The Fishwhacker Swindle?

Perhaps I’ve given the impression in previous posts that everybody who works in a hospital is a backbiting snake. This is not the case, as the following heartwarming tale shows. Unlike most of the shit I write on this site, this story is completely true.

In my second six months as a house officer I worked on a medical, as opposed to surgical, unit. Our stock-in-trade was diseased lungs, guts and limbs for the most part, with other organs like the brain and the kidneys going to the specialist disciplines of neurology and nephrology. One night I was on ward call. These vicious exercises in sadism consisted of carrying the bleep for 16 hours between five p.m. and nine a.m. and responding to any calls, emergency or otherwise, from the inpatient wards, as opposed to casualty. During this time you were the sole doctor responsible for the care of some five hundred patients. You were lucky to get two hours’ sleep, and broken at that. Furthermore, there was a full eight-hour working day on either side of this stretch. These young doctors nowadays don’t know how easy they have it, etc., etc.

Anyway, a couple of hours after my ward call started I went to the canteen to have dinner with a fellow house officer who was on call for casualty. We shuffled in line like Soviet factory workers and watched the local swill being slung into our bowls. It was the early 1990s and we used to call the stuff Dan Quayle stew because it was thick as pigshit. At the till I insisted on paying for us both. Chris, my dining companion, looked at me sharply.

‘What do you want?’ he asked.

We sat down, I grievously insulted by his suspiciousness, he still battling a hangover at seven in the evening. He looked as if he was recovering from an autopsy.

I tried making small talk but he asked again what I wanted so I asked him if he could swap shifts with me in a couple of weeks’ time as I wanted to go on holiday but he said no and I asked again and he still said no and I tried to bribe him and then threatened him.

He put his fingers in his ears and said, ‘La la la, not listening.’

As the surgeon said when he accidentally severed a major artery, aorta known better.

So I was in a foul mood when my bleep went off and I stormed out of the canteen. The extension number of one of the gastrointestinal wards came up on the screen of the bleep and I didn’t bother to ring them, just headed straight over. I was greeted at the entrance to the ward by the sister in charge who told me that I had been summoned to certify a patient as dead.

‘Liver?’ I asked. The hospital didn’t have a separate liver unit and most patients with hepatic failure were on the more general GI wards. They were the patients who tended to die on these wards, as the liver doesn’t repair itself very well. She nodded.

I checked that my pencil torch was working (for observing the patient’s pupils) and filled a large syringe with water (for squirting in his ears to test for a reaction), then wandered over. I paused at the patient’s bedside for a moment, then went back to check the bed number with the sister again, then returned to the patient.

He was a young man with a wasted physique and an abdomen swollen from the fluid that accumulates in chronic liver failure. His eyes were the dead yellow of jaundice. And the moans coming from his throat were those of a slowly dying man.

Yes, dying.

I went back to the nurses’ station. ‘Sister,’ I said, ‘he’s still alive.’

‘I know, but he’ll probably die tonight, so we thought we’d call you to certify him now to avoid having to wake you up later.’

The patient passed over some time in the early hours of the morning, and I came and certified him dead at about four a.m. I like to think that his final hours were made more comfortable by the peachy glow engendered on the ward by such a display of altruism, and that he greeted St Peter with a smile on his jaundiced lips.