I suppose a doctor's version of the Kobayashi Maru would be a medical situation where every choice ends in the patient's death . . . .
That's all too common in real life. It's also a staple of medical drama. Not always the patient's death, but certainly there are plenty of cases in which a physician makes what
should be all the correct decisions, based on the information available, and yet they turn out to be the wrong decisions.
I find myself thinking of an episode of
M*A*S*H, in which Major Winchester is faced with a decision while operating on a gravely injured soldier: either the patient will lose some strength and dexterity in his right hand, or he'll never walk again. Winchester chooses the former, not knowing that the patient is, in civilian life, a promising young concert pianist. All of his self-worth is tied up in his planned piano career. Winchester tries pep-talks, to no avail, then has the Army's music library send over a stack of left-hand-alone piano works (mostly commissioned by
Paul Wittgenstein), and takes him into the Officers' Club tent for one final pep-talk. He protests that he can't make a career out of "a few freak pieces," but Winchester persists, and the episode fades to black with the sound of the patient playing the opening piano solo of the Ravel Concerto for the Left Hand Alone.
As to real life, well, over half a lifetime ago, I was lying on my back, reading a magazine and trying to avoid nodding off, when the magazine slipped out of my fingers and scratched a cornea. The ER doctor probably wasn't aware that I was allergic to zinc compounds by skin contact, and nobody was aware that it wasn't strictly limited to zinc oxide. He prescribed Cortisporin eye ointment (which contains bacitracin zinc, and possibly other zinc compounds). By the time my own doctor was able to see me, that eye was itchy and bloodshot; the eye ointment had done more harm than good. There was no lasting eye damage, but my zinc sensitivity skyrocketed, to where I could no longer use regular Neosporin, and even just handling galvanized iron for any length of time without gloves made my hands itch.
The only doctors who
don't face medical "Kobayashi Maru" situations are the ones who never deal with situations where they might inadvertently harm a patient, nor attempt to save a life.