Christmas without the "Christ"

I know its post-Christmas, but here's something that's too good to wait for another year.

Its was the hospital's annual Christmas Tree competition. A circular from hospital management (high up in their glass tower) detailed the criteria by which the best Christmas Tree would be selected:

1.) Religiously non-offensive Christmas Tree!

2.) Compliance with Infection Control policy

3.) Cost-effectiveness

Religiously non-offensive- Christmas is a religious festival celebrating the birth of Jesus, the "messiah" to Christians. How can you make it non-religious??!! It would be like asking Jeremy Clarkson to present "Top Gear" but without any cars in it!

Infection Control- Well, the best tree from an infection control point of view would be no tree. Since we are dispensing with a tree, why not get rid of flowers or cards by patient's bedsides, telephones, curtains or television sets?!

Cost-effectiveness?- Shows how single-track our hospital management are!

To the managers who made these ridiculous rules, thanks for the laughter! We on the wards have had our share & wish you a non-religious Christmas & a target-driven New Year!

Christmas Weekend- The Killing Season

The staff on the wards are edgy knowing that something is afoot & approaching. Its Friday, the last working day before the long Christmas weekend.

During these 4 days, everything routine will grind to a halt. No blood tests, no X-rays, no specialist consultations, no operations, no procedures, NOTHING!. The hospital enters a state of "emergency" where only urgent problems will be dealt with.

In fact, most patients in hospital, will not be seen by a doctor for 4 days unless an problem or emergency develops. They’ll lie languishing in a hospital bed, waiting to catch pneumonia, a bed sore or MRSA.

“People will die! Its like this every year” quipped a senior doctor during our special Christmas lunch in the doctor’s “mess” (staff room).

Instead, the hospital will be manned by a skeleton crew of nurses & doctors. This will is a testing time for any young doctor as they’ll be overstreched on the wards managing crisis after crisis.

I have spent the last 3 Christmases working in hospital & it has always been a harrowing & depressing time. Many relatives visiting Mum or Nan on the ward will be horrified to see their loved one in pain or ignored for days & will understandably demand to see a doctor.

“What’s going on with my Nan? She’s been crying out in agony for hours but no one has seen her!” No doubt this outburst has been partially fuelled by the guilt of a weekend of merriment & a sumptuous Christmas brunch.

The doctor will struggle to explain what’s going with Nan after all, he doesn’t know the patient & doesn’t normally care for them. He’s only covering emergencies & his pager keeps going off! The best he can do is prescribe pain killers & make a hasty retreat!

But these are the lucky patients. There will be many patients who lie in bed with no visitors or loved ones all weekend as they have always done for the past few weeks or month. These are the patients who will die if they run into problems as there will be no one to act as their minder or advocate. What about the nurses you ask? Surely they see their patients’ everyday? Let me just say that nursing care on the wards can be highly variable & I’ve seen nurses who will not call the doctor until the patient has one foot in death’s door!

So why not get extra doctors to work for a few days during this period? After all, we know that this is bound to happen at least once a year! The bottom line is money! There isn’t enough of it to hire extra doctors. Our hospital like many hospitals around the country is broke & the Department of Health (bless their cotton socks!) is treating hospitals like a private business. If there isn't enough money, tough!

So, on my last day at work yesterday, I was asked to represent the doctors & join the carollers singing Christmas songs in the hospital lobby. With my consultant playing the piano & the patients singing along to the tune of “Silent Night”, the scene was surreal. It was a scene akin to one in “Titanic” where the band continued to play & the passengers danced along as the ship was slowly sinking!

I’m off work this year! Merry Christmas!

"My father wants to go home!" announced Ms. Payne the daughter of one of our patients, Mr Payne who had come in after a heart attack.

"But its Christmas weekend & your father is actually too unwell to go home. If he were to go home so soon, he could have another heart attack", I explain.

"Well, he still wans to discharge himself".

"Right! I thought to myself, "what a right pain in the arse. At this hour, just 1 hour before I go home! "

"alRIGHT MRs Payne, I'll speak to your father."

"When? The parking meter is running & I have a schedule".

Yeah, like I have nothing better to do than pander to your beck & call, I thought to myself. Doesn't she realise that I have 30 other patients? By wasting my time in this way, I can't care for the other patients".

"I'll try to see him as soon as I can", with my best sugar-sweet smile, hiding a very sour face,


I walked up to My Payne who was at his bed, his daughter sitting next to him.
Mr Payne, your daughter tells me that you want to go home today.

"I Do?" answers Mr Payne with a bewildered expression. His daughter then nudges him, which prompts him, "oh yes, of course I do".

Mrs Payne, could I speak to your father alone please.

"I'd rather like to stay please."

"Big pain in the arse! this one!", I thought to myself, I should have just gone home early! Why, Oh! why did I stay behind to do that paperwork!

"Well I have to insist, I want to make sure that Mr Payne is making this decision out of his own free will."

Mrs Payne replied, "Well, go ahead & ask him, I will just sit here."

Ok, no more Mr nice guy, "I can't speak to him like this, please leave or I'll call security"

Mrs Payne storms off in a huff. I'm glad to be rid of this tarantula of a relative.

Mr Payne, what do you want to do?

"Huh? What do you mean?", asks Mr Payne

Do you want to go home & discharge youself then?

"Well, I'm perfectly happy to stay here!"

Fine! So what the hell was that all about? I think to myself

I say to Mr Payne, "Its a shame you're not well enough yet. I suppose your daugther is desperate to get you home so you can be with the family for Christmas."

"Hardly! I'll be alone for Christmas. My daughter is flying off to Dubai for the week. I'll be on my own!"

I feel a twinge a sadness for Mr Payne

Guess the diagnosis

A 27 year old male presents with a 4 week history of lethargy, listlessness & malaise. This is accompanied with complete anhedonia, early morning wakening.

He has a Mini Mental Acore of 6 out of 10. Other than a glazed expression,

He also complains of ternderness over the right wrist region.

What is the diagnosis.


I don't even know what day of the week it is, but I can tell you which antibody you get with cerebellar para-neoplastic syndrome. I probably have a Mental Score of 6/10.

Guess the diagnosis?

MRCP sydrome!