Maybe Susan has put me through to the consultant, not the registrar. Maybe there’s been a mistake and this person isn’t even on call. Maybe this is a complete misdial, and this person isn’t even a doctor but a complete random whom I’ve woken up in the early hours of the morning.

‘Sorry, are you the ENT registrar on call?’ I ask.

‘Yes,’ the voice says flatly.

‘Oh, right.’ I’m relieved. ‘Look, I know it’s a bad time to call, I’m really sorry, but it’s kind of a touchy situation. This thirty-seven-year-old guy has come in with sudden onset hearing loss in his left …’

‘You’re calling me at one in the morning about hearing loss?’ the voice interrupts me, dripping with disgust. ‘What kind of idiot are you?’

‘It’s sensorineural deafness!’

‘Give him some fucking steroids!’

‘How much?’

‘You’re a fucking idiot! Don’t call me again and don’t admit him under us! He’s not coming in under ENT!’

‘If you could tell me the dose …’ I plead, but it’s to no avail; I’m now speaking to a dial tone.

I put the phone down. The waiting room’s full and I still don’t know what dose of steroid to give my patient.

I quickly wipe away the tears that have sprung to my eyes. This is no time for crying.

Matt walks over. ‘How’d you go with ENT?’ he asks.

I clear my throat. ‘He wasn’t very interested,’ I confess. ‘He said we couldn’t admit to the ward under ENT. What should I do?’ I’m wondering how I’m going to tell Mr Private Surgeon that his friend isn’t going to be admitted under ENT.

‘Well, admit under ENT, obviously,’ Matt says cheerfully, patting me on the back. ‘That’s why they gave ED direct admitting rights.’

I try not to think about the ENT registrar’s reaction when he arrives on the ward tomorrow morning to find I’ve admitted the patient he refused to discuss. I decide to make my signature extremely hard to read in the chart so he won’t know what my name is. The reason why doctors have such messy handwriting suddenly becomes crystal clear.

‘What dose of steroid should I start him on?’ I ask.

Matt doesn’t know.

‘His surgeon mate would probably know,’ I say.

‘Maybe just ask him,’ Matt says finally.

I walk down to the bed where my patient and his surgeon are waiting to see what will happen next.

‘I’ve spoken with ENT,’ I say, forcing a smile, ‘and we’re going to admit you.’

Mr Private Surgeon looks satisfied.

‘So we’ll just, ah, start you on the IV steroids now,’ I add, my confidence faltering. I hold the medication chart and a pen. ‘Just out of interest,’ I say awkwardly, ‘what dose of dex do you think you’d start on?’