R

RLB

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I heard this episode of RadioLab and I don't think it reinforced any fantasies about traige: I think it was pointing out that triage itself relies on the fantasy that life is a zero-sum game. The reality was that when a weaker person was given an advocate, it turned out the worst outcome of triage was avoided without any harm to anyone else. Nathalie's experimental treatment did not take anything away from anyone; had the doctor not spent time on her, he might have taken a smoke break or a nap, or spent his time with a patient who didn't end up needing immediate treatment, or who didn't end up surviving the day for some other reason. 

The fact that the doctor was pushed to think beyond the simplistic concept of triage could even be a net benefit--the next time he sees a patient with Nathalie's symptoms, he now knows how to treat them without using limited oxygen that could be used for other patients, meaning he can now save more lives with the same amount of resources and can teach other doctors to do the same. This is the strongest critique of the concept of triage: while it's a necessary last resort, offering it as an option too soon can limit creative problem-solving that could be beneficial for future crises over the longer-term. A lot of medical best practices are developed in resource-rich and lawsuit-prone environments, and medicine is therefore quite risk-averse and wasteful. In a true emergency, there are probably many solutions a smart doctor could try before giving up on patients altogether in the name of triage. The whole point of technological progress is that we don't live in the dark ages anymore, and innovation means that life and health are no longer automatically a zero-sum game.