anticipating the reasons a relationship wouldnât work in the long run.
Thatâs what I mean about being off my guard. If Iâd been thinking straight that day, he would never have got in under my radar. But I was a long way from thinking straight that day.
I couldnât remember feeling so low. I told myself it was just fatigue. Iâd had a very demanding and frustrating schedule in theatre the day before, but despite my exhaustion, I was too wired to sleep properly. After a few fitful hours I found myself lying awake at about half past four, which was when I decided to cut my losses and get up. A short while later I was pushing my mini-trolley around a twenty-four-hour supermarket, struggling to fill it with enough items to justify having anything bigger than a basket.
Walking the aisles, it was like I was navigating a living, walking (and trundling) theatre list, one that would never end. All around me were future cases, meat-wrapped parcels of symptoms filling their trolleys with precisely the items they needed to exacerbate their conditions.
It was too early in the day for the shop to sell drink, but the guzzling of it was marked indelibly on many of the faces that passed me, their cheeks yellow-tinged and their noses florid with broken capillaries.
Everywhere I turned, I saw, heard and smelled the symptoms and the causes of disease and decay. The place was dotted with overweight and conspicuously unhealthy people loading up on fat, salt and sugar, filling their trolleys with the very pathogens that were poisoning them.
It hit me that I could no longer see human beings. I could only see pathology. I was resentful of the choices they were making, wilfully creating a mess that it would be my problem to clear up.
This happens sometimes. I suddenly see myself as though from the outside, looking down, and Iâm someone else: someone I donât like. She is cruel and callous and I have no control over her. Unfortunately I canât say sheâs someone I donât recognise, because I had been seeing more and more of her back then.
Let me tell you, there are few things more pitiful than having an epiphany in Tesco at five thirty a.m., and one of them is standing in Tesco at five thirty a.m. and being in denial about what the epiphany is telling you.
Yes I was tired. I just wasnât accepting what I was tired of. I had spent so long railing against exclusion in my profession that it had never occurred to me to consider the value of what I was so determined to be included in.
When I reached the fish counter and began thinking about Dan, one of the things that struck me was that I had spent the last ten minutes getting angry about other peopleâs shopping. Thatâs got to be a pretty big indication that Iâd bottomed out. But youâre seldom so low that you canât fall further, and so it proved when I made it into work.
âWell, youâve taken the first step. Another two thousand days and you wonât need the procedure at all.â
The second the words were out there it was like I was looking down upon the scene from above, then suddenly had to pilot my body once more.
I felt so ashamed.
What was happening to me? What was I turning into? My very purpose, the thing that got me up in the morning, was to help patients like this one. There was little I didnât know about what life was like for this man and for all the bariatric patients I had operated on before him. Their conditions were a result of the most intractable psychological complexity, their lives miserable and depressed. By the time they had reached me, it was because the procedure I could carry out was their last hope.
It sounded like someone else talking: or at least the someone who lurks inside but is never permitted to surface in hospital. I am used to biting my tongue in these situations, because sometimes dealing with their denial and self-delusion is as much a part of helping them as the
MR. PINK-WHISTLE INTERFERES