On-call addiction.

©FSRH J Fam Plann Reprod Health Care 2010: 36(2) No no no no no no no. NO. I am not going to do on my own out-of-hours at night, or on the weekends for that matter. You must be high on some mind-altering chemical if you think I’m going back to something it took me over 10 years to kick. Like all addicts, I hadn’t chosen to become addicted to out-of-hours. My peers had introduced me to it. Go on, they’d said, just try it once. Then I, like so many before me, became hooked, craving the financial high that outof-hours gave. I couldn’t see that these peers had moved on to become dealers, recruiting young, eager innocents like me to fill the void they had left. In time they hoped to move further up the chain and be the ones who oversaw the whole operation, in positions on government advisory boards and committees where they could inform the outof-hours barons on ways to increase productivity and line their pockets without risking responsibility for the inevitable consequences of addiction – burned out doctors, maimed patients, broken homes, and STIs. This out-of-hours dependence was a tough one to kick. Every time I found a way to move away from it, somehow another temptation was lurking in the shadows – extensions to out-of-hours times when payment could be claimed, incentives like free parking, and so on. But what happened? Look in the mirror and my youthful, wrinklefree face had become drawn, wasted and shrivelled like an elderly man’s scrotum. I became aggressive, couldn’t think straight, made mistakes. I’d have had a better chance of staying healthy if I’d been running the ‘heartsink clinic’ or taking crystal meth. It wasn’t good for me, my family or my patients, who role-reversed, asking me how I was, whether there was something they could help with, obviously being frightened for their own safety. And they were right. After 36 hours working who could put their hand on their heart and honestly say they were in a fit state to make a decision about someone else’s health. Not me. I couldn’t even find my own heart to lay my hand on it, let alone think clearly enough to provide the advice that would decide whether a patient became a parent or not. On-call addiction