She was a planner,  她是一个有计划的人,

and she thought a lot about how she wanted to live and how she wanted to die.  她想了很多关于她想如何活和她想如何死去。

Not only did she sign advance directives,  她不仅签了预留医疗指示协议,

she wrote a 12-page document about how she had suffered enough,  而且她写下了12页, 关于她遭受的是怎样的痛苦,

how it was time for her to go.  是时候让她走了。

One day, when I was a resident physician,  一天, 当我是一名住院医师的时候,

I got a call to say that she was in the intensive care unit.  我接到电话说她在特护病房。

By the time I got there, she was about to be intubated and put on a breathing machine.  我到那儿时, 她正要被插管装上呼吸机。

But this is not what she wants, I said, and we have documents.  但是这不是她想要的, 我说, 我们有协议的。

The ICU doctor looked at me in the eye,  重症加护病房的医生看着我的眼睛,

pointed at my then 16-year-old sister, and said,  指着我16岁的妹妹说,

Do you remember when you were that age?  你记得当你是这个年纪的时候吗?

How would you have liked to grow up without your mother?  你会想要没有妈妈陪在你身边吗?

Her oncologist was there too, and said,  她的肿瘤医生也在那里对我说,

This is your mother.  这是你的妈妈。

Can you really face yourself for the rest of your life if you don't do everything for her?  在你接下去的日子里, 你真的能面对你自己如果你没有为她尽全力?

I knew my mother so well.  我非常了解我的妈妈。

I understood what her directives meant so well,  我明白她签的协议是什么,

but I was a physician.  但是我也是一名医生。

That was the single hardest decision I ever made,  这曾是我人生当中做的一个最难的决定：

to let her die in peace,  让她在平静地死去,

and I carry those words of those doctors with me every single day.  我每一天都在想这些医生的话

We can bridge the disconnect between what doctors do and what patients need. 我们能在患者需求和医生之间的这种隔阂搭建桥梁。

We can get there, because we've been there before,  我们可以做到, 因为之前我们做到过,

and we know that transparency gets us to that trust.  我们知道这种透明让我们得到信任。

Research has shown us that openness also helps doctors,  研究已经表明公开也可以帮助医生,

that having open medical records,  有一个公开的的病历,

being willing to talk about medical errors,  就会愿意去讨论医疗差错,

will increase patient trust,  这将增加患者的信任,

improve health outcomes,  改善健康结果,

and reduce malpractice.  减少治疗不当。

That openness, that trust,  公开, 信任,

is only going to be more important as we move from the infectious to the behavioral model of disease.  只会变得更加重要，因为我们关注的是疾病的行为模式， 而不是它的传染模式。

Bacteria may not care so much about trust and intimacy,  细菌可能不关心信任和亲密

but for people to tackle the hard lifestyle choices,  但是为了帮助患者彻底改变他们不良生活嗜好，

to address issues like smoking cessation,  为了让患者戒烟，

blood-pressure management and diabetes control,  为了让患者控制血压，控制血糖，

well, that requires us to establish trust.  这些都要求我们去建立医患信任感。

Here's what other transparent doctors have said.  以下是其他参与透明活动的医生说的。

Brandon Combs, an internist in Denver:  布兰登库姆斯, 在丹佛的内科医生:

This has brought me closer to my patients.  这让我和我的患者亲近。

The type of relationship I've developed that's why I entered medicine.  这种我一直以来建立起来的 医患关系恰恰就是为什么当初我行医的原因。

Aaron Stupple, an internist in Denver:  亚伦, 丹佛的一名内科医生

I tell my patients that I am totally open with them.  我告诉我的患者们，我对他们完全公开。

I don't hide anything from them.  我不向他们隐藏任何什么。

This is me. Now tell me about you.  这就是我, 你呢。

We're in this together.  我们同心协力。

May Nguyen, a family physician in Houston:  五月阮, 休斯顿的一名家庭医生:

My colleagues are astounded by what I'm doing.  我的同事对于我在做什么都很震惊。

They ask me how I could be so brave.  他们问我, 我怎么这么勇敢。

I said, I'm not being brave,  我说, 这不是勇敢,

it's my job.  这是我的工作。

I leave you today with a final thought.  今天我留给你们最后一个思考。

Being totally transparent is scary.  成为完全透明是令人害怕的,

You feel naked, exposed and vulnerable,  你感觉很不安, 脆弱,

but that vulnerability, that humility,  但是那些脆弱, 谦卑,

it can be an extraordinary benefit to the practice of medicine.  对于我们行医来说, 会带来非同凡响的益处。

When doctors are willing to step off our pedestals,  当医生愿意放下架子,

take off our white coats, 脱下白大褂,

and show our patients who we are and what medicine is all about,  向我们的患者展示我们是谁 和医学是关于什么的,

that's when we begin to overcome the sickness of fear.  那就是我们开始去克服恐惧的时候,

That's when we establish trust.  那就是我们建立信任的时候,

That's when we change the paradigm of medicine from one of secrecy and hiding to one that is fully open and engaged for our patients.  那就是我们改变医学模式从秘密和隐藏到完全开放并参与我们的患者中去。

Thank you.  谢谢。