THE NAKED SURGEON: THE POWER AND PERIL OF TRANSPARENCY IN MEDICINE

Book ID/图书代码： 13000514B71802

English Summary/英文概要： How well do those who treat us actually treat us?

We are not meant to touch hearts. We all have one; but most of us will never see one. The heart surgeon has that privilege, but for centuries, the heart was out of reach even for surgeons. So when a surgeon nowadays opens up a ribcage and mends a heart, it remains something like a miracle, even if it has to come to seem nearly as normal as plumbing.

As with plumbers, the quality of surgeons’ work varies. As with plumbers, surgeons’ opinion of their own prowess and their own attitude to risk is not always entirely reliable. Measurement is key. We’ve had a century of effective evidence-based medicine. We’ve had barely a decade of thorough monitoring of clinical outcomes. Thanks to the ground-breaking risk modelling of pioneering surgeons such as Samer Nashef, we at last know how to judge whether an operation is in a patient’s best interest, which hospital and surgeon would be best for that operation, when it might best be performed and what the exact level of risk is. We have at last made what is important in surgery measurable. But how should surgeons, and their patients, use these newfound insights?

Ever since his days as a medical student, Nashef has challenged his profession to be more open and more accurate about outcomes and variabilities in its surgical procedures, for the sake of its patients. In The Naked Surgeon he unclothes the profession to demonstrate to his reader (and prospective patient) the paradoxes at the heart of the surgeon’s craft: how anaesthetists seem to make no difference to the outcome of an operation, although surgeons do; why patients operated the day before a surgeon goes on holiday are twice as likely to die than those operated on that surgeon’s first day back from holiday; why the unexpected death of a low-risk patient during an operation does not impair a surgeon’s performance immediately afterwards; and how one surgeon can appear to be better than another by actually killing more patients. And he does all this with absolute clarity, fluency and not a little wit.

Chinese Summary/中文概要： 那些治疗我们的医生们究竟又是如何对待我们的呢？

我们谁都无法触摸心脏。尽管我们每个人都拥有一颗；然而我们当中的绝大多数人或许都不会真正有机会看到心脏。当然我们的心脏医师们会拥有这样的一项特权，然而数个世纪以来，即便是心脏外科医生也无法接触到真实的心脏。因此，当今天的医生们打开病人的胸腔并修补一颗心脏时，即便看似已经近乎在进行一项寻常的管道铺设工作，但其实这一切仍然堪称一场奇迹。

即便用管道工作比，实际上外科医生们的工作领域可谓是术业有专攻。即便用管道工作比，实际上外科医生们对于其自身专业领域的观点看法以及他们自己对医疗冒险的态度也并不总是完全可信的。评估是关键。我们现已基本拥有一个世纪长的医疗案例库。而我们也对临床治疗结果进行了将近十余年的全面监管观察。多亏了那些甘愿进行开拓性冒险的外科学标志性的开拓者们，如萨摩•纳谢夫等，我们最终得以知晓如何去评价一场手术是否最为有利于病人，哪家医院以及哪名外科医生可能最适合与进行这场手术，手术最适合于在何时进行，以及手术确切的风险程度究竟如何。最终我们确定了手术评估中最重要的因素。然而对于外科医生和病人们而言，他们又将如何运用这些最新的研究发现成果呢？

从在医学院学习时期开始，纳谢夫就不断挑战自己的专业深度，努力让思维更加开阔，让外科手术过程中的结果和变动性更加精确，以最大程度确保病人们的利益。在《赤心医师》一书中，他揭开了其职业背后的神秘面纱，向读者们展示心脏科外科医生医术中的相悖面：为何麻醉师看似对手术的结果并无太大影响，而外科执刀医师却不尽如此；为何那些在外科医师休假前一天进行手术的病人比那些在外科医师休假复班后的第一天进行手术的病人死亡的几率要高两倍；为何一场低风险手术中病人的意外死亡并不会直接影响到改名外科医生随后的手术表现；以及为何最终一名因手术导致更多病人死亡的医生会比手术死亡率低的医生更加优秀。作者将以一种绝对清晰、流利和极度睿智的口吻为我们娓娓道来这一切。（DC）

Awards/获奖情况：’[The Naked Surgeon] takes a Malcolm Gladwell-esque look at what happens in operating theatres ... If a book-length examination of the topic sounds dry, it isn’t. Nashef’s humanity and compassion shine through.’ The Times

‘Gripping, honest and numerate… an essential companion on our journey from blind trust in doctors to kind truth.’ Dr Phil Hammond

About the Author/作者介绍： 萨摩•纳谢夫是剑桥Papworth医院的一名心脏咨询医师，同时他也是手术治疗领域内一名致力于风险和质量研究的世界一流专家。作者创立了EuroSCORE（欧核），该机构对心脏手术中的死亡风险率进行预估和计算，并是医学领域内现最成功的风险模型，被广泛应用在全球，并因拯救了无数的生命而大受赞誉。作为200余篇出版物的作者，他的研究成果也被大量广泛引用，并且作者现已受邀前往过全球30余个国家进行演讲。

Samer Nashef is a consultant cardiac surgeon at Papworth Hospital, Cambridge, and the world’s leading expert on risk and quality in surgical care. He is the creator of EuroSCORE, which calculates the predicted risk of death from heart operations and is the most successful risk model in medicine, used worldwide and credited with saving tens of thousands of lives. The author of more than 200 publications, his research has been widely cited and he has been invited to lecture in more than 30 countries.

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