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披露患者不知道的5%

2017-08-08 04:33:32   中国青年网

记者周满珍

《我们——医与患:相爱,还是伤害》

孙晓飞 著

既要发现问题,也要积极寻找解决之道

接受长江日报记者采访时,孙晓飞说,他对医患关系的思考,源于国内一个顶尖的神经外科医生团队——首都医科大学宣武医院神经外科,其首席专家凌峰曾是凤凰卫视女主播刘海若的主治医生。刘海若2002年在英国旅行时遭遇意外,深度昏迷不醒。在凌峰及其团队的救治下,脑复苏成功,转危为安,引起国际医疗界的广泛关注。

后来,孙晓飞的一位朋友患病,也经由凌峰,妙手回春。这两件事情引发了孙晓飞强烈的兴趣和冲动,他历时三个多月,见缝插针,利用医生的午休时间,完成了对科室医生及患者的海量采访和田野式调查。

刚开始采访的时候,他深感这么好的团队,在中国很少见,本想单纯颂扬的。但在写作过程中,他改了主意,觉得一本书只讲述一个医疗团队的故事是不够的,眼光应该更宽阔一些,呼吁全社会关注医生这一群体,探究医患关系。

他认为,“一个有良知的学者,既要发现问题,指出问题,同时要积极寻找解决之道”。

孙晓飞花了7个月时间,读了三十几本书,包括福柯、哈贝马斯、梁漱溟的著作以及《中国儒学史》,在几百万字的资料中,写完这本书,融会中西思想精华。

带着患者5%的重压,去解决100%的问题

孙晓飞开篇就吁请“重建多重伦理关系”,首次从身体政治、医疗政治、医生的知识权力以及中国传统伦理文化与医患纠纷的解决等角度,观照医患关系,重新发现和认识医生。

其中章节《病人永远不知道的那5%》,来自北京宣武医院神经介入外科副主任梁建涛的披露。

他告诉孙晓飞,做手术,并非一是一、二是二,没有很客观的标准,比如切肿瘤,到底是切除了100%还是切除了95%,手术助手都看不出来,只有主刀大夫自己才知道。事实上,一个100%大的肿瘤,切到95%的时候,是最考验医生良心的时候,切了95%,无论是患者术后的感觉,还是核磁复查,都是完美的。但那5%切没切,只有大夫一个人知道。

“有的时候,并不是医生懒惰,而是切除这5%的精力和风险,可能会远超那95%,因为这5%非常不好切,如果与神经或血管粘连,或者有其他未知情况,一不小心,就会让医生的一世英名誉毁于一旦。”梁建涛郑重其事地说。他坦言,留下这5%不切,可能5年后肿瘤就会复发;切掉这5%,可能完全不会复发,或者20年后才会复发,所以,这5%切还是不切,是一个重要的试金石。

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