Unit1

Doctor’sLife

CollegeEnglishCenterCollegeofForeignLanguagesandLiteratureFudanUniversityQuestionstobeAnsweredWhatarethecausesforcomplaintsofdoctors’beingimpatientandcareless?Whatkindoflifedoesadoctorlead?Howcanordinaryincidentsinfluencethewaydoctorspracticemedicine?Lead-in

Brainstormalistofwordsandexpressionsrelatedtoadoctor’slifeandpractice.

overload_____________

_________________________________________________________________Lead-in

Whatdotheymeanforadoctor?

adecentcareeranoblecallingrespectableknowledgeableundergreatpressureunderpaidmistrusteddangerousTextA:NeuronOverloadandtheJugglingPhysician

Howdoyouinterpretthetitle?NeuronoverloadJugglingPhysicianDoyouagreethatitissheerneuronoverloadonthedoctorsidethatleadstothecomplaintthatdoctorsdon’tlisten?

(Pre.1)NeuronoverloadPatients’highexpectationsMistrustandmisunderstandingbetweenthepatientsandphysicianLanguageFocuses________________overload（神經(jīng)過載）…thatonestrayrequestfromapatient—evenonethatisquiterelevant—mightsendthedelicatelybalancedthree-ringcircustumblingdown.

如果病人冷不丁提個要求，即使所提要求十分中肯，也會讓我那內(nèi)心脆弱的平衡亂作一團，就像井然有序同時演出三臺節(jié)目的大馬戲場突然崩塌一樣。neuron/neuronalLanguageFocuses…thatonestrayrequestfromapatient—evenonethatisquiterelevant—mightsendthedelicatelybalancedthree-ringcircustumblingdown.

Whatisthefunctionofthedashesinthesentence?Parentheticalstatements:insertingadditionalinformationwithoutcreatingaseparatesentenceandareoftendemonstratedbyparenthesesanddash.(Task2Signpostlanguage)Mrs.Osorio’scondition

(Pre.2)A56-year-oldwomanSomewhatoverweightReasonablywell-controlleddiabetesandhypertensioncholesterolonthehighsidewithoutanymedicationsforthisNotasmuchexerciseassheshouldThinningofherbonesonlastDEXAscanStressfulbutgoodaboutkeepingherappointmentsandgettingherbloodtestsGenerallyhealthyKnowledgeofthesubjectmatterinmy

practice

><inamedical

practiceoverweightDiabeteshypertensioncholesterolonthehighsideDEXAscanthinningofherbones>lowerdensitystressfullifekeepherappointmentsbloodtestsgenerallyhealthyanaveragepatientnotexcessivelycomplicatedLanguageFocusesHypertensionhyper-abnormallyincreased,excessive（超出，過度的）“三高”?HypertensionHyperlipidemiaHyperglycemiaLanguageFocusesatypicaloffice________（典型的診所就診）DEXA_______（DEXA掃描）medical___________（行醫(yī)）visitscanpracticeGoodandbadthingsaboutMrs.Osorio’sconditionsthatrunthroughtheauthor’smind.(Pre.3)

GoodThingsBloodtestsdoneGlucosealittlebetterHerbloodpressuregoodbutnotgreatBadThingsHerweightalittleupHerbonesalittlethinontheDEXAKnowledgeofthesubjectmatter20-minconsultationGlucosestartingastatinliverenzymesnormalfivefruitsandvegetables><dietchoices30minofwalkingeachday><exercisemorningsugarscomparetohereveningsugarsthenutritionist

>hereyedoctor>thepodiatristbloodpressureaddanotherBPmedmorepillsKnowledgeofthesubjectmatterstartabisphosphonatepreventosteoporosisexperiencingjusttheusualstressoflifelurkingdepressionoranxietydisorderthedepressionquestionnaireHealth

maintenanceherlastmammogramPAPsmearColonoscopyatetanusbooster

qualifyforapneumoniavaccineLanguageFocusesosteoporosisoste（o）-bone（骨）osteitisInflammationofthebone骨炎-por-=pore-osisdiseasedorabnormalcondition（病變的或不正常的狀態(tài)）psychosisLanguageFocusesmammogrammamm（o）-breast（乳房）mammoplasty

Mammotomy-gramsomethingwrittenordrawn,arecord（書寫或圖，記錄）electrocardiogramLanguageFocusesColonoscopycolon（o）-colon（結(jié)腸）colonoscope

-scopyseeing,observation（觀看，檢查）laparoscopyLanguageFocusespneumoniapneum（o）-air,lung（氣；肺）Pneumometerpneumothorax

LanguageFocuses_________________control（血壓控制）health______________（健康保持）…I'mpilingyetanotherpillontoher…我還要再給她另加一種藥bloodpressuremaintenanceLanguageFocusesTask3FormalEnglishDegreeofformalityshouldbedeterminedbytheaudiencetheexpectationsoftheaudienceandthewriter’spurposes.LanguageFocusesTask3FormalEnglishForexample,thewriterofTextAemploysinformallanguagewhenrecordingherjugglingthoughts,andanoticeableshiftfromthatoftherestofthearticlewhereformalstyleisconsistentlymaintained.Ajugglingmindisvividlypresentedbyinformalandevenungrammaticaluseoflanguage,suchas“Maybeleavethisuntilnexttime?”DifferencesbetweenFormalEnglishItisusedinofficial,literary,academicwriting,orformalsocialevents.Itismorecommonlyusedinwritingthanspeech.Sentencesareoftenlongandcomplex.Contractionsareavoided.InformalEnglishItisusedineverydaypersonalconversationsorletterstofriends.Itismorecommonlyusedineverydayspeechthaninwriting.Sentencesareoftenshortandsimple.Contractionsarecommon.DifferencesbetweenFormalEnglishThepassivevoiceisoftenused,makingitsoundimpersonal.MuchvocabularyderivedfromFrenchandLatinisused.Colloquialterms,slangsandmanyphrasalverbsareavoided.InformalEnglishTheactivevoiceisoftenused.VocabularyderivedfromFrenchandLatinisnotused.Colloquialterms,slangsandmanyphrasalverbsarecommon.MoreExampleFormalEnglishTheresearchersidentifiedtheimportantproperties.Doctorshaveestablishedanewmethod.

ThisappearedtorectifytheproblemInformalEnglishTheresearchersfoundoutwhattheimportantthingswere.Doctorshavecomeupwithanewmethod.ThisseemedtofixtheproblemMoreExampleFormalEnglishHiswordsdemonstratethat…Detailsofthereportaretobefoundonpage26.Theexperimentwascarriedout/performed.InformalEnglishHiswordsshowthat…You

canfindoutallaboutthereportonpage26.Theydidanexperiment.LanguageFocusesKeytoTask3FormalEnglishGoodthingshedidherbloodtests.Glucoseisalittlebetter.Cholesterolisn'tgreat.Mayneedtothinkaboutstartingastatin.Areherliverenzymesnormal?Goodsignsincludethatshedidherbloodtests,andthatherglucoselevelisalittlebetter.However,hercholesterollevelisn’tgreat,andImayneedtoconsiderprescribingastatin

forher.Furthermore,Iwonderedifherliverenzymesarenormal.LanguageFocusesKeytoTask3FormalEnglishHasshebeentotheeyedoctor?Thepodiatrist?Hasshebeentotheeyedoctorandthepodiatrist?LanguageFocusesKeytoTask3FormalEnglishButnowI‘mpilingyetanotherpillontoher,andonethatrequiresdetailedinstructions.Maybeleavethisuntilnexttime?ButnowI'mpilingyetanotherpillontoher,andthepillrequiresdetailedinstructions.“Maybe,shouldIleavethisuntilnexttime?”Ithought.LanguageFocusesKeytoTask3FormalEnglishHealthmaintenance:whenwasherlastmammogram?PAPsmear?Tomymindcameherhealthmaintenance.Iaskedmyself,“WhendidshereceiveherlastmammogramandPAPsmear?”O(jiān)nestrayrequestfromMrs.Osoriosendsthedelicatelybalancedthree-ringcircustumblingdown.(Pre.4)

Theauthorwasinmoderatestateofpanic:jugglingsomanythoughtsaboutMrs.Osorio’sconditionsandtryingtoresolvethemallbeforetheclockrandownMrs.Osoriomadeatrivialrequest,notsoimportantascomparedtoherconditionsMrs.Osorioseemedtocareonlyabouther“innocent—andcompletelyjustified—request”:theformsignedbyherdoctorThedoctortriedtooratleastpretendtopayattentiontothepatientswhilecompletingdocumentationComplaintsthatdoctorsdon’tlistenmighthaveotherreasonsthanjustdoctors’neuronoverloadKnowledgeofthesubjectmatterthediet-and-exercisediscussionnotmakingeyecontactwithMrs.OsorioCommunicationskillsgetherlabresultscheckhermammogramreportdocumenttheprogressofherillnessesorderthetestsrefillherprescriptionsKnowledgeofthesubjectmatterherinsurancecompany><insurance

form><losemycoveragedoherphysicalexaminationherbackpainanythingmorethanroutinemusclestrainplaceintoaccurateandthoroughdocumentationinteractwithmypatientLanguageFocuses____________report（乳房X-線檢查報告）_________examination（體檢）…she'scaughtoneofmyneuronsinmid-fire…她讓我如火如荼的思緒戛然而止…Myinstinctistoputonehandupandkeepallinterruptionsatbay.我的本能反應是舉手，阻止她打斷我的思路。mammogramphysicalLanguageFocusesbutthefactisthatshe'scaughtoneofmyneuronsinmid-fire(theonethat'sthinkingaboutherbloodsugar,whichissegueingintotheneuronthat'spreparingthediet-and-exercisediscussion,whichisintersectingwiththeonethat'sdebatingaboutinitiatingastatin).Aninnocent—andcompletelyjustified—request,but…

Whatisthefunctionoftheparentheses/dashesinthesentence?Parentheticalstatements:insertingadditionalinformationwithoutcreatingaseparatesentenceandareoftendemonstratedbyparenthesesanddash.(Task2Signpostlanguage)Comparemultitaskinginhumanbeingsandinthecomputerfield.(Pre.5)Multitaskingoriginatedincomputerscience.Microprocessorsinfactlinear,actuallyperformingonlyonetaskatatimeMultitaskingjustasanillusionbothincomputerandhumans.Atbest,HumanjugglingonlyahandfulofthoughtsinthismannerThemorethoughtswejuggle,thelessweareabletoattunefullytoanygiventhought.MultitaskingasarecipefordisasterKnowledgeofthesubjectmatteraninsurancecompanyformorderhermammogramrefillonlyfiveofhersixmedicinesfully

explaintheside-effectsofoneofhermedicationsLanguageFocuses_________ofamedication（藥物的副作用）Themorethoughtswejuggle,thelessweareabletoattunefullytoanygiventhought.Thehigherup,theheavierthefall.Themore,thebetter.Wemerelyzipbackandforthbetweenthem,generallylosingaccuracyintheprocess.我們?nèi)祟愔皇窃趦蓚€想法之間來回快速轉(zhuǎn)換，通常情況下，在轉(zhuǎn)換的過程中丟失了精準。side-effectsUsenumberstojustifythatitisjugglingmindthatkeepsdoctorsawakeatnight.(Pre.6)

7medicalissuestoconsider5separatethoughts,atleast,foreachissue7X5=35thoughts10patientsthatafternoon35X10=3505residentsundertheauthor’ssupervision4patientsseenbyeachresidents10thoughts,atleast,generatedbyeachpatients5X4X10=200350+200=550thoughtstobehandledintotalIfthedoctordoesagoodjobjuggling98%ofthetime,thatstillleavestenthoughtsthatmightgetlostintheprocess.KnowledgeofthesubjectmattermedicalissuestoconsidersupervisefiveresidentsinaworkingdayadisastrousoutcomeapossiblelawsuitMostdoctorsarereasonablycompetent,caringindividuals,buttheoverwhelmingswirlofthoughtsthatwemustkeeptrackofleavesmanyofusinaperpetualpanicthatsomethingseriousmightslip.Thisiswhatkeepsusawakeatnight.LanguageFocusesperpetual_________（永久的恐慌）Anyoneofthoselostthoughtscouldtranslateintoadisastrousoutcome,nottomentionapossiblelawsuit.panicPossiblesolutionstotheimpossiblehigh-wireactofjugglingcompetingdetailsandpanickingaboutslippingacriticalone.(Pre.7)computer-generatedreminderscasemanagersancillaryservicesthesimplest:timeKnowledgeofthesubjectmatteranhourforeachpatient>aspectaculardoctorSituationinChina??thechoicesthatpracticingphysiciansfaceeveryday,witheverypatientrelyonourclinicaljudgmenttoprioritisetransplantfieldadedicatedandcompetentclinicalpartnersuchasaone-on-onenursemedicalbudgetsLanguageFocusesMychoicesseemtoboildowntoentertainingfewerthoughts,acceptingdecreasedaccuracyforeachthought,givinguponthoroughdocumentation,orhavingaconstantheadachefromneuronaloverload.boildownto:歸結(jié)為Itboilsdowntoaquestionofethics.它可歸結(jié)成一個倫理學問題。LanguageFocusesMostlywerelyonourclinicaljudgmenttoprioritise,acceptingthetrade-offthatisinevitablewithanycompromise.PresentparticipleasadverbialLanguageFocusesInsomecases,havingadedicatedandcompetentclinicalpartnersuchasaone-on-onenursecancomeclosetosimulatingasecondbrain,butmostmedicalbudgetsdon'tallowforsuchstaffingindulgence.有些情況下，有個專注、出色的臨床搭檔，如一對一的護士，就仿佛有了第二個大腦，不過大多數(shù)醫(yī)療預算不會如此大方，這樣配備人員。LanguageFocuses_________physicians（執(zhí)業(yè)醫(yī)生）______________field（移植領域）medical_________（醫(yī)療預算）