问答题 .  SECTION A  MULTIPLE-CHOICE QUESTIONS
    PASSAGE ONE
    (1)When I was 10 years old one of my father's customers had caught a big catfish on a weekend trip to the Colorado River. It weighed 86 pounds, a swollen, gasping, grotesque netherworld creature pulled writhing and fighting up into the bright, hot, dusty world above.
    (2)The man had brought the fish, wrapped in wet burlap, all the way out to my father's service station in the back of his car. We were to have a big barbecue that weekend, and I was given the job of keeping the fish watered and alive until the time came to kill and cook it.
    (3)All day long that Friday—in late August, school had not yet started—I knelt beside the gasping fish and kept it hosed down with a trickle of cool water, giving the fish life one silver gasp at a time, keeping its gills and its slick gray skin wet: the steady trickling of that hose, and nothing else, helping it stay alive. We had no tub large enough to hold the fish, and so I squatted beside it in the dust, resting on my heels, and studied it as I moved the silver stream of water up and down its back.
    (4)The fish, in turn, studied me with its eyes, which had a gold lining to their perimeter, like pyrite. The fish panted and watched me while the heat built all around us, rising steadily through the day from the fields, giving birth in the summer-blue sky to towering white clouds. I grew dizzy in the heat, and from the strange combination of the unblinking monotony and utter fascination of my task, until the trickling from my hose seemed to be inflating those clouds—I seemed to be watering those clouds as one would water a garden. Do you ever think that those days were different—that we had more time for such thoughts, that time had not yet been corrupted? I am speaking less of childhood than of the general nature of the world we are living in. If you are the age I am now—mid-50s—then maybe you know what I mean.
    (5)The water pooled and spread across the gravel parking lot before running in wandering rivulets out into the field beyond, where bright butterflies swarmed and fluttered, dabbing at the mud I was making.
    (6)Throughout the afternoon, some of the adults who were showing up wandered over to examine the monstrosity. Among them was an older boy, Jack, a 15-year-old who had been kicked out of school the year before for fighting. Jack waited until no adults were around and then came by and said that he wanted the fish, that it was his father's—that his father had been the one who had caught it—and that he would give me five dollars if I would let him have it.
    (7)"No," I said, "my father told me to take care of it."
    (8)Jack had me figured straightaway for a Goody Two-Shoes. "They're just going to kill it," he said. "It's mine. Give it to me and I'll let it go. I swear I will," he said. "Give it to me or I'll beat you up."
    (9)As if intuiting or otherwise discerning trouble—though trouble followed Jack, and realizing that did not require much foresight—my father appeared from around the corner, and asked us how everything was going. Jack, scowling but saying nothing, tipped his cap at the fish but not at my father or me, and walked away.
    (10)"What did he want?" my father asked.
    (11)"Nothing," I said. "He was just looking at the fish." I knew that if I told on Jack and he got in trouble, I would get beaten.
    (12)"Did he say it was his fish?" my father asked. "Was he trying to claim it?"
    (13)"I think he said his father caught it."
    (14)"His father owes us $67," my father said. "He gave me the fish instead. Don't let Jack take that fish back."
    (15)"I won't," I said.
    (16)I can't remember if I've mentioned that, while not poor, we were right at the edge of poor.
    (17)The dusty orange sky faded to the cool purple-blue of dusk. Stars appeared and fireflies emerged from the grass. I watched them, and listened to the drum and groan of the bullfrogs in the stock tank in the field below, and to the bellowing of the cattle. I kept watering the fish, and the fish kept watching me, with its gasps coming harder. From time to time I saw Jack loitering, but he didn't come back over to where I was.
    (18)Later in the evening, before dark, but only barely, a woman I thought was probably Jack's mother—I had seen her talking to him—came walking over and crouched beside me. She was dressed as if for a party of far greater celebration than ours, with sequins on her dress, and fiat leather sandals. Her toenails were painted bright red, but her pale feet were speckled with dust, as if she had been walking a long time. I could smell the whiskey on her breath, and on her clothes, I thought, and I hoped she would not try to engage me in conversation, though such was not to be my fortune.
    (19)"This's a big fish," she said.
    (20)"Yes, ma'am," I said, quietly. I dreaded that she was going to ask for the fish back.
    (21)"My boy and my old man caught that fish," she said. "You'll see. Gonna have their pictures in the newspaper." She paused and stared at the fish as if in labored communication with it. "That fish is worth a lot of money, you know?" she said.
    (22)I didn't say anything. Her diction and odor were such that I would not take my first sip of alcohol until I was 22.
    PASSAGE TWO
    (1)Improving the balance between the working part of the day and the rest of it is a goal of a growing number of workers in rich Western countries. Some are turning away from the ideals of their parents, for whom work always came first; others with scarce skills are demanding more because they know they can get it. Employers, caught between a falling population of workers and tight controls on immigration, are eager to identify extra perks that will lure more "talent" their way. Just now they are focusing on benefits (especially flexible working) that offer employees more than just pay.
    (2)Some companies saw the change of mood some time ago. IBM has more than 50 different programmes promoting work-life balance and Bank of America over 30. But plenty of other firms remain unconvinced and many lack the capacity to cater to such ideas even if they wanted to. Helen Murlis, with Hay Group, a human-resources consultancy, sees a widening gap between firms at the creative end of employment and those that are not.
    (3)The chief component of almost all schemes to promote work-life balance is flexible working. This allows people to escape rigid nine-to-five schedules and work away from a formal office. IBM says that 40% of its employees today work off the company premises. For many businesses, flexible working is a necessity. Globalization has spread the hours in which workers need to communicate with each other and increased the call for flexible shifts
    (4)Nella Barkley, an American who advises companies on work-life balance, says that large firms are beginning to understand the value of such schemes, "but only slowly". For most of them, they still mean little more than child care, health care and flexible working.
    (5)Yet some schemes go well beyond these first steps. American Century Investments, an investment manager in Kansas City, pays adoption expenses and the cost of home-fitness equipment for its employees. Rob Marcolina, a consultant with Bain & Company based in Los Angeles, Was allowed time off to marry his partner in Canada. Mr Marcolina, who has an MBA from the high-ranked Kellogg business school, says his employer's understanding makes him want to be "part of Bain for some time".
    (6)Businesses have other good reasons for improving employees' work-life balance. Wegmans Food Markets, a grocery chain based in Rochester, New York, frequently appears near the top of lists of the best employers in America. It has a broad range of flexible-work programmes, which gives it one of the lowest rates of employment turnover in its industry—8% a year for full-time workers, compared with 19% across the industry.
    (7)Simple programmes can be surprisingly cost-effective. IBM, for instance, is spending $50m over five years on "dependant-care" facilities for its employees. Although that sounds generous, it is the equivalent of little more than $30 for each IBM employee every year. That is far cheaper than a pay rise and probably a better way to retain talented mothers and fathers. Ernst & Young, a global accounting firm, has a low-cost range of initiatives called  "People First". It provides breaks for people to provide care and has over 2,300 flexi-time employees in the United States. James Freer, a senior executive, says he is "absolutely convinced" the initiatives help produce better financial results.
    (8)DeAnne Aguirre, a mother of four and a senior partner in San Francisco with Booz Allen Hamilton (BAH), says "it is easy to make the business case" for work-life balance programmes at the consultancy by looking at attrition rates. BAH calculated that it was investing more than $2m in turning a raw recruit into a partner, an investment it should be reluctant to write off. Coming, an American glass company, reckons that it costs 1.5 times a worker's salary and benefits to replace him. If it can retain just 20 workers a year who would otherwise have left, Coming reckons it would produce annual savings of $2.6m.
    (9)The spread of flexible work has come about at least partly as a result of initiatives to keep women workers. Companies have had to offer extended periods of leave for them to look after dependants (young and old), and. flexible working in between. At BAH, women partners take an average of eight-and-a-half extended breaks during their careers. Men take an average of one-and-a-half. Ernst & Young, keen to show that part-time workers can also become partners, recently made the first such appointment in Houston, Texas.
    (10)Some of these initiatives are spreading even to the castles of binge working, such as investment banks. Business schools are now climbing on the bandwagon, too. In October Tuck School at Dartmouth, New Hampshire, will start a course on returning to corporate life after an extended absence. Called "Back in Business", the 16-day, $12,000 re-entry programme is open only to students with "work experience in a high-potential career".
    (11)The majority will inevitably be mothers wanting to rejoin the workforce. But fathers are also asking for sabbaticals (公休假). Work-life balance "is not just a women's issue" any more, says Ted Childs, who is in charge of workforce diversity at IBM. "Men, too, are very concerned about it."
    (12)The demand is being stoked by the "Generation Y", the under-28s. They look sceptically at the idea of lifetime employment within a single organisation and they are wary of the commitment they believe too often drove their parents to the divorce courts. Hay's Ms Murlis says that today's business-school graduates are "looking for a workstyle to go with their lifestyle", not the other way round. They are happy to binge-work for a while, but in return want extended sabbaticals.
    (13)Many of the more imaginative schemes come from organisations that are not under pressure to report quarterly to Wall Street. Wegmans and American Century Investments are family-controlled businesses and the big accounting firms and consultancies, such as Ernst & Young, KPMG, Bain and BAH, are partnerships. This allows them to take a longer-term view of growth and costs.
    (14)To some extent, the proliferation of work-life-balance schemes is a function of today's labour market. Companies in knowledge-based industries worry about the shortage of skills and how they are going to persuade talented people to work for them. Although white-collar workers are more likely to be laid off nowadays, they are also likely to get rehired. Unemployment among college graduates in America is just over 2%. The same competition for scarce talent is evident in Britain.
    (15)For some time to come, talented people in the West will demand more from employers, and clever employers will create new gewgaws to entice them to join. Those employers should note that for a growing number of these workers the most appealing gewgaw of all is the freedom to work as and when they please.
    PASSAGE THREE
    (1)The blind, overweight patient in the wheelchair has terrible pain in her back and burning pain in her legs. She also has advanced arthritis in her knees and end-stage circulatory disease, which have left her with two useless legs that are red, swollen and infected. Now her shoulder has started to hurt. She can't raise her arm to comb her hair. Five or six other things are wrong with her—she tells me about each. Some we can help; most we can't. I tell her as much.
    (2)In my office, she listens carefully. I hardly ever have to repeat myself with Doris (not her real name). She asks questions—mostly good ones. She needs lots of tests, various therapies. I ultimately recommend an operation on her shoulder. Sick, weakened by multiple symptoms and with lousy insurance, Doris is—surprise—a really good patient. She communicates efficiently with her doctors and treats us with respect and trust. She has reasonable expectations. I can tell she looks things up, but her knowledge is helpful—never challenging. I've talked about her with other doctors, and we agree on this: when you see Doris' name on your day's list, you know you're going to work hard. But you're usually glad her name is there.
    (3)Few patients realize how deeply they can affect their doctors. That is a big secret in medicine—one doctors hate to admit. We think about, talk about, dream about our patients. We went into clinical medicine because we like dealing on a personal, even intimate level with people who have chosen to put their bodies in our hands. Our patients make or break our days.
    (4)Take the compliment. Our career choice means we really do think that you—with your aches and pains—are more interesting than trading hot securities, more fun than a courtroom full of lawyers. Massaging the ego is the key to manipulating responsible types like doctors. When we feel your trust, you have us.
    (5)The most compelling reasons to be a good patient are selfish ones. You will get more than free drug samples if your doctor is comfortable and communicates easily with you. You'll get more of the mind that you came for, a mind working better because it's relaxed—recalling and associating freely, more receptive to small, even unconscious clues. That means better medical care. But you should try to be a good patient for unselfish reasons too. We worry about you 60 hours a week. We gave up our 20s for you. Why not show us some love? It's not hard.
    (6)The medical relationship is intrinsically one-sided. It's about you and your problem. I am going to find out more about you in the next 20 minutes than you will find out about me. Don't fret about that. We don't expect you to ask much about us. Good patients answer questions accurately and completely. They ask questions too.
    (7)But many patients talk too much. You might notice that we are writing when we see you—we are creating your chart. We need specific facts but not every fact in your life. Here's a classic exchange:
    (8)How long has your shoulder hurt, Beatrice? "Oh, for quite some time now." But for how long? How many months? "Oh, at least since the wedding—well, then again it did act up a bit when Margaret came back from Ireland..."
    (9)All I want to do is write something like "Right shoulder, 6 months, no trauma" on my chart. Although I lack the heart to tell her, Beatrice would be a better patient if she tried to be a bit more concise. There are lots of Beatrices.
    (10)Here's another classic:
    (11)"Well, I don't need to have good manners—I'm sick—and I'm not going to be a patsy for some smooth talker in a white coat. The squeaky wheel gets the grease, you know."
    (12)That is the mind-set of many patients who abuse their doctors; my bet is they abuse other people as well. Any good doctor knows when you're too sick to be polite and will let it roll off his back. The squeaky wheel we don't like is the one playing a dominance game. That big wheel is likely to get a shorter, less sensitive examination and more tests, and then still more tests to follow up the abnormalities in the first tests, followed by extra consultations with specialists—anything to relieve the doctor's responsibility for a bad patient.
    (13)Are doctors good patients? Others may disagree, but I think they are. Medical terms don't faze them, so communication is easier, and their expectations tend to be more reasonable. Anyone in medicine is painfully aware that there are plenty of problems for which we have no good answer. Nurses tend to be even better patients, being adept at following doctors' orders—a virtue lacking in doctors.
    (14)Doctors and nurses also know when to respect an educated opinion. When the MRI says one thing and I want to do another, they are more likely to be on my side. But you need not be a medical professional, or educated at all, to be a great patient. It's pretty much the same strain of human decency—a truthful consideration of who the people around you are and of what they are trying to do—that infects a good patient and any good person.1.  The author's behavior of guarding the fish showed ______PASSAGE ONE
【正确答案】 B
【答案解析】 细节推断题。考查作者守护鲶鱼过程中所体现出来的性格特点。文章第6段至第11段描绘了作者一直坚持守护鲶鱼,体现了其强烈的责任感,此处文章还说到作者为避免遭到报复而撒谎,体现其机智的一面;第3段第1句话描写作者整天跪着守护鲶鱼也体现了他的责任心,故B为正确答案。
[参考译文]
   PASSAGE ONE
   (1)我10岁那年,父亲的一位顾客在科罗拉多河度周末时捉到了一条大鲶鱼。这条鱼有86磅重,鼓胀鼓胀的、扑哧作响,它是地下世界的奇异生物,被拖上光明炎热、满是尘土的地面时不停地翻腾、拼命挣扎。
   (2)那位男顾客用湿麻袋裹起鱼,放在车尾,一路驶向我爸的加油站,把鱼带了过来。那个周末我们打算吃烧烤大餐,我的任务是不停地给鱼加水,让它在被杀来做菜之前还活蹦乱跳。
   (3)那是八月底的一个星期五,学校还没有开学,我成天跪在那条喘着粗气的鱼的旁边,不停地用软管住它身上浇冷水,让它暂时死不了,仍然在闪着银光的水流下扑哧作响,让它的鱼鳃、灰色滑溜的鱼皮保持湿润:其实也没别的什么事,不过是让软管持续不断地放出细细的流水,保持鱼鲜活而已。我们的盆子不够大,装不下那条鱼,于是我就踮着脚跟,蹲在地上,守在鱼旁边看着,把闪着银光的水流往鱼脊上来回浇洒。
   (4)那条鱼反过来也用它的眼睛打量着我,它的眼圈是金黄色的,就像黄铁矿的颜色。那条鱼边盯着我边扑哧扑哧喷气,当时我被热气包围着,热气从田间蒸腾,从早到晚都不曾减弱,夏日的蓝天也因此积聚了一层层厚厚的白云。在炎热的天气下,那种一眼不眨地盯着鱼的无聊,一旦结合了对这个看鱼任务的着迷之后,我变得头晕眼花,后来觉得我手中软管喷出的涓涓细流仿佛在让云朵膨胀起来——我似乎像别人浇灌花园一样正在浇灌云朵。你是否曾想到那些与众不同的日子,那些有更多时间可以这样想象的日子,那些依旧纯洁的时光?我常常提及我们现世中的常见事物,而很少提及童年生活。如果你和我一样现在已经55岁了,你可能就会明白我的意思。
   (5)水先积成一滩,然后向碎石铺就的停车场散去,最后形成几条弯弯的细流,一直流向远处的田里。田间美丽的蝴蝶成群结对地飞来飞去,轻轻地落在我堆的泥土上。
   (6)整个下午都有一些小青年过来围着这条大得吓人的东西转。他们当中有个年纪较大的,叫杰克,15岁了,去年因为打架被踢出了校门。杰克等那些小青年都离开后,走了过来,向我要这条鱼,他说这条鱼是他爸爸的,是他爸爸抓到这条鱼的,如果我把鱼给他,他愿意付5美元。
   (7)“不,”我说,“我爸跟我说了,要我看好它。”
   (8)杰克直白地说我是一个伪君子。“他们会杀了它的,”他说,“这鱼是我的。给我,我好把它放了。我发誓我会放了它。”他还说,“把它给我,否则我揍你。”
   (9)我爸或许是因为直觉,或许是他看到杰克在找我麻烦——但实际上是杰克有了麻烦,这不用多想就能知道——他从角落里走了出来,问我一切可好。杰克皱着眉头,一声不吭,用他戴的帽子拍了拍鱼,但没有拍向我和爸爸,就走开了。
   (10)“他想要干什么?”我爸问道。
   (11)“没什么,”我说,“他只是来看看鱼。”我知道我要是把杰克的事说出来的话,杰克就会有麻烦了,而我也会挨揍了。
   (12)“他是不是说这是他的鱼?”我爸问道,“他是不是宣称这鱼是他的?”
   (13)“我记得他说是他爸捉住的鱼。”
   (14)“他爸欠我们67美元,”我爸说道,“他用这鱼来抵债。别让杰克把鱼拿走。”
   (15)“不会的。”我回答说。
   (16)我不记得之前说过没有,虽然不是很穷,但我们当时处在贫穷的边缘。
   (17)暗橙色的天空在黄昏时变为紫蓝色。星星开始出现,萤火虫也开始从草丛里出来。我望着它们,听着下面田野里的池塘中牛蛙如鼓如吟的叫声,还有牛的叫声。我一直给鱼浇水,它也一直看着我,喘气也越来越艰难。我不时看到杰克在附近游荡,但他没有回到我在的地方。
   (18)随后,在那天天黑之前,天已有暗色,一个女人,我认为很可能是杰克的妈妈——我看到她和杰克说话了——来到我面前蹲下。她的穿着好像是为了参加派对,而且是比我们的庆祝更隆重的派对,她的衣服上带着亮片,穿的是平皮革凉鞋。她的脚趾甲染成了亮红色,但她苍白的脚上却沾有一些灰尘,仿佛她走了很远的路。我想我能闻到一股威士忌的味道,她的呼吸里和衣服上都有这种味道。我希望她不要同我说话,尽管我不能那么走运。
   (19)“这是一条大鱼。”她说道。
   (20)“是的,夫人,”我轻轻回答。我害怕她会将鱼要回去。
   (21)“我儿子和丈夫捉住了那条鱼,”她说,“你很快就会知道,报纸很快会登他们的照片。”她暂停了一下,然后盯着鱼,似乎在与它艰难沟通。“这条鱼值很多钱,你知道吧?”她说道。
   (22)我没再说什么。她的措辞和气味如此这般,以至于我直到22岁才开始喝酒。
   PASSAGE TWO
   (1)改善每日工作和休息两者间的平衡是富裕的西方国家里越来越多工人们追求的目标。一些人开始厌烦父辈们那种工作第一的思维方式;另一些掌握了稀有技能的人则有更高的要求,因为他们明白他们能够达到目的。夹在工人数量下降和移民限制严格之间的老板们则急于用自已的方式确定能吸引更多“人才”的额外福利。此刻,他们正把焦点集中在福利上(尤其是弹性工作),而不仅仅是支付员工薪酬。
   (2)不久前一些公司注意到一些情况的变化。IBM有超过50种不同的方式去促进工作和生活的平衡,美国银行也有30多种办法。但是其他很多公司仍然保持质疑,即便是他们想这么做,也不具有接受这种想法的能力。作为人力资源顾问,海氏集团的海伦·玛瑞斯发现在有创意的用人单位与非此类用人单位之间存在巨大差距。
   (3)几乎所有促进工作与生活之间平衡的计划,其主要内容都是弹性工作。这允许人们脱离刚性朝九晚五的时间表,还可以在办公室以外的地方工作。IBM表示该 公呈40%员工如今不在公司里上班。对许多企业来说,弹性工作是必需的。全球化扩展了员工们需要相互沟通的时间,并且增加了对弹性换班的需求。
   (4)奈拉·巴克利是一位建议公司致力于保持工作与生活平衡的美国人,他说大型公司开始明白了这种制度的价值,“不过进展缓慢”。对大部分此类公司来说,工作与生活平衡仅限于指孩子的护理、医疗保健和弹性工作。
   (5)但有些项目则不仅限于提供孩子护理、医疗保健和弹性工作等福利。美国世纪投资公司是一家位于堪萨斯城的投资公司,该公司会为其员工支付收养费用和家庭健身设备费用。罗布·马科利纳是总部位于洛杉矾的贝恩咨询公司的顾问,他获得假期与其伴侣在加拿大结婚。马科利纳拥有著名的凯洛格商学院的工商管理硕士学位,他说上司的理解使其想在一段时间内成为“贝恩公司的一部分”。
   (6)企业有其他的好理由以支持改善雇员的工作与生活间的平衡。韦格曼斯食品超市是一家基地位于纽约罗切斯特的连锁食品超市,它频繁出现在美国最佳雇主排名榜首的位置。它有一个广泛的弹性工作计划,使得该企业成为业内员工流动率最低的企业之一,年全职(正式)员工流动率仅为8%,而该行业的员工流动率则为19%。
   (7)一些简单项目的成本效益是十分惊人的。例如,IBM将在五年内为其员工在“家属保健”设备上投入五千万美元。尽管这看起来很大方,但仅相当于每年每个员工获得三十多美元。这远比加薪便宜,而且也很可能是一种较好的留住有才母亲和父亲的方式。国际会计公司安永有一系列低成本项目,叫做“以人为本”。安永为其员工提供假期以方便其提供照料,并在全美有2300位弹性工作职员。詹姆斯·弗里尔是一名高级主管,他表示他深信这些项目可取得更好的经济效益。
   (8)德安妮·阿吉雷是四个孩子的母亲,在旧金山也是博思艾伦咨询公司(BAH)的资深合伙人。她说,“通过查看人员缩减率,在咨询行业工作生活平衡项目‘很容易做出商业案例’”。BAH正投资200多万美元以使新员工变为合伙人,这项投资是其不想撤销的。康宁是一家美国玻璃公司,该公司估算要取代一个员工需花费其1.5倍的薪水和福利。若每年能留住20位原本要离职的员工,康宁估算其每年可节省260万美元。
   (9)弹性工作得以广泛展开,至少在一定程度上源于主动留住女雇员。各个公司已经不得不延长女雇员照顾家眷(小孩和老人)的假期,并在这期间提供弹性工作。在BAH,女性合伙人在其就职期间平均有85%的假期延长了。男性平均则为15%。安永公司一直想表明兼职雇员也能够成为合伙人,最近,它在德克萨斯州休斯敦首次实现了此种任用举措。
   (10)其中一些项目开始蔓延到过度工作的场所,例如投资银行。商学院也正在迎合这一趋势。十月份,新罕布什尔州达特茅斯学院塔克商学院将开授一门关于长期离开职场又重返的课程,课程名为“重回职场”。该课程为期16天,学费为12000美元,仅对在“很大潜力职业有工作经验”的学生开放。
   (11)不可避免的是,其中大部分学生为想重入职场的妈妈。但很多爸爸也开始要求休假。工作生活平衡不再“仅仅是女性的问题”,IBM人力资源多样性负责人特德·蔡尔兹说,“男性对该问题也很关注。”
   (12)这种需求正由“年轻一代”拉动,即那些28岁以下的人。他们对终生在一家公司工作的想法持怀疑态度并对在他们看来常使其父母走向离婚法庭的忠诚保持警觉。海氏集团的玛瑞斯女士说,如今的商学院毕业生正在“寻求匹配生活方式的工作方式”,而非反其道行之。他们乐于过度工作一段时间,但反之也想获得延长的假期。
   (13)许多更具想象力的项目源于那些无需每个季度向华尔街报告的组织。韦格曼斯和美国世纪投资公司都是家族控制企业,一些大的会计事务所,例如安永,毕马威,贝恩和博思艾伦咨询公司,则是合伙企业。这使得他们能够以更长远的眼光来看待增长和成本问题。
   (14)在某种程度上,工作与生活平衡计划的不断传播是当今劳动力市场的作用。属于知识核心行业的公司担心技术匮乏,也担心如何去说服有才能的人为他们工作。尽管白领雇员如今更有可能被解雇,但他们也最有可能被重新雇用。在美国,大学毕业生中的失业人数仅超过2%。同样是为人才匮乏而进行的竞争在英国很明显。
   (15)在未来的一段时间里,西方世界有才能的人会对雇主有更多的要求,而聪明的雇主将创造新的华而不实的福利来吸引他们加入公司。那些雇主应该注意到,对于越来越多这样的工人而言,最吸引人的福利是依据个人喜好的工作自主权。
   PASSAGE THREE
   (1)双目失明且肥胖臃肿的她坐在轮椅上,背部和腿部都疼痛难忍。她膝盖上的关节炎加剧了,腿部也患了末期循环疾病,这让她的双腿又红又肿、感染严重,功能几乎丧失殆尽。现在她的肩膀也开始疼了。她无法抬起手梳理头发。不仅如此,她还受着其他五六种疾病的折磨,并一一告诉了我。对于她的问题,有些我们能提供治疗,但对大多数我们无能为力。我把这些都如实告诉了她。
   (2)在我的办公室里,多丽丝(化名)仔细地聆听着我的每一句话,我基本上用不着对她再三解释。她也会问我一些问题,这些问题大多都问得非常好。她需要做大量的检查,并面对各种不同的治疗。最后,我建议对她的肩膀进行手术治疗。虽然多丽丝病得厉害,复杂的症状使她虚弱不堪,医疗保险也很糟糕,但令我惊讶的是,她真的是一个很棒的患者。她能有效地和我们进行沟通,对我们充满尊重和信任。除此之外,她对自己病情的期望也合情合理。我看得出她对此有所了解,她的知识对理解我的话也非常有帮助,并且从不为难我们。我和其他医生谈起过她,我们一致认为:当你在就诊列表上看到多丽丝的名字时,你知道自己需要更加努力工作,还会因她是自己的患者而时常感到蝓快。
   (3)很少有患者会意识到,他们可以如此深刻地影响自己的医生。在医学上,这是一个很大的秘密——一个医生不愿意承认的秘密。我们会回想自己的患者,谈论他们,也对他们有所期待。我们之所以从事临床医学,是因为我们愿意与那些将生命托付给我们的人们建立一种富于个人感情的、甚至相当亲密的联系。我们的生活成也患者,败也患者。
   (4)请不要吝啬对我们的赞扬。既然我们选择了这份职业,就意味着我们确实认为你(和你周身的疼痛)比火爆的证券交易和紧张的法庭审判要有意思得多。真诚的赞扬是“笼络”那些具有强烈责任感的人的关键,比如医生。当我们感觉到被你信任的时候,我们的心就真正和你在一起了。
   (5)成为一个好患者最具说服力的理由显得蛮自私的。如果你的医生个性随和,他同你的交流也非常轻松,你就有可能从他那里获得更多的免费药物样品。你会从医生那里得到更多的关注,因为在他感到轻松时能够更好地工作——他能够自如地回顾、总结你的病情,更善于抓住那些细小的、甚至小到难以察觉的线索。这意味着你得到了更好的医疗服务。但是,你也应该试试去为一些无私的理由而当一个好患者。我们医生每周有60小时为你们的病情焦虑不安,我们为你们放弃享受我们二十多岁时的那些灿烂年华——你们为什么不对我们表达出一些爱呢?这并不是一件难事啊。
   (6)医疗关系在本质上是单方面的,它关乎患者及其病情。在你就诊的20分钟里,我需要更多地了解你,这比你了解我的程度要深得多。别担心,我们不指望你要问我们多少问题。良好的患者能够完整准确地回答医生提出的问题。当然,他们自己也会提出问题。
   (7)但许多病人讲的过多。你可能会留意到我们见你的时候正在写东西,我们正在为你写病历。我们需要具体的实际情况,但并非你生活中的每一个情况。下面是一个典型的对话:
   (8)比阿特丽斯,你肩膀疼了多久了?“噢,有一段时间了。”那么是多久呢?几个月了?“噢,至少从上次婚礼——恩,然后玛格丽特从爱尔兰回来的时候它也疼了……”
   (9)我想做的只是在病历本上写下诸如“右肩,6个月,无创伤”。虽然我无心告诉她,但如果比阿特丽斯能够再简洁一些,她将会是一个更好的病人。有很多类似比阿特丽斯这样的病人。
   (10)以下是另一个典型例子:
   (11)“恩,我不需要有礼貌——我病了——我不会做一个跟医生可以顺利谈话的老好人。你知道,会哭的孩子有奶吃。”
   (12)这就是许多谩骂医生的病人的固定思维模式;我敢肯定他们也会谩骂其他人。任何好医生都知道你什么时候病得太严重而顾不上礼貌,他们是不会放在心上的。我们不喜欢的会哭的孩子在玩一个由医生完全占据主导地位的游戏。这类病人可能会接受持续时间更短、医生更不敏感的检查以及更多的测试,然后经历由第一批测试发现的异常所带来的进一步测试,随后是向专家进行的额外咨询,这些都是会减少医生对不好的病人的责任心的事情。
   (13)医生会是良好的患者吗?可能有人不同意,但我认为他们是。医学术语难不倒他们,所以他们和医生之间更容易沟通,对病情的治疗期望往往更加合情合理。因为学医的人都知道,医学中实在有太多难以解决的问题,面对它们我们实在束手无策。另外,当护士成为患者时往往会做得更好,因为她们善于遵循医嘱——而医生则缺乏这种品质。
   (14)医生和护士也知道什么时候应该尊重一个专业人士的观点。当我的结论与核磁共振检查的结论有差异时,他们可能更倾向于认可我的意见。但是想成为一个很棒的患者,你并不需要成为一个医学专家或专门去接受医学教育。当一个好患者的行为实际上和人类的得体行为如出一辙——会真正关心身边有哪些人,关心他们正在努力做什么——这种行为使你能够成为一个好患者,一个好人。