English in medicine (grammar in use)GRAMMAR IN USE1. PRESENT CONTINIOUS TENSE
Present simple of the verb to be + gerund of the verb
Something that is happening at the time of speaking:
• Dr Ky is driving to the hospital.
• Dr. Ky is going to the operating room.
• I’m going to work.
Something that is happening around or close to the time of speaking, but not necessarily exactly at the time of speaking:
• I am writing an interesting article on brain tumor. I’ll lend it to you when I’ve finished it.
Something that is happening for a limited period of time around the present (e.g. today, this week, this season, this year. . .)
• Our residents are working hard this term.
• The patient is getting better with the new treatment.
• His blood pressure is rising very fast.
• I am living with other residents until I can buy my own apart- ment
Present continuous with a future meaning
To talk about what you have arranged to do in the near future (personal arrangements).
• We are stenting a renal artery on Monday.
• I am having dinner with a medical representative tomorrow.
( We can also use the form going to in these sentences, but it is less natural when you talk about arrangements.
We do not use the simple present or will for personal arrangements).2. PRESENT TENSE
Simple present shows an action that happens again and again (repeated ac- tion) in the present time, but not necessarily at the time of speaking.
To talk about something that happens all the time or repeatedly or something that is true in general:
• I do interventional radiology.
• Nurses take care of patients.
• Cigarettes cause lung cancer.
To say how often we do things:
• I begin to operate at 8.30 every morning.
• Dr. Ky does cranioplasty two evenings a week.
• How often do you go to the neurologist? Once a month.
For a permanent situation (a situation that stays the same for a long time):
• I work as an endocrinologist in the diabetes program of our hospital. I have been working there for ten years.
Some verbs are used only in simple tenses. These verbs are verbs of thinking or mental activity, feeling, possession and perception, and reporting verbs. We often use can instead of the present tense with verbs of perception:
• I now understand why the patient is in such a bad condition.
• I can see the solution to your problem now.
The simple present is often used with adverbs of frequency such as always, often, sometimes, rarely, never, every week, and twice a year:
• The chairman is always working.
• I always go to work at 6.30 am.
Simple present with a future meaning. We use it to talk about
timetables, schedules ...:
• What time does Ross’ operation conference start? It starts to- morrow at 9.30.3. TALKING ABOUT THE FUTURE
To say what we have already decided to do or what we intend to
do in the future (do not use will in this situation):
• I am going to attend the 20th International Congress of Cardiology next month.
• There is a CT course in Boston next fall. Are you going to attend it?
To say what someone has arranged to do (personal arrangements), but remember that we prefer to use the present continuous because it sounds more natural:
• What time are you meeting the vice chairman?
To say what we think will happen (making predictions):
• The patient is looking terrible. I think he is going to die soon.
If we want to say what someone intended to do in the past but did not do, we use was/were going to:
• He was going to do a CT on the patient but changed his mind.
To talk about past predictions we use was/were going to:
• She was going to become a good surgeon.
SIMPLE FUTURE (WILL)
I/We will or shall (will is more common than shall. Shall is often
used in questions to make offers and suggestions): Ex: Shall we go to the symposium (hoi nghi chuyen de) next week?
We use it when we decide to do something at the time of speaking (remember that in this situation, you cannot use the simple present):
• Have you called the cardiologist?
• No, I haven’t had time to do it.
• OK, don’t worry, I will do it.
When offering, agreeing, refusing and promising to do some- thing, or when asking someone to do something:
• That case looks difficult for you. I will help you.
• Can I have the book I lent you last week back? Of course. I will give it back to you tomorrow.
• Don’t ask to use his stethoscope. He won’t lend it to you.
• I promise I will send you a copy of the latest article on AIDS as soon as I get it.
• Will you help me with this patient, please?
You do not use will to say what someone has already decided to do or arranged to do (remember that in this situation we use going to or the present continuous)
To predict a future happening or a future situation:
• Medicine will be very different in a hundred years time.
• Neurology won’t be the same in the next two decades
Remember that if there is something in the present situation that shows us what will happen in the future (near future) we use going to instead of will:
With expressions such as: probably, I am sure, I bet, I think, I
suppose, I guess:
• I will probably attend the European Congress.
• You should listen to Dr. Higgins giving a conference. I am sure you will love it.
• I bet the patient will recover satisfactorily.
• I guess I will see you in the next annual meeting.
Will be + gerund of the verb
To say that we will be in the middle of something at a certain time in the future:
• This time tomorrow morning I will be attending the conference about drugs and the CNS.
To talk about things that are already planned or decided (similar to the present continuous with a future meaning):
• We can’t meet this evening. I will be operating on the patient we talked about.
To ask about people’s plans, especially when we want something or want someone to do something (interrogative form):
• Will you be attending to my patients this evening?
Will have + past participle of the verb
To say that something will already have happened before a certain time in the future:
• I think the liver will already have arrived by the time we begin the transplantation.
• Next spring I will have been working for 25 years in this hospital.
TALKING ABOUT THE PAST
The simple past has the following forms:
The past of the regular verbs is formed by adding -ed to the infinitive.
The past of the irregular verbs has its own form.
Did/didn’t + the base form of the verb.
Did I/you/. . . + the base form of the verb
To talk about actions or situations in the past (they have already finished):
• I enjoyed the resident’s party very much.
• When I worked as a resident in Madrid, I lived in a small apartment.
To say that one thing happened after another:
• Yesterday we had a terrible duty. We operated on five patients and then we did a kidney transplantation.
To ask or say when or what time something happened:
• When were you operated on last time?
To tell a story and to talk about happenings and actions that are not connected with the present (historical events):
• Roentgen discovered X-rays
Was/were + gerund of the verb
To say that someone was in the middle of doing something at acertain time. The action or situation had already started before this time but hadn’t finished:
• This time last year I was writing an article on lipid metabolism.
Notice that the past continuous does not tell us whether an action was finished or not. Perhaps it was, perhaps it was not.
To describe a scene:
• A lot of patients were waiting in the corridor.
Have/has + past participle of the verb
To talk about the present result of a past action.
To talk about a recent happening
In the latter situation you can use the present perfect with the following
Just (i.e., a short time ago): to say something has happened a short time ago:
• Dr. Ky has just arrived at the hospital.
Already: to say something has happened sooner than expected:
• The second-year resident has already finished her presentation.
Remember that to talk about a recent happening we can also use the simple past:
A period of time that continues up to the present (an unfinished period of time):
• We use the expressions: today, this morning, this evening, this week ...
• We often use ever and never.
Something that we are expecting. In this situation we use yet to show that the speaker is expecting something to happen, but only in questions and negative sentences:
• Dr. Nam has not arrived yet.
We can also use yet with the simple past:
• Dr. Nam did not arrive yet.
Something you have never done or something you have not done during a period of time that continues up to the present:
• I have not reported a CT scan since I was a resident.
How much we have done, how many things we have done or how many times we have done something:
• I have attended to ten patients today.
• Dr. Concepcion has operated on four hearts this weekend.
Situations that exist for a long time, especially if we say always. In this case the situation still exists now:
• Dr. Nga has always worked very hard.
• Dr. Nga has always been a very talented surgeon.
We also use the present perfect with these expressions:
Superlative: It is the most . . . :
• It is the most interesting case that I have ever seen.
The first (second, third . . .) time ...:
• This is the first time that I have seen a patient with Wilson’s disease
PRESENT PERFECT CONTINOUS.
Shows an action that began in the past and has gone on up to the present time
Have/has been + gerund
To talk about an action that began in the past and has recently
stopped or just stopped:
• You look tired. Have you been studying?
• Yes, I have been studying the Pancoast case.
To ask or say how long something has been happening. In this case the action or situation began in the past and is still happen- ing or has just stopped.
• Dr. Sancho and Dr. Martos have been working in the project from its inception.
We use the following particles:
How long . . .? (to ask how long).
For, since (to say how long):
• How long have you been working as a family doctor?
• I have been working for ten years.
• I have been working very hard since I got this post.
For (to say how long as a period of time):
• I have been studying MR imaging for three months.
Do not use for in expressions with all:
• I have worked as a doctor all my life (not “for all my life”).
Since (to say the beginning of a period):
• I have been teaching anatomy since 1980.
In the present perfect continuous the important thing is the action itself and it does not matter whether the action is finished or not. The action can be finished (just finished) or not (still happening).
In the present perfect the important thing is the result of the action and
not the action itself. The action is completely finished
Shows an action that happened in the past before another past action. It is the past of the present perfect.
Had + past participle of the verb.
To say that something had already happened before something
• When I arrived at the meeting, the chairman had already begun his presentation
PAST PERFECT CONTINOUS
Shows an action that began in the past and went on up to a time in the past. It is the past of the present perfect continuous.
Had been + gerund of the verb
To say how long something had been happening before something else happened:
• She had been working as an endocrinologist for forty years before she was awarded the Nobel prize.
Imagine this situation:
The surgeon says to the radiologist, “Why don’t you do a CT scan to the patient with an acute abdominal pain?”
The surgeon proposes (that) the radiologist do a CT scan to the patient with an acute abdominal pain.
The subjunctive is formed always with the base form of the verb (the infinitive without to):
I suggest (that) you work harder.
She recommended (that) he give up drinking alcohol.