2004年医学博士外语真题试卷

Robert Spring, a 19th century forger, was so good at his profession that he was able to make his living for 15 years by selling false signatures of famous Americans. Spring was born in England in 1813 and【C1】___in Philadelphia in 1858 to open a bookstore. At first he prospered by selling his small but【C2】collection of early U. S. autographs. Discovering his ability at copying handwriting , he began【C3】signatures of George Washington and Ben Franklin and writing them on the title pages of old books. To lesson the chance of detection, he sent his forgeries to England and Canada for sale and【C4】___

Forgers have a hard time selling their products. A forger can’ t approach a【C5】___buyer must deal with people who don’ t have much knowledge in the field. Forgers have many ways to make their work look real. For example, they buy old books to use the【C6】___paper of the title page, and they can treat paper and ink with chemicals.

In Spring’s time,【C7】___after the Civil War, Britain was still fond of the Southern state, so Spring【C8】a respectable maiden lady known as Miss Fanny Jackson, the only daughter of General “Stonewall” Jackson. For several years Miss Fanny’ s【C9】problems forced her to sell a great number of letters and manuscripts belonging to her famous father. Spring had to work very hard to satisfy the demand. All this activity did not prevent Spring from dying in poverty, leaving sharp-eyed experts the difficult task of separating his forgeries from the【C10】___

Although speech and writing are the special means of communicating of humans, the interchange also takes place in many other ways. A person may relay his or her feelings, thoughts, and reactions through body positioning, body contact, body odors, eye contact, responsive actions, habits, attitudes, interests, state of health, dress and grooming, choice of life-style, and use of talents—in fact, through everything the individual says or does.

In turn, every person is constantly receiving multitudes of external and internal messages through his or her five senses and personal biorhythm system. An individual screens, selects, regulates , and controls specific aspects of this information through a process of mental choices. Some of these choices are automatic; some are subconscious because of habit, block, or lack of development; and some are made by a conscious process. The degree to which a person is able to communicate depends upon the extent of his or her conscious awareness, priority of need, and control of this process.

The person with a behavior disorder is shut off from the communicative flow that normally exists among humans. His or her mind is confused, and he or she may feel unable to express personal thoughts, needs, and emotions, and unable to make himself or herself understood. Sometimes the person may feel that he or she is communicating clearly but that others cannot or will not understand. Because the person is thus isolated in internal problems, he or she is interested only in these problems and cannot focus attention on the messages of others. The person often projects fears and fantasies onto others, so that no matter what the real content is of the messages that others relay, the messages received are threatening ones.

The causes of such communicative shutoffs are blocks in the neural pathways of the person’ s processing of information. Sometimes a block is physical, as in deafness, mental retardation, brain tumor, or hardening of the cerebral arteries. However, the most common causes of blocks are injuries to a person’ s emotional system.

Emotional blocks occur to some degree in all human beings. They usually occur in childhood before good communicative skills are learned, and they are connected to individual symbolism. Unless such a block is removed shortly after happening, it can have profound and complicating effects that will distort emotional and mental growth and arrest the development potential of the individual. Even though a child with blocks will appear to grow and to seem mature in some ways, he or she will show the evidence of emotional blocking in efforts to communicate.

Depression is a state of low vitality and discontent with life in which the individual withdraws from normal life activities even to the point of considering death as an attractive alternative.

Although everyone experiences “the blues” or periods of low spirits when nothing in life seems to go well, when everything seems to be an effort, and when efforts lead to frustration, these periods are usually brief and are likely to occur when the person is tired, hungry, lonely, or sick. Rest, good food, talking with friends, some fun, and/or an end to the sickness are usually enough to cure the blues. But when the low spirits persist, or when there are large swings in mood from elation to desolation, when nothing seems to catch the interest of the person, when relatives or friends cannot cheer the person and he or she continues to withdraw, then the person is depressed. Even such depressions are normal under certain circumstances. Anyone who is faced with a serious and painful illness or the loss of a limb, is exhausted by repeated narrow escapes from death(such as occurs in wartime),has been exposed to a dehumanizing environment(such as occurred with the Jews in Nazi Germany),has had an overwhelming series of stressful setbacks, or has experienced the death of several family members within a short time is expected to be depressed.

However, there are many depressed people who seem to the casual observer to have no reason to be depressed. Depression under these circumstances stems from severe behavior disturbance in which the person sees himself or herself as worthless. Such an image is usually the result of the psychosocial conditioning of a childhood deprived of a parental role model of security, love, care, and attention essential for the development of trusting relationships. The depressed person needs to build a new image of himself or herself as a useful and needed person. Psychotherapy is often helpful in restoring natural inner confidence and capacity for meaningful and trusting relationships.

The depressed person can find little beauty or fun in life. His or her talk is filled with gloomy negatives. Doom and anxiety fill his or her mind. Depression is often cyclical, and when the anxiety does lift the person may demonstrate an opposite extreme of carefree irresponsibility.

Although it often takes years of psychotherapy for the individual to work through the underlying suspicion and anger of his or her problems, acceptance by another will get through to even the most deeply depressed person if the other is sincere. An attitude of matter-of-fact hopefulness on the part of those around the depressed person can reassure him or her of eventual recovery.

The disturbed thoughts of the depressed person cannot be forgotten until they are replaced by other thoughts. Yet, in depression, the person does not see that he or she has choices about what thoughts occupy his or her mind. The person needs to explore alternatives for thoughts and actions and learn to care for himself or herself enough to modify his or her own behavior.

Seana lived in the inpatient hospice unit for more than a month, far longer than anyone would have predicted, sustained only on pain medications and Popsicles.

Late March in Chicago is only technically spring. Most of the time it is still cold and overcast. However, this day was warm, 60 degrees and sunny. It was a Saturday and we planned to go outside after I finished rounds. I found Seana back on the unit sitting in her wheelchair, IV pole and pumps in tow, her winter coat partially covering her hospital gown. Her sister-in-law and Carla, her nurse’ s aide, were ready to go. Everyone was in a great mood.

We went down the elevator, into the brightly sunlit outdoor, and onto the driveway by the women ’ s hospital. Though the initial idea was to just sit in the sun a bit, we were drawn toward the sidewalk. There were the usual smokers outside the hospital, and the smell of cigarette smoke was the first thing I noticed. It seemed horrible to come out here, to have that smell be the first thing to greet Seana. Simultaneous with that thought, though, she said, “What a wonderful smell!” I asked her what smell was so wonderful and she said that it smelled like McDonald’ s. I was thinking, she really does appreciate everything. We went on to the sidewalk and watched a father pitching a ball to his 4-year-old son. The continuity between generations was moving, almost beyond words. As we got to the corner, an inspiration came: we could make it to Lake Michigan, only a few blocks a-way. Did she want to try? Did everyone want to try? Of course we did \ Carla said that it felt like we were cutting school. So off we went, across Sheridan Road, the four of us quite a motley sight; Seana looking like death warmed over in her wheelchair, I wearing my gray hospital coat, the nurse’ s aide in an outrageous green leather coat, her sister-in-law in an Ohio State sweatshirt. Cars slowed down; we waved. We walked up the road to the beach, cutting through rutted lawns, the wheelchair bumping in the spring mud. Seana didn’ t say much, but she seemed translucent in the sun, beaming, lit from within. I imagined it as her farewell tour of the world. I can only fathom the poignant wealth of feelings that were stimulated. For me, it evoked the sense of being a tourist, where everything seems special, a little strange, and very impermanent. I had experienced this same lakefront that way three years before. Then, I had just recovered from my own near death in the form of a myocardial infarction and cardiac arrest and was filled with joy and gratitude that I was still here. The world looked new.

I had been Seana’s age.

She taught me that awareness of death and appreciation of life go together: to imagine that you are seeing things for the last time has the same intensity as seeing them for the first.

Two equally brilliant scientists apply for a prestigious research fellowship awarded by a top scientific organization. One is white, the other black. Does the color of their skin matter?

Most scientists will already be screaming a resounding “no”. Those who progress in science do so because of their work, not their pigmentation. Science is meritocratic and objective. It must therefore be rigorously color-blind and shun both racial discrimination and affirmative action.

Well, let’ s think about this. If science really is so meritocratic, where are all the black Nobel prizewinners and fellows of the Royal Society? The black chairs of government scientific panels? The black Richard Dawkinses and Susan Greenfields? When Newsweekmagazine recently surveyed Europe’ s largest 100 companies, it was shocked to unearth only six board members of non-European racial origin. One shudders to thinks what a similar survey of upper echelons of European science would reveal.

Even the usually stick-in-the-mud British government now acknowledges there is a problem. Last month it promised new funding for projects designed to combat institutional racism in science education in schools. As measures go it is little and late, but welcome nonetheless. Despite starting school as the top achievers, black British children have long underperformed in science.

And there are positive changes afoot higher up the scientific career ladder too. At present, few scientific organizations, funding bodies or labs in Europe bother even to track the racial background of those they hire or fund. As a result the full scale of the under-representation problem is hidden. Not for much longer. Britain’ s newly amended Race Relations Act requires all government bodies, including funding councils, to track the effects of their activities on different ethnic groups and ensure that all benefit equally. And next year a European Union directive will push all EU employers this way too.

But ethnic monitoring alone will not create the back role models European Science so badly needs. Something else is needed. Funding agencies and influential organizations like the Royal Society must bite the bullet of affirmative action. That means ring-fencing fellowship and grants for applicants from particular racial background. And it means seeking out those who have broken through the barriers of race and giving them preference over their equally well-qualified white peers for positions of influence and places in the spotlight.

Tokenism and fine sentiments will no longer do. With other professions having already leapt a-head in this area, the enduring whiteness of science is more than an embarrassment: it is a barrier to its very credibility. If a large segment of Europe’ s schoolchildren never see a scientist who looks like them, they will continue to think science is not for them. And if scientists don’ t reflect the multiracial societies they live in, they’ ll find it hard to win the public trust they crave. Does color matter? You bet it does.

About 14,000 people will contract HIV today. And tomorrow and the day after that, and every day for the foreseeable future. That’ s 5 million by the end of the year, most of whom will be dead within a decade.

Figures like these bring home the devastating impact of AIDS and the urgent need for a cheap, effective vaccine. As a stroke, a vaccine could stop the tide of infection and stem the need for more, costly treatments. It could even help people who already have the virus stay healthy.

Back in 1990, drugs companies and researchers confidently predicted we’ d have a vaccine against HIV-1 within 10 years. These were rash statements. The virus has turned out to be more cunning and stealthy than anyone expected, and our knowledge of how vaccine bolster the immune system hasn’t been good enough. A dozen years on, we still have no clear-cut candidate for a vaccine.

So you might expect the announcement of two large-scale trials of AIDS Vaccines to be applauded. Yet they have been criticized as a monumental waste of money. The trials will test almost i-dentical vaccine, neither of which is expected to offer great protection against the virus. What’ s more, both are funded by the US government, one through the national Institute of Health and the other through the Department of Defense.

The NIH and the DoD have a long history of rivalry in AIDS research. But in this case it seems sensible for the NIH to back down. Although the NIH is under pressure “ to be seen to be doing something” , duplicating work of questionable value is itself questionable. Better to join forces with the military for this trail and spend money saved—which amounts to about $ 60 million—elsewhere.

There are, after all, reasons for optimism. A new wave of vaccine from industry and academia has nearly completed safety tests. It makes sense to carry out limited trials of all this newcomers, to identify which ones offer the best protection, before committing tens of millions of dollars to larger trials.

Such a strategy would need the agreement of drugs companies, government Agencies and medical charities—something that’ s not as Utopian as it sounds. The NIH has already signed a deal to test a new AIDS vaccine made by the Pharmaceuticals giant Merck. And the international AIDS Vaccine Initiative, a not-for-profit funding organization based in New York, has pioneered new ways to divide up intellectual property rights for successful vaccines.

What’s needed is cooperation and coordination, not competition. The important thing is to find the fastest route to an effective vaccine. Every day we forget that, another 14,000 people pay the price.

A boy who struggles to read English primary-school storybooks yet has no trouble with university physics textbooks in Japanese is challenging current thinking on dyslexia. The 17-year-old boy, known as AS, is the first person shown to be dyslexic in one language but not in another.

” This could have profound consequences for concepts of reading,” says Taeko Wydell of Brunei University in west London, who has studied AS. “ If there is a specific brain area for reading and a person has impairment in this area, in theory all his languages should be affected. ” The case is also posing problems for researchers who argue that dyslexia is visual procession disorder.

AS has two English-speaking parents but lives in Japan. At the age of six, he began attending a Japanese primary school, but it soon became clear that he was lagging behind his Japanese counterparts in English. When AS was 13, tests confirmed that the problem was dyslexia, a congenital difficulty with reading.

The causes of dyslexia are poorly understood, but have been linked to damage in part of the brain’ s left hemisphere known as the perisylvian area. The condition is marked by an impaired a-bility to process the written symbols of language, such as letters—which has led some researchers to suggest that the problem lies ultimately in faulty visual processing.

Intrigued by AS’ s case, Wydell and her colleague Brain Butterworth of University College London looked at his reading in Japanese. Japanese has two written forms. One, called kanji, consists of symbols that carry meaning but have no phonetic value. The kana script contains symbols that correspond to particular sounds.

Wydell first tested AS’ s ability to read 160 words written in kanji. Many kanji characters have two pronunciations—one in the Chinese from which the symbols were derived and the other unique to Japanese—but only one is correct in a given context. Knowing how to pronounce a word can be extremely difficult. Yet AS read kanji at undergraduate level and so has no problem with his visual processing skills. He has also passed competitive high school entrance exams, which require expertise in kana.

In English, however, AS scored half as well as the average person of his age when asked to read real words and made-up words out loud. And he could read only one of 50 “difficult” words, such as “nausea” and “aisle”. Nevertheless, AS perceives English sounds “just like a native”, says Wydell.

Wydell argues that AS’ s case is difficult to reconcile with conventional theories about dyslexia. “If AS has a problem with visual processing,” She says, “it should show up even more in kanji. ” She accepts that many children diagnosed as dyslexic may well have problems processing visual information , but suspects that others—like AS—suffer from a kind of dyslexia that occurs primary in English. The problem, she believes, like in the brain’ s ability to tackle the English language’ s complex system of mapping sounds to letters, which gives rise to some eccentric spellings. By contrast, kana letters always sound the same.

Not all researchers in the field are persuaded, however. “ If AS’ s sight vocabulary is so good in Japanese,” asks Marjorie Perlman Lorch, a neurolinguist at Birkbeck College, “ why hasn’ t he adopted the same strategy for irregular words in English?” She suspects that AS’ s reading problems could stem from his position as a cultural outsider in Japan. “ Social identity and motivational factors can be crucial. “