A、Cooperative. B、Appreciative. C、Passive. D、Responsive. C细节辨认题。讲话者借助凯伦.布鲁特妮的话，表明了美国医护人员对待患者的态度。根据原文可知，他们希望患者是完全被动的。因此答案为C。

Appear to be submissive, humble, grateful and undemanding； show great pleasure when a doctor comes into your room, even if the visit is brief and useless. Don’t challenge anyone with authority unless you are famous or very rich.
    Those are a few strategies for dealing with today’s American medical establishment. What patients want is to be treated with respect and consideration. But in my experience, too few hospitals and doctors are ready to do that. In his book, A Whole New Life, novelist Reynolds Price recalls that his doctors chose a crowded hallway as the place to tell him he might have a tumor on his spinal cord. It did not occur to the two physicians that a hallway was not the most appropriate place for that particular piece of news.
    My surgeon, who is in his mid-thirties, looks tired. He has been overwhelmed with patients who have fallen on the winter ice. He is a witty man, but sometimes his wit is unwelcome.
    "The health insurance company Blue Cross wants me to put you out in the snow tomorrow afternoon," he tells me after I have been in the hospital for more than a week. I’m terrified because I have no idea where to go. I cannot walk or even lift my leg a few inches. The hospital social worker strikes me as an idiot. But my complaints about her only annoy my surgeon. "I have to work with these people," he tells my friend, Dr. Karen Brudney, when she mercifully intervenes on my behalf and arranges for me to be transferred to another hospital.
    "If you say one negative thing, they get defensive," she tells me later. "They have this kind of institutional loyalty. Always bring an advocate, that is, any other person with you to the hospital, and write down every single question and the answer, the name of every doctor and nurse. When people know you have their names, they behave better. And," Brudney adds, "if you, as a patient, suggest that you might like to control even part of the situation or be consulted or informed, then you are considered difficult. (18)They want you to be totally passive. The entire health care system, particularly hospitals and nursing homes, exists for reasons that have nothing to do with taking care of patients. Patients are incidental."
    16. What does the speaker say about most American hospitals?
    17. What does Karen Brudney suggest patients do?
    18. What do American doctors expect their patients to be, according to Karen Brudney?