Chris Ak-abuse-i

Many people frown on racism. Not the Worm's team. For at least one of our patients, racism is actually a very positive sign. As far as Mr Bradshaw is concerned, the more racist the better.

Other patients have their blood pressure and pulse monitored every 4 hours. Mr Bradshaw gets asked how he feels about immigration.

He was a devoted racist before he came into hospital. Since he was admitted, any weakening of his belief system has correlated pretty well with him getting sicker. Racist abuse is the best barometer we way have for him: any sign of a "live and let live" attitude is pretty worrying. We want to get him back to his pre-hospital best, which means aiming for some truly objectionable opinions.

It's usually the other way round - as patients get more confused, they get more abusive. Abuse of medical staff can itself be a worrying symptom. I for one was extremely worried when a small elderly woman in the canteen today threatened me with a plate of carrots and tried to eject me from the area. Most worryingly of all, bystanders were more concerned by the threat of carrot spillage than any potential bodily harm on my part.

A lot of routine abuse is aimed at the nursing staff, who bear the brunt of patients' frustration. Relatives also head their way: 2 nursing students burst into tears earlier, after being screamed at by an angry son. It was interesting to see him apologise afterwards to other patients, who he thought he might have disturbed with his outburst, but not to the two girls he'd reduced to tears.

I found some respite from this evening storm at the nurses' station by slinking off to do some small jobs. When you're covering other people's patients it's easy to see them as one-off jobs: bloods, cannula, Xray. Tonight was different - it was an absolute pleasure to have a proper conversation at normal volume with someone who wasn't racist or confused, or both. I actually paid attention to the patient I was sticking needles into, and it paid off. He was a professor of politics who talked me through the break-up of the USSR, because we both felt like being real people for a few minutes.

The doctor-patient partnership is like any other abusive relationship. There's an infectious sense of optimism when things go well. When things take a turn for the worse, both partners promise to try harder, and to watch out for the warning signs of impending conflict. I for one know to look out for the racism and the carrots.