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A Piece of My Mind |

Running a Code in My Ice Skates, and Other Tales

David Alfandre, MD, MSPH1
[+] Author Affiliations
1VHA National Center for Ethics in Health Care, NYU School of Medicine, New York, New York
JAMA. 2015;314(4):351-352. doi:10.1001/jama.2015.4880.
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“Is there a doctor here? We need someone!” The impassioned call for medical help outside the hospital has for me always generated a troubling mix of obligation and dread. In the 10 years since I finished my postgraduate training, I’ve responded to patients in distress numerous times and in various public settings. I now work in an outpatient setting, and the medical problems I manage are important but usually not emergent. In responding to sick patients outside the hospital, I’m driven by a strong obligation to serve, which I know originates from my long socialization and professionalism as a student and trainee. But my dread is something deeper and more complicated. I don’t fear liability or the possibility of committing a medical error in a very public setting. It is something more varied and subtle that has become clearer to me over the years with the (many) new patients I was called to treat. Recently I’ve reflected on these situations and considered how my professional identity has been affected.


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