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Subject: Alex said the quality is perfect
From: "Evelyn" <viqqeupja () 163data ! com ! cn>
Date: 2007-05-21 3:13:08
Message-ID: 5F1F5106.B956FEBD () 163data ! com ! cn
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<TD class=t1 width=270><B>Hello Ian,</B><BR><BR>Here you'll find the largest \
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<LI>Worldwide shipping
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<LI><B>You won't see any difference</B></LI><BR><BR><BR></TD>
<TD class=t2><IMG alt="" hspace=0 src="cid:70A8E90E.3C7AD5D5@163data.com.cn" \
align=baseline border=0></TD></TR></TABLE> <P class=p1>Medical educators are only now \
beginning to teach this skill. What’s much less certain is whether society is \
prepared to bear the costs of implementing such intrusive and costly measures for the \
months that would be required to manufacture a vaccine.” Before the late 1940s, each \
state had just one university. Better still, Niall knew him as a child. Biography, as \
Ian Donaldson showed in his essay ‘Matters of Life and Death: The Return of \
Biography’ (ABR, November 2006), is now a plastic, responsive, democratic and, yes, \
reputable art, capable of all sorts of liberties and latitude. <BR> The messages had \
this in common: They were all written to a correspondent who led an unquestionably \
normal life. They were not written to a haunted self, or someone who had failed \
trials of antipsychotic drugs, or someone who had been hospitalized again and again \
under duress. The unquestionably normal person, whose photograph still looked as \
though it were reading its e-mail messages from the opposite side of the Web page, \
had already fled — to find peace, or reconciliation or relief, I don’t know. Modern \
medical education can be traced to a series of reforms that began in the late 19th \
century. <BR> Next were the overworked residents, who essentially lived in the \
hospital while training. Last were the medical students, who spent the most time with \
patients but were most assuredly at the bottom of the heap. Finding him there after \
death seemed imperative. The messages had this in common: They were all written to a \
correspondent who led an unquestionably normal life. They were an introduction to a \
man I had not properly known.<BR> But he had ignored his hallucinations long enough \
to write of a different yet equally true self here, and he had found friends who \
identified him not by psychiatric symptoms but by astrological sign. One of the most \
notable occurred at the Johns Hopkins University School of Medicine, where educators \
initiated a formal system to train students on the clinical wards. Although some \
senior physicians welcomed feedback from their juniors, others disdained it, either \
overtly or through intimidation. Wolfberg wrote in the same journal last month, for \
years medical students performed pelvic examinations on anesthetized women who had \
not given consent because senior obstetricians said it was the best way to learn \
internal anatomy.<BR> On the opposite side of the screen, there were scrolls of \
e-mail messages that other MySpace members had sent him: friendly, uncapitalized, \
hallucination-free greetings. Some voiced hopes of meeting one day, some had comments \
about other correspondents on the site, some sent good wishes on relevant holidays. \
The messages had this in common: They were all written to a correspondent who led an \
unquestionably normal life. They were an introduction to a man I had not properly \
known. The last dozen messages on the screen were exactly the same. <BR> At the same \
time, professors at Johns Hopkins and elsewhere instituted early versions of modern \
residency training programs, in which residents — newly minted doctors — learned \
their profession on the wards from attending physicians and, in turn, taught \
students. Although this practice made many students uncomfortable, most were afraid \
to speak up. And, she added sheepishly, both the resident and the attending physician \
would be grading her. He then reminded the student that while he had examined \
hundreds of such cases, the student had seen only a few. <What should a medical \
student do in such a situation? One possibility is to take the matter up with a more \
senior doctor. Students and residents are now expected to provide routine feedback — \
positive and negative — about their supervising physicians at the close of their \
rotation.BR> Back she went to Raheen, flattered and excited, only to be outfoxed by \
the wily Irish charmer, then ninety-five and giving nothing away. Batchelor, with \
just under five hundred student places allocated for 2006, is the sole survivor of \
pre-Dawkins days. Better still, Niall knew him as a child. Brenda’s social life \
‘virtually stopped’. But for Commonwealth-supported places – still the overwhelming \
majority of Australia’s university students – the price charged through HECS has no \
relation to the cost of providing a course.<BR> I typed his name into MySpace, \
feeling covert and slightly criminal. On the opposite side of the screen, there were \
scrolls of e-mail messages that other MySpace members had sent him: friendly, \
uncapitalized, hallucination-free greetings. Nor, apparently, was that unseen self \
writing back. I had gone on the site only a day after his death, but his \
cyberobituary must have traveled faster. By now, of course, the messages had no \
recipient, and the friends my patient had made were writing to one another. This new \
division of labor established hierarchies.<BR> On the top were the senior physicians \
who made rounds on the wards once or twice daily. Next were the overworked residents, \
who essentially lived in the hospital while training. Finding him there after death \
seemed imperative. They were an introduction to a man I had not properly known. Yet \
even though such acts can jeopardize patients, the inclination and ability of young \
doctors to speak up is hampered by the hierarchies in teaching hospitals. This new \
division of labor established hierarchies. Last were the medical students, who spent \
the most time with patients but were most assuredly at the bottom of the heap.<BR> \
Although this practice made many students uncomfortable, most were afraid to speak \
up. The resident was a good doctor, she said, and so she had given him the benefit of \
the doubt. But when he told the resident, who had seen the patient earlier and more \
quickly, the resident refused to re-examine the patient.<BR> He then reminded the \
student that while he had examined hundreds of such cases, the student had seen only \
a few. In our last meeting, before he stopped coming to appointments, he told me that \
he had joined the site to meet friends. The messages had this in common: They were \
all written to a correspondent who led an unquestionably normal life. I had gone on \
the site only a day after his death, but his cyberobituary must have traveled faster. \
On the top were the senior physicians who made rounds on the wards once or twice \
daily. And, she added sheepishly, both the resident and the attending physician would \
be grading her. Or the student might go directly to the patient or family, telling \
them that the physicians have a genuine disagreement and that they deserve to know \
about it.<BR> Medical educators are only now beginning to teach this skill. At one \
point, she considers writing a book about the Palmer marriage. Benefits flowed too in \
socio-economic terms; an Australian Council of Education Research study con-cluded \
the proportion of children of unskilled manual workers going to university nearly \
doubled between 1980 and 1994.<BR> Better still, Niall knew him as a child. In our \
last meeting, before he stopped coming to appointments, he told me that he had joined \
the site to meet friends.</P> </BODY></HTML>
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