《变形记》:患者存在困境的隐喻

The Metamorphosis : A Metaphor of the Patients' Existential Plights

卡夫卡的中篇小说《变形记》是医学人文教育中的名篇,入选叙事医学细读文本。故事主人公格雷戈尔·萨姆沙变形的经历,类似人们突然罹患疾病,尤其是慢性疾病,身体发生变形、行动不便、不能自理、需要人照顾,而且他的发声也受到影响,处于无法言说的失语状态,从这层意义上来说,也可将其视为一则疾病故事来阅读。它隐喻了患者的存在困境,如疾病羞耻、照护问题、去人化境遇、存在的孤独以及失语问题等。通过对这些困境的分析,建议重新思考慢病时代医学的目标,关注患者生活世界,并强调理解患者存在困境的双向意义。

Kafka's The Metamorphosis is taught as a classic literary piece in medical humanities and chosen for close-reading teaching in narrative medicine.The transformation undergone by Gregor Samsa appears similar to the experience of people taken ill,especially chronic diseases,which may cause deformation,debilitation,even disability,and they have to be looked after by the caregivers.Moreover,the transformation also affected Gregor's voice,leaving him in Aphasia state.Therefore,the novella can be read as an illness story.It is a metaphor for the existential plights such as the disease shame,the patients'care,the dehumanization,the existential aloneness and the loss of voice.It urges us to reflect on the goal of medicine in the age of chronic disease,calls our attention to the patients'lifeworld,and emphasizes the reciprocity of understanding the patients'existential plights.