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

重點(diǎn)詞匯

inevitable /in5evitEbl/ 不可避免的;必然的)←in+evitablein-否定前綴,evitable=avoidable可避免的。Change is inevitable. In a progressive country change is constant.變革不可避免,在進(jìn)步的國(guó)家里變革是永恒的。In war there is no substitute for victory.在戰(zhàn)爭(zhēng)中沒(méi)有什么可以取代勝利。Those who make peaceful revolution impossible will make violent revolution inevitable.那些使和平改革成為不可能的人,必會(huì)使暴力革命成為可能。the inevitable of history 歷史必由之路。

life expectancy 預(yù)期壽命。

depression /di5preFEn/ 消沉;蕭條)←de向下+press+ion名詞后綴,動(dòng)詞為depress(壓抑;使沮喪)。Noble deeds and hot baths are the best cures for depression.高尚的行為和熱水澡是治療抑郁的最佳方法。It's recession when your neighbor loses his job; it's a depression when you lose yours.鄰居失業(yè)的時(shí)候就是經(jīng)濟(jì)衰退,自己失業(yè)的時(shí)候就是經(jīng)濟(jì)蕭條。

cataract /5kAtErAkt/ 大瀑布;白內(nèi)障)可看作cat+ar+actcat貓,ar~~,act動(dòng)作,“貓啊一聲從‘大瀑布’里跳出來(lái)摔成了‘白內(nèi)障’”,白內(nèi)障的主要癥狀就是自覺(jué)眼睛前面有條瀑布而視物不清。

surgical /5sE:dVikEl/ 外科的;外科醫(yī)生的;手術(shù)的;手術(shù);外科病房)←surg+ical;surgery(外科;外科學(xué);手術(shù);手術(shù)室)←surg+ery;surgeon /5sE:dVEn/ 外科醫(yī)生;軍醫(yī))←surg+eon。

genetically /dVi5netikEli/ 由遺傳決定地)←gene基因+tical形容詞后綴+ly副詞后綴。

disintegrate /dis5inti^reit/ 使分裂;使解體)←dis使分離+integrate,integrate(使成為一體)←integr完整+ate動(dòng)詞后綴;integer(整數(shù);完整的東西);integrity(完整;誠(chéng)實(shí);正直)。

perish /5periF/ 喪生;凋謝;消亡)←per(=away)+ish動(dòng)詞后綴。The great tragedy of life is not that men perish but that they cease to love.人生的巨大悲劇不是人們死亡,而是他們不再去愛(ài)。Truth may languish but can never perish.真理可能衰微,但決不會(huì)滅亡。

obvious /5CbviEs/ 顯而易見(jiàn)的)可把b看作6,再把vi看作羅馬數(shù)字6,兩邊的兩個(gè)o看作兩只眼睛,-ous為形容詞后綴,因?yàn)?/span>6=6,所以b=vi,這是“顯而易見(jiàn)的”。No question is so difficult to answer as that to which the answer is obvious.最難回答的問(wèn)題是答案明顯的問(wèn)題。All great truths are obvious truths. But no all obvious truths are great truths.所有偉大的真理都是顯而易見(jiàn)的事實(shí),但并非所有顯而易見(jiàn)的事實(shí)都是偉大的真理。

aggressive /E5^resiv/ 侵略的;好斗的;有進(jìn)取心的)←ag(=to)+gress+ive形容詞后綴。War is an aggressive action of man to man independent of his own will.戰(zhàn)爭(zhēng)是人對(duì)人的侵略行為,不為其自身意志左右。

unsustainable /7QnsEs5teinEbl/ 不能持續(xù)的)即un+sustain+able,un-前綴表否定,sustain /sEs5tein/ 支撐;保持)←sus(=sub)在下面+tain(=hold)。同根詞:contain(包含)←con一起+tain;retain(保留)←re+tain。sustainable development 可持續(xù)發(fā)展。

reverse /ri5vE:s/ 顛倒的;使倒轉(zhuǎn);背面)←re(=back)+verse(=turn)The historian is a prophet in reverse.史學(xué)家是顛倒的預(yù)言家。

infirm /in5fE:m/ 虛弱的;不堅(jiān)固的)←in否定前綴+firm堅(jiān)固的。

potential /pE5tenF(E)l/ 潛在的;潛力)可看作pot+ent+ial,pot即“罐子”,-ent-ial是后綴,“暫時(shí)藏在罐子里面的東東”→潛在的、潛力。Most of us haven't begun to tap our own potential for happiness.我們大多數(shù)人尚未著手開(kāi)發(fā)自身獲得幸福的潛力。

routinely /ru:5ti:nli/ 例行公事地)←routine+ly,routine可看作由routein組成→“按路線走的”→常規(guī)的;慣例。Man's usual routine is to work and to dream.人的日常行為就是工作與夢(mèng)想。

humble /5hQmbl/ 卑賤的;謙卑的v.貶抑)A humble man argues for his fault, while a brave man makes his faults known to all.卑微的人為自己的過(guò)失辯解,勇敢的人則把自己的過(guò)失公之于眾。

pursuit /pE5sju:t/ 追求;職業(yè))←pursu(e)+it名詞后綴;動(dòng)詞為pursue(追求;從事)。Love is strongest in pursuit; friendship in possession.愛(ài)情在追求的時(shí)候最熱烈,友情是在擁有的時(shí)候。

therapy /5WerEpi/ 治療;理療)可看作the+rap輕敲+y名詞后綴←“一種輕輕叩擊的方法”。

fatal /5feitl/ 致命的,毀滅性的)←fat(e)命運(yùn)+al。It is most important in this world to be pushing, but it is fatal to seem so.世間最重要的是有進(jìn)取心,但徒有其表是致命的。God was satisfied with his own work, and that is fatal.上帝很滿意他自己的工作,這點(diǎn)是致命的。

extravagantly /iks5trAvE^Entli/ 奢侈地)←extra(=ex)加強(qiáng)語(yǔ)氣+vag+ant形容詞后綴+ly;extravagant(奢侈的)←extra+vag+ant;extravagance(奢侈)←extra+vag+anceWaste of time is the most extravagant and costly of all expenses.時(shí)間的浪費(fèi)是一切花費(fèi)中最奢侈、最昂貴的一種。extravagance anything you buy that is of no earthly use to your wife the way the other fellow spends his money 奢侈——①你所買的對(duì)妻子毫無(wú)用處的任何東西 ②其他人花錢的方法。

難句解析

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看成獨(dú)立主格結(jié)構(gòu),其實(shí)兩個(gè)逗號(hào)連接的是三個(gè)平行部分,后面兩個(gè)可以被視為省略了動(dòng)詞前“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.
▲本句的主干結(jié)構(gòu)可以縮為we demand everything,everything的后面緊跟了一個(gè)that引導(dǎo)的定語(yǔ)從句,主句的前面是過(guò)去分詞短語(yǔ)作狀語(yǔ),主句的后面是even if引導(dǎo)的讓步狀語(yǔ)從句。
△本句的閱讀重點(diǎn)是抓出最主干的成分之后,了解分詞短語(yǔ)作狀語(yǔ)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.
▲本句的主干結(jié)構(gòu)是physicians off treatment,兩個(gè)破折號(hào)之間是補(bǔ)充說(shuō)明的部分,補(bǔ)充說(shuō)明成分是由and連接的兩個(gè)分詞短語(yǔ)。介詞beyond之后跟了一個(gè)賓語(yǔ)從句,構(gòu)成介賓結(jié)構(gòu)。
△通過(guò)本句應(yīng)該掌握破折號(hào)之間內(nèi)容的作用,兩個(gè)破折號(hào)之間通常是補(bǔ)充說(shuō)明的作用,在第一遍閱讀的時(shí)候可以先略過(guò)不讀,這樣便可以較為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.
▲本句的主干結(jié)構(gòu)是I know that,that后面跟了一個(gè)完整的賓語(yǔ)從句,賓語(yǔ)從句的謂語(yǔ)動(dòng)詞是have achieved,主語(yǔ)是people。countriesJapanSweden的同位語(yǔ),并且country的后面跟了一個(gè)that引導(dǎo)的定語(yǔ)從句。
△本句應(yīng)該重點(diǎn)理解同位語(yǔ)的用法,本句中的同位語(yǔ)的中心詞是countries,后面緊跟了一個(gè)定語(yǔ)從句來(lái)限定修飾它。

試題解析

  這是一篇議論文。在文章中,作者談到了隨著醫(yī)療技術(shù)的發(fā)展,人們的壽命得以延長(zhǎng),人們?cè)絹?lái)越難接受死亡,經(jīng)常過(guò)多的投入在那些無(wú)法治愈、毫無(wú)希望的治療中。作者認(rèn)為,人們應(yīng)該勇于接受死亡這一自然規(guī)律,不要以為醫(yī)學(xué)無(wú)所不能,徒勞地追求長(zhǎng)命百歲。
  這篇文章語(yǔ)言通俗,作者觀點(diǎn)獨(dú)特,而且舉了很多例子,邊敘邊議,是篇很有意思的文章。這篇文章的5個(gè)小題考查了考生理解文章要義、篇章結(jié)構(gòu)的能力,以及進(jìn)行推斷、引申的能力。5個(gè)小題難度適中。

56. [C]
  該題問(wèn)的是篇首第一句的含義,考查的是考生對(duì)比較手法的理解能力。這句話說(shuō)的是:“據(jù)說(shuō),在英國(guó)死亡是迫在眉睫的,在加拿大(死亡)是不可避免的,在加利福尼亞(死亡)是可以選擇的。”從這句話中,我們不難看出美國(guó)人的驕傲和狂妄,他們認(rèn)為美國(guó)擁有高端的醫(yī)療技術(shù),死亡是可以控制的。所以C項(xiàng)是正確的:“美國(guó)人對(duì)他們的醫(yī)療技術(shù)過(guò)分自信?!?/span>
  A項(xiàng)毫無(wú)道理,事實(shí)上,美國(guó)人比其他國(guó)家的人更害怕死亡,所以不惜投入許多金錢,期望醫(yī)療技術(shù)能延緩他們的生命。
  B項(xiàng)是將美國(guó)人的現(xiàn)狀與過(guò)去相比,與篇首的比較句沒(méi)有關(guān)系。
  D項(xiàng)說(shuō)的是美國(guó)人為他們的壽命長(zhǎng)而感到驕傲,也是沒(méi)有理解原話的意思。原句中用了“optional”一詞,不是說(shuō)死亡會(huì)遲遲不來(lái),而是說(shuō)美國(guó)的醫(yī)療技術(shù)如此發(fā)達(dá),人們可以選擇什么時(shí)候死亡。借助醫(yī)療技術(shù),人們可以想活多久就活多久。所以D項(xiàng)不正確。
  這道小題屬于中等難度的題目。

57. [A]
  該小題問(wèn)的是癌癥病人的例子說(shuō)明了什么,考查的是考生對(duì)論證過(guò)程的理解。
  在第二段中,作者舉出晚期癌癥患者的例子,指出醫(yī)生們?yōu)榱瞬蛔尰颊邌适M?,往往采取一些過(guò)激的,缺乏科學(xué)根據(jù)的治療方法。光看這一句,似乎A、B、C選項(xiàng)都正確。但是,結(jié)合文章來(lái)看(這篇文章是為了說(shuō)服人們勇敢地接受死亡這一自然規(guī)律),我們發(fā)現(xiàn)它的作用是為了說(shuō)明人們通常浪費(fèi)了醫(yī)療資源,過(guò)度地投入在回天無(wú)力的事情上。從這道題中,我們可以學(xué)到,論據(jù)就是為了證明論點(diǎn)的,文章中的任何一句話都不能孤立地去理解。而應(yīng)該結(jié)合文章大意,結(jié)合上下文去理解。所以A選項(xiàng)是正確的。
  B、C選項(xiàng)都沒(méi)有答到點(diǎn)子上。
  文中并沒(méi)有提及D項(xiàng)內(nèi)容,所以是錯(cuò)誤的。
  該題屬中等難度的題目,區(qū)分度較好。

58. [B]
  該題考查的是作者對(duì)于Lamm所說(shuō)的話的態(tài)度。
  Lamm所說(shuō)的話也是作者引用的一個(gè)論據(jù)。Lamm認(rèn)為老年人有義務(wù)死亡,以免擋?。贻p人的)道路。在接下來(lái)的一段,作者對(duì)于Lamm的觀點(diǎn)發(fā)表了看法:“I would not go that far.”(我不會(huì)那么極端)。接著,作者舉出了許多例子,說(shuō)明老年人也可以活得有生氣,還能為社會(huì)做貢獻(xiàn)。有的考生看到這兒就匆匆地選擇了A,認(rèn)為作者極力反對(duì)Lamm的觀點(diǎn)。這就有點(diǎn)斷章取義了。因?yàn)樵诮酉聛?lái)的一段中,作者用“Yet”表示了轉(zhuǎn)折,表述了另外一個(gè)角度的意見(jiàn)。說(shuō)的是,一個(gè)社會(huì)在這方面(追求高質(zhì)量的老年生活)的花費(fèi)是有限的。從作者的論述中,我們可以推斷出,作者希望人們接受新陳代謝的自然規(guī)律,所以在一定程度上與Lamm所提倡的是一致的。所以選B,作者對(duì)Lamm的觀點(diǎn)基本同意,但有所保留。
  該小題屬較難的題目。

59. [D]
  該小題考查的是考生進(jìn)行推斷。引申的能力。
  文中的原話是:“I also know that people in Japan and Sweded, countries that spend far less on medical care, have achieved longer, healthier have.”,說(shuō)明了雖然日本和瑞典在醫(yī)療保健上的花費(fèi)比美國(guó)少,但壽命卻比美國(guó)人長(zhǎng),身體也更健康。接著,作者提出倡議,與其將資金徒勞地花在沒(méi)有希望的治療上,還不如投入到較一般的治療中,以提高人們的生活質(zhì)量。所以可以推斷出,日本和瑞典在醫(yī)療保健上的投資更合理。因此選擇D
  該小題屬中等難度偏易的題目。區(qū)分度很好。

60. [C]
  該小題考查的是考生對(duì)文章主旨要義的理解能力。
  A項(xiàng)與作者觀點(diǎn)相反。
  B項(xiàng)也不正確,作者在第四段已舉例反駁了這種過(guò)激的看法。
  D項(xiàng)闡述的是事實(shí),原則上沒(méi)有錯(cuò),但卻不是文章主要要表達(dá)的思想。
  該小題屬中等難度的題目。

全文翻譯

  據(jù)說(shuō),在英國(guó)死亡很緊迫,在加拿大死亡不可避免,在加利福尼亞死亡可以選擇。難怪,在過(guò)去的一個(gè)世紀(jì)里,美國(guó)人的壽命幾乎翻了一番。髖骨不行了可以更換,臨床的憂郁癥得到了控制,白內(nèi)障僅用30分鐘手術(shù)便可以切除。這些進(jìn)步給老年人口帶來(lái)的高質(zhì)量生活在50年前我剛從事醫(yī)學(xué)時(shí)是不可想像的。但是即使有一個(gè)偉大的醫(yī)療衛(wèi)生體系,死亡也是無(wú)法戰(zhàn)勝的——而我們不能面對(duì)這個(gè)現(xiàn)實(shí),正危及我們自身的偉大。死亡是正常的;我們的基因決定我們即使在最理想的環(huán)境里也會(huì)解體和滅亡。我們所有人在某種程度上都懂得這一點(diǎn),但是作為醫(yī)療消費(fèi)者,我們常將死亡視為一個(gè)問(wèn)題來(lái)解決。由于醫(yī)療費(fèi)用由第三方支付,我們常常要求用盡所有的醫(yī)療手段,即使它們不會(huì)有任何作用。最明顯的例子是晚期癌癥的治療。醫(yī)生由于不能治愈疾病,同時(shí)又擔(dān)心病人失去希望,常常采用極端大膽的治療方法,這些方法遠(yuǎn)遠(yuǎn)超出了科學(xué)能夠認(rèn)同的界限。
  1950年,美國(guó)在醫(yī)療衛(wèi)生方面的開(kāi)支是127億美元。2002年,這項(xiàng)開(kāi)支將達(dá)到15400億。任何人都明白這個(gè)趨勢(shì)不可持續(xù),但是很少有人愿意扭轉(zhuǎn)它。有些學(xué)者總結(jié)說(shuō),如果政府資金有限,它應(yīng)該停止支付延緩某一個(gè)年齡以上人群壽命的醫(yī)療費(fèi)用——比如83歲左右。據(jù)說(shuō),科羅拉多州前州長(zhǎng)理查德·拉姆曾經(jīng)說(shuō),老年多病者“有責(zé)任死去和讓位”,以讓更年輕、更健康的人們?nèi)グl(fā)揮他們的潛能。
  我不會(huì)說(shuō)得這么絕對(duì),畢竟現(xiàn)在精力充沛的人們通常能工作到60歲,甚至更久,并仍然具有驚人的創(chuàng)造力。78歲的Viacom公司總裁薩姆勒·雷斯頓開(kāi)玩笑說(shuō)他只有53歲。最高法院法官桑德拉·歐康奈70有余,前衛(wèi)生局醫(yī)務(wù)主任C·庫(kù)普80來(lái)歲還出任了一個(gè)互聯(lián)網(wǎng)公司的總裁。這些領(lǐng)導(dǎo)人就是活生生的證據(jù),證明對(duì)疾病的防治是有意義的,證明我們能夠?qū)Ω赌挲g帶來(lái)的健康問(wèn)題。作為一名年僅68歲的人,我希望像他們一樣在老齡階段保持創(chuàng)造力。
  然而在這樣的追求中,一個(gè)社會(huì)能夠承擔(dān)的費(fèi)用是有限的。作為一名醫(yī)生,我深知最昂貴和最激進(jìn)的手段也可能是無(wú)效的和痛苦的。我也深知在醫(yī)療開(kāi)銷少得多的日本和瑞典,人們獲得了比我們更長(zhǎng)的、更健康的壽命。作為一個(gè)民族,我們可能在尋求不可能奏效的治療方法上花錢太多,而在研究能提高人們生活質(zhì)量的更平常的方法上花錢太少。