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“一个小墓地”:当代英国手术室里的死亡与濒死。

'A small cemetery': death and dying in the contemporary British operating theatre.

机构信息

Humanities, University of Roehampton, London SW15 5PU, UK

出版信息

Med Humanit. 2020 Sep;46(3):278-287. doi: 10.1136/medhum-2019-011668. Epub 2019 Jul 25.

Abstract

Surgeon Henry Marsh begins his autobiography, , with a quotation from the French practitioner René Leriche, "Every surgeon carries within himself a small cemetery, where from time to time he goes to pray-a place of bitterness and regret, where he must look for an explanation for his failures". This article uses memoirs and oral history interviews to enter the operating theatre and consider the contemporary history of surgeons' embodied experiences of patient death. It will argue that these experiences take an under-appreciated emotional toll on surgeons, but also that they are deployed as a narrative device through which surgeons construct their professional identity. Crucially, however, there is as much forgetting as remembering in their accounts, and the 'labour' of death has been increasingly shifted out of the operating theatre, off the surgeons' hands and into the laps of others. The emotional costs of surgical care remain understudied. Indeed, while many researchers agree that undergoing surgery can be a troubling emotional experience for the patient, less scholarly attention has been paid to the emotional demands performing surgery makes on surgical practitioners. Is detachment the modus operandi of the modern surgeon and if so, is it tenable in moments of emotional intensity-like patient death?

摘要

外科医生亨利·马什(Henry Marsh)在他的自传《当呼吸化为空气》(Do Not Go Gentle)的开篇引用了法国医生勒里希(René Leriche)的一句话:“每个外科医生的内心深处都有一个小小的墓地,他不时地去那里祈祷——一个充满痛苦和悔恨的地方,他必须在那里为自己的失败寻找解释。”本文通过回忆录和口述历史访谈进入手术室,探讨了外科医生对患者死亡的当代身体体验史。本文认为,这些经历对外科医生的情感造成了被低估的影响,但它们也被用作一种叙事手段,外科医生通过这种手段构建自己的职业身份。然而,至关重要的是,在他们的叙述中既有遗忘也有记忆,死亡的“劳动”已经越来越多地从手术室中、从外科医生的手中转移到其他人的手中。外科护理的情感成本仍然研究不足。事实上,尽管许多研究人员都认为手术对患者来说可能是一种令人困扰的情感体验,但很少有学者关注手术对外科医生的情感要求。那么,超脱是否是现代外科医生的惯用手法,如果是,那么在情感强烈的时刻——比如患者死亡——是否可行?

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本文引用的文献

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Why were surgical gloves not used earlier?为什么手术手套没有更早被使用?
Lancet. 2015 Sep 26;386(10000):1234-5. doi: 10.1016/S0140-6736(15)00271-8.
6
Mortality after surgery in Europe: a 7 day cohort study.欧洲手术后死亡率:一项 7 天队列研究。
Lancet. 2012 Sep 22;380(9847):1059-65. doi: 10.1016/S0140-6736(12)61148-9.
9
Emotional intelligence medical education: measuring the unmeasurable?情商医学教育:衡量不可衡量之物?
Adv Health Sci Educ Theory Pract. 2005 Nov;10(4):339-55. doi: 10.1007/s10459-005-4861-0.
10
Facing up to surgical deaths.直面手术死亡。
BMJ. 2004 Feb 14;328(7436):361-2. doi: 10.1136/bmj.328.7436.361.

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