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            雨楓軒原創文學網 - 純凈的綠色文學家園 !

            雨楓軒

            被醫生嚇死的病人

            時間:2018-02-26來源:網友提供 作者:維爾納·巴爾滕斯 點擊:
            被醫生嚇死的病人
             
              一個男人被判處死刑,在監獄等待行刑。一個醫生走進來,蒙上他的眼睛,用手術刀割開他手腕和腳踝的皮膚,同時在一個水袋上扎出一些小洞。刀割下去之后,馬上讓水滴在鐵碗中,發出滴滴答答的聲音。醫生哼唱著一首簡單的歌曲,聲音越來越輕。漸漸地,滴水聲越來越慢,男人沒有了聲息——他被自己血已流盡的錯覺嚇死了,實際上他流的血還不滿一燒酒杯。
             
              這個殘忍的實驗發生在20世紀30年代的印度,它被作為“負面感覺和想象的力量”的極端例子載入醫學史。實際上,正是本該救人的醫生,常常使病人覺得自己病入膏肓。在這種情況下,醫生就是病人生病的原因:草率的診斷,對藥物或治療風險和副作用的夸張警告,都可能給病人帶來巨大損害;有時,只是負責鉆孔的牙醫的說話聲都會引起病人的疼痛,盡管鉆孔還未真正開始。
             
              這種消極思想的力量幾乎讓凡斯·范德思走向毀滅。這又是一個廣為人知的例子,也發生在20世紀30年代,這次是在美國。一天傍晚,范德思在亞拉巴馬州的一塊墓地中遇到一個巫醫。他拿著一瓶發出惡臭的液體,在范德思的臉前搖晃,然后預言他馬上就會死亡,沒有活命的機會。
             
              從那以后,范德思就像真的被言中了。他躲在家中,情緒越來越糟。幾天后,他虛弱不堪,不得不住進醫院。醫生無法找出他痛苦的原因,后來,范德思的妻子對醫生講述了這個奇特的詛咒。醫生最初十分迷茫,隨后,他開始了診治。他打電話叫來范德思的家人,站在病床前,說他和巫醫談過話了,那個巫醫當時把蜥蜴卵引進了范德思的胃里,一條小蜥蜴在那里孵化出來了。這個寄居在他身體中的爬行動物,會慢慢地從內部將他吞噬。
             
              在醫生的命令下,一個護士走進來,拿著一個裝有催吐劑的大針管。醫生把針扎進病人的身體,病人開始嘔吐。在混亂中,趁病人沒有注意,醫生從口袋中拿出一條蜥蜴,帶著勝利的微笑說:“看,你吐出了什么?現在好了,詛咒解除了。”病人喝下一口水,陷入了深度睡眠。一周后,他出院了,完全恢復了健康。
             
              醫生的詛咒
             
              在醫學界,存在一種非常普遍的現象:病人在聽到醫生關于某種副作用的警告后,就真的會出現該種副作用,糟糕的好奇心引發糟糕的身體反應。在服藥之后,病人開始受苦,說明書中列舉的副作用一一出現,口干、皮疹、疲倦、視力障礙、便秘等。“可能出現的副作用”這種說法對有些病人來說就像一個可怕的詛咒。
             
              美國人山姆·蘇曼在20世紀70年代時被診斷為肝癌晚期。蘇曼、他的家人和醫生都認為他只能活幾個月了,而他也確實在幾周之后死亡。然而,尸檢結果讓所有醫生大吃一驚:這是一個直徑僅3厘米的小腫瘤,沒有感染其他器官,癌細胞也沒有轉移。這個男人不是死于癌癥,而是死于自己即將死于癌癥的想法。
             
              心身醫學(研究心理對疾病影響的科學)認為:病人對醫生語言的不同理解,會使治療要么出現可怕后果,要么出現神奇療效。相信女人更易死于早搏的女人,死亡率比沒有這種想法的女人要高三倍。對所有人來說,負面感覺都會像高血壓一樣,極大地增加心肌梗塞的危險。非常典型的是,病人會在心肌梗塞發生前6個月內,出現筋疲力盡或絕望的癥狀。醫生應該更多地關注病人的精神痛苦和情緒低谷,而不僅僅是觀察高血壓、糖尿病和升高的膽固醇等傳統的風險因素。
             
              在一個研究中,一組病人服食同樣的藥物,卻被告知不同的藥物價格。得知藥物很貴的病人中85%都稱疼痛減輕了,而那些故意被告知藥品價格很低的病人有61%感受到疼痛減輕。醫生也可以從每天的出診中得出這個結論。很多病人都更傾向于服用昂貴的處方鎮痛藥物,而不是低價的非處方藥。很多病人抱怨,廉價的藥物不如昂貴的藥物有效,盡管它們所含的有效成分可能完全一樣。所以,醫生應該盡可能多花時間向病人解釋,廉價的藥物和昂貴的藥物一樣有效,而不是簡單地對他們說“醫保不會為其他藥物付款”。
             
              此外,很多人因為害怕可能出現的副作用而選擇不吃藥,醫生必須更好地對此作出解釋。如今,制藥公司正在履行越來越嚴格的藥品安全義務,每一種副作用,哪怕只出現過一次,都必須列在說明書中。正因如此,再無害的藥物可能帶來的不良反應列出來也像一張恐怖清單,其實,這些副作用出現的概率比被雷電劈死還要小。
             
              言語的力量
             
              醫生總是低估了他們言語的力量,所以專家建議,將來的醫學專業學生必須學習和病人對話、交流,進行角色扮演訓練,醫生應該真正在醫患互動的細節上下功夫。那些對醫生來說很好理解的醫學術語,卻可能讓病人誤解,引發他們的強烈反應,大大降低疾病治愈的可能性。
             
              美國心臟病醫師、諾貝爾和平獎獲得者伯納德·勞恩在著作《痊愈的遺失藝術》中敘述了年輕的他做醫生助手時經歷的一件事。當時的主任醫師情緒很糟,匆匆探視病人后,在病床邊對其他醫生說,這位女病人患的是典型的TS。TS在醫學術語中是三尖瓣狹窄的意思,實際上大部分都不會帶來很大的身體損害,絕對不算致命的疾病。女病人聚精會神地聽著。探視之后,她對勞恩說:“看來一切都結束了,TS肯定意味著晚期。”盡管勞恩馬上向她解釋這個縮寫的含義,并告訴她不需要擔心,但她的狀況還是迅速惡化。她呼吸困難,肺中的液體越積越多,數小時后,她便死于肺積水。
             
              在醫院里,每天都會出現醫生不加考慮說出的話語,有的可能出自好意,最后卻帶來致命的后果。心慌意亂的病人會細細斟酌醫生說的每一個字。如果醫生在給孕婦做超聲波的時候嘟囔了句“嬰兒的頭有點大”,本來滿懷希望的父母可能立馬就會想到腦積水或嚴重的殘疾。“這種藥可能會起作用”或“我們試試這種藥”之類的話都足以使病人陷入深深的不安。形象描述出來的專業術語(如在計算機斷層掃描前說“現在我們把您切成一些薄片”)或報告好消息時采用負面的表達方式(如“腫瘤擴散的結果為負”)也會給無法很快理解其意的病人帶來擔憂。有些安慰也絲毫不起作用,只會引起病人不必要的不安,比如“您不需要害怕”“您感到疼就告訴我”或“現在會流一點血”。
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