Section A 优雅的双手
我从未见过克拉克夫人，但看过她的医疗记录和上一位值班医生交给我的报告后，我知道她今晚会去世。 她屋里唯一的光线来自一台医疗设备，它闪着红光，似乎在发出警告。我站在那里，一股怪味刺激着我的鼻子，我想起了过去闻到过的腐烂的气味，我闭上了眼睛。我嘴里有一股从胃里返上来的酸味。我伸手去开灯。灯静静地照亮了整个病房，我走回病床边，用无动于衷的、医生的目光观察着病人。
克拉克夫人已奄奄一息了。她一动不动地躺着：骨瘦如柴的身体使她的头显得特别大；皮肤呈暗黄色，松松地裹在嶙峋的、连毛毯也遮掩不住的骨骼上；她的右臂平伸在床边，被无情地用胶带固定在一块板上，以便能固定针头使液体滴入；左臂横放在深陷的胸部，胸口随着不均匀的呼吸一起一伏。
我伸手去触摸她放在胸口的细长手指。冰凉冰凉的。我忙将手移到她的手腕，去感觉那微弱的脉搏。 克拉克夫人将头稍稍转向我，微微地睁开眼。我俯过身去，勉强听见她微弱的声音：“水。”我从桌上拿起一杯水，用手指封着吸管的一端，滴了几滴凉凉的水到她的嘴里，以缓解她的干渴。她没有用力去吞咽，因为力气不够。 “还要，”那干涩的声音说。于是我们又重复了一次。这次她终于咽了一些，并轻轻说了声：“谢谢，你。”
她虚弱得没法交谈，因此没等她要求，我就开始做她所需要的。我像抱孩子似的把她抱起来，给她翻了个身。除了一件浅色的病号服，她什么也没穿。她又小又轻，像遭受了严重饥荒一样。我打开护肤霜的瓶盖，揩了一些在手心。为了不伤着她，我小心翼翼地把护肤霜擦在她发黄的皮肤上。她的皮肤松松地在骨头上滑动，背上每块骨头的轮廓都能清楚地摸到。当我把枕头放在她两腿之间时，发现它们也是冰凉的，直到把手移到她膝盖以上的部位，我才感受到血液供给生命的热度。
而后，我挪了把椅子面朝她坐在床边，握住她那只没被固定的手，此时我又一次注意到她细长的手指。 很优雅。一时间，我突然想知道她是否有家庭，接着我发现病房里没有花，没有孩子们画的彩虹和蝴蝶，也没有卡片。房间中没有任何迹象表明她是一个被人爱着的人。她似乎读懂了我的心思，平静地回答我说：“今天„„我让„„家里人„„都„„回家„„不想„„他们„„看见„„”她耗尽了最后的那点力气，再也说不下去了。但我已然明白她做了些什么。我不知道说什么好，所以什么也没说。她好像又看穿了我的心思：“你„„留下„„”
时间似乎停滞了。在一片寂静中，我感觉自己的脉搏加快了，我听到自己的呼吸开始伴随着她那不均匀的呼吸一起一落。我们互相对视，不知怎么的，我们都意识到，这是两个生命间的一个特殊时刻。她那细长的手指很轻易地就拢住了我的手，我微笑着慢慢点了点头。无需任何语言，我从她发黄的眼睛中感受到了她对我的谢意，她慢慢闭上了眼睛。
不知过了多长时间，她又睁开了双眼，只是这一次目光里没有任何反应，只有空洞的凝视。没有一点先兆，她那细弱的呼吸停止了。很快，微弱的脉搏也消失了。一颗泪珠从她的左眼中流出，滑过脸颊，落在枕上。我开始轻声哭泣。对这位迅速走进又走出我生活的陌生人，我心间涌起了一股感情。她的痛苦结束了，可她的生命也结束了。我依然握着她的手，渐渐地，我意识到我并不害怕这种感情之战，意识到这实际是她赐予我的特殊荣幸，而且我还乐意再来一次。克拉克夫人没有让她的家人目睹这一幕他们或许无力面对的人生插曲，却与我分享了它。她不想让家人看着她死去，然而她也不愿孤独地离去。不应当有人孤独离去的，我很高兴能守候在她身边。
两天后，我在报上读到了克拉克夫人的消息。原来她是7个孩子的母亲、18个孩子的祖母、教会里的活跃分子、社区志愿者协会的领导人、音乐会钢琴演奏家、从教30余年的钢琴教师。
是啊，她的手指是那样细长而优雅。
Section B 充满爱心的决策
假设你90岁的母亲最近得了中风。她是个惯用右手的人，如今却不能移动她的右胳膊和右腿──对她
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而言，它们已没有用了。她虽然还可以发出声音，却无法让人明白她的意思。
这种状况持续了两个月，因为一直没有好转的迹象，医生告诉你她可能永远也不能康复了。在此之前，你的母亲一直健康活跃，生活自理，独自居住。如今她却要完全依赖他人了。
而后，X光透视显示，你母亲肺部受到感染，这是中风病人的常见病症。于是医生给你打电话，因为你是她唯一在世的亲人。
“我们可以用药物治疗感染，一周后她可能会好起来”他说，“我说‘好起来’，是指她会保持她感染前的状况──直到出现某种别的病菌。或者，我可以停止给她用药，这样一来，她可能三四天后就会去世。 我们可以让她舒服地度过这几天，办法是给她用止疼片和安眠药。你希望我采用哪一种方法？”
这是个棘手的问题，对不对？
一方面，你不忍心看着自己一度精力充沛的母亲活在因中风而变得痛苦而有限的生命里。另一方面，你又不愿让母亲坐以待毙。
我来告诉你我在这种假想的情况下会怎么做。
我会说：“不要给她服用任何抗感染的药物了。要让她舒服，然后看看会发生什么情况。也许她会自己克服感染。如果不能，那她也会死得安详。我不愿担当硬让自己的母亲活受罪的责任。”
我之所以能做出这样的决定，是因为我多次碰到这样的病人。最近，我给一位80岁的患肝癌的妇女动过手术，但没有成功。对缓解癌症导致的问题我无计可施。她是个聪明女人，没有任何直系亲属。手术后几天，我坐在她身边给她解释了当时的情况。
“我可以给你用一些抗癌药，”我说，“但是它们会让你难受，而且还治不好你的病。同样，我也可以在你手臂上插上针管，给你输液，这可以让你在食欲渐渐消退时不觉得饥饿；输液可能让你的生命延长一至两周。或者，我可以撤消所有的治疗，只给你吃维他命，然后再看看有什么效果。我个人建议你选最后一种方案。我会让你没有痛苦，然后看看会发生什么事。”
病人选择了听从我的建议。两周后，她安详地、毫无痛苦地离世了。
而有时，要做出如此显而易见的决定却很困难。最近，我有一个病人严重中风。他完全动弹不得，而且不能吞咽任何东西。头两个礼拜我们给他输液，后来又通过一根导管将食物从他的鼻子输送到他的胃里。
三周后，他依旧昏迷不醒，而导管使他的喉咙经常疼痛。我与他的四个成年孩子商量，告诉他们我认为该把一根导管通过一个小洞直接插进他的胃里，这样喂食他就不会那么痛苦。我还告诉他们说：“我可以把导管拿掉，就让他吃些他能吃得下的东西。有可能他活不长久，但他不会太痛苦。”没有人愿意承担允许施行手术的责任，也没有人愿意允许完全停止给病人进食。
结果，可怜的老人又多活了近三个月，喉咙依然疼痛不已，嘴里也因疼痛而经常出血。他死于严重感染── 一种令人悲痛的死法。
那么，作为负责任的人，在需要做出这样大的决定时该怎么办呢？
归根到底是个常识问题。在我行医的30年里，以及在这之前的数百年里，医生和病人家属一直合作默契，共同决定在疾病的最后阶段怎么做才对病人最好。
有95％的病例，在恰当磋商之后，都能做出人道而合理的决定。另外的5％不能立即达成这样的决议。遇上这种病例，做上几天或数周的基本治疗，观察病人的进展之后，正确的决定就一目了然了。
在此我警告一句。不论是家属还是医生，他们都不愿做出生死攸关的决定。可是毫无疑问，如果任何一方坚持要有所谓 “中立”的第三方（通常是政府代表或者职业律师）介入，那不但会拖长决策过程，而且在很多时候，决策还会更加武断、更不人道。
我们试图避免的就是中立。唯一有权做出决定的，是那些非常熟悉病人、能将病人的利益放在首位的人。 如果有一个地方应该禁止律师和政府官员的干涉，那就是危在旦夕的病人的房间。 Key to exercises
Section A
III
1. switch 2. decay 3. secured 4. loose 5. slid 6. privileges 7. interval 8. outline 9. preceding 10. shallow *11. naked 12. emotions 13. hints 14. Association 15. dripping
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IV
1. reached for 2. feel for 3. trying to avoid breathing 4. so that 5. managed to accomplish 6. sense my thoughts 7. provide for 8. spared me 9. read about 10. go about V
1.N 2.I 3.K 4.G 5.M 6.L 7.A 8.F 9.C 10.D VI
1.pain 2.fear 3.tension 4.mind 5.stress 6.crisis 7.anger 8.anxiety 9.signs 10.hunger VII
1. growth: the act of growing or developing; physical or natural development 2. warmth: the state or quality of being warm; warm-heartedness and kindness 3. depth: the distance from the top to the bottom of something
4. truth: the state or quality of being true; the actual facts or reality of something 5. length: the measurement of how long something is in size 6. breadth: the distance from one side of something to the other
7. width: the distance from one side of something to the other; the quality of being wide 8. death: the state of being dead VIII
1.exposure 2.failures 3.disclosure 4.pressure 5.mountaineers 6.closure 7.profiteers 8.seizure IX
1. did he realize that the task was a little too difficult for the new secretary to finish on her own. 2. did Mary stop weeping.
3. will all the employees know the result of their performance evaluation.
4. did she become aware how hard it was for her mother to have brought up her sister and her on her own. 5. did I get to know what happened in the end to the main characters. X
1. Having finished their morning work, the clerks stood up behind their desk, stretching themselves. 2. The secretary worked late into the night, preparing a speech for the President. 3. Seeing no prospect of success, we quitted the attempt to climb the mountain. 4. Knowing that they were going traveling, the students began to make preparation. 5. Having been found guilty, the man was given a severe sentence by the judge. XI
1. Not until he saw his mother lying in bed, dying, did he realize how much he loved her.
2. Taking into account of his recent physical condition, I think he has done quite well in the exam. 3. Mrs. Clark lies in bed motionless, and I wondered briefly if she is still alive.
4. The building was darkened except for a single light burning in a third-storey window.
5. These soldiers have received very strict training and are well equipped to fulfill the new task. 6. He reached for the phone, picked it up, and dialed the hotel’s number. XII
1. 直到 60 年代早期，人们似乎才普遍认同英国不再是以前心目中那样的大国了。 2. 在决定了租房之后，我们便着手与市内所有的房屋代理商联系。
3. 我小心翼翼地替她擦身子，尽量避免弄疼她，因为她瘦的只剩皮包骨了。
4. 我心间对这位老人涌起了一股感情。他那暗黄的皮肤松弛地裹在显得异常大的骨头上，深陷的胸部随着不均匀的呼吸一起一伏。
5. 你在报上读到那位著名画家的消息了吗？他实际上是为了要成为视觉艺术大师的抱负而累死的。 6. 有迹象表明，这位老太太想孤独地离开人世，不让她的家人看到他们或许无力面对的人生插曲。
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XIII
1 B 2 C 3 B 4 A 5 D 6 B 7 D 8 A 9 C 10 A 11 C 12 A 13 C 14 B 15 A 16 D 17 D 18 A 19 B 20 A X V.
To many people, a cowboy is a fantastic hero. A cowboy is a tall and strong man, wearing cowboy hat and boots, riding a horse and with guns around his waist. He remains alert to everything around him all the time. When danger is around, he never fails to sense or detect it, and he is always brave to face the danger. A cowboy is a skilled horseman and good gunman. He is a hero who helps the good people while punishing the bad. He seems like a superman who appears where he is needed. A cowboy does what’s right and refuses money for his good actions, because he does not care about money. What he cares about is doing justice.
Section B
Ⅰ.
1.B 2.B 3.C 4.A 5.C 6.A 7.B 8.C 9. C 10.A Ⅱ.
1. She is right-handed, and now she is unable to move her right arm and leg—they are worthless to her. 2. Now she is completely relying on others
3. We can make those days comfortable by giving her painkillers and sleeping pills. 4. “I don’t want to bear responsibility for condemning my mother to a living hell.” 5. Recently I operated in vain on an eighty-year-old woman with cancer of the liver.
6. As a result, the poor man continued on for nearly three more months with a painful throat and frequent bleeding caused by sores in the mouth.
7. In 95 percent of the cases a sympathetic, reasonable decision can be made after appropriate discussion.
8. What we are trying to avoid is neutrality; the only people with any qualification to decide are those who know the patient closely and can put his or her interests first. Ⅲ.
1.permission 2.inserted 3.necessities 4.relieve 5.withdraw 6.arbitrary 7.phase 8.elected 9.transparent 10.cooperate
*11.profession 12.sympathetic 13.qualifications 14. intimate（*该部分为网上补充练习答案） Ⅳ.
1. Her voice was beginning to tremble and she tried to control it but in vain. 2. Jennifer was late for class the other day as a result of the heavy snow.
3. The small company is now confronted with intense competition for the market share. 4. In wintertime, food was hard to come by, so many animals died of hunger.
5. Tom decided to follow his father’s advice and apply for a job in the bank, as he liked working with numbers. 6. I’m sorry I forgot his birthday: The date just completely slipped my mind. 7. In the end our choices came down to going or staying.
8. The old man had a stroke, which condemned him to bed in the hospital for about half a year. 9. My French was so poor at that time that I often had trouble making myself understood. 10.If you have someone on your mind, let her know. Chances are you are on hers as well. （*该部分为网上补充练习答案）
*11.What it comes down to is who is going to be the best on the basketball court for us. 12.None of their plans worked and Barbara and Ted decided to let life takes its course.
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