Bottom of the Food Chain

I don't actually practise much medicine. I'm more like a PA to the general public; organising their appointments, making sure they're in the right place and getting the right scans at the right time. I don't make cups of tea, but neither am I called upon to make fine medical judgments. I write notes dictated by other doctors, and watch enviously as nurses and physiotherapists make decisions of their own.

Even the patients are more in control of their own destinies. Ms D, a young lady with a recurrence of gallstones (despite having had her gallbladder removed with keyhole surgery several years ago) was discharged today - but only because she was determined not to miss her holiday flight, booked for tomorrow morning. We would have kept her in for another couple of days, but she took charge.

In the pecking order of the hospital, I am senior only to the nurse who keeps believing the dementia patient who promises not to pull out his feeding tube.

I'd like to think it's not any particular personal deficit that's relegated me to this algae-like status. Most of the other new doctors inhabit the same desolate plain of existence.

As instructed by our seniors, we congregate outside the Imaging department, bearing requests for expensive scans. The Radiology registrar on call listens contemptuously, and then dispenses his verdicts like Simon Cowell on acid. If you thought auditioning for X Factor was tough, try getting a same-day CT scan in your local hospital. G4 would crap their pants.

Due to some inventive changes to the rota by the Human Resources department (ensuring that noone in Brussels is upset by the number of hours I work in a week), I now have very few patients to look after. This may seem like an odd complaint, given that last week I was almost catatonically stressed by my workload. But hanging around a hospital turns out not be much fun when you're neither a patient nor gainfully employed there. It's also annoying that, of the 5 patients we do have to take care of, we're largely watching them get better by themselves.

At least in medical terms, I know exactly where I stand. There's surprisingly little ambiguity on the bottom rung of the ladder. Truly, I am the lowliest worm.

The only way is up??