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1、新编研究生综合英语教程新编研究生综合英语教程Advanced English for Graduate Students:Advanced English for Graduate Students:General Skills&Academic LiteracyGeneral Skills&Academic LiteracyUnit SIXUnit SIXMedicineMedicineText A Text A It Doesnt Have to Be Sad:It Doesnt Have to Be Sad:The Life of a Hospice nurseThe Life of a
2、 Hospice nurseText BText B Why Relatives Do Not Why Relatives Do Not Donate Organs for Transplants:Donate Organs for Transplants:“Sacrifice”or“Gift of Life”“Sacrifice”or“Gift of Life”Everyone must experience birth,growth and death.Life and death,as a sensitive topic,arouses different feelings from d
3、ifferent people.For many death brings sadness,but others think death is a renewal of life.Nowadays many people are more concerned about how to enjoy a good and decent death than how to live a happy life.In this unit,we will talk about life and death.When people hear the word hospice,they usually lin
4、k it to death and dying.In fact,hospice is focused more about providing care,comfort and support to patients during their final days of life.Hospice care is actually end-of-Preface PrefaceLife care.A team of health care professionals and volunteers provides it.They give medical,psychological,and spi
5、ritual support.The goal of the care is to help people who are dying have peace,comfort,and dignity.The caregivers try to control pain and other symptoms so a person can remain as alert and comfortable as possible.Hospice programs also provide services to support a patients family.Usually,a hospice p
6、atient is expected to live 6 months or less.Hospice care can take place at home,at a hospice center,in a hospital or in a skilled nursing facility.Background Information Background Information Pre-reading QuestionsPre-reading QuestionsText A It doesnt have to be sad:the life of a Hospice nurse Text
7、A It doesnt have to be sad:the life of a Hospice nurse VocabularyVocabularyExercises Exercises Text A It doesnText A It doesn t Have to Be Sad:The Life of a t Have to Be Sad:The Life of a Hospice NurseHospice NurseContents1.Information about the 1.Information about the authorsauthors2.Information ab
8、out hospice care2.Information about hospice careBackground Information Background Information Diana K.Sugg is an independent writer and professional editor.She won a Pulitzer Prize in 2003 in the Beat Reporting category for“Cruelest Mystery:Death Before Life”.As a health reporter at the Baltimore Su
9、n,Diana K.Snugg covers a broad range of medical advances,research and health policy.In her eight years at the paper,Sugg has won local,state and national awards.BackgroundBackground1.Information about the authors1.Information about the authors9Hospicecareisatypeofcareandphilosophyofcarefocusingonthe
10、palliationofaterminallyillorseriouslyillpatientspainandsymptoms,andattendingtotheiremotionalandspiritualneeds.Theconceptofhospicehasbeenevolvingsincethe11thcentury.Then,andforcenturiesthereafter,hospiceswereplacesofhospitalityforthesick,wounded,ordying,aswellasthosefortravelersandpilgrims.Themodernc
11、onceptofhospiceincludespalliativecarefortheincurablyillgiveninsuchinstitutions ashospitalsornursing homes,butalsocareprovidedtothosewhowouldratherspendtheirlastmonthsanddaysoflifeintheirownhomes.Itbegantoemergeinthe17thcentury,butmanyofthefoundationalprinciplesbywhichmodernhospiceservicesoperatewere
12、pioneeredinthe1950sbyDameCicelySaunders.WithintheUnitedStatesthetermislargelydefinedbythepracticesoftheMedicaresystemandotherhealthinsuranceproviders,whichmakehospicecareavailable,eitherinaninpatientfacility or at the patients home,to patients with a terminal prognosis who are medicallycertifiedtoha
13、velessthansixmonthstolive.BackgroundBackground2.Information about hospice care2.Information about hospice careOutsidetheUSA,thetermhospice tendstobeprimarilyassociatedwiththeparticularbuildingsorinstitutionsthatspecializeinsuchcare(althoughso-called“hospiceathome”servicesmayalsobeavailable).Outsidet
14、heUSAsuchinstitutionsmaysimilarlyprovidecaremostlyinanend-of-lifesetting,buttheymayalsobeavailableforpatientswithotherspecificpalliativecareneeds.Hospicecarealsoinvolvesassistanceforpatientsfamiliestohelpthemcopewithwhatishappeningandprovidecareandsupporttokeepthepatientathome.Althoughthemovementhas
15、metwithsomeresistance,hospicehasrapidlyexpandedthroughtheUnitedKingdom,theUniteStatesandelsewhere.BackgroundBackgroundQ1:What is the purpose of life?How do you understand the meaning of life?How do you think a good life should be lived?Are you satisfied with your life?Q2:What is your attitude toward
16、s death?And how can people have a decent death?Pre-reading QuestionsPre-reading QuestionsQ3:What qualities do you think are most important in a doctor/patient relationship?Q4:Who should be responsible for the old people?Q5:If you knew you were going to die,would you choose hospice care?Pre-reading Q
17、uestionsPre-reading QuestionsOrganization of the TextOrganization of the TextText Explanation&TranslationText Explanation&TranslationText A It doesnt have to be sad:The life of a hospice nurse Main Idea Main IdeaPart One:(Para.1-7)The brief introduction of the hospice care,the nurse Jill Campbell,an
18、d her job.Part Two(Para.8-13)It develops around her job,how she juggles crisis,how much help the hospice care can provide to the patients.Part Three(Para.14-22)It gives the exact example,Linda Schuberth,to show Jill Campbells effort and the importance of the hospice care.Organization of the TextOrga
19、nization of the TextWhatdoesitfeelliketohelpdyingpatientsthroughtheirfinaldays?ExperienceitthroughtheeyesofhospicenurseJillCampbell,whodoesherjobwithgrace,compassion,andgratitude.1.Outside,itsnoisyonthisbusyblockofrowhousesinBaltimore.Butinsideonetidylivingroom,allisquietexceptforthesoundofawomansra
20、spybreathing.Thepatientishuddledinaneasychairunderahandmadepink-and-blueafghan,aknitcaponherheadandbootiesonherfeet.Shehastroublestayingwarmthesedays.Hercancerhasreturnedwithavengeanceandshehasonlyafewweekstolife.Text A It DoesnText A It Doesnt t Have to Be Sad:The Life of a Hospice Nurse Have to Be
21、 Sad:The Life of a Hospice Nurse帮助即将离世的患者度过最后的时光会是怎样的感受呢？让我们借助吉尔坎贝尔的所见经历这一切吧。吉尔坎贝尔把优雅、同情和感激全然融入到工作中。1.在巴尔的摩的这个由联排房屋构成的繁忙街区，外面一片喧闹，但是在里面一间洁净的卧室里，除了只能听到一位女士刺耳的呼吸声之外，周围一片寂静。这位病人蜷缩在一把安乐椅上、身上盖着一条厚厚的手工制的粉蓝色毛毯、头上戴着一顶针织帽，脚上穿着一双软毛袜。这些天来这位病人一直没办法让自己保持温暖的状态。她的癌症复发了，而且到了很严重的程度。她在世上的日子不过几个星期了。Diana K.SuggDiana K
22、.SuggHospicenurseJillCampbellkneelsdownbesideherpatient,listenstoherbreathing,andthenchecksherbloodpressure.Campbellhasalreadyhauledinoxygentanks,showedfamilymembershowtoworkthem,organizedthemedicine,andassessedhowherpatienthasbeeneatingandsleeping.Text A It Doesnt Have to Be Sad:The Life of a Hospi
23、ce NurseText A It Doesnt Have to Be Sad:The Life of a Hospice Nurse临终关怀护士吉尔坎贝尔跪在她的病人身旁，听她的呼气，检查她的血压。坎贝尔已经把氧气瓶拉近了，她向病人家属展示如何使用氧气瓶，之后她又准备好药物，紧接着又评估了一下病人的饮食和睡眠状况。Diana K.SuggDiana K.Sugg2.Butnowisamomenttoconnectone-on-one.Campbellwrapsherhandsaroundthewomanshandsandrubsthemtogethertowarmthem.Shelooksi
24、ntoherface.“areyoufeelingalittlebetter?”sheaskssoftly.Text A It Doesnt Have to Be Sad:The Life of a Hospice NurseText A It Doesnt Have to Be Sad:The Life of a Hospice Nurse2.但是现在是坎贝尔和患者之间一对一的接触时刻。坎贝尔用自己的手捂住这位女病人的手。为了让病人的双手暖和些，她帮这位病人揉搓着双手。坎贝尔看着病人的脸，轻柔地问道：“现在感觉好一些了吗？”Diana K.SuggDiana K.Sugg3.Gettingt
25、oknowherpatientsandhelpingthemthroughthetoughesttimeoftheirlivesiswhatCampbell,43,appreciatesmostaboutbeingahospicenurse.“Idontknowofanotherpositionwhereyoucandomoreforpeople,”shesays.Text A It Doesnt Have to Be Sad:The Life of a Hospice NurseText A It Doesnt Have to Be Sad:The Life of a Hospice Nur
26、se 3.坎贝尔43岁，身为一名临终关怀护士，坎贝尔最为珍视的就是了解她的病人并且帮助他们度过生命中最艰难的时光。她说：“我不知道还有哪个职业能像临终关怀工作一样为人们做出更多贡献。”Diana K.SuggDiana K.Sugg4.Herpatientshaveallbeentoldthattheyhavesixmonthsorlesstolive.Ratherthancontinuewithoften-difficultorpainfultreatmentsthatprobablywontextendtheirlives,theyhavedecidedtostoptryingforacu
27、re.Instead,withthehelpofhospicecare,theyllfocusoncomfortandonlivingwhatevertheyhaveleftoftheirlivestothefullest-usuallyintheirownhome.Text A It Doesnt Have to Be Sad:The Life of a Hospice NurseText A It Doesnt Have to Be Sad:The Life of a Hospice Nurse4.她的病患都被告知他们在世上的时光最多不过6个月。与其继续一向很艰难又痛苦的治疗，而且往往这些
28、治疗可能并不会延长他们的寿命，这些病患已经决定不再尝试寻找任何治疗手段。相反地，在临终关怀的帮助下，他们往往更注重如何舒适地生活并且尽情地享用余生。他们通常会选择在自己家里接受临终关怀。Diana K.SuggDiana K.Sugg5.Beingabletodieathomeisamajorpartoftheappealofhospice,butpatientsandfamilymembersmaynotseeitthatwayatfirst.“Alotofpeoplestillviewhospiceasgivingupandlettingthediseasein,”saysCampbell
29、.Thatswhythedecisiontocallinhospicecarecanbeanincrediblydifficultoneforafamilytomake.Oncetheydo,though,mostpatientsandtheirfamiliessoonunderstandthevalueofhavingateamofdedicatedprofessionals-includingsocialworkers,healthaides,chaplains,andnurses-worktogethertoprovidenotonlyphysicalbutalsoemotionalan
30、dspiritualsupport.5.能够在家中逝去是人们选择临终关怀的主要原因之一。但是病人和他们的家属起初并没有认识到这一点。坎贝尔说:“很多人把临终关怀视为放弃治疗并且向疾病屈服。”这正是为什么对于家人来说做出选择临终关怀这个决定有如此艰难的原因。然而，一旦他们做了这个决定，大多数病人和家人很快就会理解其中的意义所在，即一支由社工、健康师（助理）、牧师和护士组成的专业人士通力合作为病人和家属提供身体上、感情上和精神上的支持与帮助。WhenCampbelltookthejobatGilchristHospiceCarethreeyearsago,shehadthesamefearsasa
31、nyoneabouthospice.Asamotherofthreeandaveterannursewhodworkedinoperatingrooms,sheexpectedittobeunbearablysad.Butonherfirsthomevisit,shewassurprisedthatthefamilymemberswererelaxedandsharingfunnystoriesabouttheirdyingfather.“Theresstillhappinessinthesadnessofit,”shesays.三年前当坎贝尔开始在吉尔克里斯特临终关怀中心工作时，她和其他人一
32、样对临终关怀抱有相同的畏惧和忧虑。作为三个孩子的妈妈和经历丰富的手术室护士，坎贝尔原以为这份工作需要承受难以忍受的悲伤。但是当她第一次到病人家造访时，她很惊讶地看到病人的家人都很放松，并且他们能够和即将离世的父亲分享有趣的故事。坎贝尔说：“在悲伤中仍然能够感受到幸福。”6.Byspendingtimeinsidepatientshomes,Campbellhaswitnessedtheblessingsofapeacefulendingtolife.Shesseenfamilymembersresolvelongstanding,hurtfuldisputesandbereunited.For
33、somepatientsthevictorieshavebeensmallerbutequallyprofound:avisittoahairsalonorbeingabletositoutsideonaniceday.Butgettingpateientsandtheirrelativestothatplaceofpeaceandacceptancecanbetough.Somefamiliesaredividedorresistanttotheideaofhospice.OnefamilyaskedCampbelltocoverherbadge,thinkingthatiftheirgra
34、ndmothersawthewordhospiceshedgiveupanddie.6 6 在病人家度过的时光让坎贝尔目睹了平静地向生命告别是何等蒙恩。她看到家人是如何解决那些持久又伤人的争论之后又言归于好，一团和气的。对于许多患者来讲能够去一趟美发沙龙、在晴朗的天气里去外面坐坐都是莫大的胜利。这些看似很小的事情对患者来讲却有着深远的意义。但是要想让患者和他们的家人能够平静地接受临终关怀却是一件难事。在很多家庭里成员间意见有分歧，还有些家庭对临终关怀持抵制态度。曾经有这样一个家庭，他们要求坎贝尔挡住她的徽章。因为他们担心如果祖母看到了徽章上临终关怀的字样，她将会放弃，进而离世。7.Others
35、,unnecessarilyworriedaboutdrugaddiction,wontgivetheirsickrelativepainmedicinewhenitsneeded.Andsomepatientsareafraidoftakingmorphine,thinkingitwillstoptheirreathingormakethemfeeloutofit.“Didyoutakethemedicine?”Campbellasksacancerpatient,whoisholdingherribcageinagony.Campbellsquatsbesidethehesitantwom
36、anandassureshershellstaywithherwhileshetakesit,tomakesureshesokay.Thepatientisworriedshelljustsleepawaythetimeshehasleft,butpainmedicineoftenallowsapersontofeelbetterandactuallydomore.7.7.还有一些家庭即便在病人需要服用止痛药的时候也不让病人服用，因为他们担心病人会因服用药物而上瘾。然而这些担心都是不必要的。有些病人害怕服用吗啡，因为他们认为吗啡会让他们呼吸停止并且很不自在。“你吃药了吗？”坎贝尔问一位癌症患者
37、，这位患者正在痛苦地抓着胸腔。坎贝尔蹲在这位犹豫的病人身旁，向她保证当她服药的时候坎贝尔会陪着她以确保她会平安无事。这位病人担心她会把所剩的时光都睡过去，但是止痛药通常能让病人感觉更好并且实际上能起到更大的作用。24Juggling Crises8.ManydaysCampbellisbusyjugglingcrises-onepatienthasfallendown,anotherisvomiting,andanotherisclosetodaying.Otherdays,shedelicatelynavigatesthefearsofpatientsandfamilieswithherge
38、ntle,groundedspirit.Inhomeafterhome,shefindsthatpeoplewhattoknowthesamethins:howlongtheyhaveleftandwhatthefinalmomentswillbelike.Someonlywanttoknowifshecankeepthemcalmandoutofpain.Shecan.Otherswantdetails,soshellexplainthataftertheystopeatinganddrinking,forexample,theywillbecomesemicomatoseandjustgr
39、aduallyslipaway.处理危机处理危机8.很多天来坎贝尔一直忙于处理各种危象：一位患者跌倒了，另外一位正在呕吐、还有一位马上就要离世了。其它的日子里，坎贝尔细心地凭借自己温柔善意的、不屈不挠的精神排解病人和家属的恐惧。走访了一家又一家坎贝尔发现人们都想知道相同的事情：一是他们还有多少时光；二是最后的时刻会是什么样子。有些人只想知道坎贝尔能否让他们平静下来并且脱离痛苦。她能做到。另外一些人想知道一些细节，于是坎贝尔会向他们解释例如在他们停止进食后，他们会处于半昏迷状态并且会渐渐地离开人世。9.Somestillwonderiftheycouldbetherarepersonwhosur
40、vives.“Hasthereeverbeenacasewheresomebodywalksawayfromthis?”one75-year-oldgrandfatherasksherhopefully.“Idontknow,”Campbellsaysafteramoment.Sheexplainsthatitshardtosaywithhiskidneydisease.“liveeachday,”shetellshim.Then,notinghisjokesabouteatingwhateverhewantsandhavinghisdaughterandwifewaitonhim,shead
41、dswithasmile,“Andobviouslyyouare.”9.一些人依旧想知道他们是否会是能够幸存的少数人。曾经有一个75岁的祖父，他满怀希望地问坎贝尔“有没有哪个病人从这活着走出去？”过了一会儿，坎贝尔说:“我不知道。”她解释道对于他的这种肾病很难说能否幸存下来。她告诉老人“活好每一天。”紧接着老人开玩笑说想吃什么就吃点什么吧，并且让他的女儿和妻子等着他。注意到老人的玩笑后坎贝尔微笑着补充道:“很显然你就是这样做的，享受活着的每一天。”10.Becausemanypeopleseehospicecareastheendofhope,therareevensomedoctorswho
42、arereluctnttobringuptheoption.Asaresult,morethanathirdofhospicepatientsdontstartpalliativecareuntiltheyhavejustdayslefttolive.Ironically,somepatientswhogethospicecarelivelongerthanthosewhodont,studiesshow.Butmanywaituntilitsnearlytoolate,andthosepeopleoftensacrificethechanceforclosure.10.因为很多人把临终关怀视
43、作最后的希望，因此很多医生甚至都不情愿向病人提出临终关怀这项选择。而这么做的结果是多于三分之一的临终关怀患者直到生命仅剩几天时光时才开始接受临终关怀治疗。而具有讽刺意味的是：研究显示相比那些没有接受临终关怀的患者来说，接受临终关怀的患者活的时间要更长。但是很多人一直等到几乎是太晚了以至于他们经常牺牲了以临终关怀的方式向生命告别的机会。11OnedayCampbellgetsamessage:Themanshesjustseenforthefirsttimetwohoursearlierhasalreadydied.“Ooh,”shesays,lettingoutalong,frustrated
44、sigh.Sheknowswhatshecouldhavedoneforhimifshedhadmoretime-thesamethingshewantsforherselfwhenherlifeisending:achancetohavethoselastconversations,tobecomfortable,athome,surroundedbylovedones.11.一天坎贝尔收到了一条信息：就在两小时前她第一次探望的病人辞世了。“噢，”她说，伴随着一声很长的沮丧的叹息。如果坎贝尔有更多时间的话，她知道她会为这位病人做些什么：创造机会让病人在家中舒服地被所爱的人包围，最后再和他们说
45、说话，而这正是她所希望自己在生命尽头时所能拥有的。12.Thatswhyshetriestofocusonwhatpatientswant.Andwhenaterminallyillpersonhangsonlongerthanseemspossible,Campbellhaslearnedthatthepatientisoftenwaitingforsomethingtoberesovled.Inonecaseadyingwomansadultchildrenaregatheredatherbedside.Oneofthedaughters,inparticular,isheartbroke
46、nanddistraught.Thechaplainleadstheminprayerandthenthechildren,leaningoneachother,leavetheroom.“look,theyretogether,”Campbellwhisperedtothewoman,sensingsheisworriedaboutthem.“Ifyouwant,itsokaytogo.Theyregoingtobeokay.”Withinminutes,thewomandies.12.这也正是她尽所能关注患者所需的原因所在。坎贝尔的亲身经历让她知晓当身患绝症的病人比看似可能的情况下坚持了更
47、长的时间，这通常说明患者在等待某件事情得以解决。有这样一个案例：在一位即将离世的妇人床边聚集了她的成年子女。其中的一个女儿悲痛欲绝。牧师带领他们祷告，紧接着孩子们相互依偎走出了房间。坎贝尔意识到老妇人放心不下她的孩子们，于是对她耳语道：“看，他们在一起。如果这就是你所期望的，那就放心地走吧。他们会没事的。”几分钟后，老妇人辞世了。13.“Peoplearesoafraidofhowitsgoingtoend,”Campbellsays.“Butwhenyourebeenthereandheldtheirhandandwatchedthemtaketheirlastbreath,youseeth
48、atitsarealypowefulmoment-powerfulandpeaceful.”13.坎贝尔说：“人们对如何离开人世都心存恐惧。但是一旦当你在场，握住他们的手，看着他们咽下最后一口气，你就会明白这真的是一个强大的时刻强大又平安的时刻。”Connecting14.GettingtoknowherpatientsisthemostrewardingpartofJillCampbellsjobasahospicenurse.DuringthefourmonthsCampbellcaresforher,Schuberthcanbarelyspeak.Butbyusingherexpress
49、iveeyes,aswellasbytappingoutwordsonaniPad,shemanagestohavearunningconversationwithCampbellaboutfrozenyogurt,theirfamilies,andherbeloveddogs.联系联系 14.对于一位临终关怀护士来说，吉尔坎贝尔认为她工作中最让她欣慰的就是了解她的患者们。在坎贝尔照顾舒伯茨的四个月里，舒伯茨几乎不能说话。但是舒伯茨通过在iPad 上敲字，同时用她那会说话的眼睛尽量与坎贝尔进行连续的交流。她们谈论的话题包括冷冻酸奶、她们的家庭和她心爱的狗。15.Itsasif,underoth
50、ercircumstances,theycouldbefriends.Therearesomepatientsthatyoubecomeemotionallyattachedto,”Campbellsays.HowcouldyounotLinda?Shessuchanawesomeperson.”Sheneverleaveswithoutgivingherabighug.15.如果在其它场合结实，她们很可能会成为朋友。坎贝尔说：“有一些患者会让你在感情上很依恋。如果没有琳达，该怎么办呀？她是这么出色。”每次离开时坎贝尔都不忘给琳达一个大大的拥抱。16.EverytimeCampbellvisi