ВСТУПЛЕНИЕ 18 страница

Dr. Nikitina: I'd like to add that the main task of this Centre is to ensure the birth of a healthy baby. That is why the doctors focus on the problem of the care for the foetus or «intra-uterine patient» as we say. New methods of disease prevention, diagnostics and treatment devel­oped at the Centre are made known to the numerous maternity consul­tation centres of our country which provide health care for expectant mothers starting from the early months of pregnancy.

Dr. Stewart:I for myself, am very much curious to know about pri­vate medical practice and medical insurance in Russia.

Dr.Napalkov: At present, there have emerged a number of private diagnostic and consultation centres, general hospitals and specialised clinics. Medical and health care is provided in line with compulsory and voluntary medical insurance programmmes set up by the state via pri­vate insurance companies.

Dr. Sharland: Dear colleagues, we've seen much of the practice of medicine in Russia. And what are the problems facing medical science in your country?

Dr. Kruglqv: As for scientific problems, medical research is concerned with the prevention and treatment of cardiovascular, and oncological diseases, as well as infections, HIV and ТВin particular. Medical scientists are doing research into the problems of gerontology, medical genetics, immunology and the development of artificial organs. Modern non-invasive/minimally invasive techniques of the surgical treatment of ischemic heart disease have been introduced, among them coronary artery bypass grafting, percutaneous transloominal coronary angioplasty or intracoronary stenting.

Dr. Sharland: I'd like to thank you for the warm reception and for the opportunity to get acquainted with the health care system in your country. We hope to see a delegation of Russian doctors in Great Brit­ain in the near future. Thanks very much, again.

Active Words and Word Combinations

health care systemсистема

здравоохранения healthcare/service

здравоохранение healtheducationсанитарное

просвещение, пропаганда

здорового образа жизни topreventпредотвращать preventiveпрофилактический preventionпрофилактика tocureизлечивать curativeлечебный

to treatлечить

treatmentлечение

chargeплата;

totreatлечить

treatmentлечение

medicine1 медицина 2 терапия,

консервативное лечение 3

лекарственный препарат tosufferfromстрадать от

(болезни)

unitотделение в стационаре, специализированный кабинет в поликлинике districtdoctorучастковый врач tobeoncallзд. ходить по вызовам, посещать больных на дому emergencyсрочность emergencyambulanceserviceскорая (неотложная) помощь emergentсрочный toemergeзд. появляться,

возникать researchисследование;

исследовательский todoresearch (intotheproblem...) проводить научные исследования (по проблеме...) primarymedicalcareпервичная

медицинская помощь, toprovidemedicalcareоказывать, предоставлять медицинскую помощь toequipоборудовать, снабжать tobeequippedwithбыть оборудованным чем-либо equipmentоборудование Mother-and-ChildHealthCareCentreЦентр охраны здоровья матери и ребенка foetusплод, зародыш «intra-uterinepatient»

«внутриутробныйпациент» private medical practiceчастная

медицинскаяпрактикаmedical insuranceмедицинское

страхованиеscienceнаукаscientistученыйscientificнаучныйHIV (human immunodeficiency virus) ВИЧ (вирусиммунодефицитачеловека) ТВ(tuberculosis)туберкулезcoronary artery bypass grafting аорто-коронарноешунтированиеpercutaneous transloominal coronary angioplasty чрезкожнаятранслюминальнаякоронарнаяангиопластика

Упражнение 6. Ответьте на вопросы вашего товарища. Используйте в ответах слова, данные в скобках.

1. What were the British doctors acquainted with? (health care, pre­ventive, curative) 2. What is the characteristic feature of health care in our country? (to pay attention to; prophylaxis) 3. Where is the primary medical care provided? (polyclinic, out-patient department, ambulant patients, district doctor) 4. What do you know about the work of a district doctor? (to be on call, to visit patients in their homes, to see 5. What are the problems facing medical science in our country? (pre­vention, treatment, cardiovascular diseases, oncological diseases, artifi­cial organs, to do research into, infectious diseases, HIV, ТВ, to intro­duce, modern minimally invasive surgical techniques).

Упражнение 7. Прочтите следующие утверждения и выразите согласие или несогласие. НачнитесвоиответысословI believe you are right saying that.,или:In my opinion you are not quite right...

1. Prevention of diseases is the main principle of health care 2. in our country. 2. There are private clinics in Russia and some medical institutions are not financed by the state. 3. Large industrial enterpris­es do not provide medical care for the workers. 4. Periodic screening is restricted only to ТВpatients and does not involve patients with hy­pertension, coronary heart diseases, and diseases of the GIT (gastro­intestinal tract).

Упражнение 8. Ваш товарищ работает фельдшером (doctor'sassistant) на станции скорой помощи. Попросите его рассказать, как и кому оказыва­ется скорая медицинская помощь. Используйтеследующиесловосочета­нияввашек^беседе.

emergency medical service, to deal with urgent cases, free of charge, to dial 03 for the doctor to come, blood-transfusion equipment, cases of myocardial infarction, acute heart disease, to handle any emergency, to give emergent treatment

Упражнение 9. Прослушайте (прочитайте) диалог. Скажите, какой вопрос обсуждался на занятии по терапии.

Dialogue

Teacher: Dear colleagues, you know, patients are not used to talking about their bodily functions and abnormalities. Very often they cannot easily find the precise words to describe the character of their pain and of the kind of cough ([kof] кашель) that they have, and so on. Today we'll lalk about pain. The words «pain» and «ache» mean the same thing.

Student If «pain» and «ache» mean the same thing, then we may ask our patient if he has an ache in his shoulder, for example. It's correct, isn't it?

Teacher: No, you are mistaken. The thing is that both of these words are nouns but the word «ache» can be used only with the following words to form a compound noun: backache, headache, earache, stom- ach-ache, toothache. For the other parts of the body we say: «I have a pain in my shoulder, chest», etc.

Student: Is it possible to have pain in the back or in the head?

Teacher: Yes, it is possible to have pain in the back, head and stom­ach but this generally refers to a more serious condition than backache, headache and stomach-ache. /

Student: Can we use the word «ache» as a verb? Is it possible to say j «My tooth is aching»? i

Teacher: Quite so. The word «ache» can also be used as a verb. And the patient may say: «My leg aches after much walking», or «My bade aches after gardening». /

Student: And what about the word «hurt»? My patient told me: «Ifly i chest hurts when I cough». f

у

Teacher: The word «hurt» is another verb used to express injury and t

r.

pain. So it's absolutely correct when patients describe their complaint! L (жалобы) as: «My chest hurts when I cough» or «My neck hurts when \

I turn my head». It means that coughing causes pain in the chest. f

)

Упражнение 10. Прочитайте диалог еще раз и объясните разницу в ? употреблении английских слов:«pain», «ache», «hurt».

Упражнение 11. а) Прослушайте (прочитайте) диалог и скажите, какую проблему обсуждают американская студентка и ее подруга из России, которая учится в США; б) прочитайте диалог еще раз и найдите англий­ские эквиваленты следующих словосочетаний:

быть больным, плохо себя чувствовать; слабость в ногах; изме­рять температуру; повышенная температура (жар); посчитать/из­мерить пульс; частый пульс; белый/обложенный язык; воспален­ное горло; заболеть гриппом (подхватить грипп)

Dialogue

Linda: You look rather pale, Marina. Are you ill? Marina: I hope not. But as a matter of fact, I have a headache and I am a little shaky in my legs.

Linda: Did you take your temperature? Marina: I did and I found that I had a slight fever. Linda: Let me have a look at your tongue and feel your pulse. First show me your tongue. It is coated (white, furred), and your pulse is rapid and irregular. Besides, you have a sore throat. Marina: Oh, yes, I see — that's why I'm feeling unwell. Linda: I fear you have caught a bad flu (influenza). You'dbetterseeadoctor.

Упражнение 12. Используя информацию и лексический материал диалога (упр. 11), разыграйте ситуацию, в которой Марина приходит на прием к врачу.

Doctor: Well, what seems to be the problem? Marina:

Doctor: How long have you had this headache? Which part of your head hurts? Marina:

Doctor:Apart from your headache are there any other problems? Marina:

Doctor: I'd just like to examine your mouth. Your tongue is coated. Any other problems? Marina:

Doctor: I am going to check your temperature and I would also like to feel your pulse. Some laboratory tests will be needed as well.

Упражнение 13. Приведенные в случайном порядке высказывания взяты из беседы врача и его пациента:

а) запишите эту беседу, поставив высказывания в логической последовательности.

б) прочитайте диалог несколько раз и постарайтесь воспроизвести его как можно ближе к тексту.

Dialogue

Patient:About 90 kilograms, I think / It usually comes after meals/ I've had pain/ Well, I'll try, but it's not going to be easy/ For about a month / Well, yes, I tend to overeat, I'm afraid / No, it is not continuous, it comes and goes/ I've always been fond of eating good things /I haven't been feeling well, doctor/ Here — just below where my heart is/

Doctor: Does it come on at any particular time?/ Show me where it hurts /Well, what seems to be the problem?/ Is your pain continuous or does it come and go?/ Do you eat big meals?/ I would like to take some measurements — we need your BMI (body mass index)/ What is your weight?/ How long have you had this pain?/ After meals?/ You'd better not eat so much/ I'll check your blood pressure first/Try to get your weight down by 5% in three months/ That is probably the cause of your pain/ Some laboratory tests will be needed : let's begin with fasting blood sugar/Let's first of all discuss your diet: no heavy meals, not so much bread, no sugar in your tea, no cake/ But before we decide on the treatment I would like to examine you/

Упражнение 14. Иностранные друзья попросили вас рассказать о вашей сестре, которая работает участковым врачом в районной поликлинике. Составьтерассказ, используяследующиесловаисловосочетания:

local polyclinic, to be on call, to visit patients in their homes, to work in shifts, to examine patients, to have the patient X-rayed, to auscultate the heart and lungs, to check the blood-pressure, to give a sick-leave^

(certificate), to diagnose, to prescribe medicine |

t

Упражнение 15. Прослушайте (прочитайте) диалог между врачом тера­певтического отделения клиники Московской медицинской академии и ординатором из Малайзии. Определитетемубеседы.

Dialogue

Resident: This patient is doing well with treatment for heart failure but I have problems in treating his hypertension.

Dr. Pavlova (head of the department): What is his case history?

Resident: He is 53. Six years ago he consulted a physician because of morning headaches. He was diagnosed to have hypertension, and weight reduction, shorter hours of work, and small doses of captopril and beta- blockers were prescribed.

Dr. Pavlova: Is there hypertension in the family?

Resident. No, there's no cardiovascular disease in the family. As I said earlier, his heart failure has been corrected but the blood pressure remains 220—180 over 120—110 mm Hg.

Dr. Pavlova: Give the patient antihypertension drugs and then we will try to find out the cause of his high blood pressure. The cause of hyper­tension may be renal, vascular or endocrine. Tomorrow we'll have the results of the laboratory tests and then we'll try to clear up the case.

Упражнение 16. Прослушайте (прочитайте) диалог еще раз. Скажите, какие утверждения соответствуют содержанию диалога.

1. а) Больной поступил в больницу по поводу почечной недоста­точности; б) Больной поступил в больницу по поводу сердечной недо­статочности. 2. а) У родителей больного отмечалась гипертония; б) Никто в семье больного не жаловался на гипертонию. 3. а) Причи­ной гипертонии может быть заболевание почек; б) Пиелонефрит не может быть причиной высокого давления.

Упражнение 17. Прослушайте (прочитайте) диалог и скажите, о чем беседуют Дима и Джон.

Dialogue

Dima: What are you reading, John?

John: It's a book «You are what you eat».

Dima:I can't understand what the book is about.

John: «If you know what you eat, you know yourself», said the philos­opher. It's important to know what we eat, it explains a lot about how our body functions. So let's find out what we know about our diet. Here are some statements which are, in fact, questions, and the answers to them. Let's test ourselves.

Dima: It sounds very interesting. What's the first statement?

John: Meat contains certain vital amino acids not found in vegetable matter - true or false?

Dima: I think, true. All the amino acids needed by the body for protein synthesis can't be obtained even from a well-chosen combina­tion of vegetables.

John: Yes, right you are. The next statement is like this: eating carrots will improve your ability to see at night — true or false?

Dima: Oh, it's very simple. Of course, it's true. Night vision depends on the presence in the retina of the eye of a pigment called «visual pur­ple». The body manufactures this pigment and requires vitamin A to do so. Carrots contain no vitamin A but they do contain large amounts of a pigment called beta carotene, which the body can convert to vitamin A. So, if you are suffering from impaired night vision due to vitamin A deficiency carrots can help.

John: Simple sugars should be included in the diet in minimal quan­tities. True or false?

Dima: Well, I think it is correct. It is known that excessive uptake of simple sugars (cakes, sweets, rolls, etc) may lead to frank obesity.

John: Yes, you are absolutely right.

Dima: What's the next statement?

John: And the next statement sounds like this. It is impossible to take too much protein — true or false?

Dima: I think it's false.

John: No. «True» is correct. Excess protein cannot be stored and thus is excreted. Nutritionists recommend that protein should make up only 10 or 15 per cent of the daily caloric allowance.

Dima: The book is really very interesting. I'd like to read it.

John: I'll give you the book in two days after I finish reading it.

Упражнение 18. Прослушайте (прочитайте) диалог еще раз.

I

1) Найдите и запишите английские эквиваленты следующих словосочетаний:

жизненно важные аминокислоты; продукты (вещества) расти­тельного происхождения; правильно (хорошо) подобранное соче­тание; организм вырабатывает; организму требуется; превращать (преобразовывать) в витамин; недостаток (дефицит) витамина; (ежедневный) рацион питания; чрезмерное потребление; ожире­ние; минимальное количество; избыток (чрезмерное количество); накапливаться (сохраняться в организме); диетолог; ежедневная норма потребления калорий

2) Используя текст диалога, сформулируйте требования к рациону питания здорового взрослого человека. Начнитесоследующейфразы:The daily diet of a normal adult should contain...; I would recommend you to...

Упражнение 19. Вы участвуете в конференции «Медицинское обслуживание в России».

а) шесть студентов вашей группы подготовили доклады по следу­ющим темам: 1. Medical care in Russia. 2. Types of medical institutions in our country. 3. The work of a district polyclinic. 4. Specialised medical care in Russia. 5. Private medical and health care institutions. Medical insurance. 6. Problems facing medical science in our country.

б) прослушайте выступления и задайте вопрос каждому докладчику.

MEDICAL EDUCATION IN THE USA

Упражнение 1.Прослушайте (прочитайте) и запомните следующие слова и словосочетания. Переведите предложения.

1. humanities гуманитарные науки.

The girl was very capable in the humanities. The humanities are in­cluded in the school cirriculum in our country.

2. academic achievement успеваемость.

In his report the Dean of the Faculty spoke about the academic achievements of the second-year students.

Academic achievement is a decisive factor in the selection of students for medical schools.

3. to assess (the general qualities of an applicant)зд.определять, оценивать (общийуровеньабитуриента).

A special committee assesses the professional qualities of young doctors.

The admission committee worked out new criteria to assess the gen­eral qualities of the applicants.

4. teaching hospital клиническая база.

Students of the Johns Hopkins University School of Medicine do (heir medical practicum at the Johns Hopkins teaching hospital.

The Johns Hopkins teaching hospital has 1050 beds.

5. a ward палата.

There are four patients in this ward.

The patient asked his ward doctor to give him some medicine for a headache.

Упражнение 2. Прослушайте и повторите за диктором (преподавателем) следующие слова. Обратите внимание на ударения.

guest [gestb^eolleague ['koli:g], committee [ks'mitti], representative |,repri'zentativ], quality ['kwolitij, competition [,kompi'tiJn], diagnosis |,daiag'nousis], patient ['peijbnt], participate [pa:'tisipeit]

Упражнение 3. Назовите пары слов, относящихся к одному лексическому гнезду.

to admit, to achieve, emphasis, academy, achievement, to concen­trate, admission, to emphasize, academic, concentration

Упражнение 4. Прочтите и переведите текст.

Medical Education in the USA

Dr. Frank Nelson and his colleagues from the Johns Hopkins Uni­versity School of Medicine had been guests for some time of the Sech- cnov Moscow Medical Academy. They had a meeting with the Profes­sors and students of the Medical Faculty. This is what Dr. Nelson told them about the training of doctors in the USA.

Dr. Nelson: To begin with, after finishing his primary school and secondary studies at the age of 18, the candidate for a medical school must complete at least three years of higher education in a college or university.

This period of college or-univefsky^tudieis is called «the pre-medical phase». The students who are taking this course of studies preparing them for a medical school are called «pre-meds». A student applies to a medical school when he has completed pre-medical studies. The appli- cation costs approximately $ 50.

Sasha Nikiforov: Dr. Nelson, would you kindly tell us about the se­lection of students for medical schools?

Dr. Nelson: Sure. Academic achievement is the most important fac­tor in the selection of students. In most medical schools candidates are required to pass the admission test. This is a national multiple-choice test. The test lasts about eight hours over a one-day period and include» questions in biology, chemistry, physics, mathematics, and English. Then, _L special admission committees have personal interviews with the appli- f cant in order to rissfeii the candidate's general qualities, his character | and his ability to study medicine. |

Nina Mironova: Dr. Nelson, is there any competition among the ар- I plicants to medical school? ■ • |

Dr. Nelson: There certainly is. I must tell you that the competition is | very high and only about half of those who apply to medical school are j accepted and begin their medical education. By the way, what we call J «medical school» is «medical institute» in your country.

Dean of the Medical Faculty: Dr. Nelson, we know that the curricu­lum of medical schools in the USA does not greatly differ from the curriculum in our medical institutes. Is that right?

Dr. Nelson: Well, the basic sciences are taught largely during the first two years of medical studies. For instance, in the first year at Johns Hopkins students study anatomy, biophysics, biochemistry, physiology, bacteriology, histology and other subjects. In the second year they study microbiology, pathology, physical diagnosis, pharmacology and laboratory diagnosis.

The curriculum of the final two years includes clinical subjects. Med­ical students do their practicum at teaching hospitals affiliated to the_w medical school. Students in small groups meet their teachers in the wards and in the out-patient departments where they participate in the treatment Of patients. v

At the end of four years all students receive the Degree of Doctor of \ Medicine, that is the M.D. Then they must work for one year as interns, This course of training at the hospital or clinic is called an internship.

Dr. Smirnov: Dr. Nelson, yesterday we spoke about the work of you^ig doctors. You told us thatbfter their internship young doctors must have a period of residency at the clinic^ For how many years must a doctor work as a resident? *

Dr. Nelson: First of all, the period of residency is obligatory for all medical graduates. This period varies, depending on the specialty of the doctor. Generally, the period of residency is three or four years. For instance, residency in surgery and neurosurgery in the Johns Hopkins School of Medicine lasts four years. Residency in internal medicine,
preventive medicine and radiology- lasts for three years. After the resi­dency, the graduate is granted a licence to practice and he may work cither in government service or in private practice.

Sasha Nikiforov: Dr. Nelson, what is the cost of medical education in America?

Dr. Nelson: Well, medical schools are gradually increasing their tuition Гееin all the universities of the USA. Only a small percentage of the students receive scholarships. The majority of the students have to work to pay for their studies. The government-financed universities charge less, while the tuition of the private colleges and universities is extremely high. For instance, when I was a student (and it's much higher now), the cost of medical studies for one academic year at the Medical School of Cornell University in New York, which is privately endowed, was as follows: Tuition — 9,100 dollars; books, instruments, etc. - 600 dollars; food

- 1,800 dollars; lodging and utilities - 1,400 dollars; health service fee

- 200 dollars; hospital insurance — 143 dollars, personal - 1,200. All in all it amounted to 14,443 dollars. These figures represent what used to he a typical budget for an academic year.

The Dean of the Medical Faculty thanked Dr. Nelson and his col­leagues for the talk and invited them to visit the clinics of the Academy.

Active Words and Word Combinations

higher education (syn. higher learning) высшееобразование

in the first (second) year на

первом (втором) курсе

medicalschoolамер. медицйнский институт

pre-medsстуденты младших курсов медицинского института

admissionstestвступительное тестирование

admissionscommitteeприемная комиссия

multiple-choicetestтестовый экзамен с ответами в виде множественного выбора

affiliated with/to a medical school

зд. принадлежащий мединституту, входящий в структуру института

participate (syn. takepart)

участвовать

DegreeofDoctorofMedicine, M.D. доктор медицины, (экв. русскому «Врач») звание, которое получают выпускники американских медицинских вузов

personalinterviewличное собеседование

residentординатор, врач, проходящий специализацию

residencyрезидентура

(ординатура), специализация

Упражнение 9. Прочтите методические указания к курсу физиологии для студентов 2 курса медицинского факультета Университета Джонса Хопкинса. Расскажите, какорганизованэтоткурсввашеминституте.

The department provides instruction in cell physiology and systems physiology for second year medical students. The general subject of physiology and certain aspects of biophysics are presented to the second year medical students in lectures given two times a week during the second trimester, and five times weekly throughout the third trimester. During the second trimester lectures on the general properties of cells are delivered. Lectures of the third trimester are devoted to systems of mammalian physiology. During the third trimester laboratory experi­ments are carried out on two days of each week by students in small groups, under the supervision of the teaching staff. The laboratory work of each week is summarized in small group conferences at which the significance of the findings is reviewed and discussed. Seminars in renal and electrolyte physiology are held throughout the third trimester, with an emphasis on clinical problems and pathological physiology.

Упражнение 10. Группа американских студентов беседует со студентами 2 курса Московской медицинской академии. Выступите в роли переводчика, Используйте в вашем переводе данные в скобках слова и словосочетания.

Игорь: Мы знаем, что вы — студенты-медики из Балтимора. Как называется ваше учебное заведение (medicalschool)?

Alan: We study at the Johns Hopkins University School of Medicinc (медицинскийинститут).

Игорь: Скажите, пожалуйста, Алан, Джонс Хопкинс был известным американским ученым?

Alan: Oh, no. Johns Hopkins was a merchant (коммерсант) of Bal­timore who gave 7,000,000 dollars for the establishment (^снование) of a university and a hospital. And in 1876, three years after Johns Hop­kins' death, the Medical School of the University began its work.

Наташа: А наша Академия названа в честь (wasnamedafter) основоположника (founder) русской школы физиологии И.М. Сеченова,

Paul: Yes, we know that Sechenov was a great physiologist. He developed the theory of brain (головноймозг) reflexes. I've read his book «Reflexes of the Brain».

Лена:СеченовзакончилмедицинскийфакультетМосковскогоуниверситета, азатемвозглавлял(to be the head of) кафедруфи­зиологии. У нас в Академии есть музей-лаборатория И.М. Сече­нова.

James: Oh, it would be very interesting to visit it. Do you think it's possible?

Саша: Конечно. Давайте пойдем в этот музей в среду в три часа после лекции по физиологии.

Alan: That will be wonderful. So, good-bye till Wednesday.

Упражнение 11. Прослушайте (прочитайте) диалог и скажите, какие вопросы интересуют английского профессора.

Dialogue

An English professor is interviewing his American colleague.

Dr. Kelly: I'm glad to have this opportunity to talk to you, Dr. Bar­ton. Do you mind my asking some questions about medical school in America?

Dr. Barton:Certainly not. What do you want to know?

Dr. Kelly: First, can students go to a medical school free of charge?

Dr. Barton: No, everyone must pay a tuition fee. The amount varies from state to state and from one school to another. A student's total expenses throughout the year are about several thousand dollars. This creates financial hardship for some people. Though each school offers a number of grants, many of the students have to work to pay part of their expenses.

Dr. Kelly: What degree does a Medical School offer?

Dr. Barton:After completing 4 years all students receive the Degree of Doctor of Medicine.

Dr. Kelly: That clears up most of my questions, Dr. Barton. It's good iоhave this information from someone directly connected with the world of medicine. I hope to visit two medical schools — the Pritzker School and the Kansas University Medical School — while I'm here in the United States.

Dr. Barton: It was a pleasure to talk with you.

Упражнение 12. а) прочитайте диалог (упр. 11) и найдите английские жвиваленты следующих словосочетаний:

бесплатно учиться в медицинском вузе; плата за обучение; общие (суммарные) расходы; создавать финансовые/материальные итруднения; предоставлять гранты; получать звание (степень).

ft) используя диалог в качестве модели, составьте новый диалог между российским и американским студентами-медиками. Расспросите друг друга об изучаемых предметах, о вступительных экзаменах и конкурсном отборе и т.д.