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operation itself. When you ask them about their diet, it’s like asking an alcoholic about how much they drink: you know they’re lying to you, but more importantly they’re lying to themselves. So you have to handle it subtly. They describe a modest intake of food, so I respond by suggesting that this procedure isn’t the right one for them, as it will only help people who grossly over-consume. They usually fess up to a few more Mars bars after that.
    I have been outraged by colleagues who have spoken indiscreetly about such patients, never mind to their faces. Such as the anaesthetist who once expressed his incredulity that a woman with a BMI of sixty was a vegetarian. ‘What does she eat?’ he asked: ‘Fucking trees?’
    I laid into him for his lack of professionalism and for his insensitivity.
    And yet here I was, saying possibly the worst thing I could as the person who was going to operate on this man. I might as well have called him a greedy bastard.
    It was inexcusable.
    There were mitigating circumstances, but I didn’t think ‘having an existential crisis’ was something I should include in my written response to the inevitable formal complaint.
    It was the culmination of a lot of things. My sleep-deprived and brittle state of mind was not improved when I first got to my office that morning and discovered I had been locked out of the hospital intranet. This meant I would have to get in touch with our utterly hopeless IT department and be patronised over the phone for ten minutes, or worse: that it would require an on-site visit and I’d have to endure being patronised in person by Creepy Craig.
    That was how things stood by 7.35, before I had gone to surgical high dependency and learned that they no longer had a bed for the first patient on my list, despite my securing a guarantee of this last thing before leaving yesterday evening.
    It was fair to say I was ready to blow, and I used up the last of my restraint in not responding when the patient voiced his assumption – despite me having spoken to him several times before – that I was not the consultant and that Hipster Jesus was my boss.
    Everybody’s got their limits, an endurance of frustration beyond which their composure cracks. But I was doubly angry about what I said to that patient because as a woman in this job, you’re judged more harshly if you lose your cool. Women are too emotional, see? Fragile temperament. When a chap cuts a strip off of someone it’s because he ‘doesn’t suffer fools’, and it’s a sign of strength. When a woman does the same, it’s interpreted as a sign of weakness.
    So I was in a personal hell of self-flagellation as I worked through the list that day, and just to put a cherry on top, I had a techie visit to look forward to. I had quickly called the IT department to report the problem while the anaesthetist was prepping my next patient, and been given the bad news that it wasn’t something they could sort from their end.
    For reasons I’m sure you’re familiar with, hospital IT personnel were not my favourite people in the world at this point. Obviously the ones at IRI hadn’t done anything as utterly loathsome as I’d endured in the past, but nor were they doing much to improve the low regard in which I held their fraternity.
    What normally happened was that Creepy Craig would show up, at least twenty minutes later than stated, then proceed to walk me through a sequence of steps intended to determine whether the problem was down to stupidity at my end. He never assumed any knowledge. It was like his brain didn’t accept cookies, so he had no recollection of the level of proficiency he could expect in assessing my dealings with the system or with computers in general.
    That’s my more charitable explanation anyway. The alternative interpretation is that this part of the procedure, with him leaning over my left