It was 6.25 am and the surgical floor at St Mary's Hospital in London was a hive of activity. The nursing staff was getting ready to change shifts and a small group of junior registrars stood laughing and chatting in the brightly lit corridor outside the wards where they waited to begin morning rounds. They all suddenly straightened up and stared down the corridor as the main doors to the surgical floor opened and a tall, distinguished looking man entered.

The ward immediately took on a charged atmosphere, the chatter stopped and everyone's attention was riveted on the man as he approached. His bearing had an unmistakable aura of authority. He was impeccably dressed in a dark blue suit with a light blue shirt and red tie. A frown creased his forehead making his face look stern and by the furrows on his brow it was evident that the frown was more or less a permanent feature. An impatient energy seemed to fill the space in front of him as he approached.

The ward sister stepped forward as she prepared to accompany him on his rounds. "Good morning Mr Ellingham,"

Ellingham nodded at her and grunted his usual, "Yes," by way of a greeting as he swept by.

A new junior nurse standing some distance away stared at him, wide-eyed. Her colleague whispered, "That's Martin Ellingham – he's the top vascular surgeon at St Mary's…actually probably in the whole of Britain. He's got no patience, so pay attention when he's around…you don't want to get on the wrong side of him."

Ellingham strode towards the first of the wards where the group of junior doctors waited and his frown deepened. Hopefully this morning one of them would actually be able to answer a question when asked, he thought. He could never understand why it was so difficult for them to see the obvious when looking at a patient's chart or at the medical history that was right under their noses. The thought made him scowl as he picked up the first clipboard.

The rounds went more or less as he had predicted. The junior doctors were, for the most part, unprepared and unobservant and his temper grew as the rounds progressed. In a curt and succinct manner he pointed out the finer details of each case.

After asking one of the doctors to examine a patient and share his findings with the group, Ellingham asked whether he would advise any changes to the patient's regime. The doctor said he didn't think so. Ellingham stared at him for what seemed like an eternity. His intense gaze had the young doctor squirming. "You don't think so," he said slowly, his tone scathing. "In that case I am relieved you are not my doctor…either you know or you don't." He looked down at the name tag on the doctor's coat. "If you had been paying attention…err…Chisholm," he said, "You might have noticed the mottled appearance on the lower limbs. Does that look normal to you? I think not. That, combined with the latest pathology results, indicates the need for urgent intervention on your part. But you missed it and the outcome would not have been very good for the patient now would it?" Ellingham enunciated each word. He spoke quietly which made the dressing down seem even worse. Chisholm, stung by Ellingham's tone, countered that he thought his initial observation was valid given the circumstances. Ellingham's stony face and narrowed eyes should have warned Chisholm to stop talking but he carried on until he realised that everyone was staring at him and his voice petered out.

Ellingham couldn't stand fools at the best of times and right now his patience had all but run out as he glared at Chisholm. Not only did this moron completely miss an obvious diagnosis but he had the temerity to argue with him too. His grey eyes were like chips of ice and his tone clipped as he said, "If you ever acquire enough diagnostic skills Chisholm, you will realise just how stupid your last remarks were." He thrust the patient's chart at him. "I suggest you read the patient's history again. You will eventually see that failing to pick up these changes in the patient's condition since his last observation would more than likely have killed him."

Chisholm was about to speak again and Ellingham cut in, "Don't argue with me…read it. Look at the pathology." He looked around at the rest of the group who all pointedly looked anywhere but at him. "Does anyone have anything to offer?" he asked in an exasperated tone. None was forthcoming so he launched into a point by point explanation of what the cluster of symptoms indicated and what needed to be done about it. When he had finished he snatched the chart from Chisholm's hands and proceeded to write up his notes.

The junior doctors murmured among themselves. In thirty seconds he'd taught them more than they had learnt in a day from their lectures and they were grateful but at the same time they were all terrified of him. His eyes missed nothing. Anyone coming into contact with him would be left in no doubt that this man expected total focus and commitment.

At the next bed the patient tried to engage Ellingham in conversation. "Be quiet." he said curtly without raising his head as he read the patient's notes. The registrars fidgeted, embarrassed at his abrasive manner. Ellingham looked up. "It says here that you had a stent put in two years ago." His eyes flicked over the obese patient. "Judging by your weight I take it that you did not follow the dietary plan you were given when you were discharged?"

The patient looked uncomfortable, "It's so hard to cut out all the things on that list Doc…no, biscuits with your tea. No pint down at the pub..."

Ellingham's expression of disgust was unmistakable. "And I suppose the exercise regime followed the same fate?"

"Well I did try for a while but it's really hard to find the time Doc."

"You're an idiot Mr…errr," Ellingham looked at the chart, "…Carson. Your failure to follow advice has landed you back here needing further intervention to prevent you dying of a heart attack. Well done." The registrars gaped at Ellingham as he went on, "If you are not prepared to take your health seriously, intervention is futile and a waste of my time. You'll be back here again in less than two years if you're not dead by then."

The patient was shocked but wise enough not to say anything as those grey eyes bored through him. He looked suitably subdued as Ellingham wrote up his instructions before heading for the next ward followed by the now silent registrars.

Ellingham sighed inwardly as the rounds went on. He understood the need for them and the explanations he had to give the junior doctors but it frustrated him when they showed no initiative. He would willingly spend his time doing it if they did. This morning he felt that he'd wasted his time. Idiots the lot of them. And some of the patients were no better. His mood deteriorated and his patience, such as it was, evaporated completely.

It was 7.30 am when he finally headed towards his suite of rooms in the consultants' wing. The deep scowl on his face ensured that people got out of his way and those that chanced a greeting received just a grunt in reply. He was relieved to find his rooms empty and he remembered that it was his receptionist's day off. He went straight to the little galley kitchen and prepared himself an espresso, one of the few indulgences he allowed himself. At least he could enjoy it in peace and quiet. He took the little cup back to his desk while he went through the notes for the patient he would be operating on in a little over an hour. The patient was elderly and not in good shape but all going well he could see another ten years of quality life if he heeded his advice – unlike that idiot Carson.

Just before 8 am he went to the little en suite bathroom-cum-dressing room and changed from his suit into scrubs. He brushed his teeth and dried his face as he looked in the mirror where his grey eyes stared back at him. The frown was still pronounced. His day had not started well but being in theatre would redeem it somewhat. At least he would be surrounded by an experienced team who knew what they were doing. He turned and switched off the light.

As he strode through the corridors people automatically seemed to get out of his way. He entered the theatre complex and went straight to the scrub room, hoping that everything would run smoothly this morning. The previous morning he'd had to wait for the scrub nurse to appear. God knows where she'd been. But as he entered the room it was once again deserted and he scowled as he began to scrub up. She'd better be here by the time he finished.

I don't have a medical background so I've had to wing it a bit. Apologies if I've made any glaring errors.

The character of Martin Ellingham belongs to Buffalo Pictures. It is with great respect that I spin this story with him at its centre – no infringement intended.