It looked like my consultant had so much more “Room in the Inn” than we could handle.

A lot of sick patients in the hospital and bed shortages everywhere.

In addition to this the F1 – who was on-call over the weekend – dropped out of medicine completely – and we were left on Monday morning without any extra help for our workload.

Before I go on further, I do like express my sincere sadness about the F1 dropping out. I have never met this particular junior doctor, but it does tell you something about the state of the NHS and how broken it is.

From what I have heard it was all multifactorial and it tends to be little things which contribute to big decisions. I do hope that the junior doctor is not regretting his/her decision.

So, 40odd patients on the list – me and our UGI F1 with our two registrars in two different theatres for backup.

It’s not surprising that it was chaotic, but we managed to get through the workload although leaving late (90 minutes for me).

Our elective patient list when ahead without any problems which is close to a miracle as most of our electives are getting cancelled due to the shortage of beds.

Two short bariatric cases (Gastric balloon removal & Gastric band and port removal) aided probably the decision not to cancel the list.

Our pancreatitis patients from last week are still in and they are not really improving, and interval scans are needed this week.

During the weekend one of the patients being admitted is a family member of one of my former mentors. Love mentor and really lovely family which makes the discussion around the care we can provide really difficult – Small bowel obstruction (SBO) (potentially close looped) with no surgical option.

The national/international shortage of gastrografin is also not aided resolving the SBO. We use gastrografin in patients with adhesional SBO as it’s not only a radiopaque (can be seen on radiological imaging) but also works as a hypertonic. This effect means it draws fluid out of the small bowel wall back into the lumen of the bowel and helps “kickstart” peristalsis.

I managed to get one of the two bottles in the hospital (after some tough negotiations) and hopefully that will sort the patient out and resolves the SBO. If it doesn’t then we – most likely – going down the palliative route.

Day off today and some shores to do at home. I tend to have a list of things to do from my wife and – mostly – they get done. Martial Arts later with our son and maybe some tennis. He actually got selected playing in the next County match against either Devon or Cornwall at the end of the month. That’ll be exciting!!!