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1、新编研究生综合英语教程UNIT(潘海英),Unit SIXMedicine,Text A It Doesnt Have to Be Sad:The Life of a Hospice nurseText B Why Relatives Do Not Donate Organs for Transplants:“Sacrifice”or“Gift of Life”,Everyone must experience birth,growth and death.Life and death,as a sensitive topic,arouses different feelings from d
2、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
3、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,Life care.A team of health care professionals and volunteers provides it.They give medical,psychological,and spiritual
4、 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 patient
5、 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 Pre-reading QuestionsText A It doesnt have to be sad:the life of a Hospice nurse VocabularyExercises,Text A It doesnt Have to Be Sad:Th
6、e Life of a Hospice Nurse,Contents,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 Sun,Diana K.Snugg covers a broad range
7、 of medical advances,research and health policy.In her eight years at the paper,Sugg has won local,state and national awards.,Background,1.Information about the authors,9,Hospicecare is a type of care and philosophy of care focusing on thepalliation of aterminally ill or seriously ill patients pain
8、and symptoms,and attending to their emotional and spiritual needs.The concept of hospice has been evolving since the 11th century.Then,and for centuries thereafter,hospices were places of hospitality for the sick,wounded,or dying,as well as those for travelers and pilgrims.The modern concept of hosp
9、ice includes palliative care for the incurably ill given in such institutions ashospitalsornursing homes,but also care provided to those who would rather spend their last months and days of life in their own homes.It began to emerge in the 17th century,but many of the foundational principles by whic
10、h modern hospice services operate were pioneered in the 1950s by DameCicely Saunders.Within the United Statesthe term is largely defined by the practices of theMedicaresystem and otherhealth insuranceproviders,which make hospice care available,either in an inpatient facility or at the patients home,
11、to patients with a terminal prognosis who are medically certified to have less than six months to live.,Background,2.Information about hospice care,Outside the USA,the term hospice tends to be primarily associated with the particular buildings or institutions that specialize in such care(although so
12、-called“hospice at home”services may also be available).Outside the USA such institutions may similarly provide care mostly in an end-of-life setting,but they may also be available for patients with other specific palliative care needs.Hospice care also involves assistance for patients families to h
13、elp them cope with what is happening and provide care and support to keep the patient at home.Although the movement has met with some resistance,hospice has rapidly expanded through the United Kingdom,the Unite States and elsewhere.,Background,Q1:What is the purpose of life?How do you understand the
14、 meaning of life?How do you think a good life should be lived?Are you satisfied with your life?Q2:What is your attitude towards death?And how can people have a decent death?,Pre-reading Questions,Q3:What qualities do you think are most important in a doctor/patient relationship?Q4:Who should be resp
15、onsible for the old people?Q5:If you knew you were going to die,would you choose hospice care?,Pre-reading Questions,Text A It doesnt have to be sad:The life of a hospice nurse,Organization of the Text,What does it feel like to help dying patients through their final days?Experience it through the e
16、yes of hospice nurse Jill Campbell,who does her job with grace,compassion,and gratitude.1.Outside,its noisy on this busy block of row houses in Baltimore.But inside one tidy living room,all is quiet except for the sound of a womans raspy breathing.The patient is huddled in an easy chair under a hand
17、made pink-and-blue afghan,a knit cap on her head and booties on her feet.She has trouble staying warm these days.Her cancer has returned with a vengeance and she has only a few weeks to life.,Text A It Doesnt Have to Be 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
18、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.Sugg,Hospice nurse Jill Campbell kneels down beside her patient,listens to her breathing,a
19、nd then checks her blood pressure.Campbell has already hauled in oxygen tanks,showed family members how to work them,organized the medicine,and assessed how her patient has been eating and sleeping.,Text 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
20、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.Sugg,2.But now is a moment to connect one-on-one.Campbell wraps her hands around the womans hands and rubs them together to warm them.She looks into her face.“are you feeling a little better?”she asks softly.,Text A It Doesnt Have to Be Sad
21、:The Life of a Hospice Nurse,2.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.Sugg,3.Getting to know her patients and helping them through the toughest time of their lives is what Campbell,43,appreciates most about being a hospice nurse.“I dont k
22、now of another position where you can do more for people,”she says.,Text A It Doesnt Have to Be Sad:The Life of a Hospice Nurse,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.Sugg,4.Her patients have all been told that they have six months or less t
23、o live.Rather than continue with often-difficult or painful treatments that probably wont extend their lives,they have decided to stop trying for a cure.Instead,with the help of hospice care,theyll focus on comfort and on living whatever they have left of their lives to the fullest-usually in their
24、own home.,Text A It Doesnt Have to Be Sad:The Life of a Hospice Nurse,4.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.Sugg,5.Being able to die at home is a major part of the appeal of hospice,but pa
25、tients and family members may not see it that way at first.“A lot of people still view hospice as giving up and letting the disease in,”says Campbell.Thats why the decision to call in hospice care can be an incredibly difficult one for a family to make.Once they do,though,most patients and their fam
26、ilies soon understand the value of having a team of dedicated professionals-including social workers,health aides,chaplains,and nurses-work together to provide not only physical but also emotional and spiritual support.,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
27、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。,When Campbell took the job at Gilchrist Hospice Care three years ago,she had the same fears as anyone about hospice.As a mother of three and a veteran nurse whod worked in oper
28、ating rooms,she expected it to be unbearably sad.But on her first home visit,she was surprised that the family members were relaxed and sharing funny stories about their dying father.“Theres still happiness in the sadness of it,”she says.,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
29、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.By spending time inside patients homes,Campbell has witnessed the blessings of a peaceful ending to life.She s seen family members resolve longstanding,hurtful disputes and be reunited.For so
30、me patients the victories have been smaller but equally profound:a visit to a hair salon or being able to sit outside on a nice day.But getting pateients and their relatives to that place of peace and acceptance can be tough.Some families are divided or resistant to the idea of hospice.One family as
31、ked Campbell to cover her badge,thinking that if their grandmother saw the word hospice shed give up and die.,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
32、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,unnecessarily worried about drug addiction,wont give their sick relative pain medicine when its needed.And some patients are afraid of taking morphine,thinking it will stop their reathing or make them feel out of it.“Did you take th
33、e medicine?”Campbell asks a cancer patient,who is holding her rib cage in agony.Campbell squats beside the hesitant woman and assures her shell stay with her while she takes it,to make sure shes okay.The patient is worried shell just sleep away the time she has left,but pain medicine often allows a
34、person to feel better and actually do more.,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，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。,24,Juggling Crises8.Many days Campb
35、ell is busy juggling crises-one patient has fallen down,another is vomiting,and another is close to daying.Other days,she delicately navigates the fears of patients and families with her gentle,grounded spirit.In home after home,she finds that people what to know the same thins:how long they have le
36、ft and what the final moments will be like.Some only want to know if she can keep them calm and out of pain.She can.Others want details,so shell explain that after they stop eating and drinking,for example,they will become semicomatose and just gradually slip away.,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
37、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.Some still wonder if they could be the rare person who survives.“Has there ever been a case where so
38、mebody walks away from this?”one 75-year-old grandfather asks her hopefully.“I dont know,”Campbell says after a moment.She explains that its hard to say with his kidney disease.“live each day,”she tells him.Then,noting his jokes about eating whatever he wants and having his daughter and wife wait on
39、 him,she adds with a smile,“And obviously you are.”,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.Because many people see hospice care as the end of h
40、ope,ther are even some doctors who are reluctnt to bring up the option.As a result,more than a third of hospice patients dont start palliative care until they have just days left to live.Ironically,some patients who get hospice care live longer than those who dont,studies show.But many wait until it
41、s nearly too late,and those people often sacrifice the chance for closure.,10.因为很多人把临终关怀视作最后的希望，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。,11 One day Campbell gets a message:The man
42、 shes just seen for the first time two hours earlier has already died.“Ooh,”she says,letting out a long,frustrated sigh.She knows what she could have done for him if shed had more time-the same thing she wants for herself when her life is ending:a chance to have those last conversations,to be comfor
43、table,at home,surrounded by loved ones.,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，最后再和他们说说话，而这正是她所希望自己在生命尽头时所能拥有的。,12.Thats why she tries to focus on what patients want.And when a terminally ill person hangs on longer than seems possible
44、,Campbell has learned that the patient is often waiting for something to be resovled.In one case a dying womans adult children are gathered at her bedside.One of the daughters,in particular,is heartbroken and distraught.The chaplain leads them in prayer and then the children,leaning on each other,le
45、ave the room.“look,theyre together,”Campbell whispered to the woman,sensing she is worried about them.“If you want,its okay to go.They re going to be okay.”Within minutes,the woman dies.,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
46、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.“People are so afraid of how its going to end,”Campbell says.“But when youre been there and held their hand and watched them take their last breath,you see that its a realy poweful moment
47、-powerful and peaceful.”,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.Getting to know her patients is the most rewarding part of Jill Campbells job as a hospice nurse.During the four months Campbell cares for her,Schuberth can barely speak.But by using
48、her expressive eyes,as well as by tapping out words on an iPad,she manages to have a running conversation with Campbell about frozen yogurt,their families,and her beloved dogs.,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
49、冻酸奶、她们的家庭和她心爱的狗。,15.Its as if,under other circumstances,they could be friends.There are some patients that you become emotionally attached to,”Campbell says.How could you not Linda?Shes such an awesome person.”She never leaves without giving her a big hug.,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
50、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.Every time Campbell visits Linda Schuberth,she feels as though she s getting a gift.Schuberth,56,is suffering from amyotrophic lateral sclerosis,or Lou Gehrigs disease As an occupational therapist who specializes in swallowing disorders in children,s
