2003 Text 4  

  It is said that in England death is pressing, in Canada inevitable and in California optional. Small wonder. Americans' life expectancy has nearly doubled over the past century. Failing hips can be replaced, clinical depression controlled, cataracts removed in a 30-minute surgical procedure. Such advances offer the aging population a quality of life that was unimaginable when I entered medicine 50 years ago. But not even a great health-care system can cure death — and our failure to confront that reality now threatens this greatness of ours. Death is normal; we are genetically programmed to disintegrate and perish, even under ideal conditions. We all understand that at some level, yet as medical consumers we treat death as a problem to be solved. Shielded by third-party payers from the cost of our care, we demand everything that can possibly be done for us, even if it's useless. The most obvious example is late-stage cancer care. Physicians — frustrated by their inability to cure the disease and fearing loss of hope in the patient — too often offer aggressive treatment far beyond what is scientifically justified.

  In 1950, the US spent $12.7 billion on health care. In 2002, the cost will be $1540 billion. Anyone can see this trend is unsustainable. Yet few seem willing to try to reverse it. Some scholars conclude that a government with finite resources should simply stop paying for medical care that sustains life beyond a certain age — say 83 or so. Former Colorado governor Richard Lamm has been quoted as saying that the old and infirm "have a duty to die and get out of the way", so that younger, healthier people can realize their potential.

  I would not go that far. Energetic people now routinely work through their 60s and beyond, and remain dazzlingly productive. At 78, Viacom chairman Sumner Redstone jokingly claims to be 53. Supreme Court Justice Sandra Day O'Connor is in her 70s, and former surgeon general C.Everett Koop chairs an Internet start-up in his 80s. These leaders are living proof that prevention works and that we can manage the health problems that come naturally with age. As a mere 68-year-old, I wish to age as productively as they have.

  Yet there are limits to what a society can spend in this pursuit. As a physician, I know the most costly and dramatic measures may be ineffective and painful. I also know that people in Japan and Sweden, countries that spend far less on medical care, have achieved longer, healthier lives than we have. As a nation, we may be overfunding the quest for unlikely cures while underfunding research on humbler therapies that could improve people's lives.

56. What is implied in the first sentence?
  [A] Americans are better prepared for death than other people.
  [B] Americans enjoy a higher life quality than ever before.
  [C] Americans are over-confident of their medical technology.
  [D] Americans take a vain pride in their long life expectancy.

57. The author uses the example of caner patients to show that ________.
  [A] medical resources are often wasted
  [B] doctors are helpless against fatal diseases
  [C] some treatments are too aggressive
  [D] medical costs are becoming unaffordable

58. The author's attitude to ward Richard Lamm's remark is one of ________.
  [A] strong disapproval
  [B] reserved consent
  [C] slight contempt
  [D] enthusiastic support

59. In contras to the US, Japan and Sweden are funding their medical care ________.
  [A] more flexibly
  [B] more extravagantly
  [C] more cautiously
  [D] more reasonably

60. The text intends to express the idea that ________.
  [A] medicine will further prolong people's lives
  [B] life beyond a certain limit is not worth living
  [C] death should be accepted as a fact of life
  [D] excessive demands increase the cost of health care

重点词汇

inevitable /in5evitEbl/ 不可避免的;必然的)←in+evitablein-否定前缀,evitable=avoidable可避免的。Change is inevitable. In a progressive country change is constant.变革不可避免,在进步的国家里变革是永恒的。In war there is no substitute for victory.在战争中没有什么可以取代胜利。Those who make peaceful revolution impossible will make violent revolution inevitable.那些使和平改革成为不可能的人,必会使暴力革命成为可能。the inevitable of history 历史必由之路。

life expectancy 预期寿命。

depression /di5preFEn/ 消沉;萧条)←de向下+press+ion名词后缀,动词为depress(压抑;使沮丧)。Noble deeds and hot baths are the best cures for depression.高尚的行为和热水澡是治疗抑郁的最佳方法。It's recession when your neighbor loses his job; it's a depression when you lose yours.邻居失业的时候就是经济衰退,自己失业的时候就是经济萧条。

cataract /5kAtErAkt/ 大瀑布;白内障)可看作cat+ar+actcat猫,ar~~act动作,“猫啊一声从‘大瀑布’里跳出来摔成了‘白内障’”,白内障的主要症状就是自觉眼睛前面有条瀑布而视物不清。

surgical /5sE:dVikEl/ 外科的;外科医生的;手术的;手术;外科病房)←surg+icalsurgery(外科;外科学;手术;手术室)←surg+erysurgeon /5sE:dVEn/ 外科医生;军医)←surg+eon

genetically /dVi5netikEli/ 由遗传决定地)←gene基因+tical形容词后缀+ly副词后缀。

disintegrate /dis5inti^reit/ 使分裂;使解体)←dis使分离+integrateintegrate(使成为一体)←integr完整+ate动词后缀;integer(整数;完整的东西);integrity(完整;诚实;正直)。

perish /5periF/ 丧生;凋谢;消亡)←per(=away)+ish动词后缀。The great tragedy of life is not that men perish but that they cease to love.人生的巨大悲剧不是人们死亡,而是他们不再去爱。Truth may languish but can never perish.真理可能衰微,但决不会灭亡。

obvious /5CbviEs/ 显而易见的)可把b看作6,再把vi看作罗马数字6,两边的两个o看作两只眼睛,-ous为形容词后缀,因为6=6,所以b=vi,这是“显而易见的”。No question is so difficult to answer as that to which the answer is obvious.最难回答的问题是答案明显的问题。All great truths are obvious truths. But no all obvious truths are great truths.所有伟大的真理都是显而易见的事实,但并非所有显而易见的事实都是伟大的真理。

aggressive /E5^resiv/ 侵略的;好斗的;有进取心的)←ag(=to)+gress+ive形容词后缀。War is an aggressive action of man to man independent of his own will.战争是人对人的侵略行为,不为其自身意志左右。

unsustainable /7QnsEs5teinEbl/ 不能持续的)即un+sustain+ableun-前缀表否定,sustain /sEs5tein/ 支撑;保持)←sus(=sub)在下面+tain(=hold)。同根词:contain(包含)←con一起+tainretain(保留)←re+tainsustainable development 可持续发展。

reverse /ri5vE:s/ 颠倒的;使倒转;背面)←re(=back)+verse(=turn)The historian is a prophet in reverse.史学家是颠倒的预言家。

infirm /in5fE:m/ 虚弱的;不坚固的)←in否定前缀+firm坚固的。

potential /pE5tenF(E)l/ 潜在的;潜力)可看作pot+ent+ialpot即“罐子”,-ent-ial是后缀,“暂时藏在罐子里面的东东”→潜在的、潜力。Most of us haven't begun to tap our own potential for happiness.我们大多数人尚未着手开发自身获得幸福的潜力。

routinely /ru:5ti:nli/ 例行公事地)←routine+lyroutine可看作由routein组成→“按路线走的”→常规的;惯例。Man's usual routine is to work and to dream.人的日常行为就是工作与梦想。

humble /5hQmbl/ 卑贱的;谦卑的v.贬抑)A humble man argues for his fault, while a brave man makes his faults known to all.卑微的人为自己的过失辩解,勇敢的人则把自己的过失公之于众。

pursuit /pE5sju:t/ 追求;职业)←pursu(e)+it名词后缀;动词为pursue(追求;从事)。Love is strongest in pursuit; friendship in possession.爱情在追求的时候最热烈,友情是在拥有的时候。

therapy /5WerEpi/ 治疗;理疗)可看作the+rap轻敲+y名词后缀←“一种轻轻叩击的方法”。

fatal /5feitl/ 致命的,毁灭性的)←fat(e)命运+alIt is most important in this world to be pushing, but it is fatal to seem so.世间最重要的是有进取心,但徒有其表是致命的。God was satisfied with his own work, and that is fatal.上帝很满意他自己的工作,这点是致命的。

extravagantly /iks5trAvE^Entli/ 奢侈地)←extra(=ex)加强语气+vag+ant形容词后缀+lyextravagant(奢侈的)←extra+vag+antextravagance(奢侈)←extra+vag+anceWaste of time is the most extravagant and costly of all expenses.时间的浪费是一切花费中最奢侈、最昂贵的一种。extravagance anything you buy that is of no earthly use to your wife the way the other fellow spends his money 奢侈——①你所买的对妻子毫无用处的任何东西 ②其他人花钱的方法。

难句解析

Failing hips can be replaced, clinical depression controlled, cataracts removed in a 30-minute surgical procedure.
controlled的前面和removed的前面省略了can be
△不要把clinical depression controlledcataracts removed in a 30-minute surgical procedure看成独立主格结构,其实两个逗号连接的是三个平行部分,后面两个可以被视为省略了动词前“can be”的成分。

Shielded by third-party payers from the cost of our care, we demand everything that can possibly be done for us, even if it's useless.
▲本句的主干结构可以缩为we demand everythingeverything的后面紧跟了一个that引导的定语从句,主句的前面是过去分词短语作状语,主句的后面是even if引导的让步状语从句。
△本句的阅读重点是抓出最主干的成分之后,了解分词短语作状语的用法。

Physicians frustrated by their inability to cure the disease and fearing loss of hope in the patient too often offer aggressive treatment far beyond what is scientifically justified.
▲本句的主干结构是physicians off treatment,两个破折号之间是补充说明的部分,补充说明成分是由and连接的两个分词短语。介词beyond之后跟了一个宾语从句,构成介宾结构。
△通过本句应该掌握破折号之间内容的作用,两个破折号之间通常是补充说明的作用,在第一遍阅读的时候可以先略过不读,这样便可以较为迅速地抓住最主干的成分。

I also know that people in Japan and Sweden, countries that spent far less on medical care, have achieved longer, healthier lives than we have.
▲本句的主干结构是I know thatthat后面跟了一个完整的宾语从句,宾语从句的谓语动词是have achieved,主语是peoplecountriesJapanSweden的同位语,并且country的后面跟了一个that引导的定语从句。
△本句应该重点理解同位语的用法,本句中的同位语的中心词是countries,后面紧跟了一个定语从句来限定修饰它。

试题解析

  这是一篇议论文。在文章中,作者谈到了随着医疗技术的发展,人们的寿命得以延长,人们越来越难接受死亡,经常过多的投入在那些无法治愈、毫无希望的治疗中。作者认为,人们应该勇于接受死亡这一自然规律,不要以为医学无所不能,徒劳地追求长命百岁。
  这篇文章语言通俗,作者观点独特,而且举了很多例子,边叙边议,是篇很有意思的文章。这篇文章的5个小题考查了考生理解文章要义、篇章结构的能力,以及进行推断、引申的能力。5个小题难度适中。

56. [C]
  该题问的是篇首第一句的含义,考查的是考生对比较手法的理解能力。这句话说的是:“据说,在英国死亡是迫在眉睫的,在加拿大(死亡)是不可避免的,在加利福尼亚(死亡)是可以选择的。”从这句话中,我们不难看出美国人的骄傲和狂妄,他们认为美国拥有高端的医疗技术,死亡是可以控制的。所以C项是正确的:“美国人对他们的医疗技术过分自信。”
  A项毫无道理,事实上,美国人比其他国家的人更害怕死亡,所以不惜投入许多金钱,期望医疗技术能延缓他们的生命。
  B项是将美国人的现状与过去相比,与篇首的比较句没有关系。
  D项说的是美国人为他们的寿命长而感到骄傲,也是没有理解原话的意思。原句中用了“optional”一词,不是说死亡会迟迟不来,而是说美国的医疗技术如此发达,人们可以选择什么时候死亡。借助医疗技术,人们可以想活多久就活多久。所以D项不正确。
  这道小题属于中等难度的题目。

57. [A]
  该小题问的是癌症病人的例子说明了什么,考查的是考生对论证过程的理解。
  在第二段中,作者举出晚期癌症患者的例子,指出医生们为了不让患者丧失希望,往往采取一些过激的,缺乏科学根据的治疗方法。光看这一句,似乎ABC选项都正确。但是,结合文章来看(这篇文章是为了说服人们勇敢地接受死亡这一自然规律),我们发现它的作用是为了说明人们通常浪费了医疗资源,过度地投入在回天无力的事情上。从这道题中,我们可以学到,论据就是为了证明论点的,文章中的任何一句话都不能孤立地去理解。而应该结合文章大意,结合上下文去理解。所以A选项是正确的。
  BC选项都没有答到点子上。
  文中并没有提及D项内容,所以是错误的。
  该题属中等难度的题目,区分度较好。

58. [B]
  该题考查的是作者对于Lamm所说的话的态度。
  Lamm所说的话也是作者引用的一个论据。Lamm认为老年人有义务死亡,以免挡住(年轻人的)道路。在接下来的一段,作者对于Lamm的观点发表了看法:“I would not go that far.”(我不会那么极端)。接着,作者举出了许多例子,说明老年人也可以活得有生气,还能为社会做贡献。有的考生看到这儿就匆匆地选择了A,认为作者极力反对Lamm的观点。这就有点断章取义了。因为在接下来的一段中,作者用“Yet”表示了转折,表述了另外一个角度的意见。说的是,一个社会在这方面(追求高质量的老年生活)的花费是有限的。从作者的论述中,我们可以推断出,作者希望人们接受新陈代谢的自然规律,所以在一定程度上与Lamm所提倡的是一致的。所以选B,作者对Lamm的观点基本同意,但有所保留。
  该小题属较难的题目。

59. [D]
  该小题考查的是考生进行推断。引申的能力。
  文中的原话是:“I also know that people in Japan and Sweded, countries that spend far less on medical care, have achieved longer, healthier have.”,说明了虽然日本和瑞典在医疗保健上的花费比美国少,但寿命却比美国人长,身体也更健康。接着,作者提出倡议,与其将资金徒劳地花在没有希望的治疗上,还不如投入到较一般的治疗中,以提高人们的生活质量。所以可以推断出,日本和瑞典在医疗保健上的投资更合理。因此选择D
  该小题属中等难度偏易的题目。区分度很好。

60. [C]
  该小题考查的是考生对文章主旨要义的理解能力。
  A项与作者观点相反。
  B项也不正确,作者在第四段已举例反驳了这种过激的看法。
  D项阐述的是事实,原则上没有错,但却不是文章主要要表达的思想。
  该小题属中等难度的题目。

全文翻译

  据说,在英国死亡很紧迫,在加拿大死亡不可避免,在加利福尼亚死亡可以选择。难怪,在过去的一个世纪里,美国人的寿命几乎翻了一番。髋骨不行了可以更换,临床的忧郁症得到了控制,白内障仅用30分钟手术便可以切除。这些进步给老年人口带来的高质量生活在50年前我刚从事医学时是不可想像的。但是即使有一个伟大的医疗卫生体系,死亡也是无法战胜的——而我们不能面对这个现实,正危及我们自身的伟大。死亡是正常的;我们的基因决定我们即使在最理想的环境里也会解体和灭亡。我们所有人在某种程度上都懂得这一点,但是作为医疗消费者,我们常将死亡视为一个问题来解决。由于医疗费用由第三方支付,我们常常要求用尽所有的医疗手段,即使它们不会有任何作用。最明显的例子是晚期癌症的治疗。医生由于不能治愈疾病,同时又担心病人失去希望,常常采用极端大胆的治疗方法,这些方法远远超出了科学能够认同的界限。
  1950年,美国在医疗卫生方面的开支是127亿美元。2002年,这项开支将达到15400亿。任何人都明白这个趋势不可持续,但是很少有人愿意扭转它。有些学者总结说,如果政府资金有限,它应该停止支付延缓某一个年龄以上人群寿命的医疗费用——比如83岁左右。据说,科罗拉多州前州长理查德·拉姆曾经说,老年多病者“有责任死去和让位”,以让更年轻、更健康的人们去发挥他们的潜能。
  我不会说得这么绝对,毕竟现在精力充沛的人们通常能工作到60岁,甚至更久,并仍然具有惊人的创造力。78岁的Viacom公司总裁萨姆勒·雷斯顿开玩笑说他只有53岁。最高法院法官桑德拉·欧康奈70有余,前卫生局医务主任C·库普80来岁还出任了一个互联网公司的总裁。这些领导人就是活生生的证据,证明对疾病的防治是有意义的,证明我们能够对付年龄带来的健康问题。作为一名年仅68岁的人,我希望像他们一样在老龄阶段保持创造力。
  然而在这样的追求中,一个社会能够承担的费用是有限的。作为一名医生,我深知最昂贵和最激进的手段也可能是无效的和痛苦的。我也深知在医疗开销少得多的日本和瑞典,人们获得了比我们更长的、更健康的寿命。作为一个民族,我们可能在寻求不可能奏效的治疗方法上花钱太多,而在研究能提高人们生活质量的更平常的方法上花钱太少。