Wise old man. Probably thinking about ethics.

First blog. Big day.

First patient: ancient man, advanced dementia. Even the dementia nursing home couldn't cope. Not his usual self. Normally happily demented. Now not so. Agitated, tearing clothes off, not eating. The nurses managed to get some blood off him. Turns out he was in acute renal failure, big style. And still totally demented. What can we do?

Sat down with the family: don't worry, they said. We were expecting this. Let him go. He's had a good life. Served in the war and got the shrapnel to prove it.

No problem, you've picked the right doctor for the job, I said. Dignity is my mot du jour.

Discuss it with my senior, been in the job 7 or 8 years. Let's try some intravenous fluid, catheterise him, check the heart trace, do an arterial blood gas sample (ouch) and repeat the bloods in a few hours, she says.

An interventionalist

Hmm. Ethical day.