Consumption of Medicine

Morning all, or should that be evening all?

This week’s blog is a little late and for that I partially apologise!

I say partially as I am on a series of night shifts at the moment. This, is what I’d like to talk to you about – albeit briefly, as at 11.15am, I really need to be asleep right now.

Night shifts as a doctor are surreal. Surreal inside the hospital, on the way home from hospital, and when you get home.

In hospital at night, it can be a antagonistic blend of pure silence and pure chaos. You see as I walk along the hospital corrdiors at night, on my way to put in another cannula, prescribe some antibioitcs or assess a patient that now has spiked a temperature on 39.5 degress (just as I have sat down to lunch at midnight), it is eerly quiet. The corridors are lit up with a neon, artificial blue light that almost makes me feel like I could be on a space-ship and all i have for company are my footsteps, and of course the occassional mellow voice of Otis Redding’s “Sitting on the Dock of the Bay” as my senior house officer calls me from A&E to say he wants me to come and see some A&E patients. As a disclaimer for the Otis Redding ring tone – 1) you need a ring tone that you’ll recognise as yours on a busy ward with phones ringing off all the time 2) patients tend to like it, and most importanlty 3) it is my favourite song of all time (big Karaoke number for me) and helps me remember that there is more to life than work when it is sheer chaos.

And…so we come to the chaos – A&E at night. I think I have spoken about A&E before – and no doubt will again next year when I spend 4 months there but it is just such a mix of nightmarish fun! Loud. VERY LOUD! Lots of bleeping, LOTS of shouting, crying, swearing, emergency calls, screams, phones ringing (including Otis) – and yet…the A&E staff are as cool as a cucumber. THAT is the part I love and aspire to – the coolness in the chaos. It is a bit like seasonsed soldiers under fire (I can only imagine and in fact am absolutely sure that a shift in A&E pales in comparison to the horrors of a battlefield). But A&E is fun and time stands still, for no matter what time of day it is, the artificial lights, tell the same story – it’s time for you to work! That said, my melatonin levels where telling me another thing at 1am. It didnt help this week that I had a great date and then terrible outcome (she retracted her offer for a second date…who does that?!) and so I was busy licking my own personal wounds.

And then, after the night shift (that for me, as a junior doctor ends about 3am) I have the 9.5 mile cycle ride home through london. The astute of you will realise that public transport at 3am in London is a little dubious and could well take me across most of london on several night buses…no thank you. So, I got out the lycra, the road bike and enough lights to show up on an orbiting satellite and off I blitzed on my road bike through london for 40mins in the dead of night…


Amazing in fact. I mean just imagine having London to yourself for 40mins. It allowed me to just gather my thoughts, process what I had done well, and not so well that night and to decompress and plan for the next day. I think I’ll make an effort to cycle more often…though I doubt it will be half as much fun in rush hour traffic….

Finally we come to sleep (something which is on my mind right now). Sleep after a night shift, for me at least, is filled with vivid dreams of patients, scans I ordered and scenarios I encountered that night. I constantly wake to think them through, not realising in my semi-sleep state that none of it matters, it’s happened, been and gone. It’s by no means a refreshing sleep but I guess you can’t do this job without giving your pound of fresh somewhere…

Time for bed.

Medicine consumes you. You become synonomous with it. As long as it doesnt swallow you up too soon, it must be mastered and controlled. Afterall, it is just a job…

See you next week.

Dr Nick


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