Oh to sleep without the wretched bleep: Susan de Muth in bed with John MacGure

Susan de Muth
Tuesday 05 April 1994 23:02 BST
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WHEN I'm on call at night and I've been bleeped out of bed, I sometimes look out of the window as I stagger upstairs to the ward and think of all the people in the city out there, fast asleep in their beds, and I hate them so much.

One or two nights a week I sleep in the hospital, having worked all day, and am bleeped, on average, every half hour. If I get a weekend on call that can mean up to 80 hours on duty without any proper sleep - from Friday morning through to Monday afternoon.

When I first started, two-and-a- half years ago, I used to lie on top of the bed with all my clothes on and couldn't sleep at all, knowing I'd be interrupted any minute. Even at home I'd be woken up by the slightest noise and have the delusion that my bleep had gone off and start reaching for the phone. I'm a bit more used to it now.

All the worst medical dramas occur at night. When people sleep they are more vulnerable to disease processes and more likely to die. The ward looks particularly eerie, almost Gothic, in the dark when I stumble around to a soundtrack of beeping monitors. There is hardly any light except at the table where the nurses sit around drinking cups of tea.

I was 48 hours into my chosen career when I saw my first real dead body as opposed to all the pickled bits they have at medical school. It was the middle of a Sunday night and I was on call, wondering why the hell I'd become a doctor. I didn't know how to certify her dead - I had to look it up in a book. I was too tired to be emotionally affected; more interested in my return to bed than her demise. In fact I kind of envied her. Death is like a sleep you can't be bleeped out of.

The mind is dominated by entirely negative emotions during those nights on call - self-interest being the most pressing. My bedside manner can be downright rude when anger takes over, especially when a patient complains I've woken them up - 'Christ, I want to sleep as well you bastard,' I think. I always try to look really tired so they'll tell people. When I'm fresh I'm cheerful to patients and quite reassuring, which is how I'd really like to be.

Then I feel resentment, too, the vulnerable thing that lies behind anger; I'm not stupid and I could have gone off and made lots of money - that altruism has been betrayed by society. And in the depths of my misery I think how marvellous it would be if Virginia Bottomley were to be rushed to hospital and killed by an over-tired junior doctor.

Sometimes things do get to you. You witness tragedies and you realise that life is exceptionally unfair. I'm angry with myself if I connect with people, though; it is disturbing and blunts you emotionally. A few weeks ago I had no trouble telling someone her husband had died and I thought 'Why have I become so inhuman?'. You're like a machine trained to work beyond the sensible limits of endurance - both physical and emotional.

Yet in terms of relationships I'm just as easy to take for a ride as anyone else. At the moment I live alone and am happy with that. But I like to make enjoyable mistakes. Although I'm nearly always exhausted, like anyone else in their mid-

twenties I don't want to go to bed at seven o'clock with a mug of cocoa, so I try to ignore all my lost sleep and go out on most nights off.

Writing is a hobby and I did the television series in my spare time. I used to look forward to it and wrote quite a lot when I came home from the pub, before I went to bed. My friends are nearly all doctors so I'd hear good stories or have a new idea over a few drinks with them. I'd like to do some more writing but I'm not going to give up the day job yet.

I never have any trouble going off to sleep once I've hung my unfashionable clothes up in the wardrobe. I have the same sleep physiology as anyone else, complete with rapid eye movement, but do not attribute any great significance to my dreams, which are unremarkable - even when I'm on call.

When I was a teenager I spent a lot of time gazing at the moon and the stars with my telescope, which most boys of my age would have had trained on women undressing. I used to wonder what it would be like to travel through the universe, but that's something I've lost now.

I did a lot of growing up at medical college, which suppressed any poetic sensitivity I may once have had. I am very grateful for that - it would be a great embarrassment to me now.

John MacGure, 27, is a junior doctor in a Birmingham NHS hospital. He has written a television series based on his experiences, 'Cardiac Arrest', which starts on BBC 1 later this month.

(Photograph omitted)

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