Doctor On Call

Dr Frances Hale has been my educational supervisor for eighteen months and she's the only person in this building who's ever looked at me like she can see the wiring.

Consultant in acute medicine. Mid-fifties. Divorced, one daughter at Oxford, runs the medical take like air traffic control. She's the person who signs the form that says I'm safe to keep being a doctor. Once a rotation I sit in her office and lie to her about how I'm coping, and once a rotation she watches me do it and writes "satisfactory progress" anyway.

Except this time. This time the email said 6pm, her office, bring your portfolio, and underneath, in a separate line on its own:

"And Will. Come rested."

Nobody at Addenbrooke's has ever told me to come rested. Rested isn't a thing that happens here, rested is for patients.

So obviously I turn up at 6pm off the back of four long days, having slept about eleven hours across them, one of which was in my car in the multistorey.

Her office is on the second floor of the medical block. In her office there is an actual plant, alive and everything. She's at her desk with my e-portfolio open on the screen and her reading glasses on, and she doesn't look up when I knock.

'Sit down, Will.Your portfolio's a work of fiction.'

Right. Straight in, then.

'The audit's real. The teaching sessions are real.'

'The reflections.' She turns the screen towards me. My own words. *This experience taught me the importance of clear communication within the multidisciplinary team.* 'You've written four of these this year and three of them are lies. This one's about the arrest on ward 7. You ran that arrest four hours after intubating a seizing twenty-six-year-old, and what you took away from it, apparently, was clear communication within the multidisciplinary team.'

'That's what the form wants.'

'I know what the form wants. I'm asking what happened to you.'

'Nothing happened to me. The patient survived. Both patients.'

She takes her glasses off. Folds them. Puts them on the desk with a little click, and looks at me for a long time.

'You've lost half a stone since August. You had a needlestick in October you reported six hours late because you, quote, forgot. Two nurses have asked me, separately, casually, in the way people do when they're not being casual at all, whether you're alright.'

Two nurses. Brilliant. I wonder which two. I have an uncomfortably short list of candidates.

'I'm an FY2 in winter. Nobody's alright.'

'No,' she agrees. 'But most of them are falling apart in the normal ways. Crying in the sluice. Drinking too much. Applying to Australia.' She leans back. 'You've gone the other way. You've stopped feeling it. And people who stop feeling it start looking for things that are strong enough to get through. Usually that's dangerous for patients. In your case I don't think it's patients.'

The office is very quiet. Down the corridor a printer's doing something long and grudging.

'I don't know what you mean.'

'Will.' Not cross. Almost kind. Which is worse. 'I've worked in this hospital for twenty-two years. There is nothing, and I mean nothing, that moves faster than the nursing grapevine, and you are currently the most interesting man on it.'

Oh God.

'Nothing that's happened has affected patient care.'

'I know. I checked. Believe me, I checked, because the form on my desk asks me whether you're fit to progress, and I take that form seriously.' She stands. Comes round the desk and leans against the edge of it, arms folded, close enough that I have to look up at her. Her skirt is knee length, and beneath it her legs are in black nylons with a seam up the back, which I noticed when she crossed the room, because of course I noticed, because that's my entire problem in one fucking image. I think with my cock.

'Here's what I think,' she says. 'I think you're twenty-four and exhausted past the point of sense, and the only moments in your week when anybody touches you, or looks at you, or wants anything from you that isn't a jobs list, are moments that could end your career. And I think some part of you has decided that's a fair exchange. Because at least it's proof you exist.'

Nobody's ever said it out loud before. I've not even said it out loud, and I narrate my own life like an idiot most of the time.

'That's.' I stop. Try again. 'That's a bit much for an appraisal.'

'It's supervision. It's supposed to be a bit much.' She watches me. 'Am I wrong?'

'...No.'

'No,' she says softly. 'I'm not.'

She doesn't move for a while. She looks at the form on her desk instead, the one that matters, and she picks it up and reads it as if she's never seen it before. Then she puts it down, squarely, and straightens it with one finger until the edge is parallel with the desk.

'There's a correct version of this conversation,' she says. 'I refer you to occupational health. I flag concerns at ARCP. I hand your supervision to Dr Osei, because I've become too involved to be objective, and I write a careful email to the foundation programme director that follows you around for the rest of your training.' She's still looking at the form. 'I've drafted that email four times since Christmas. I've never sent it.'

'Why not?'

'Because occupational health will give you a leaflet on sleep hygiene, and Osei will sign whatever's put in front of him, and the careful email will end your career for the crime of being twenty-four and unloved in winter.' She looks up at last. 'And because I didn't want to hand you to anyone else. Which is the part I'm not proud of, and the part you should probably run from.'

I don't run. I sit in the chair she told me to sit in, because that's what I do, and she watches me not run. A decision arriving that was made weeks ago and has only now been allowed through the door.

'Two months,' she says. 'Telling myself it was none of my business.'

She reaches out and puts her hand against the side of my face.

I should move. This is my supervisor. This is the woman who signs the form.

I lean into her hand like a dog.

'That's what I thought,' she says. Almost to herself.

'Frances.' First time I've ever used it. 'This is a spectacularly bad idea.'

'Yes. You're the expert on those.' Her other hand finds the door behind me and turns the lock. 'It's my business now. Stand up.'

Obviously I stand up.

She kisses me and it's nothing like Laura's prosecco urgency or June's efficiency. She kisses me like she's got all evening and knows it.

'Sit in my chair,' she says.

'What?'

'You've spent a month being used against filing cabinets, Will. Sit in the chair.'

I sit in her chair. Big consultant's chair, worn leather, and she stands in front of me in the lamplight and unzips the dark skirt and steps out of it, and there they are. Proper stockings, seamed, suspender straps against her thighs, and above them lacy black knickers.

'Knew it,' I say, stupidly.

'Knew what?'

'The seams. When you walked across the room.'

'Twenty-two years in this place.' She hooks the knickers down and off, leaves the stockings on, and climbs into the chair over me, knees either side of my thighs. 'You think you're the only one who needs proof they exist?'

She undoes my belt without hurry. Frees me, and there's no hiding what a month of this has done to me, and she wraps her hand round me and just holds me for a moment, looking at my face, not my lap.

'Condom's in my bag. Side pocket.'

'You had this planned?'

'I'm a physician. I don't plan. I anticipate.'

I reach the bag. Manage the foil on the second go. She rolls it onto me herself, no fuss about it, then rises up on her knees, positions me, and sinks down in one long slow movement that empties every thought out of my head at once.

'Oh My God.'

'Mmm.' Her eyes have gone unfocused. 'There we are.'

She rides me slowly, eyes half closed, her hips working, her breathing going ragged by degrees, the seams of her stockings under my palms where I'm gripping her thighs. The leather creaks. The printer's still going down the corridor. Someone's overhead page floats past, not mine, nothing to do with me, nothing in the entire hospital is anything to do with me except this chair.

'Touch me,' she says, and takes my hand and puts it exactly where she wants it, and tells me the pressure, tells me the rhythm, corrects me once like she's supervising a procedure, and when I get it right her head drops forward and she says 'yes, that, don't change anything' in a voice I've never heard her use.

She comes quietly, which surprises me. A long shudder, her forehead against mine, her whole body tightening round me, gripping my wrist to keep my hand still. She stays like that through all of it. Then she starts moving again, faster now, for me, watching my face come apart.

'I'm close.'

'I know you are. Look at me.'

I look at her. That's what does it. Being looked at.

I come with her hands in my hair and my face against her neck, and it goes on longer than it has any right to, and afterwards she doesn't climb off. She just stays, holding my head against her, one hand moving slowly over the back of my scalp, and we sit like that while my heart rate comes down from something frankly pathological.

'Your hands,' she says eventually.

I look at them, flat against her thighs. Steady.

'Yeah.'

We put ourselves back together. She's a consultant again in about ninety seconds, skirt zipped, hair perfect, and she sits on the edge of the desk and picks up the form and signs it.

'Satisfactory progress,' she says, and looks at me over her glasses. 'Barely. New arrangement. Supervision's no longer once a rotation. It's weekly. My office, same time. We'll start with why you can't say no to women who outrank you, which as your supervisor I should tell you is every woman in this hospital.'

'Is that clinical governance or jealousy?'

'Yes,' she says.

I'm at the door when she adds, not looking up from her desk:

'One more thing. The chief executive's launching a leadership programme for foundation doctors. She's asked departments to nominate. I put your name in last week.'

'Why would you do that to me?'

'Because it'll look good at ARCP.' She turns a page. 'And because Diane Mercer eats junior doctors for breakfast, and I want to see what she makes of you.'

I stand in the corridor for a while after that.

The head of the entire trust.

Absolutely not. No. Under no circumstances.

I go home and iron a shirt.