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During staff cutbacks, hiring freezes and every July when a new class of interns hits the wards, hospital workers everywhere ask themselves one question:

“When is the worst time to be a patient in the hospital?”

That question crossed my mind one morning during my training when an emergency department nurse warned me about a pileup on a nearby interstate involving a school bus. “You’d better mobilize all the help you can,” she said. “There may be dozens of injured kids coming in, and we’re stretched to the limit here.”

She was not exaggerating. It wasn’t even noon yet, and the emergency room already had gurneys crammed into every available space. Supply carts, usually full of gauze, syringes, basins and bedpans, looked as if they had been hastily looted, and the din typical of the department was louder than usual, punctuated by shrieks from inebriated patients or cries for help from elderly ones. While some patients were lucky enough to have secured a modicum of privacy behind the curtains of makeshift rooms, most waited in the hallways for their beds to come open up upstairs.

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