Category Archives: Medical

5 People Who Made Positive World Changes in 2019

“In a year of many dispiriting headlines, Fixes still found the better angels of human nature at work.” T. Rosenberg, The New York Times

Note: Fixes is a column from the New York Times that looks at solutions to social problems and why they work.

ESL Voices Lesson Plan for this post  with Answer Key

Excerpt: Five Who Spread Hope in 2019-By Tina Rosenberg, The New York Times

“O.K. so Time magazine has Greta Thunberg. But many other individuals also changed the world for the better in 2019. Here, for a second year, is a list of five whose contributions Fixes wrote about.

Scott O’Neill fights tropical disease.

Scott O’Neill, director of the World Mosquito Program, with a cage of Wolbachia-carrying mosquitoes in his Melbourne laboratory. Credit- Shaney Cameron

There’s a new weapon in the fight against mosquito-borne diseases.

Before 1970, only nine countries had experienced severe epidemics of dengue fever. Now, the disease is endemic in 100 countries, infects 400 million people a year and is intensifying rapidly.

Like Zika and chikungunya, dengue is spread by the bite of the Aedes aegypti mosquito, and no workable vaccine or cure has been found.

The normal public health response to mosquitoes is attack: spray pesticide, eliminate breeding grounds and help people ward off their bites. But these strategies have failed to control dengue. The world is desperate for something new. Scott O’Neill leads a team that is doing just the opposite — adding millions of mosquitoes to areas affected by disease. Professor O’Neill directs the World Mosquito Program, which is based at Monash University in Melbourne, Australia.

The mosquitoes the program releases are infected with Wolbachia bacteria, which block their ability to transmit disease. Wolbachia occurs naturally in most insect species and is harmless to vertebrates and humans. When enough Wolbachia-infected mosquitoes are released, they take over the whole population…In Yogyakarta, Indonesia, Wolbachia zones had 76 percent fewer cases of dengue than other areas. Wolbachia has also led to reductions in disease in Brazil and Vietnam.

Kimberly McGrath heals trafficked children.

Kimberly McGrath coordinates foster care services at the Citrus Health Network in Hialeah, Fla. Credit- Maria A. Cardona for The New York Times

What happens to a child who is exploited commercially for sex? Kimberly McGrath is changing the answer to that question. Historically, trafficked children have been arrested for solicitation and sent to juvenile court…’The core understanding was that these were defiant, rebellious youth who would rebel in a family,’ Dr. McGrath said. In 2013, Florida officials asked Dr. McGrath, who coordinates foster care services at the Citrus Health Network in South Florida, to come up with a different response.

She started from the premise that these children were not defiant criminals. A vast majority had been abused, which made them more susceptible to the manipulations of traffickers. And they had never gotten help to recover from that abuse.

Dr. McGrath and her colleagues looked at what had worked for other traumatized children and adapted it to trafficked children. They educated not just therapists and social workers, but also foster parents…’When foster parents are equipped and prepared to deal with their special needs, children thrive in family-based environments,’ she said. “They really are just traumatized kids.’

Dr. Dixon Chibanda transforms global mental health care.

Dr. Dixon Chibanda turned benches into destinations for therapy. Credit- Markus Schreiber:Associated Press

Depression occurs everywhere. By some measures, it’s the world’s most debilitating disease. But treatment is not everywhere. Even in New York City, less than 40 percent of people with depression get treatment. In poor countries, it’s closer to zero percent.

So what can be done in places with no public mental health care and only a tiny number of mental health professionals? As with medical care, the answer is training nonprofessionals. Every health clinic in Harare, Zimbabwe, has a ‘friendship bench‘ in its yard. It’s an ordinary wooden bench. Seated on it is a community health worker with a few weeks’ training in problem-solving therapy. Patients go to the bench, talk to the health worker about their problems and come up with possible solutions. They go home and try them, and return.

The friendship bench was invented in 2006 by a psychiatrist, Dixon Chibanda, after a patient committed suicide. He had asked her to come see him at Harare Central Hospital, but she lived in another city and didn’t have bus fare.

Dr. Chibanda decided to bring treatment for depression to Harare’s health clinics. At first he wanted to train nurses and put offices inside the buildings, but the nurses had not enough  time and clinics had not enough space. But what seemed like a setback is what has allowed the program to spread.

Now, there’s a bench in the yard of every government-run health clinic in Harare, and the practice is spreading throughout Zimbabwe and to other African countries. In a different form, the strategy has also reached New York. Research shows that friendship benches are effective at treating depression.

Dr. Rebekah Gee makes medicines affordable.

Dr. Rebekah Gee, Louisiana’s health secretary. Credit- Tom Williams:CQ Roll Call, via Associated Press

Louisiana is doing two things no other state is doing about hepatitis C, which kills more Americans than all other infectious diseases combined. One is that the state is suddenly treating more people.

Hep C is curable — but the drugs are astronomically expensive. Even the cheapest generic version in the United States costs $24,000 for a course of treatment. (In India, the same drug is $550.) Because of the price, state Medicaid programs ration the drugs. In 2018, Louisiana treated 1,200 people… Louisiana could do that because of the second innovation: The drugs were made a lot less expensive. In July, the state began buying hep C medicines in a new way. Just as you pay Netflix a flat fee for all you want to watch, Louisiana now pays Asegua Therapeutics $58 million per year for all the hep C medicine the state can use.

Dr. Rebekah Gee, Louisiana’s secretary of health, adopted the scheme from Australia, where it has allowed Australia to treat seven times as many patients for the same money. Louisiana is the first state in America to do the same. The State of Washington is about to start as well. Other states are likely to follow.

Phil Keisling deepens democracy.

Illustration by Jeffrey Henson Scales; photographs by Marcin Jastrzebski and Digiphoto:iStock, via Getty Images

There’s a lot of attention, and rightly so, paid to Republican efforts to suppress voting. But there’s also a movement in both parties to expand voting. It abandons the traditional polling booth in favor of voting at home

It’s one of the most effective ways to increase turnout — possibly the best way.

Increasingly, other states are following the path first set by Oregon, which mails every voter a ballot. Voters fill it out at their leisure and mail it in or drop it off at a ballot center.

In next year’s elections, all voters in Oregon, Colorado, Washington, Utah and Hawaii will vote at home. California will soon follow. Large parts of North Dakota and Nebraska vote at home. In last year’s midterms, 69 percent of all votes in the West were cast by voters who received ballots in the mail.

Phil Keisling was Oregon’s secretary of state, in charge of elections, when Oregon began home voting in 1998. Now he leads the Vote at Home Institute.

The institute asserts that it saves taxpayers money (some election officials disagree). It argues that because the approach uses paper ballots, it’s secure against hacking… Home voting probably doesn’t affect turnout in big elections. But it does in local elections, races at the end of the ballot, ballot propositions and judicial elections.

ESL Voices Lesson Plan for this post

NOTE: Lessons can also be used with native English speakers.

Level: Intermediate – Advanced


Language Skills: Reading, writing, and speaking. Vocabulary and grammar activities are included.


Time: Approximately 2 hours.


Materials: Student handout (from this lesson) and access to news article.


Objective: Students will read and discuss the article
with a focus on improving reading comprehension and improving oral skills. At the end of the lesson students will express their personal views on the topic through group work and writing.

Pre-reading Exercises

 

 Predictions: Using a Pre-reading Organizer

Directions: Have  students to examine the title of the post and of the actual article they are about to read. Then, have them  examine the photos. Ask students to write a paragraph describing what they think this article will discuss. Students can use a Pre-reading organizer for assistance.

Pre-reading chart by J. Swann

 

II. While Reading Activities

Word Inference

Directions: Students are to infer the meanings of the words in bold taken from the article. They may use a dictionary, thesaurus, and Word Chart for assistance.

  1. Before 1970, only nine countries had experienced severe epidemics of dengue fever.
  2. The normal public health response to mosquitoes is attack: spray pesticide.
  3. What happens to a child who is exploited?
  4. Historically, trafficked children have been arrested for solicitation.
  5. Depression occurs everywhere.
  6. So what can be done in places with no public mental health care?
  7. Louisiana is doing two things no other state is doing about hepatitis C.
  8. Hepatitis C kills more Americans than all other infectious diseases combined.
  9. There’s a lot of attention, and rightly so, paid to Republican efforts to suppress voting.
  10. Increasingly, other states are following the path first set by Oregon, which mails every voter a ballot.

Source: New Oxford American Dictionary   

Grammar Focus: Structure and Usage

Directions: The following groups of sentences are from the article. One of the sentences in each group contains a grammatical  error. Students are to identify the sentence (1, 2, or 3 ) from each group that contains the grammatical error.

I

Many other individual also changed the world for the better in 2019.

The normal public health response to mosquitoes is attack.

The mosquitoes the program releases are infected with Wolbachia bacteria.

II

The friendship bench was invented in 2006.

There’s a bench in the yard of every government-run health clinic in Harare.

Louisiana is treating more people for hepatitis C.

III

Because of an price, state Medicaid programs ration their drugs.

In next year’s elections, all voters in Oregon, Colorado, Washington, Utah and Hawaii will vote at home.

Turnout for these elections can be in the single digits.

Identify The  Speakers

Directions: Place students in groups. Hand out the following quotes from speakers in the article. Members are to identify the speakers from the article. The first group to correctlyidentify all of the speakers wins.

  1. “People who understand dengue and live in transmission areas are horrified and scared.”
  2. “Now we know they really are just extremely traumatized youth.”
  3. I started to realize that psychiatry in an institution is not the way to go. We have to take it to the community.”
  4. “Why couldn’t we change health care in this country?”
  5. “For millions of citizens, especially those with uncertain work schedules, family obligations and other daily demands, the traditional polling place has now become the most powerful voter suppression tool of all.”

 

III. Post Reading Activities

Discussion Questions for Comprehension /Writing

Directions: Place students in groups and have them discuss the following questions/statements. Afterwards, have the groups share their thoughts as a class. To reinforce the ideas, students can write an essay on one of the topics mentioned.

  1. Which of the profiles do you find most inspiring or heartwarming? Why?
  2. Do they make you more hopeful and optimistic about the world?
  3. Do they inspire you to make a difference? How?
  4. Have you observed other ordinary heroes of 2019 in the news?In your community? Describe them.
  5. What qualities make it possible for individuals to affect change?
  6. Do you think you made a positive difference in the lives of others in 2019? Explain how.
  7. Has anyone made a difference in your life this past year? 

 

3-2-1-Writing

Directions: Allow students 5 minutes to write down three new ideas they’ve learned about the topic from the reading, two things they did not understand in the reading, and one thing they would like to know that the article did not mention. Review the responses as a class.

ANSWER KEY

For Deaf Children: The Sound of Hope

“My mother practically cried when I heard a cricket chirping in the house,” says a woman who got a cochlear implant at age 11. Jane R. Madell, a pediatric audiology consultant …in Brooklyn, N.Y., wants every parent with a child who is born hearing-impaired to know that it is now possible for nearly all children with severe hearing loss to learn to listen and speak as if their hearing were completely normal.” J. Brody, The New York Times

ESL Voices Lesson Plan for this post  With Answer Key

Photo- tcpreschool.org

Excerpt: “Unlocking The world of Sound for Deaf Children” By Jane E. Brody, The New York Times

‘Children identified with hearing loss at birth and fitted with technology in the first weeks of life blend in so well with everyone else that people don’t realize there are so many deaf children,’ she told me.

With the appropriate hearing device and auditory training for children and their caregivers during the preschool years, even those born deaf ‘will have the ability to learn with their peers when they start school,’ Dr. Madell said. ‘Eighty-five percent of such children are successfully mainstreamed. Parents need to know that listening and spoken language is a possibility for their children.’

Central Institute for the Deaf

Determined to get this message out to all who learn their children lack normal hearing, Dr. Madell and Irene Taylor Brodsky produced a documentary,“The Listening Project, to demonstrate the enormous help available through modern hearing assists and auditory training…

Ms. [Amy] Pollick, a psychologist, 43 and deaf since birth, lives in Washington, D.C., with her husband and two young children, all with normal hearing. Her deaf parents, determined that she learn to speak, got her a hearing aid at 6 months along with years of auditory therapy…She told me, ‘The earlier you get the implant, the more successful it is because the more auditory input the brain gets at an early age, the better the auditory skills you will develop.’

Central Institute for the Deafjpeg

A cochlear implant bypasses the nonfunctioning hair cells of the auditory system and transmits sound directly to the auditory nerve so that the brain can process it. Implants can be inserted in babies before they can walk.

According to the National Institute on Deafness and Other Communication Disorders, children with profound hearing loss who receive implants before 18 months of age ‘develop language skills at a rate comparable to children with normal hearing… But, as Dr. Madell points out, only 0.1 percent of the population knows sign language, and 95 percent of deaf children are born to hearing parents, who then have to spend a long time learning to sign, during a period when children are normally learning to speak.

‘Deafness today is not what it was 20 years ago,’ she said. Every baby born in the United States is supposed to be screened at birth for hearing loss. One baby in 1,000 of those screened will turn out to have moderate, severe or profound hearing loss that, if not promptly and properly treated, can delay their ability to learn to speak and understand speech. Today’s auditory technology makes it possible for these babies to be fitted with a device that enables them to hear and, with auditory training, develop language skills as good as those of their normal-hearing peers.”

 

ESL Voices Lesson Plan for this post

NOTE: Lessons can also be used with native English speakers.

Level: Intermediate – Advanced


Language Skills: Reading, writing, and speaking. Vocabulary and grammar activities are included.


Time: Approximately 2 hours.


Materials: Student handout (from this lesson) and access to news article.


Objective: Students will read and discuss the article
with a focus on improving reading comprehension and improving oral skills. At the end of the lesson students will express their personal views on the topic through group work and writing

I. Pre-Reading Activities

Stimulating background knowledge: Brainstorming

Directions: Place students in groups, ask students to think about what they already know about  deaf people.  Next, have students look at the pictures in the text and generate ideas or words that may be connected to the article.  Regroup as a class and list these ideas on the board. Students can use a brainstorming chart for assistance.

Brainstorming Map by rentonschools.us

 

For additional charts Visit ESL Voices List of Charts  http://esl-voices.com/teachers/charts-and-organizers/

II. While Reading Activities

Word Inference

Directions: Students are to infer the meanings of the words in bold taken from the article. They may use a dictionary, thesaurus, and Word Chart for assistance.

  1. Children fitted with technology in the first weeks of life blend in well with everyone else.
  2. Children need the appropriate hearing device and auditory training during the preschool years.
  3. Eighty-five percent will be  successfully mainstreamed.
  4. Still, many deaf people resist the current technology.
  5. They reject the idea that deafness needs to be corrected.
  6. Every child with hearing loss will be able to hear with  hearing aids and cochlear implants.
  7. One baby in 1,000 of those screened will turn out to have moderate, severe or profound hearing loss.
  8. Jane R. Madell, a pediatric audiology consultant.
  9. Many children will have the ability to learn with their peers when they start school.
  10. I heard a cricket chirping in the house for the first time.

Reading Comprehension

Fill-ins

Directions: Place students in groups and after they have read the entire article, have them complete the following sentencestaken from the article. They can use the words and terms from the list provided, or provide their own terms. They are to find the meanings of any new vocabulary.

All started out with___that helped them learn to ___and ___spoken language. But now all have___implants that, as Ms. Lippert put it, “really revolutionized my world” when, at age 11, she became the first___to get a cochlear implant at New York University Medical Center. “Suddenly when I was playing___I could hear what my ___were saying,” Ms. Lippert, now 33, recalled.

WORD LIST:speak, cochlear, teammates preteen, soccer, hearing aids, understand,

Grammar Focus: Word -Recognition

Directions: Students choose the correct word to complete the sentences taken from the article. They are to choose from the options presented.

My mother practically/practical cried/cry when I hear/heard a cricket chirping in/on the house. I couldn’t talk on/in the phone before. Now in my/mine job at the Veteran’s Affairs Hospital in Manhattan, I’d/I’m on the phone all days/day long. The implant have/has been a/an wonderful gift.

III. Post Reading Activities

WH-How Questions

Directions: Have students use the  WH-question format to discuss or to write the main points from the article.

Who or What is the article about?

Where does the action/event take place?

When does the action/event take place?

Why did the action/event occur?

How did the action/event occur?

Discussion for Comprehension /Writing

Directions: In groups, have students discuss the following questions taken from the blog: Myths and Misconceptions about Deaf People  After, have them check their answers and share them as a class.

  1. All deaf and hard of hearing persons benefit from hearing devices. Why or why not?
  2. For some deaf people, English is a second language. Why do you think this is so?
  3. Most deaf people communicate in sign language. Do you think that this is true? Explain why or why not.
  4. Do you think that a deaf person can drive a car? Explain why or why not.
  5. Do you believe that most deaf people are able to read lips?
  6. Many believe that deaf people can’t talk. Is this true or false? Why?
  7. If you shout at a person with a hearing loss they will hear you better. Does this work? How do you know?

1-Minute Free Writing Exercise

Directions: Allow students 1 minute to write down one new idea they’ve learned from the reading. Ask them to write down one thing they did not understand in the reading.  Review the responses as a class. Note: For the lower levels allow more time for this writing activity.

ANSWER KEY

Category: Medical, People | Tags:

The Trouble With Advance Directives: Doctors Often Miss Them

“This is not how it was supposed to happen…First there was a cancer diagnosis, too far gone for cure, then surgery…The elderly man had been found there earlier that evening, pale, feverish and too confused to communicate. There’s no family around. We’re probably going to have to intubate, the emergency room doctor told me… one of the doctors in training tapped me on the shoulder and pointed urgently at the computer screen. There was something important there at the very end of a progress note from the patient’s outpatient oncologist…Facing a prognosis on the order of months, the elderly man had requested that when things got worse, there would be no breathing tubes or chest compressions. Only comfort and quiet.” Dr. D. Lamas, The New York Times

ESL Voices Lesson Plan for this post with Answer Key

Image- Stuart Bradford

Excerpt: You’ve Detailed Your Last Wishes, but Doctors May Not See Them-By Daniella Lamas, M.D., The New York Times

“But now he was unable to speak for himself. Too busy with X-rays and ultrasounds and medications, the emergency team hadn’t seen the note. I sent a page off to the attending taking care of the patient to alert him to the patient’s wishes, and my resident gathered his papers to run down to the emergency room.

This patient had done everything we could have asked. He’d been brave enough to talk with his doctors about his cancer and acknowledge that time was short. He had designated a health care proxy. But there he was, surrounded by strangers, the intubation he never would have wanted looming and the record of that conversation buried in his electronic record.

Something had gone wrong. And though it would be easy to blame the oncologist for not sending the patient home with a legally binding directive documenting his end-of-life wishes, or the emergency doctors for not searching harder in the chart, it’s not that simple. As it usually is with a surgery performed on the wrong side of the patient’s body or a medication that’s prescribed despite a known allergy, the problem here is not about individuals, but instead about a system that doesn’t sufficiently protect patients from getting care they do not want.

 Increasingly, doctors like me are trained to have frank, hard conversations with our patients about prognosis and care goals. Outside the hospital, people with serious illnesses are encouraged to discuss these issues with their friends and family.

But what happens after? As a doctor working in the I.C.U., I knew firsthand the frustrations of searching the electronic record for notes and scanned documents. But I had no idea how common this problem was…Through my interviews, I heard stories of patients who had been transferred to nursing facilities without their advance directives and returned to the hospital intubated when that was explicitly not what they wanted. Others told me about patients of theirs who’d grown ill on vacation only to end up in a hospital they’d never been to, with an entirely different electronic medical record, where no one was able to access any prior documentation… In the absence of nationwide standards, there’s significant variability among hospitals and among electronic records. Some have worked to make end-of-life documentation more easily accessible.

At my hospital, for example, clicking on an ‘Advance Care Planning’ tab will bring you to a record of all advance care planning notes, health care proxy forms, scanned directives and code status orders.

This is a start, but it wasn’t enough for that elderly man in the emergency room. Habits are hard to break, and without a clear set of incentives, training and ongoing education, doctors (myself included) continue to record information about end-of-life conversations in progress notes, where they are not readily available, particularly when they are urgently needed.”

ESL Voices Lesson Plan for this post

NOTE: Lessons can also be used with native English speakers.

Level: Intermediate – Advanced


Language Skills: Reading, writing, and speaking. Vocabulary and grammar activities are included.


Time: Approximately 2 hours.


Materials: Student handout (from this lesson) and access to news article.


Objective: Students will read and discuss the article
with a focus on improving reading comprehension and learning new vocabulary. At the end of the lesson students will express their personal views on the topic through group work and writing.

I. Pre-Reading Activities

Stimulating background knowledge: Brainstorming

Directions: Place students in groups, ask students to think about what they already know about  the topic.  Next, have students look at the pictures in the text and generate ideas or words that may be connected to the article.  Regroup as a class and list these ideas on the board. Students can use a brainstorming chart for assistance.

 

Brainstorming chart by UIE

 

II. While Reading Activities

Word Inference

Directions: Students are to infer the meanings of the words in bold taken from the article. They may use a dictionary, thesaurus, and Word Chart for assistance.

  1. Many patients do not have advance directives.
  2. I was working  in the intensive care unit.
  3. The patient finally had  a discharge to go home.
  4. There was a note from the patient’s oncologist.
  5. Doctors gave him ultrasounds and medications.
  6. There was the intubation he never would have wanted looming.
  7. Increasingly, doctors are trained to have frank conversations with patients about prognosis and care goals.
  8. Some have worked to make end-of-life documentation more easily accessible.
  9. Doctors and health care workers need a clear set of incentives and training.
  10. Just imagine, your E.D. doctor is fumbling to find your information in your chart.

Word Chart By Education Oasis

 

Reading Comprehension

Sentence Match

Directions: Students  are to complete the sentences from the article by selecting the correct words or phrases.

  1. This ___ had done everything we could have asked.
  2. It’s tempting to assume that if you tell one ___ what you want at the end of your life, that’s enough.
  3. For the past year, I delved into the unexpectedly interesting world of advance ___planning.
  4. Recently, a ___ of start-ups have stepped in, trying to offer a solution.
  5. There’s software and ___patient apps that work outside the electronic record.
  6. Just imagine, your doctor is fumbling to find your ___in your chart, but you have an advance directive that was safely uploaded onto your smartphone.
  7. This most likely could have helped my ___ that day.
  8. At least, all related advance care planning documentation should be in one place in the ___.
  9. Beyond that, maybe all ___could require identification of a health care proxy for all patients.
  10. Yet as it is, we’re___.

WORDS/PHRASES: a-care, b-playing catch-up, c-clever, d-patient,  e-medical record,  f-handful,  g-information,  h-health systems,  i-patient,  j-doctor

 

Grammar Focus: Word -Recognition

Directions: Students choose the correct word to complete the sentences taken from the article. They are to choose from the options presented.

When the resident/reside arrived outside my patient’s room, he was relieved/relive to see that the elderly/elder man was still breathe/breathing on his own. The E.D. attending had held off. The patient’s family was on the way. Up in the I.C.U., we treated/trotted him gentle/gently with fluids and antibiotics and oxygen. He never did get strong/strength enough to make it back home, but I think he was quite/quiet and comfortable in the end, as he had wanted.

III. Post Reading Activities

WH-How Questions

Directions: Have students use the  WH-question format to discuss or to write the main points from the article.

Who or What is the article about?

Where does the action/event take place?

When does the action/event take place?

Why did the action/event occur?

How did the action/event occur?

Discussion for Comprehension /Writing

Directions: Place students in groups  and  have each group read the following statements from Dr. Lamas. Then see if each group can think of solutions to this problem. Share ideas as a class.

“As a doctor working in the I.C.U., I knew firsthand the frustrations of searching the electronic record for notes and scanned documents. But I had no idea how common this problem was… Through my interviews, I heard stories of patients who had been transferred to nursing facilities without their advance directives and returned to the hospital intubated when that was explicitly not what they wanted. Others told me about patients of theirs who’d grown ill on vacation only to end up in a hospital they’d never been to, with an entirely different electronic medical record, where no one was able to access any prior documentation.”

1-Minute Free Writing Exercise

Directions: Allow students 1 minute to write down one new idea they’ve learned from the reading. Ask them to write down one thing they did not understand in the reading.  Review the responses as a class. Note: For the lower levels allow more time for this writing activity.

ANSWER KEY

Category: Medical | Tags:

The Doctor’s Dilemma: Helping Patients to Die…Or Not

“I was leafing through a patient’s chart last year when a colleague tapped me on the shoulder. ‘I have a patient who is asking about the End of Life Option Act,’ he said in a low voice. ‘Can we even do that here?’ I practice both critical and palliative care medicine at a public hospital in Oakland. In June 2016, our state became the fourth in the nation to allow medical aid in dying for patients suffering from terminal illness. Now, five months after the law took effect here in California, I was facing my first request for assistance to shorten the life of a patient. I could see my own discomfort mirrored in his face. ‘Can you help us with it?’ he asked me. ‘Of course,’ I said. Then I felt my stomach lurch.”  J. N. Zitter, The New York Times

ESL Voices Lesson Plan for this post with Answer Key

Excerpt: Should I Help My Patients Die? By Jessica N. Zitter, The New York Times

“California’s law permits physicians to prescribe a lethal cocktail to patients who request it and meet certain criteria: They must be adults expected to die within six months who are able to self-administer the drug and retain the mental capacity to make a decision like this.

But that is where the law leaves off. The details of patient selection and protocol, even the composition of the lethal compound, are left to the individual doctor or hospital policy.

Our hospital, like many others at that time, was still in the early stages of creating a policy and procedure. To me and many of my colleagues in California, it felt as if the law had passed so quickly that we weren’t fully prepared to deal with it.

This first patient of mine was not a simple case. When I walked into his room, he glared at me.  ‘Are you here to help me with this aid-in-dying thing?’ he asked. He was in his early 60s, thin and tired, but in no obvious distress.  From my read of his chart, he met all criteria to qualify. Terminal illness, decision-making capacity, ability to self-administer the medications. And he had made the requisite first request for the drugs two weeks earlier, as procedure dictates.

When I asked why he wanted to end his life early, he shrugged. ‘I’m just sick of living.’ I asked about any symptoms that might lie behind his request: unrelenting pain, nausea, shortness of breath. He denied them all. In palliative care, we are taught that suffering can take many forms besides the physical.

At our second meeting, with more trust established, he issued a sob, almost a keening. He felt terrified and powerless, he said. He didn’t want to live this way anymore. I understood. I could imagine my own distress in his condition — being shuttled like a bag of bones between the nursing home and the hospital. It was his legal right to request this intervention from me. But given how uncomfortable I was feeling, was it my right to say no? …I’ll admit it: I want this option available to me and my family.

I realized it was past time to sort out my thinking and turned to the de facto specialist in our area on this issue for counsel. Dr. Lonny Shavelson, an emergency medicine and primary care physician in Northern California, has been grappling with the subject for many years. Given his interest in the topic, Dr. Shavelson felt a personal obligation to ensure that this new practice would be carried out responsibly after the law was passed. He founded Bay Area End of Life Options, a consulting group that educates physicians, advocates on patients’ behalf and prescribes the lethal concoction for some patients who meet the criteria for participation. Since starting his practice, he has been approached by 398 patients. He has accepted 79 of those into his program and overseen ingestion and death for 48. When I asked Dr. Shavelson how he might have proceeded with my patient, he said he would have tried everything to relieve his distress without using the lethal medication. But if in the end the patient still wanted to proceed, he would have obliged, presuming his depression was not so severe as to impair his judgment.

Photo- The Atlantic

The American Society of Clinical Oncology recommends that patients with advanced cancer receive concurrent palliative care beginning early in the course of disease. In my experience, far too few of these patients actually get it…We must continue to shape our policies and protocols to account for the nuanced social, legal and ethical questions that will continue to arise. We must identify the clinicians who are best qualified and most willing to do this work and then train them appropriately, not ad hoc. And we must remember that this is just one tool in the toolbox of caring for the dying — a tool of last resort.”  

NOTICE: UPDATE: 

Obama’s tweet after Charlottesville one of most popular tweets ever

former U.S. President Barack Obama

“In subsequent tweets, Obama continued the quote, which read: “People must learn to hate, and if they can learn to hate, they can be taught to love … For love comes more naturally to the human heart than its opposite.”

ESL Voices Lesson Plan for this post

NOTE: Lessons can also be used with native English speakers.

Level: Intermediate – Advanced


Language Skills: Reading, writing, and speaking. Vocabulary and grammar activities are included.


Time: Approximately 2 hours.


Materials: Student handout (from this lesson) and access to news article.


Objective: Students will read and discuss the article
with a focus on improving reading comprehension and learning new vocabulary. At the end of the lesson students will express their personal views on the topic through group work and writing.

I. Pre-Reading Activities

Stimulating background knowledge: Brainstorming

Directions: Place students in groups, ask students to think about what they already know about  the topic.  Next, have students look at the picture(s) in the text and generate ideas or words that may be connected to the article. Debrief as a class and list these ideas on the board. Students can use a brainstorming chart for assistance.

G. Cluster Brainstorming-workshopexercises

 

II. While Reading Activities

Word Inference

Directions: Students are to infer the meanings of the words in bold taken from the article. They may use a dictionary, thesaurus, and Word Chart for assistance.

  1. Doctors are taught that in palliative care suffering can take many forms.
  2. Oregon was the pioneer 20 years ago.
  3. The law allows physicians  prescribe a lethal cocktail.
  4. The idea of hastening death is uncomfortable.
  5. Many oppose this practice for ethical reasons.
  6. The doctor probed further to find out the truth.
  7. Some terminally ill patients want to die sooner.
  8. Many feel abandoned by their family.
  9. Doctors feel a personal obligation to this new practice.
  10. Dr. Shavelson strives to mitigate all symptoms.

ELLteaching 2.0 vocabualry chart

 

Reading Comprehension

True /False/NA-Statements

Directions: Review the following statements from the reading.  If  a statement is true they mark it T. If the statement is  not applicable, they mark it NA. If the statement is false they  mark  it F and provide the correct answer. 

  1. In June 2016, California became the  seventh in the nation to allow medical aid in dying.
  2. The details of patient selection and protocol, even the composition of the lethal compound, are left to the patients.
  3. The author felt that  she wasn’t fully prepared to deal with the new law.
  4. The American Medical Association, the nation’s largest association of doctors, has been formally opposed to the practice for 23 years.
  5. The  author’s first patient died in a nursing home, of natural causes, the following year.
  6. Dr. Lonny Shavelson is  an emergency medicine and primary care physician in New York City.
  7. Catholic health systems do not participate in the program.
  8. Dr. Shavelson offers  the medications to most of the patients who request them.
  9. One problem is payment, because many insurers won’t cover it.
  10. Doctors worry that public hospital patients like mine will not be able to afford this degree of care.

 Grammar Focus: Structure and Usage

Directions: The following groups of sentences are from the article. One of the sentences in each group contains a grammatical  error. Students are to identify the sentence (1, 2, or 3 ) from each group that contains the grammatical error.

I

  1. His patient intake procedures is time-consuming.
  2. Providers can bill for an office visit.
  3. Many insurers won’t cover  treatment.

II

  1. He counts this cases among his greatest successes.
  2. The patient had carefully thought through the decision.
  3. The vast majority of cases here have gone smoothly.

III

  1. Most communities won’t have doctors that offer discounts.
  2. These  is inequities we must address.
  3. We must continue to shape our policies.

III. Post Reading Activities

WH-How Questions

Directions: Have students use the  WH-question format to discuss or to write the main points from the article.

Who or What is the article about?

Where does the action/event take place?

When does the action/event take place?

Why did the action/event occur?

How did the action/event occur?

Discussion for Comprehension /Writing

Directions: Place students in groups and have them  discuss the following statements. Afterwards, have the groups share their thoughts as a class. To reinforce the ideas, students can write an essay on one of the topics mentioned.

“But still. I didn’t feel comfortable with the idea of helping to shorten the life of a patient because of depression and resentment. In truth, I’m not sure I am comfortable with helping to intentionally hasten anyone’s death for any reason. Does that make me a hypocrite?”

“There is another question I feel compelled to raise. Is medical aid in dying a reductive response to a highly complex problem? The over-mechanization of dying in America has created a public health crisis. People feel out of control around death. A life-ending concoction at the bedside can lend a sense of autonomy at a tremendously vulnerable time.”

Extra: Web Search

Directions: In groups/partners have students “Google” the topic and see what additional information they can find. Students can either have further discussions or write an essay about the subject.

3-2-1-Writing

Directions: Allow students 5 minutes to write down three new ideas they’ve learned about the topic from the reading,  two things they did not understand in the reading, and one thing they would like to know that the article did not mention. Review the responses as a class.

ANSWER KEY

Category: Culture, Medical | Tags:

Name Your Fear… A New Drug Can Cure It…Maybe

“Who among us hasn’t wanted to let go of anxiety or forget about fear? Phobias, panic attacks and disorders like post-traumatic stress are extremely common… Sitting at the heart of much anxiety and fear is emotional memory — all the associations that you have between various stimuli and experiences and your emotional response to them…. New research suggests that it may be possible not just to change certain types of emotional memories, but even to erase them.” R. Friedman, New York Times

ESL Voices Lesson Plan for this post with Answer Key

Image-

Excerpt: A Drug to Cure Fear by Richard A. Friedman, NYT

“Whether it’s the fear of being embarrassed while talking to strangers (typical of social phobia) or the dread of being attacked while walking down a dark street after you’ve been assaulted (a symptom of PTSD), you have learned that a previously harmless situation predicts something dangerous. 

Photo- telegraph.co.uk

Photo- telegraph.co.uk

It has been an article of faith in neuroscience and psychiatry that, once formed, emotional memories are permanent. Afraid of heights or spiders? The best we could do was to get you to tolerate them, but we could never really rid you of your initial fear. Or so the thinking has gone.

Photo-senselessscrutiny.com

Photo-senselessscrutiny.com

The current standard of treatment for such phobias revolves around exposure therapy. This involves repeatedly presenting the feared object or frightening memory in a safe setting, so that the patient acquires a new safe memory that resides in his brain alongside the bad memory. But if he is re-traumatized or re-exposed with sufficient intensity to the original experience, his old fear will awaken with a vengeance.

This is one of the limitations of exposure therapy, along with the fact that it generally works in only about half of the PTSD patients who try it…Several studies of rats done in 2000 showed that a drug called anisomycin, which blocks the synthesis of proteins in the brain, could reduce fear associations.

In one, researchers taught rats to fear a sound by pairing it with a shock. After the animals were fear-conditioned, they were presented with the sound and then immediately given the drug. When the animals were exposed to the sound again, they no longer appeared afraid; they had forgotten their original fear.

Curiously, there is a very narrow time window after retrieving a fear memory when you can disrupt that memory — hours, in the animal studies — before it closes and the drug has no effect.

Some may view any attempt to tamper with human memory as disturbing because it seems at odds with what we ought to do as a culture with the darker aspects of our history… Some may also argue that it’s a mistake to tinker with our fear responses because they’re natural — they evolved this way for a reason.

People who suffer panic attacks hyperventilate and have an intense desire to flee in situations where there is rarely actual danger. It turns out that panic disorder is associated with an increased sensitivity to carbon dioxide in the brain. If you lived in a cave with a clan of hominid fire-dwellers, you’d have been one of the first to get out when the oxygen supply was dwindling.

Evolutionary design has left us a few million years out of date; we are hard-wired for a Paleolithic world, but have to live in a modern one. The irrational fear of anxiety disorders was once probably useful and lifesaving. No longer.”

ESL Voices Lesson Plan for this post

NOTE: Lessons can also be used with native English speakers.

L2 Student Level: Intermediate – Advanced


Language Skills: Reading, writing, and speaking. Vocabulary and grammar activities are included.


Time: Approximately 2 hours.


Materials: Student handout (from this lesson) and access to news article.


Objective: Students will read and discuss the article
with a focus on improving reading comprehension and learning new vocabulary. At the end of the lesson students will express their personal views on the topic through group work and writing.

I. Pre-Reading Activities

Stimulating background knowledge: Brainstorming

Directions: Place students in groups, ask students to think about what they already know about  the topic.  Next, have students look at the pictures  in the article  and generate ideas or words that may be connected to the article. Debrief as a class and list these ideas on the board. Students can use a brainstorming chart for assistance.

Colorful Brainstorming chart from Live It Magazine.

Colorful Brainstorming chart from Live It Magazine.

II. While Reading Tasks

Word Inference

Directions: Students are to infer the meanings of the words in bold taken from the article. They may use a dictionary, thesaurus, and Word Chart for assistance.

  1. Fear of being attacked while walking down a dark street after you’ve been assaulted is a symptom of PTSD.
  2. A harmless situation can suddenly predict something dangerous.
  3. The best doctors could do was to get you to tolerate them.
  4. They could never really rid you of your initial fear.
  5. The current standard of treatment for such phobias are exposure therapy.
  6. The patient acquires a new safe memory that resides in his brain.
  7. But if he is re-traumatized his old fear will awaken with a vengeance.
  8. This might be a cure for people with arachnophobia.
  9. Exposure to your fear at the right moment, could free you of that fear forever.
  10. We should think twice about casually prescribing stimulants for young people.Word Map Education Oasis

Reading Comprehension

Fill-ins

Directions: Place students in groups and after they have read the entire article, have them complete the following paragraphs taken from the article. They can use the words and terms from the list provided, or provide their own terms. They are to find the meanings for  any new vocabulary.

Anxiety enhances___memory. We all know that — it’s why you can easily ___where you put your___, but will never forget being___.

Indeed, a ___that will be published next month found that the escalating use of ___by the ___in active duty___, including those serving in Iraq and Afghanistan, was strongly correlated with an ___in the rates of___, even when___ for other factors, like the rate of attention deficit ___disorder.

The study___ the use of prescription stimulants, like Ritalin and Adderall, and the rates of PTSD in nearly 26,000 military service members between 2001 and 2008, and found that the ___of PTSD ___along with the prescriptions.

Word List: controlling, increase, forget, emotional, military, stimulants,

examined, increased, incidence, study, hyperactivity, attacked,

wallet, soldiers, PTSD,

 Grammar Focus: Structure and Usage

Directions: The following groups of sentences are from the article. One of the sentences in each group contains a grammatical  error. Students are to identify the sentence (1, 2, or 3 ) from each group that contains the grammatical error.

I.

  1. It has been a article of faith in neuroscience.
  2. This is one of the limitations of exposure therapy.
  3. Their fear did not return even at the end of one year.

II.

  1. Arachnophobes has an emotional memory.
  2. The basic idea is that they are no longer afraid of spiders.
  3. When the animals were exposed to the sound again, they no longer appeared afraid.

III.

  1. There’s a flip side to this story.
  2. Evolutionary design has left us a few million years out of date.
  3. Some may also argue that it’s an mistake to tinker with our fear responses.

III. Post Reading Tasks

WH-How Questions

Directions: Have students use the  WH-question format to discuss or to write the main points from the article.

Who or What is the article about?

Where does the action/event take place?

When does the action/event take place?

Why did the action/event occur?

How did the action/event occur?

Discussion/Writing Exercise

Directions: Place students in groups and have them restate the following three statements in their own words. Afterwards, have the groups share their thoughts as a class. To reinforce the ideas, students can write an essay on one of the following discussion topics.

  1. “So it is possible that taking stimulants could increase one’s risk of developing PTSD when exposed to trauma… a study that will be published next month found that the escalating use of stimulants by the military in active duty soldiers, including those serving in Iraq and Afghanistan, was strongly correlated with an increase in the rates of PTSD, even when controlling for other factors, like the rate of attention deficit hyperactivity disorder.”

  2. “Some may view any attempt to tamper with human memory as disturbing because it seems at odds with what we ought to do as a culture with the darker aspects of our history: Never alter the facts, even if we have divergent interpretations of them.”

  3. “Some may also argue that it’s a mistake to tinker with our fear responses because they’re natural — they evolved this way for a reason. Like most other animals, we come hard-wired with a flight or fight response along with its associated anxiety and fear. Without this warning system to protect us from predators and other dangers, we’d have been dinner long ago on the savanna.”

3-2-1-Writing

Directions: Allow students 5 minutes to write down three new ideas they’ve learned about the topic from the reading,  two things they did not understand in the reading, and one thing they would like to know that the article did not mention. Review the responses as a class.

ANSWER KEY

Category: Medical