Health and Wellness

The unit opens with a wellness wheel: eight parts of life that together make you well. If one part is weak, the wheel is flat on that side and life doesn’t roll smoothly, however strong the other parts are.

Before you read

What kind of text it is

The text is an open letter, written to all health workers and published in Hospital News, a Canadian newspaper for people who work in hospitals. The writer signs herself “an appreciative mother”, and near the end we learn something surprising: she is a health worker herself. So it is not an attack from outside; it is a colleague telling her own profession how it looks from the patient’s chair.

The letter, part by part

1. What happened

She opens with “a parent’s worst nightmare”. Her baby daughter, only nine weeks old, got an extremely high fever one evening. They rushed to their local hospital, went in through the emergency department, were moved to the pediatric unit (the ward for children), and went home three days later.

She is thankful: the doctors and nurses were skilled, and the baby got better. Her baby’s care was “fantastic”, she says, but her experience as a parent was “less than satisfactory”, a polite way of saying it was bad. The rest of the letter explains why.

2. Staff complaining about each other

When she was alone with them, many staff bad-mouthed (spoke badly of) their colleagues. She isn’t sure why: perhaps she looked trustworthy, perhaps they wanted to show they were better than the others. The complaints went round in a circle:

• the emergency nurses complained about the doctors’ orders and how slowly the children’s nurses came;
• the children’s nurses complained that the emergency nurses couldn’t put in an intravenous line (a thin tube into a vein, for fluids and medicine);
• the children’s doctor complained about the emergency doctor’s orders;
• the children’s nurse complained about the children’s doctors’ way of treating the baby;
• and the children’s doctor complained that the nurse couldn’t get a urine sample.

She wanted to scream: Stop complaining about each other and look after my sick baby! To her, everyone seemed so busy with their own needs and skills that they forgot the baby in front of them. Their egos (their pride in themselves) seemed more important than her daughter.

3. “I am so busy today”

Nurses told her again and again how busy they were. Maybe they meant it as an excuse for her daughter’s medicines being late; maybe they wanted sympathy. But each time she heard it, her mind turned it into “your daughter is not a priority”.

Her advice: don’t use patients or their families as your confidante (someone you tell your private troubles to). The family is there to see the patient get better, not to hear that the staff can’t manage. Tell patients they come first, and share good news with them.

4. Read the chart

The chart is the patient’s record, where everything done should be written. Yet every doctor and student asked her the same two questions, “Was she premature?” and “Was your delivery normal?”, and she gave the same answers each time. Surely, she says, someone wrote this down.

5. “Him”: the gender error

Most of the staff called her daughter “he”. She politely corrected them each time. The baby wore only a diaper, so nothing showed whether it was a boy or a girl, but her papers must have said “female”. Tired and stressed from lack of sleep, she began to wonder what other mistakes might be in her baby’s papers. Her lesson: be careful what you say to patients; when you slip, apologize sincerely and don’t do it again. The error made the staff look sloppy (careless) and unfocused, though it was an innocent mistake.

6. “I am a health care worker just like you”

Here is the turn. She too is a health worker, and she knows people trust health workers with their dearest ones when they are most vulnerable. Health workers do this job with pride, but the way they treat each other is “dreadful”. Patients know it isn’t a glamorous job and believe most health workers do it to help sick people; she asks them to prove that belief true. She admits she has said some of these things herself, and promises to be more careful from now on.

7. The closing

She ends with an appeal: treat patients in a way that gives them confidence in you and in your whole team, because you alone can make a patient’s experience good. She signs off “Yours truly, An appreciative mother”: still thankful, despite everything.

Words from the letter

Words linked here open in English Vocabulary, where you can see an example and practice them in the word game.

Word	Meaning here
nightmare	a very frightening experience (also, a bad dream)
pediatric (British paediatric)	to do with the medical care of children; a pediatrician is a children’s doctor
discharge	to allow a patient to leave the hospital
bad-mouth	to say bad things about someone
colleague	a person you work with
competent	able to do a job well
intravenous	into a vein (an IV line is a thin tube into a vein)
vantage point	the place you see something from; your point of view
ego	your sense of your own importance
priority	the thing that comes first, that matters most
medication	a medicine; treatment with medicines
confidante	a person you tell your private worries and secrets to
premature	born before the full nine months
deprivation	not having something you need (sleep deprivation: too little sleep)
genuine	real and honest
refrain (from)	to stop yourself from doing something
vulnerable	weak and easily hurt; needing special care
dreadful	very bad or unpleasant
glamorous	exciting and attractive, admired by others
instill	to put a feeling or idea into someone gradually (British instil)

A. Match the words with their meanings

B. True or false?

C. Answer the questions

D. If you were a health worker

The letters oo stand for two different sounds. In book it is short /ʊ/, lips loosely rounded, the sound of put. In food it is long /uː/, lips pushed forward, held longer, the sound of blue.

Short /ʊ/ as in book	Long /uː/ as in food
book, cook, foot, good, look, hook, stood, took, wood, wool	food, moon, noon, roof, school, too, zoo, zoom, mood

A. At the doctor’s

In the picture for this task, a doctor tells a boy, Aakash, “Don’t eat junk food. Get some rest.” His friends in the waiting room report it:

• “What did the doctor tell him?”
• “The doctor forbade him to eat junk food.”
• “She also told him to rest.”

Notice the pattern: reporting verb + the person + to + verb. Forbade already means “told him not to”, so it takes plain to.

B. In threes

C. Report the instructions for a paper boat

An imperative sentence gives an order, makes a request or gives advice: Keep quiet!, Please close the window, Don’t overeat. To report it:

1. Use a reporting verb that fits: told, ordered, commanded (an order); asked, requested, begged (a request); advised, urged, warned (advice or a warning).
2. Put the person spoken to straight after it: told me, asked the driver.
3. Turn the verb into the to-infinitive: close → to close.
4. For a negative order, put not before to: Don’t overeat → not to overeat.
5. Drop please, the name of the person addressed and the exclamation mark; change person, time and place words as usual.

Direct and reported, side by side

Direct speech	Reported speech
She said, “Keep quiet!”	She ordered me to keep quiet.
“Please close the window,” the teacher said.	The teacher requested me to close the window.
The doctor said, “Don’t overeat.”	The doctor urged me not to overeat.
She said, “Take the test next week.”	She advised them to take the test the following week.
He said, “Take a taxi home.”	He insisted that we take a taxi home. (or: He urged us to take a taxi home.)
He said to me, “Please wait here till I return.”	He requested me to wait there till he returned.
Pranik said, “Let’s go out.”	Pranik suggested that we should go out. (or: Pranik suggested going out.)
I said to him, “Excuse me, sir.”	I begged him to excuse me. (or: I politely asked him to excuse me.)

B. Report the requests and orders

How to write an email of apology

An email has the same parts as a letter, set out more simply:

1. To (the address) and a clear Subject line.
2. Greeting: Dear Madam, or Dear Mrs. Sharma, for a formal email.
3. Thanks or reason for writing: what the email is about.
4. The apology: say exactly what was wrong (“We complained to you about our colleagues”), take responsibility, and don’t make excuses.
5. What you will do: a promise someone can check.
6. Closing: a kind last line, then Yours sincerely, With sincere apologies or Best regards, your name and your position.

What kind of text it is

The text is a speech: the opening address that Máire Geoghegan-Quinn, the European Commissioner for Research, Innovation and Science, gave in Brussels on 28 March 2014, at a conference of the Joint Programming Initiative “A Healthy Diet for a Healthy Life”. (A joint programming initiative is a plan in which the countries of the European Union run their research on one big problem together, instead of each on its own.) A speech is written to be heard, so watch for its signs: it addresses the audience (Ladies and gentlemen), says I and we, repeats key words, and ends by thanking them.

The speech, part by part

1. Opening

She greets the audience and says she is delighted to open the conference.

2. The problem

Diet is always in the news, with endless arguments about whether carbs, fat, sugar or protein are good or bad, and stories of some new “wonderfood” that will stop cancer or make us live longer. Behind the noise is a real public health challenge: diseases caused by diet and lifestyle, such as overweight and obesity, sometimes called the greatest public health challenge of our time.

3. Why work together

Every country in the EU faces it, to different degrees, so it makes sense, for science and for money, to pool (put together) their knowledge. That is why the Initiative matters.

4. The facts

When the Initiative began, the EU’s Council noted that overweight and obesity had risen dramatically over thirty years, especially among children, and that poor diet and too little physical activity were getting worse. Many chronic (long-lasting) diseases, such as cancer, disorders of the nerves and the mind, heart and blood vessel diseases, obesity and type 2 diabetes, can be prevented or changed by better lifestyles and healthier diets. Research projects are already showing how diabetes and obesity can be prevented, how they progress, how early diagnosis improves life, and how to choose treatments. But much more is needed, because their effects pass on from one generation to the next.

5. Horizon 2020

Horizon 2020 is Europe’s research and innovation program, worth about 80 billion euros, for society’s biggest challenges. Two of its challenges fit this Initiative: food safety and the bioeconomy, and health, demographic change and wellbeing. For seven years they will fund the best research on nutrition, health, diet-related disease and ageing, and turn it into products, treatments and services that help patients and stop people falling ill in the first place.

That will need unprecedented (never-before-seen) cooperation along the whole chain: from the researchers who describe diseases, to those who develop biomarkers (signs in the body that show a disease), diagnostics (tests) and medicines, to the officials who check and approve them.

6. Why a new approach

So far, campaigns for healthier eating have not changed what people buy and eat very much. That is where a multidisciplinary approach comes in: health and nutrition research joined with the social sciences, because understanding people’s behavior and their relationship with food and exercise is vital to helping them choose better.

7. From plans to action

Good intentions are worthless unless they become concrete action, so implementation matters: first by coordinating each country’s research. The plan launched that day, for putting the Strategic Research Agenda (the Initiative’s list of research to do) into action, is a big step. She encourages them to find other avenues (ways), such as linking with other initiatives and sharing Europe’s research facilities, and above all urges the member states to release national money for research and to align (bring into line) their research and innovation policies.

8. Closing

She wishes them an excellent conference, full of new ideas, says she looks forward to the results, and thanks them.

Words from the speech

Word	Meaning here
delighted	very pleased
conference	a large formal meeting where people discuss one subject
wonderfood	a food that people claim will do wonders for health (a “superfood”)
innovation	a new idea, method or product
obesity	being so overweight that health is at risk
dramatically	suddenly and by a large amount
trend	the general direction in which something is changing
chronic	lasting a long time, or coming back again and again
neurological	to do with the nerves and the brain
cardiovascular	to do with the heart and the blood vessels
diagnosis	finding out what disease a person has
transgenerational	passed on from one generation to the next
bioeconomy	the part of the economy that uses living resources (crops, forests, fish) to make food, materials and energy
demographic change	a change in the make-up of a population, such as more old people
unprecedented	never seen or done before
biomarker	something measurable in the body (in the blood, for example) that shows a disease or how it is going
diagnostics	tests used to find out what disease someone has
consumption	the amount used or eaten
multidisciplinary	using several fields of knowledge together
avenue	a way of doing something
align	to bring into line with something else

A. Define the words

B. Complete the sentences

C. Choose the best answers

D. Answer the questions

E. A speech on exercise

The textbook’s listening task is a radio interview with a doctor who specializes in the stomach and gut. CDC’s own recording is below: read the questions in B and C first, then listen, as many times as you need.

B and C. The textbook’s audio: answers

Practice listening alone

A. Choose the correct words

B. Use the reporting verbs given

C. Report the sentences

How to write a speech

A speech is written to be heard, so it must be easy to follow by ear.

1. Address the audience, most important first: Respected chairperson, chief guest, teachers and friends,
2. Greet them and introduce the topic: why it matters now.
3. Body: your main points in a clear order, one paragraph each. Signal each one (What causes it?, First…, Secondly…, Finally…): a listener can’t look back.
4. Closing: sum up in one strong line, or call on the audience to act.
5. Thank them.

Rule 1. An imperative sentence gives a command, makes a request, or gives advice. Choose a reporting verb that fits:

Verbs of command	Verbs of request	Verbs of advice
tell, order, command, charge, bid, require, forbid	ask, request, desire, beg, solicit, beseech, pray, entreat, implore	advise, exhort, urge, persuade, warn

Rule 2. The verb of the imperative becomes the to-infinitive.
Direct: I said to my friend, “Please explain this lesson to me.”
Indirect: I requested my friend to explain that lesson to me.

Rule 3. A negative imperative puts not before to.
Direct: The teacher said to the boys, “Don’t make a noise.”
Indirect: The teacher asked the boys not to make a noise.

Rule 4. The name of the person addressed (a vocative) is dropped from the words and becomes the object of the reporting verb.
Direct: The teacher said, “Muna, come to the office.”
Indirect: The teacher told Muna to go to the office. (Come becomes go because the speaker is no longer in the office.)

Rule 5. When let’s makes a suggestion, use suggest or propose, with should or the plain verb, or suggested + -ing.
Direct: He said, “Let’s play outside.”
Indirect: He suggested that they should play outside. / He proposed that they play outside. / He suggested playing outside.
But when let me, let him or let them asks for permission, report it with asked + to let: “Let me go,” he said. → He asked me to let him go.

SEE-style practice on this unit. Try each one as in the exam, then open the answer.