Fear. Cold hearted, steel gripping fear. That’s what I felt as I crossed the road towards work on my way to my first ever night shift. I was now a month and a half into my first job and I was starting to get the hang of it. I was basically a glorified secretary spending my time filling out paperwork and making appointments. I was given an order by a senior doctor and I carried out the task. Simple, it didn’t take a medical degree to do most of what I had to do. The few times I got to give my brain a work out were my weekly long day shifts. On these days, after 5pm I would cover all the medical wards until 9pm dealing with any urgent problems that came up and couldn’t wait. It was here that I was given the chance to practice medicine, interpreting blood results and examination findings, talking to patients and relatives and working with the nursing staff to keep things running smoothly. For some reason, going home at 9pm meant that those shifts didn’t seem so bad. It was only four hours and even I could hold things together for four hours. Nights were another story. It suddenly went from holding things together for four hours to doing it for twelve hours while the rest of the city slept. That was a daunting challenge. I knew what I felt like if ever I had to be awake in the early hours of the morning and it wasn’t a pretty sight. I was terrified that this would be when everyone would see me for the impostor I really was. I wasn’t good enough to be a doctor, by some miracle I had completed my course and got the degree but I couldn’t cope with twelve hours of making life and death decisions, I was much better with the paper work.
I had already heard the horror stories from my friends of the constant bleeps, numerous new admissions and lack of senior support that made up a night shift and these stories just added to my anxieties. So, the facts? I was to cover ten wards, all with approximately twenty five beds and the Medical Admissions Unit of twenty beds. If any of the wards had any problems, new admissions or emergencies, I would be the first point of contact for them and on top of that, I was also a part of the dreaded crash team. How hard could it be? How many things can go wrong in just twelve hours, and shouldn’t everyone be asleep anyway?
The day doctor looked on the verge of tears. He handed over five new admissions waiting to be seen, two sets of bloods awaiting review and an elderly man who hadn’t passed urine in the last two days, had a bladder the size of a football and would require a catheter to drain this. He also warned me of an outbreak of vomiting on one of the elderly wards and advised that if at all possible, I should avoid that ward and try to put off any problems until their own staff arrived at 9am. Just the way you wanted to start a Friday night? No, not me, you have the wrong man, I wanted to be down the pub, on my third pint with a pizza or maybe a kebab waiting for me at the end of the night. With my heart sinking into my shoes, I set off towards the nearest ward that needed my help. It was then that it started - the bleeping. The constant, high pitched, incessant bleeping noise that would invade my dreams and turn each sleep for the next week into a nightmare. Anyone who has been a junior doctor will know just how painful the constant sound is and what it can do to your sanity. Friday night had turned the wards into chaos and suddenly, everyone needed me at once but I couldn’t go anywhere or do anything because I was stuck at the desk in the doctors’ mess attached to a phone, answering my never silent bleep. The list of jobs grew by the second and all I could do was try and reassure the nurse at the other end that I would be there as soon as possible and yes, that noise was my bleep going off again so I better go.
My list now included;
1. A 33 year old man with chest pain wanting to self discharge as we wouldn’t allow him out to the pub for an hour
2. A 79 year old delirious woman who had tried to get into the wrong bed, realised there was someone already in the bed and thrown herself to the floor in fright and now couldn’t move her left leg
3. A 55 year old man who had started vomiting on a ward without the vomiting outbreak
4. An IV drug user who appeared to be now withdrawing from alcohol as well as heroin and needed detoxing
The list went on and on and on…
I don’t know how many of you have been to a hospital in the middle of the night but my view is that a hospital at night is very different to one during the day. The corridor lights were set to dim and the wards themselves were cast in darkness with just a glow being emitted from the nursing station. The thing that I hated the most at first was the silence. It was unnatural, these rooms and halls should never be so quiet but as you race to an emergency at 3am, all you hear is your own heart beating. By the end of the first nightshift however I had grown to love the silence and found it a welcome break as I walked from one job to the next.
The old part of the hospital I worked in was rumoured to be haunted and these storied hardly surprised me. I have already mentioned the gothic architecture of the ward I’m based on, well the entire wing of the hospital looks the same. The main entrance hall of the wing is dominated by a sweeping stone staircase overlooked by a stern statue of the hospital’s founder. Great arched windows flank each side of the stair case casting the corners of the room in shadows and creating shapes out of nothingness. Many of the wards have high ceiling which cause an echo as you walk down them at night that would not be out of place on a sound effect CD for a horror film. I had been rewriting several drug charts on one of these wards and as a thank you, one of the nurses had made me a cup of coffee. I sat at the ward desk with the two night nurses drinking my coffee, hoping it would give me the motivation to walk to the far side of the hospital to see an old lady with recent onset diarrhoea. The nurses decided that this was the perfect time to fill me, the ‘new recruit’, in on the ghostly goings on that they had witnessed in their time on the wards at night. They spoke about hearing a crying baby in a room a new mother took her own life in, about feeling a hand on their shoulder whenever taking vital signs from a patient who is about to die, even of a patient being admitted who vanished into thin air once they got into bed! They told me the stories with such conviction I was completely drawn in to them. How was I to know they were having a laugh with me?!
Later that night, as I was walking down one of these old corridors, my mind started to go into over drive. The main lights were all switched off leaving just the occasional side light to illuminate my path and they left large parts of my route in complete darkness. The pipes above my head had started to rattle and the vacuum tubes that were used to transport bloods to the lab started to grown, normal noises in an old hospital but with my head filled with ghosts and ghouls, I could feel my heart rate increasing and let me tell you, as the clock reaches 4.30am and you’ve had only 10 minutes to yourself since you started at 9pm the night before, there is no logic left in your head! I felt myself walking quicker, pushed on by the tricks my exhausted brain had started playing on me. It was at that point I started to hear footsteps behind me. Now I realise looking back on this I was acting like I was some kind of extra in a bad horror film but this was not what I was thinking at the time. I decided to break out in a light jog, aiming for the far end of the corridor which would open out into the nice new state of the art, modern wing of the hospital. It was then that my bleep decided to go off. The noise was so sudden and so piercing as it echoed through the darkness that I jumped about a foot in the air, landed in a pile of clean bed linen sending it all crashing to the floor and shouted out “Fuck!” This was met with a roar of laughter as the source of the footsteps behind me ran over to check if I was alright. It was the nurse who had fed my head with ghost storied earlier that night. She was on her way back from the canteen with several rounds of toast and was not in fact a serial killer preying on junior doctors lost in the darkness of the old hospital. She found the sight of me sitting in a heap of bed sheets so funny that she dropped her toast. After helping me to my feet she finally stopped laughing and asked me if her horror stories had made me paranoid. She clearly decided that my denial was a lie and promised to make it up to me the next night be ordering a pizza and letting me share it. She told me it was a Saturday night ritual for her if ever she was on nights and told me that I was always welcome to join in. Feeling more embarrassed than I ever thought possible, I thanked her, told her I loved the sound of pizza and then ran off to answer my bleep.
“Doctor, I’m sorry to bother you but you have to come straight away. That patient you saw who was withdrawing from alcohol, well he’s picked up one of the nurses and he won’t put her down…”
I made my way over to the ward that had called me. The whole way there all I could think was how stupid it was that medical school had never prepared me for a patient refusing to put down a member of staff. What the hell was I going to do about it? Surely it would have made more sense for the ward to call security? When I got there I was confronted by the withdrawing patient not only holding the poor Filipino nurse over his shoulder but also standing on a rather insecure looking chair and occasionally letting out a small scream. The healthcare assistant came over to me with a look of sheer panic on her face. She informed me that the patient woke up screaming about spiders and when the nurse went over to check on him, he had grabbed her and made his way to higher ground. The nurse did not look happy. Fair enough, the patient hadn’t taken a bath in weeks and the smell of the street living mixed in with stale alcohol was enough to make me feel nauseous at a comfortable distance so I could only imagine what it was like for her being so up close and personal with him.
“Hello sir, I’m the on call doctor tonight, I need to ask you to come down off the chair and let go of our nurse.”
“Can’t do that.”
“Why can’t you do that?”
“The spiders will get us, can’t you see them? They’re all over the floor, they might be dangerous.”
“I can’t see any spiders sir. I think you’re not feeling very well because of not having a drink today. If you come down, we can get you some medication to help with that.”
It took ten minutes and a visit from security to talk him down. He let go of the nurse and was given enough sedatives to drop a charging rhino. I went over to ask the nurse if she was okay and offer my assistance in anything that she needed but within minutes my bleep was going off again summoning me to the far side of the hospital.
“Doctor one of our ladies is having trouble going to the toilet, she’s in quite a lot of pain.”
“I’ll be there as soon as I can.”