读《纽约时报》

daphnis

Breaking Down Medicine's Culture of Silence

DR. MICHAEL LEONARD, an anesthesiologist and chief of surgery for Kaiser Permanente in Denver, was operating on a cancer patient a few months ago when he reached into a drawer for medicine. Inside were two vials, side by side. Both had yellow labels. Both had yellow caps. One was a paralyzing agent, which Dr. Leonard had correctly administered to keep the patient still during the operation. The other was the reversal agent, which he needed next. \"I grabbed the wrong one,\" Dr. Leonard recalled. \"I used the wrong drug.\"

句中的“an anesthesiologist and chief of surgery for Kaiser Permanente in Denver”作为同位语结构，使句子精炼。另外此句用了动词的过去进行时态was operating很恰当，比一般过去时operated要更生动些。reached into意为“伸手去拿”。 第二句开始用倒装句，而且不重复第一句，句子多变且工整。句子选用agent是避免medicine的重复。administered在此地是“使用”的意思。I grabbed the wrong one意思是I took the wrong one。这里的grab很生动，比get或take要好。recall和remember不一样。

It would have been easy for the doctor to keep quiet; the drug wore off and the patient was not harmed. Instead, he talked -- to the surgeon and scrub nurses, the patient's wife and the hospital pharmacist, who has since relabeled the paralyzing agents with red stickers and put them in a separate drawer. He also talked to his five partners, whose reaction unnerved him.

keep quiet是“不声张”的意思，比do not talk anybody或者do not let others know要好。wore （wear） off是动词短语。the patient was not harmed中的harm同hurt和injury不一样，应该注意区别。hurt一般指对感情的伤害，而injury一般是对身体的伤害。第二句中的talked意为“和他们谈了此事”，而不必用talked about it以避免重复。最后半句whose reaction unnerved him非常简练，而不用After he talked to them, they said something to him which made him uneasy.

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daphnis

''Four of the five of them said, 'You know, I've done the same thing,' '' Dr. Leonard said. ''One of them said, 'I did the same thing last week.' And I'm thinking, I've been chief of this department for five years. Now I'm chief of surgery. And nobody has ever said to me, 'We have this problem.' A lot of it comes back to this culture of silence.''

最后两句非常精炼。用“We have this problem”，而不是用“This problem has existed for
a long time”。动词exist太大，也不口语化。A lot of it comes back to this culture of silence中的a lot of it很常用，应该学会使用。类似的表达方法如：I think I will see a lot of you here on campus. 动词短语come back既简单又恰到好处。至于this culture如果写成this problem，那么精炼与生硬的区别也就显而易见了。

That culture of silence, and why it needs to be broken, was the unstated theme of a report that shook the medical profession last week. The study, by the independent Institute of Medicine, estimated that in hospitals alone mistakes, from drug mix-ups to surgical errors to misdiagnoses, kill as many as 98,000 people yearly. In addressing basic safety, it said, health care is at least a decade behind other high-risk industries.

That culture … needs to be broken 比 This culture … needs to be abandoned要好得多。另外注意在此句中，作者用了theme这个单词，同类的单词还有issue和concern。在这里… shook the medical profession同… shook the medical area不太一样。前者与职业道德相关。Drug和medicine相近。

第二句中，作者可以用each year或者every year，但使用yearly并不是单纯追究简练，这里的目的更出于使句子优美的考虑。最后一句中的address应该尽快掌握，比如：In his speech, he addressed many issues. 另外注意behind的用法，它会使句子简单生动。

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daphnis

The report is likely to turn the Congressional debate over patients' rights on its head. That discussion revolves around whether patients should be able to sue their health plans; this one revolves around what health care can do to create a climate in which patients are less likely to sue because mistakes are less likely to occur in the first place. The report's authors called on Congress to create a new agency that would collect data on medical errors, analyze their causes, identify trends and recommend changes, in much the same way Dr. Leonard changed the drug labels from yellow to red.

第一句中的is likely值得注意，后面作者又连续使用了两次。这个词要比is possible在词义上更清晰点，比如：It is likely that we will lose the game to them this weekend.

介词短语on one’s head于动词turn连用。第二句中的revolves around比较常用，也可以用介词on。类似意义上的动词词组还有center around，focus on。要学会使用in the first place，比如：He did not mention it in the first place.

Call on是动词词组。还应注意最后一句中动词和名词的搭配使用。

''To err is human,'' the institute panel concluded, ''but errors can be prevented.''

The idea that doctors make mistakes is, of course, nothing new. But the idea that mistakes can be prevented by changing systems has been slow to catch on, in part because doctors rarely talk openly about their errors. The pat explanation is that they are afraid of being disciplined, or sued. But it is not the whole truth, says Dr. Lucian Leape, a professor of health policy at Harvard Medical School who studies medical error.

To err同to make mistakes区别不大。在这里前者是泛指，后者所指比较具体。一般用to prevent the errors而不用to get rid of the errors。

第三句中的slow to catch on意为“生效慢”，是很地道的用法。下面一句中的truth应引起注意。另外注意studies medical error中的study是研究的意思，应少用research这个单词。Error在这里作抽象意义使用，所以前面没有冠词。


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coolboydl

不错不错，很好