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I was a second-year medical student at the university, and was on my second
I was a second-year medical student at the university, and was on my second
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2023-11-04
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问题
I was a second-year medical student at the university, and was on my second day of rounds at a nearby hospital. My university’s philosophy was to get students seeing patients early in their education. Nice idea, but it overlooked one detail: second-year students know next to nothing about medicine.
Assigned to my team that day was an attending—a senior faculty member who was there mostly to make patients feel they weren’t in the hands of amateurs. Many attendings were researchers who didn’t have much recent hospital experience. Mine was actually an arthritis specialist. Also along was a resident(the real boss, with a staggering mastery of medicine, at least to a rookie like myself). In addition, there were two interns(住院实习医生). These guys were just as green as I was, but in a scarier way: they had recently graduated from the medical school, so they were technically MDs.
I began the day at 6:30 am. An intern and I did a quick check of our eight patients: later, we were to present our findings to the resident and then to the attending. I had three patients and the intern had the other five—piece of cake.
But when I arrived in the room of 71-year-old Mr. Adams, he was sitting up in bed, sweating heavily and panting(喘气). He’d just had a hip operation and looked terrible. I listened to his lungs with my stethoscope, but they sounded clear. Next I checked the log of his vital signs and saw that his respiration and heart rate had been climbing, but his temperature was steady. It didn’t seem like heart failure, nor did it appear to be pneumonia. So I asked Mr. Adams what he thought was going on.
" It’s really hot in here, Doc," he replied.
So I attributed his condition to the stuffy room and told him the rest of the team would return in a few hours. He smiled and feebly waved goodbye.
At 8:40 am, during our team meeting, "Code Blue Room 307!" blared from the loudspeaker.
I froze.
That was Mr. Adams’s room.
When we arrived, he was motionless.
The autopsy(尸体解剖)later found Mr. Adams had suffered a massive pulmonary embolism(肺部栓塞). A blood clot had formed in his leg, worked its way to his lungs, and cut his breathing capacity in half. His symptoms had been textbook: heavy perspiration and shortness of breath despite clear lungs. The only thing was: I hadn’t read that chapter in the textbook yet. And I was too scared, insecure, and proud to ask a real doctor for help.
This mistake has haunted me for nearly 30 years, but what’s particularly frustrating is that the same medical education system persists. Who know how many people have died or suffered harm at the hands of students as naive as I, and how many more will? [br] "His symptoms had been textbook" means that his symptoms were
选项
A、part of the textbook.
B、no longer in the textbook.
C、recently included in the textbook.
D、explained in the textbook.
答案
D
解析
语义题。由题干定位至第十一段。该段第三句中的冒号后面指出“heavy perspiration and shortness of breath despiteclear lungs”,即大量出汗、呼吸困难但肺部清晰,这是教科书对这种症状的记载,该段第二句则说明了这种症状的成因,而第四句提到“I hadn’t read that chapter in the textbook yet”,即“我”还没有读到教科书的这个章节。综合看来,这种症状背后的成因在教科书里有所解释,作者之所以不知道,是因为还没有读到此处,故[D]为答案。
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