“Is that the Duty Microbiologist? Can I please discuss a patient with you and get your advice?” asked the Junior Doctor.
 
The Microbiologist nearly fell off his chair… people were rarely that polite when calling…
 
“Certainly, what can I help you with?” he replied, feeling immediately predisposed to being happy and helpful. (A very weird and unfamiliar feeling for the Microbiologist!)
 
“I have a complex patient who had a kidney transplant about 6 months ago who keeps getting UTIs. She has had a number of positive urine cultures and she feels better after being treated, but when the antibiotics stop, she quickly becomes symptomatic again. We’re wondering where we go from here. Should we try a longer course of antibiotics to see if that helps or would she benefit from antibiotic prophylaxis?”
 
The Microbiologist had been listening intently.
 
“This could be BK virus infection causing ureteral stenosis. Have you imaged the transplanted renal tract?”
 
“Beaky what virus?” asked the Junior.
 
And it had been going so well….

The Microbiologist was doing his daily Critical Care ward round. The next patient to see had been admitted with severe abdominal pain and been diagnosed with a perforated appendix. They had had an urgent laparotomy the night before and had come to the Critical Care Unit as they were a bit unstable after the operation and needed close monitoring. They had improved steadily.
 
The Registrar mentioned that the patient had been on antibiotic prophylaxis since the operation, and they wondered whether it should stop after 24 hours.
 
“It’s not prophylaxis” said the Microbiologist.
 
“Yes, it is” replied the Registrar, “the Surgeons have written that they want the antibiotic prophylaxis to continue, but they haven’t said for how long.”
 
“No, it’s not prophylaxis” said the Microbiologist again, “it’s treatment. They are different things with different purposes”.
 
“Oh, here we go” muttered the Registrar, “pedantics again!”
 
“I heard that!” Exclaimed the Microbiologist, smiling, at least he knew someone had read his blog. “Let me explain…” he said in that manner of, shhh…listen!
 
The Registrar groaned inwardly, knowing a mini-lecture was coming and there was nothing he could now do to stop it…

The Microbiologist sat quietly eating his lunch, partially hidden behind a pot plant in the staff canteen, when he sensed someone standing behind him. “Damn!” he thought, thinking he had hidden well enough to prevent his lunch being interrupted with any clinical questions... but clearly not.
 
Looking around he met the gaze of the Cardiology Registrar who was clearly waiting to make eye contact before launching into “the patient’s story”!
 
…“I have a patient in her early twenties who came in with a fever and a rash, but over the last few days she has started to go into heart failure”.
 
The Registrar had been in the Microbiologist’s teaching session early in the week, and had clearly “swotted up” after being asked questions he didn’t know the answers too.
 
The Cardiology Registrar then delivered the “piece de resistance” and declared “I think this might be Rheumatic Fever”.