Resus One

It's 04:12 and there's a man in majors with chest pain. The registrar is waiting for you to say what you think it is. You're the doctor. You take the history and work out what's actually worth asking. You write your own differential. You order the tests you can defend, because ordering everything isn't a plan and the registrar will say so. You decide what to give her, and when, and whether she's safe to wait. Then the consultant asks, and you have to commit. Every call moves your trust with the team. Get one right and it climbs. Get one wrong and it drops further, and it follows you from patient to patient all night rather than politely resetting each time. Run it into the ground and the consultant quietly takes the patient off you, and then a letter arrives from the clinical director. It is beautifully polite. It also ends your post. Thirty-nine patients, each one written by hand by a…