"I don't trust that Paki much." I always find comments like this a little bit tricky to deal with. When a patient (who in this case was in a fairly bad way) focuses such forthright racism on a senior colleague, you're trapped between too many conflicting values and motivations. One fairly compelling option is to look them square in the eye, index finger expressively aloft, and suggest plainly: "Why don't you stop being such a racist arse?"

It's a strategy with obvious flaws. I want to be the patient's friend, I want him to trust me, I don't want to alienate him on first sight. And it seems likely that his comment was constructed, on some level, to be part of a caucasian bonding moment, by someone confronting mortality more than a little bit sooner than they had earlier planned, and who felt scared and alone.

Also, is it necessarily my job to go around challenging every person I encounter in the workplace? Even if I might imagine I am doing tons of public good?

I am in fact the only caucasian doctor on our firm, and also by far the most junior. "You're awlright, mate, I know I can trust you. It's just that lot that bother me."

He smiles warmly. I start to fumble with embarrassment. "Well, really it's all, no, right, OK, gosh," I offer, looking at the floor. You're an idiot and you are definitely trusting the wrong man, I think to myself. I consented a patient for the wrong operation last week (although he had the right one).

Perhaps this is karma in action.

I struggle to work out which of our team it is whose appearance has so offended him. They are all male (there are no women in surgery), they all went to public school in the UK, and his terminology didn't seem to fit any of the West African, Arabic and Oriental genes in the firm.

Either way, in five hours' time all three of them were going to be up to their elbows in racist abdomen. Do I tell my bosses what he said about them? And if so, should I tell them before or after they get their scalpels out? The temptation is great.

In the event, I belly out and decide not to mention it at all. Does this make me a conspirator? The patient seemed to think so. "I'd like a bit of that," he said to me that afternoon on his way back from theatre in the lift, pointing at a physiotherapist's behind.

"Know what I mean, 'ey, doc?" he continued, as if I was his best mate.

While everyone else in the lift stared at me in astonishment.

This, I should point out, is the only interesting thing that has happened to me in three weeks. Apart from the novelty of having patients under the age of 70, being a surgical house officer is so tedious that on some afternoons I have almost gnawed my own leg off with boredom, and the only relief comes when I am on call and get to see patients fresh in A&E.

The basic problem with surgery is that unless you're into the railway modelling aspect of it all, it's a bit of a one-laugh gag. I can still remember the first time I went to theatre as a medical student, being amazed at how counter-intuitive it was to stick a knife into somebody's guts: it was all I could do to stop myself reaching out and grabbing the surgeon's hand as it zoomed in on the patient's tummy and saying: "Are you mad? You were going to cut that bloke's tummy open with that knife! Somebody call the police." Now I just stand there holding a retractor while they talk about sport and women (as I said before, there are no women in surgery ...), or discuss new and exciting surgical tools just like the DIY nerds that deep down they know they really are.

And in the morning, we do 8am ward rounds on 20 patients in half an hour, where I don't even have time to find the notes for each patient, let alone write in them. Then they all bugger off to theatre while I have a little paperwork party all on my own. In my medical job, I was rushed off my feet, because pressure of work (and the loveliness of my team) meant that I participated in patient management as well as doing the administrative tedium.

I spend most of my day here twiddling my thumbs, with the unnerving feeling that there must be something I should be doing, and that it probably involves standing up in theatre holding a retractor for four hours, wearing blue pyjamas and a funny hat.