讀 ' Do No Harm' 有感

今年失眠比較多, 睡不好自然沒心情做太多的事, 有時累極了也吃半片安眠藥, 睡到快要上班時才起來, 所以運動也減少了些.

睡不好就沒有做吃的心情, 上班時用花生醬塗麵包夾黃瓜夾香蕉應付竟然覺得蠻香, 用各種不同的菜刨絲後涼拌吃起來也特別爽口, 簡單營養健康.

因為睡不好看了不少書, 基本不到一周就看完一本. 2個平板同時下載了4本書, 交替著看, 有時從一本跳到第二本連人物都會搞錯:)

昨晚看完了英國腦外科醫生Henry Marsh 寫的" Do no harm", 書中描寫了他成長的經曆, 從醫學生到腦科專家的曆史, 30多年手術的成功和錯誤, 還寫了很多腦外科疾病的治療手術過程及病人和家屬的反應等.

我很喜歡 Marsh 醫生, 他非常誠實, 書裏很多次他描寫了在治療病人時犯的錯誤, 被病人家屬投訴吃官司的過程. 他說, 醫生是人不是上帝, 沒有醫生不犯錯的, 尤其在剛開始行醫的時候, 他們就是用病人的身體練手藝, 診斷錯誤, 用藥錯誤, 手術錯誤等等. 他說, 太多的醫生不願意承認自己犯的錯誤, 很多醫生為了不吃官司在寫的手術記錄裏做手腳掩蓋事實, 因為沒有人會知道手術中發生了什麽, 病人出了狀況都可以推到手術前講過的並發症做借口, 醫生診斷錯了用藥錯了也不會給病人和家屬交代事實. 他坦然承認年輕時的狂傲, 成年後的隨和. 最可貴的是當他的手術失敗了(比如為了多切掉一些腫瘤病人術中出血太多導致中風昏迷)他會跟病人和家屬道歉, 有時他會鼓勵他們打官司, 他說一些並發症對醫生來說就是1-5%的幾率, 但對手術的病人來說是100%的不幸. 他20多年主動去烏克蘭給腦外科病人看病做手術, 培訓他們的醫生, 還免費帶一些病人到英國做手術.

醫院做久了自然什麽都看到聽到過, 記得剛畢業時, 聽到手術室的人傳出笑話, 某醫生給病人做手術, 邊做邊說, 怎麽這麽臭啊, 助手說腹腔有大便呢, 他趕緊清洗找不小心劃開的大腸, 醫院的人把這當笑話傳, 可憐的病人怎麽知道手術中發生了什麽呢?

看完這本書的第二感想是, 身體健康比什麽都重要. 吃的健康營養,  鍛煉好身體, 盡量不讓自己得不該得的病, 不住院不做手術. 至於癌症, 沒有人能防的了, 照現代醫學的說法, 得了就是倒黴 "bad luck", 基因變異防不勝防.

抄來幾個書中的經典語言:

Life without hope is hopelessly difficult but at the end hope can so easily make fools of us all.

Neuroscience tells us that it is highly improbable that we have souls, as everything we think and feel is no more or no less than the electrochemical chatter of our nerve cells. Our sense of self, our feelings and our thoughts, our love for others, our hopes and ambitions, our hates and fears all die when our brains die.

Healthy people, I have concluded, including myself, do not understand how everything changes once you have been diagnosed with a fatal illness. How you cling to hope, however false, however slight, and how reluctant most doctors are to deprive patients of that fragile beam of light in so much darkness.

Some of my operations are great triumphs and tremendous. But they're only triumphs because there are also disasters

Psychological research has shown that the most reliable route to personal happiness is to make others happy. I have made many patients very happy with successful operations but there have been many terrible failures and most neurosurgeons’ lives are punctuated by periods of deep despair.