Everyone, I hope you don't understand what I'm about to tell you. I'm tired of everything, every day is a repetition of the same day, but which was last week, I get up and go to the sharaga, where my only desire is to get home as soon as possible and this is repeated every day, on weekends I thump, I don't know why , maybe just to get drunk and forget, forget this week, and better life. I’m looking for that one, but I always get past, for them I’m supposedly a friend, but I understand that they just don’t want to offend me, in fact, they would just send me to hell and forget about my existence if they allowed upbringing. I understand that I am a game, I am a rag, that for them I am just a weed, but I still go to them, because at home it will only get worse .. I will go into my thoughts and a new depression because of a girl who doesn’t care about me, doesn’t care how and everyone. I'm tired of it all, but I'm so weak-willed that I'm afraid to commit suicide, I cling to something, not knowing what for myself, and day after day I repeat the same actions, going to bed every night, I hope I don't wake up , but every time I wake up, getting into a minibus and falling asleep in it, I again hope that I won’t wake up, that it will break or that I will have some banal hemorrhage in the brain, although ideally, to be slaughtered for a couple of hundred, a phone and a half-empty pack of cigarettes, but every time I get off the minibus and go to the same sharaga. For what? I do not know. Perhaps for my mother, because she is the only person who needs me, although I behave towards her like scum. Today I will get drunk again and this time, I hope that I will still be gone, but as always I will get up in the morning and I will be ashamed, ashamed of what I did, but then I will repeat it again, you probably don’t want to listen to all this, you're tired of my whining, but that's me. Probably later it will be easier, but the phrase "tomorrow will be worse" has long been my motto. And each time remembering that "these are mine best years", I'm thinking "what kind of tin will happen next"
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Set , age: 18 / 01.12.2016
Responses:
If you start with the motto "tomorrow will be better", if you believe in yourself, believe sincerely in God, your life will change, you will want to live. Our soul is immortal and it will continue to suffer in the next world a hundred times stronger if we take our own life. Therefore, problems need to be solved in this life. There's nothing to change. Think about it. And even better, read what awaits a suicide after death. Patience to you. May God keep you
natalia, age: 35 / 02.12.2016
You know, Set, there are a lot of good things in this world that you pass by every day without noticing. And even the girls are kind and understanding. You just narrowed your world too much and boiled in your experiences like in a cauldron. You look at everything through yourself - "how it is in relation to me", therefore you do not have a true picture of the world. Are you moving in? You do not live independently, you are a continuous reaction to what is happening around. And on this you lose your vital energy - the strength of your personality. Do you want to change everything? Start to feed your mind and your senses with other food - watch a really good movie, read it. But not the consumer goods, which is full around. I recently discovered an unusual film, I recommend "The Night is Bright" 2004. It is useful even to think about what is happening outside your "cauldron" ... After all, there is a war going on somewhere, people are dying for something ... For what? And what thoughts does my mother suffer from? And what is the most important thing in this life? What is all this for? That's when you start to become a person who can influence this world, and not just react. Understand? I sincerely hope for your understanding. I believe in you, because I feel good potential in your letter. With God!
Igor, age: 27 / 02.12.2016
Hello. In addition to relationships, there are many other interesting things in life. Why are you so obsessed with girls? Better sign up for the pool, go to the gym, go to the stadium. Find a job. Love will come when you don't expect it at all. Don't be discouraged! AND bad habits declare taboo. 18 is not the right age to take stock. I wish you success!
Irina, age: 28 / 02.12.2016
Hey Set!
There is an expression: "Life without a goal leads to the degradation of the individual," which is true in your case.
I'm sure you have this moment no purpose. And you don't even know yourself. The labels you put on yourself don't mean anything. It's like scolding parked car- a rubbish car, no speed, no cross-country ability, etc. But is it okay that the car is not going anywhere yet? How can you judge its capabilities? You draw up a route, start the car, practice driving, and then take out the marks.
A person is known in deeds. I heard Vysotsky "Pull the guy into the mountains - take a chance, ... There you will understand who he is." Mountains, they may not be in the literal sense. What peaks would you like to conquer? Think! There are a couple (dozens) of picks that should be yours??? Let's! That's when you will understand what your strengths and what to work and work on. And the girls will see exactly you, the real one, and not something loitering from nothing to do. And you will respect yourself for what and live interestingly. Being a vegetable even at 18 is a small joy, but being a person who makes his own life is interesting even at 90! My granny will soon be 90, imagine her to-do list for every day. And on holidays, she comes home later than the children and grandchildren from her company!
It seems to me that you are a talented guy and you yourself have no idea what you are capable of yet! I believe in you! Perseverance in achieving goals and success!
Elena, age: 39 / 04.12.2016
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Verbs, names and adverbs in a sentence can act as introductory words, which in one way or another - grammatically, lexically, intonationally - express the speaker's attitude to what he reports.
Compare two sentences:
This question, it seemed troubled the guest.
Face his seemed calm .
In both examples, the word seemed , but only in the second case is this word included in the members of the sentence: there it is part of the compound nominal predicate.
In the first example, the word seemed serves only to express the attitude of the speaker to what he reports. Such words are called introductory; they are not part of the sentence and can easily be omitted, for example: This question ... made the guest difficult. Note that in the second sentence, skip the word seemed impossible.
Compare a few more examples in the table:
|
Take with you By the way, our books. |
These words are spoken By the way. This phrase was spoken by the way. |
|
Words separated by commas can be removed from a sentence without destroying its meaning. |
By the way, from the first sentence, you can ask the question HOW? |
Many words can be used as introductory words. But there is a group of words that are never introductory. Read two sentences:
There will obviously be a good harvest this year;
There will certainly be a good harvest this year.
The first sentence uses the word obviously, in the second - certainly . Although these words are very close in meaning, only the word from the first sentence is separated by commas and is introductory. The words below must be remembered: they are very similar to introductory words, but they are not and commas are not separated:
MAYBE, AS IF, SUDDENLY, BECAUSE, HERE, IS HARD TO, ALL THE SAME, EVEN, EXACTLY, AS IF, JUST, ALWAYS, ALWAYS, MANDATORY, ALMOST, ONLY, ALLEGEDLY.
Introductory words can convey five various types values:
Most often, with the help of introductory words, the speaker conveys various degree of certainty in what he says. For example: You will surely do well in the exam. or You seem to need to do more. This group includes the words:
OF COURSE, OF COURSE, UNDOubtedly, DEFINITELY, WITHOUT A DOUBT, DEFINITELY, REALLY, SEEMS, PROBABLY, POSSIBLY, PLEASE.
Introductory words can also convey feelings and attitude speaker to what he is talking about. For example: Unfortunately, you didn't do well in your exam.
LUCKYLY, UNFORTUNATELY, SURPRISELY, UNFORTUNATELY.
Sometimes introductory words indicate on the The source of information reported by the speaker. Introductory phrases in this case, they begin with the words BY MESSAGE, BY WORDS, BY OPINION. For example: You, according to doctors, need to interrupt training for a while.
The source of the message may also be the speaker himself (IN MY OPINION, IN MY OPINION), or the source may be indefinite (SPOKEN, HEARD). For example: You, they say, will have to interrupt training.
BY MESSAGE, BY WORDS, BY OPINION, BY HEARING, SAYING, HEARD, IN MY OPINION, IN MY OPINION, IN YOUR WAY.
Introductory words are also used for ordering thoughts and indications of their relationship with each other. For example: Firstly, this participle was formed from the verb perfect look; secondly, it has dependent words. Therefore, it should contain two letters N.
FIRSTLY, SECONDLY, THIRDLY, FINALLY, THEREFORE, THEREFORE, SO, ON THE CONTRAST, FOR EXAMPLE, ON THE REVERSE.
There are also sentences where the introductory words indicate on the way of thinking. For example: In a word, everything went well.
OTHERWISE, IN ONE WORD, IT IS BETTER TO SAY IT SOFTLY.
Introductory words also include words that serve to attract attention interlocutor:
KNOW (KNOW), UNDERSTAND (UNDERSTAND), LISTEN (LISTEN), SEE (SEE) and others.
The same meanings can be expressed not only by introductory words, but also by similar predicative constructions (introductory sentences). Compare: Snowfall likely to end soon And The snowfall, I think, will end soon. In addition to commas, for highlighting introductory proposals brackets or dashes may be used. This is done when the introductory construction is very common and contains additional comments or explanations. For example:
Here we pass once through our village, years will be - how to tell you not to lie - fifteen years. (Turgenev)
Alexey (the reader has already recognized it) meanwhile he gazed intently at the young peasant woman. (Pushkin)
The rule of isolation of introductory words and sentences has several very important notes.
If the introductory word is preceded by the union A or BUT, then a comma is not always placed between the introductory word and the union. Compare a couple of sentences:
The doctor has finished but of course, look at a seriously ill patient.
He gave his word and consequently, must restrain him.
The introductory word can be rearranged or removed without a union only in the first case, so a comma is required between the introductory word and the union. In the second sentence, this cannot be done, which means that the comma is not put.
Very often, difficulties arise in sentences with the words HOWEVER and FINALLY. The word HOWEVER stands out only when it cannot be replaced by the union BUT. Compare two sentences:
but we understand that this figure is still low(HOWEVER = BUT) . Bye, but, we still don't have a clear picture of what's going on(BUT - introductory word).
The word FINALLY is introductory only when it has no spatial or temporal meaning, but indicates the order of thoughts. For example:
I hope this project will be completed soon. finally will be implemented. AND, finally, The last thing I would like to pay attention to.
Introductory words can begin with a separate construction, for example, a clarifying phrase. In this case, a comma is not placed after the introductory word (in other words, the comma, which was supposed to “close” the introductory word, is transferred to the end of a separate turnover).
I saw, or rather felt, that she was not indifferent to me.
In addition, a comma is not placed before the introductory word located at the end of a separate turnover.
For the holidays, we decided to go somewhere, to Kolomna for example.
If the introductory word is in the middle of a separate construction, then it is separated by commas on a common basis.
I decided to declare my love, feeling, it seems, in my heart that she, too, was not indifferent to me.
If the introductory words are located before the turn, beginning with the words "how" or "to", then they are separated by commas.
The day she lived seemed meaningless to her, in fact, like all life.
He thought for a moment probably, to find the right words.
The exercise
- The portraits hung in front of the mirror.
- On the contrary, he did not even change his face.
- On the one hand, I completely agree with you.
- On the one hand, a double-headed eagle was depicted on the coin.
- The truth is always better than a lie.
- I_true_ was somewhat surprised by this news.
- In spring, flooding is possible.
- There will be a flood in the spring.
- Everyone in our city is already talking about it.
- In Greece_ they say_ everything is there.
- Maybe_ you deigned to express yourself in this way for the beauty of the style? (Gogol).
- The weather forecast says it will be colder next week.
- As scientists say, global warming awaits us.
- The train leaves in an hour_ therefore_ we need to leave the house.
- Fortunately, Pechorin was immersed in thought (Lermontov).
- We have gathered here _ firstly_ in order to resolve the issue of the timing of work.
- He didn’t want to shoot himself_ thank God_ he didn’t want to try ... (Pushkin).
- Of course, you have seen the album (Pushkin) of the county young lady more than once.
- In one word, you got off lightly.
- So_ now we can conclude.
- You do not interfere with me in the least,” he objected, “if you please, shoot, but_ by the way_ as you please; your shot is yours; I am always ready at your service (Pushkin).
- She suffered for a very long time after separation, but_ as you know, time heals any wounds.
- The wind, however, was strong.
- Fedya brought flowers_ however_ Masha did not like it.
- A strong yet warm wind blew through the window.
- A good upbringing, as you know, is obtained in boarding schools (Gogol).
- However, there are various improvements and changes in methods ... (Gogol).
- You must certainly come to us.
- I took from the table_ as I remember now_ the ace of hearts and threw it up (Lermontov).
- However, even General Khvalynsky himself did not like to talk about his service career; he seems to have never been to war (Turgenev).
- You become wild - you know - if you live locked up all the time (Gogol).
- Probably_ he was a man of gratitude and wanted to pay this for good treatment.
- You supposedly were supposed to come to his office and report on the trip.
- Yes, I confess, I thought so myself.
- Anyway, I decided to do things my own way.
- Ivan Petrovich_ you know_ was an extraordinary person.
- Nobody went to him, of course, (Turgenev).
- Gleb, as far as I knew, studied well at the Bryansk gymnasium (Paustovsky).
- But_ perhaps_ the reader is already tired of sitting with me at Ovsyannikov's one-palace, and therefore I eloquently fall silent (Turgenev).
- My arrival - I could notice it - at first somewhat embarrassed the guests.
- But_ political process began to develop in a different way.
- In my last report, I hastened to inform you that we finally managed to solve this problem.
- The experiences of transformations that were around us, no doubt, had a strong influence on the thoughts of most of the people involved in them (M. M. Speransky).
- A group of border guards led by an officer went to the violators with the intention, as it_ happened_ earlier, to protest and demand that they leave the territory.
- Finalization of the agreement will probably take several more months.
- Secondly, there are many abuses in the field of international tourism.
- However_ if you remain committed to the spirit and letter of this document, it could not be otherwise.
- We all know very well, and everyone here knows well that on the western, or, as they say, the second front, about 1.5 million Allied troops and about 560 thousand German troops were concentrated.
- This modest, symbolic gesture_ seems to me_ full of deep meaning.
- Luckily, the examples mentioned above are the exception, not the rule.
- Extra value luggage_ can be claimed for certain types of items.
- The reason for this is obvious: when the mind begins to recognize the price of freedom, it dismisses with negligence all the children's toys, so to speak, with which it amused itself in its infancy (M. M. Speransky).
- Pravda_ spoke to me politely, did not force me to do anything, and I remember that I had the impression that he did not take all these accusations seriously.
- But in our case, the truth quickly came out, and we were soon released.
Hello. There is such a sentence: “And I hope you won’t refuse toast?” Do I need to highlight “hope” with commas and
- Of course you do.
And I hope you understand that. - Introductory words are words or constructions that are part of a sentence, but do not enter into grammatical connection. As a rule, introductory words express the speaker's attitude to the statement, its assessment, provide information about the source of the message or connection with the context.
Commas separate introductory words and phrases. There are several main groups of introductory words according to their meaning:1. Introductory words expressing the speaker's feelings (joy, regret, surprise, etc.) in connection with the message: fortunately, unfortunately, fortunately, unfortunately, to joy, to chagrin, to regret, to annoyance, unfortunately, to surprise, to amazement, to horror, to shame, for happiness, for joy, for trouble, what good, there is nothing to hide a sin, a strange thing, an amazing thing and others
2. Introductory words expressing the speaker's assessment of the degree of reliability of what is being reported (confidence, assumption, possibility, uncertainty): of course, undoubtedly, without any doubt, obviously, certainly, of course, goes without saying, indisputably, indeed, probably, perhaps, true, probably , in all likelihood, maybe, maybe, perhaps, it seems, it would seem, apparently, apparently, perhaps, in fact, really, really, isn't it, in essence, in essence, in fact, right, tea, presumably, I think, I hope, I suppose and others
3. Introductory words indicating the connection of thoughts, the sequence of presentation: so, therefore, means, on the contrary, on the contrary, further, finally, by the way, by the way, in general, in particular, first of all, in addition, moreover, therefore, for example, for example, the main thing, thus, by the way, by the way, by the way, firstly, secondly, and so on, on the one hand, on the other hand, I repeat, I emphasize and others
4 Introductory words indicating the techniques and ways of formulating thoughts: in a word, in a word, in other words, in other words, in other words, in short, simply put, to put it mildly, if I may say so, if I may say so, if I may say so, better to say, so to speak, what is called and others; the words actually, in general, or rather, more precisely, rather, and the like are introductory, if after them a word can be added saying: The Board authorized him to speed up the work, that is, in other words, he authorized himself to this;
5. Introductory words indicating the source of the message: they say, report, transmit, according to ..., according to the message ..., according to information ..., according to ..., in my opinion, in your opinion, in - ours, in your opinion, in my opinion, according to rumors, according to legend, I remember, hear, say, and others
6 Introductory words, which are an appeal to the interlocutor or to the reader in order to draw his attention to what is being reported, to inspire a certain attitude to the thoughts expressed, to the facts presented, and so on: see (whether), see (whether), understand (whether), understand (whether), know (whether), know (whether), understand, understand, believe, listen, agree, imagine, imagine, excuse, forgive, believe (whether), believe (whether), please and so on - necessary!
and they all confirmed it - Necessarily)))
- yes, introductory word)
- "I hope" stands out as a separate definite-personal sentence ("I hope"), it can be said that it has the meaning of an introductory word with the meaning of possibility, desirability.
- In April, everyone was happy - it seemed that the story of your case was over.
It didn't end in April. On April 16, the Moscow City Court ruled to return the case for additional investigation, indicating that all the evidence presented by the investigation was unreliable, not scientifically substantiated, and the motives were not indicated. According to the order of the Moscow City Court, I was to be cleared of all charges, to remove my undertaking not to leave, to carry out new investigative actions, appointed by the Moscow City Court, after them - forensic medical examination, and based on the results of this data, decide who is to blame.
Unfortunately, it turned out differently. The case was resumed, accepted for production in the UK. No investigative actions were carried out, but a decision was written on the appointment new expertise, where I again appear as an accused.
Naturally, this raised questions in me - why is this happening, where is the execution of the orders of the Moscow City Court? Against the same background, letters from public organizations worried about what was happening, as a result, the case was taken under control. And I really hope that now everything will be according to the law.
- Taken under control - meaning investigative committee(SK)?
There was news in the media that the case would be under the control of the leadership of the Investigative Committee and transferred to another division of the Investigative Committee in Moscow. No one has officially contacted me yet.
Many medical specialists spoke in your defense, their comments and assessments were not taken into account and added to the case?
Unfortunately, the opinions of specialists, officially received by the lawyer, were not included in the investigation, all these petitions were rejected. During court sessions the conclusions of international experts were attached to the case file, but no one listened to them, they were considered untrustworthy.
- Have you still not been charged with a written undertaking not to leave?
No, not removed. I am not a free person yet. Considering that this is the fifth year, of course, this interferes with life and work.
We want to become one of the best hematology centers in Russia
Parallel to litigation After all, there was also work on a new branch? Do you open a bone marrow transplantation (BMT) department in the hospital?
We planned to open it a little earlier, but taking into account all these circumstances, the project has shifted by about six months. We hope that in September-October this year we will be able to open two new departments: bone marrow transplantation and hematological resuscitation.
This project began several years ago, with the support of the Moscow Health Department and the hospital management, it was possible to make modern repairs and equip the departments with the equipment that is required to provide high-tech care to patients in the oncohematology profile. Today, the final touches remain.
I hope that in the near future we will be able to move to these departments and we will have more opportunities to treat patients. Now we are doing autologous stem cell transplantation, and the new department will allow for allogeneic BMT. And I hope that the good pace that we have taken on transplantation now, we will continue.
Hematology resuscitation is one of the most important departments for centers or hospitals that deal with high-dose chemotherapy, it is a different approach to patients.
In oncohematological patients who receive high-dose chemotherapy, various infections join in the post-cycle period and may be serious complications, there is a risk of developing critical conditions. And the task of hematological resuscitation is to prevent the development of these critical situations, correctly "hold" the patient, which will save him.
Elena Misyurina (center). Photo: GBUZ GKB No. 52 DZM
After the opening of these departments, we will be able to say that in the structure of the Moscow Health Department it is now possible to provide any high-tech medical care to oncohematological patients, this will significantly increase the overall and relapse-free survival of these patients. And we will try to become one of the best hematology centers in Russia.
I had to prove that the Earth is round, and does not stand on three pillars
- After the April decision of the Moscow City Court, did it become easier or more comfortable for you to come to work?
I always enjoy going to work. As for the internal sensations associated with the criminal case, which has been going on for the fifth year, they cannot be classified as pleasant. Of course, thoughts and worries about this take time, distract from work and normal life. It is especially unpleasant to prove obvious things that are clear to any doctor, I would compare this with proving that the Earth is round, and does not stand on three pillars.
Of course, all this takes energy, time, emotions. But this situation already exists in parallel with my main life. And you can’t lose heart, slow down and cancel tasks. I have certain promises for the development of the hematological service to the hospital management, to the colleagues who came with me to this project, and of course, to the patients who entrusted us with their health.
In 2017, 3,758 patients received medical care in hematology at the hospital, and with the opening of new departments, their number will increase.
- How did the patients feel about this story when it received such a response?
Everyone said: we support you, we are with you. Many people ask me the question: “Elena Nikolaevna, why did everyone stand up for you so much?” I don’t know, but I can assume that the absurdity of the accusation and, in principle, the impossibility of such a sequence of events developing in the patient influenced this - caused such a response from caring people and their reaction after the unfair sentence was passed on me.
The absurdity of everything that is happening is understood even by people who are far from medicine.
I am all the more surprised by forensic experts who put their signatures under the conclusions, the meaning of which does not fit in with human anatomy and physiology, the basics of medicine and the nature of the course of certain diseases. Moreover, in support of their position, they cite arguments that can in no way be classified as scientifically substantiated and reliable.
Elena Misyurina in the courtroom. Photo: Efim Erichman
Could you give an example of such arguments?
- Here is an example understandable to any person: someone “cut” his veins on his wrists - all people know about this situation. Can a person with such damage live without medical care two days? No. And in the situation with me, it is said that the patient’s artery is damaged, when the blood does not ooze, but beats like a fountain.
Or another example: on the battlefield, a wound in an artery - without emergency medical care, a person can live for two days? In terms of physiology, a person with a wound to the upper right gluteal artery will not live more than 17 minutes. And from the materials of the case, I learn that the patient, after the injury to the artery allegedly caused by me, drove the car on his own, worked all day and then arrived at the hospital, where he was operated on 18 hours after admission to the hospital. This is almost two days from the moment of the alleged injury to the artery. Arterial bleeding is very unusual.
But after all, experts, in addition, groundlessly assert that in addition to the injury to the artery, the patient also had damage to the pelvic venous plexus. True, the pathologist could not specify which one, since he believes that he “should not know this.” In addition to the alleged injuries of the artery and vein, the patient had a serious hematological disease in the progression stage - leukemia, which was accompanied by DIC. With all the above data, such a patient would not live after damage to the artery and venous plexus for more than seven minutes.
The next inconsistency in the data is probably more for the doctors: on the part of the prosecution, massive blood loss is confirmed by the description of the CT scan of the small pelvis, although no one saw the pictures. According to the CT description, there was a large hematoma - it should correspond to the loss of 50% of the patient's total circulating blood, a shock index of 1.54. This is the third degree of bleeding - extremely severe, when the patient must be in intensive care and needs to be treated, and he was in the general surgical department and no help was provided to him. This was something that was alarming.
And if we calculate the shock index at the same moment, based on general analysis blood (hematocrit - 38, hemoglobin - 134 g / l) and ECG data (where the pulse was recorded at 68 beats per minute), then it was 0.72. This indicates the absence of bleeding, all changes fit into the progression of hematological disease. The question arises: according to various data, how can a patient have a shock index of 1.54 and 0.72 at the same time? Moreover, the shock index of 0.72 was fixed by objective data from the patient's medical history, and 1.54 - on the description of CT without images. Where is the truth?
Can't forensics calculate the shock index? Why would a resuscitator with a Ph.D. degree, who has been working at the department for decades, subscribe to the fact that a shock index of 0.72 corresponds to massive blood loss of the third degree? Is it not clear from the medical history that the blood loss occurred during the operation (loss of hemoglobin from 130 g/l to 53 g/l), and not when the patient was punctured and not when he was admitted to the hospital?
Elena Misyurina. Photo: Marina Murkova
An expert resuscitator does not know how to treat hemorrhagic shock that occurred during the operation? Is it possible to remove a patient in hemorrhagic shock from artificial lung ventilation? How can a patient in shock with a pressure of 80/40 mm Hg. Art. be without inotropic support? Is it possible to stop bleeding in a patient with DIC without a transfusion of fresh frozen plasma? Is it possible to replenish such blood loss without central access (special catheter)?
And, imagine, according to experts, such "omissions" of the doctors of CB No. 3 "Medsi" did not affect the outcome of the disease in any way! And the formulation of the diagnosis - iatrogenic damage to the vessel - appears in the history of the disease from the first day of the patient's admission to the clinic, although the iatrogenic nature can only be established during an autopsy. And this also did not cause any questions? It is not clear why a well-known surgeon, doctor of sciences, a professor working in a well-known city clinic, should sign that fine-needle trephine biopsy and the sampling of an autograft from the ilium for reconstructive operations on the spine are one and the same, and their complications are the same.
At the trial, the medical examiner said: “I’m not in the circus, I won’t tell anything”
- How did the experts react to these arguments at the trial?
– Next question I ask in court: who saw the damaged artery? I ask the operating surgeon - have you seen it? The answer is no. I ask the pathologist about the wound: did he see the damaged artery during the autopsy? In response, I hear: no, I should not have found a wound. And what happens? With an injury to the artery of the patient, live like this long time could not, no one saw the injury, the evidence of massive blood loss according to the CT scan, to put it mildly, crumbles.
A logical question arises: why was a forensic autopsy not performed in the case of a fatal outcome in a private clinic that did not have a license for pathoanatomical activities, and with a diagnosis of “iatrogenic damage to the artery”? All such cases at that time were regulated by orders of the Moscow Health Department No. 354, the Ministry of Health No. 82 and federal law №323.
Another question: a person died in the clinic, where is the targeted expertise of the insurance company? All lethal cases under compulsory medical insurance are subject to such an examination - the quality of medical care is checked. How did the insurance company pay for Medsi Clinical Hospital No. 3 for the autopsy of the patient's body, given the lack of a license for pathoanatomical activities? I doubt very much that the insurance company went to this kind of violation. Did the insurance company even know about the death of this patient? According to what codes of medical and economic standards, CB No. 3 Medsi filed this case for payment in insurance company? You see, the puzzle does not fit, and no one wants to put it together.
At the trial, I ask the medical examiner - tell me, what was the course of the wound channel, because it is not indicated in the documents? This is a normal question, which should have interested not only me, but also the prosecution. The medical examiner answers me: "I'm not in the circus, I won't tell or show anything." This is fine? Is this allowed?
And when we try to draw the supposed course of the wound channel - in the way it follows from the autopsy protocol and which is confirmed by the forensic experts - the iron needle had to go straight into the bone, then inside the bone turn left about 90 degrees, go again, turn 180 degrees, and at the end - fork.
- A very gutta-percha needle is obtained.
This is just the tip of the iceberg, it is impossible to list all the questions and unreliable data in this case.
Elena Misyurina in the courtroom. Photo: Efim Erichman
I don't think we'll ever know the truth
- Is it possible now to understand what actually happened?
I think that it is impossible, we will not know the truth. I can only say for sure that a patient came to me, he underwent a puncture, he was observed by me for about an hour, after which he left for work. No complaints or feeling unwell The patient did not have any during the follow-up period.
And I found out that the patient had died six months later, when I received an invitation to visit the UK. About everything that happened to the patient after that, I can only guess and only according to the medical documentation that was presented by Medsi Design Bureau No. 3. And the content of this documentation raises many professional questions.
When you write a medical history, you enter all the reliable data - what happens to the patient. And when, according to all the rules, the completed case history gets to the experts, they can restore the entire clinical situation by the minute, find the mistake and understand what happened to the patient. In my opinion, in this situation there are too many inconsistencies and direct contradictions both in medical documents and in the testimony of doctors.
- How did your colleagues react to this new round of business?
Many thought that justice had triumphed, but here again new circle has begun. At the moment, the investigation is once again on the beaten path. Colleagues are worried. It's all unpleasant. I am very sorry that I and other doctors are faced with this, somehow there has been a lot of injustice.
- And how did your family, your children react to the resumption of the case?
Everyone is worried. Nobody wants a repeat of the situation.
- And your husband?
He is also worried. Moreover, we have already studied everything so thoroughly in 4.5 years, the whole absurdity of the accusations against me is visible. But it just needs to be lived through. It can't go on indefinitely.
- Do I understand correctly that your colleagues and friends will also support you this time?
Hope so. I would like to believe in it. By supporting me, my colleagues probably support themselves, since any doctor can be in my place. Of course, I would not wish anyone to go through what I had to go through and still have to go through. I would like to believe in a fair future and that a balance will be found between the medical community, patients, legislative framework and power structures.
Did you know that in Russian there are introductory words that are separated by commas in a sentence? If you do not know anything about this or have an idea, but incomplete, then this article is for you. Let's refresh our memory or learn the rules with us.
The Importance of Punctuation
Knowing punctuation is extremely important. Unfortunately, the average Russian does not know that “by the way”, “maybe”, “firstly”, “in my opinion” are separated by commas. And the word "probably" is not always even written with the letter "e" at the end.
When we communicate with a person not live, but via the Internet, we often encounter illiteracy on the other side of the chat. This, of course, spoils the impression of the interlocutor, because it is literate people who are able to draw our attention to their personality. If we see that all the commas are in place, all the words are spelled correctly, the thought is expressed clearly, immediately there is a desire to get to know the person better, there is a feeling that we are communicating with an intelligent, well-read and wise interlocutor.
Some people think that in everyday communication literacy is not important. It's their business. Perhaps such people can impress us with something else. But if you work with clients? By communicating with them, you represent the company. Your potential client may also refuse your services if he understands through correspondence that you cannot competently build an elementary proposal.
Modern bloggers post their posts 3 times a day. And many already have several thousand subscribers. And of these, a third are schoolchildren and students who, thinking that their idol is perfect in everything, adopt the spelling of words and the style of expressing thoughts due to their inexperience. If an Instagram star becomes famous, she should think about the fact that she has a huge responsibility. You should not forget about your audience and send posts to your friends for at least an elementary check - there will definitely be at least one friend who can help.
In general, as we see, there are solid pluses in literacy. And now let's study how introductory words are written and how they stand apart in a sentence.
What are "introductory words"?
Introductory words are combinations of words or words that are not members of a sentence. With their help, we express our attitude towards what we communicate. Introductory constructions and the words in the letter in the sentence are separated by commas, and in oral speech stand out intonation, that is, pauses or rapid pronunciation.
Meanings of introductory words
They have various meanings. Consider the following table with relevant examples:
We hope that with the help of the table we have quite clearly explained the punctuation marks in sentences with introductory words and constructions.
Introductory deception words
Do not forget that there are homonymous constructions that usually confuse when studying the rule. In many sentences, introductory words are members of the sentence. Let's see in what situations they are part of the grammatical basis. Compare the following examples:
- The doctor's decision was undeniable. The doctor's decision was undeniably correct.
- To my happiness, a sense of satisfaction was added. Luckily for me, the project was delivered on time.
- Everything seemed so boring. Everyone seemed to be bored.
As you can see, we cannot at first glance determine whether this is an introductory word or part of a grammatical basis. Be sure to read the sentence in order to understand the meaning, and then highlight the members of the sentence. Commas for words containing grammatical basis, are not highlighted.
Define Syntax Function
So, you met introductory words in a sentence, but there is no comma after them, although the source is very reliable. And so you asked yourself: are the words “generally”, “really”, “however” distinguished by commas or not?
The answer is simple. It is necessary to track their syntactic function in the sentence. It depends on this whether a comma is placed or not. Let's look at some examples:
- The word "in general" is isolated if it has the meaning "generally speaking". Compare: I generally do not eat dairy products. I am not allowed to consume dairy products at all.
- The combination "in any case" is introductory, if it has a restrictive-evaluative value. Compare: Anyway, you did the task first. I must at least help you with the test.
- The word "probably" is introductory, if used in the sense of "probably". Wed: There will probably be a thunderstorm in two hours. I know for certain (=certainly, undoubtedly) that there will be a thunderstorm in two hours.
- The word "really" is introductory if it means "true, exactly." Cf .: Indeed, I have already seen this picture. I'm really (=really, really) smart, according to the results of the test.
- The combination "really" is not introductory in the meaning of "really". Wed: You are really smart. Why is he really mad at me? (meaning of bewilderment, indignation)
- If the word "however" can be replaced by the union "but", then a comma is not needed. Wed: However, I will try to get into the budget with my points.
- The combination “in my opinion” (note that the spelling is separate) is not isolated if it is a preposition and a pronoun. For example: A play was staged according to my script. In my opinion (introductory word, written with a hyphen), it turned out well. - here "in my opinion" is separated by commas.
Important note
Identical to the introductory words, interjections and the words “yes”, “no” are distinguished by commas in the letter. Look at the following examples:
- Oh, how long do we have to go.
- Wow, it's raining!
- No, I will not eat this soup with meat.
- Yes, somehow the weather did not work out today, we will have to cancel the trip.
Leading word "I hope"
If this word is not grammatically connected with other members of the sentence, that is, it is impossible to ask a syntactic question from it and to it, then it is not a member of the sentence. In such a syntactic situation, the word in question is introductory. It can be removed from the sentence without distorting the meaning of the message. This introductory word expresses an assumption, assumption, uncertainty, for example:
I hope I didn't upset you with my answer.
The following introductory words and phrases have the same meaning:
- probably;
- probably;
- in all likelihood;
- obviously;
- perhaps etc.
By its origin, the analyzed introductory word goes back to the verb in the form of the 1st person singular of the present tense of the indicative mood. Similarly, the following verb forms and combinations of words are introductory:
- I think;
- think;
- I suppose;
- must be assumed;
- I hope;
- let's put;
- suppose;
- if you like;
- allow.
Examples of delimiting the word "hope" with a comma
In a sentence, the introductory word must be distinguished by punctuation marks. At the beginning of a sentence, it is separated by a comma, for example:
Hope we meet again.
Second case. If the introductory word is in the middle of a sentence, then a comma is placed before and after it, for example:
We won't be late, hopefully for the concert, if we use the subway.
Third case. The introductory word is at the end of the sentence and completes it. In such a situation, a comma is placed before the introductory word, for example:
We'll meet later, I hope.
The word "hope" is a predicate
I hope for you.
I hope you can do well in this difficult exam.
I hope that nothing will stop us on the way.
In all these sentences, both simple and complex, the word "I hope" plays the role of a predicate.
From the subject, you can ask a syntactic question:
what am I doing?
In the last complex sentence, the word "I hope", at first glance, very similar to the introductory. It starts a sentence and is followed by a punctuation mark. An illusion is created that the introductory word is separated by a comma. Let's take a closer look at this case of punctuation. The first part is a simple definite-personal sentence, expressed by the predicate in the form of a verb in the first person singular of the present tense. There is no subject in it, but we can ask a question from the predicate to the subordinate clause:
hope for what?
This means that the word "I hope" is a member of the proposal. The punctuation mark after it has a different function. A comma separates the main clause from the subordinate clause.
