学术英语(医学)_Unit 1

.,学术英语医学,AcademicEnglishforMedicine,.,Unit1,DoctorsLifeDoctorsarethoughtasnoble,respectable,andcaring,butitisreallycommontoreadorhearaboutthecomplaintsofdoctorsbeingimpatientandcareless.Whatarethecausesforsuchcomplaints?Howcanordinaryincidentsinfluencethewaydoctorspracticemedicine?Thisunitexploresdoctorslifefromdifferentperspectivessothatyoucanunderstandthembetter.,.,Unit1DoctorsLife,UnitContents,Lead-in,TextA,TextB,TextC,Listening,Speaking,Writing,GetreadingforUnit2,.,Lead-in,QuestionstobeansweredBrainstormAdditionalactivity,Unit1DoctorsLife,.,Lead-in,Questionstobeanswered,Whatarethecausesforcomplaintsofdoctorsbeingimpatientandcareless?Whatkindoflifedoesadoctorlead?Howcanordinaryincidentsinfluencethewaydoctorspracticemedicine?,Unit1DoctorsLife,.,Lead-in,Brainstorm,Brainstormalistofwordsandexpressionsrelatedtoadoctorslifeandpractice.,Unit1DoctorsLife,.,Lead-in,Additionalactivity,Whatdotheymeanforadoctor?adecentcareeranoblecallingrespectableknowledgeableundergreatpressureunderpaidmistrusteddangerous,Unit1DoctorsLife,.,TextA,CriticalreadingandthinkingQuestionsfordiscussionTopicsforpresentationUsefulexpressionsDifficultsentencesLanguagebuilding-upSignpostlanguageFormalEnglishVocabularytestSuggestedanswers,Unit1DoctorsLife,.,TextACriticalreadingandthinking,Questionsfordiscussion,Howdoyouinterpretthetitle?neuronoverloadjugglingphysician,Unit1DoctorsLife,.,TextACriticalreadingandthinking,Topicsforpresentation,1Doyouagreethatitissheerneuronoverloadonthedoctorsidethatleadstothecomplaintthatdoctorsdontlisten?,neuronoverloadpatientshighexpectationsmistrustandmisunderstandingbetweenthepatientsandphysician,Unit1DoctorsLife,.,2DescribeMrs.Osorioscondition.,TextA,Topicsforpresentation,Unit1DoctorsLife,.,TextA,Usefulexpressions,a56-year-oldwomansomewhatoverweightreasonablywell-controlleddiabetesandhypertensioncholesterolonthehighsidewithoutanymedicationsforthisnotasmuchexerciseassheshouldthinningofherbonesonlastDEXAscanstressfulbutgoodaboutkeepingherappointmentsandgettingherbloodtestsgenerallyhealthy,Unit1DoctorsLife,Criticalreadingandthinking,.,TextA,Usefulexpressions,inmypractice/inamedicalpracticeoverweightdiabeteshypertensioncholesterolonthehighsideDEXAscanthinningofherbones/lowerdensitystressfullifekeepherappointmentsbloodtestsgenerallyhealthyanaveragepatientnotexcessivelycomplicated,Unit1DoctorsLife,Criticalreadingandthinking,.,TextA,Topicsforpresentation,3WhatarethegoodandbadthingsaboutMrs.Osoriosconditionsthatrunthroughtheauthorsmind?,Unit1DoctorsLife,Criticalreadingandthinking,.,TextA,Usefulexpressions,GoodThingsBloodtestsdoneGlucosealittlebetterHerbloodpressuregoodbutnotgreatBadThingsHerweightalittleupHerbonesalittlethinontheDEXA,Unit1DoctorsLife,Criticalreadingandthinking,.,TextA,Usefulexpressions,20-minconsultationglucosestartingastatinliverenzymesnormalfivefruitsandvegetablesdietchoices30minofwalkingeachdayexercisemorningsugarscomparetohereveningsugarsthenutritionist/hereyedoctor/thepodiatristbloodpressureaddanotherBPmedmorepills,Unit1DoctorsLife,Criticalreadingandthinking,.,TextA,Usefulexpressions,startabisphosphonatepreventosteoporosisexperiencingjusttheusualstressoflifelurkingdepressionoranxietydisorderthedepressionquestionnairehealthmaintenanceherlastmammogramPAPsmearcolonoscopyatetanusboosterqualifyforapneumoniavaccine,Unit1DoctorsLife,Criticalreadingandthinking,.,TextA,Topicsforpresentation,4DescribethesituationwhenMrs.Ororiomightsendtheauthorsdelicatelybalancedthree-ringcircustumblingdown.,Unit1DoctorsLife,Criticalreadingandthinking,.,TextA,Usefulexpressions,Theauthorwasinmoderatestateofpanic:jugglingsomanythoughtsaboutMrs.Osoriosconditionsandtryingtoresolvethemallbeforetheclockrandown.Mrs.Osoriomadeatrivialrequest,notsoimportantascomparedtoherconditions.Mrs.Osorioseemedtocareonlyabouther“innocentandcompletelyjustifiedrequest”:theformsignedbyherdoctor.Thedoctortriedtooratleastpretendtopayattentiontothepatientswhilecompletingdocumentation.Complaintsthatdoctorsdontlistenmighthaveotherreasonsthanjustdoctorsneuronoverload.,Unit1DoctorsLife,Criticalreadingandthinking,.,TextA,Usefulexpressions,thediet-and-exercisediscussionnotmakingeyecontactwithMrs.Osorio(communicationskills)getherlabresultscheckhermammogramreportdocumenttheprogressofherillnessesorderthetestsrefillherprescriptions,Unit1DoctorsLife,Criticalreadingandthinking,.,TextA,Usefulexpressions,herinsurancecompany/insuranceform/losemycoveragedoherphysicalexaminationherbackpainanythingmorethanroutinemusclestrainplaceintoaccurateandthoroughdocumentationinteractwithmypatient,Unit1DoctorsLife,Criticalreadingandthinking,.,5Comparemultitaskinginhumanbeingsandcomputers.,TextA,Topicsforpresentation,Unit1DoctorsLife,Criticalreadingandthinking,.,TextA,Usefulexpressions,Multitaskingoriginatedincomputerscience.Microprocessorsinfactlinear,actuallyperformingonlyonetaskatatime.Multitaskingjustasanillusionbothincomputerandhumans.Atbest,Humanjugglingonlyahandfulofthoughtsinthismanner.Themorethoughtswejuggle,thelessweareabletoattunefullytoanygiventhought.Multitaskingasarecipefordisaster,Unit1DoctorsLife,Criticalreadingandthinking,.,TextA,Usefulexpressions,aninsurancecompanyformorderhermammogramrefillonlyfiveofhersixmedicinesfullyexplaintheside-effectsofoneofhermedications,Unit1DoctorsLife,Criticalreadingandthinking,.,6Usenumberstojustifythatitisthejugglingmindthatkeepsdoctorsawakeatnight.,TextA,Topicsforpresentation,Unit1DoctorsLife,Criticalreadingandthinking,.,TextA,Usefulexpressions,7medicalissuestoconsider5separatethoughts,atleast,foreachissue7X5=35thoughts10patientsthatafternoon35X10=3505residentsundertheauthorssupervision4patientsseenbyeachresidents10thoughts,atleast,generatedbyeachpatients5X4X10=200350+200=550thoughtstobehandledintotalIfthedoctordoesagoodjobjuggling98%ofthetime,thatstillleavestenthoughtsthatmightgetlostintheprocess.,Unit1DoctorsLife,Criticalreadingandthinking,.,TextA,Usefulexpressions,medicalissuestoconsidersupervisefiveresidentsinaworkingdayadisastrousoutcomeapossiblelawsuitMostdoctorsarereasonablycompetent,caringindividuals,buttheoverwhelmingswirlofthoughtsthatwemustkeeptrackofleavesmanyofusinaperpetualpanicthatsomethingseriousmightslip.Thisiswhatkeepsusawakeatnight.,Unit1DoctorsLife,Criticalreadingandthinking,.,7Whatarepossiblesolutionstotheimpossiblehigh-wireactofjugglingcompetingdetailsandpanickingaboutslippingacriticalone?,TextA,Topicsforpresentation,Unit1DoctorsLife,Criticalreadingandthinking,.,TextA,Usefulexpressions,computer-generatedreminderscasemanagersancillaryservicesthesimplest:time,Unit1DoctorsLife,Criticalreadingandthinking,.,TextA,Usefulexpressions,anhourforeachpatientaspectaculardoctorSituationinChina?thechoicesthatpracticingphysiciansfaceeveryday,witheverypatientrelyonourclinicaljudgmenttoprioritisetransplantfieldadedicatedandcompetentclinicalpartnersuchasaone-on-onenursemedicalbudgets,Unit1DoctorsLife,Criticalreadingandthinking,.,TextA,DifficultSentences,1thatonestrayrequestfromapatientevenonethatisquiterelevantmightsendthedelicatelybalancedthree-ringcircustumblingdown.(Para.1)如果病人冷不丁提个要求，即使所提要求十分中肯，也会让我那内心脆弱的平衡乱作一团，就像井然有序同时演出三台节目的大马戏场突然崩塌一样。,Unit1DoctorsLife,Criticalreadingandthinking,.,2.Impilingyetanotherpillontoher.(Para.3)我还要再给她另加一种药,TextA,DifficultSentences,Unit1DoctorsLife,.,TextA,DifficultSentences,shescaughtoneofmyneuronsinmid-fire(Para.4)她让我如火如荼的思绪戛然而止Myinstinctistoputonehandupandkeepallinterruptionsatbay.(Para.4)我的本能反应是举手，阻止她打断我的思路。,Unit1DoctorsLife,Criticalreadingandthinking,.,TextA,DifficultSentences,Wemerelyzipbackandforthbetweenthem,generallylosingaccuracyintheprocess.(Para.7)我们人类只是在两个想法之间来回快速转换，通常情况下，在转换的过程中丢失了精准。Themorethoughtswejuggle,thelessweareabletoattunefullytoanygiventhought.(Para.8)Thehigherup,theheavierthefall.Themore,thebetter.,Unit1DoctorsLife,Criticalreadingandthinking,.,TextA,DifficultSentences,Mychoicesseemtoboildowntoentertainingfewerthoughts,acceptingdecreasedaccuracyforeachthought,givinguponthoroughdocumentation,orhavingaconstantheadachefromneuronaloverload.(Para.10)boildownto:归结为Itboilsdowntoaquestionofethics.它可归结成一个伦理学问题。,Unit1DoctorsLife,Criticalreadingandthinking,.,TextA,DifficultSentences,Insomecases,havingadedicatedandcompetentclinicalpartnersuchasaone-on-onenursecancomeclosetosimulatingasecondbrain,butmostmedicalbudgetsdontallowforsuchstaffingindulgence.(Para.12)有些情况下，有个专注、出色的临床搭档，如一对一的护士，就仿佛有了第二个大脑，不过大多数医疗预算不会如此大方，这样配备人员。,Unit1DoctorsLife,Criticalreadingandthinking,.,TextALanguageBuilding-up,SignpostLanguage,Aninnocentandcompletelyjustifiedrequest,but(Para.5)Whatisthefunctionoftheparentheses/dashesinthesentence?Parentheticalstatements:insertingadditionalinformationwithoutcreatingaseparatesentenceandareoftendemonstratedbyparenthesesanddash.,Unit1DoctorsLife,.,TextALanguageBuilding-up,FormalEnglish,DegreeofformalityshouldbedeterminedbytheaudiencetheexpectationsoftheaudiencethewriterspurposesForexample,thewriterofTextAemploysinformallanguagewhenrecordingherjugglingthoughts,andanoticeableshiftfromthatoftherestofthearticlewhereformalstyleisconsistentlymaintained.Ajugglingmindisvividlypresentedbyinformalandevenungrammaticaluseoflanguage,suchas“Maybeleavethisuntilnexttime?”,Unit1DoctorsLife,.,TextALanguageBuilding-up,FormalEnglish,FormalEnglish,Itisusedinofficial,literary,academicwriting,orformalsocialevents.Itismorecommonlyusedinwritingthanspeech.Sentencesareoftenlongandcomplex.Contractionsareavoided.,InformalEnglish,Itisusedineverydaypersonalconversationsorletterstofriends.Itismorecommonlyusedineverydayspeechthaninwriting.Sentencesareoftenshortandsimple.Contractionsarecommon.,Unit1DoctorsLife,.,TextALanguageBuilding-up,FormalEnglish,FormalEnglish,Thepassivevoiceisoftenused,makingitsoundimpersonal.MuchvocabularyderivedfromFrenchandLatinisused.Colloquialterms,slangsandmanyphrasalverbsareavoided.,InformalEnglish,Theactivevoiceisoftenused.VocabularyderivedfromFrenchandLatinisnotused.Colloquialterms,slangsandmanyphrasalverbsarecommon.,Unit1DoctorsLife,.,TextALanguageBuilding-up,FormalEnglish,FormalEnglish,Theresearchersidentifiedtheimportantproperties.Doctorshaveestablishedanewmethod.Thisappearedtorectifytheproblem,InformalEnglish,Theresearchersfoundoutwhattheimportantthingswere.Doctorshavecomeupwithanewmethod.Thisseemedtofixtheproblem,Unit1DoctorsLife,.,TextALanguageBuilding-up,FormalEnglish,FormalEnglish,HiswordsdemonstratethatDetailsofthereportaretobefoundonPage26.Theexperimentwascarriedout/performed.,InformalEnglish,HiswordsshowthatYoucanfindoutallaboutthereportonpage26.Theydidanexperiment.,Unit1DoctorsLife,.,TextALanguageBuilding-up,FormalEnglishkeytoTask3,1Goodthingshedidherbloodtests.Glucoseisalittlebetter.Cholesterolisntgreat.Mayneedtothinkaboutstartingastatin.Areherliverenzymesnormal?(Para.3)Goodsignsincludethatshedidherbloodtests,andthatherglucoselevelisalittlebetter.However,hercholesterollevelisntgreat,andImayneedtoconsiderprescribingastatinforher.Furthermore,Iwonderedifherliverenzymesarenormal.,Unit1DoctorsLife,Task3RewritethefollowingsentencesfromTextAwithamoreformalstyle.,.,TextALanguageBuilding-up,FormalEnglishkeytoTask3,2Hasshebeentotheeyedoctor?Thepodiatrist?(Para.3),Unit1DoctorsLife,Hasshebeentotheeyedoctorandthepodiatrist?,.,TextALanguageBuilding-up,FormalEnglishkeytoTask3,3ButnowImpilingyetanotherpillontoher,andonethatrequiresdetailedinstructions.Maybeleavethisuntilnexttime?(Para.3),Unit1DoctorsLife,ButnowImpilingyetanotherpillontoher,andthepillrequiresdetailedinstructions.“Maybe,shouldIleavethisuntilnexttime?”Ithought.,.,TextALanguageBuilding-up,FormalEnglishkeytoTask3,4Healthmaintenance:whenwasherlastmammogram?PAPsmear?(Para.3),Unit1DoctorsLife,Tomymindcameherhealthmaintenance.Iaskedmyself,“WhendidshereceiveherlastmammogramandPAPsmear?”,.,TextA,Vocabularytest,_overload（神经过载）atypicaloffice_（典型的诊所就诊）DEXA_（DEXA扫描）medical_（行医）,visit,scan,practice,neuron/neuronal,_report（乳房X-线检查报告）_examination（体检）_ofamedication（药物的副作用）,mammogram,side-effects,physical,Unit1DoctorsLife,LanguageBuilding-up,.,TextA,Vocabularytest,_control（血压控制）health_（健康保持）perpetual_（永久的恐慌）_physicians（执业医生）_field（移植领域）medical_（医疗预算）paracetamol_（扑热息痛药片）_cap（防孩子打开的盖子）,panic,bloodpressure,maintenance,practicing,transplant,budget,tablet,childproof,Unit1DoctorsLife,LanguageBuilding-up,.,TextA,Suggestedanswers,Unit1DoctorsLife,Task1.2MatcheachofthefollowingEnglishtermandChineseequivalent.,pneumothoraxnutrienthypertensioncolonoscopymammectomyrefillneuralgiapodiatristnutritionistosteoporosisneurontransmittransplantpneumoniamammogram,a.移植b.高血压c.乳房X线照片d.结肠镜检查（术）e.神经元，神经细胞f.肺炎g.营养物h.神经痛i.营养学家j.再配（处方）k.气胸l.传染m.骨质疏松n.足病医生o.乳房切除术,k,g,b,d,o,j,h,n,i,m,e,i,a,f,c,.,TextA,Suggestedanswerslanguagebuilding-up,Unit1DoctorsLife,Task1.2MatcheachofthefollowingdefinitionswithitscorrespondingEnglishtermandChineseequivalent.,colonoscopy,结肠镜检查（术）,hypertension,高血压,mammogram,乳房X线照片,neuron,神经元，神经细胞,nutritionist,营养学家,osteoporosis,骨质疏松,.,TextA,Suggestedanswerslanguagebuilding-up,Unit1DoctorsLife,Task1.2MatcheachofthefollowingdefinitionswithitscorrespondingEnglishtermandChineseequivalent.,transplant,移植,pneumonia,肺炎,podiatrist,足病医生,refill,再配（处方）,.,TextA,Suggestedanswerslanguagebuilding-up,Unit1DoctorsLife,Task2Signpostlanguage,FindsomeexamplesofparentheticalstatementfromTextA.,Fromherperspective,thisisprobablythemostimportantiteminourvisit,butthefactisthatshescaughtoneofmyneuronsinmid-fire(theonethatsthinkingaboutherbloodsugar,whichissegueingintotheneuronthatspreparingthediet-and-exercisediscussion,whichisintersectingwiththeonethatsdebatingaboutinitiatingastatin).(Para.4)WhatifIdroponewhatifoneofmythoughtsevaporateswhileIaddressanotherconcern?(Para.4),.,TextA,Suggestedanswerslanguagebuilding-up,Unit1DoctorsLife,Task2Signpostlanguage,FindsomeexamplesofparentheticalstatementfromTextA.,Aninnocentandcompletelyjustifiedrequest,butIfeelthatthiscouldbethestrawthatbreaksthecamelsback,thattheprecariousbalanceofallthatImkeepingintheairwillbesimplyunhinged.(Para.5)Therearemanyproposedsolutionscomputer-generatedreminders,casemanagers,ancillaryservices.(Para.10),.,TextB,Pre-readingquestionCriticalreadingandthinkingResearchingLanguagebuilding-up,Unit1DoctorsLife,.,Hownontrivialcantrivialincidentsbeinoneslife?,TextB,Pre-readingquestion,Unit1DoctorsLife,.,TextB,CriticalReadingandThinking,Reflection,Whatotherlessonscanyoulearnfromthetext?,Unit1DoctorsLife,.,TextB,CriticalReadingandThinking,Reflection,Dr.SackettschallengetothetraditionalwisdomintreatinghishepatitispatientNeverbeablindbelieverofauthorityorconventionalwisdom.Scientificprogressrequiresunconventionalwayofthinking.ChallengingauthorityisaMustforrealscientistsBetolerantandopen-mindedaboutnovelties.Besensitivetotrivialities.Thinkdifferently.,Unit1DoctorsLife,.,TextB,CriticalReadingandThinking,Reflection,Dr.Sackettseventful“clinicalcourse”andiconoclasmAttitudecanbelife-changing.Sticktothejustifiablebeliefsandactout.Beyourselforbeuniquemaybringaboutsurprises.Developyourownpersonalityispartofprofessionallife.Scienceowesmuchtothosenon-conventionalistsandiconoclasts.,Unit1DoctorsLife,.,TextB,CriticalReadingandThinking,1DesignofThomasChalmerstrial,Unit1DoctorsLife,Cleardescriptionoftheeligibilitycriteriaofparticipants,andtheirrandomallocationComparisonsoftworegimenspertrialPrecisedefinitionofexperimentalandcontrolregimensClosemonitoringandreinforcementofcompliancewithregimensInclusionofallpatientsattheendofthetrialsClearandtransparentanalysesThe“externalvalidity”ofthetrialresultstestedbycomparisonwithanother,independentcontrolgroupofpatientsAssessmentoflateeffectsofthetreatmentregimensina10-yearfollow-upstudy,Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.,.,TextB,CriticalReadingandThinking,2influenceofThomasChalmerspaper,Unit1DoctorsLife,OneofthemostdetailedreportsofclinicaltrialseverpublishedwithaTableofContentsandafurther71pagesofsmalltypeAmodelofforreportingrandomizedtrialsDramaticchangesintheauthorscareer,Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.,.,TextB,CriticalReadingandThinking,3conventionalwisdomofType-Ahepatitisinthe1950s,Unit1DoctorsLife,BedrestuntilrecessionofenlargeliverandreturnofbilirubintonormaltoavoidpermanentliverdamageBedrestrequiredagainbyrelapseofthereboundoftheenzymesafterthepatientsgotupandaroundConventionalwisdomservingasbasisfordailyconfrontationbetweenthepatientandtheclinicalclerk,Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.,.,TextB,CriticalReadingandThinking,4theauthorseventful“clinicalcourse”,Unit1DoctorsLife,LatenticonoclasmApologytohispatientA“trouble-maker”withconstantdoubtforconventionaltherapeuticwisdomandoffensesespeciallyagainstthesubspecialistsAstormytimeinobstetricsUnfavorablenotorietyonmedicalwardDeepoffenseagainstaprofessorofpaediatricsbypubliclycorrectinghimonthenumberofhumanchromosomes,Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.,.,TextB,CriticalReadingandThinking,5historyofrandomizedtrials,Unit1DoctorsLife,In1955,duringthedawnofthemoderneraofrandomizedclinicaltrials,only347reportsofrandomizedtrialsHalfacenturylater,about50,000reportsofrandomizedtrialseveryyear,withthetotalnumberoftrialreportsbythenexceedinghalfamillion,Writedowntheinformationonthefollowingtopics.Thencompareyouranswerswithyourpartner.,.,TextB,Difficultsentences,Thisconventionalwisdomformedthebasisfordailyconfrontationsbetweenanincreasinglyrestlessandresentfulpatientandanincreasinglyadamantanddoom-predictingclinicalclerk.(Para.4)有的病人越来越焦躁不安、越来越愤愤不满，有的临床医生越来越固执己见、越来越热衷于生死决断。这种传统智慧就成了这些病人和临床医生之间天天对抗不断的基础。,Unit1DoctorsLife,CriticalReadingandThinking,.,TextB,Difficultsentences,Mysubsequentclinicalcoursewasfarfromuneventful.(Para.9)我后来的“临床之路”远非平淡无奇theyhadfallenfrom48to46thepreviousmonth!(Para.9)（染色体的数量）在上个月已经从48条变为46！（人体到底有多少条染色体？这个问题经过了几十年的反复，到1954年才确定为23对，46条。）,Unit1DoctorsLife,Criti