🚧 Placeholder · Hippocrates L3 This lesson is scaffolded but not written. Plan: Mood disorders. Anxiety. Personality. Impulse control. Fifteen DSM conditions laid side by side, plus a matching exercise that judges built for people who will one day have to name… The sections below still show L1 content (Anna's ER story, FAST triage briefing) — will be replaced with L3-specific reading, listening, cloze, speaking, homework in a future session.
Lesson 3 · Diagnosis
Fifteen names for how the mind fails
Mood disorders. Anxiety. Personality. Impulse control. Fifteen DSM conditions laid side by side, plus a matching exercise that judges built for people who will one day have to name what they see. The language of stigma, the language of care, and the difference between the two.
Level
B2+
Duration
60 min
Formats
Olympiad · IELTS · Clinical case
Writing
5–7 sentences
Hippocrates · a 7-lesson course · English for Medicine
From the first symptom to Freud — the language a doctor uses when the words themselves must save time.
L1 · First Diagnosis. Emergency room, midnight. A junior doctor's first shift and a patient who cannot finish a sentence. Sixteen words of core medical vocabulary and the three-question triage. Ends with an original short story — The Third Question — and a differential diagnosis you will replay in your head for a week.
L2 · What is Psychology? The Greek myth of Psyche and Cupid, retold from a doctor's angle. Etymology of half the words in a modern medical textbook. A TED-Ed listening on the same myth, and the first appearance of the words libido, repression, id.
L3 · The Mental Landscape (you're here). Fifteen mental-health conditions from the DSM: mood, anxiety, personality, impulse-control. A matching exercise built for people who will one day have to name what they see. Stigma and language.
L4 · Speak the Diagnosis. A translation round from Russian to English on plague, cholera, myocardial infarction, yellow fever. Paired with a full patient-history dialogue drill.
L5 · The Body in Detail. Advanced vocabulary — tissue, blood clot, obstruction, mood stabilizers, frontal lobotomy, asylum — and the culture around each word.
L6 · Voices from the Ward. Speaking marathon on five discussion topics: AIDS, allergies, alternative medicine, aromatherapy, psychology. One monologue per student, jury-style questions.
L7 · Freud and the Latin Plurals. Psychoanalytic vocab (Freudian slip, libido, repression, neurotic) meets the Latin plurals every medical student must eventually meet — bacterium/bacteria, criterion/criteria, appendix/appendices. The myth of Narcissus closes the arc.
01
Warm-up — speaking
two minutes · then borrow one phrase from the model below
You are the first person on the scene. The patient can only speak in three-word bursts before they stop to breathe. What do you ask?♪ tap to hear
Talk for about two minutes. Don't plan — just start. Then read the sample model below and steal one or two phrases for later sections.
Model · steal a phrase
"If I only had thirty seconds and three questions, I would not ask them about the pain first — I would ask them about the last hour. When did it start? What were you doing? Have you taken anything? Because pain lies about its own origin, but time does not. Time is the one thing a body cannot fake. The rest — the chest, the arm, the sweat — those are symptoms, and symptoms are a story the body is telling. Time is the shape of that story, and if I get the shape wrong, the words will follow me for a week."
Why these phrases: they show three olympiad moves — (1) reframe the question (from what to when), (2) prefer a sharper word (symptoms as a story, not a list), (3) name the personal cost of a mistake. Borrow one for Section 6.
02
Words for today
tap any card to flip · tap the word to hear it · these ten will come back in every section
symptom
n
симптом
a sign the patient's body sends about an illness
stroke
n
инсульт
sudden loss of blood flow to a part of the brain
heart attack
n
инфаркт (миокарда)
sudden blockage of a coronary artery — heart muscle dies
migraine
n
мигрень
severe throbbing headache, usually one-sided, lasting hours
appendicitis
n
аппендицит
inflammation of the appendix — needs surgery, fast
hemorrhage
n
кровоизлияние
heavy bleeding, especially internal
cardiovascular
adj
сердечно-сосудистый
relating to the heart and blood vessels
coma
n
кома
deep unconscious state — patient cannot be woken
tuberculosis
n
туберкулёз
infectious lung disease — bloody cough, weight loss (also called consumption)
perspiration
n
потоотделение
sweating — often a symptom, not the cause
Heads up: the harder medical words — appendix, artery, nitroglycerin, anaphylaxis, differential, triage — show up inside the story and listening as tap-to-hear highlights. You meet them in context, not as a list.
03
Reading — short story
about 320 words · written for this lesson
The Third Question
It was Anna's first night shift, and the man on gurney three had chest pain, shortness of breath, and a family who had already decided what it was. "Heart attack," his wife said, before Anna had asked anything. "He took the nitroglycerin we keep for his angina. It made him worse."
Anna had been taught two questions. The first — when did it start? — she asked, and the answer was about ninety minutes ago, at the wedding. The second — have you taken anything? — the wife had already answered. It was the third question, the one they'd drilled into her at medical school, that felt rude to ask a man in visible pain.
"When did you last urinate?"
The wife's face closed. The man opened his eyes and, in three-word bursts, said: "Not — since — yesterday."
Anna checked his flank. He winced. His skin was cold and wet with perspiration — but not the cool sweat of a cardiovascular event. It was the sharper, sicker sweat of something else. She pressed once, gently, above his hip.
He screamed.
Twelve minutes later, imaging showed a stone obstructing the left ureter, and bloodwork was already coming back with the signature of sepsis — the kind that starts quietly in the urinary tract and only announces itself when the whole body begins to fail. The nitroglycerin had done nothing because there was nothing cardiac to open. The chest pain was referred.
In the corridor, Anna's attending said only: "Good third question." Then he went to write the antibiotics himself.
Quick check
1
The wife had already decided the diagnosis before Anna had a chance to ask questions.
2
Anna asked the third question because she found the first two insufficient during the examination.
3
Why did the nitroglycerin make the patient worse rather than better?
4
What was the actual diagnosis?
For me — answer keys (Quick check) open if needed
True — the wife announces the diagnosis before Anna asks anything («"Heart attack," his wife said, before Anna had asked anything»).
False — the third question was drilled into her at medical school; it's a protocol, not a mid-exam discovery.
c — nitroglycerin dilates coronary arteries; if the pain isn't cardiac, dilation of vessels can drop blood pressure and worsen a systemic problem.
b — kidney stone obstructing the ureter, with early sepsis. Referred pain to the chest is the trap.
Discussion prompt: ask the student what "referred pain" means and where else in the body it commonly misleads doctors (jaw pain in real MI, right-shoulder pain in gallbladder disease).
Original story written for this lesson · NG English · Hippocrates · L1
04
Listening — three rules to save thirty seconds in triage
about 90 seconds · listen twice · the script is hidden until after the questions
A short briefing from an emergency medicine attending. Take notes on three points: (1) the three questions the attending drills into juniors, (2) what "the ABCD" stands for in the stroke check, (3) the attending's rule about family testimony.
Rule 1 · The three questions
Not the twelve on the intake sheet. Three, in this order: When did it start? What were you doing? Have you taken anything? These get juniors 80% of the way to the right differential before they touch the patient. Nothing on the intake form bypasses the timeline.
Rule 2 · FAST stroke check
For anyone over forty who looks off, run FAST — Face (does one side droop?), Arm (can they hold both arms up for ten seconds?), Speech (is it slurred?), Time (when did symptoms start?). Not ABCD — that's the airway drill. The time-since-onset decides whether the thrombolysis window is still open. Miss the time, miss the drug.
Rule 3 · Never take the diagnosis from family
Take the timeline from them. Take the medication list from them. Do not take the diagnosis. They will hand you one — «it's his heart», «it's a migraine», «it's the flu» — because they are frightened and want a word to hold. If they were right, everyone wins. If they were wrong, you will have found what they missed — and that is the difference between a doctor and a very concerned bystander.
Script (open after the questions):
Every year I get a new batch of junior doctors, and every year I make them memorise the same three questions. Not the twelve on the intake sheet. Three. When did it start? What were you doing when it started? Have you taken anything for it? Those three, in that order, will get you eighty per cent of the way to the right differential before you touch the patient. Nothing on the intake sheet bypasses the timeline.
Rule two is what I call the stroke check. If the patient is above forty and anything looks off, run FAST — face, arm, speech, time. Not ABCD, that's the airway drill. FAST asks: does one side of the face droop? Can they hold both arms up for ten seconds? Is their speech slurred? And what time did the symptoms start? That last one — the time — decides whether you can still give thrombolysis. The window is narrow. Miss the time and you miss the drug.
Rule three is about the family. Never let them give you the diagnosis. Ever. They will hand you a diagnosis — it's his heart, it's a migraine, it's the flu — because they are frightened and they want a word to hold. Take the timeline from them. Take the medication list from them. Do not take the diagnosis from them. If it turns out they were right, everyone wins. If they were wrong, you will have found what they missed — and that is the difference between a doctor and a very concerned bystander.
Check your notes
1
According to the attending, how many questions does she make juniors memorise?
2
What does FAST stand for in the stroke check?
3
Why does the time of symptom onset matter so much in the stroke check?
4
The attending's rule about the family is:
For me — answer keys (Listening) open if needed
b — three, in that order (when did it start / what were you doing / have you taken anything).
c — Face, Arm, Speech, Time. ABCD is the airway drill, not the stroke check.
a — the time-since-onset defines whether the thrombolysis window is still open. Miss the time, miss the drug.
c — take the timeline and medications from the family; never take their diagnosis. Anna's third-question moment is a direct application of this rule.
Разбор: the story in Section 03 dramatises rule three. Anna's third question — urination timing — comes because she refuses the family's diagnosis and returns to the timeline.
Original listening script · NG English · Hippocrates · L1
05
Lex-gram mixed cloze — olympiad practice
school / municipal stage standard · 10 gaps · 6 lexical (choose A / B / C / D) + 4 grammatical (write one word)
Read the text. For gaps 1–6 choose A, B, C or D. For gaps 7–10 write ONE word. Theme follows today's lesson — emergency medicine, timing, diagnosis.
In medicine, the words a doctor knows often (1) the patient she saves. A junior who cannot tell a symptom from a sign will treat the visible and miss what is (2). Every emergency department drills the same rule: (3) the patient's timeline first, take the medication list second, and never (4) the diagnosis from the family. The reason is simple. A heart attack, a stroke, and a kidney stone can all begin with chest pain, and the difference lies (5) the story behind that pain — not in the pain itself. Anna, on her first night shift, learnt this the hard way. She had two questions (6), but the third — an awkward one about urination — is what turned a suspected cardiac event (7) a diagnosis of sepsis. Twelve minutes later, the imaging (8) her right. Her attending said very little afterwards, only (9) quiet good third question, but Anna understood the sentence for what it was. It was a promotion, delivered in the smallest number of words (10) which a promotion can be delivered.
Lexical gaps · 1–6
1
2
3
4
5
6
Grammatical gaps · 7–10 · write ONE word
7
8
9
10
For me — keys + what this trains open if needed
Lexical keys (1–6):
C — decide (agentive collocation: «words decide the outcome»)
A — systemic (contrast: visible vs systemic disease)
B — establish (formal collocation: «establish the timeline»)
D — accept (attending's rule: never accept the diagnosis)
A — in («lies in» — abstract location)
B — ready («had two questions ready»)
Grammatical keys (7–10):
into — «turn X into Y» collocation, transformation of state
proved — past simple verb, «imaging proved her right»
a — indefinite article with adjective+noun («a quiet good-third-question»)
in — «the number of words in which…» — preposition with relative clause
Что тренирует: medical register vocabulary (systemic, differential, establish), phrasal transformations (turn X into Y), articles with abstract nouns, prepositions in relative clauses. Все 4 «открытых» пропуска — типичная грамматика муниципального этапа + register clinical English.
06
Speaking — pick the format
two parallel tracks · IELTS cue-card or olympiad monologue + dialogue
Classic IELTS Part 2 cue-card. 1 min prep · 1.5–2 min monologue.
Describe a time when you or someone close to you had a serious health scare.
You should say:
what happened and where
what symptoms you or the person noticed first
how the doctors reached the correct diagnosis
and explain what this experience taught you about health.
0:00
Follow-up (after the monologue)
Do you think people in your country pay enough attention to early symptoms, or do they wait too long to see a doctor?
Should schools teach basic emergency response — CPR, the FAST stroke check, when to call an ambulance — as part of the required curriculum?
Real all-Russian olympiad oral format (regional / final stage). 3 min prep · 2 min monologue · 2 min dialogue with the teacher.
Topic — defend your position
Artificial intelligence should be allowed to perform initial patient triage in emergency departments before a human doctor sees the patient.
Your monologue must contain:
a clear position (agree / disagree / partly)
two reasons with one concrete example each — one about accuracy, one about ethics
one objection you anticipate, and your response to it
a closing sentence connecting back to today's story or listening — the third question, the FAST rule, or Anna's attending
0:00
Dialogue questions (teacher asks one)
If an AI triage system misdiagnoses a patient like Anna's — chest pain from a kidney stone — who bears the moral responsibility: the hospital, the vendor, or the training data?
Would you personally rather have your ambulance-arrival vitals read by an AI or by a human triage nurse — and does your answer change if it is 3 a.m. after a twelve-hour shift?
The attending in the listening says never take the diagnosis from the family. Should the same rule apply to AI: take the timeline and readings, but never the diagnosis?
For me — how to run this open if needed
Этот format — регион/финал ВсОШ. Не путать с IELTS — here нет шаблона «what you should say», нужно защитить позицию.
Подготовка 3 мин — он пишет план в блокноте, не печатает в окно. Заметки на русском OK, монолог на английском.
Монолог 2 мин — слушай не перебивая. Засеки time. После — задай 1 из dialogue-вопросов.
Диалог 2 мин — это обсуждение, не допрос. Жюри ищет умение поддержать, развить, согласиться/возразить.
4 категории оценки: communicative task fulfillment, organization, lexical/grammatical accuracy, phonetics.
Особый акцент на этом уроке: ученик должен связать позицию с конкретной сценой из reading/listening — Anna's third question, or the attending's rule. Не «в общем и целом», а с якорем.
06+
Speech tracker · check your pace
Right after your monologue (IELTS or olympiad), press the mic and re-deliver it. The tracker counts your words and gives WPM with a verdict against B2+ targets.
07
Use of English — olympiad practice
two standard task types from the school / municipal stage · cloze + sentence transformation
A · Multiple-choice cloze (6 gaps)
Read the short text. For each gap, choose A, B, C or D. Continuation of today's theme — clinical thinking and the language of diagnosis.
Emergency medicine has always (1) writers and film-makers, but the reality is quieter. The dramatic television scene — a shouted diagnosis, a rushed corridor — is briefly (2) by hours of waiting, careful re-reading of the intake form, and the slow (3) of one hypothesis being replaced by another. The best juniors are not those who reach a diagnosis (4). They are the ones who can hold three possible diagnoses in mind at the same time, weigh them against each new piece of evidence, and change their answer without (5). The mistake that ends careers is not a wrong diagnosis. It is a diagnosis that is (6) too early and never reviewed.
1
2
3
4
5
6
For me — cloze answer key (A)open if needed
B — fascinated (collocation: «has always fascinated writers»)
C — interrupted (the dramatic scene is interrupted by hours of waiting)
A — process (of one hypothesis being replaced by another)
C — fastest (contrast: not fastest, but ability to hold three in mind)
D — shame (changing your answer without shame — professional courage)
A — locked in (idiomatic: a diagnosis is «locked in» too early — cognitive anchoring)
Что тренирует: register clinical English + collocations «has always fascinated», «hold X in mind», «lock in a diagnosis», «hypothesis is replaced». Also cognitive anchoring — концепт из EM literature (anchoring bias · premature closure).
B · Sentence transformation (4 items)
Rewrite the second sentence so it means the same as the first, using the word in CAPITALS. Write between 2 and 4 words. The capitalised word must stay unchanged.
1. The attending said that a junior should never accept a diagnosis from the family. According to the attending, a diagnosis SHOULD ____________ from the family.
Model: never be accepted
2. Nobody had asked the patient about urination before Anna did. Anna was the FIRST ____________ the patient about urination.
Model: to ask
3. The wife refused to consider any other diagnosis. The wife DISMISSED ____________ any other diagnosis.
Model: dismissed considering (or just considering)
4. If Anna had not asked the third question, the sepsis would have gone undetected. Had Anna NOT ____________ the third question, the sepsis would have gone undetected.
Model: asked
For me — what this trains open if needed
Cloze trains clinical-register collocations + a concept from EM literature (anchoring bias / premature closure — one of the top cognitive errors in diagnosis). Real ВсОШ school-stage format.
Transformation trains: modal + adverb + passive («should never be accepted»), the first to + inf, dismiss + gerund, inversion in mixed conditionals — all standard ЕГЭ / school-olympiad transforms.
Если ученик угадывает не вспоминая правило — спроси «почему именно это, а не C?». Он сам перейдёт от чутья к объяснению. Именно это меряет жюри.
08
Mini-writing · finish here
5–7 sentences · no homework · we read it together at the end
Doctors are trained to keep emotional distance from their patients. Is this necessary for their work — or does it slowly make them worse doctors?
5–7 sentences. Take a position. Anchor at least one idea to today's story (the wife's grief, Anna's third question, the attending's rule) and use at least three vocab words from Section 02.
Mini-writing · in-class only0 words
What's next
You just finished L1 of Hippocrates — the emergency block.
In L2 · What is Psychology? we keep the same routine — short reading, short listening, speaking, mini-write — but the question turns inward. The Greek myth of Psyche and Cupid, retold from a doctor's angle. Etymology of half the words in a modern medical textbook. Same words come back: symptom, coma, migraine — but this time the body is the mind.
Your vocab box carries with you. See you next lesson.
📚 Homework · olympiad practice tap to open
Three short olympiad-style tasks on related themes — clinical reasoning, memory in medicine, and close reading of «The Third Question». Do at home in any order. Not required, but the lesson sticks better when you try at least one.
A · Word formation (5 items)
Read the sentence. Use the word in CAPITALS to form a word that fits the gap.
1. The patient's symptoms were so unusual that the junior doctor's first response was ______ (BELIEVE).
2. In emergency medicine, a ______ diagnosis on the first pass can cost a life (WRONG).
3. A single ______ reading of vital signs can shift a whole differential diagnosis (ACCURATE).
4. Anna did not invent the third question — her medical school had already ______ it into her (DRILL).
5. The attending's tone was ______ optimistic: praise, but no smile (CAUTION).
B · Mini cloze · memory in medicine (5 gaps, 4 options each)
Choose A, B, C or D for each gap.
Doctors rarely remember every patient. Instead, the mind (1) a few sharp cases and lets the rest (2). The ones that stay tend (3) the rule of surprise: an atypical presentation, a symptom that arrived out of order, a diagnosis missed by three colleagues before you found it. Years later a doctor is surprised at (4) they kept and what they lost. Clinical memory, in this sense, is closer to editing than (5) recording.
1
2
3
4
5
C · Reading T / F / NG · «The Third Question»
Re-read the story carefully (Section 03). For each statement, choose True, False, or Not Given. Trains close reading — the same skill judges look at on the regional Reading round.
1
The patient's family arrived at the ER already convinced of the diagnosis.
2
The nitroglycerin worked briefly before the patient's condition worsened.
3
Anna considered the third question rude to ask at first.
4
The attending praised Anna in a long private conversation afterwards.
5
The imaging revealed a kidney stone obstructing the left ureter.
6
The patient had been drinking alcohol at the wedding before the pain started.
For me — model answers open if needed
Word formation answers:
disbelief
wrong (unchanged — grammatically fits) OR wrongful if you want a formation move; safer key: wrong
Reading T/F/NG answers: 1-T (the wife had already decided «heart attack»), 2-F (made him worse — never worked briefly), 3-T (Anna found it «rude to ask a man in visible pain»), 4-F (attending said only «Good third question» — no long conversation), 5-T (a stone obstructing the left ureter), 6-NG (wedding is mentioned but no drinking details).
