The patients you carry home

Early in my training, a senior consultant told me something I didn't understand at the time. He said the job changes you in two ways. The first you notice quickly — the long hours, the missed meals, the strange relationship you develop with sleep. The second, he said, takes longer to notice, because it happens quietly.

He meant the patients you carry home.

Not all of them. Most pass through your week and are gone before the weekend — names you'll forget, faces you might recognise if you saw them in Tesco but probably wouldn't place. That's normal. That's the job working as it should.

But every doctor I know has a handful that stay. The ones you think about years later, sometimes decades later. Sometimes for the obvious reasons — the case that didn't go the way you wanted, the conversation you didn't quite get right, the diagnosis that came too late. Other times for reasons you can't fully name. Something about how they spoke, or what they said in the last appointment, or the family member who sat very still in the corner of the room.

You don't share them often. There's nowhere to put them. The mortality and morbidity meetings address the clinical facts. The mess used to address the rest — over coffee, in corridors, in the quiet half-hour between handover and the drive home. Now most of that is in WhatsApp threads or not anywhere at all.

I think about this when I design something for Clerked. The references are dry on purpose. The humour is small on purpose. The pieces aren't trying to capture what the job actually is, because nothing made of cotton can do that. But they can be a small, shared signal between people who know — yes, this. Me too.

That's most of what I wanted Clerked to be. A wink across a crowded canteen. A thing you wear that quietly says you're part of this.

The senior consultant who told me about the patients you carry home retired years ago. I think of him often. He was right about most things, but particularly about that.

— From the Mess