兰馨小屋
一个喜欢做梦的人, 后来爱上了写作。总是想把生活过得快乐，丰富多彩。
正文
近年来, 医生和医院题材的作品在美国很popular, 有一本华人女医生Pauline W. Chen写的"Final Exam", 就成为NY TIMES畅销书．我去年看了三分之一，但不慎染上网瘾，结果到现在书还没看完，给大家贴个读者的review:
Nonfiction. Final Exam. A Surgeon's Reflections on Mortality. By Pauline W. Chen.
When it comes to confronting death, doctors are as much at a loss as the rest of us. They are in the business of saving lives, not ending them. By instinct and by training, they avoid what Dr. Pauline W. Chen calls "the final exam," the emotional challenges posed by terminally ill patients. Death represents failure. It asks unanswerable questions. Perhaps most vexingly, it threatens to crack the hard professional shell of detachment that medical training puts in place. In modern American medicine, death is everywhere and nowhere at the same time.
Chen, a surgeon specializing in liver transplants, is her own patient in "Final Exam," a series of thoughtful, moving essays on the troubled relationship between modern medical practice and the emotional events surrounding death. She recalls episodes from her own medical training, and cases in which she was involved, to dramatize her misgivings about the "lessons in denial and depersonalization" that help doctors achieve a high level of technical competence but can also prevent them from expressing empathy or confronting their own fears about death.
In the current system, she writes, "few of us ever adequately learn how to care for patients at the end of life." Among other things, "Final Exam" is a crash course in the specifics of human mortality. Chen begins with her first dead body, the dissecting-room cadaver that she disassembles as she learns to itemize every muscle and bone.
It is a strangely intimate ritual. "My partners and I would know our cadaver's body better than any patient we would ever take care of," she writes. Later she learns how to poke and prod a dead body before drawing up a death certificate, witnesses a failed attempt to resuscitate a patient in cardiac arrest and experiences the first death of a patient under her care. She struggles to find a professional middle ground between inappropriate attachment and cold indifference.
The middle ground proves to be elusive. As a student, Chen found it difficult to regard death as "a clinical event." Instead, she writes, "seeing patients die bothered me." Her own family background only compounded her sense of confusion. The daughter of immigrants from Taiwan, she grew up regarding death as a matter of fate. On the day of her birth, her parents engaged an old man in Taiwan to tell her fortune. Much more than she could admit to her fellow students or teachers, her feelings about death were shaped by her culture.
"That great passing of life was too sacred; it was nearly magical," she writes. "Death was an immutable moment in time, locked up as much in our particular destiny as in the time and date of our birth."
Chen vividly conveys the fears and anxieties of medical training, as well as its pleasures. She also laments the lack of training in talking to patients, especially about death. Doctors, like everyone else, avoid the topic.
Institutionally, discussions of death are limited to formal inquiries known as morbidity and mortality conferences, in which surgeons analyze recent deaths on the operating table in the hope of learning from them.
Outside the conferences, death is the unwelcome, awkward visitor who stops conversation. Chen cites a survey showing that one-quarter of oncologists failed to tell their patients that they were suffering from an incurable disease. Often, with several specialists and sub-specialists assigned to a dying patient, each doctor waits for the other to provide unwelcome information.
Chen experiences an epiphany when she witnesses a break with tradition. Normally, in a patient's final hours, doctors close the curtain around the bed and disappear, leaving family members alone with their dying relative. But one doctor, trying to console an elderly woman whose husband was dying, stays with her by the side of the bed. As she holds her husband's hand, he tells her what the strange sights and sounds on the monitors are saying, and what her husband is experiencing as life ebbs away. That scene of compassion and communication, in the midst of high-tech beepings and buzzings, shows what doctors can do when nothing can be done.
另一本national best seller 是 Better: A Surgeon's Notes on Performance by Atul Gawande
简介：
The struggle to perform well is universal: each of us faces fatigue, limited resources, and imperfect abilities in whatever we do. But nowhere is this drive to do better more important than in medicine, where lives may be on the line with any decision.
Atul Gawande, the New York Times bestselling author of Complications, examines, in riveting accounts of medical failure and triumph, how success is achieved in this complex and risk-filled profession. At once unflinching and compassionate, Better is an exhilarating journey, narrated by "arguably the best nonfiction doctor-writer around"
Nonfiction. Final Exam. A Surgeon's Reflections on Mortality. By Pauline W. Chen.
When it comes to confronting death, doctors are as much at a loss as the rest of us. They are in the business of saving lives, not ending them. By instinct and by training, they avoid what Dr. Pauline W. Chen calls "the final exam," the emotional challenges posed by terminally ill patients. Death represents failure. It asks unanswerable questions. Perhaps most vexingly, it threatens to crack the hard professional shell of detachment that medical training puts in place. In modern American medicine, death is everywhere and nowhere at the same time.
Chen, a surgeon specializing in liver transplants, is her own patient in "Final Exam," a series of thoughtful, moving essays on the troubled relationship between modern medical practice and the emotional events surrounding death. She recalls episodes from her own medical training, and cases in which she was involved, to dramatize her misgivings about the "lessons in denial and depersonalization" that help doctors achieve a high level of technical competence but can also prevent them from expressing empathy or confronting their own fears about death.
In the current system, she writes, "few of us ever adequately learn how to care for patients at the end of life." Among other things, "Final Exam" is a crash course in the specifics of human mortality. Chen begins with her first dead body, the dissecting-room cadaver that she disassembles as she learns to itemize every muscle and bone.
It is a strangely intimate ritual. "My partners and I would know our cadaver's body better than any patient we would ever take care of," she writes. Later she learns how to poke and prod a dead body before drawing up a death certificate, witnesses a failed attempt to resuscitate a patient in cardiac arrest and experiences the first death of a patient under her care. She struggles to find a professional middle ground between inappropriate attachment and cold indifference.
The middle ground proves to be elusive. As a student, Chen found it difficult to regard death as "a clinical event." Instead, she writes, "seeing patients die bothered me." Her own family background only compounded her sense of confusion. The daughter of immigrants from Taiwan, she grew up regarding death as a matter of fate. On the day of her birth, her parents engaged an old man in Taiwan to tell her fortune. Much more than she could admit to her fellow students or teachers, her feelings about death were shaped by her culture.
"That great passing of life was too sacred; it was nearly magical," she writes. "Death was an immutable moment in time, locked up as much in our particular destiny as in the time and date of our birth."
Chen vividly conveys the fears and anxieties of medical training, as well as its pleasures. She also laments the lack of training in talking to patients, especially about death. Doctors, like everyone else, avoid the topic.
Institutionally, discussions of death are limited to formal inquiries known as morbidity and mortality conferences, in which surgeons analyze recent deaths on the operating table in the hope of learning from them.
Outside the conferences, death is the unwelcome, awkward visitor who stops conversation. Chen cites a survey showing that one-quarter of oncologists failed to tell their patients that they were suffering from an incurable disease. Often, with several specialists and sub-specialists assigned to a dying patient, each doctor waits for the other to provide unwelcome information.
Chen experiences an epiphany when she witnesses a break with tradition. Normally, in a patient's final hours, doctors close the curtain around the bed and disappear, leaving family members alone with their dying relative. But one doctor, trying to console an elderly woman whose husband was dying, stays with her by the side of the bed. As she holds her husband's hand, he tells her what the strange sights and sounds on the monitors are saying, and what her husband is experiencing as life ebbs away. That scene of compassion and communication, in the midst of high-tech beepings and buzzings, shows what doctors can do when nothing can be done.
另一本national best seller 是 Better: A Surgeon's Notes on Performance by Atul Gawande
简介：
The struggle to perform well is universal: each of us faces fatigue, limited resources, and imperfect abilities in whatever we do. But nowhere is this drive to do better more important than in medicine, where lives may be on the line with any decision.
Atul Gawande, the New York Times bestselling author of Complications, examines, in riveting accounts of medical failure and triumph, how success is achieved in this complex and risk-filled profession. At once unflinching and compassionate, Better is an exhilarating journey, narrated by "arguably the best nonfiction doctor-writer around"
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