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Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore t
Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore t
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2014-09-05
17
问题
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 litigation and do whatever they’ re asked to avoid getting in trouble.
According to the text, doctors seem to accept death more readily than patients because______.
选项
A、they have seen so much deaths in their life that they take it for granted
B、they know quite well that there is a limit to what technology can do with one’ s life
C、they don’ t want to go through harsh and painful treatment
D、they are very conservative when it comes to applying new treatment on themselves
答案
B
解析
文章以作者导师平静面对死亡的例子引出了一个问题,那就是“为什么很多医生都能够泰然自若地面对死亡,而不去拼命接受治疗?”文章第二段对这个问题给出了回答。因为,they know enough about modern medicine to know its limits,“他们对现代医学心中有数,知道它的局限性。”[B]是对这句原话的同义改写,因此为正确答案。[A]说“他们因为看惯生死,而不惧怕死亡”,是文中没有提到的信息。[C]说“他们不愿经历痛苦的治疗”是对原文内容偷换概念,原文的意思是说他们知道很多激进的治疗手段毫无效果,因此才不愿意接受治疗,而不是他们本身害怕痛苦而不接受治疗。[D]利用原文中提到的“过度治疗”设置干扰,很多医生当然是反对激进治疗手段的,但这并不是因为他们为人保守,而是因为他们知道这么做根本毫无用处。
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0
考研英语一
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