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The long and lonely night...

“See you, Ed. Good luck!” shouts Olsetin as he heads out of OPD. The sinking feeling in my belly drops at little lower. It is Friday. 5pm. Everyone is leaving. Except me.

I am starting my weekend on call. I started work at 7:30 this morning. I will finish at 5pm on Monday. As I look at the receding back of my colleague heading off on a Weekend Of Fun (how I hate them all right now) it seems like an eternity. That I have just finished 7 weeks of my Weekends Of Fun (a considerably longer period than in any UK rota) counts for nothing.

I turn back to the OPD cubicles. Give the colleagues credit. They have worked solidly and there are only 6 or 7 people still to be seen. I get going and see 2 chronic coughs (“query TB”), an elderly gent with arthritis, a young child with a chest infection, and a 2 day old baby whose mother was sent to the hospital by her local clinic because they thought it was “too big” (birth weight 4.3kg). Sure it looks a big baby but it takes some conversing to establish that that was the only reason the clinic sent her up. I feel terrible that the mother has spent half a day taking taxis to get here only to pay her R20 at the hospital reception and be told it was a pointless trip. I pull out my wallet and give her R20 back – less than £1.30 to me but considerably more significant to her.

The curtain of my cubicle twitches. It is the UK medical student, here on elective. “Ahh, Jenny,” I greet her.

“Actually, it’s Rachel,” she replies. I have been referring to her as Jenny to other people for several days but so far had managed to avoid using it to her face. She looks like a Jenny.

Rachel has a child with fever and neck stiffness. Never done a lumbar puncture on a kid before. I assume it is similar to an adult. We get the Mum to hold the child in a curled up shape and the LP goes fine. “Thanks Jenny,” I say.

“Rachel,” she mutters.

Next, a 16 year old stabbed in the back whilst playing football. I cannot hear any air entry on the right side of his chest. I call out the X-ray man and 10 minutes later a chest X-ray confirms the stabbing has deflated one lung slightly. I stick in a chest drain (in essence hacking a hole in his chest for the air to drain out – along with, as it turns out, a fair bit of blood that had leaked into his chest after the stabbing).

Then a flurry of children with diarrhoea, head lacerations, a lady the same age as my Mum who fell out of a tree trying to pick oranges and a drunk paramedic who tries to convince me his ankle is broken and he must have an X-ray (he only turned whilst walking along the street and it is not even tender).

The activity dies down. Rachel looks around. “I think I’m going to go now. Can I come on Sunday to help as well?”

“No problem – you’ve been brilliant. Thanks for helping J.. Rachel.” She rolls her eyes and walks away. I walk out of OPD – the patients I saw earlier are getting ready to sleep over – there is no way they can make the long journeys back home at this time. Mattresses have been laid on every piece of available floor space and people are curling up with blankets. Some nights there may be 20 or 30 people we haven’t had time to see – tonight is good. Everyone has been seen.

20 minutes later I am in my flat. It is midnight. I am about to climb into bed. Sleep seems someway off – it is hard to release the knot of nervous anticipation. I could be called at any moment...

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