Hastings Cent Rep. 2017 Mar;47(2):3-4. doi: 10.1002/hast.680.
As I stood outside of Carlos's room, I felt caught on the horns of a dilemma. It seemed impossible to truly "be there" for Carlos without sacrificing my other intern duties. This tension pervaded much of my residency training, as I often found myself spending more time completing chart notes, answering pages, and giving sign out than I did at the bedside with my patients. I knew I had a duty to "do my job"-I could not let my team down. But what about my duty to Carlos, a duty to act on my intuition and try to "get to the bottom" of his illness, if that was even possible? And what about my thirteen other patients? Wasn't I was their doctor as well? I have spent countless hours studying the ethical frameworks for medical rationing. And yet no framework could have told me how to weigh my intuition in that crucial moment of decision-making, or when it was okay to leave a few notes unfinished in order to have the time to talk with Carlos. Suddenly, I knew what I had to do.
当我站在卡洛斯的病房外时，我感到进退两难。如果不牺牲我其他实习职责，似乎就不可能真正“在那里”为卡洛斯服务。这种紧张感贯穿了我住院医师培训的大部分时间，因为我经常发现自己花更多的时间完成图表注释、回复呼叫和交接工作，而不是在床边与我的病人在一起。我知道我有责任“做好我的工作”-我不能让我的团队失望。但我对卡洛斯有责任，有责任根据我的直觉行事，试图“深入了解”他的病情，如果这是可能的话？那我还有其他十三个病人呢？我不是他们的医生吗？我花了无数个小时研究医疗资源分配的伦理框架。然而，没有任何框架可以告诉我如何在那个关键的决策时刻权衡我的直觉，或者在为了有时间与卡洛斯交谈而不完成一些笔记的情况下是否可以。突然间，我知道我必须做什么。
