After 6 years as a medical student at a sandstone university, my post-graduate medical career followed the usual pattern of two years as a resident medical officer then three years as a registrar at a large metropolitan general hospital.
The inevitable sleep deprivation associated with junior staff hospital jobs was, I realise in retrospect, an integral part of the job and appropriate training for the rest of my career.
As was the relentless pressure of making critical decisions in a hurry.
The attraction of private practice was twofold.
Not only were private practitioners obscenely overpaid, but in many specialties they could reasonably expect to work a nine-to-five day with no after-hours call.
So, at the first opportunity - after completing my three-year registrar post and achieving registration in that specialty - I joined an established private practice in a large rural city.
But being obscenely overpaid and getting a good night's sleep were not the reasons I had spent my childhood dreaming of becoming a doctor.
I resigned to return to hospital medicine, taking the opportunity to leave the land of my birth to return to the land of my fathers, obtaining a senior consultant's position with the NHS in the United Kingdom.
The virtual absence of private medicine in Scotland at that time meant that hospitals were well staffed, and a consultant's job was a gentlemanly affair, with an optional on-call roster (which was only attractive to those anxious to enhance an already perfectly respectable salary.)
Eventually and inevitably I returned to Australia and, fired with enthusiasm for salaried hospital practice, accepted a position as Director in a busy public hospital department.
But because a Staff Specialist's salary was around 20% of the salary of an associate in private practice (I know this because I rejected an offer to join a large metropolitan practice), and because most doctors were motivated to pay back the loan on the wife's Mercedes C200 coupe (rather than pay back their debt to the society that footed the bill for their education), staff specialists in rural hospitals were either non-existent or graduates from some second-string university in India who were exchanging a few years public hospital service for unrestricted registration to practice privately in Australia.
To be fair, private specialists who were prepared to accept the generous fee-for-service payment to do sessional work at public hospitals were not altogether motivated by the supplement to their lucrative private practice incomes.
The status of being able to include "Visiting Specialist" on their CV is actually quite seductive, and the break from the relentless procession of patients through their private rooms quite invigorating.
(The side issue of being able to claim a tax deduction for the lease repayments on their Maserati Cambiocorsas - if the vehicles were used for travel between two places of work - is neither here nor there.)
Staff Specialists were an anomaly.
These positions were usually occupied by those whose personality was not entirely suited to dealing with fee-for-service customers (OK, weirdos) or those zealots whose political and social convictions determined for them that Medicine was a caring profession underpinned by compassion and goodwill.
Consequently such individuals were rare, and I became head of a department with a staff establishment of five specialists, but a staff of one. Me.
I found myself trapped in a situation where my capacity to manage the Sisyphusian demands of my job was diminishing dramatically.
This became evident to me when I was climbing into my bed at 3 am after an 18 hour day and the phone rang to notify me that an ambulance was on the way to the hospital with the badly injured survivors of a multi-vehicle accident, and I nearly began to cry.
In order to attempt to recover some semblance of control over my in-hours life, I posted a notice on the door of my office at the hospital which read, in big, bold capitals "NO. PISS OFF."
This was helpful, but only effective if the reason for the interruption was trivial.
And its effectiveness diminished with time.
That was when, in the depths of my despair, I stumbled upon the "Final Solution".
Somehow I had acquired one of those nodding dog toys that used to be seen in the back windows of cars belonging to completely irredeemable dags*.
I placed the dog on my desk in front of the bookcase in my office, and if some bumptious, arrogant little shit of a first year Resident had the gall to ignore my NO PISS OFF sign and invade my office with his whining request for an urgent something-or-other that his equally bumptious arrogant shit-of-a-Registrar had, on a pococurante whim, told him to arrange, I would look deeply into the annoying little bastard's eyes and say "Let's ask the dog!"
Believe it or not, it worked. Every time.
They would just shrug and go away..
* Dag (noun): "An Australian slang term for someone lacking in self-consciousness about their appearance, with poor social skills yet affable and amusing." (Wikipedia)