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1、Unit1DoctorsLifeLead-innBrainstorm a list of words and expressions related to a doctors life and practice.noverload_n_n_Lead-innWhat do they mean for a doctor?qadecentcareerqanoblecalling(崇高的事业)qrespectableqknowledgeablequndergreatpressurequnderpaidqmistrustedqdangerousWarm-upVideonPhysicianBurnoutT
2、extA:NeuronOverloadandtheJugglingPhysiciannHowdoyouinterpretthetitle?qNeuronoverload(神经过载)qJugglingPhysician(忙乱的医生)Busy with too many things.Patientscomplaint.Doctors do not listen.The cause:Neuron overload LanguageFocusesnthatonestrayrequestfromapatientevenonethatisquiterelevantmightsendthedelicate
3、lybalancedthree-ringcircustumblingdown.q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。Doyouagreethatitissheerneuronoverloadonthedoctorsidethatleadstothecomplaintthatdoctorsdontlisten?(Pre.1)nNeuronoverloadnPatientshighexpectationsnMistrustandmisunderstandingbetweenthepatientsandp
4、hysicianAcaseinpointtoexemplifyhowmanydetailsadoctorneedstothinkover.Mrs.Osorioscondition(Pre.2)nA56-year-oldwomannSomewhatoverweightnReasonablywell-controlleddiabetesandhypertensionncholesterolonthehighsidewithoutanymedicationsforthisnNotasmuchexerciseassheshouldnThinningofherbonesonlastDEXAscannSt
5、ressfulbutgoodaboutkeepingherappointmentsandgettingherbloodtestsnGenerallyhealthy重要短语inmypractice行医overweight超重diabetes糖尿病hypertension高血压重要短语cholesterolonthehighside胆固醇高DEXAscanDEXA扫描thinningofherboneslowerdensity骨骼变细密度变低stressfullife生活压力大重要短语keepherappointments守约bloodtests验血generallyhealthy总体健康anav
6、eragepatient普通患者LanguageFocusesnHypertensionnhyper-nabnormallyincreased,excessive（超出，过度的）n“三高”?nHypertensionnHyperlipidemianHyperglycemiaLanguageFocusesnatypicaloffice_（典型的诊所就诊）nDEXA_（DEXA扫描）nmedical_（行医）visitscanpracticeGoodandbadthingsaboutMrs.Osoriosconditionsthatrunthroughtheauthorsmind.(Pre.3)n
7、GoodThingsqBloodtestsdoneqGlucosealittlebetterqHerbloodpressuregoodbutnotgreatnBadThingsqHerweightalittleupqHerbonesalittlethinontheDEXA重要短语20-minconsultation20分钟诊治glucose葡萄糖startingastatin开始使用statinliverenzymesnormal肝酶正常重要短语morningsugarscomparetohereveningsugars早晨血糖和傍晚血糖相比较bloodpressure血压morepills更
8、多药丸重要短语preventosteoporosis预防骨质疏松detailedinstructions详细医嘱lurkingdepressionoranxietydisorder隐秘的抑郁症或焦虑症thedepressionquestionnaire抑郁症调查表重要短语healthmaintenance保健herlastmammogram最新的乳房X光片qualifyforapneumoniavaccine需要肺炎疫苗LanguageFocusesnColonoscopyncolon（o）-ncolon（结肠）qcolonoscopen-scopynseeing,observation（观看
9、，检查）qlaparoscopyLanguageFocusesn_control（血压控制）nhealth_（健康保持）nImpilingyetanotherpillontoherq我还要再给她另加一种药bloodpressuremaintenanceLanguageFocusesnTask3FormalEnglishnDegreeofformalityshouldbedeterminedbyqtheaudienceqtheexpectationsoftheaudienceqandthewriterspurposes.LanguageFocusesnTask3FormalEnglishnFor
10、example,thewriterofTextAemploysinformallanguagewhenrecordingherjugglingthoughts,andanoticeableshiftfromthatoftherestofthearticlewhereformalstyleisconsistentlymaintained.Ajugglingmindisvividlypresentedbyinformalandevenungrammaticaluseoflanguage,suchas“Maybe leave this until next time?”Differencesbetw
11、eenFormalEnglishnItisusedinofficial,literary,academicwriting,orformalsocialevents.nItismorecommonlyusedinwritingthanspeech.nSentencesareoftenlongandcomplex.nContractions(缩写)areavoided.InformalEnglishnItisusedineverydaypersonalconversationsorletterstofriends.nItismorecommonlyusedineverydayspeechthani
12、nwriting.nSentencesareoftenshortandsimple.nContractionsarecommon.DifferencesbetweenFormalEnglishnThepassivevoiceisoftenused,makingitsoundimpersonal.nMuchvocabularyderivedfromFrenchandLatinisused.nColloquialterms,slangsandmanyphrasalverbsareavoided.InformalEnglishnTheactivevoiceisoftenused.nVocabular
13、yderivedfromFrenchandLatinisnotused.nColloquialterms,slangsandmanyphrasalverbsarecommon.MoreExampleFormalEnglishnTheresearchersidentifiedtheimportantproperties.nDoctorshaveestablishedanewmethod.nThisappearedtorectifytheproblemInformalEnglishnTheresearchersfoundoutwhattheimportantthingswere.nDoctorsh
14、avecomeupwithanewmethod.nThisseemedtofixtheproblemMoreExampleFormalEnglishnHiswordsdemonstratethatnDetailsofthereportaretobefoundonpage26.nTheexperimentwascarriedout/performed.InformalEnglishnHiswordsshowthatnYoucanfindoutallaboutthereportonpage26.nTheydidanexperiment.LanguageFocusesnKeytoTask3Forma
15、lEnglishnGoodthingshedidherbloodtests.Glucoseisalittlebetter.Cholesterolisntgreat.Mayneedtothinkaboutstartingastatin.Areherliverenzymesnormal?LanguageFocusesnKeytoTask3FormalEnglishqGoodsignsincludethatshedidherbloodtests,andthatherglucoselevelisalittlebetter.However,hercholesterollevelisntgreat,and
16、Imayneedtoconsiderprescribingastatinforher.Furthermore,Iwonderedifherliverenzymesarenormal.LanguageFocusesnKeytoTask3FormalEnglishnButnowImpilingyetanotherpillontoher,andonethatrequiresdetailedinstructions.Maybeleavethisuntilnexttime?LanguageFocusesnKeytoTask3FormalEnglishqButnowImpilingyetanotherpi
17、llontoher,andthepillrequiresdetailedinstructions.“Maybe,shouldIleavethisuntilnexttime?”Ithought.Onestrayrequest（偏离正题的要求）fromMrs.Osoriosendsthedelicatelybalancedthree-ringcircustumblingdown.(Pre.4)nTheauthorwasinmoderatestateofpanic:jugglingsomanythoughtsaboutMrs.Osoriosconditionsandtryingtoresolveth
18、emallnMrs.Osoriomadeatrivialrequest,notsoimportantascomparedtoherconditionsOnestrayrequestfromMrs.Osoriosendsthedelicatelybalancedthree-ringcircustumblingdown.(Pre.4)nMrs.Osorioseemedtocareonlyabouther“innocentandcompletelyjustifiedrequest”:theformsignedbyherdoctornThedoctortriedtooratleastpretended
19、topayattentiontothepatientswhilecompletingdocumentationnThedoctorcouldnolongerhandleeverythingproperly.重要短语thediet-and-exercisediscussion饮食和运动相关讨论notmakingeyecontactwith没有目光接触重要短语checkhermammogramreport检查乳房X光报告documenttheprogressofherillnesses记录病情发展orderthetests开具化验refillherprescriptions重写处方重要短语insu
20、rancecompany/insuranceform保险公司/保险单physicalexamination体检backpain背痛anythingmorethanroutinemusclestrain只是普通的肌肉劳损LanguageFocusesn_report（乳房X-线检查报告）n_examination（体检）mammogramphysicalLanguageFocusesnshescaughtoneofmyneuronsinmid-fireq她让我如火如荼的思绪戛然而止nMyinstinctistoputonehandupandkeepallinterruptionsatbay.q我
21、的本能反应是举手，阻止她打断我的思路。Comparemultitaskinginhumanbeingsandinthecomputerfield.(Pre.5)nMultitaskingoriginatedincomputerscience.nMicroprocessorsinfactlinear,actuallyperformingonlyonetaskatatimenMultitaskingjustasanillusionbothincomputerandhumans.nAtbest,HumanjugglingonlyahandfulofthoughtsinthismannernThemo
22、rethoughtswejuggle,thelessweareabletoattunefullytoanygiventhought.LanguageFocusesnWemerelyzipbackandforthbetweenthem,generallylosingaccuracyintheprocess.q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。LanguageFocusesnThemorethoughtswejuggle,thelessweareabletoattunefullytoanygiventhought.n头脑中思绪越多，越难充分协调特定思绪U
23、senumberstojustifythatitisjugglingmindthatkeepsdoctorsawakeatnight.(Pre.6)n7medicalissuesforonepatientn5thoughtforonemedicalissuen10patientsoneafternoon.n7X5X10=350(thoughts)Usenumberstojustifythatitisjugglingmindthatkeepsdoctorsawakeatnight.(Pre.6)n5residentsundertheauthorssupervisionn4patientsseen
24、byeachresidentn10thoughts,atleast,generatedbyeachpatientn5X4X10=200(thoughts)n350+200=550thoughtstobehandledintotalUsenumberstojustifythatitisjugglingmindthatkeepsdoctorsawakeatnight.(Pre.6)nIfthedoctordoesagoodjobjuggling98%ofthetime,thatstillleavestenthoughtsthatmightgetlostintheprocess.n如果医生成功思考9
25、8%的内容，思考过程中仍有10件事可能丢失。TheoutcomenAnyoneofthoselostthoughtscouldtranslateintoadisastrousoutcome,nottomentionapossiblelawsuit.n任何丢失的思绪可能变成灾难性后果，更不用提潜在的诉讼。Possiblesolutionstotheimpossiblehigh-wireactofjugglingcompetingdetailsandpanickingaboutslippingacriticalone.(Pre.7)ncomputer-generatedreminders(计算机提
26、示)ncasemanagers(病例管理人)nancillaryservices(辅助服务)nthesimplest:time重要短语thechoicesthatpracticingphysiciansfaceeveryday执业医师每天面对的选择relyonourclinicaljudgmenttoprioritise依靠临床判断确定优先选择adedicatedandcompetentclinicalpartner尽心并能干的临床合作者LanguageFocusesMychoicesseemtoboildownto(归结为)entertainingfewerthoughts,acceptin
27、gdecreasedaccuracyforeachthought,givinguponthoroughdocumentation,orhavingaconstantheadachefromneuronaloverload.TheConcludingparagraphnIthastheluxuryofbeingabletocrash,andofareassuring,omniscienthandtopresstherebootbutton.Physiciansarepermittednosuchextravagance.n(计算机)能够崩溃，也能有令人放心的全知之手按下重启键。医生无此特权。Th
28、eEndnHardDocsLife(HospitalistAnthem)Task1MedicalTerminologynRootsncolon（o）-qcolon（结肠）ngluc（o）-qglucose，sweetness（葡萄糖，甜）qglucocorticoidq糖皮质激素糖皮质激素niatr（o）-qphysician，treatment（医师,医疗）qiatrologyq医学Task1MedicalTerminologynRootsnmamm（o）-qbreast（乳房）nneur-qnerve（神经）qneurologynnutri-qnourishment（营养）qnutrien
29、tTask1MedicalTerminologynRootsnoste（o）-qbone（骨）npneum（o）-qair,lung（气；肺）npod-qfoot（足，脚）qpodocyteq足状突细胞足状突细胞Task1MedicalTerminologynRootsnpor-qacavity,opening,passageorpore（腔，孔，洞）qporousqporeTask1MedicalTerminologynPrefixesnhyper-qabnormallyincreased,excessive（超出，过度的）nre-qagain；back；contrary（再，又，回，反）q
30、relapsentrans-qthrough,across,beyond（经，透过，越，横过）qtranscriptionqtransfusionTask1MedicalTerminologyn-gramqsomethingwrittenordrawn,arecord（书写或图，记录）n-iaqdisease,pathologicalorabnormalcondition（疾病，行为异常或失常的状态）qleukemiaqtachycardian-ionqnoun-formingsuffix（构成名词的后缀）Task1MedicalTerminologyn-istqaspecialist（专家）
31、n-onqaunit（单元）qneutronqnephronn-osisqdiseasedorabnormalcondition（病变的或不正常的状态）qSclerosisq硬化Task1MedicalTerminologyn-scopyqseeing,observation（观看，检查）qarthroscopyq关节镜检查qesophagoscopyq食管镜检查qgastroscopyq胃镜检查法qhysteroscopyq子宫镜检查（术）Task1MedicalTerminologyKeyncolonoscopynhypertensionnmammogramnneuronnnutritionistnosteoporosisnpneumonianpodiatristnrefillntransplantn结肠镜检查（术）n高血压n乳房X线照片n神经元，神经细胞n营养学家n骨质疏松n肺炎n足病医生n再配（处方）n移植