【英语语言学习】搭建医生和病人沟通的桥梁

Norman Swan: One of the things often missing in modern medicine is attention to or respect for the spiritual life of patients and families, which includes miraculous¹ thinking. And that's why Rhonda Cooper developed the AMEN tool. Reverend Cooper is the Kimmel Cancer Center Chaplain at Johns Hopkins University in Baltimore.

Rhonda Cooper: The AMEN tool was developed in part because I observed the team, not only the physicians but the nurses, being a bit stymied². The doctor says to the family of a very ill patient, 'We've done everything we can and we fear that your loved one will not survive his illness.' The family would listen very respectfully, but after the physician finished they would say, 'Thanks Doctor, but we believe God will heal our husband by a miracle.'

Norman Swan: Even if they didn't say that, a lot of people still hope that something miraculous would occur, even if they don't have any particular religious belief.

Rhonda Cooper: Of course. However, when they say it, the team would often respond in an argumentative way or try to convince them that was not going to happen, which is outside their scope of practice, to talk theologically. Or they would say something that might sound snide. So how do you help them join with the patient and see this kind of comment as an invitation to continue their conversation, not to stop it.

For instance, if someone says, 'Well, Doc, I'm hoping for a miracle,' a way to join them could be, 'I hear that you are hopeful, and we always have hope too.' Instead of saying, 'Well, you can hope that all you want but it's not going to happen,' which I actually heard that once. Respecting, reflecting back what they've said, and to, above all, assure them that no matter what the future brings, that we on the team will accompany you on that journey.

Norman Swan: Which is what palliative care physicians and nurses do all the time, it's just it doesn't happen on the regular ward³.

Rhonda Cooper: Yes, right.

Norman Swan: Dealing⁴ with the spiritual world, regardless of whether you have a religious belief or not.

Rhonda Cooper: Exactly, and also the concept of non-abandonment. Sometimes a committed medical team, even though they may not say it this way, if they have suggested wonderful treatment and the patient has been compliant⁵ and everything has been done, yet that patient's path leads them to death instead of cure, when a caregiver is really invested in that they may have a tendency to take that personally and disengage.

Norman Swan: How does it work?

Rhonda Cooper: So the protocol⁶, which is entitled AMEN, the A is for 'Affirm the patient or the family's belief'. Affirm that does not mean agree with it. When the patient says, 'Well, I am praying or I'm believing there will be a miracle,' a simple response would be, 'I'm hopeful too.' And then the second part would be the M or the 'Meet the patient where they are'.

Then thirdly you can then 'Educate from your own role', this is the E. The provider's role is to give the patient or the family their best medical opinion. And so they might move to, 'I'm hopeful too, and I would like to share some information that I think will be helpful.' But we say throw out the word 'but', which is really hard to do actually. Throw that out and say, 'I'm hopeful and let me also share some information that may be helpful to you from my perspective.'

And finally is the 'No matter what', or the idea of non-abandonment. That is, we are committed to your loved one's care, or as the patient we are committed to your care and we are going to be with you every step of the way. And we don't say I am going to be with you the whole way, because frankly⁷ that's probably not true, but someone on the team, your caregivers, we will be with you. And so this allows both the provider and the patient or family to stay in their role with integrity.

Norman Swan: No matter what.

Reverend Rhonda Cooper is a Chaplain at Johns Hopkins University Medical Center in Baltimore.

1 miraculous   

adj.像奇迹一样的，不可思议的

参考例句：

• The wounded man made a miraculous recovery.伤员奇迹般地痊愈了。
• They won a miraculous victory over much stronger enemy.他们战胜了远比自己强大的敌人，赢得了非凡的胜利。

2 stymied   

n.被侵袭的v.妨碍，阻挠( stymie的过去式和过去分词 )

参考例句：

• Relief efforts have been stymied in recent weeks by armed gunmen. 最近几周的救援工作一直受到武装分子的阻挠。 来自辞典例句
• I was completely stymied by her refusal to help. 由于她拒不相助， 我完全陷入了困境。 来自互联网

3 ward   

n.守卫，监护，病房，行政区，由监护人或法院保护的人（尤指儿童）；vt.守护，躲开

参考例句：

• The hospital has a medical ward and a surgical ward.这家医院有内科病房和外科病房。
• During the evening picnic,I'll carry a torch to ward off the bugs.傍晚野餐时，我要点根火把，抵挡蚊虫。

4 dealing   

n.经商方法，待人态度

参考例句：

• This store has an excellent reputation for fair dealing.该商店因买卖公道而享有极高的声誉。
• His fair dealing earned our confidence.他的诚实的行为获得我们的信任。

5 compliant   

adj.服从的，顺从的

参考例句：

• I don't respect people who are too compliant.我看不起那种唯命是从，唯唯诺诺的人。
• For years I had tried to be a compliant and dutiful wife.几年来，我努力做一名顺从和尽职尽职的妻子。

6 protocol   

n.议定书，草约，会谈记录，外交礼节

参考例句：

• We must observe the correct protocol.我们必须遵守应有的礼仪。
• The statesmen signed a protocol.那些政治家签了议定书。

7 frankly   

adv.坦白地，直率地；坦率地说

参考例句：

• To speak frankly, I don't like the idea at all.老实说，我一点也不赞成这个主意。
• Frankly speaking, I'm not opposed to reform.坦率地说，我不反对改革。