セカンド・オピニオン―患者よ、一人の医者で安心するな! [単行本]

緊迫した医療現場の裏側で繰り広げられる杜撰な現実。それがいま白日の下に晒されつつある。医者の権威が絶対ではないことが明らかになってきた。

そもそもある病状に対する診断と治療は一つではなく、また医者の腕前も一律ではない。患者は自分の生命を左右しかねない決定を一人の人間に委ねるべきではないのだ。患者自身の自立と傲慢な医者への警告。セカンド・オピニオンの重要性が叫ばれている。

息子の症状を重く見た母親の直感と医者の冷淡な反応。費用対効果を盾に満足な治療を受けられない白血病患者。研究データとして即物的に患者を扱う医者の姿。ここに収められた8つの事例は憤りと悲しみを誘う。

著者はハーバード大学医学部教授、監訳に『患者よ、がんと闘うな』の著者である近藤誠、血液腫瘍の最前線で活躍する平岡諦と、3名の医師が内部から告発する。セカンド・オピニオンという言葉を知らない人も是非これを機に、自分に置き換えて考えて欲しい。

それでも医者のことばを鵜呑みにしますか?闇に包まれた医療現場の実態を、医療ミスで自らの下半身と息子の命を失いかけた医者が語る衝撃のドキュメンタリー。

混迷する医療現場の裏側を暴く。医療ミスで自らの下半身と息子の命を失いかけた医者が語る、衝撃のドキュメンタリー。絶対ではない医者の誤診から患者は「如何に自分を守るべきなのか」を問い直す。

Respected AIDS and cancer specialist Jerome Groopman, M.D., discussed the convergence of illness and spirituality in his first book, The Measure of Our Days. In Second Opinions: Stories of Intuition and Choice in the Changing World of Medicine, he shifts his focus to the ways intuition informs his medical decisions and enhances the quality of his patient relationships (even giving him an edge when examining a patient on referral). In eight chapters that vividly recount cases whose outcomes hinge as much on the doctor's gut feeling and empathy as on his expertise, Groopman eschews the impersonal and know-it-all role of the doctor, describing instead dire cases in which careful consideration of both the emotional and medical issues positively impacted his approach to treatment.

"A clinical compass is built not only from the doctor's medical knowledge but also from joining his intuition with that of his patient," Groopman writes. "This melding of minds occurs when the physician probes not only his patient's body but also his spirit." This uniquely integrated compass is the guide that determines the safest, least traumatic treatment for people who are in advanced stages of illness or whose diagnoses are clinical conundrums. Of the eight stories here, there's Isabella, who was diagnosed with asthma but actually has acute leukemia; Peter, whose sickness is an enigma although he's clearly dying of a vicious lung-tissue disorder; and Alex, who will die from bone marrow failure unless its exact cause is identified. Groopman's narrative nimbly relates all the details of his patients' battles as well as the professional and emotional steps he takes when facing a medical challenge. In most cases, he has been sought out to provide a second opinion of the patient's diagnosis and proposed treatment. More often than not, the original diagnosis was inaccurate and Groopman's meticulous and insightful examinations yield findings that mean the difference between life and death.

Second Opinions is a thoughtful, riveting book and a compelling tribute to the efficacy of medical care when handled responsibly and with empathy. It is also a cautionary collection of stories that reveal oversights inevitable in the health-care industry's rush to maximize efficiency, and as such it teaches an important lesson about the patient's role in ensuring a high quality of care. While Groopman runs the risk of seeming self-congratulatory, he proves himself a trustworthy advocate of patient empowerment and his sincere, articulate portrayal of intuition's subtle force will be inspirational for anyone confronting illness. --Rebecca Wright
--このテキストは、絶版本またはこのタイトルには設定されていない版型に関連付けられています。

As he so ably demonstrated in The Measure of Our Days, Groopman, a clinician and researcher at the Harvard Medical School, writes expressively and compassionately about illness. In the eight case histories presented here, he beautifully illustrates his strong belief that "a clinical compass is built not only from the doctor's medical knowledge, but also from joining his intuition with that of his patient." A well-respected hematologist told Alex Orkin he had six months to live unless he underwent a bone marrow transplant. In the absence of an appropriate donor, a very dangerous unmatched transplant was scheduled. Orkin then consulted with Groopman, who, after repeating many tests and getting to know his patient, concluded that the diagnosis was unclear and the proposed transplant too risky. Groopman intuitively decided to rely on a dictum learned in medical school: in some cases it is preferable to do nothing. Despite one scary bout of pneumonia, Orkin's marrow production increased and he recovered. Some of the other histories don't end so happily, however. One case involved a misdiagnosis of asthma by a managed care physician; by the time Groopman became involved and correctly diagnosed acute leukemia, it was too late. The author is convinced that the money-saving practices of HMOs are causing a loss of quality medical care. He also movingly describes his own experience, in which his infant son nearly died because the pediatrician, a poor diagnostician, apparently overlooked a serious condition. Fortunately, the medical expertise of Groopman and his wife (also a physician) saved their son's life. This is an excellent book by a thoughtful physician. First serial to the New Yorker; second serial to Good Housekeeping. (Mar.)
Copyright 2000 Reed Business Information, Inc. --このテキストは、絶版本またはこのタイトルには設定されていない版型に関連付けられています。

The acclaimed doctor and author of the best-selling The Measure of Our Days---who writes "beautifully, tenderly, truthfully" (Oliver Sacks)--explores the art and science of decision-making in today's complex medical universe.

Jerome Groopman, an eminent clinician and researcher at Harvard Medical School and a staff writer for The New Yorker magazine, explored the spiritual dimension of illness in his highly praised The Measure of Our Days. In Second Opinions, he focuses on the greatest challenge that patients and their families face--how to evaluate and act on medical advice.

Told in eight gripping clinical dramas, linked by Groopman's unique insider's vantage point, Second Opinions is a book that reveals the forces at play--from the realities of medical politics to the importance of patient intuition--in making critical medical decisions. As we accompany Groopman, we witness him and his wife as anxious young parents of an infant near-fatally misdiagnosed; a family trapped by an HMO's rote plan about what seemed like routine asthma; and doctors' conflicts over a patient with no clear diagnosis--a case where non-intervention turned out to be the wise, lifesaving choice. An extraordinary reading experience, Second Opinions takes us into the complex and ever-changing world of medicine where knowledge is imperfect, no therapy is without risks, no prognosis fully predictable. Readers will come away with a profoundly changed perspective and a new ability to make medical choices, from a doctor Publishers Weekly said writes "with the eye of a poet, the heart of a philosopher, and the voice of a novelist."
--このテキストは、絶版本またはこのタイトルには設定されていない版型に関連付けられています。

--このテキストは、 ペーパーバック 版に関連付けられています。

Jerome Groopman, M.D., is the Recanati Professor at Harvard Medical School, Chief of Experimental Medicine at Beth Israel Deaconess Medical Center, and one of the world's leading researchers in cancer and AIDS. A staff writer in medicine and biology for The New Yorker, he contributes regularly to The New York Times, The New Republic, The Wall Street Journal, Time magazine, and in numerous scientific journals. He lives in Brookline, Massachusetts.
--このテキストは、絶版本またはこのタイトルには設定されていない版型に関連付けられています。

グループマン,ジェローム
ハーバード大学医学部教授(The Recanati Professor)兼ベス・イスラエル・ディーコネス医療センター実験医学主任。がん、エイズ治療の第一人者。『ニューヨーカー』誌で医学・生物学分野のスタッフライターを務め、また「ニューヨーク・タイムズ」や「ウォール・ストリート・ジャーナル」などの新聞や多くの科学論文に寄稿し、旺盛な執筆活動も続けている。マサチューセッツ州ブルックリン在住

近藤 誠
1948年東京都生まれ。慶応義塾大学医学部卒。現在、同大学医学部放射線科講師。悪性リンパ腫の抗がん剤治療で成果をあげ、乳がんに対する乳房温存療法のパイオニアとして知られる。「日本は手術のしすぎ」など医学界の常識を覆す主張を展開。また、「医療事故調査会」や「患者の権利法をつくる会」の世話人を務めるなど、市民と連携した医療改革、情報公開の徹底を目指し、早くからセカンド・オピニオンの重要性を説いている

平岡 諦
1945年大阪府生まれ。大阪大学医学部卒業後、同大学付属病院助手、市立芦屋病院勤務、シカゴ大学留学などを経て、1985年より大阪府立成人病センターに勤務。現在、第五内科部長兼大阪大学医学部臨床教授。白血病の骨髄移植療法を中心に日本の血液腫瘍の治療をリードする。また、患者の精神的支援にも熱心で、セカンド・オピニオン運動の推進や、ファクシミリによる血液疾患の相談も受け付けている(本データはこの書籍が刊行された当時に掲載されていたものです)