Its 5.00 am.

The metallic trill of your mobile phone wakes you, sounding like clanging dustbin lids. You never sleep well when you are on call; the subliminal anxiety of awaiting a call constantly nibbles away, never letting you relax properly. The department is overloaded with patients. The 4 hour target is the stuff of legend. The staff need your help. Perversely, it’s almost a relief to get called in; the unbearable lightness of being available is answered.

Feeling guilty to take a shower, you grab something to drink and drive in. The roads are quiet, but then it is Sunday morning. As you walk into the hospital you can see the waiting room is very crowded. The smiles from your medical, nursing and clerical colleagues reflect their relief that a member of the cavalry has arrived. You exchange greetings and ask a few pertinent questions about the volume and acuity of the night’s work. There are no surprises. You go to your office, grab a pen and your stethoscope metaphorically if not physically roll up your sleeves, take a big sigh and you’re off. You work steadily after an initial blitz; deal with some …