Flaming AugustBMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7060.824a (Published 28 September 1996) Cite this as: BMJ 1996;313:824
With our children leaving school I have taken to working through August. After two years patterns seem to be emerging. A summary may be helpful to people thinking of doing the same.
Early in August you notice that your senior house officer has moved on. Thanks to the new partial shift system a series of unfamiliar young doctors begins to appear in your clinics. Each spends a little too much time staring at you, searching for clues to your character and mood.
Suddenly self conscious, you decide to lose weight and start using the stairs. Your office on the top floor of the hospital has by now become stiflingly hot (the airconditioning does not react until September because the sensor is in the basement). Throughout August there is a film of sweat over your unseasonal pallor.
The outpatients become more and more tanned. They all reply: “No, in the back garden, actually.” Default rates are low because holiday makers have rearranged their appointments and those who are left are pleased to have something to do.
In the first half of August there is a sharp increase in emergency telephone calls. These are due not to the juniors' changeover but to people inviting you to give a lecture some time next year. You wonder why their voices sound so urgent. Then you realise they are finishing off their list of “must dos” before going on holiday. Guiltily, you remember making the same kind of calls, often from the departure lounge.
Proper emergencies occur too. “You do know you are covering today?” Er, yes. “Can you come immediately?” Of course. Any change in the on call rota usually means that you will preside over something spectacular. August provides good opportunities to discover how acute medicine has advanced since last summer. This year I spent a Saturday afternoon marvelling at the gadgetry in the magnetic resonance imaging suite: I emerged with renewed respect for the radiologist and the finance director.
For clinical academics the university's long vacation is no more than a student free fortnight. Nevertheless, up till July you nurse a hope that in the summer you will catch up on your writing if not on your thinking. In late August seasonal depression sets in as the extent of your overoptimism becomes clear.
The telephone is even more useless than usual. The nation is in the grip of ansaphones: in desperation you actually begin to talk to them. You wonder uneasily if by some statistical quirk all the doctors in England have gone to gites in the Dordogne simultaneously. When at last you find a human being you cling to each other, unwilling to hang up.
August's coup de grace is its last weekend. The hospital could almost survive a one day bank holiday but the NHS takes two days. The reason is unclear—something to do with chaos theory, perhaps. Clinics and operating lists are rearranged and woe betide Friday's admissions: their investigations will be delayed for a week. Still, by then it will be September.