医生的修炼:在不完美中探索行医的真相

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医生的修炼:在不完美中探索行医的真相
医生的修炼:在不完美中探索行医的真相
医生的修炼:在不完美中探索行医的真相
医生的修炼:在不完美中探索行医的真相

医生的修炼:在不完美中探索行医的真相

Brand: 浙江人民出版社    Sold By: EM China
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医生的修炼:在不完美中探索行医的真相

医生的修炼:在不完美中探索行医的真相

$35.56

编辑推荐

入选“亚马逊年度10大好书”,比《豪斯医生》更人性,比《白色巨塔》更真实。

 医学有理可循,疾病变化万千。世间没有完美的医生,在病魔面前,妙手仁心...

Product Details
编辑推荐

亚马逊年度10大好,比《豪斯医生》更人性,比《白色巨塔》更真

 医学有理可循,疾病化万千。世没有完美的医生,在病魔面前,妙手仁心的医工作者也会不体会孩童般的无力感。里看花的错觉和偏,将在诚恳的医生手中烟消云散。

 作者阿·葛文德是哈佛医学院外科副教授,于2010身《周刊》评选“100位**影响力人物,他是白*年的健康政策顾问,全托出医体系中那些鲜为人知的真相。

文化出品。

 

阿图葛文德三部曲: 《* 好的告别》      《医生的精进》      《医生的修炼》     

 
内容简介

手医生阿图满怀抱负进入梦想中的白色巨塔,他将遇到哪些意想不到的试炼?硬着皮*次拿起手刀的他,将如何理突如其来的故?在错误切开病人气管的候,他如何面从手丝丝逝去的生命?在成功是常,失就是一条人命职业生涯中,在每一个或者温暖或悚的病例故事背后,都是生与死的殊死量。

14个主,从不同面展了医生所面的世界的不确定性,和做抉择时需要考的复因素。一个个医学象背后,是外科医生群体的自我审视与修

适合医界人士、政策制定者和普通大众阅读

作者简介

(美)阿图·葛文德
白宫年轻的健康政策顾问,影响奥巴马医改政策的关键人物,受到金融大鳄查理·芒格大力褒奖的医学工作者。
《时代周刊》2010年全球“100位*影响力人物”榜单中的医生,2014年《展望》杂志年度“全球十大思想家”。

克林顿政府年轻的卫生医疗政策高级顾问
阿图出生在纽约布鲁克林区一个医生世家。作为印度新移民的后代,阿图成长在西方文化和教育环境下,先后就读于斯坦福大学、牛津大学和哈佛医学院。在牛津大学攻读著名的PPE专业(哲学、政治和经济学)的经历,对他在医学人文思想和社会支持方面的看法产生了巨大影响。他在哈佛医学院就读期间,恰逢克林顿竞选美国总统,他成为卫生保健部门中的一员。克林顿就职美国总统之后,他成为克林顿卫生与人类服务部的高级顾问,指导由3个委员会组成的75人医疗小组,那年他只有27岁。
目  录

楔子当简单科学遇到复杂个体

第1部分孰能无过
第1章 一把刀的修炼
我把手术刀放在病人皮肤上,划下刀。这种感受实在太奇特了,会让人欲罢不能,它混合了见血的亢奋、担心出错的焦虑和坚定不移的成功信念。
第2章 像机器一样精准
长久以来,西方医学界不断追求的一个目标就是近乎机器的完美。怎样才能达到这种程度呢?要诀就是“多做”,连续不断地做,有朝一日自然会像庖丁解牛一样熟练而精准。
第3章 切烂的喉咙
我在她脖子上摸索着,寻找甲状软骨的突起,但只摸到一层层脂肪,找不到可以下手的地方。该切下去吗?是横切还是纵切?我真痛恨自己。没有一个外科医师会犹豫不决,而我竟这般踌躇。
第4章 9000个医生的嘉年华
主办单位安排了3间放映室,接连6天从早到晚播放手术视频,我看得目眩神迷。片中呈现了各种手术,有大胆的,有精细的,还有既简单又高明、令人拍案叫绝的处理方法。
前  言
[总序]
了不起的葛文德:生命之思与医学之悟
北京大学医学部 王一方教授
如今的阅读多少带些偶像情结,让大家读读葛文德得给个理由先。他是何方神圣?首先,他服务的机构在国人眼里颇为荣耀——美国波士顿的哈佛大学医学院,职位是外科教授。大伙印象中的外科大夫大多比较明快、潇洒,他也不例外。更厉害的是,这位老兄还是WHO全球病患安全挑战项目负责人,克林顿、奥巴马两届民主党政府的医改顾问。这说明什么呢?能耐与境界,够水准。不过,读书不是读身份,要读文章气象,还要读文字品味,是否优美、雅致?这一点也不含糊,这位外科医生不仅手术做得漂亮,文字也够典雅,他是一位畅销书作家、风韵杂志《纽约客》上有他的专栏。
媒体评论

葛文德这个医生作家,有一支犀利如手术刀的笔,一双如X光般具有穿透力的眼睛……他描述的每一个病例故事,从枪伤到病态肥胖到噬肉菌,都是迷你惊悚小说。诊断结果:这是本让人目不转睛、不忍释卷的精彩之作。
《时代周刊》

没有一个作家比葛文德更会营造现场感。他的文字有种魔力,能让病房里的真实故事在我们眼前上演。每一出都是惊心动魄的医学奇案或感人肺腑的外科戏剧,给人无比真实的感觉。作者笔力万钧,是*忠实的记录者!
《纽约时报》
在线试读
第2章 外科机器
医学界的“深蓝大战”
1996 年夏季的一天,就职于瑞典兰德大学附属医院,负责冠状动脉特护病房的汉斯·沃林(Hans Ohlin)主任,一个 50 岁的老头,坐在办公室里,面前堆积着 2 240 份心电图。每份心电图都是一张 4 开左右的方格纸,由左至右有一条弯曲起伏的线。沃林独自一个人在办公室里审阅它们。他迅速而仔细地浏览着,将他认为代表心脏病发作的心电图挑出来。为了避免因为疲倦带来的疏忽,他每两小时休息一会儿。他不想因为粗心大意而犯错,代价太大了。这是医学界的“深蓝大战”,而沃林就是心脏病学界的棋王卡斯帕罗夫。他将与电脑进行对决。
心电图是一种非常普遍的诊断检查,在美国一年就有多达 5 000 万次的这种检查。我们将电极片贴在病人皮肤上,接收心脏每次收缩扩张产生的电流,由此绘制出心电图。心电图上的曲线显示了心肌电位的变化,一旦心脏出现问题,心电图的曲线就会出现异常。具体来说就是由于部分心肌坏死,电流通过这些坏死的部分,导致心电图上的曲线产生变化。有时这些变化很明显,但更多的时候这种变化很细微。
对于医学院的学生来说,心电图看起来很复杂,难以理解。图中包含了12 导极,每一个导极都会产生一种不同的曲线记录,每一种曲线都有英文字母做标识:比如,从一开始就下降的曲线被称为 Q 波,心脏收缩突然向上升起的被称为 R 波,随后又向下的被称为 S 波,受冲击后显示环型波的曲线型被称为 T 波。学生要学习辨别这一打甚至更多的曲线。在医学院里次学习解读心电图时,我感觉它就像复杂的推算。我和同学们将那些晦涩难解的译解指南写在一些小卡片上,放在白大褂的口袋里,方便随时查看。
随着不断的练习,译解心电图就变得容易多了,就像植入中心静脉导管那样简单。经验丰富的心脏外科医生有时只要扫一眼就能判断出病人是否心脏病发作,好比小孩可以马上认出房间另一端的母亲。但心电图实在太复杂,有些细微的变化很容易被忽略掉,即使是专家的判断也不能保证百分之百正确。研究表明,送到急诊室的 2%~8% 的心脏病患者会被误诊为没有问题,这些人中的 1/4 终死于心脏骤停。有人试图让电脑看懂心电图。他们认为如果电脑能比人更准确地为病人诊断,那么我们就可以使用电脑解读心电图,每年就可以使几千人免于死亡。

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编辑推荐

亚马逊年度10大好,比《豪斯医生》更人性,比《白色巨塔》更真

 医学有理可循,疾病化万千。世没有完美的医生,在病魔面前,妙手仁心的医工作者也会不体会孩童般的无力感。里看花的错觉和偏,将在诚恳的医生手中烟消云散。

 作者阿·葛文德是哈佛医学院外科副教授,于2010身《周刊》评选“100位**影响力人物,他是白*年的健康政策顾问,全托出医体系中那些鲜为人知的真相。

文化出品。

 

阿图葛文德三部曲: 《* 好的告别》      《医生的精进》      《医生的修炼》     

 
内容简介

手医生阿图满怀抱负进入梦想中的白色巨塔,他将遇到哪些意想不到的试炼?硬着皮*次拿起手刀的他,将如何理突如其来的故?在错误切开病人气管的候,他如何面从手丝丝逝去的生命?在成功是常,失就是一条人命职业生涯中,在每一个或者温暖或悚的病例故事背后,都是生与死的殊死量。

14个主,从不同面展了医生所面的世界的不确定性,和做抉择时需要考的复因素。一个个医学象背后,是外科医生群体的自我审视与修

适合医界人士、政策制定者和普通大众阅读

作者简介

(美)阿图·葛文德
白宫年轻的健康政策顾问,影响奥巴马医改政策的关键人物,受到金融大鳄查理·芒格大力褒奖的医学工作者。
《时代周刊》2010年全球“100位*影响力人物”榜单中的医生,2014年《展望》杂志年度“全球十大思想家”。

克林顿政府年轻的卫生医疗政策高级顾问
阿图出生在纽约布鲁克林区一个医生世家。作为印度新移民的后代,阿图成长在西方文化和教育环境下,先后就读于斯坦福大学、牛津大学和哈佛医学院。在牛津大学攻读著名的PPE专业(哲学、政治和经济学)的经历,对他在医学人文思想和社会支持方面的看法产生了巨大影响。他在哈佛医学院就读期间,恰逢克林顿竞选美国总统,他成为卫生保健部门中的一员。克林顿就职美国总统之后,他成为克林顿卫生与人类服务部的高级顾问,指导由3个委员会组成的75人医疗小组,那年他只有27岁。
目  录

楔子当简单科学遇到复杂个体

第1部分孰能无过
第1章 一把刀的修炼
我把手术刀放在病人皮肤上,划下刀。这种感受实在太奇特了,会让人欲罢不能,它混合了见血的亢奋、担心出错的焦虑和坚定不移的成功信念。
第2章 像机器一样精准
长久以来,西方医学界不断追求的一个目标就是近乎机器的完美。怎样才能达到这种程度呢?要诀就是“多做”,连续不断地做,有朝一日自然会像庖丁解牛一样熟练而精准。
第3章 切烂的喉咙
我在她脖子上摸索着,寻找甲状软骨的突起,但只摸到一层层脂肪,找不到可以下手的地方。该切下去吗?是横切还是纵切?我真痛恨自己。没有一个外科医师会犹豫不决,而我竟这般踌躇。
第4章 9000个医生的嘉年华
主办单位安排了3间放映室,接连6天从早到晚播放手术视频,我看得目眩神迷。片中呈现了各种手术,有大胆的,有精细的,还有既简单又高明、令人拍案叫绝的处理方法。
前  言
[总序]
了不起的葛文德:生命之思与医学之悟
北京大学医学部 王一方教授
如今的阅读多少带些偶像情结,让大家读读葛文德得给个理由先。他是何方神圣?首先,他服务的机构在国人眼里颇为荣耀——美国波士顿的哈佛大学医学院,职位是外科教授。大伙印象中的外科大夫大多比较明快、潇洒,他也不例外。更厉害的是,这位老兄还是WHO全球病患安全挑战项目负责人,克林顿、奥巴马两届民主党政府的医改顾问。这说明什么呢?能耐与境界,够水准。不过,读书不是读身份,要读文章气象,还要读文字品味,是否优美、雅致?这一点也不含糊,这位外科医生不仅手术做得漂亮,文字也够典雅,他是一位畅销书作家、风韵杂志《纽约客》上有他的专栏。
媒体评论

葛文德这个医生作家,有一支犀利如手术刀的笔,一双如X光般具有穿透力的眼睛……他描述的每一个病例故事,从枪伤到病态肥胖到噬肉菌,都是迷你惊悚小说。诊断结果:这是本让人目不转睛、不忍释卷的精彩之作。
《时代周刊》

没有一个作家比葛文德更会营造现场感。他的文字有种魔力,能让病房里的真实故事在我们眼前上演。每一出都是惊心动魄的医学奇案或感人肺腑的外科戏剧,给人无比真实的感觉。作者笔力万钧,是*忠实的记录者!
《纽约时报》
在线试读
第2章 外科机器
医学界的“深蓝大战”
1996 年夏季的一天,就职于瑞典兰德大学附属医院,负责冠状动脉特护病房的汉斯·沃林(Hans Ohlin)主任,一个 50 岁的老头,坐在办公室里,面前堆积着 2 240 份心电图。每份心电图都是一张 4 开左右的方格纸,由左至右有一条弯曲起伏的线。沃林独自一个人在办公室里审阅它们。他迅速而仔细地浏览着,将他认为代表心脏病发作的心电图挑出来。为了避免因为疲倦带来的疏忽,他每两小时休息一会儿。他不想因为粗心大意而犯错,代价太大了。这是医学界的“深蓝大战”,而沃林就是心脏病学界的棋王卡斯帕罗夫。他将与电脑进行对决。
心电图是一种非常普遍的诊断检查,在美国一年就有多达 5 000 万次的这种检查。我们将电极片贴在病人皮肤上,接收心脏每次收缩扩张产生的电流,由此绘制出心电图。心电图上的曲线显示了心肌电位的变化,一旦心脏出现问题,心电图的曲线就会出现异常。具体来说就是由于部分心肌坏死,电流通过这些坏死的部分,导致心电图上的曲线产生变化。有时这些变化很明显,但更多的时候这种变化很细微。
对于医学院的学生来说,心电图看起来很复杂,难以理解。图中包含了12 导极,每一个导极都会产生一种不同的曲线记录,每一种曲线都有英文字母做标识:比如,从一开始就下降的曲线被称为 Q 波,心脏收缩突然向上升起的被称为 R 波,随后又向下的被称为 S 波,受冲击后显示环型波的曲线型被称为 T 波。学生要学习辨别这一打甚至更多的曲线。在医学院里次学习解读心电图时,我感觉它就像复杂的推算。我和同学们将那些晦涩难解的译解指南写在一些小卡片上,放在白大褂的口袋里,方便随时查看。
随着不断的练习,译解心电图就变得容易多了,就像植入中心静脉导管那样简单。经验丰富的心脏外科医生有时只要扫一眼就能判断出病人是否心脏病发作,好比小孩可以马上认出房间另一端的母亲。但心电图实在太复杂,有些细微的变化很容易被忽略掉,即使是专家的判断也不能保证百分之百正确。研究表明,送到急诊室的 2%~8% 的心脏病患者会被误诊为没有问题,这些人中的 1/4 终死于心脏骤停。有人试图让电脑看懂心电图。他们认为如果电脑能比人更准确地为病人诊断,那么我们就可以使用电脑解读心电图,每年就可以使几千人免于死亡。

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