Cultural English 207 - Ask an American

Complete Transcript

You’re listening to ESL Podcast’s English Café number 207.

This is ESL Podcast’s English Café episode 207. I’m your host, Dr. Jeff McQuillan, coming to you from the Center for Educational Development in beautiful Los Angeles, California.

On this Café, we’re going to have another one of our Ask an American segments, where we listen to other native speakers talking at a normal rate of speech – a normal speed. We’re going to listen to them and then explain what they’re talking about. Today we’re going to talk about nursing, the people in the hospitals and the clinics that take care of you – help take care of you, that help the doctor take care of you. And as always, we’ll answer a few of your questions. Let’s get started.

Our topic on this Café’s Ask an American segment is nursing. We’ll listen first to a short quote from a woman who is the leader – the dean (dean) of a school of nursing in Ohio, a state located in eastern part of the U.S. It’s very quick. We’ll listen to what she has to say and then we’ll go back and explain it. Let’s listen:

[recording]

We’ve always been known in the past as a handmaiden to the physician.

[end of recording]

This is a woman being interviewed on the telephone. She says, “We’ve always been known in the past as a handmaiden to the physician.” The physician is the doctor. A “handmaiden” is an old word for a female “servant,” or a woman whose job it is to help another woman. In the past, very wealthy women would have a handmaiden to help them with things throughout the day, like getting dressed, doing their hair, shopping, and so forth. When people think of nurses as a handmaiden to the doctor, they think of the nurse as being a helper to the doctor, but not someone who is very important or even necessary for medical care. That was the way people used to think of nurses, that’s what she’s saying.

Let’s listen again:

[recording]

We’ve always been known in the past as a handmaiden to the physician.

[end of recording]

While this is a very traditional view, the view that nurses are just helping the doctors. In fact, many medical professionals here in the United States recognize how important nurses are, not just in hospitals and clinics here, but throughout the world. Here’s one gentleman talking about the importance of nurses. Let’s listen:

[recording]

A nurse is the actual keystone of the medical profession. They have the first interaction with the patient. They are the only ones that are there consistently while the doctor isn’t there, the only ones that are constantly giving care.

[end of recording]

He begins by saying that a nurse is the actual keystone of the medical profession. A “keystone” (keystone – one word) is something that is very important, something that makes other things possible. When you build an arch, or a curved shape for a door for example, and you use rocks or bricks, there’s a large stone at the top of the arch – at the center of the arch that we call the keystone. If you remove that stone, then the whole arch falls down. An arch is like an upside down letter “U” and you can think of the keystone as the very top of the “U”. So he’s saying here that without the nursing profession, medicine would not be able to survive – doctors wouldn’t be able to do their job.

He says also that nurses have the first interaction with the patient (the sick person). “Interaction” is the way that two or more people communicate with each other, speak with each other, or perhaps work together. You and I don’t have a face-to-face interaction – unless, of course, you come and visit me here in Los Angeles. But you can communicate with me through email or letters, then we could have an interaction. Most of you just listen to me, so there is no communication necessarily, and therefore no interaction. Nurses are usually the first people in a clinic or a hospital to see the patients, and so they have the first interaction – first communication with that patient.

He also says that nurses are the only ones – the only people that are consistently there, that are with the patient consistently even when the doctor isn’t. To do something “consistently” means to do it the same way over time, or to be there constantly, without changing or stopping. At a hospital, nurses are consistently around the patients, meaning they’re always near them somehow. But doctors will typically come for only a part of the day, and then go back and play golf – I guess, I’m not sure. That’s my doctor! He says that nurses are the only ones who are constantly giving care. The phrase “to give care” means to provide medical assistance for a person, maybe by taking that person’s temperature or giving them an injection (a shot, we would call it, where you take a long, sharp piece of metal called a needle, and you stick it into their arm or another part of their body).

Let’s listen to this gentleman talk one more time about the importance of nurses:

[recording]

[end of recording]

Next we’ll listen to a nurse who works in Washington, D.C., the capital of the United States, on the eastern coast of America. She’s going to say that many patients will also tell you the importance of nurses. Let’s listen:

[recording]

You know, I think if you ask patients what makes the difference when they go into a hospital for care, many of them will tell you that the nurses are the ones that pull them through.

[end of recording]

She says that if you ask patients what makes the difference (what is the important thing) when they go into a hospital for care when they’re sick, or what makes them feel like they’ve received good medical care, many of them will tell you that the nurses are the ones that pull them through. The phrase “to pull someone through” means to help someone in a difficult situation, helping them find a solution, or at least staying with him or her until the difficulty has ended. If your co-worker has too much work to do one day, you might pull her through by offering to buy her some coffee or by doing some of her work for her. Nurses pull their patients through their illness, helping them survive when they are sick. We sometimes use this expression, “to pull through,” to mean to survive. For example, if you have a difficult surgery, or a dangerous surgery, the person after the surgery, if they live, you would say, “Well, they pulled through.” They lived; they survived.

Let’s listen to this nurse talk one more time:

[recording]

You know, I think if you ask patients what makes the difference when they go into a hospital for care, many of them will tell you that the nurses are the ones that pull them through.

[end of recording]

Next, the same nurse is going to tell us a story about something that happened to her, about one of her former patient’s sons who came up to her and told her what a great job she did – how important she was. Let’s listen to the story; it’s a little long, but listen to the story and then we’ll go back and explain it.

[recording]

A man came up to me and said to me – said to my children, said, “Excuse me, is this your mother?” and the kids looked at him and said, “Yes, it is.” He said, “I just want you to know that your mother changed my life,” and proceeded to tell them that I was involved in the care of his father, who was critically ill, and he lived through that experience, and he has been able to meet that particular man’s six children as a result. So, you know, how do you measure something like that?

[end of recording]

She begins by saying that a man came up to her. The phrase “to come up to (someone)” means walked towards someone – to approach someone, usually because they want to say something to you. You might be standing on the corner in the street, and someone may come up to you and ask you directions: “How do I get to Venice Beach?” and they’ll give you directions to Venice Beach, a famous beach here in Los Angeles.

The nurse was walking with her children somewhere, we’re not sure where, when this man came up to the nurse and her children and asked the children, “Excuse me, is this your mother?” The kids – the children looked at him and said, “Yes, it is.” And then he said, “I just want you to know that your mother changed my life,” or did something that had a big impact on his life.

He then proceeded to tell them something else. The verb “to proceed” (proceed) means to continue, to do the next part of something. Don’t confuse this with another verb that sounds sort of the same: “precede” (precede). That means to come before something else. “Proceed,” in this case, means to continue. We will proceed with answering questions from listeners after we finish talking about nurses; it’s what we’re going to do afterward.

Well, after the man found out that the children were the kids of the nurse, the man proceeded to tell them that their mother, the nurse, was involved in the care or the medical treatment of this man’s father, who was critically ill. When we say someone is critically ill, we mean they are very sick; they’re about to die or could die. The man says that his father lived through the experience – he pulled through, we might say – and got better. And because this man’s father survived, he lived long enough to see this man’s children, the grandchildren of the man who was sick, because he survived – because he survived due to the help of this nurse. Of course, what the man is telling the nurse’s children is how important her mother is.

The nurse ends her story by asking a question: “How do you measure something like that?” The verb “to measure” normally means to find out how big or how heavy something is. When you go to a doctor’s office, the nurse measures your height to see how tall you are, and your weight to see how fat you are – well, me anyway! In this case, the nurse is talking about measuring the importance of her work, knowing just how important her work is, in this case in helping that man and his father. This is not a question that she expects an answer for; it’s what we would sometimes call a rhetorical question, meaning you ask a question but you’re not expecting anyone to answer it. You’re really sort of making a statement with this question.

So the nurse believes that her job is very important. Let’s listen once more:

[recording]

[end of recording]

Finally, we go back and listen another quote from the first nurse that we heard from at the beginning of this episode. She’s going to talk about all the different jobs that nurses can do, and the places that nurses can work. Let’s listen:

[recording]

You can be a teacher. You can be an administrator. You can specialize in a different field. You can work out in the community. You can work in the schools. And so there’s a lot more to it than just the acute-care hospitals, where we see a lot of nurses working.

[end of recording]

She starts by saying that you can be a teacher, meaning a nurse can be teacher; you can be an administrator, an administrator is someone who is the director of a program or leads a group of people. She says you can also specialize in a different field. To “specialize” means to learn a lot about a specific area. If you’re a biologist, you may specialize in ornithology (the study of birds), or microbiology, or my favorite, ichthyology (the study of fish) – because I love eating fish! Nurses can specialize in many different areas of nursing.

A nurse can also work out in the community. The phrase “out in” seems sort of odd because we think of these words as being opposite, but when we use them together we are actually giving emphasis to the idea that nurses are really involved in the community, working with different people – not just in a hospital or in a clinic. So she says a nurse can work out in the community, meaning directly involved with the community – directly involved with the people around them, not just in a hospital.

Nurses can also work in schools. It was very common when I was in school many years ago – back before electricity was invented! – that there was a nurse that would come at least once a week, perhaps twice a week, in order to give any sort of medical care or to give exams to students – many different types of tests, that sort of thing, take care of any student that was sick. She says that nurses have many choices other than just working at the acute-care hospitals, where many nurses work. The word “acute” (acute) here means very serious or urgent. People who go to an acute-care hospital are very sick; they have serious problems that need immediate attention. Many nurses, of course, do work in acute-care hospitals, but she’s saying that they also have other possibilities – other options open to them.

Let’s listen one more time:

[recording]

[end of recording]

So that’s a little bit about nurses and people’s opinions or views of nurses here in the United States. Now let’s answer a few of your questions.

Our first question comes from Ina (Ina) in South Korea. The question has to do with the difference between the words “responsible” and “accountable.” Let’s start with “responsible,” it has a couple of different meanings.

“To be responsible” means that you are considered in charge, you are the leader of a project or a task (something to be done). I am responsible for recording this episode – it’s my job, it’s my responsibility. “Responsible” can also mean the cause or the reason for something: “We had a large fire here in California, it was responsible for a lot of homes being destroyed.” “Responsible” can also mean reliable, someone who you can depend on: “Although Bridget is very young, she’s responsible enough to take care of the other children. We trust her.”

“Accountable” means that you are answerable, meaning that you have to be able to defend or justify something that you do. “Accountable” comes from the word “account,” which means a story – a description of something. We often use the verb “to hold” with this word, so we would say “I’m going to hold you accountable,” meaning you’re responsible, so it’s similar to that first meaning of “responsible,” and you’re also “accountable,” meaning you’re going to have to explain to me if you are successful, or especially if you’re not successful. The noun is “accountability,” and it’s a word that you hear a lot now in American schools. The government says that schools have to be accountable for their students, meaning they’re responsible for them and if something goes wrong they need to explain what happened, and often to be punished for it. So when we say someone is held accountable, we often mean that if something goes wrong they’re going to be punished – something bad is going to happen to them.

So, “accountable” and “responsible” are similar in meaning, at least the first meaning we gave of “responsible,” but “accountable” has to be something that refers to giving an explanation, we might say answerable. So a dog, for example, may go into the kitchen and eat some food that he’s not supposed eat. Well, the dog is responsible, but we wouldn’t say the dog is accountable – unless your dog can talk!

Our next question comes from Mitch (Mitch) in Italy. Mitch wants to know the meaning of the verb “to double back.” “To double back” means to go back the way you came, to go back the route or the places – the direction that you came from. So for example, let’s say I want to go to Venice Beach here in Los Angeles, and I’m going north on Venice Boulevard and I drive a mile. Then I realize that Venice Beach is south, so I turn my car around and I double back, meaning I drive the same distance – the same route that I took to get where I was when I turned around. I have to go back that same way in order to get to where I want to go.

“Double back” is definitely an informal expression, probably not something you would use in a formal situation.

Finally, Banafsheh (Banafsheh) in Canada wants to know why sometimes in English we add the word “wise,” usually a hyphen and then w-i-s-e in the expressions such as “time-wise” or “pressure-wise.”

Adding the w-i-s-e is a way of saying in the way of, having to do with something. For example: “My friend said that he was having difficulty finishing his homework time-wise,” meaning in terms of time, he didn’t have enough time to do this homework. So, “time-wise” means related to that subject – that topic. You could ask somebody, “How was your weekend?” and they may say, “Well, weather-wise it was really nice, but I had to work.” “Weather-wise” means if you’re talking about the weather or related to the weather, that would be one way of using that w-i-s-e ending.

There’s also a very common word “clockwise” and “counterclockwise.” “Clockwise,” and “counterclockwise” are not spelled with a hyphen; they’re considered regular words in English. “Clockwise” means related to the way a clock moves – the hands on the clock move. So if you think of a clock, and you have two different little pointers, we call “hands” of the clock, they move in a certain direction. The normal direction is “clockwise.” If it goes in the other direction we would say it’s “counterclockwise,” in the opposite direction that a clock normally moves.

Usually we use this hyphen w-i-s-e to qualify our answer or reaction to something. If your boss has a big project for you, you may say to him, “Well, time-wise we’re doing okay on the project, but budget-wise (or money-wise) we don’t have enough.” So, that’s how we use “-wise.” It’s very easy to over use that, however. Sometimes it’s used by people who are trying to sound important, so you have to be careful about it.

From Los Angeles, California, I’m Jeff McQuillan. Thank you for listening. Come back and listen to us next time on the English Café.

Glossary

handmaiden – an old word for a female servant, or a woman whose job is to help another woman

* Princess Bella asked her handmaiden to help her get dressed.

keystone – something that is very important, making other things possible; literally the large center stone in an arch that keeps all the other stones from falling down

* Tourism is the keystone of Hawaii’s economy.

interaction – the way that two or more people communicate with each other, speak with each other, or work together

* Does your department have very much interaction with the marketing team?

consistently – in the same way over time, without changing or stopping temporarily; constantly

* If we consistently reward our dog for good behavior, it will stop misbehaving.

to give care – to provide medical assistance for a person, maybe by taking that person’s temperature or giving a shot

* Now that you’ve visited several retirement homes, which do you think gives the best care?

to pull (someone) through – to help someone in a difficult situation, helping them find a solution, or at least staying with him or her until the difficulty has ended

* His sister helped to pull him through this past year after he lost his job, giving him a little bit of money until he was able to find a new job.

to come up to (someone) – to approach; to come nearer to someone, usually because one wants to say something to that person

* A young man came up to Gretchen at the bar and asked if he could buy her a drink.

to proceed – to continue; to do the next part of something

* After telling us about the problems the company is going through, the president proceeded to talk about the things we’ll be doing in the next year to reduce costs.

to measure – to find out how big or heavy something is

* I’ll need to measure your waist before I can make you a skirt.

to specialize – to learn a lot about a specific area; to gain deep knowledge and special skills in a specific area

* The astronomer specialized in astrophysics.

out in – out, giving emphasis to the idea that one is involved in something that is big and spread out

* Ben is hiking out in the mountains and we won’t see him until sometime next week.

acute-care – dealing with people who have serious medical problems and emergencies

* If you cut your finger, you can just go to the doctor’s office, but if you break your arm, you need to go to an acute-care clinic.

responsible – being the person or thing considered to be in charge of or the leader of a project, job, or task; being the cause or reason for something; reliable

* Who’s responsible for cleaning the bathrooms in this restaurant?

accountable – considered to be answerable for an act or job; being required to justify (have a good reason for) one’s actions

* I’m sorry your order was delayed. We’re going to figure out who’s responsible and hold him accountable for the problem.

-wise – in the way of; in regard to; having to do with

* Money-wise, the past few months have been very difficult for us.

to double back – to retrace the original route, usually in order to take another direction; to turn around, possibly to take a different direction

* While Thierry was walking, he realized that he must have dropped his wallet, so he doubled back to look for it.

What Insiders Know

Famous TV/movie nurses

There are many American TV shows about medicine, such as ER and Scrubs. One old “series” (a group of episodes with the same characters and basic story) called M*A*S*H was about a group of American doctors and nurses who were working in South Korea during the Korean War.

The show was based on a book, MASH: A Novel About Three Army Doctors. It was also based on interviews with doctors and nurses who worked for the army during the Korean War. The episodes “dealt with” (covered) many serious topics, but it was a comedy (funny show).

In M*A*S*H, the “head nurse” (most important nurse) is a woman named Margaret “Hot Lips” Houlihan. “Lips” are the pieces of skin that separate when one opens one’s mouth, and the “nickname” (a name that is used by a person’s friends and family members) “Hot Lips” is used to describe someone who kisses very well. The Houlihan “character” (a person in a book, movie, or TV show) follows the “stereotype” (an idea about how people in a particular group should be) that nurses should be beautiful, even getting patients to fall in love with them.

Another famous “on-screen” (in a movie or TV show) nurse is from a 1975 movie called One Flew Over the Cuckoo’s Nest. This movie is about a “mental hospital” (a medical building where people go when they have serious mental problems) that is “dominated” (controlled strongly) by Nurse Ratched, who keeps the patients “in line” (under control) through “humiliating” (making people feel embarrassed) techniques and by using unpleasant medical treatments as “punishment” (something that happens to a person when one has done something bad).