Question

    The first patient who died on my watch was an older man with a faulty heart — the main pump had failed and his heart was beating irregularly and far too fast. We tried to slow it down with treatment, but it suddenly stopped beating completely. Later, whenever I would have a case like that one, I found myself second-guessing my clinical management. However, it turns out that thinking twice may actually cause more harm than good.

In a working paper, Emory University researchers found that when doctors delivering a baby have an adverse outcome, they are more likely to switch to a different delivery method with the next patient, often unnecessarily and sometimes with worse results.

Because doctors make so many decisions that have serious consequences, the fallout from second-guessing looms especially large for us. A 2006 study found that if a patient had a bleed after being prescribed warfarin, the physician was about 20% less likely to prescribe subsequent patients the blood thinner that prevents strokes. However, if a patient had a stroke and was not on warfarin, physicians were still no more likely to prescribe warfarin to their other patients.

These findings highlight interesting behavioral patterns in doctors. In the blood-thinner study, doctors were more affected by the act of doing harm (prescribing a blood thinner that ended up hurting a patient) and less affected by letting harm happen (not prescribing a blood thinner and the patient having a stroke). Yet a stroke is often more permanent and damaging than a bleed.

But this phenomenon is not unique to medicine. “Overreaction to Fearsome Risks” holds true for broader society.

For instance, sensational headlines about shark attacks on humans in Florida in 2001 caused a panic and led the state to prohibit shark feeding expeditions. Yet shark attacks had actually fallen that year and, according to the study, such a change was probably unnecessary given the extremely small risk of such an attack happening.

Humans are susceptible to emotional and often irrational thinking when processing information, adverse events and mistakes. As much as we don’t want to cause an unfortunate event to recur — in a medical setting or in the wider world — we need to be aware that a worst case scenario doesn’t necessarily mean we did anything wrong. When we overthink, we fail to rely on thinking based on what we know or have experienced. Instead, we may inadvertently overanalyze and come to the wrong conclusion.

I have treated dozens of patients who presented with the same illnesses as my first patient, who died more than a year ago. Instead of second guessing myself, I trusted my clinical instinct and stayed the course. Every one of those patients survived. You should trust your instinct in your life, too.

1.The first two paragraphs suggest that ______

A.Bad medical outcomes affect doctors.

B.Delivering babies can be difficult work.

C.Some doctors are not very experienced.

D.Doctors sometimes make silly mistakes.

2.In the blood-thinner study, doctors ______.

A.tend to prescribe less effective medicine

B.are more concerned about the patients’ safety

C.believe a stroke is more treatable than a bleeding

D.become less confident in writing certain prescriptions

3.The author develops his idea mainly by ______.

A.giving examples B.making comparisons

C.using metaphors D.quoting famous sayings

4.The author will probably agree that ______.

A.we shouldn’t doubt our own decisions

B.our experience will pave way for our future

C.humans are emotional and irrational on the whole

D.instincts don’t necessarily lead to wrong directions

Answer

1.A

2.D

3.A

4.D

【解析】

这是一篇夹叙夹议。文章通过作者自己的经历论述了，人类在处理信息、不良事件和错误时易受情绪化和非理性思维的影响，会过度思考，此时我们就不能依赖于基于我们所知或所经历的思考，反而要相信直觉。

1.

推理判断题。由第一段中的“Later, whenever I would have a case like that one, I found myself second-guessing my clinical management.”（后来，每当我遇到这样的病例时，我都会怀疑自己的临床管理。）和第二段 “In a working paper, Emory University researchers found that when doctors delivering a baby have an adverse outcome, they are more likely to switch to a different delivery method with the next patient, often unnecessarily and sometimes with worse results.”（在一篇工作论文中，埃默里大学的研究人员发现，当医生接生婴儿时出现不良后果时，他们更有可能对下一个病人改用不同的接生方式，这往往是不必要的，有时甚至会带来更糟糕的结果。），可推断出糟糕的医疗结果影响医生。故选A项。

2.

推理判断题。由第三段中的“A 2006 study found that if a patient had a bleed after being prescribed warfarin, the physician was about 20% less likely to prescribe subsequent patients the blood thinner that prevents strokes.”（2006年的一项研究发现，如果患者在服用华法林后出现出血，医生给后续患者开预防中风的血液稀释剂的可能性要低20%。），可推断出在血液稀释剂研究中，一旦病人服用华法林后出现出血后，医生们在开某些处方时变得不那么自信。故选D项。

3.

推理判断题。由第一段讲述“自己遇到的病例情况”，第二段的“医生接生案例”，第三四段的“2006年关于给患者开预防中风的血液稀释剂的研究”和第六段的“2001年佛罗里达州禁止鲨鱼进食探险的例子”，可推断出作者主要是通过举例来发展自己的观点。故选A项。

4.

推理判断题。由倒数第二段中的“When we overthink, we fail to rely on thinking based on what we know or have experienced. Instead, we may inadvertently overanalyze and come to the wrong conclusion.”（当我们过度思考时，我们就不能依赖于基于我们所知或所经历的思考。相反，我们可能会无意中过度分析，得出错误的结论。）和最后一段中的“Instead of second guessing myself, I trusted my clinical instinct and stayed the course. Every one of those patients survived. You should trust your instinct in your life, too.”（我相信自己的临床直觉，坚持到底，而不是事后猜测。所有的病人都活了下来。你也应该相信你的直觉。），可推断出作者认为 直觉不一定会导致错误的方向。故选D项。