Unit 89

Sleep is a funny thing. We're taught that we should get seven or eight hours a night, but a lot of us get by just fine on less, and some of us actually sleep too much. A study out of the University of Buffalo last month reported that people who routinely sleep more than eight hours a day and are still tired are nearly three times as likely to die of stroke--probably as a result of an underlying disorder that keeps them from snoozing soundly.

 

Doctors have their own special sleep problems. Residents are famously sleep deprived. When I was training to become a neurosurgeon, it was not unusual to work 40 hours in a row without rest. Most of us took it in stride, confident we could still deliver the highest quality of medical care. Maybe we shouldn't have been so sure of ourselves. An article in the Journal of the American Medical Association points out that in the morning after 24 hours of sleeplessness, a person's motor performance is comparable to that of someone who is legally intoxicated. Curiously, surgeons who believe that operating under the influence is grounds for dismissal often don't think twice about operating without enough sleep.

 

"I could tell you horror stories," says Jaya Agrawal, president of the American Medical Student Association, which runs a website where residents can post anonymous anecdotes. Some are terrifying. "I was operating after being up for over 36 hours," one writes. "I literally fell asleep standing up and nearly face planted into the wound."

 

"Practically every surgical resident I know has fallen asleep at the wheel driving home from work," writes another. "I know of three who have hit parked cars. Another hit a 'Jersey barrier' on the New Jersey Turnpike, going 65 m.p.h." "Your own patients have become the enemy," writes a third, because they are "the one thing that stands between you and a few hours of sleep."

 

Agrawal's organization is supporting the Patient and Physician Safety and Protection Act of 2001, introduced last November by Representative John Conyers Jr. of Michigan. Its key provisions, modeled on New York State's regulations, include an 80-hour workweek and a 24-hour work-shift limit.Most doctors, however, resist such interference. Dr. Charles Binkley, a senior surgery resident at the University of Michigan, agrees that something needs to be done but believes "doctors should be bound by their conscience, not by the government."

 

The U.S. controls the hours of pilots and truck drivers. But until such a system is in place for doctors, patients are on their own. If you're worried about the people treating you or a loved one, you should feel free to ask how many hours of sleep they have had and if more-rested staffers are available. Doctors, for their part, have to give up their pose of infallibility and get the rest they need.

注（1）：本文选自Time；3/11/2002, p73, 3/4p, 1c;

注（2）：本文习题命题模仿对象：第1、2题分别模仿1999年真题text4的第1题和text2的第2题；第3题模仿1998年真题text3的第2题；第4、5题分别模仿2004年真题text2的第3题和text3的第5题;

 

1.       We can learn from the first paragraph that ____________.

 

[A] people who sleep less than 8 hours a day are more prone to illness

[B] poor sleep quality may be a sign of physical disorder

[C] stroke is often associated with sleep

[D] too much sleep can be as harmful as lack of sleep

 

2.       Speaking of the sleep problems doctors face, the author implies that ________________.

 

[A] doctors often need little sleep to keep them energetic

[B] doctors’ sleep is deprived by residents

[C] doctors tend to neglect their own sleep problems

[D] sleep-deprived doctors are intoxicated

 

3.       Paragraph 3 and 4 are written to ____________.

 

[A] entertain the audience with some anecdotes

[B] discuss the cause of doctors’ sleep problems

[C] show the hostility doctors harbor against their patients

[D] exemplify the danger doctors face caused by lack of sleep

 

4.       By “doctors should be bound by their conscience, not by the government” (line 6, paragraph 5), Dr. Charles Binkley means that ____________.

 

[A] doctors should not abide by government’s regulations

[B] the government is interfering too much

[C] the regulations about workweek and work shift are too specific

[D] law can not force a doctor to sleep while his conscience can

 

5.       To which of the following is the author likely to agree?

 

[A] Patients should control the hours of their doctors.

[B] Pilots and truck drivers work in safer environments than that of doctors’.

[C] Patients are facing more risks if their doctors are not adequately-rested.

[D] People concerned have the right to remove their doctors from their positions.

 

答案：B C D B C

 

篇章剖析：

本篇文章采用提出问题－分析问题－解决问题的模式指出了医生睡眠不足会带来的危害以及解决办法。第一段说明了睡眠对人的影响，第二段指出了医生睡眠不足的问题以及医生对此的态度，第三段和第四段以两个事例说明医生睡眠不足可能带来的危害，第四段介绍了针对这一问题政府所采取的措施以及医生对此的反应，最后一段分别对病人，相关人员及医生提出建议。

 

词汇注释：

underlying: [5QndE5laiiN] adj. 隐晦的; 潜在的

resident: [5rezidEnt] n. 〈医〉住院医生

deprived: [di5praivd] adj. 缺乏的，不足的

neurosurgeon: [9njJErEJ`s\:dVEn] n. 神经外科医生

intoxicated: [In`tCksIkeItId] adj. 醉酒的

dismissal: [dis5misEl] n. 免职, 解雇

anonymous: [E5nCnimEs] adj.

Turnpike: [6tE :n7paik] n. AmE. 收费公路，收通行税的公路

provision: [prE5viVEn] n. 规定；条款

staffer: [`stB:fE] n. 职员

infallibility: [in7fAlE5biliti] n. 绝无错误, 绝对可靠性

 

难句突破：

1.       A study out of the University of Buffalo last month reported that people who routinely sleep more than eight hours a day and are still tired are nearly three times as likely to die of stroke--probably as a result of an underlying disorder that keeps them from snoozing soundly.

主体句式：a study reported that…

结构分析：本句是个复杂长句，包含一个宾语从句（reported之后由that引导），两个定语从句（who引导的修饰people的从句和that引导修饰disorder的从句），一个比较结构的省略形式（three times as likely to…）和一个容易理解错误的动词短语keep…from。

句子译文：上个月由布法罗大学所做的一项研究显示那些每天习惯睡八个小时以上但仍然感觉疲劳的人死于中风的危险是普通人的三倍---也许这是一种潜在的紊乱导致的结果，正是这种紊乱才让他们难以安睡。

2.       Curiously, surgeons who believe that operating under the influence is grounds for dismissal often don't think twice about operating without enough sleep.

主体句式：surgeons often don’t think twice about…

结构分析：本句涉及定语从句（who引导的修饰surgeons的从句），宾语从句（believe后面由that引导的从句），和一个英语习语think twice about something以及容易引起歧义的介词without。

句子译文：令人好奇的是，那些认为酒后作业应该被免职的外科医生对于在睡眠不足的情况下操刀手术却很少认真思考。

 

题目分析

1. 答案为B，属推理判断题。从第一段最后一句话中的“probably as a result of an underlying disorder that keeps them from snoozing soundly”可以看出潜在的紊乱可能导致人们睡眠质量不高，虽然睡眠时间长，但仍然感到疲惫。因此B项是正确的。

2. 答案为C，属推理判断题。文章第二段最后一句话说医生们虽然们认为醉酒开刀应该受到严惩，但对于在睡眠不足的情况下做手术却并不“think twice”。由此可见C是正确的。

3. 答案为D，属推理判断题。文章第二段指出医生睡眠不足以及医生对此缺乏重视的问题，紧接着就在第3、4段里举了几个例子：医生的脸差点碰到伤口；医生开车时在方向盘上睡着；医生撞车；医生撞到公路收费站栏杆等，可见这些例子是要说明睡眠不足的医生可能带来的危害。

4. 答案为B，属推理判断题。对于政府制定法规解决医生睡眠不足的问题，文章第五段第四行说：“Most doctors, however, resist such interference”，并进一步引用Charles Binkley医生的话进行论证，可见Charles Binkley也认为政府干预过多了。所以应该选择B。

5. 答案为C，属推理判断题。文章在最后给医生提出建议，认为医生应该放弃他们决不出错的姿态，得到充足的休息，否则“patients are on their own”，病人就只能听天由命了。由此可见C是正确答案。

 

参考译文

睡眠是一件有趣的事情。我们被教导每晚要睡七到八个小时，但我们很多人并没有睡够这个时间却依然身体健康，而我们中的一些人实际上睡得过多。上个月由布法罗大学所做的一项研究显示那些每天习惯睡八个小时以上但仍然感觉疲劳的人死于中风的危险是普通人的三倍---也许这是一种潜在的紊乱导致的结果，正是这种紊乱才让他们难以安睡。

 

医生们也有自己的睡眠问题。住院医生以缺少睡眠而著称。我在受训成为一名神经外科医生的时候，时常会连续工作40个小时。我们大多数人对此不以为意，自信我们仍然能够给病人最高质量的医疗护理。也许我们不应该对自己这么自信。《美国医学会杂志》上刊登的一篇文章指出，一个人如果连续24小时不睡，那么到了早晨，他的运动能力就和喝醉了酒的人差不多。令人好奇的是，那些认为醉酒做手术应该被免职的外科医生对于在睡眠不足的情况下做手术却很少认真思考。

 

“我可以告诉你一些恐怖故事，”美国医学生学会主席杰雅·阿格拉瓦说。阿格拉瓦经营着一个网站，住院医生们可以在那里匿名留言，讲一些奇闻轶事。有一些故事非常可怕。“我当时在做手术，已经有36个小时没有睡觉了，”其中一人写道。“我差不多站着睡着了，而且我的脸几乎碰到了伤口。”

 

“实际上我认识的每个外科住院医生都曾经有过在下班开车回家的路上在方向盘上睡着的经历，”另一人写道。“我听说有三个人还曾经撞在停放好的汽车上。另一个人在纽约收费公路上行驶时以65英里的时速撞上了一个收费站栏杆。”“你自己的病人都成了敌人，”第三个人写道，因为他们“把你和几个小时的睡眠隔开了。”

 

阿格拉瓦的组织支持由密歇根众议员约翰·科尼尔斯去年十一月提出的“2001年病人和医生安全保护规定”。该规定模仿纽约州的法规，其关键规定包括一周工作80小时，最多24小时轮一次班等。不过，大多数医生讨厌这种干涉。查尔斯·宾克利是密歇根大学的一位资深住院外科医生，他也认为需要采取一些措施，但在他看来“医生应该受到良心的约束，而不是政府的管制。”

 

在美国，飞行员和卡车司机的工作时间都有着严格的控制。但除非也给医生们制定这样一套规定，否则病人就得听天由命了。如果你担心给你治病的人或者一个你爱的人，你可以大胆问他们每天睡几个小时，以及可不可以找到休息得更好的职员。对医生来说，他们不能继续摆出一副从不出错的样子，而应该得到充分的休息。