Night shift, three in the morning. I'm staring at a row of middle-aged men who are waiting for their second blood tests - the ones that will tell them whether or not they have had heart attacks. And my overdose girl is sleeping it off in the corner cubicle, and the boy who got off the train before it stopped moving is getting his wrist and ankle put in plaster, and Mrs Ouch (not her real name) is having something vital and doubtless therapeutic done to her shoulder.
And for a few blessed moments it's quiet here.
I was talking to one of the other registrars here, and we worked out we had something weird in common. We all have the same nightmares.
Not all the same nightmares, which would alarm me, as if something somewhere was broadcasting horrible visions into everyone's head, like something out of a Lovecraft story, but we all have had, at some time, the same nightmare.
It's one of the ones where something shameful has been discovered. In the dream somehow someone finds out that we are not qualified, that we have lied or cheated or that there has been an administrative mistake of Swiftian proportions or (in one unusual twist) the real "us" died in the womb and we are the next door neighbour's kid roped in as a standin.
We're fakes. We are not who we say we are. It's all been a lie.
Whatever the cause, the consequence is the same. Our falsity has been detected by authority, justice is swift. Everything is taken away. In the dream we lose jobs, family, clothing. One dream-person was deported, another had her nails and hair and teeth forcibly removed. In the most benign form we are set back to primary school, hunching over tiny desks in front of contemptuous six-year-olds.
What's going on? Firstly, I have worked out these conversations are not always a good idea last thing at night for anyone even slightly morbidly inclined.
Second, why are all the doctors all having the same nightmare? I think that's the obvious question here. There's an obvious question, and an obvious answer, but the obvious question is the wrong way around, and the obvious answer is wrong.
The obvious question is "what is it about doctors (I don't know if it's especially emergency medicine, but I've asked a fair few doctors) that makes them so fearful?".
What makes them have these barely suppressed fears that come out at night when your defences are down, terrors you think you've crushed but that silently send their tendrils out when you look away, like a weed growing out from under a rock?
I don't know that it's even a serious question - this is me asking a couple of exhausted people at five in the morning to tell me about their dreams - it's not a randomised double-blind trial. But if it is a question, then the answer might be as follows:
I think the answer is it is the fear of inadequacy, of discovery, of people finding out that they are fakes, that makes these people overcompensate by studying more and more and finding out more and more.
It's not that people who are doctors have these nightmares. It's that people who have these nightmares become doctors. It's those nightmares that make them doctors.
Anyway, work beckons. Four weeks to the exam. Next post - drugs that affect the central nervous system.