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As the day came to a close on December 31, 2016, I was preparing to retire for the night and reflect on the year gone by. I was posted in a rural secondary care hospital in the Vellore district of Tamil Nadu in India as part of my Community Health rotation during my internship at Christian Medical College (CMC). My co-intern had taken off to celebrate New YearLs Day with her friends in the main hospital campus and I was alone in the internsL quarters. It was a cold and quiet night. The emergency room (ER) was empty and our patients in the wards were stable.

Just when I thought I would have a peaceful night, my beeper rang, and I was called to the ER. A middle-aged man had come with breathing difficulty that had worsened over the past couple of hours and showed no signs of improvement with oxygen supplementation. I assessed him quickly and made a diagnosis of probable acute respiratory failure. I knew this …