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爱医币
鲜花
注册时间2003-6-19
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This novel is a sad story about the sincere relationship between a freshman in an American medical school and his first patient, an old lady. I have read it for many times, but still I am deeply moved by it each time. It is a kind of ideal relationship worth being pursuited by every medical student. But unfortunately when I took my practice as an intern in a teaching hospital, I found it is very difficult to establish a relationship like this. The human dimesion in the treatment is or has to be neglected by many doctors. And they influence their students.
THE FIRST PATIENT
September 25, 6:45 a.m.
In an hour, Paul Stevens will meet his first patient. The course is called " Freshman Intervi***g -- An
Introduction to the Doctor-Patient Relationship. " The title of the course does not discribe Paul's feeling,
however, for although he has been in classes for 3 weeks, this morning will be his first time up on the wards of
the hospital. In the dim light he pushes aside the cup of coffee he made himself. It is already growing cold. He
has barely touched it, for he is nervous, though he doesn't like to admit this to himself. He tells himself instead
that this morning is really no big deal. He's only going to go talk to a patient. And he has talked to people all of
his life. Yet, doubts surface. What if the patient is silent and Paul can't get him to talk? Or hostile? Or even
crazy? He heard that that happened to one of his classmates earlier in the week. A thousand " what if's " run
through his mind.
He goes into the bedroom and straightens his tie in front of the mirror. He puts on the white coat he
bought at the bookstore yesterday and then pins his new name tag over the left breast pocket. It takes several
tries to get the tag lined up straight. He notices that the price tag is still dangling from the lapel of the coat and
cuts it off with hid wife's manicure scissors.
As far as Paul is concerned, he still doesn't look like a doctor. With his new Litman stethoscope in
one pocket and a thick manual of lab values and procedures in the other, he should look like a real doctor, but
he feels like an imposter. The coat isn't part of him. Wearing it like this makes him feel like he's pretending, and
this makes him uncomfortable. The day fefore, Paul argued this very point in class. He was among those who
argued that students wearing white coats and calling themselves doctors is an exploitation of patients--that
they are subtly " lying " to their patients, poor people in a county hospital being used for training purposes. He
still feels this way; but this morning in the pale light, he simply thinks to himself, " This isn't me . "
His preceptor will be Dr.Irving Gellman. He hasn't met Gellman yet. The word from the sophomores is
that he's OK, " a nice guy, " one student told Paul. Whatever means, Paul thought. Paul received word the day
before through Gellman's secretary to meet on Ward Six North at 7:30 a.m. Dr.Gellman had to meet with the
students early so that he could attend his own patients across town on rounds later that morning.
Paul shrugs his shoulders and turns from the mirror toward his wife Joan, who still lies nestled
enviably in sleep, the sheets pulled up over her head. He kisses her lightly and whispers good-bye. They have
been married less than a year. They moved from St.Peterburg, Florida, so that Paul could go to medical school
in Los Angeles. He is 22 and she is 21. Being a year behind him, she had to drop out of college after her junior
year. The plan is for her to go back and finish her senior year at UCLA " as soon as possible. " For the moment,
however, she is working to help put Paul through medical school. At 9:00 she will drive to the medical center
herself in the old VW ( their only car ) where she works as a secretary in Radiology. This morning Paul will ride
in on his bicycle. He locks the door behind him and ventures out into the smoggy L.A. morning. At 7:15 he
chains his bicycle to a fence near the medical school. Across the street the County Hospital scowls down at
him through the smog like a massive concrete magistrate. It is the largest building for miles, and it dominates
the east L.A. landscape. Paul was told by one of the sophomores that the building had once been used in a
movie version of Orwell's 1984-- The Ministry of Information. Paul can believe it, for it is huge, impervious, and
seemingly indestructible. During the Depression, it held many thousands of patients. In more recent years, the
census has been reduced to a little more than 2000, but it remains one of the largest hospitals in the country.
Paul has heard other doubtless apocryphal stories about the building: that its walls are 3 feet of solid granite
and so strong they could not be dented by the wrecher's ball, and that deep in its bowels, its foundation rests
on huge iron rollers which could withstand any earthquake. It is as though people regard the building as a
symbol for illness and human suffering itself, eternal and, in the end, indefeatable. Paul looks up at its myriad
windows. So many sick people in there, he thinks. |
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