BMJ Published 16 December 1995    Cite this as: BMJ 1995;311:1646


One of the great joys, and at the same time one of the great sorrows, of a medical career is the many friends we make and the many friends we lose. The nature of the job forges bonds deeper than mere sex; young people stressed to their breaking point, sharing long hours, warm bodies, and late nights, we get to know each other as we truly are, no facade can abide the ordeals.

Our hopes and dreams, our fears and insecurities–sharing them came as naturally as surviving. A war situation was no place for reticence or foreplay, and, despised by everyone else, we had to stick together to endure.

And then, the nature of the job meant we would move on after six months. For a while we would stay in touch, maybe meet sometimes for a few beers and to rake over old times, nostalgia softening the memories of exhaustion and humiliation; then the pressures of time and distance would become too strong, and the new friendships we were building in our new trenches would take their place.

I had one particular group of friends in college; we had a poker school every week and we diligently skipped lectures to attend racecourses all over Ireland. Fairyhouse, Punchestown, Kilbeggan – the names still roll like music off my tongue and conjure a little tear in my eye, redolent with the scent of cheap whiskey and cigars, and the silky texture of torn bookies’ dockets.

Ah, that unforgettable day when Patsy’s potential jackpot winner fell at the final fence; the expression on his face was like one of those Greek plays where everybody dies, his acceptance of our profuse commiserations rather less than gracious. As La Rochefoucauld observed, “There is in the misfortune of one’s best friends something not entirely unpleasant.”

We arrived at a definition of a true friend; (1) someone who lets you down (consistently) and (2) someone who will speak of you to a third party in a denigratory manner.

But through all these good times we somehow believed that the best was yet to come; when we qualified, and had some spending money, we’d be able to do whatever we wanted; Cheltenham, Saratoga, Longchamp–what fun, what excitement we would have. But it hasn’t worked out that way; first our jobs, now our families have separated us. We have been displaced to exotic destinations all over the world–Saskatoon, Perth, Boston, Crossmaglen; and I don’t think we’ll ever all get together again.

When we are young it seems that we can do anything we want; we have freedom but no funds, dreams but no resources. But as we get older and our authority grows so do our responsibilities, and our options become more and more limited. Until it comes to the point where our duties allow us no choices any more; we have children to support, patients to look after, absolute obligations we must fulfil.

So at the last there is only that one thing which we must do, that one course which we must follow–and it ain’t a racecourse.


Footnote; dedicated to Mickleen og, Big Johnny, P.I, Hamish, and the late and much missed Patsy.





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