ABSTRACT
One early spring Saturday in 1984, when I was an intern on call at an urban community hospital, the emergency room doctor beeped me. “2191, 2191,” the beeper said, a number that still makes all my muscles tense, my heart pound, my breath quicken, and the hair on the back of my neck stand up. Interns then would typically be called to the emergency room five to ten times a day, and asked to assume the care of people who had just come in. Their situations were not well known yet. They were people who could crash and die, people who could scream and yell, people who could complain and threaten. Sometimes they were people whose medical care we would, inadvertently, screw up, leading to their worsening incapacity or death and to a lifetime of finger pointing and recrimination for us, the interns. The common thing any of us knew about those people was that someone with the power to decide had determined that they should be admitted to the hospital, and that the intern was responsible for admitting them, then finding the problem and fixing it, whatever the problem happened to be.
