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My mother fought her cancer for eight years.
我的媽媽和癌癥做了八年的斗爭。
She was a planner,and she thought a lot about how she wanted to live and how she wanted to die.
她是一個有計劃的人,她想了很多關于她想如何活和她想如何死去。
Not only did she sign advance directives,she wrote a 12-page document about how she had suffered enough,how it was time for her to go.
她不僅簽了預留醫療指示協議,而且她寫下了12頁, 關于她遭受的是怎樣的痛苦,是時候讓她走了。
One day, when I was a resident physician,I got a call to say that she was in the intensive care unit.
一天, 當我是一名住院醫師的時候,我接到電話說她在特護病房。
By the time I got there, she was about to be intubated and put on a breathing machine.
我到那兒時, 她正要被插管裝上呼吸機。
But this is not what she wants, I said, and we have documents.
但是這不是她想要的, 我說, 我們有協議的。
The ICU doctor looked at me in the eye,pointed at my then 16-year-old sister, and said.
重癥加護病房的醫生看著我的眼睛,指著我16歲的妹妹說。
Do you remember when you were that age?
你記得當你是這個年紀的時候嗎?
How would you have liked to grow up without your mother?
你會想要沒有媽媽陪在你身邊嗎?
Her oncologist was there too, and said,
她的腫瘤醫生也在那里對我說,
This is your mother.
這是你的媽媽。
Can you really face yourself for the rest of your life if you don't do everything for her?
在你接下去的日子里, 你真的能面對你自己如果你沒有為她盡全力?
I knew my mother so well.
我非常了解我的媽媽。
I understood what her directives meant so well,but I was a physician.
我明白她簽的協議是什么,但是我也是一名醫生。
That was the single hardest decision I ever made,to let her die in peace,and I carry those words of those doctors with me every single day.
這曾是我人生當中做的一個最難的決定：讓她在平靜地死去,我每一天都在想這些醫生的話
We can bridge the disconnect between what doctors do and what patients need.
我們能在患者需求和醫生之間的這種隔閡搭建橋梁。
We can get there, because we've been there before,and we know that transparency gets us to that trust.
我們可以做到, 因為之前我們做到過,我們知道這種透明讓我們得到信任。
Research has shown us that openness also helps doctors,that having open medical records,being willing to talk about medical errors,will increase patient trust,improve health outcomes,and reduce malpractice.
研究已經表明公開也可以幫助醫生,有一個公開的的病歷,就會愿意去討論醫療差錯,這將增加患者的信任,改善健康結果,減少治療不當。
That openness, that trust,is only going to be more important as we move from the infectious to the behavioral model of disease.
公開, 信任,只會變得更加重要，因為我們關注的是疾病的行為模式， 而不是它的傳染模式。
Bacteria may not care so much about trust and intimacy,but for people to tackle the hard lifestyle choices,to address issues like smoking cessation,blood-pressure management and diabetes control,well, that requires us to establish trust.
細菌可能不關心信任和親密但是為了幫助患者徹底改變他們不良生活嗜好，為了讓患者戒煙，為了讓患者控制血壓，控制血糖，這些都要求我們去建立醫患信任感。
Here's what other transparent doctors have said.
以下是其他參與透明活動的醫生說的。
Brandon Combs, an internist in Denver:
布蘭登庫姆斯, 在丹佛的內科醫生:
This has brought me closer to my patients.
這讓我和我的患者親近。
The type of relationship I've developed that's why I entered medicine.
這種我一直以來建立起來的 醫患關系恰恰就是為什么當初我行醫的原因。
Aaron Stupple, an internist in Denver:
亞倫, 丹佛的一名內科醫生
I tell my patients that I am totally open with them.
我告訴我的患者們，我對他們完全公開。
I don't hide anything from them.
我不向他們隱藏任何什么。
This is me. Now tell me about you.
這就是我, 你呢。
We're in this together.
我們同心協力。
May Nguyen, a family physician in Houston:
五月阮, 休斯頓的一名家庭醫生:
My colleagues are astounded by what I'm doing.
我的同事對于我在做什么都很震驚。
They ask me how I could be so brave.
他們問我, 我怎么這么勇敢。
I said, I'm not being brave,it's my job.
我說, 這不是勇敢,這是我的工作。
I leave you today with a final thought.
今天我留給你們最后一個思考。
Being totally transparent is scary.
成為完全透明是令人害怕的,
You feel naked, exposed and vulnerable,but that vulnerability, that humility,it can be an extraordinary benefit to the practice of medicine.
你感覺很不安, 脆弱,但是那些脆弱, 謙卑,對于我們行醫來說, 會帶來非同凡響的益處。
When doctors are willing to step off our pedestals,take off our white coats,and show our patients who we are and what medicine is all about,that's when we begin to overcome the sickness of fear.
當醫生愿意放下架子,脫下白大褂,向我們的患者展示我們是誰 和醫學是關于什么的,那就是我們開始去克服恐懼的時候,
That's when we establish trust.
那就是我們建立信任的時候,
That's when we change the paradigm of medicine from one of secrecy and hiding to one that is fully open and engaged for our patients.
那就是我們改變醫學模式從秘密和隱藏到完全開放并參與我們的患者中去。
Thank you.
謝謝。
