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2. … pretty smile, Tom.
3. …cute jeans, Willy.
4. … nice bows
5
, Kitty.
5. …. great teddy bear, Bil ly.
6
6. … cool sneakers
, Harry.
4. Practise other expressions to pay a compli ment.
I like your + noun
Example: I l ike your jeans, Ed.
What a + adjective + noun
Example: What a cute te ddy bear!
13. Work in pairs. Practise using the phrases in Exercise 11 (b) in these scena-
rios:
1. Kitty, a five-year-old girl, is very shy. She’s come with her favourite toy, a
teddy bear.
2. Mike, a six-year-old boy, has brought a new transformer .
3. Dolly, a seven-year-old girl, is wearing a fashion pink skirt and blouse. She
has a new model of Barbie in her hand.
4. Nick, an eight-year-old boy, is very proud of his jeans and trainers his parents
presented h im for his birthday.
14. As the interview progresses, it is important for a doctor to acknowledge
a child’s feelings, to show empathy, and to ask a child for a permission before
examining them. Listen to the continuation of the dialogue in Exercise 7 and
fill in the gaps:
Doctor: OK, Billy, now your mummy tells me that you have a nasty cough and it
keeps you awake at night. Is that right?
5
bow – бант
6
sneakers (US English) – trainers
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Billy: Yes.
Doctor: Are you _______ sad?
Billy: Yes, I’m tired.
Doctor: I can _______ why you’re feeling sad.
Mrs. Jones: And you can’t eat your favourite cereal in the morning at the moment
because it ______ you cough, doesn’t it, darling?
Billy: Yes.
Doctor: Oh, dear, that is a nasty cough, isn’t it? _____ ____have you had it for?
Billy: I got it on Friday and I couldn’t _____ ______ all weeke nd.
Doctor: You must have missed that, Billy. Well, what I need to do is to have a
look at your chest to ______ _____ where that nasty cough of yours is coming
from. Will you let me look at your chest, Billy?
Billy: OK.
1. How does the doctor s how empathy and support?
2. Does the doctor share Billy’s thoughts and f eelings? Give examples.
3. Does the doctor explain why the examination is necessary?
4. Does the doctor ask for permissi on to examine him?
5. Does the doctor gain Billy’s trus t and co-operation? Give your comments.
15. Study the f ollowing constructions. Practise to show empathy:
1. That/You must + infinitive
Example: You must be tired.
2. That/You m ust + perfect infinitive
Example: You must have missed that, Billy.
1. That must be difficult for you.
2. You must feel a lot of pain.
3. You must feel sad.
4. You must have been disappointed.
5. You must have been upset.
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16. Work in pairs. Practise using t hese phrases in the fol lowing situations:
1. A nine-year-old boy has come to see you because he has a nasty cough. He
tells that he had to m iss the school football championship.
2. A ten-year-old girl has come to see you because she has stomach cramps and
a runny tummy. She’s upset she can’t go to her fr iend’s birt hday party today.
3. A six-year-old boy has come to see you because he has an earache. It kept
him awake at night.
17. Read the dialogue in Exercise 5 and make changes to improve the consultation. Role-play the improved dialogue.
Remembe r to:
• Introduce yourself an d clarify your role.
• Make sure the child is comfortable.
• Pay the child a compliment.
• Show empathy and support.
18. Make up your own dialogues.
19. Read text I and discuss the difference between the two visits:
Text I. Two Consultations
When I was 14 years old my mother took me to see a doctor about some skin
lesions on my face and neck. The doctor was reputed to be one of the best in town.
At his clinic, we paid consultation fee and waited in a queue. After about 20 minutes, somebody called out my name and asked us to enter the doctor’s room. During the check up, I explained all my problems to him. He examined my lesions,
quickly wrote down a prescription of drugs and asked us to come for follow-up after a week. It hardly took a minute for him to see us off.
I hadn’t expected such a short consultation and felt he hadn’t given me
enough time to explain about my problems and treatment in detail. Though he gave
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me a prescription, he failed to give any assurance or encouragement. I know my
mother felt the same. I used the drugs that he had prescribed, and they cured my
problem. But I never came back to him for follow-up.
About a year ago, I accompanied my sick mother to another doctor for a
very different consultation. Firstly, my mother explained all her problems in detail.
The doctor listened carefully and, after thoroughly examining her, told us all about
the disease she had and the treatment he was going to give. Finally he asked her if
she understood everything. My mother nodded happily. I could see from her face
how happy and relieved s he felt after this cons ultation.
Now I am in my final year at medical school. Looking back at those two
consultations, I think they epitomize bad and good doctor-patient relationships. I
see many patients daily; as a student, I can’t give them anything but assurance,
support, hope, and my time to listen to their concerns. I know it helps them. This
reinforces my belief that the best management strategy for a patient can be made
stronger when laid on a strong foundation of a go od doctor-patient relat ionship.
(Taken from Good Practice, McCullagh and Wright, 2008)
20. Read the text II and give its summary:
Text II. History Taking
Children and Doctors
The history
A structured approach to history taking is important to avoid forgetting
things, but this must not become too rigid, as it is sometimes necessary to pursue a
different line of questioning to gain essential information. The table opposite is a
list of useful he adings in pediatric history taking, and this should be memorized.
Talking to the child
Children should be asked to give their account of events with parental corroboration. Children under 5 years old will lack the vocabulary and communication
skills to describe their sym ptoms, but will be able to point to par ts tha t hur t.
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Talking to the parents
Most of the history is likely to be gained from the parents or guardians.
• Ask if they have the infant medical record book ”this contains information
about height and weight centiles, immunizations, development, and illnesses
in the first f ew years of life.
• Ask whether the parents have any views on what the cause of the child's
trouble is. Listen carefully to the parents; they are acute observers of their
children.
• Ensure that all terms used are appropriately defined and you should be
gleaning information from the parents' observations and not their interpreta-
tion of the symptoms. Further, the parent may interpret a baby's cries as pain
when, in fact, it is your task to establish the circumstances of the cries and,
therefore, the cause.
• As children get older, the parents ma y have a hazy memory for early events.
Establishing symptoms in relation to easily remembered events (e.g. first
walked) m ay clarify the timeline.
Outline of paed iat ric hist o ry
• Presenting complaint and history of presenting compla int.
• Birth history :
o Place of birth.
o Gestation and pr e gna nc y .
o Birth weight.
o Delivery.
o Perinatal e vents and SC BU admission.
• Feeding methods and weaning.
o If bottle fed, note how the bottle fee d is mixed (how many
scoops/num be r of ounc e s).
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• PMH including hospital admissions, infections, injuries.
• Developm enta l hi story.
• School progr ess.
• Immunizations.
• Drugs.
• Allergies.
• Family tree with sibli ng's ages, in cluding de aths, miscar riages, and sti ll-
births.
• Parental age and occupation.
• Family illnesses and allergies.
• Housing.
o This should include a discussion about the chi ld's bedroom as they
may spend 12 hours of eac h day there.
• Travel.
• Systems review
You can do anything with children if you only play with them.
21. Translate the text III, give its abstract:
Text III. The Examin at ion: an Approach
Examination in children varies depending on the age and co-operation of the
child. School-age children and babies may be examined on a couch with a parent
nearby, whereas toddlers are best examined on the parent's lap. If the child is asleep on the parent's lap, much of the examination should be completed before waking them up.
Undressing
Let the parent undress the child: and only expose the part of the body you
will be examini ng.
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Positioning
Some children may prefer to be examined standing up. Only lay the child
down when you have to, as this can be ve ry threatening.
Putting the chi ld at ease
Slowly introduce yourself to the child's space during the examination by exchanging toys, for example.
Explain what you are going to do and be repeatedly reassuring, children can
be embarrassed by silence after a doctor's question, but will be comforted by endless natter ing. And remember-don't ask permission, as this will often be refused!
The examination
Firstly, use a hands-off approach. Allow the child to look at you, and let
them play in your presence. Watch the child. How do they interact with their parents? Do they look well or ill? Do they look clean, well nourished, and well cared
for?
Kneel on the floor so that you are at the child's level. Use a style and language appropriate to the age of the child, a toddler will understand the word
˜”tummy” better than the word ˜” abdomen”.
Be opportunistic
Do not adhere to a rigid examination schedule, e.g. you may have to listen to
the heart first while the child is quiet, then look at the hands later. Never examine
the presenting part only. Be thorough and train yourself to be a generalist. Leave
unpleasant pr oc ed ures, such as examination of the tonsils, until last.
Presenting yo ur fi n ding s
When presenting your findings, translate what you see into appropriate terminology. Informing a senior that a child looks funny is not very helpful but the
saying the child is dysmorphic, followed by a detailed description is acceptable.
Describe in simple terms the relevant features that make the child look unusual,
e.g. low set e ars, wide set e yes.
There is no substitute f or examini ng lots of normal children.
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Paediatrics is a specialty bound by age and not by system. Some distraction
private doct or
частный врач
resident
врач-стажёр (проходящий последипломную
to inoculate
делать прививку
inoculation
прививка
consulting physician
врач-консультант
disability
нетрудоспособность, инвалидность
the disabled
Инвалиды
retirement benefits
пенсионные выплаты
emergency unit
отделение неотложной помощи
the injured
пострадавшие, раненые
the blind
незрячие, слепые
Medicare
правительственная программа, предусматри-
techniques to help with examination
• Playing peek-a-boo.
• Letting toddlers play with Letting toddlers play with your stethoscope.
• Giving infa nts somethi ng to hold.
• Asking mum or dad to wave a bright toy in front of t hem.
Unit 2. Health Care Abroad
Health Care in the USA
1. Read and learn the words by heart:
ACTIVE VOCABULARY
клиническую подготовку после интернатуры)
вающая частичную оплату медицинского об-
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служивания престарелым за счет страхования,
остальную часть – за счет государства
Medicaid
социальная правительственная программа,
dependent c hildren
несовершеннолетние дети
the aged (syn. the elderly)
пожилые, старые люди
stroke
инсульт
mental dise ases
психические заболевания
drug addiction
пристрастие к наркотикам, наркомания
staff
штат
trauma
Травма
insurance
Страхование
to regard
касаться, иметь отношение
employee (employe
Служащий; работающий по найму
cost
цена, стоимость
to force smb to do smth
вынудить (кого-л.) сделать что-л.
income
Доход
expense
трата, расход
обеспечивающая бесплатное медицинское об-
служивание беднякам и инвалидам
(амер.))
2. Translate the word combinations with the given key-words:
private: private doctors; private medical practice; private patients; private treat-
ment; private in s ura n ce com pan ie s
hospital: gove r nment-financed hospi tal; hospital facilities; priva te hospitals
provide: provided; provides; to provide primary medical care; to provide health
care to the sick and injured; to provide free medical care
consult: consults; consulted; consulting; consulting physician; consulting hours;
consultati on centre; consulting room
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3. Read and translate:
1) the level of the family doctor
a) это заставило федеральное прави-
2) to give inoculations
b) делать прививки
3) hospital’s facilities
c) основные отделения
4) health care to the sick and injured
d) на протяжении всего пребывания
5) throughout the patients’ stay in the
e) уровень семейного врача
6) major departments
f) малоимущие
7) disability insurance
g) больничное оборудование
8) it forced the federal government to
h) страхование по инвалидности
9) low-income people;
i) медицинская помощь больным и
10) providing free medical care
j) обеспечивающий бесплатную ме-
medical examination, regular inoculation, directly, necessary, treatment, important,
personal, psychiatric, insurance , employm ent, scient ific, cardi ovascular, mental
4. Match Russian and English equiv alents:
тельство разработать две программы
по страхованию здоровья
пациентов в больнице
hospital
develop two hea lth in sur a nc e pro gra ms
пострадавшим
дицинскую помощь
5. Read and translate t he followin g word-combinations:
directly from the patient, own private office, government-financed hospitals , clinics staffed by consulting physicians, intensive care unit, health insurance, continued illness, place of employment, maternal and child health care, retirement benefits, great cost of me dical care