好英语网医生能学会同情患者么？
My colleague loved performing surgery as much as anyone I had ever met. Every morning he bounded into the hospital, full of energy and cheerful anticipation of the day's surgical schedule, his prominent mouth stretched into a broad grin.
再没有谁能比我这位同事更酷爱动手术了。每天一大早，只见他健步跃入医院大门，精神抖擞、满心欢喜地盼着手术时间表，他咧着厚厚的嘴唇，露出灿烂饱满的笑容。
"Too bad his foot is always in it," another doctor whispered one day as our colleague passed by.
“怎么他到哪儿都要掺一脚啊，”某日，另一位医生在他走过去时小声说到。
The sad truth was that despite his gusto, patients often complained about our colleague. He was brusque when the moment required sensitivity, flip when the conversation was grave, and heavy-handed when the situation called for a light touch. Just a few days earlier, we were shocked to learn he'd bluntly told an elderly war hero in the hospital for his diabetes, "I need to cut off your leg."
真是遗憾，尽管他对工作热情无限，病人却经常投诉他。因为他总是在需要斟词酌句冒出唐突之词；在话题沉重时轻率调侃；又在必须委婉道来时直言快语……前几天，他还刚直截了当地告诉一位患糖尿病的高龄战争英雄：“我得把你的腿锯了。”这着实让我们震惊不已。
"He sure doesn't lack enthusiasm," the other doctor continued as our colleague rounded the corner, the bounce in his step unmistakable. "It's just too bad you can't learn empathy."
“他真的一点儿不缺激情，”见我们这位同事轻快地拐过弯去之后，又一位医生评论道：“可就是学不会同情病人。”
Empathy has always been considered an essential component of compassionate care, and recent research has shown that its benefits go far beyond the exam room. Greater physician empathy has been associated with fewer medical errors, better patient outcomes and more satisfied patients. It also results in fewer malpractice claims and happier doctors.
与病人感同身受的同情心(empathy)一直被认为是人文关怀的精髓。最近的研究也显示，这种同情心带来的益处远远超出了诊室的范围。医师的同情心越强，医疗失误也就越少，患者恢复越好、满意度越高；同时也减少了医疗索赔事件，让医生的心情更好。
A growing number of professional accrediting and licensing agencies have taken these findings to heart, developing requirements that make empathy a core value and an absolute "learning objective" for all doctors. But even for the most enthusiastic supporters of such initiatives, the vexing question remains: Can people learn to be empathetic?
这些研究结果引起越来越多职业认证和执照发放机构的重视，他们开始要求把同情心作为医疗的核心理念以及所有医生必须达到的学习目标。然而，即使是最热心于此创举的支持者也不免被一个疑问所困扰：同情心，能“学”得来么？
A new study reveals that they can.
一项新的研究表明：能。
Building on research over the last decade that has shown that empathetic observers have brain activity, heart rate and skin electrical conductance that mirror those of the person undergoing the emotional experience -- observing a friend's hand getting slammed in a car door, for example, causes us to flinch because an image of the accident gets mapped onto the pain and threat sensors in our own brain -- Dr. Helen Riess, director of the Empathy and Relational Science Program in the department of psychiatry at the Massachusetts General Hospital in Boston, created a series of empathy "training modules" for doctors. The tools are designed to teach methods for recognizing key nonverbal cues and facial expressions in patients as well as strategies for dealing with one's own physiologic responses to highly emotional encounters.
过去十年的研究结果显示：具有同情心的观察者跟亲历者之间的大脑活动、心率和皮肤电导率均相互合拍。比如，看到朋友关车门时夹到了手，我们会下意识地缩缩手，因为那画面直接映射到我们大脑内的疼痛与威胁感知系统。波士顿麻省总医院(Massachusetts General Hospital) 精神科“同情与关系学”项目主管海伦·里斯医生(Helen Riess)设计出了一套“医师同情心训练模块”，用来指导医生如何甄别病人的关键性非语言暗示和表情，以及如何处理高度情绪化事件中医生自身出现的生理反应。
In one lesson, for example, doctors watch a video of a tense exam room interaction while a striking graphic sidebar records the electrical skin conductance of both patient and doctor, the mismatched spikes peaking as each person's frustration with the other escalates. Another lesson walks doctors through a series of pictures of a patient whose face expresses anger, contempt, happiness, fear, surprise, disgust or sadness.
举例来说，有一节课是让医生们观看一段诊室的录像，其中医患间正进行着紧张的交流。视频侧栏用曲线图记录着两人皮肤电导率的变化。每当二者情绪不统一时（一人沮丧而另一人兴奋），图上就会出现脉冲尖峰。还有一节课是让医生们看一系列照片，上面拍下了一位病人生气、轻蔑、高兴、畏惧、惊讶、厌恶和难过时的表情。
To test the effectiveness of the lessons, Dr. Riess and several of her colleagues enrolled about 100 doctors-in-training and asked their patients to evaluate their empathy, based on the doctor's ability to make them feel at ease, show care and compassion and fully understand patient concerns. Half of the doctors then took part in three one-hour empathy training sessions.
为检验课程的效果，里斯和同事们招募了100名实习医生进行实验。首先，她们让患者对这些医生的同情心进行评估，标准包括：医生是否能让病人感到自在、不拘束；是否显示出了关怀、怜悯之情；是否可以完全理解患者的担忧。然后，让其中一半医生参加同情心培训，每次1小时，共3次。
Two months later, the researchers asked a second group of patients to evaluate all the doctors again. They found that the doctors who had taken the empathy classes showed significant improvements in their empathetic behavior, while those who had not actually got worse at empathizing with patients.
两个月后，另一批患者对这100名实习医生的同情心重新进行了测评。结果发现，培训过的医生其同情心及相关行为有明显进步，而未经培训的医生则表现得还不如两个月前。
"People tend to believe that you are either born with empathy or not," said Dr. Helen Riess, lead author of the study. "But empathy can be taught, and you can improve."
“人们倾向于认为同情心是天生的。”研究的第一作者里斯医生说：“其实不然，同情心是可以被教会的，（通过学习）是能够进步的。”
Compared with their peers, doctors who went through the empathy course interrupted their patients less, maintained better eye contact and were better able to maintain their equanimity if patients became angry, frustrated or upset. They also appeared to develop resistance to the notorious "dehumanizing effects" of medical training. After the empathy classes, one physician who had complained about being burned out said, "I feel as though like I like my job again."
相比之下，上过同情心课程的医生更少会打断患者的话，与患者有更好的眼神交流，当患者发怒、沮丧或烦躁不安时更能保持镇定。同时，他们似乎也开始对医疗训练所导致的臭名昭著的“去人性化结果(dehumanizing effects)”心生抵触。参加过同情心培训后，一位曾抱怨被工作搞得精疲力竭的医生说：“我好像又重新喜欢上我的工作了。”
Responses to this study have so far been enthusiastic, in part because it is one of the first to rely on patient evaluations of empathy rather than physician self-assessment. "The holy grail of this kind of research is whether patients think doctors are empathic, not whether the doctors think they are," Dr. Riess said. She and her colleagues plan to expand their research and offer the training to more doctors, as well as to nurses, physician assistants and others.
迄今为止，这项研究一直得到了热情的回馈，部分原因在于这是第一次由病人对医生进行同情心评价，而非医生自测。“我们的研究妙就妙在裁判是患者，不是医生自己。”里斯说。她们还准备扩大研究规模，为更多的医生、护士、医师助理和其他医务工作者提供同情心培训。
"We are in a special place in the history of medicine," she said. "We have the neurophysiology data that validates and helps move medicine back to a real balance between the science and the art."
“我们正处在医学发展史的一个特殊位置上，”她说：“神经生理学的有效应用可以帮医学重建科学与艺术之平衡。”
Curious to know whether the empathy course worked, I decided to try out what I had learned in researching this column. The next day at the hospital, I took extra care to sit down facing my patients and not a computer screen, to observe the changing expressions on their faces and to take note of the subtle gestures and voice modulations covered in the course. While I found it challenging at first to incorporate the additional information when my mind was already juggling possible diagnoses and treatment plans, eventually it became fun, a return to the kind of focused one-on-one interaction that drew me to medicine in the first place.
因好奇心趋势，我亲自试验了一下写这篇专栏时从同情心课程里学到的一些方法，看看是否真能奏效。第二天上班时，我特意面朝患者坐着，而不像以往总盯着电脑；观察患者的表情变化，留心课上教过的一些不易察觉的手势和音调变化。刚开始还挺困难，我的大脑在处理这些额外信息的同时，已然塞满了各种可能的诊断与治疗方案。不过后来就尝到乐趣了，回归这种专注的一对一交流能够将我带回到医学最初的本质。
Just before leaving, one of the patients pulled me aside. "Thanks, Doc," he said. "I have never felt so listened to before."
一位患者在离开前把我拉到一边说：“谢谢你医生，从来没有人这么认真地听我说话。”