One of my last medical school interviews was a good ole fashioned stress interview. The guy was a plastic surgeon who had a reputation for terrorizing interviewees, and he definitely delivered. As a follow-up to a very heated debate as to whether healthcare should be a right or a privilege, I was thrown into a catastrophic accident clinical scenario where I was forced to triage healthcare. As I went through my imaginary patient load, I was forced to either treat or triage each case, having only a nurse and secretary to lighten the load. There were no “right” decisions, just shades of gray, but the interviewer played devil’s advocate to every choice I made. I suppose this was to underline his point that, while healthcare for all is great in theory, it will still involve some degree of allocating limited medical resources to people.
About halfway through the scenario, I was given a patient who had a fixable injury. The only problem was that the surgery he required would take six hours and had to be performed immediately. I still had four additional patients to treat/triage. After attempting to transfer the patient to another facility or allow my nurse to provide a temporizing measure, I eventually had to admit defeat and triage the guy. I was forced to inform this patient that he was going to die, even as “my patient” pleaded for his life. It was pretty much awful. I don’t even remember what I said, but I’m sure I tripped and stumbled over my words like an idiot.
Before we moved over to the next patient, I told my interviewer that I’d send my secretary to the dying patient’s bedside. Thinking I was still trying to save the patient, the interviewer scoffed and taunted me, saying “there’s nothing your secretary can do to help him now.”
I replied: “yes, but no one deserves to die alone.”
For the first (and last) time in the interview, my interviewer was visibly caught off-guard and fumbled for words to retaliate.
As the start of intern years gets closer, I’ve been doing a lot of thinking lately about the kind of doctor I want to be. I’ve had lots of great examples of brilliant clinicians and gifted teachers. And while I value both of those characteristics, above all else I hope to retain a basic kindness and that idealistic ability to always remember I’m dealing with people instead of cases.
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