Unit 5

Section (A)

Graceful Hands


I have never seen Mrs. Clark before, but I know from her medical chart and the report I received

from the preceding shift that tonight she will die.

The only light in her room is coming from a piece of medical equipment, which is flashing its red light

as if in warning. As I stand there, the smell hits my nose, and I close my eyes as I remember the smell

of decay from past experience. In my mouth I have a sour, vinegar taste coming from the pit of my

stomach. I reach for the light switch, and as it silently lights the scene, I return to the bed to observe

the patient with an unemotional, medical eye.

Mrs. Clark is dying. She lies motionless: the head seems unusually large on a skeleton body; the skin

is dark yellow and hangs loosely around exaggerated bones that not even a blanket can hide; the right

arm lies straight out at the side, taped cruelly to a board to secure a needle so that fluid may drip in;

the left arm is across the sunken chest, which rises and falls with the uneven breaths.

I reach for the long, thin fingers that are lying on the chest. They are ice cold, and I quickly move to

the wrist and feel for the faint pulse. Mrs. Clark's eyes open somewhat as her head turns toward me

slightly. I bend close to her and scarcely hear as she whispers, "Water." Taking a glass of water from

the table, I put my finger over the end of the straw and allow a few drops of the cool moisture to slide

into her mouth and ease her thirst. She makes no attempt to swallow; there is just not enough strength.

"More," the dry voice says, and we repeat the procedure. This time she does manage to swallow some

liquid and weakly says, "Thank, you."

She is too weak for conversation, so without asking, I go about providing for her needs. Picking her

up in my arms like a child, I turn her on her side. Naked, except for a light hospital gown, she is so very

small and light that she seems like a victim of some terrible famine. I remove the lid from a jar of skin

cream and put some on the palm of my hand. Carefully, to avoid injuring her, I rub cream into the

yellow skin, which rolls freely over the bones, feeling perfectly the outline of each bone in the back.

Placing a pillow between her legs, I notice that these too are ice cold, and not until I run my hand up

over her knees do I feel any of the life-giving warmth of blood.

When I am finished, I pull a chair up beside the bed to face her and, taking her free hand between

mine, again notice the long, thin fingers. Graceful. I wonder briefly if she has any family, and then I see

that there are neither flowers, nor pictures of rainbows and butterflies drawn by children, nor cards.

There is no hint in the room anywhere that this is a person who is loved. As though she is a mind

reader, Mrs. Clark answers my thoughts and quietly tells me, "I sent ... my family ... home ... tonight ...

didn't want ... them ... to see ..." Having spent her last ounce of strength she cannot go on, but I have

understood what she has done. Not knowing what to say, I say nothing. Again she seems to sense my

thoughts, "You …stay …"

Time seems to stand still. In the total silence, I feel my own pulse quicken and hear my breathing as

it begins to match hers, breath for uneven breath. Our eyes meet and somehow, together, we become

aware that this is a special moment between two human beings ... Her long fingers curl easily around

my hand and I nod my head slowly, smiling. Without words, through yellowed eyes, I receive my thank

you and her eyes slowly close.

Some unknown interval of time passes before her eyes open again, only this time there is no response

in them, just a blank stare. Without warning, her shallow breathing stops, and within a few moments,

the faint pulse is also gone. One single tear flows from her left eye, across the cheek and down onto the

pillow. I begin to cry quietly. There is a swell of emotion within me for this stranger who so quickly

came into and went from my life. Her suffering is done, yet so is the life. Slowly, still holding her hand, I

become aware that I do not mind this emotional battle, that in fact, it was a privilege she has allowed

me, and I would do it again, gladly. Mrs. Clark spared her family an episode that perhaps they were not

equipped to handle and instead shared it with me. She had not wanted to have her family see her die,

yet she did not want to die alone. No one should die alone, and I am glad I was there for her.

Two days later, I read about Mrs. Clark in the newspaper. She was the mother of seven,

grandmother of eighteen, an active member of her church, a leader of volunteer associations in her

community, a concert piano player, and a piano teacher for over thirty years.

Yes, they were long and graceful fingers.

Words: 910

New Words

　graceful a. 1.优美的，优雅的 2.得体的
　chart n. 图，图表
vt. 制图表
　preceding a. 在前的，在先的，前面的
　decay n. 变坏，腐烂，衰败
vi. 1.腐烂，变坏 2.衰退，衰落，衰败
　vinegar n. 醋
　pit n. 1.坑 2.矿井，煤矿
▲skeleton n. 1.骨骼，骨架 2.梗概，提要
　loose a. 1.宽松的，不紧的 2.自由的，散漫的
　loosely ad. 松地，大致地
　secure vt. 1.关紧，固定 2.使安全，保护 3.得到，获得
a. 1.安全的 2.牢固的 3.无忧的，安心的
　fluid n. 液体，流体
　drip v. 滴
n. 1.(连续落下的)液滴 2.一滴
　faint a. 1.微弱的 2.虚弱
　pulse n. 脉搏
vi. 搏动，跳动
　straw n. 1.吸管，麦管 2.稻草，麦杆
　moisture n. 潮湿，湿气
　slide v. 1.（使）滑动 2.（使）悄悄地移动
n. 1.滑，滑行 2.幻灯片
　thirst n. 1.渴，口渴 2.渴望
　liquid n. 液体
　naked a. 1.赤身的，裸露的 2.赤裸裸的，无遮蔽的
▲gown n. 女长服；罩衣
　famine n. 饥荒
　lid n. 盖，盖子
　jar n. 罐子，坛子
　palm n. 1.手掌，掌心 2.棕榈树
　injure vt. 伤害，损伤
　outline n. 1.轮廓，外形 2.要点，大纲
vt. 概述
　pillow n. 枕头
　rainbow n. 虹，彩虹
　butterfly n. 蝴蝶
　hint n. 1.细微的迹象 2.暗示，提示
v. 暗示
　reader n. 1.读者 2.读物，读本
　ounce n. (重量单位)盎司
　being n. 1.生物，人 2.存在
　interval n. 1.间隔，间距 2.幕间休息，中场休息
　blank a. 1.茫然的，无表情的 2.空白的，无字的，空着的
n. 空白
　shallow a. 1.(呼吸)浅的，弱的 2.浅的 3.肤浅的，浅薄的
n. 浅水处，浅滩
　emotion n. 情感，感情，激情
　privilege n. 特权，优惠
　episode n. 1.一个事件，一组事件 2.(尤指电视或无线电广播的)一集，一出，一部分
　association n. 1.协会，社团，组织 2.联合，结交，结合



Phrases and Expressions

　the pit of the stomach 胸口，心窝
　hang around sth. (使)在……上挂着， （使）围在……上
　so that 为的是，以便
　reach for 伸出手以触到或拿到
　feel for （用手、足、棍等）摸索，寻找
　turn towards 转向
　bend to 俯向
　make an attempt to do sth. 尝试，企图
　go about doing sth. 着手处理，开始做
　provide for sth. 为可能发生的事做安排
　pick sb. up 举起，抱起
　pull up 把... ...拉过来，把... ...拉向前



Proper Names

　Mrs. Clark 克拉克夫人


Section (B)

Decisions of the Heart


Assume for a moment that your 90-year-old mother has recently suffered a stroke. She is right-

handed, and now she is unable to move her right arm and leg — they are worthless to her. She can

make sounds, but she can't make herself understood.

The condition has lasted two months and since there has been no sign of improvement, the doctor

tells you she will never get significantly better. Until this time your mother has always been an active,

independent person who lived on her own. Now she is completely dependent on others.

Next, x-rays show your mother has a lung infection — a frequent problem with stroke patients. The

doctor then calls you, her only surviving relative.

"We can treat the infection with drugs and she'll probably get better in a week," he says. "When I say

better, I mean she'll go on as she has — until some other germ comes along. Or I can deny her the

medicine, in which case she'll probably die in three or four days. We can make those days comfortable

by giving her painkillers and sleeping pills. Which course do you want me to follow?"

Tough question, isn't it? On the one hand, you cannot bear to see your once vigorous mother living

the painful, limited life to which the stroke has condemned her. On the other hand, you hate to be the

one to decide to let nature take its course.

I'll tell you which choice I would make in this theoretical situation. I'd say, "Don't give her anything to

fight the infection. Keep her comfortable and let's see what happens; maybe she'll fight off the infection

on her own and if she doesn't, she'll die a peaceful death. I don't want to be responsible for condemning

my mother to a living hell."

I can make this decision because I've gone down this road with patients many times. Recently I

operated in vain on an eighty -year-old woman with cancer of the liver ... There was nothing I could do

to relieve the problems the cancer had caused. She was an intelligent woman, without any close

relatives, and a couple of days after the operation I sat down with her and explained the situation.

"I can give you some anti-cancer drugs," I said, "but they will make you sick and cannot cure you.

Similarly, I can give you fluids through a needle in your arm, which will keep you fed as your appetite

slips away; the fluids might add a week or two to your life. Or I can withdraw all other treatment and

just give you a vitamin pill, and we can see what happens. Personally, my recommendation would be

the last choice. I'll keep you comfortable, and we'll see what happens."

The patient elected to follow my advice and died peacefully, pain free, a fortnight later.

Sometimes such a transparent decision is more difficult to come by. Recently I had a patient who

suffered a severe stroke. He was completely unable to move and couldn't swallow anything. We gave

him fluids for the first two weeks and then fed him through a tube which passed through his nose into

his stomach.

After three weeks he was still completely unconscious, and the tube caused him to have a constant,

painful sore throat ... I talked to his four grown children and told them I thought we should insert a

tube directly into his stomach through a small hole so he could be fed without so much pain. I also told

them, "I can remove the tube and just let him swallow whatever he can. Chances are he won't live long,

but he won't be in pain." No one wanted to take the responsibility for permitting an operation, yet no

one would give permission to stop feeding the patient entirely.

As a result, the poor man continued on for nearly three more months with a painful throat and

frequent bleeding caused by sores in the mouth. He died of a major infection - a sad way to die.

So what should responsible persons do when confronted with the necessity of such an enormous

decision?

What it all comes down to is common sense. For the 30 years I have been a doctor, and for hundreds

of years before that, doctors and families have been quietly cooperating to decide what is best for a

patient in the final phase of an illness.

In 95 percent of the cases a sympathetic, reasonable decision can be made after appropriate

discussion. In 5 percent of cases where such a judgment cannot immediately be reached, the proper

decision will become apparent after a few days or weeks of basic treatment, observing the patient's

progress.

Let me sound one note of warning. Neither families nor doctors like to make life-death decisions. But

there is no question that if either party insists on bringing in a so-called "neutral"; third party (usually

some representative of the state or legal profession), not only will the process take longer, in many

instances it will be more arbitrary and less sympathetic.

What we are trying to avoid is neutrality; the only people with any qualification to decide are those

who know the patient intimately and can put his or her interests first. If there's one place from which

the interference of lawyers and government officials should be barred, it's from the rooms of critically ill

patients.

Words: 902

New Words

　stroke n. 1.中风 2.击，打，敲
vt. 抚摸
　worthless a. 无价值的，没有用处的
　dependent a. 1.依赖的，依靠的 2.取决于... ...的
　x-ray n. 1. [C] X光照片 2. [C] X射线; X光
■infection n. 1.传染病 2.传染，感染
　germ n. 1.微生物，病菌，细菌 2.萌芽，起源
　deny vt. 1.拒绝给予，拒绝……的要求 2.不承认，否认
　condemn vt. 1.迫使……陷于不幸的境地 2.批评，谴责 3.判……刑，给……定罪
　theoretical a. 1.理论（上）的，假设的，推理的 2.根据理论（而非实践）的
　hell n. 1.地狱 2.极不愉快的经历（或事） 3.用以表示愤怒或惊讶，或用以加强语气
　vain a. 1.不成功的，无效的，没有意义的 2.自负的，虚荣的
　eighty num. 八十
　liver n. [C, U] 肝
　relieve vt. 1.减轻，解除（痛苦、疾病等） 2.救济，援助
　similarly ad. 也; 同样地， 类似地
　withdraw vt. 收回，撤消，撤退
vi. 缩回，退出，撤退
　recommendation n. 1.建议，忠告 2.推荐，介绍
　elect vt. 1.选择，决定 2.选举
　fortnight n. 十四天，两星期
　transparent a. 1.明显的，无疑的 2.透明的
　tube n. 1.管，软管 2.（伦敦的）地下铁道
　throat n. 咽喉，喉咙，嗓子
　insert vt. 插入，嵌进
　permission n. 许可，准许，同意
　necessity n. 1.必要性，需要 2.必需品
　cooperate vi. 合作，协作，配合
　phase n. 阶段，时期
vt. 分期计划，按阶段执行
　sympathetic a. 1.有同情心的，表示同情的，同感的 2.表示好感或赞同的
　so-called a. 所谓的，号称的
　neutral a. 1.中立的 2.（化学）中性的
　profession n. 1.（尤指需要特殊训练或专门知识的）职业 2.行业，（某一）职业界 3.声明，表白
　arbitrary a. 任意的，武断的；专断的
　qualification n. 1.能力，条件；合格性 2.资格，资历
　intimate a. 1.亲近的，亲密的 2.私人的，秘密的
vt. 暗示，提示
　intimately ad. 亲密地，私下地
　interference n. 干涉，干预
　bar vt. 1.阻止，不许 2.阻碍，阻塞
n. 酒吧，吧台



Phrases and Expressions

　make oneself understood 使他人明白自己的意思，说清楚自己的意思
　on one's own 单独，独自 独立地
　be dependent on 依赖，依靠
　treat with 以... ...治疗，用... ...治病
　go on （情况、形势、状态等）持续不变
　come along 到达，出现
　on the one hand …on the other hand… 一方面... ...另一方面... ...
　condemn sb. to sth. 使某人做不愿做的事，把某人逼入某种状态
　take its course 任其自然发展，按常规进行
　fight off 抵抗，击退，避开
　be responsible for 对……负有责任
　in vain 无结果地，无用地
　come by 努力获得
　chances are (that…) 可能
　confront with 使面对（问题、挑战等）
　die of 死于
　come down to 归结为，实质上是
　bar… from 禁止某人做某事

Section (C)

Generations


My mother called last week to tell me that my grandmother is dying. She has refused an operation

that would delay, but not prevent, her death from cancer. She can't eat, she has been bleeding, and her

skin is a deep yellow color. "I always prided myself on being different," she told my mother. "Now I am

different. I'm yellow."

My grandmother was born in Russia to a large and prosperous Jewish (犹太人的) family. But the

prosperity didn't last. She tells stories of attacks by other Russians when she was twelve. Soon after

that, her family moved to Canada, where she met my grandfather.

Their children were the center of their life. Though they never had much money, my grandmother

saw to it that her daughter had speaking lessons and piano lessons, and assured her that she would go

to college.

But while she was at college, my mother met my father, who was blue-eyed and yellow-haired and

not Jewish. When my father sent love letters to my mother, my grandmother would open and then

hide them.

After my grandfather died, my grandmother lived, more than ever, through her children. When she

came to visit, I would hide my diary. She couldn't understand that some things were private. She

couldn't bear it if my mother left the house without her.

This desire to possess and control others made my mother very angry (and then guilty that she felt

that way, when of course she owed so much to her mother). So I felt the anger that my mother — the

good daughter — would not allow herself. I — who had always performed especially well for my

grandmother, danced and sung for her, presented her with kisses and good report cards — stopped

writing to her, ceased to visit.

But when I heard that she was dying, I realized I wanted to go to see her one more time. Mostly to

make my mother happy, I told myself (certain patterns being hard to break). But also, I was

presenting to her one more particularly fine achievement: my own dark-eyed, dark-skinned, dark-

haired daughter, whom my grandmother had never met.

I put on my daughter's best dress for our visit, the way the best dresses were always put on me, and

I filled my pockets with small cookies, in case my daughter started to cry. I washed her face without

mercy. Going up to Grandma's hospital room, I realized how much I was sweating.

Grandma was lying flat with her eyes shut, but she opened them when I leaned over to kiss her. "It's

Dorothy's daughter, Kathleen," I shouted, because she doesn't hear well anymore, but I could see that

no explanation was necessary. "You came," she said. "You brought the baby."

Laurie is just one year old, but she has seen enough of the world to know that people in beds are not

meant to be so still and yellow, and she looked frightened. I had never wanted, more, for her to smile.

Then Grandma waved at her — the same kind of slow wave a baby makes — and Laurie waved back.

I spread her toys out on my grandmother's bed and sat her down. There she stayed, most of the

afternoon, playing and singing and drinking from her bottle, sleeping at one point, leaning against my

grandmother's leg. When I played some music, Laurie stood up on the bed and danced. Grandma

wouldn't talk much anymore, though every once in a while she would say how sorry she was that she

wasn't having a better day. "I'm not always like this," she said. Mostly she just watched Laurie.

We were flying back to the US that night and I had hated telling her, remembering how she had

always cried when I left. But in the end, I was the one who cried. She had said she was ready to die. But

as I leaned over to stroke her forehead, what she said was, "I wish I had your hair" and "I wish I was

well."

On the plane flying home, with Laurie in my arms, I thought about mothers and daughters, and the

four generations of the family that I know most intimately. Every one of those mothers loves and needs

her daughter more than her daughter will ever love or need her mother. We mothers are, each of us,

the only person on earth who has quite such an all-consuming interest in our child.

Sometimes I kiss and hold Laurie so much she starts crying — which is, in effect, what my

grandmother was doing to my mother, all her life. And what makes my mother sad right now, I think, is

not simply that her mother will die in a day or two, but that, once her mother dies, there will never

again be someone to love her in quite such a complete, unrestrained way. She will only be a mother,

then, not a daughter anymore.

Laurie and I have stopped over for a night to be with my mother. Tomorrow my mother will fly back

to be with my grandmother. But tonight she is feeding me, as she always does when I come, and I am

eating more than I do anywhere else. I admire the wedding dishes (once my grandmother's) that my

mother has set on the table. She says (the way Grandma used to say to her), "Some day they will be

yours."

Words: 906