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

"If they're going to kill themselves, they might as well do it properly!" stormed Janey. "Honestly, the first thing I'm going to do when I get some spare time is churn out a draft copy of a leaflet entitled 'How to kill yourself properly'. Number One : don't take 10 paracetamol; take 100."

"And don't call 999 10 minutes after you take the overdose," chimed in Charles eagerly.

"And that one zopiclone you take along with the 200 amitryptilline," advised Janey. "Don't bother, love."

"I bet they sit there at 4 in the morning, thinking 'Now, what would the Medical SHO really like to be doing at this moment in time? Sleeping? No! I know, I'll make their day.'" yawned Gordon, once again hit by the tidal wave of ODs which he seemed to attract.

Jade, my medical student and I, spent an entire day last week trying to find the right moment to tell Gordon that his pants were on show. He must have been in a hurry and tucked them into his shirt, and was sporting at least 2 inches of bright azure cotton out the back of his chinos. Unfortunately, the ward round required him to perform several palpations, which he does with a slight spinal flexion, thus maximising the flashing potential. It was a post-take ward round as well (minus Consultant) and so we had a big team of hangers-on, including a bevvy of giggling nurses, nudging each other and pointing at Gordon's high-riding boxers.

"Couldn't you have found a more opportune moment to tell me?" demanded Gordon.

"I didn't want to say in front of the patients," I mumbled, shuffling my shoes, eyes downcast.

"'Cos it was just so much better to let the entire staff of Ward 8 see," said Gordon sarcastically.

"Alright chaps, how was your Cannulation Course?" asked Edward jovially.

The medical students had just been on an intensive 3 hour venflon induction, and were all sporting haematomas of varying sizes over their arms.

"Pretty good, pretty good," said Nick, changing swabs in a desperate attempt to stem the bleeding.

"Jolly super," said Edward. "That means you can go and put in a venflon for me."

Paddy stifled a giggle and Nick glared at him.

"What venflon do you want?" he asked. "Green?"

"Good heavens, no," fussed Edward. "I have a rule that says always use pinks unless otherwise indicated. Greens if they're needing urgent blood or their blood pressure is in their boots."

"Greys?" said Nick interestedly.

"Gosh, no," said Edward. "The only indication for putting in a grey venflon is if it's a drunk old man and you want to hurt them. They're going to self-discharge in four hours anyway, so you may as well put a grey venflon in them in the meantime."

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

I was in the middle of signing my regulation 90 billion bits of paper which go in the 'Results' section of the notes and which nobody ever looks at apart from Haematologists, when I was disturbed by a loud squawk.

"What the bloody hell do you think you're doing?" came Amos' voice, indignantly.

"I say, play fair, old boy!" protested Edward. "I was only trying to help you out."

"Don't. Ever. Grope. Me. Again." said Amos, teeth clenched.

"I was just trying to help you out," insisted Edward. "I saw all that stuff you were carting about and you looked as if you had quite a load between your legs."

"I'm USED to having loads between my legs," said Amos witheringly, before swaggering off past Jade and Sally, a secret smile playing at the corners of his lips. He was probably off to read 'Hospital Doctor'. Amos loves 'Hospital Doctor'. This is not a physician of such social standing that he is referred to as such by the rest of the hospital, but the magazine which Consultants and Registrars are sent when they achieve this status.

"You know you're somebody when they send you 'Hospital Doctor'," said Amos smugly, from behind a huge copy of said magazine.

"Thanks Daisy, I would have found this pretty tricky on my own. Hrrrrrrugh!" huffed John.

"No problem John," I smiled. "Uuuurgh!"

We were trying to lift one of our more sedated patients into an upright position, as he had a habit of slithering off the chairs and onto the floor. It was my opinion that he should not have been transferred to the chair in the first place, but the nursing staff, obviously desperate to move this man on after a month, had taken to dragging him out of bed in the morning, feet trailing on the ground, and propping him up in an easy chair, where he snored loudly and exuberantly through the afternoons, whereupon they shunted him back into bed where he snored fruitily through the night.

John had been instructed by Dr. Berkeley to bleed Mr. Thomas as his Hb was a bit on the low side and from his social history, it seemed like his platelets might also be slightly deranged. He really was very relaxed, so much so that Dr. Berkeley had felt compelled to request a CT scan of the head the previous week. Remembering his occasional bursts of 'extreme behaviour', as we liked to document it in the notes, I had hurriedly scurried to the ward, with half an hour to go until the CT and grabbed the venflon essentials. Dr. White was inclined to be a bit shirty if patients did not have the grace to remain motionless during their scans and I felt that some IV lorazepam was in order. Something told me that this man was not going to swallow.

Several nurses and more than a few bruises later, I had managed to insert a drip and threw in some benzodiazepines, praying that he wouldn't rip this one out. As I finished squeezing the last few drops out of the syringe, our one porter arrived to escort Mr. Thomas to his appointment. I breathed a sigh of relief and carried on with the rest of my day. Two days later, I received the CT report, along with a sarcastic inference from Dr. White as to the patient's restlessness during the CT scan. After that, I found myself consciously looking for radiological interventions which might be appropriate for this man, so as I could sedate him to a higher level the next time and so show Dr. White that not all my patients were purposely either manically hyper or morbidly obese. They didn't like fat people down there either. Fat disrupts the waves apparently. Whether this was in reference to the physical waves or the karma waves keeping X-Ray so sweet, I was never sure. One thing was certain, I wasn't going to be the one to ask. Especially not after I had innocently queried the difference between an Isotope Bone Scan and a Skeletal Survey and Dr. White had nearly imploded with indignation that a House Officer was not suitably acquainted with myriad of possible investigations which were on offer. I quietly turned red and tried to to blend into Amos and Mary, who protectively expanded to cover me.

Anyhow, John had been asked to Group and Save Mr. Thomas. As said gentleman was apt to suddenly extend his various limbs ("There you go!" said Amos in delight, "A perfect demonstration of the extension response to pain!"), I had gone with him to assist. In reality, I just wanted to ogle John's bottom but he didn't need to know that. We had spent a fun half hour needling, and finally ended up in his feet. 6 attempts later, we had managed to suck up enough for a cross match and so danced off the ward in glee.

John received a phone call from BTS this morning. Apparently, Mr. Thomas had a really rare blood type and they wanted another sample.

"Oh sod it," said Amos. "It's just like smokers. Man, those bastards piss me off! What they should do is hand them a stick of dynamite and then when they light up, bang! Just like in the cartoons." Sometimes I feel Amos is living in a fantasy world. One in which smoking cessation therapy works on a Totalitarian level and alcoholics remain in a special wing of their own, cut off from the medical wards.

"You could always refer them to Gordon?" suggested Charles. "'Dear Dr, it is my opinion that you should refer this chronic alcoholic chain smoker to Dr. McDonald, who would be grateful to take over his care.'".

"Yeah," said Gordon. "Would love to."

Hence John and I were stuck on the ward, heading towards our man with twenty needles to cover all eventualities. John pulled the curtain closed and we were suddenly alone in the cubicle together. Well, apart from Mr. Thomas, but he didn't really count as he was unconscious. Some nurse had thoughtfully propped him up in the chair and he was dangerously close to sliding off and hitting the floor.

"Hello Mr. Thomas," said John loudly. "You're looking a bit low in that chair."

Mr. Thomas snored on peacefully.

"Hrrrrumph!" grunted John, attempting to heave him into a more upright position.

"I'll go round the other side and try from there," I said, seizing my chance.

Unfortunately, the gap between the chair and the bedside table was a bit on the small side, and all those WRVS donuts were starting to take their toll.

"John," I said in a small voice. "I'm stuck."

He looked at me quizically, and dragged Mr. Thomas forwards.

"Thank you John," I said sheepishly, inching along the bed.

We were both crouching, one on either side of him, tourniquets at the ready. I knew I had to get blood out of his arm this time. To preserve the patient's life, obviously. And impressing John wouldn't go amiss, either.

"You're looking very pleased with yourself," said Janey when I sauntered into the Doctor's Room.

Paddy and Nick tittered.

"I go-ot blo-od, I g-ot blo-od," I sang, moonwalking backwards around the room.

"I hardly suppose the means by which you obtained this sample counts," she sniffed.

She was talking like it was a sperm sample. Yuk, what a thought.

"It was hardly a sperm sample, Janey," I said self-righteously.

"It might as well have been!" she shot back.

"I just used a needle, Janey," I said, astounded.

"Well, maybe you did, Daisy," she retorted. "All I know is that you and John were behind the curtain in an otherwise silent ward, and what I heard was not pretty!"

"Uh?" I said.

"Perhaps we can refresh your memory?" said Janey icily.

"'I can't get it up', 'Ooh, that feels nice!' and 'It's just going in now'," supplied Paddy gleefully.

"And my own personal favourite," said Janey. "'Just a little prick'."

"Poor show, John," said Darren, shaking his head sadly. "Poor show."

"Reminds me of the Royals," said Amos suddenly. "Glasgow Royal," he added hastily, as whipped round our heads. "There was this one Consultant who used to scope and one afternoon in particular, he was having trouble passing a gastroscope."

"Come on, my dear," boomed the Consultant encouragingly, rocking back and forth with the effort. "Let's see some good swallowing action."

Amos shuddered and retreated further into 'Hospital Doctor'.

"We were just taking blood!" I said, outraged on the face of it but secretly delighted that they thought we might have been up to something in there. Of course, not delighted that they thought we would go a-courting in the presence of an unconcious patient, but that we were a potential love match.

"Oh, is that what they call it these days?" asked Sally cheekily.

It was Wednesday morning and I had the mother of all spots. I suppose that to have one on the end of my nose might have been marginally worse, but honestly, on my neck? Consequently, I was covering up in a massive polo neck, despite the Indian summer we were currently enjoying.

"What are you hiding, Daisy?" enquired Mary suspiciously.

"Nothing!" I said defensively, wishing I had thought to bring more deodorant with me.

"Have you got a boyfriend?" she asked innocently.

"NO!" I said loudly, noticing John copying out blood results in front of us. "Boyfriend? Me? Goodness, no! As if?"

"Yeah, I guess," she agreed.

"What do you mean, I guess?" I asked, outraged.

She smiled enigmatically at me and minced off, probably to minister to some ailing granny or knit clothes for orphans.

"Gosh, it's hot in here," said Mary, fanning herself.

"Very funny, Mary!" I snapped from the depths of my clerking.

"No,I really do mean it Daisy," she said. "I really am extremely hot."

Nick sniggered.

"Hmph!" I sniffed and retreated to the Geris Ward, where nobody was young enough to understand the significance of polo necks in summer.

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

"It's going to be a struggle Daisy," said Darren, staggering past with 20 blood culture bottles.

"Why's that Darren?" I asked.

"Just you and me," he shrugged. "Dr. Sinclair had to drive Mary home."

"Huh?" I sat up.

"Yeah, she was feeling really, really hot earlier on," he continued, dashing off blood chits.

Oh shit.

"She managed to crawl into Amos' office and tell him though."

"Poor Mary," I gasped. "What did Amos do?"

"Told her to be quiet until he'd finished his dictation," answered Darren.

"Yes, I really do feel quite bad about that," said Amos, entering the room. "I thought it was just another House Officer jape and so I told her that she could get a couple of paracetamol from the nurses if she wanted."

"That was when she passed out," supplied Darren, looking genuinely moved.

"Mary passed out?" said Edward, sticking his head through the door and looking thoroughly alarmed.

"Oh, you two are just such an old married couple!" said one of the nurses, waddling by.

"Fiddlesticks!" muttered Edward, turning red. "I, er, must press on. Tally-ho!"

I seem to have had a lot of diabetics in through the door of late. On the wards, diabetes ceases to be just a dead cert for the MEQs, but an actual condition. All the ones in the Royal Scottish Hospital catchement area seem to be having a pretty bad run of things at the moment, going off left right and centre with a seemingly limitless catalogue of retinopathies, vasculopathies and nephropathies.

I had seized the chance to do a bit of health promotion the other day, and was arguing my case as to why smoking cessation would help one young man's diabetic prognosis.

"But it won't help me social life, Doc," he argued.

"On the contrary, it will!" I smiled aggressively. "You can get rid of a whole bunch of unpleasant side effects. Such as halitosis, heart attacks and er, early death."

He looked unimpressed.

"And impotence!" I rushed.

Aha. That had his attention.

"We could give you some kind of replacement therapy," I suggested. Toss him a line and reel him in.

"Diabetics can't use nicotine patches, Doc," he said mockingly.

"I think you'll find that they can?" I smiled sweetly. Who did he think he was? The Doctor?

"Irritates their skin, Doc," he said, leaning back.

Bugger.

"Well, we can try gum," I pressed on determinedly. "Seamus, do we stock nicotine gum?"

Seamus is our on-site pharmacist. He wears comedy ties with test tubes and pipettes on them.

"Sure, Daisy. But not today," he said, shaking his head.

"Told you," said my diabetic guy, with a self-satisfied smirk.

"Could we try to get some for tomorrow?" I asked smoothly, trying to inject a hint of danger into my voice.

"Can try," he shrugged, from behind a pile of kardexes.

From then on, I sensed a change in my diabetic friend. He took to following me around the hospital and I began to try to hide. Oh well, at least I had made contact with one of my patients. Even if it was just a rogue diabetic trailing me to safeguard against impending impotence.

*******************************
"Whaddya think?" asked John, pushing my new BNF towards me.

It had been carefully doctored so that various letters had been blacked out.

"British Anal Formulary," I read. Nice.

"Don't forget the National Arm Society," he said eagerly.

"How could I?" I smiled sweetly, gazing into his eyes.

"What's that on your socks?" asked Charles

Why had Chuck been gazing at John's legs? Not that I blamed him; they were nice legs after all.

"Edward," read Chuck. "Why do you have his name on your socks? Are you gay?"

What? Noooooooooooooooooooooooooooooooooooooooooo!!!!!!!!!!!!!!!

"I'll be off," said Edward, sidling out the door with a quick glance at Mary.

"I, er, well," said John, flustered.

"Told you," I heard one of the nurses say to the OTs. "I said he was too nice to be straight."

I looked pleadingly at Darren.

"Uh-uh Daisy," he said. "I have to keep my mind on the job. No distractions for me."

Was I about to lose John to Edward? Was I doomed to spend my life as a spinster, locked in some endless world of impotent diabetics and comatose re-bleeders? At least Mary and I could comfort each other in the loss of our not-boyfriends, I supposed.

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