Unit 3: Health and Wellness

Health is not only about doctors and medicine; it is also about kindness, communication and the food we eat. In this unit a worried mother complains, in a letter, about the way a hospital treated her sick baby, and a European speaker explains why healthy eating needs research and teamwork. You will practise reporting commands and requests, using a wider range of reporting verbs, writing an apology email and drafting a speech.

3.1 A Letter from a Patient

About the text

"A Letter from a Patient" is a personal letter from the mother of a very sick baby to the people who looked after her in hospital. Its purpose is not to attack health workers but to remind them how their behaviour feels to a frightened family. It is written in the first person and in an emotional but controlled voice. It is useful as a model of a letter of complaint that wants improvement, not revenge.

What the text says

The writer's nightmare begins when her baby, only a few weeks old, develops a very high fever and has to be admitted to the paediatric (children's) ward. She is exhausted and frightened and needs help, but she finds that the staff are more concerned with their own affairs than with the child.

She lists the weaknesses she saw.

• Bad-mouthing. Staff of different departments and units spoke ill of one another in front of patients' families instead of working harmoniously as a team.
• Lack of priority. When she asked for help, a nurse said she was "so busy today". The nurse did not say, "Your daughter is not a priority", but the writer felt exactly that.
• Repeated questions and careless paperwork. She was asked the same questions again and again ("Was the delivery normal?" "Was the baby premature?"), which showed that nobody read the chart; the chart even confused the baby's gender, and people referred to her daughter by the wrong sex.
• No human warmth. Staff talked about their own problems and wishes but did not show interest in her feelings.

Even so, the writer ends with respect. She knows that health work is a noble, precious career. Patients and their families, she says, are vulnerable; they trust health workers to be honest, serious and caring. She asks the hospital staff to remember that, for the family, each patient is the most important person in the world.

Vocabulary

Word	Meaning	Example
nightmare	a very unpleasant or frightening experience	The long night in the ward was a nightmare.
paediatric	relating to the medical care of children	The paediatric ward was full of toys.
intravenous	into or connected to a vein	An intravenous drip gave the baby fluids.
priority	something regarded as more important than other things	A patient in danger is a priority.
medication	treatment using drugs	She gave the baby her medication on time.
confidante	a person with whom private matters are discussed	The nurse became her confidante.
deprivation	lack of something considered a necessity	Sleep deprivation made her weak.
vulnerable	in need of special care, support or protection	Newborn babies are vulnerable.
dreadful	very bad or unpleasant	The waiting room was dreadful.

Themes and ideas

• Empathy. Health workers must care about how patients feel, not only about treatment.
• Teamwork and professionalism. Staff who gossip about colleagues lose the trust of families.
• Accuracy. Careless records are dangerous: a wrong chart can mean a wrong treatment.
• Vulnerability. A frightened parent notices every word and tone.

Questions and model answers

Objective questions (1 mark each)

1. Write True or False: The writer was happy with the service of the health workers. [1]
2. Write True or False: The hospital chart was unclear about the baby's gender. [1]
3. "Vulnerable" means [1]aangrybin need of special carecrichdhealthy
4. "Intravenous" means [1]agiven by mouthbinto a veincon the skindin the ear

Answers

1. False.

2. True.

3. (b).

4. (b).

Short-answer questions (2 marks each)

1. What was the nightmare for the author? [2]
2. According to the author, what was the main weakness of the hospital staff? [2]
3. Did the nurses really say, "Your daughter is not a priority"? Why did the author think so? [2]
4. List the questions the author was asked frequently in the hospital. [2]
5. What do patients and their families expect from health workers? [2]

Model answers

1. Her baby had a very high fever and had to be admitted to hospital; this fear and exhaustion, together with the poor treatment, was her nightmare.

2. The staff did not work as a harmonious team and did not show care for the patient's family; they spoke badly about other staff and units instead.

3. No, the nurses did not say it in words. The writer felt it because the nurse said she was too busy, which showed that her daughter was not treated as a priority.

4. "Was the delivery normal?" and "Was the baby premature?"

5. They expect health workers to be honest, serious and caring, and to give each patient's needs the first place.

Long-answer questions (4 marks each)

1. What is the main purpose of the letter, and does it succeed? [4]
2. If you become a health worker in the future, what would be your priority? How would you treat patients and their families? [4]

Model answers

1. The purpose is to make health workers aware of how careless behaviour hurts patients and their families, and to ask them to improve. It succeeds because the writer is specific: she names bad-mouthing, a busy nurse, repeated questions and a wrong chart. She does not insult anyone and she closes by praising the work. Such a respectful complaint is more likely to be listened to.

2. My first priority would be the patient's life and comfort. I would treat every patient equally, whether rich or poor, listen carefully and explain things in simple words. I would read the chart before I spoke so that no family had to repeat the story. I would treat families kindly because they are frightened, and I would never gossip about colleagues. I would also keep records accurate. In this way I would earn trust and give good care.

3.2 A Healthy Diet for a Healthy Life

About the text

This text is a speech, not an essay. It was delivered to an audience of European officials and researchers at a conference about a research-and-innovation programme called the Joint Programming Initiative "A Healthy Diet for a Healthy Life". The speaker's aim is to persuade the member states of the European Union (EU) to cooperate. Notice the typical features of a speech: it greets the audience, uses we and you, repeats key ideas, asks for action and ends by thanking the listeners.

What the speaker says

She begins with a subject that is "never out of the media": food and health. Obesity is, she says, the greatest public-health challenge today. Poor diet and low physical activity are on the rise, and the trend among children in the EU has been getting worse for three decades. Poor diet leads to diseases such as type 2 diabetes, cardiovascular diseases, some cancers and, later in life, neurological disorders. People can prevent many of these by adopting better lifestyles and healthier diets.

Research is the key to this. Scientists must learn how diet affects health, how to measure it (through biomarkers), and how to change people's habits. Because the problem has many sides — biology, food industry, economics, psychology — a multidisciplinary approach is necessary. The speaker explains that the innovation chain begins with researchers, goes through companies and ends with consumers and patients.

The Joint Programming Initiative brings together the knowledge of member states so that they do not repeat each other's work. Europe's research programme Horizon 2020, worth about 80 billion euros, can fund top-level research on nutrition, health, diet-related diseases and ageing. If it is used effectively, the results will be new products, treatments, services and strategies, healthier citizens and opportunities for competitive European businesses. She ends by saying she expects the conference to take this work forward and thanks the audience.

Vocabulary

Word	Meaning	Example
wonderfood	a food thought to be very good for health	Many people call blueberries a wonderfood.
cardiovascular	relating to the heart and blood vessels	Walking reduces cardiovascular disease.
bioeconomy	the part of the economy that uses renewable biological resources	Farming is part of the bioeconomy.
demographic change	change in the structure of a population	Demographic change means more old people.
multidisciplinary	involving people from different subjects	The team is multidisciplinary.
inequality	difference in income or wealth	Economic inequalities affect diet.
neurological	relating to the brain, spine and nerves	Epilepsy is a neurological disorder.
biomarker	a measurable sign of a biological condition	Blood sugar is a biomarker for diabetes.
unprecedented	never known or done before	Unprecedented floods hit the town.
dramatically	suddenly and very greatly	Prices rose dramatically.
diagnosis	identification of a disease	Early diagnosis saves lives.

A healthy plate

Nutrition experts commonly advise that half of every meal should be vegetables and fruit, about a quarter whole grains and about a quarter protein (pulses, eggs, fish, meat), with little sugar, salt and fried food and plenty of water.

Questions and model answers

Objective questions (1 mark each)

1. The greatest public health challenge at present, according to the speaker, is [1]amalariabobesitycaccidentsdpollution
2. Horizon 2020 is [1]aa hospitalbEurope's research and innovation programmeca food brandda medicine
3. The healthcare innovation chain begins with [1]aresearchersbpatientscshopkeepersdlawyers
4. The speech is meant to [1]asell foodbappeal to EU members to collaborate in researchcpraise doctorsdtell a story

Answers

1. (b).

2. (b).

3. (a).

4. (b).

Short-answer questions (2 marks each)

1. According to the speaker, what is the cause of obesity among children in the EU? [2]
2. What should people do to prevent diseases like type 2 diabetes? [2]
3. What is Horizon 2020? [2]
4. Why is research important in the fight against health challenges? [2]
5. What result can Horizon 2020 bring if it is used effectively? [2]

Model answers

1. Poor diet and low physical activity, which have been getting worse over the last three decades.

2. They should adopt healthier lifestyles — better food and more activity.

3. It is Europe's research and innovation programme with a budget of about 80 billion euros.

4. Research gives the knowledge to prevent and manage long-term illnesses and to design products and policies that work.

5. It can bring excellent progress in research and innovation for healthy diets and healthy lives: new products, treatments, services and strategies.

Long-answer question (4 marks)

1. Do you think people of the EU will benefit from this conference? Give reasons. [4]

Model answer

1. Yes, I think they will. The conference is meant to bring the knowledge of many countries together so that research is not repeated. With the funding of Horizon 2020, scientists can find out how food affects diseases such as diabetes and heart disease. This knowledge can be turned into healthier food products, better treatments and good advice for citizens. It will also give European companies new business, creating jobs. In the long run, people will live healthier and longer lives.

3.3 Grammar and writing tasks of the unit

Grammar I: Reported commands, requests and advice

A command or request in direct speech uses the imperative mood (Do it!, Please help me.). In reported speech it becomes reporting verb + person + to-infinitive (positive) or + not to + infinitive (negative). There is no backshift because there is no tense to shift.

Direct	Reported
"Do your homework!"	The teacher told me to do my homework.
"Don't make a mess!"	My mother told me not to make a mess.
"Please help me fix this machine."	She requested me to help her fix the machine.
"Don't switch on the fan, please."	The electrician requested me not to switch on the fan.
"You should stop smoking." / "Don't smoke!"	The doctor advised him not to smoke.
"Be not afraid, noble prince," said the Guru.	The Guru told the prince not to be afraid.
"Let me do my work."	He asked/requested me to let him do his work.
"Let's play a friendly football match," said the coach.	The coach suggested/proposed playing a friendly football match.

Choose the verb that matches the tone

Direct sentence has	Reporting verb
a strong order	ordered, commanded, told
please, would you, could you	requested, asked, begged
advice (you should, if I were you)	advised, suggested, urged
a warning	warned
Let's...	suggested / proposed + -ing

Exercise A — Change into reported speech

1. "Please help me fix this machine," she said to me.
2. "Don't switch on the fan, please," the electrician said to me.
3. "Lend me some money, please," she said to him.
4. "Do your homework!" the teacher said to me.
5. "Don't smoke!" the doctor said to him.
6. The General said to his troops, "Guard the fort."
7. Aaswin said to the teacher, "Please excuse me, madam."
8. The guide said to the visitors, "Follow me carefully."
9. Mother said to the daughter, "Get ready to receive the guests."
10. Father said to me, "Do not tell a lie."
11. The monk said to us, "Give up bad habits."
12. The coach said, "Let's play a friendly football match."

Grammar II: Reporting verbs in different kinds of sentences

Real reports mix statements, questions and commands. The right reporting verb tells the reader what the speaker was doing.

Sentence type	Typical reporting verbs and patterns
statement	said / told + that; explained, replied, added, announced, admitted
question	asked / wanted to know / inquired + if, whether, wh-word
command, request	told, ordered, requested, asked + object + to
advice	advised, suggested, urged + object + to
warning	warned + object + (not) to
promise, offer, refusal	promised, offered, refused + to
thanks, apology, congratulation	thanked / apologised / congratulated + object + for -ing

Said is followed by that or to someone (said to me); told needs an object (told me). Use advised, warned and told with an object.

Exercise B — Circle the correct word

1. The doctor (told / said) me to do some exercise every day.
2. My mother (asked / told) me whether I had finished my homework.
3. The pilot (warned / advised) the passengers not to leave their seats.
4. He (apologised / promised) for losing my book.
5. The headteacher (said / told) that the school would remain closed on Friday.

Exercise C — Report using the verb in brackets

1. "You should drink more water," the doctor said to me. (advised)
2. "I will help you with the project," said Rina to me. (promised)
3. "Well done, Binod! You have won the match," said the coach. (congratulated)
4. "Don't touch the wire," said the electrician. (warned)
5. "Shall I carry your bag?" said the boy to the old woman. (offered)

Writing I: An email of apology

An email has a subject line, a salutation, a short body and a closing. Formal emails are polite, use full sentences and say clearly why you are writing. An apology email should (1) say sorry plainly, (2) state what went wrong, (3) say what you will do to put it right, and (4) end politely.

Task. Imagine you are one of the hospital staff. Write an email to the patient's mother apologising for your behaviour and assuring her of improvement.

Writing II: A speech

A speech is written to be heard. Open with a greeting and a hook; state the topic; use short, clear sentences, repetition and rhetorical questions; give two or three main points; close with a summary or appeal and a thank-you.

Task. Obesity has become a matter of concern. Draft a speech on obesity answering: What are its primary causes? What are its consequences? What should an individual do to avoid it?

Chapter summary

• A Letter from a Patient: a mother's respectful complaint about a hospital — bad-mouthing between staff, a busy nurse who made the baby feel "not a priority", repeated questions and a wrong chart. Message: health workers must be honest, serious and caring.
• A Healthy Diet for a Healthy Life: a speech asking EU member states to cooperate on research; obesity is the greatest public-health challenge; Horizon 2020 (about 80 billion euros) can fund the research; a multidisciplinary approach is needed.
• Reported commands: reporting verb + object + (not) to + infinitive; no backshift; choose told, ordered, requested, advised, warned, suggested by tone.
• Said + that; told + object + that; asked + if/whether.
• An apology email: sorry, what went wrong, what you will do, polite close. A speech: greeting, topic, main points, appeal, thanks.

Practice questions

Objective questions (1 mark each)

1. The word "priority" means [1]asomething done lastbsomething regarded as more importantca dutyda bill
2. The healthcare innovation chain begins with [1]apatientsbresearcherscshopsdschools
3. "Don't smoke!" the doctor said to him. → The doctor ____ him not to smoke. [1]asaidbadvisedcasked thatdanswered
4. Which one is a feature of a speech? [1]aa headlineba greeting to the audienceca datelineda by-line

Answers

1. (b).

2. (b).

3. (b).

4. (b).

Short answer questions (2 marks each)

1. Why did the writer feel that her daughter was not a priority? [2]
2. Why is a multidisciplinary approach needed? [2]
3. Report: "Please open the window," Rohan said to Sita. [2]
4. Report: The nurse said to the patient, "Don't eat anything before the test." [2]

Answers

1. Because a nurse said she was too busy, so help for the baby did not come quickly.

2. Because health problems such as obesity have biological, social, economic and psychological sides, so experts from several subjects must work together.

3. Rohan requested Sita to open the window.

4. The nurse told the patient not to eat anything before the test.

Long answer questions (4 marks each)

1. Write an email to a friend who is unwell, suggesting how to stay healthy. [4]
2. Draft a short speech (about 120 words) on "The Importance of Exercise for a Healthy Life". [4]

Answers

1. Outline: subject (Get well soon); greeting; sympathy; three pieces of advice (rest, healthy food, medicines on time and a doctor visit); a wish to see him soon; closing.

2. Outline: greeting; hook (a healthy mind lives in a healthy body); three benefits (strong heart and muscles, better sleep and mood, lower risk of diabetes and obesity); a call to action (thirty minutes a day); thanks.