In our hospital all the house officers take their turn doing a week of night duty on emergency medical take. This usually leaves time for considered decision making about patients, something that is in short supply in the daytime.

We arrive at the emergency ward and immediately scan the board for arrivals, as if at some very small airport where planes only carry individuals. The nurses put big magnetic tags on the white board to indicate triage categories. The effect of this is that, on first entering the ward from the furthest entrance, we can immediately tell what sort of a night we are going to have.

The first clerking of the night is always painful. Basics are forgotten as I wipe the sleep from my eyes and try to focus on the task in hand. Did I already ask about her appetite? Were those crackles on the left or right? And does she really need gases done? Sometimes overdoses come as a relief-at least there is a proforma to follow that speeds the clerking and leaves time for some discussion of feelings and expressions of sympathy.

Usually a bit later on in the night comes the inappropriate referral from casualty. This IRC usually hinges around some basic test result that has been misinterpreted or some intervention that should have been done before transfer. It allows all doctors present to feel temporarily that they are in some way better than those downstairs and provides much needed conversation over 2 am sandwiches.

Back to work, and generally there are some long-stay ward matters to deal with. I am assigned to the task. I venture forth from the warm emergency ward to stalk the darkened corridors, medical textbook at my side. I am the medical vigilante, the sole defender of good health in a slumbering hulk of sickness. I arrive like a knight in shining armour to work my magic. No fluid chart is left unsigned, no pyrexia left uncultured.

I return as the first rays of light enter the wards-the end is in sight. Soon our night is over and we hand the entire ward back to the unsuspecting day take. We greet our colleagues happily, gloating at the prospect of imminent sleep. When we return, all the patients will have been filed off to their destination wards, or discharged as the cold light of day illuminates the reality of their complaints. And once again we shall have a whole new set of patients to experiment on.