The Steel Windpipe, Mikhail Bulgakov  

Guiding Discussion

1. What are the boundaries, implicit and explicit, in this story?           
2. Was there a moment when you, as an emergency medicine clinician, felt particularly uncomfortable?
3. Did the physician cross a line in this story? Would his actions be considered commendable, irresponsible, or both? How is that value judgment determined?

Exercise: 

The physician in “The Steel Windpipe” is fresh out of training and feels unprepared for this rural practice. Scalpel in hand, faced with securing an emergency airway on a young girl, he thinks, “I went cold and my forehead broke out in a sweat. I bitterly regretted having studied medicine and having landed myself in this wilderness.” Wilderness could describe his practice setting, but how else might you describe elements of a wilderness--in literal and creative terms--in medical practice or medical training?  Have you ever had moments when you harbored thoughts of regret, or felt ill-prepared, or were struck by great uncertainty and anxiety? Take 5-10 minutes and write about a particular situation. Was it a shock? How did you respond?

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