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動態
本期仁醫醫療特別邀請到國際著名脊柱專家Prof. Michael A. Rauschmann做專題訪問。Prof. Rauschmann現任Sana集團奧芬巴赫醫院脊柱外科和重建骨科外科主任、法蘭克福大學教授，他曾擔任德國脊柱學會（DWG）主席(2015年)，連續11年獲得FOCUS頂級醫師獎(2012年-2022年)。2022年貴陽市第四人民醫院脊柱外科肖宇醫生將成為Prof. Rauschmann在中國的第一個臨床醫學博士（MD）。
Prof. Rauschmann編寫了《Spine Surgery》
△Prof. Rauschmann贈與仁醫醫療團隊《Spine Surgery》
他還是Die Orthopädie《骨科》（原：Der Orthopäde）雜誌專題發行負責人
精彩回顧
戳視頻 搶先看
1、您為什麼學醫，又為什麼決定專攻脊柱疾病呢？
Why did you decide to pursue a career in medicine and why, in particular, did you decide to specialize in the spine (or spine surgery)?
我一直都對大自然感興趣，在學校我最喜歡的科目是生物。作為一名學生，我在15suideshihouquleyijiayaodianshixi，yaodiandegongzuoduiyuwolaishuoguoyulilunhuaershijiwentijiaoshao，houlaiwojiudaoleyijiazhiliaoyanzhongshenjingxitongjibingdeyiyuanshixi，zheyecushiwoxiadingjuexinxuexiyixue。
buguoyouyuwodexuexichengjibugou，wozanshiwufaduyi，suoyiwoxianquledeguojunduifubingyi，yinianhouwoyouqulexuexiqichexiuli。wanchengqichexiulipeixunhou，wohuodelequxiongyalibudapeisixuexiyixuedejihui。lianggeyuehou，wodedaoyigehuideguofalankefuxuexideminge。suoyiwojiuhuidaolefalankefu——我的出生地，並在此完成了我的學業。
我wo最zui感gan興xing趣qu的de是shi解jie剖pou學xue。我wo和he其qi中zhong一yi位wei教jiao授shou相xiang處chu友you好hao，他ta點dian名ming讓rang我wo學xue習xi顯xian微wei鏡jing切qie片pian製zhi備bei，後hou來lai他ta還hai安an排pai了le一yi個ge實shi踐jian解jie剖pou學xue研yan究jiu課ke題ti讓rang我wo準zhun備bei論lun文wen。這zhe很hen大da程cheng度du影ying響xiang了le我wo學xue習xi外wai科ke專zhuan業ye的de決jue定ding。後hou來lai我wo在zai德de國guo的de不bu同tong醫yi院yuan接jie受shou實shi習xi培pei訓xun，我wo也ye去qu過guo奧ao地di利li、美(mei)國(guo)和(he)南(nan)非(fei)的(de)醫(yi)院(yuan)實(shi)習(xi)了(le)六(liu)個(ge)月(yue)。在(zai)這(zhe)些(xie)實(shi)習(xi)經(jing)曆(li)中(zhong)，我(wo)總(zong)是(shi)喜(xi)歡(huan)在(zai)骨(gu)科(ke)手(shou)術(shu)室(shi)工(gong)作(zuo)。完(wan)成(cheng)醫(yi)學(xue)考(kao)試(shi)後(hou)，我(wo)開(kai)始(shi)了(le)我(wo)的(de)第(di)一(yi)份(fen)工(gong)作(zuo)，在(zai)一(yi)個(ge)創(chuang)傷(shang)科(ke)室(shi)當(dang)醫(yi)生(sheng)。兩(liang)年(nian)後(hou)，我(wo)轉(zhuan)到(dao)法(fa)蘭(lan)克(ke)福(fu)大(da)學(xue)骨(gu)科(ke)醫(yi)院(yuan)專(zhuan)攻(gong)骨(gu)科(ke)，我(wo)在(zai)那(na)裏(li)至(zhi)少(shao)呆(dai)了(le)23年。
Thank you for the question. I always was interested in nature, in school my favorite subject was biology. So therefore first I did a practical training in a pharmacy as a student at the age of 15 years. This was for me too theoretical with less practical issues, so I did a practical training in a hospital for severe neurological diseases. This gave me the decision to study medicine. Due to my school grade, I was not able to start immediately with the medicine study, so I went at first to the German military and after one year I started an education as a car-mechanic. After finishing this education as a car-mechanic, I had the opportunity to start my medical studies in Budapest in Hungary and 2 month later I got a place in Frankfurt Germany, so I changed my study place and did my whole study in Frankfurt, here where I was born.
My favorite interest was anatomy. So I got a very intensive contact to one of my professors and he chose me to learn microscopic preparation and later he gave me a practical anatomical study to prepare my thesis, which I did. This influenced me very much in the decision to do a surgical subject in medicine. Then I did practical trainings in different hospitals here in Germany, I went to Austria, to the United States and to South Africa for six months. Here I always preferred to work in the orthopedic surgery units. After finishing my exams, I started my first work as a doctor in a trauma unit. Two years later I changed to the orthopedic university hospital in Frankfurt for specialization in orthopedics where I stayed at least 23 years.
2、在您的職業生涯中，是否有對您來說很重要的導師？他們教會您什麼，是如何啟發您的呢？
Who have been you greatest influences? What have they taught you and how have they inspired you?
正如我之前提到的，對我影響最大的是我遇到的第一位教授，他是教解剖學的Oelschläger教授，他不僅給我安排畢業論文的研究課題，而且對我的科研基礎有著深刻影響。
後來當我在法蘭克福大學骨科醫院工作時，我遇到了兩位對我影響深遠的教授。一位是Ludwig Zichner教授，他是醫院院長也是一位骨科醫生，他影響著我的骨科科研工作，也激發我探索醫學曆史的興趣。對於我的臨床工作， 不得不提及Erich Schmitt教授，他是一名脊柱外科醫生也是脊柱外科主任。在他的影響之下，我完成了骨科學習後選擇了脊柱外科作為我的專業。
My greatest influence, as I mentioned before, was my first professor in anatomy, his name was Prof. Oelschläger, and he gave me my theme for the thesis and he really had a big influence, concerning the base of my scientific work. Later on, when I went to the orthopedic university hospital I had two professors, the chair of the hospital was Prof. Ludwig Zichner, he was the general orthopedic surgeon and he influenced me due to my scientific orthopedic work and my interest in history of medicine. And concerning my clinical work, Prof. Erich Schmitt, he was the spine surgeon and he was running the spine unit, and he influenced me doing spine surgery as my specialization after finishing the education in orthopedics.
3、作為大學教授、科室主任、眾多學會成員，您是如何平衡行政、臨床、科研工作、教學以及個人生活？
As a university professor, chief physician, members of many professional societies, how do you balance the administration, clinical practice, research activities, teaching and personal life?
首shou先xian，在zai我wo心xin目mu中zhong，家jia庭ting是shi排pai第di一yi位wei，其qi次ci是shi我wo的de臨lin床chuang工gong作zuo，但dan實shi際ji上shang，毫hao無wu疑yi問wen我wo的de臨lin床chuang工gong作zuo以yi及ji科ke研yan工gong作zuo占zhan據ju了le我wo生sheng活huo中zhong的de大da部bu分fen時shi間jian。我wo非fei常chang喜xi歡huan教jiao學xue工gong作zuo，無wu論lun對dui象xiang是shi學xue生sheng還hai是shi醫yi生sheng，所suo以yi我wo在zai德de國guo脊ji柱zhu學xue會hui（DWG）非常活躍。我是DWG學院的執行董事，負責學會所有證書的教學課程。
First of all, in my mind, the family is the first choice and secondary of course, my clinical work, but in reality concerning my time, I would say of course the clinic and my clinical work and my scientific work takes most of the time in my life. Teaching students and doctors in education I like very much. Therefore I’m very active in the German Spine Society (DWG). I’m the executive director of the academy of the DWG and responsible for all the educational courses for our certificates.
4、作為眾多醫學學會的成員，您參加過許多國內外的學術活動，這對您的職業生涯有何幫助？
You have been an active member of a number of medical organizations, and have been engaging in many regional and international academic activities, how has this helped to shape your career?
canjiagezhongdahuihuoyantaohuiyouzhuyuzengjinyujizhuwaikelingyudeyijianlingxiuhezhongyaorenwudelianxi，woyededaoyutamendiyicijiechudejihui。tongguozhanshiwodechengguo，wohuodelezunzhongbingbeiyaoqingfuzedeguojizhuxuehuidejiaoxuekechenggongzuo。wotouruledaliangjingli，yincizai2015年德國脊柱學會董事會選舉我擔任主席。這些經曆對我職業生涯的影響是深遠的。
Going to congresses and workshops helps a lot to get in contact with opinion-leaders and important persons in the field of spine surgery. This helped me a lot to get my first contacts. By showing my results, I got respect and was asked to support these courses in the German Spine Society. I committed myself intensively and so the board of the German Spine Society elected me in 2015 to be the president of the German Spine Society. All this together shaped my career in a very important way.
5、在2017年，您離開法蘭克福到Sana集團奧芬巴赫醫院就職，並在該院擔任脊柱外科和重建骨科外科主任至今，能否分享一下當時過渡期間，您遇到最大的挑戰是什麼？
In 2017, you moved to the Sana Clinic in Offenbach from Frankfurt, and since then you have been the head of the Department of Spine and Reconstructive Orthopaedic Surgery there. Could you please share with us what was the biggest challenge you encountered during the time of transition?
在過渡期間，我遇到了許多挑戰。
shouxian，wohuidanxinbingrenhuibuhuizhuisuiwo。yinweiruguomeiyoubingren，yishengjiuwushikezuo。qici，yiyuandeyishenghejiaoshouduiwodetaidushizenmeyangdene？hushihexingzhengbumenshifouhuijieshouwoyijiruhepeihewodegongzuo？disan，wozaixindehuanjingzhongshifouhuigandaokuaile？
worenweizuihouyidianfeichangzhongyao，ruguonizaiyigedifanggongzuobukaixin，nijiuwufafahuinizuidadenengli。wozhendehengaoxingtamennengjieshouwo，jieshouwodegongzuofangshiyijiwosuozuodegongzuo。bujiuhou，wojiuyuyiyuandegegexuekejianlilelianxi。Sanajituanaofenbaheyiyuanshiyijiadaxingyiyuan，yongyoushangqianzhangchuangwei。zhejiayiyuandeyidayoudianshigegekeshihexuekedegongzuopeihejinmi，woyehenkuaishiyinglexinhuanjing。wohenrongxingnengchengweizhegeyou20多個學科組成的團隊中的一員。我們以完美、專業的工作方式來共同幫助我們的病人。這對我來說是最重要的事情，我可以按照我喜歡的方式來完成我的工作。
There were a lot of challenges by doing this transfer. First of all, I was scared if the patients will follow me, because if you do not have patients, you do not have something to work. The second was how will the doctors in the hospital and the professors react to me? How will the nurses and the administration will work with me and accept me in my work? And third, will I be happy in a new environment?
I think the last point is very important, if you are not happy in the place where you work, you cannot give your maximum power. Therefore I was really glad that they accepted me, that they accepted the way how I work and also accepted my work which I do. It took not a long time until I got in contact with all the different disciplines. The Sana Clinic Offenbach is a very big institution with thousand beds. And a big advantage is that all these institutions and disciplines work very close together and that worked out for me also quite fast, so I'm really happy to be a member of this team of more than 20 disciplines in the house and we work in a very perfect way, a very professional way, together to help our patients. So this is for my side, the most important thing, that I can do my work how I like to do it.
6、Sana集團奧芬巴赫醫院大骨科有分科嗎？
Are there any orthopedic sub-specialties in the Sana Clinic Offenbach?
奧ao芬fen巴ba赫he醫yi院yuan大da骨gu科ke有you不bu同tong的de亞ya專zhuan科ke。我wo們men有you一yi個ge髖kuan膝xi關guan節jie假jia體ti置zhi換huan中zhong心xin，還hai有you一yi個ge與yu整zheng形xing外wai科ke醫yi生sheng團tuan隊dui組zu成cheng的de卓zhuo越yue燒shao傷shang中zhong心xin，它ta不bu僅jin服fu務wu於yu當dang地di區qu域yu。我wo們men還hai有you一yi個ge足zu踝huai中zhong心xin，與yu兒er科ke合he作zuo治zhi療liao足zu部bu和he小xiao腿tui的de畸ji形xing。我wo們men醫yi院yuan的de創chuang傷shang救jiu治zhi工gong作zuo也ye非fei常chang優you秀xiu，由you於yu這zhe是shi一yi家jia位wei於yu大da城cheng市shi的de大da型xing醫yi院yuan，我wo們men配pei有you直zhi升sheng機ji以yi及ji3組創傷急救人員專門接收和運送病人。因此我們的創傷中心是非常大型的，每年救治成千上萬的病人。
There are different sub-specialization, we have a sub-unit for endoprosthesis of hip and knee and we have a burning unit together with plastic surgeons which is a very exceptional and is not working only for our region. And we have a special unit for foot and ankle and we also work with a pediatric department concerning deformities in the foot and lower leg. And of course the trauma work is very exceptional, because it's a big hospital in a very big area, so we have the helicopter, we have three emergency units who go out and bring the patients in. So it's very big with thousands of patients every year.
7、您科室每年做多少台手術？
How many surgeries are performed in your department every year?
就目前來說，每年大約有800taishoushu。danwoyaobuchongyidian，zhexieshoushudaduoshudoushidashoushu，wanchengyitaizhongliuqiechushuhuoshoushuchulijizhuzhuijianpanyantongchanghaoshixujiu，suoyiwaikeyishengbukenengzaiyitianneiwanchengtaiduoshoushu。danxianshishiwomenmeitian24小時都接收很多急診病人，因此我們的手術量不會少。而且科室每天會開放兩間手術室，一間用於做大型的、耗時長的手術，而另外一間用於做各類小型手術，如髓核切除術、減壓術等。
Nowadays I would say around 800 surgeries. You must take in mind that a majority of these surgeries are always big surgeries, so if you do a tumor surgery or a surgery in spondylodiscitis, that takes typically many hours of the day, you cannot do so much more on one day. But due to the fact that we have also a lot of emergency cases which are running 24/7. This makes the high number and also we are running two OR rooms every day. Here we have one room where we do the big surgeries, the long surgeries, and in the second room, we do more the smaller ones like nucleotomies and decompressions or something like that.
8、能否分享一下您治療過的最具挑戰性且最印象深刻的病例？
Could you please share one case that you think is the most challenging and impressive one?
congyiduonianyilai，woyudaoguoxuduobutongqiejijutiaozhanxingdebingli，dangzhongyoubaoguidejingyanyeyoushibaidejiaoxun。wojidewozengjingzuoguoyitaishangxiongzhuidazhongliuqiechushoushu，shiyoupankesitezhongliu（Pancoast tumor）引起的。我花了至少12小時來操作這台手術，然後胸外科醫生才把腫瘤連同肺部一起切除，這是一台非常具有挑戰性的手術。
haiyouqiechudigushangdejisuoliuzheleishoushu，duiwolaishuoyeshifeichangyoutiaozhanxingde。womenxiwangzaibuchujizhongliudeqingkuangxiajinxingguangfanxingqiechu，zhejiudaozhishoushuhaoshifeichangchang。tongshidigushiyigefeichangcuiruodebuwei，jinxingzheleishoushuduibingrenyehuiyouyanzhongdeyingxiang。
當然，在我的腦海中，我仍然記得有一個“死在手術台上”（Mors in Tabula）的(de)病(bing)例(li)，是(shi)一(yi)個(ge)患(huan)有(you)嚴(yan)重(zhong)的(de)多(duo)節(jie)段(duan)腰(yao)椎(zhui)間(jian)盤(pan)炎(yan)的(de)病(bing)人(ren)，在(zai)手(shou)術(shu)最(zui)後(hou)因(yin)心(xin)髒(zang)病(bing)發(fa)作(zuo)而(er)死(si)亡(wang)。當(dang)時(shi)我(wo)承(cheng)受(shou)了(le)很(hen)大(da)的(de)壓(ya)力(li)，因(yin)為(wei)我(wo)不(bu)清(qing)楚(chu)病(bing)人(ren)猝(cu)死(si)的(de)原(yuan)因(yin)是(shi)什(shen)麼(me)。直(zhi)到(dao)最(zui)後(hou)，對(dui)病(bing)人(ren)進(jin)行(xing)病(bing)理(li)調(tiao)查(zha)後(hou)，我(wo)們(men)才(cai)發(fa)現(xian)這(zhe)不(bu)是(shi)外(wai)科(ke)醫(yi)生(sheng)的(de)過(guo)失(shi)，而(er)是(shi)由(you)於(yu)病(bing)人(ren)心(xin)髒(zang)病(bing)發(fa)作(zuo)才(cai)導(dao)致(zhi)死(si)亡(wang)。這(zhe)給(gei)我(wo)留(liu)下(xia)了(le)深(shen)刻(ke)的(de)印(yin)象(xiang)，至(zhi)今(jin)我(wo)仍(reng)會(hui)想(xiang)起(qi)我(wo)生(sheng)命(ming)中(zhong)那(na)黑(hei)暗(an)的(de)一(yi)天(tian)。
During all these years I had different cases in my life which were very challenging for me, on the one hand of course pearls, but also pitfalls, so I remember a big tumor resection in the upper thoracic spine by a so-called Pancoast tumor, so that took at least a surgery time for me of 12 hours and then the thoracic surgeon had to take away the tumor in combination with the lung, so this was a very challenging surgery.
And also different surgeries on Chordomas in the sacrum where were very challenging for me. It’s a very long surgery where we want to get a wide resection without touching the tumor. This is a very delicate region, also there are severe consequences for the patient.
And of course in my mind, there is still a so-called “mors in tabula” where a patient with a severe spondylodiscitis in different segments of the lumber spine died in the last part of the surgery due to a heart attack. So this for me was a big stress because I didn't know what was the reason for this sudden death. And only at the very end when the patient was investigated by the pathology, we found out, that this was not the fault of the surgeon and this was a heart attack, but this impressed me very much and I nowadays still think about this very bad day in my life.
9、法蘭克福市因您在醫學領域享有盛譽而任命您為該市“大會大使”，這對您來說意味著什麼？
The city of Frankfurt am Main has appointed you as one of its congress ambassadors because of your reputation in medicine, what does this appointment mean to you?
我很榮幸能成為法蘭克福市的“大會大使”當中的一員。這要歸功於2015年舉辦的德國脊柱學會年會。這場大型盛會彙聚了2750mingcanhuizhe，zheduiyufalankefushi，tebieshiduiyuhuiwuzhongxinjiqizhouweidejiudianhecanguanlaishuoshiyichangdaxingshangyehuodong。dangranyaoqingguoneiwaijiabincanjiazhechangshenghui，duiwomendechengshilaishuoyeshiyizhongrongyu，woyehengaoxingnengchengweidahuidashizhongdeyiyuan。xianzaiwomenrengzaituidongzhezhexiehuodong，wohuizuzhigeleixueshuzuotanhuiheyantaohui，yaoqinglaizishijiegedideyishengcanguanwomenzaiyiyuandegongzuoqingkuang。tamenhaikeyiyoulanchengshi，falankefushiyeyinzhexiejiabindedaolaierzengsetiancai。tashiyizuofeichangpiaoliangdechengshi，renmenchengtaweimeiyinha頓（Mainhattan），因為這裏的摩天大樓在德國是獨一無二的。
It was an honor for me, belonging to the group of ambassadors of our city here in Frankfurt, this was due to the congress in 2015. For the city, such a big congress means, that we had 2750 participants at the congress which is a big business for the city of course, especially for the convention center, for the hotels around the convention center, and for the restaurants in the city. And having national and international guests for such a congress, it is also an honor for our city and therefore I'm happy to be one of the ambassadors. And still nowadays, we continue with this program and I do further symposiums and seminars where doctors from all over the world come to visit me and to see me how we work in the hospital. They all get contact with the city and get a walk around with me, and so also Frankfurt has a profit of guest doctors because Frankfurt is a very nice city, you know they call it Mainhattan because of the skyscrapers which is exceptional here in Germany.
10、至今您最自豪的職業成就是什麼，為什麼？
What is your proudest career achievement to date and why?
每(mei)天(tian)都(dou)有(you)我(wo)成(cheng)功(gong)治(zhi)療(liao)的(de)病(bing)人(ren)，他(ta)們(men)對(dui)我(wo)的(de)工(gong)作(zuo)表(biao)示(shi)非(fei)常(chang)感(gan)謝(xie)，這(zhe)是(shi)我(wo)最(zui)自(zi)豪(hao)的(de)職(zhi)業(ye)成(cheng)就(jiu)。此(ci)外(wai)，如(ru)之(zhi)前(qian)提(ti)及(ji)，我(wo)擔(dan)任(ren)過(guo)德(de)國(guo)脊(ji)柱(zhu)學(xue)會(hui)的(de)主(zhu)席(xi)。我(wo)能(neng)在(zai)德(de)國(guo)乃(nai)至(zhi)國(guo)際(ji)著(zhu)名(ming)的(de)脊(ji)柱(zhu)外(wai)科(ke)醫(yi)生(sheng)當(dang)中(zhong)脫(tuo)穎(ying)而(er)出(chu)當(dang)選(xuan)主(zhu)席(xi)，對(dui)於(yu)我(wo)來(lai)說(shuo)是(shi)一(yi)個(ge)極(ji)大(da)的(de)榮(rong)譽(yu)。當(dang)然(ran)最(zui)重(zhong)要(yao)的(de)是(shi)我(wo)的(de)病(bing)人(ren)，我(wo)工(gong)作(zuo)中(zhong)最(zui)大(da)的(de)成(cheng)就(jiu)是(shi)，病(bing)人(ren)術(shu)後(hou)能(neng)感(gan)到(dao)開(kai)心(xin)和(he)滿(man)意(yi)。
Everyday the patients which I have successfully treated and who are very thankful to my work, this is the proudest career achievement for me. Furthermore the presidency of the DWG which I mentioned already, because I was elected from a board who are the most important spine surgeons in Germany but also international. This was a very big honor for me. But on the first place, I still see the patients and this is my biggest achievement in my work having happy and satisfied patients after my surgical work.
11、您對想要開啟他們的脊柱外科生涯的年輕醫生有什麼建議？
What advice would you give to young surgeons hoping to start a career in spine surgery?
第一，我建議他們先在普外科學起，或者在一家醫院全麵地學習普外科、血管外科和創傷外科的知識。
第二，花時間認真處理每一個病例，陪伴病人。你要學習治療的方法，從診斷、手術切口的製作、手術適應症、genjinshoushuguochengyijishoushuchenggongdeyuanyin，haiyoubingrendeyuheguochenghechangqiliaoxiao。haiyouyidianhenzhongyao，dangbingrenxiangnixunqiujinyibuyijianshi，niyaoqingchunengweibingrentigongshenmejianyi，shizuoshoushuhaishicaiqubaoshouzhiliaodengdeng。
第三，永遠都要製定一個B計ji劃hua。你ni的de第di一yi個ge治zhi療liao方fang案an不bu一yi定ding能neng通tong過guo做zuo手shou術shu實shi現xian，尤you其qi是shi在zai脊ji柱zhu外wai科ke手shou術shu中zhong，所suo以yi一yi定ding要yao考kao慮lv，如ru果guo第di一yi個ge治zhi療liao方fang案an失shi敗bai了le，下xia一yi步bu該gai做zuo什shen麼me。
第(di)四(si)，永(yong)遠(yuan)不(bu)要(yao)違(wei)背(bei)病(bing)人(ren)的(de)意(yi)願(yuan)進(jin)行(xing)治(zhi)療(liao)。如(ru)果(guo)沒(mei)有(you)獲(huo)得(de)病(bing)人(ren)的(de)信(xin)任(ren)就(jiu)不(bu)能(neng)治(zhi)療(liao)，也(ye)不(bu)能(neng)給(gei)他(ta)做(zuo)手(shou)術(shu)。治(zhi)療(liao)病(bing)人(ren)的(de)前(qian)提(ti)是(shi)，病(bing)人(ren)必(bi)須(xu)接(jie)納(na)你(ni)的(de)治(zhi)療(liao)方(fang)案(an)，以(yi)及(ji)信(xin)任(ren)你(ni)作(zuo)為(wei)他(ta)的(de)外(wai)科(ke)醫(yi)生(sheng)。
第五，觀察的病人症狀，始終對你的診斷持保留意見，並且要相信病人。當病人說：“我對手術不滿意，我還有疼痛、麻痹或者癱瘓的症狀”。認ren真zhen對dui待dai病bing人ren說shuo的de話hua，當dang作zuo事shi實shi並bing試shi著zhe去qu驗yan證zheng它ta，通tong常chang都dou能neng找zhao出chu原yuan因yin。病bing人ren是shi從cong不bu說shuo謊huang的de。而er且qie重zhong要yao的de是shi，你ni要yao清qing楚chu即ji使shi你ni堅jian信xin你ni所suo做zuo的de手shou術shu是shi完wan美mei的de，也ye可ke能neng發fa生sheng一yi些xie意yi外wai，從cong而er導dao致zhi手shou術shu不bu成cheng功gong。
第(di)六(liu)，手(shou)術(shu)前(qian)與(yu)病(bing)人(ren)會(hui)麵(mian)，這(zhe)點(dian)在(zai)病(bing)人(ren)的(de)康(kang)複(fu)過(guo)程(cheng)中(zhong)也(ye)非(fei)常(chang)重(zhong)要(yao)。讓(rang)病(bing)人(ren)知(zhi)道(dao)你(ni)和(he)他(ta)們(men)待(dai)一(yi)起(qi)，照(zhao)顧(gu)著(zhe)他(ta)們(men)。這(zhe)樣(yang)在(zai)病(bing)人(ren)麻(ma)醉(zui)前(qian)的(de)最(zui)後(hou)一(yi)刻(ke)，你(ni)都(dou)可(ke)以(yi)掌(zhang)握(wo)他(ta)們(men)的(de)真(zhen)實(shi)症(zheng)狀(zhuang)。因(yin)為(wei)有(you)時(shi)病(bing)人(ren)的(de)症(zheng)狀(zhuang)會(hui)改(gai)變(bian)，有(you)時(shi)右(you)腿(tui)的(de)症(zheng)狀(zhuang)已(yi)經(jing)沒(mei)有(you)了(le)，而(er)表(biao)現(xian)在(zai)左(zuo)腿(tui)、右臂或者左臂。所以手術前與病人會麵，獲得病人最新的情況非常重要。
第di七qi，對dui病bing人ren要yao誠cheng實shi。即ji使shi你ni出chu現xian了le失shi誤wu，也ye要yao告gao訴su病bing人ren發fa生sheng了le什shen麼me，並bing解jie釋shi為wei什shen麼me會hui發fa生sheng這zhe種zhong情qing況kuang。病bing人ren可ke能neng會hui同tong意yi再zai做zuo一yi次ci翻fan修xiu手shou術shu。對dui病bing人ren要yao誠cheng實shi，不bu要yao對dui他ta們men有you隱yin瞞man。
以上是我對年輕外科醫生的建議。
I would always say they should start in a general surgery unit or in a hospital where they get a broad education in general and vascular surgery but also in trauma surgery.
Take the time for every case and stay with the patients. That's very important that you learn the way of the treatment starting with the diagnosis, doing the incision making and indication for the surgery, following the surgery and following the success of the surgery, the healing process, but also the longtime results of these patients. That's important to have an idea what you recommend to the patients later on, when you have to give them your opinion what they should do, if they should do a surgery or conservative treatment or whatever.
Try always to have a plan B for a treatment, especially in spine surgery not always your first plan will be realized in the OR, so you have to have an idea what you have to do if your first idea, if your first plan will fail.
Never do a treatment against the conviction of the patient. If the patient is not convinced, don't treat him, don't do the surgery. Patients have to be convinced of the treatment method which you will do and they have to be convinced of you as the surgeon.
Be always critical to the prescriptions from symptoms to the patients and believe them, so when a patient says, “I'm not happy with the surgery, I still have pain or I have numbness or I have a paralysis”. Take that as a truth and try to proof it, very often you will find a reason. And patients never lie, that's important to know that even if you are convinced that your surgery which you have done was perfect, even then, something can happen and can lead to an unsuccessful problem.
Try always to see a patient before doing a surgery. That's very important, also for the healing process after patients, that they know you're with them, you take care of them and you have in the very last step before the patients get the narcosis, you have another idea of their real symptoms, sometimes they change, sometimes it's not anymore on the right leg, it's now on the left leg or on the right arm, on the left arm, so it's important to see the patients just before the surgery to get all these new information about them.
At the end of the day, be honest to the patients. Even if you make a mistake, tell the patients what happened and explain them why that happened and then they still go with you also this hard way of revision surgery if this is possible, but be honest to them and don't lie to the patients.
These are my advice for young surgeons.
12、能和我們說說脊柱外科手術未來發展趨勢？
What’s the future trends of spine surgery?
jizhuwaikeshoushudefazhanqianjingshifenguangming。yinweijizhushoushuyukuanxiguanjiezhihuanshuxiangbi，qianzhehaiyouxuduodaifajuedekongjian。woxiangxinweilaijinianjiqirendaohanghexindeshoushujishuhuiruchunsunbanyongxianchulai，weilaidejizhuwaikeshoushuhuigengjiapengbofazhan。suoyiwojianxinjizhuwaikeshoushuzaiwaikelingyudefazhandaoluhuibiandegengjiaguangkuo，daohanghejiqirenjishuyehuirangzheleishoushujishubiandegengjiajingque。
外科醫生的手感永遠是重要的，手術的成功不能僅依靠機器人和導航裝置。手感、治(zhi)療(liao)計(ji)劃(hua)的(de)製(zhi)定(ding)以(yi)及(ji)正(zheng)確(que)的(de)手(shou)術(shu)指(zhi)征(zheng)判(pan)斷(duan)都(dou)是(shi)需(xu)要(yao)外(wai)科(ke)醫(yi)生(sheng)來(lai)決(jue)定(ding)，而(er)不(bu)是(shi)由(you)計(ji)算(suan)機(ji)來(lai)決(jue)定(ding)。因(yin)此(ci)我(wo)們(men)必(bi)須(xu)記(ji)住(zhu)醫(yi)生(sheng)的(de)手(shou)術(shu)技(ji)能(neng)和(he)手(shou)感(gan)才(cai)是(shi)脊(ji)柱(zhu)外(wai)科(ke)手(shou)術(shu)獲(huo)得(de)成(cheng)功(gong)最(zui)關(guan)鍵(jian)、最重要的因素。當然所有的這些技術裝置是能輔助外科醫生、提高手術成功率，還有提高手術精確度，可能也會增加或縮短未來的手術時間。
There will be a great future concerning spine surgery because if you compare spine surgery with endoprosthesis in hips and knees, we are far away from the discovery, so I think navigation robotics and new surgical techniques will come over during the next years and they will increase even more in the field of spine surgery in comparison to today. So I'm very convinced that spine surgery will get bigger in the field of the surgical disciplines and also the techniques will get more precise concerning navigation and robotics. But still the feeling of the surgeon will always be important, a robot and a navigation unit cannot be only responsible for the success of the surgery, still the fingers, and the therapeutic plan which is done by the surgeon itself, making the right indication is still in the hand of the surgeon and not in the hand of a computer. So this is what we still have to take in mind that our handwork and our feeling in doing such a surgery is still the biggest, important thing to have success. But all these technical things, they will support us and they will increase our success and will increase our precision doing it and probably it will also increase or shorten the time of surgery in the future.
13、假如您不從醫的話，您會從事什麼行業？
What would you have been if you had not been a medical doctor?
如(ru)果(guo)我(wo)沒(mei)有(you)機(ji)會(hui)學(xue)習(xi)醫(yi)學(xue)，我(wo)不(bu)知(zhi)道(dao)我(wo)的(de)未(wei)來(lai)會(hui)如(ru)何(he)，但(dan)正(zheng)如(ru)我(wo)在(zai)采(cai)訪(fang)初(chu)始(shi)時(shi)提(ti)到(dao)的(de)，我(wo)的(de)家(jia)人(ren)是(shi)從(cong)事(shi)技(ji)術(shu)勞(lao)動(dong)工(gong)作(zuo)的(de)。我(wo)父(fu)親(qin)有(you)一(yi)家(jia)汽(qi)車(che)噴(pen)漆(qi)公(gong)司(si)，我(wo)曾(zeng)經(jing)也(ye)學(xue)過(guo)汽(qi)車(che)修(xiu)理(li)，所(suo)以(yi)假(jia)如(ru)我(wo)沒(mei)有(you)學(xue)醫(yi)，我(wo)可(ke)能(neng)會(hui)接(jie)管(guan)我(wo)父(fu)親(qin)的(de)生(sheng)意(yi)，繼(ji)續(xu)經(jing)營(ying)他(ta)的(de)汽(qi)車(che)噴(pen)漆(qi)公(gong)司(si)，這(zhe)可(ke)能(neng)就(jiu)是(shi)所(suo)謂(wei)的(de)B計劃。但其實我不想學習其他東西，我隻對醫學感興趣。
I don't know exactly what will have happened, if I would not have got the opportunity to study medicine, but as I mentioned at the very beginning of our interview, you know, I'm coming out of a family of hand workers. My father has had a car painting company and I was educated as a car mechanic, so probably I would have taken over his business and would have continued with the car company, that would have been probably the so-called plan B if I would not have had the chance to study medicine. I didn't want to study anything else, I only was interested in medicine as a study.
14、除了學醫外，您還有什麼興趣愛好？
What are your interests and hobbies outside medicine?
我喜愛大自然，所以我的愛好都與大自然有關。我喜歡養蜂、打da獵lie，也ye喜xi歡huan劃hua著zhe獨du木mu舟zhou或huo乘cheng坐zuo摩mo托tuo艇ting在zai水shui上shang航hang行xing。每mei個ge暑shu假jia我wo們men都dou會hui去qu海hai邊bian乘cheng船chuan遊you覽lan，這zhe是shi讓rang我wo非fei常chang享xiang受shou的de愛ai好hao。我wo還hai喜xi歡huan騎qi自zi行xing車che，喜xi歡huan待dai在zai我wo的de花hua園yuan裏li觀guan賞shang花hua卉hui植zhi物wu。每mei年nian我wo都dou會hui購gou買mai一yi些xie新xin植zhi物wu，增zeng添tian我wo花hua園yuan裏li的de植zhi物wu，看kan著zhe它ta們men如ru何he生sheng長chang開kai花hua。
I love the nature, therefore all my hobbies have something to do with nature. I'm a beekeeper, I like to go hunting, but I also like to go on the water either with my wooden canoe or with my motorboat. In every summer holidays, we go to the sea with our boat and do day cruises, so this is what I like very much. Also I like cycling and I like to go in my garden and look to the plants, and buy new plants every year to increase the number of plants in my garden and see how they grow and how they flower.
