mediocre

Driving to work in sunshine after overnight rain. Bare branches of the deciduous trees glistening. The  grass green and fresh. Suddenly I feel self loathing. I should get up earlier and do a proper ward round. I should organise my clinics better so I have time for other work. I should support the residents more, be like the stern confident consultants who taught me.I am inadequate. I make poor choices. Poor choices. I don't review my patients often enough, always stuck in clinic, but never able to see enough. My waiting time is too long. I should have worked in the city, earned more money, had more time for everything.

People are too kind. The resident respectfully waits to discuss the progress of the inpatients. In the clinic the public are friendly and polite.I don't deserve their consideration. I am a fraud.
After answering a question I tell one woman that I really can't speak with any authority. I am just making it up as best I can. She laughs and thanks me for my effort anyway.
The relentless clinic rolls on. GPs call me for advice and I tell them I don't really know but perhaps they could try my suggestion. They would almost certainly get a more correct response from another specialist, but they seem happy with my proposals.

As the day progresses the hallway is being painted. The paint fumes are so strong and pervasive that I start to feel loose, relaxed, slightly high. I care a little less.
 Someone fails to attend so I do a ward round and sort things out like a real doctor. Although I felt that they must resent me, the midwives seemed pleased to see me. Plans are established and confidence rises. Responsibility is being taken.

The day eventually ends. I am drained but less afflicted with despair. As I am packing to leave I am called to the labour ward to manage a third degree tear. I am supposed to be off duty for this one night except for emergencies but I feel oddly cheerful about this injustice as I go up to assess the injury. Subsequently, in contrast with my mood of crushing inadequacy, the repair is surprisingly easy. The staff seem to value my work but a more impressive obstetrician, the one I once hoped to be, would have arranged a formal procedure in theatre. I just leaned over and sewed it back into place. My technique has always had a good long-term outcome despite the informality but I am sure it would be frowned upon in a big city hospital. The patient was treated quickly, with good anatomical apposition, and wasn't separated from her newborn baby. That will have to suffice. I am a mediocre country workhorse but better than nothing.

Perhaps it is the effect of the paint fumes, but for the moment I feel that I can live with that.