The good slut

The acute medical ward is the slut of medicine; it’ll take on anyone, anytime, and it is the place of last resort. This is a good thing, and a most honourable calling; it is a haven, a sanctuary, a place of refuge. Sometimes what a patient needs most is a warm bath, a hot meal, a comfortable bed, some company, and a few kind words, what in more innocent times we used to call nursing care. But the NHS has no overt facility for this kind of acute care, so part of the ritual is that the general practitioner then has to construct a flimsy Trojan horse of plausible medical grounds to access this care.

These lies rise blithely to our lips; our moral compromise is slow but implacable, and such invention and dissimulation become easy with practice, and so many illnesses accompany neglect that it is only a matter of choosing the handiest one.

Admissions in Great Britain are very similar to the US. The general internal medicine wards are the final common destination. We take all comers. Often the patient could easily go to another service, but for various reasons (politics, lame excuses, laziness) the patient ends up on the general medicine service. We care for patients, even when some other service should really take responsibility.

So we are the common dumping ground and thus we claim the moral high ground.. And our patients benefit.