why such a decision has been taken on their relative. I wait for it, and when they utter those magical words, "When I was a nurse!" I can see the light of understanding come on in Amos' eyes.

When you get past all the little things, though, Medicine is an extremely rewarding career. I was looking for a decanted patient of mine, in the hope that he might have been merely misplaced on the surgical ward when I heard a deep voice behind me.

"You won't find any of yours here. They're out on the balcony."

I turned round in surprise and beheld my forty-something stroke gentleman.

"Your speech!" I said, amazed. "It's so much better!"

"I know," he said, still slightly hesitantly. "I can read the paper as well now."

"But that's great!" I said, casting around for something. "Here, can you read this headline for me?"

"Britney performs sexy stage strip to fans delight," he read.

"And what a girl she is!" I said cheerfully. Damn the Sun. "That's fantastic!"

"I can walk about too," he said. "They say that in time I will be able to drive again."

I saw him with his partner later that day. They didn't see me, but as I watched them together, heads bent over some photographs (of the sheep?) I knew that something good would have come out of the episode.

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