2014年12月8日 星期一

Hippocrates (醫手遮天)

All medecins (medical doctors) are required to take what's been called the Oath of Hippocrates which in its ancient form runs something as follows: "By Apollo (the physician), by Asclepius (god of healing), by Hygeia (god of health), by Panacea (god of remedy), and all the gods and goddesses, together as witnesses, I hereby swear that I will carry out, inasmuch as I am able and true to my considered judgment, this oath and the ensuing duties:
1. To hold my teacher in this art on a par with my parents...To teach his/her family the art of medicine, if they want to learn it, without tuition or any other conditions of service. To impart all the lessons necessary to practice medicine to my own sons and daughters, the sons and daughters of my teacher and to my own students, who have taken this oath-but to no one else.
2. I will help the sick according to my skill and judgment, but never with an intent to do harm or injury to another.
3. I will never administer poison to anyone-even when asked to do so. Nor will I ever suggest a way that others (even the patient) could do so. Similarly, I will never induce an abortion. Instead, I will keep holy my life and art.
4. I will not engage in surgery--not even upon suffers from stone, but will withdraw in favor of others who do this work.
5. Whoever I visit, rich or poor, I will concern myself with the well being of the sick. I will commit no intentional misdeeds, nor any other harmful action such as engaging in sexual relations with my patients (regardless of their status).
6. Whatever I hear or see in the course of my professional duties (or even outside the course of treatment) regarding my patients is strictly confidential and I will not allow it to be spread about. But instead, will hold these as holy secrets.
    Now if I carry out this oath and not break its injunctions, may I enjoy a good life and may my reputation be pure and honored for all generations. But if I fail and break this oath, then may the opposite befall me".

In 2014, "Hippocrate" has become the name of a film by Thomas Lilti ('Les Yeux Bandés 2007), the second film of this general medical practitioner, about the first year in the life of a young intern whose father is the head of the hospital where he is attached as a "houseman". It's not a the kind of film like Emergency Room but through the eyes of the young Benjamin (Vincent Lacost) and his initial conflict with Abdel (Reda Kateb )an Algerian colleague posted to France to get his "equivalence" who cared more for the comfort of a patient than the strict and rigid guidelines which all doctors are supposed to follow. Young Benjamin did not do an EEG on a patient because the EEG machine had not been repaired for months owing to budget cuts by implemented by a chief hospital administrator whose previous experience is in computer production as a result of which an alcoholic patient Monsieur Lemoine (Thierry Levaret) nicknamed "Tsunami" because his violent resistance to treatment, developed some unexpected convulsions during the night and died the following morning. It was Benjamin's first death and it deeply affected him. He tried to evade responsibility by lying to Lemoine's separated wife who came to find out what happened that it was Abdel who was the doctor in charge when in fact it was him although Abdel did assist him in helping the patient. His father also tried to cover him when confronted by Madame Lemoine.

Then another incident happened, another patient, Denormandy( Marianne Denicourt) a late 80-ish  former gynast, asked not to be operated on for her metatased cancer and not to be resuscitated when her heart fails and just be given morphine to alleviate her pains. In accordance with the regulations, Benjamin tried to turn on the resuscitation machine but it was obvious that she was suffering extreme pain. When Abdel was on duty, he complied with her wish and had it turned off and merely gave her morphine. She felt greatly relieved and grateful and appeared quite at ease and ready to go into the next world for her own death because she knew that her chances of success in the operation is about 10%. But it was against hospital guidelines and a disciplinary hearing was held in which he was sanctioned, something which will mar his career forever. Benjamin felt sorry for him and felt the judgment of the disciplinary panel unfair as were the rest of his professional colleague who went on strike demanding the revocation of its decision. The protests was the occasion for the ventilation of all kinds of complaints against the way the hospital was run because for budgetary reasons, the number of nurses was cut in half and many and the hours of the staff had to be on duty and on call was far too long. Eventually, because of political reasons, the decision was rescinded.

This is an excellent film which documents with sensitivity the various kinds of problems and stresses faced by various hospital staff, their different attitudes to hospital regulations and patients, the divers "crazy" and often funny ways different staff had to resort to to try to relieve the often inhuman tensions generated by long hours of intensive work and gives us a "taste" of atmosphere of a busy, understaffed and under-equipped hospital, with all trying to do their best under the financial and other staff constraints. If it doesn't do anything else, it at least puts a "human" face on one of the smaller French hospitals: it shows persuasively how it's can sometimes be a real struggle to faithfully implement the Hippocrate's oath. Perhaps Abdel is right when he tells young Benjamin" It's "curse" to be called to be a doctor."