A Love Letter to Coffee
There are many hundreds drugs circulating through a hospital at any given moment, but only one has helped more careers, steadied more trembling hands, and soothed more existential crises than the rest combined. Let's face it, coffee has probably helped save more lives than penicillin.
For all our pharmacological sophistication, the most important agent we administer each day remains caffeine. It requires no charting, triggers no awkward conversations with the pharmacist, and comes with no finicky storage requirements. It simply exists—faithful, available, and entirely unbothered by the chaos unfolding around it. If anything can claim to understand the working clinician better than their own colleagues, it is a cup of coffee.
My relationship with coffee began the way many unhealthy lifelong attachments do: quietly, slowly, and with the distinct aftertaste of regret. As a medical student I didn’t drink much of it; I thought I was somehow above needing a stimulant to function. Then came my first night shift. A registrar handed me a polystyrene cup filled with what I can only describe as brown foam, assured me it would “help,” and disappeared into the ward fluoro-light. That first sip—scalding, bitter, suspiciously gritty—marked a rite of passage. You do not choose coffee in medicine. Coffee chooses you, usually sometime between midnight and the first MET call.
Hospital instant coffee deserves its own paragraph in the chronicles of suffering. No matter the institution, the tin is always the same: a battered cylinder of International Roast, half-filled with what appears to be dehydrated disappointment. The flavour profile resembles something between burnt toast and a broken promise. The texture is granular in a way that leaves you wondering whether it is, in fact, meant for human consumption. Yet every doctor, from intern to consultant, has stood at that communal bench, shaking the tin to dislodge the final teaspoon stuck stubbornly in the corners. It is the unofficial house wine of healthcare—terrible, unpretentious, and universally shared (and loathed).
Long nights in the hospital are measured not by time but by caffeine levels. There is a predictable pharmacokinetic curve to survival: the 10 p.m. loading dose, the 1 a.m. coffee of necessity, the 3 a.m. maintenance infusion, and the 6 a.m. weaning. Each cup serves a purpose. The early ones stave off fatigue; the later ones soften the blow of reviewing imaging that should never have been ordered or rewriting discharge summaries that have mysteriously vanished from the EMR. By dawn, the caffeine half-life blends seamlessly into the morning handover, leaving you alert enough to function but tremulous enough to forget basic English.
Through all of this, coffee remains the one colleague who never lets you down. It doesn’t page you for trivial tasks. It doesn’t hand over incomplete information or disappear when the list gets messy. It sits quietly beside you in the doctor’s room while you question every decision you have ever made, from your choice of specialty to the cannula you definitely should have put in sooner. It listens without judgement when you talk to it out loud on night shift, which you will inevitably do.
Every clinician develops a taxonomy of coffees without ever meaning to. There is the emergency espresso, gulped seconds before sprinting to a deteriorating patient. There is the “I absolutely do not have time for this” instant coffee, stirred with a pen or tongue depressor because the spoons have mysteriously vanished again. There is the sacred post–night shift latte, obtained through a drive-through window while blinking into the morning sun like a cave-dwelling creature. And then there is the team coffee, the rare moment of unity where a single beverage order temporarily resolves all interprofessional tension.
As with any relationship, there are emotional stages. Some clinicians still attempt denial—claiming they will “cut down” or “only have one today.” Bargaining follows: if they finish the ward list, they earn a latte. Acceptance arrives quickly. Most of us reach a point where caffeine is no longer a beverage but a component of our personality. We are not proud of this; we are simply honest.
Occasionally, we try to break up with coffee, swearing this is the week we will switch to herbal tea or hydration. These separations are brief and theatrical, lasting until approximately 10 a.m. on the next busy day. Coffee waits patiently through these lapses, knowing full well we will return. It is, after all, the most stable relationship we have.
So here’s to the true hero of healthcare: the companion of night shifts, the stabiliser of ward rounds, the silent witness to our greatest and most questionable clinical moments. Coffee, you are more than a drink. You are the attending physician supervising my entire career, the quiet force keeping half the hospital upright, the one constant in a world full of variable vital signs. And for that, we are profoundly, eternally grateful.