Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.
It’s not a frequent topic of discussion, but doctors die, too. And they don’t die like the rest of us. What’s unusual about them is not how much treatment they get compared to most Americans, but how little. Of course, doctors don’t want to die ; they want to live. But they know enough about modern medicine to know its limits. Almost all medical professionals have seen what we call "futile care" being performed on people. That’s when doctors bring the cutting edge of technology to bear on a grievously ill person near the end of life. The patient will get cut open, perforated with tubes, hooked up to machines, and assaulted with drugs. I cannot count the number of times fellow physicians have told me, in words that vary only slightly, "Promise me if you find me like this that you’ ll kill me. "
How has it come to this—that doctors administer so much care that they wouldn’t want for themselves The simple, or not-so-simple, answer is this: patients, doctors, and the system.
To see how patients play a role, imagine a scenario in which someone has lost consciousness and been admitted to an emergency room, and shocked and scared family members find themselves caught up in a maze of choices. When doctors ask if they want "everything" done, they answer yes. Then the nightmare begins. Feeding into the problem are unrealistic expectations of what doctors can accomplish. For example, many people think of CPR as a reliable lifesaver when, in fact, the results are usually poor.
But of course it’s not just patients making these things happen. Doctors play an enabling role, too. The trouble is that even doctors who hate to administer futile care must find a way to address the wishes of patients and families. Imagine, once again, the emergency room with those grieving family members. They do not know the doctor. Establishing trust and confidence under such circumstances is a very delicate thing. People are prepared to think the doctor is acting out of base motives, trying to save time, or money, or effort, especially if the doctor is advising against further treatment.
It’s easy to find fault with both doctors and patients in such stories, but in many ways all the parties are simply victims of a larger system that encourages excessive treatment. In some unfortunate cases, doctors use the fee-for-service model to do everything they can, no matter how pointless, to make money. More commonly, though, doctors are fearful of litgation and do whatever they’re asked to avoid getting in trouble.
A:put excessive emphasis on medical treatment B:have a good understanding of medical treatment C:have a deep faith in doctors’ professional advice D:can not think rationally when it comes to saving their loved ones’ lives
My friend Mike was shaking his head in disbelief. "That young woman who just waited on me," he said, pointing to an employee of the fast food restaurant where we were eating, "had to call someone over to help her count the change. The cash register (出纳机) showed her I need 99 cents, but she couldn’t figure out how to count out the coins." I understood Mike’s concern. What we have done in this country, although unintentionally, is to create several generations of individuals most of whom have no idea how to reason, how to do simple math, how to do research, or finally how to be creative. The reason for this is our overuse of information technology: video games, television, digital watches, calculators, and computers. Information technology feeds us information without requiring us to think about it and let us perform operations without understanding them.
It is time for us to take a hard look at an educational system that only teaches our children how to push buttons. Our kids can’t tell time if the clock hasn’t hands. They can use calculators, but cannot add, subtract, divide or multiply. Video games have taken the place of active, imaginative play. Although most of them are technically literate, they choose not to read. They are so used to television and movies that they cannot use their imagination to stay interested in a book.
It is not enough to recognize the problem. What we need is solution. The one I offer is simple to suggest, but may be impossible to carry out. We must unplug our children. If we don’t, they will never learn how to solve problems. They will never learn basic reasoning skills and will certainly not develop creativity. Instead of filling classrooms with electronics, let’s concentrate on good old-fashioned literacy—reading books. Students must be taught not only to perform computer operations, but to figure and reason for themselves. They must see how things work and how process leads to results, they must also stretch their imagination.
A:The educational system is now creating people who can’t think for themselves. B:People now rarely do things on their own. C:Computers feed us too much information nowadays. D:The restaurant does not provide good service.
Are you a good reader Good readers know that reading isn’t just about knowing words-it’s a way of thinking. Here are some tips that may be of some help.
Think before you read. Before you read the text, ask yourself the questions that why you are reading it and what you want to get from it. These will help you choose what words you need to know and what words you can skip or scan.
Think while you are reading. Can you get the meaning of the text without looking up new words in a dictionary A text will often give examples that may help you understand some words. For example: Many large Russian cities, such as Chelyabinsk and Irkutsk, have taken steps to protect their culture. The words "Chelyabinsk" and "Irkutsk" may be new to us, but the sentences before and after it tell us what they are.
Think after you read. What is the main idea of the text Is the text too easy or too hard for you
If you practice reading and thinking in this way, you will become a better reader and you will learn better and faster.
A:Reading is just a way of knowing new words B:A good reader must learn more new words C:A good reader can think before, while and after reading D:Reading takes a lot of time
Are you a good reader Good readers know that reading isn’t just about knowing words— it’s a way of thinking. Here are some tips that may be of some help.
Think before you read. Before you read the text, ask yourself the questions that why you are reading it and what you want to get from it. These will help you choose what words you need to know and what words you can skip or scan.
Think while you are reading. Can you get the meaning of the text without looking up new words in a dictionary A text will often give examples that may help you understand some words. For example: Many large Russian cities, such as Chelyabinsk and Irkutsk, have taken steps to protect their culture. The words "Chelyabinsk’ and "Irkutsk’ may be new to us, but the sentences before and after it tell us what they are.
Think after you read. What is the main idea of the text Is the text too easy or too hard for you
If you practice reading and thinking in this way, you will become a better reader and you will learn better and faster.
We can learn from the passage that______.
A:Reading is just a way of knowing new words B:A good reader must learn more new words C:A good reader can think before, while and after reading D:Reading takes a lot of time
The weather is not as cold (as you think). So (I don' t think) the ice is thick (enough) to (walk on it).
A:as you think B:I don' t think C:enough D:walk on it
Directions: There are five reading passages in this part. Each passage is
followed by five questions. For each question there are four suggested
answers marked A, B, C and D. Choose the best answer and blacken the
corresponding letter on the answer sheet.
Passage One
Are you a good reader Good readers
know that reading isn’t just about knowing words— it’s a way of thinking.
Here are some tips that may be of some help. Think before you read. Before you read the text, ask yourself the questions that why you are reading it and what you want to get from it. These will help you choose what words you need to know and what words you can skip or scan. Think while you are reading. Can you get the meaning of the text without looking up new words in a dictionary A text will often give examples that may help you understand some words. For example: Many large Russian cities, such as Chelyabinsk and Irkutsk, have taken steps to protect their culture. The words "Chelyabinsk’ and "Irkutsk’ may be new to us, but the sentences before and after it tell us what they are. Think after you read. What is the main idea of the text Is the text too easy or too hard for you If you practice reading and thinking in this way, you will become a better reader and you will learn better and faster. |
A:Reading is just a way of knowing new words B:A good reader must learn more new words C:A good reader can think before, while and after reading D:Reading takes a lot of time
We happen to agree with a lot of people who think that sequestration (capturing carbon and burying it underground) is probably not really a good ide
A:a. It prevents it from going in the air, but then if you are going to hide it somewhere, there are all kinds of questions on how and where you are going to hide it. Are you sure that it is not going to be released B:Why isn’t sequestration really a good idea Because people are not sure yet how and where to hide carbon. Because people are sure that carbon will not release after buried. Because it will prevent carbon from going into the air. Because capturing carbon is too difficult to put into practic
A:they pay over attention to their health. B:they think animals don’ t taste as good as vegetavbles. C:they believe animal agriculture hurts the environment. D:they think meat is more expensive than vegetables.
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