Irecently enjoyed a dinner with a group of junior doctors, and as always it was not long before the conversation turned to medicine. Of course, it was not an academic discussion of the latest advances in surgical procedures, nor the swapping of vignettes from recent journal articles, but the more common subjects of medical disasters, hospital mayhem, and job dissatisfaction, with the usual smatterings of blood, guts, and excrement thrown in.

These are the usual themes of the junior doctors' dinner conversation. Small, harmless stories are told first, but it proceeds in snowball fashion gathering momentum in a spiral of oneupmanship. Who has the worst rota? Who is working for the least supportive, slave driving consultant? Who has the goriest story of trauma and disaster to tell? A young senior house officer tells the story of an 18 year old who threw himself in front of a train and is brought to the accident and emergency department in two ambulances. But this is immediately surpassed by the …