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1、UNIT 6 The Making of a SurgeonA famous surgeon tells about the importance of self-confidence from his own experience. How does a doctor recognize the point in time when he is finally a surgeon? As my year as chief resident drew to a close I asked myself this question on more than one occasion. The a

2、nswer, I concluded, was self-confidence. When you can say to yourself, There is no surgical patient I cannot treat competently, treat just as well as or better than any other surgeon - then, and not until then, you are indeed a surgeon. I was nearing that point. Take, for example, the emergency situ

3、ations that we encountered almost every night. The first few months of the year I had dreaded the ringing of the telephone. I knew it meant another critical decision to be made. Often, after I had told Walt or Larry what to do in a particular situation, Id have trouble getting back to sleep. Id revi

4、ew all the facts of the case and, not infrequently, wonder if I hadnt made a poor decision. More than once at two or three in the morning, after lying awake for an hour, Id get out of bed, dress and drive to the hospital to see the patient myself. It was the only way I could find the peace of mind I

5、 needed to relax. Now, in the last month of my residency, sleeping was no longer a problem. There were still situations in which I couldnt be certain my decision had been the right one, but I had learned to accept this as a constant problem for a surgeon, one that could never be completely resolved

6、- and I could live with it. So, once I had made a considered decision, I no longer dwelt on it. Reviewing it wasnt going to help and I knew that with my knowledge and experience, any decision Id made was bound to be a sound one. It was a nice feeling. In the operating room I was equally confident. I

7、 knew I had the knowledge, the skill, the experience to handle any surgical situation Id ever encounter in practice. There were no more butterflies in my stomach when I opened up an abdomen or a chest. I knew that even if the case was one in which it was impossible to anticipate the problem in advan

8、ce, I could handle whatever l found. Id sweated through my share of stab wounds of the belly, of punctured lungs, of compound fractures. I had sweated over them for five years. I didnt need to sweat any more. Nor was I afraid of making mistakes. I knew that when I was out in practice I would inevita

9、bly err at one time or another and operate on someone who didnt need surgery or sit on someone who did. Five years earlier - even one year earlier - I wouldnt have been able to live with myself if I had had to take sole responsibility for a mistake in judgment. Now I could. I still dreaded errors -

10、would do my best to avoid them - but I knew they were part of a surgeons life. I could accept this fact with calmness because I knew that if I wasnt able to avoid a mistake, chances were that no other surgeon could have, either. This all sounds conceited and I guess it is - but a surgeon needs conce

11、it. He needs it to encourage him in trying moments when hes bothered by the doubts and uncertainties that are part of the practice of medicine. He has to feel that hes as good as and probably better than any other surgeon in the world. Call it conceit - call it self-confidence; whatever it was, I ha

12、d it.一位著名的外科大夫告訴說,在他的經(jīng)歷中自信是重要的。一名外科大夫的成功之道諾蘭博士一名醫(yī)生是怎樣看待他成為一名外科大夫那一刻的?當(dāng)我做為一名住院醫(yī)生的歲月即將結(jié)束時我不止一次地這樣問自己。這個答案,我判斷,是自信。當(dāng)你能對自己說,沒有外科病人我不能熟練治療,就像其他外科大夫治療的一樣好甚至比他們還要好那么,一直到這時候,你才確實是一名外科大夫。我正在期待著這一刻。例如,我們幾乎每天夜晚都要遇到緊急狀態(tài)。這一年開頭的幾個月我害怕電話鈴聲響起。我知道它意味著另一次批評的機會被制造。經(jīng)常,當(dāng)我告訴瓦特或勞瑞在一個特殊的情形下做什么之后,我很難再入睡了。我回想這件事的全部事實,不是少有的,想

13、知道我是否已經(jīng)做了一個糟糕的決定。不止一次在凌晨2點至3點,我醒著躺在床上一個小時,就起床,穿上衣服并驅(qū)車到醫(yī)院看望我的病人。這是我能夠找到的讓心靈平靜并松馳下來的惟一途徑?,F(xiàn)在,在我的住院實習(xí)的最后一個月,睡覺不再是一個問題。依然有我不能確定我的決定是否正確的情形,但我已經(jīng)了解到一名外科大夫存在的經(jīng)常的問題,他從來不能夠完全能解決并且我能夠與它同在。于是,我做出了一個深思熟慮的決定,我不再想這事?;叵雽⑹菬o助的并且我知道憑我的知識與能力,我所做出的決定是正確的。這是一種很不錯的感覺。在手術(shù)室里,我通常是自信的。我知道我有知識、技術(shù),和在以往實踐中遭遇到的緊急情形的把握能力。沒有更多的緊張當(dāng)我切開一個腹部或一個胸腔時。我知道即使這個病例不能夠預(yù)見前進中的問題,但我能夠把握住我發(fā)現(xiàn)的什么。我出的汗流過戳傷的肺、刺穿的胃和粉碎性骨折的我的部分。我已經(jīng)流汗淌過這些部位有5年了。我不需要出更多的汗?,F(xiàn)在我也不害怕出錯。當(dāng)我結(jié)束實習(xí)期后我知道自己不可避免地要出一次又一次錯,并且為不需要做手術(shù)的人做了手術(shù)或者忽視了某人的這種情形。5年前甚至一年前我還不能夠單獨地為自己判斷上出現(xiàn)的

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