that I should be fired,

我應該被炒魷魚，

have my medical license taken away,

我的醫師執照應被吊銷，

that I should go back to my own country.

甚至要我回到我自己的國家去。

My email got hacked.

我的電子信箱被駭。

In a discussion forum for other doctors,

在另一個醫生論壇裡，

someone took credit for "Twitter-bombing" my account.

有人聲稱他「推特轟炸」我的帳號。

Now, I didn't know if this was a good or bad thing,

我不知道那究竟是好還是壞，

but then came the response:

後來卻看到回覆說：

"Too bad it wasn't a real bomb."

「真可惜那不是真的炸彈」。

I never thought that I would do something

我從來沒想到

that would provoke this level of anger among other doctors.

我做的事會激起其他醫生

Becoming a doctor was my dream.

這種程度的仇恨。

I grew up in China,

成為醫生是我的夢想。

and my earliest memories are of being rushed to the hospital

我在中國大陸長大，

because I had such bad asthma that I was there nearly every week.

我最早的兒時記憶就是被緊急送醫，

I had this one doctor, Dr. Sam, who always took care of me.

因為我有很嚴重的氣喘， 幾乎每週都去醫院。

She was about the same age as my mother.

當時一直照顧我的是山姆醫生，

She had this wild, curly hair,

她大概和我的母親一樣大。

and she always wore these bright yellow flowery dresses.

披著一頭很亂的捲髮，

She was one of those doctors who,

她總是穿著鮮黃印花的洋裝。

if you fell and you broke your arm,

她這種醫生就是

she would ask you why you weren't laughing

如果你摔倒斷了手臂，

because it's your humerus. Get it?

她會問你為何不笑呢？

See, you'd groan,

因為那是你的肱骨（英文與幽默同音）。 明白嗎？

but she'd always make you feel better after having seen her.

你在痛苦呻吟，

Well, we all have that childhood hero

但她總能讓你見到她之後 覺得舒服一點。

that we want to grow up to be just like, right?

我們都有兒時崇拜的英雄，

Well, I wanted to be just like Dr. Sam.

希望長大後成為那樣的人，對吧？

When I was eight, my parents and I moved to the U.S.,

我從小就想成為山姆醫生那樣。

and ours became the typical immigrant narrative.

八歲時我隨父母搬到美國，

My parents cleaned hotel rooms and washed dishes and pumped gas

我們的生活和典型的移民一樣。

so that I could pursue my dream.

父母靠打掃飯店房間、 做洗碗工和為人加油賺錢，

Well, eventually I learned enough English,

讓我可以追求我的夢想。

and my parents were so happy

後來我學了夠多的英語，

the day that I got into medical school and took my oath of healing and service.

在我進入醫學院 為治療和服務宣誓那天，

But then one day, everything changed.

我的父母非常開心。

My mother called me to tell me that she wasn't feeling well,

但有一天，一切都改變了。

she had a cough that wouldn't go away, she was short of breath and tired.

媽媽打電話告訴我她覺得很不舒服，

Well, I knew that my mother was someone who never complained about anything.

咳嗽咳很久都不會好， 而且呼吸困難又疲憊。

For her to tell me that something was the matter,

我知道媽媽是那種 從不抱怨任何事的人。

I knew something had to be really wrong.

當她告訴我這些身體的不適時，

And it was:

我就覺得這件事很不妙。

We found out that she had stage IV breast cancer,

結果也是如此：

cancer that by then had spread to her lungs, her bones, and her brain.

我們發現她是乳癌第四期，

My mother was brave, though, and she had hope.

那時癌細胞已經擴散到 她的肺、骨頭和腦部。

She went through surgery and radiation,

我媽媽當時還是很勇敢並懷抱希望。

and was on her third round of chemotherapy

她經歷了手術和放射治療，

when she lost her address book.

然後在做第三階段的化療時，

She tried to look up her oncologist's phone number on the Internet

她找不到她的通訊錄。

and she found it, but she found something else too.

她試著在網路上找腫瘤醫生的電話，

On several websites,

她找到了，但她也找到了其他東西。

he was listed as a highly paid speaker to a drug company,

在一些網站上，

and in fact often spoke on behalf

她的醫生被列為 一家製藥公司的高薪發言人，

of the same chemo regimen that he had prescribed her.

而且他其實常代言

She called me in a panic,

他開給她的化療方案。

and I didn't know what to believe.

她驚慌地打電話給我，

Maybe this was the right chemo regimen for her,

我不知道該相信什麼。

but maybe it wasn't.

也許這個化療方案對她來說是對的，

It made her scared and it made her doubt.

但也可能不是對的。

When it comes to medicine,

這讓她感到恐懼和懷疑。

having that trust is a must,

當涉及到藥物時，

and when that trust is gone, then all that's left is fear.

信任是必須的，

There's another side to this fear.

但當信任消失後，剩下的只有恐懼。

As a medical student, I was taking care of this 19-year-old

這個恐懼還有另外一面。

who was biking back to his dorm

當我還是醫學院學生的時候，

when he got struck and hit,

我照顧一位 19 歲的年輕人，

run over by an SUV.

他在騎腳踏車回宿舍時

He had seven broken ribs,

被一輛休旅車撞倒，

shattered hip bones,

並輾了過去。

and he was bleeding inside his belly and inside his brain.

他的七根肋骨骨折，

Now, imagine being his parents

臀骨粉碎，

who flew in from Seattle, 2,000 miles away,

他當時腹部和顱內都在出血。

to find their son in a coma.

現在，你想像他的父母

I mean, you'd want to find out what's going on with him, right?

從兩千多英里外的西雅圖坐飛機過來，

They asked to attend our bedside rounds

看到他們的兒子仍然昏迷。

where we discussed his condition and his plan,

你一定想知道他現在是什麼狀況吧？

which I thought was a reasonable request,

他們請求參與我們的病房巡視，

and also would give us a chance to show them

那時我們會討論 病人的現況和處理方案，

how much we were trying and how much we cared.

我認為這是很合理的請求，

The head doctor, though, said no.

並且也給我們機會

He gave all kinds of reasons.

展示我們是多麼努力和關心。

Maybe they'll get in the nurse's way.

然而主治醫生卻拒絕了，

Maybe they'll stop students from asking questions.

他列出了各種理由，

He even said,

例如他們會妨礙護士工作、

"What if they see mistakes and sue us?"

或許他們會阻止實習醫師提問。

What I saw behind every excuse was deep fear,

他甚至說：

and what I learned was that to become a doctor,

「如果他們看到我們出差錯， 起訴我們怎麼辦？」

we have to put on our white coats,

我看到在每個藉口背後 是深深的恐懼，

put up a wall, and hide behind it.

因此我學到：要成為醫生，

There's a hidden epidemic in medicine.

我們要穿上白袍，

Of course, patients are scared when they come to the doctor.

築起一道牆，把自己藏在牆後。

Imagine you wake up with this terrible bellyache,

其實在醫療界有一個隱藏的 「傳染病」。

you go to the hospital,

當然，病人就醫時總是心存恐懼。

you're lying in this strange place, you're on this hospital gurney,

想像你因腹部劇痛而醒來，

you're wearing this flimsy gown,

你去醫院看病，

strangers are coming to poke and prod at you.

你躺在這個奇怪的地方， 你在醫院的病床上，

You don't know what's going to happen.

你穿著單薄的病服，

You don't even know if you're going to get the blanket you asked for 30 minutes ago.

陌生人們過來對你又戳又刺。

But it's not just patients who are scared;

你不知道接下來會發生什麼事。

doctors are scared too.

你甚至不知道會不會拿到 30 分鐘前要的毛毯。

We're scared of patients finding out who we are

然而害怕的不只是病人；

and what medicine is all about.

醫生其實也害怕。

And so what do we do?

我們害怕病人發現我們的真面目，

We put on our white coats and we hide behind them.

並且洞悉醫療的真相。

Of course, the more we hide,

所以我們怎麼辦呢？

the more people want to know what it is that we're hiding.

我們穿上白袍，將自己藏在後面。

The more fear then spirals into mistrust and poor medical care.

當然，我們藏得越多，

We don't just have a fear of sickness,

就越多人好奇我們究竟在隱藏什麼。

we have a sickness of fear.

過多的恐懼演變為 不信任和不良的醫療處置。

Can we bridge this disconnect

我們現在不只是害怕生病，

between what patients need and what doctors do?

我們也患了恐懼症。

Can we overcome the sickness of fear?

我們能在病人所需和醫生所為之間的斷層 搭起橋樑嗎？

Let me ask you differently:

我們能克服恐懼症嗎？

If hiding isn't the answer, what if we did the opposite?

讓我換個方式提問：

What if doctors were to become totally transparent with their patients?

如果隱藏不是正確的答案時，

Last fall, I conducted a research study to find out

假如我們反其道而行，會怎麼樣呢？

what it is that people want to know about their healthcare.

如果醫生變成必須對病人完全透明， 會怎麼樣呢？

I didn't just want to study patients in a hospital,

去年秋天，我做了一項實地調查，

but everyday people.

為了了解關於醫療 大家最想知道的是什麼。

So my two medical students, Suhavi Tucker and Laura Johns,

我不想只研究醫院裡病人的想法，

literally took their research to the streets.

而是一般常人的想法。

They went to banks, coffee shops, senior centers,

所以我的兩個學生── 蘇哈維．塔克和勞拉．約翰，

Chinese restaurants and train stations.

直接到街上做調查，

What did they find?

他們去了銀行、咖啡館、老人活動中心、

Well, when we asked people,

中餐館和火車站。

"What do you want to know about your healthcare?"

你猜他們發現了什麼？

people responded with what they want to know about their doctors,

當我們問民眾：

because people understand health care

「對於你的醫療， 你最想知道的是什麼？」

to be the individual interaction between them and their doctors.

民眾回應說， 他們想了解的是他們的醫生，

When we asked, "What do you want to know about your doctors?"

因為人們所了解的醫療

people gave three different answers.

是他們自己與醫生之間的個別互動。

Some want to know that their doctor is competent

那我們就問： 「你想知道關於你醫生的什麼呢？」

and certified to practice medicine.

他們給了三種不同的答案。

Some want to be sure that their doctor is unbiased

有些人想知道他們的醫生是否稱職，

and is making decisions based on evidence and science,

是否有從事醫療工作的認證。

not on who pays them.

有些人想確定他們的醫生是公正的，

Surprisingly to us,

會依靠證據和科學做出決定，

many people want to know something else about their doctors.

而不是根據誰付錢。

Jonathan, a 28-year-old law student,

讓我們感到驚訝的是，

says he wants to find someone who is comfortable with LGBTQ patients

很多人想知道醫生其他的事情。

and specializes in LGBT health.

喬納森，28 歲的法學院學生，

Serena, a 32-year-old accountant,

表示他在找能夠接受 「非異性戀患者」，

says that it's important to her for her doctor to share her values

並且專長於「非異性戀疾病」治療的醫生。

when it comes to reproductive choice and women's rights.

賽琳娜，32 歲的會計師，

Frank, a 59-year-old hardware store owner,

表示醫生認同她的價值觀 對她而言很重要，

doesn't even like going to the doctor

尤其是涉及生育選擇和女性權利時。

and wants to find someone who believes in prevention first,

弗蘭克，59 歲的五金行老闆，

but who is comfortable with alternative treatments.

甚至不喜歡去看醫生，

One after another, our respondents told us

他想找的是相信預防優先，

that that doctor-patient relationship is a deeply intimate one —

並且能接受另類療法的醫生。

that to show their doctors their bodies

一個接一個的受訪者告訴我們

and tell them their deepest secrets,

醫生和病人之間的關係 其實是非常親密的，

they want to first understand their doctor's values.

在讓他們的醫生看到自己的身體

Just because doctors have to see every patient

並告訴他們自己最深層的秘密之前，

doesn't mean that patients have to see every doctor.

他們想先了解醫生的價值準則。

People want to know about their doctors first

僅僅因為醫生需要看他們所有的病人，

so that they can make an informed choice.

並不意味著病人需要去看所有的醫生。

As a result of this, I formed a campaign,

人們想先了解醫生，

Who's My Doctor?

他們才可以做出有根據的選擇。

that calls for total transparency in medicine.

根據這個調查結果，我發起了一個活動，

Participating doctors voluntarily disclose

「我的醫生是誰？」

on a public website

呼籲醫學界完全透明化。

not just information about where we went to medical school

參與的醫生

and what specialty we're in,

自願在一個公共網站上公開，

but also our conflicts of interest.

不僅是關於我們讀哪所醫學院

We go beyond the Government in the Sunshine Act

和我們的醫療專長，

about drug company affiliations,

並且公開我們的利益衝突。

and we talk about how we're paid.

我們超越政府在陽光法案中

Incentives matter.

醫生和藥廠的關係要公開的規定，

If you go to your doctor because of back pain,

我們公布自己的收入來源。

you might want to know he's getting paid 5,000 dollars to perform spine surgery

金錢誘因是很重要的。

versus 25 dollars to refer you to see a physical therapist,

如果你因為背痛去看醫生，

or if he's getting paid the same thing no matter what he recommends.

你也許想知道

Then, we go one step further.

他幫你做脊椎手術會賺到五千美元，

We add our values when it comes to women's health,

而推薦你去看復健師只能賺到 25 美元，

LGBT health, alternative medicine,

或者不管他推薦哪一種，收入都一樣。

preventive health, and end-of-life decisions.

然後，我們再進一步。

We pledge to our patients that we are here to serve you,

我們在談到婦女健康、

so you have a right to know who we are.

非異性戀者的健康、另類醫療、

We believe that transparency can be the cure for fear.

預防保健和臨終決定時 會提出自己的價值觀。

I thought some doctors would sign on and others wouldn't,

我們對病人宣誓要服務你們，

but I had no idea of the huge backlash that would ensue.

所以你們有權了解我們。

Within one week of starting Who's My Doctor?

我們相信這種透明可以治療恐懼症。

Medscape's public forum

我原以為有些醫生會加入我們，有些不會，

and several online doctors' communities

但我從沒想到會因此引起強烈反彈。

had thousands of posts about this topic.

在「我的醫生是誰」發起的一周內，

Here are a few.

醫景 (Medscape) 公共論壇

From a gastroenterologist in Portland:

和一些醫生社團網站

"I devoted 12 years of my life to being a slave.

出現上千則關於這個話題的貼文。

I have loans and mortgages.

這裡有一些例子。

I depend on lunches from drug companies to serve patients."

波特蘭的腸胃科醫生說：

Well, times may be hard for everyone,

「我奉獻了 12 年的生命做奴隸。

but try telling your patient

我有一些貸款和房貸。

making 35,000 dollars a year to serve a family of four

我得靠製藥公司提供午餐 才能服務患者。」

that you need the free lunch.

生活在這個時代每個人都很困難，

From an orthopedic surgeon in Charlotte:

但是你可以試試告訴那些

"I find it an invasion of my privacy to disclose where my income comes from.

每年賺三萬五千美元養活一家四口的病人

My patients don't disclose their incomes to me."

你需要免費的午餐。

But your patients' sources of income don't affect your health.

來自夏洛特的一名整形外科醫生說：

From a psychiatrist in New York City:

「我認為公開收入來源 是侵犯我的隱私。」

"Pretty soon we will have to disclose whether we prefer cats to dogs,

「我的病人也不向我公開他們的收入。」

what model of car we drive,

但是病人的收入來源不影響你的健康。

and what toilet paper we use."

來自紐約市的一名精神科醫生寫道：

Well, how you feel about Toyotas or Cottonelle

「不久後我們就必須公開 我們喜歡貓還是狗、

won't affect your patients' health,

開哪種車、

but your views on a woman's right to choose

用哪種衛生紙。」

and preventive medicine and end-of-life decisions just might.

你對豐田汽車或者綿柔衛生紙的看法

And my favorite, from a Kansas City cardiologist:

不會影響病人的健康，

"More government-mandated stuff?

但是你對於婦女選擇權、預防醫學

Dr. Wen needs to move back to her own country."

和臨終決定的觀點，就可能會影響。

Well, two pieces of good news.

我最喜歡的一則是 來自堪薩斯市的心臟科醫生說：

First of all, this is meant to be voluntary and not mandatory,

「更多政府強制管理的鳥事？

and second of all, I'm American and I'm already here.

溫醫生可以回自己的國家去​​了。」

(Laughter) (Applause)

好的，我有兩個好消息。

Within a month, my employers were getting calls

首先，這是自願而不是強制的，

asking for me to be fired.

其次，我是美國人，我已經在這裡了。

I received mail at my undisclosed home address

（笑聲）（掌聲）

with threats to contact the medical board to sanction me.

在一個月之內，我的僱主接到很多來電

My friends and family urged me to quit this campaign.

要求解僱我。

After the bomb threat, I was done.

我在從未公開的住家地址收到

But then I heard from patients.

威脅要聯繫醫務委員制裁我的郵件。

Over social media, a TweetChat,

我的朋友和家人力勸我放棄這個活動。

which I'd learned what that was by then,

在收到炸彈威脅後，我停止了活動。

generated 4.3 million impressions,

後來我卻收到來自病人的訊息。

and thousands of people wrote to encourage me to continue.

在社交媒體推特聊天室上，

They wrote with things like,

當時我才知道那個網站，

"If doctors are doing something they're that ashamed of,

這件事出現在 430 萬人次的版上，

they shouldn't be doing it."

有數千人留言鼓勵我堅持下去。

"Elected officials have to disclose campaign contributions.

他們留言說：

Lawyers have to disclose conflicts of interests.

「如果醫生在做他們自己都 感到羞恥的事情，

Why shouldn't doctors?"

他們就不該繼續做。」

And finally, many people wrote and said,

「民選官員必須公開選舉經費明細。

"Let us patients decide

律師必須要公開是否有利益衝突，

what's important when we're choosing a doctor."

為什麼醫生就不行？」

In our initial trial,

最後，還有很多人留言：

over 300 doctors have taken the total transparency pledge.

「讓我們這些病人來決定

What a crazy new idea, right?

選醫生要看什麼才重要。」

But actually, this is not that new of a concept at all.

我們初次嘗試的時候，

Remember Dr. Sam, my doctor in China,

超過三百位醫生參與了這項 完全透明的承諾。