A MODEL PATIENT.(modern medical training)

Four students in their third year at Harvard Medical School recently met a patient named Mr. Martin. The students' mentors, two physicians, told them that Martin had come to the emergency room complaining of abdominal pain that had grown steadily worse over several days.

Martin was lying on a stretcher, moaning. A monitor next to the stretcher indicated that his blood pressure was dangerously low--eighty over fifty-four--and his heart was racing at a hundred and eighteen beats per minute. An X-ray mounted on a light box on the wall showed loops of distended bowel, called an ileus. The intestine can swell like this when it is obstructed or inflamed.

"It hurts!" Martin cried as the students reviewed his chart. "They told me you'd give me something for the pain."

"Should we give him something?" one student asked.

"I guess so," another replied.

The first student emptied a syringe of morphine into an intravenous line attached to Martin's arm. Within a few seconds, Martin stopped moaning. Then the monitor started to beep rapidly. Martin had stopped breathing. The syringe had contained twenty milligrams of morphine, a potentially lethal dose for someone in his condition.

The students began to perform CPR. One passed an endotracheal tube through Martin's vocal cords into his airway. Another began to pump oxygen into the tube.