The Bow-tied Radiologist

There are frost crystals on the grass this morning, making the lawn crunchy underfoot, and the water in the can has frozen lumpy around floating leaves. The bikes waiting to be serviced and given away look arthritic with rust. My toes are telling me I shouldn't have come out in my socks. But as I turn, there between the bare branches is the first warming ray of the sun, and I remember the bow-tied radiologist.

January morning - my photo

Every House Officer would rather not need anything from a radiologist. 

When your consultant orders a special test, one that is complex, new or expensive enough to require the time of a radiology specialist, the boss doesn't usually stop to explain why. You're the fourth or fifth white coat in the line, struggling to hear what they're saying from where they are, over there at the head of the bed, and they're nonchalantly flicking the frisbee of, say, an ERCP or a transcranial doppler that you can still barely translate into English and you're standing there still hoping someone else will catch the job when, 'Dr. Dormouse!' it hits you in the solar plexus on its way down.

Later in the day, having done all the other ward work just to delay the moment, you are dragging yourself down the long functional corridors to the radiology department, rehearsing your reasons. Trying to get them terse and spare and absolutely unassailable. 

Every other time you've had to ask for a special test it's gone like this:

'Good morning Dr. Bur...'

'What?' Still standing with his back to me, he's a gaunt man in a white coat that's too wide for him, staring at the jumble of little bones on the wrist Xray on the wall. 

'Mr Fotherington asked me to order an ERCP for this patient.' I'm so worried about his reaction, it's coming out in a mumble. My fear is that not only am I incompetent to do this, he's already annoyed enough to tell me so. 

He whisks around and pounces, a hungry hawk on a mouse. His skin is pale and dry as if he never leaves the dull neon of the hospital lighting. 'Why?'

'Er, right upper quadrant pain radiating to the back, weight loss, jaundice...'

'Stones? Bowels?' 

'There weren't any stones visible on the...' He looks away, shakes his head despairingly and doesn't deign to look at me again. 'I don't have time for this. Give it to me now, but I won't be so understanding next time.' 

He grabs the form from my trembling hand, scans it and shoves it back at my chin. 'And never ever bring me an incomplete form again.'

As I scribble the patient's age next to her date of birth he has his back to me again, removing the backlit X-ray from the box.

'Dr. Bu...'

'What now?'

'The form?' Sigh.

It was obvious that as a group, hospital Radiologists feel unfairly overworked and undervalued and to them it seems within the rules to kick the House Dog who is bringing tyet more work. I knew the temptation, when a student nurse woke me from sleep for the third time in an hour to give me a job that could wait till morning. And I can't pretend I never did any kicking myself.

But today is a good day because when I open the door to the reviewing room it's Dr. Smart rising from the desk to greet me. 

Dr. Smart has a neat blond beard and his cheeks and blue eyes always look as if he's just been for a bracing walk. He wears a lively bow tie and pastel shirt under a white coat that looks freshly ironed and could have been tailored for him. When he sees you're there in the radiology department he greets you like a friend.

'Ah, lovely to see a bushy-tailed young doctor this morning, what can I do for you?'

'Hello Dr. Smart.' It was no chore to smile back. 'Mr Fotherington asked me to order an ERCP for this patient.'

'All right, why don't you tell me what he was thinking? At least as far as you can tell from the end of the procession! Now, was it ERCP or ERPC?' 

He is a blessed interloper in an underlit purgatory of a department. How much better would my life be, and the lives of anyone near them, if all doctors were so kind?

This was still in the days when there was a doctors' mess, when there were dinner ladies behind a barrier of boiled cabbage and custard in a private room somewhere on the first floor. Those days passed away into history before I even left that job, a throwback to the nineteen fifties when the needs of the doctors were still seen as the responsibility of their employer. 

The nurses knew that the junior doctors were NOT TO BE DISTURBED for the whole hour between twelve and one so we could eat and do the Telegraph crossword together. It was a gift in a life where there was no other privacy from the bleep, even through the night, unless you dropped it in the loo. Which, not surprisingly, happened to someone on average once a fortnight, accidentally or otherwise. 

So the doctor's mess was the place for relaxation and, since it was only us there, gossip. One day, wanting to escape a circular general moan about Radiology, I talked of my relief in finding Dr Smart taking requests that morning. 

'Yeah, I always try to get him.' In every hospital there's always one floppy young doctor who knows everyone. 'It's easy for Charlie Smart, he's married to some heiress and doesn't have to work at all. Does it for the fun of it.'

But privately I reckoned it couldn't be that much fun. And that he most likely got the heiress because of his attitude, not the other way around. If you could choose to marry anyone in the world, you would choose the one who made you feel welcome. Who when you didn't know how to do something would take the time to educate you and appreciate you just for existing. Who intended to be kind and would never, or at least try to never, lay their dissatisfactions at your door.

I gulped down the last of my sixth coffee of the day, anticipating the volley of bleeps any moment, and marched myself back to the ward.

At two the next morning, my pager went after only twenty minutes sleep. I had my usual panic response to being woken by a pager, shook my head to wake it and jabbed the extension number into the bedside phone. 

'Dr Dormouse, somebody paged me?'

'Yes doctor, those drug charts are still waiting to be updated.' She had the singsong voice of a girl mimicking her mother telling her that her bed was still unmade. 

I could feel the scream erupting from my stomach, the why can't you let me sleep just one hour, just one undisturbed bloody hour. Are you trying to drive me mad? I took a deep breath. 

And as I let it slowly out the thought came: How much better would my life be, and the lives of those near me, if I decided to be the warmth on a frosty day? 

'Doctor are you there?'

'Is that Alison?' A big lungful of air to banish the resentment. 'Hi Ali, so you got dumped with the job of reminding me?'

'So you'll come and do it now?' No you selfish idiot I have to sleep sometime. Breathe.

'I won't do it now, but when you do handover at 7 you can tell the day shift I'll get the charts done before the first drug round. I'll be there anyway for Mr. Murray's ward round so I promise I will do it in time.'

'Oh!' There was a pause while she worked it out. 'You're working tonight's shift AND the day shift tomorrow?'

'Yes, and in fact I did all day yesterday.'

Another pause. 'You don't do shifts?'

She was too inexperienced to have known she was disturbing my sleep. Perhaps never had a real conversation with a doctor before. Not selfish, not inconsiderate, not stupid, just in the dark like the rest of us. And forgiving an innocent is as easy as breathing out.

'If only!' 

'Wow, I thought shifts was bad enough.' 

'Yeah, shifts is bad enough.' 

We colluded in a laugh, and I fell back into bed, hopeful that one nurse at least would think twice before calling me at night. Thinking as I fell into sleep how bringing the warmth doesn't just defrost the other people in the room.