HEART BEAT Maurice Neligan: I don't think they were big into Longfellow in those past days in the Mater Hospital.
Each morning sees some task begin,
Each evening sees it close;
Something attempted, something done,
Has earned a night's repose.
- Longfellow
You might have earned the repose, but it seldom worked out that way. I had been recalling my experiences of the hospital at night in my intern days and now I learn that a study of call patterns for NCHDs (junior doctors), and an assessment of what actually happens in a big hospital at night is under way.
It was fairly simple in my day. Your range of calls went from the small, eg resiting an infusion, or getting a consent form signed, to dire emergency calling on all your meagre reserves of knowledge and experience.
There were calls for night sedation for patients who could not sleep. The rationale for this seemed to be that if that were not sleeping on the ward then you weren't going to sleep either. There were calls to deal with everything from the DTs to death and as sure as hell you didn't wander round the wards at night just for fun.
Calls sometimes came from the private hospital. This was not the impressive Mater Private of today, but rather a collection of interconnected Georgian houses adjoining the main hospital on Eccles Street.
These were not popular calls because if the interconnecting door between the hospital and the private was locked, you had to leave by the main door and make your way down the street and then bang on the door to gain admission. The weather was no better then and wet cold and miserable in the small hours, you felt as if the woes of the world were upon you.
The said woes did not stop there. Staffing at night was less than in the main hospital and everything was locked, medicine cabinets and equipment stores of all kinds. Trying to organise anything there was difficult and took an inordinate time.
One of the top corridors in the private was reputed to be haunted, as indeed was one of the staircases in the main hospital. God knows I suppose enough people perished in odd circumstances in both institutions to make this entirely plausible.
I never encountered either restless spirit despite being abroad in the witching hours often enough.
It was during this time that we became really aware that patients were essentially divided into two groups. These were called public and private and they were supposed to be different. It wasn't immediately obvious wherein the difference lay, but it existed.
It was more discernible in the female of the species. They often let you know that they clearly understood the menial place you occupied in the grand scheme of things. They were quick to complain and more demanding of service. Sometimes we interns felt that the level of hypochondriasis in this group was above average and the tolerance of minor discomfort was way below average. Any opinions you held on this interesting social phenomenon, if you were wise you kept to yourself.
There were a lot of religious in this elite group. I well remember a colleague, who although not on duty, was deputed by his boss to look after an eminent cleric who had undergone a prostatectomy that morning. This was not an operation that generally gave a lot of trouble post-operatively and our colleague was incensed at being told, not asked, to give up his time off to look after the eminent patient. He made these points eloquently to the rest of us, who having listened sympathetically, urged him to go and tell his boss what to do. The coward did not take our advice and thus preserved his career. He moped around the residence all evening, occasionally checking the entirely stable patient in the private hospital.
Eventually the lure of the bright lights of Hartigan's pub in Leeson Street grew irresistible and having briefed his cover and the nurse in charge, and leaving Hartigan's telephone number he decamped to join his fellows.
At 10.30 he was called to the phone in the noisy bar and found he was talking to his consultant. How was bishop X? He is very well sir. Pulse and blood pressure are all right? They are normal sir. Is the urinary catheter draining freely? Yes sir. There is no bleeding? No sir. At this stage a freezing blast of air emanated from the earpiece of the phone. I don't know where you are doctor Y, but I am here with the bishop and the resuscitation team. The bishop has no pulse or blood pressure, the catheter is blocked and the drip is not running. You had better present yourself forthwith. Sheer panic, pint abandoned, run to Shelbourne, taxi to Mater career in ruins. Dear Jesus what do I do? Think of an excuse. In the door of the Private run three flights of stairs, night nurse looking at him curiously. What's happening, he gasped? Nothing she said, the bishop has been stable all evening. Mr consultant rang just after you left and I gave him the number you left.
We learned at all levels and as Tacitus put it "Experientia docuit".
Nursing home problems arise, why am I not surprised? Bet you anything nobody is responsible.
Maurice Neligan is a cardiac surgeon