I. Transform direct speech into reported speech.

1. Helen says, “I suffer from severe headaches beginning in the morning and worsening during the day”.

2. Dr. John Smith is going to say, “I have already completed the diagnosis”.

3. The patient will say, “I am being explained the treatment plan and prognosis now”.

4. The physician has said, “On Monday I’ll order blood and urine tests, electrocardiogram and magnetic resonance imaging for you”.

You must change the tense in the reported speech if the introductory clause is in past. This is called backshift. The basic rules for backshift when transforming direct speech into reported speech are:
Direct Speech	Reported Speech
Present Indefinite	Past Indefinite
Present Continuous	Past Continuous
Present Perfect Past Indefinite Past Perfect	Past Perfect
Past Continuous Present Perfect Continuous Past Perfect Continuous	Past Perfect Continuous
Future Indefinite (Perfect, Continuous, Perfect Continuous)	Future Indefinite (Perfect, Continuous, Perfect Continuous)-in-the-Past
The verbs could, should, would, might, must, needn’t, ought to, used to do not normally change. (He said, “She might be right.” – He said that she might be right.) Backshift of Present Indefinite is optional if the situation is still unchanged or if you agree with the original speaker. (She said that Canberra is/was the capital of Australia.) Past Indefinite and Past Continuous don’t normally change in sentences with when/if. He said, “When I was questioning the patient, the telephone suddenly rang”. – She said that when she was questioning the patient, the telephone suddenly rang.

II. Transform direct speech into reported speech. Pay attention to backshift.

1. Describing his general state the patient said, “I suffer from migraine and have trouble sleeping”.

2. The student answered, “I am writing a report on the approaches of making a provocative diagnosis”.

3. “The district doctor isn’t in his consulting room, he has left for visiting the sick patients at home”, the nurse said to us.

4. The physician said to Peter’s mother, “We decided to perform biopsy in order to confirm or disprove the proposed diagnosis”.

5. “I had learnt the main techniques of obtaining a correct diagnosis before I gave the textbook back to Mike”, Lily said to me.

6. The exhausted patient complained, “For an hour and a half I was being asked every possible question concerning the symptoms, general state of health, bad habits, etc. in order all possible data were collected”.

7. The doctor in charge of the case spoke first, “We’ve been talking it over since we performed computed tomography scanning”.

8. “For two days the doctors had been trying to reach a diagnosis on the basis of examination and testing before the diagnosis of exclusion was made by elimination of other reasonable possibilities,” Alice explained to her granny.

9. The lecturer said, “You’ll have to know in detail all the available information on the decision tree used for most diagnostic hypothesis”.

10. The health care provider ensured, “The diagnosis will have been reached by Friday as only on Thursday we’ll know the results of the laboratory tests”.

11. The nurse tried to calm dawn the child, “The teddy bear will be playing with you while the doctor will be listening with a stethoscope as you breathe”.

12. The neurologist says to my mother who suffers from migraine headaches, “You must take the drugs every day to prevent migraine attacks from recurring”.

13. My friend who is a medical student explained to me, “Diagnosis is the process of determining the nature of a disorder by considering the patient’s signs and symptoms, medical background, and – when necessary – results of laboratory tests and X-ray examinations”.

Direct Speech	Reported Speech
this these here now today yesterday the day before yesterday last month five days ago tomorrow the day after tomorrow next year in two weeks	that those there then, at that time that day the day before, the previous day two days before the month before, the previous (preceding) month five days before, five days earlier the following day, the next day, a day later two days later the following year, the next year, a year later two weeks from then