老片一部,常常在電影台重播,但卻沒有一次好好從頭看到尾。年紀大了,稍稍無法融入片中那美式光明樂觀的熱血氛圍,多想幾層,就無法這樣樂觀,生性使然。要成為這樣的醫生,很吃人格特質,不是每個人都合適。
但有些基本原則,還是非常值得深思,尤其其中關於是否退學的ㄧ個審議橋段:
審議官:Did you consider the ramifications of your actions?
What if one of your patients had died?
Adams: What's wrong with death, sir?
What are we so mortally afraid of?
Why can't we treat death with a certain amount of humanity and dignity and decency...
and, God forbid, maybe even humor?
Death is not the enemy, gentlemen.
If we're gonna fight a disease, let's fight one of the most terrible diseases of all--
indifference.
(死亡有什麼好懼怕的。比死更可怕:冷漠)
Now, I've sat in your schools and heard people lecture on transference...
and professional distance.
Transference is inevitable, sir.
Every human being has an impact on another.
Why don't we want that in a patient/doctor relationship?
That's why I've listened to your teachings, and I believe they're wrong.(一般教導醫生,不可以對病人產生移情作,必須維持專業距離。但移情是無可避免的。)
A doctor's mission should be not just to prevent death...
but also to improve the quality of life. (醫生最重要的任務不是避免死亡,而是改善生活的品質。)
That's why you treat a disease, you win, you lose.
You treat a person, I guarantee you, you win, no matter what the outcome. (治病有時候贏有時候輸;但如果治人,我保證,你一定會贏,無論結果是什麼。)
至於他提倡的 "radical ideas":醫療應該 free access、holistic health、treating patients as friends,ㄜ,我就不是那麼能夠很放鬆的張開雙臂接受。從來就沒有什麼事免費的,只是看資源要從哪裡取得,或許是幾個願意出資的富翁,或許是社會集體的共識產生的制度,能穩定提供和兼顧品質的服務,才可長可久啊。一時熱情的計畫,若中途中斷,把人丟回原地,不也是不負責任嗎?treating patients as friends 得看個人對於關係親疏的不同感受,我想,醫師願意作到盡量同理,已經是很棒了。
醫病間的專業距離,可能是高傲的,可能是為了維持理性判斷不得不的,可能避免權力的誤使而為,可能是醫師終日面對苦痛的心理保護機制,醫師也是人,難免在和病人的互動中產生關係,但關係的親疏、好壞、對錯,牽涉個人的修養、動機、作為。
Patch Adams 本人應該是個很有感染力的人,現實中,想必有許多在他身邊協助他而不出風頭的人們,甚至是可能暗中幫他擋掉現實的不愉悅的人們,向她他們致敬。
延伸閱讀:
台灣紅鼻子醫生:https://zh-tw.facebook.com/DrRedNose/

