Nachtanruf (German Edition)


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Esci Entra Scllg interloc: Senza risposta chiamata da collegare: Collega chiamata in attesa o Errore collegamento chiamata: Segnale intercept Chiamata in ingresso In ingresso chiamante in attesa in attesa. Conferenza Completa trasferimento Completa conferenza Scegli chiamata: Vil du forts tte med at administrere denne konferenceopkald? Bruger Brugerindstillinger Ukendt nummer Ukendt navn Communicator Enabled Device er ikke registreret Shoretel Mobility Client er k re i baggrunden Brugeren annullerede handlingen Handlingen mislykkedes af ikke-angivne rsager Der opstod en midlertidig fejl.

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EP0467071A2 - Calling device for telecommunication terminals - Google Patents

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Fluisteroproep Onhoorbare coach Onbekende fout Onbekende oproep gesprek om uit de wacht te halen: Parkeren Gemist gesprek om aan deel te nemen: Deelnemen aan gesprek in de wacht of Fout bij deelnemen aan gesprek: Onderscheppingstoon Inkomende oproep Inkomend beller in de wacht staat in de wacht. Weet u zeker dat u het gesprek wilt afbreken? Conferentie Doorverbinden voltooien Conferentie voltooien Oproep kiezen: Vr tstl in Cijfers invoeren: Utilisateur Options de l'utilisateur ro inconnu Nom inconnu Communicator Enabled Device non enregistr Shoretel Mobility Client s'ex cuter en arri re-plan L'utilisateur a annul l'op ration L'op ration a chou pour des raisons non sp cifi Une erreur transitoire s'est produite.

R essayez ult rieurement. Impossible de traiter votre demande. Appel est actuellement en attente? Raccrocher de toute fa L'op ration s'est termin e avec succ L'op ration n'a pas termin e par le commutateur pendant la p riode impartie Le p riph rique est hors service Cette op ration n'est pas possible lorsque le t phone est raccroch ration non prise en charge sur cette plate-forme.

Sonneries Pas de r Occup ou si pas de r Dest. Fermer la session Envoi de chiffres pendant l'appel lect. R ponse auto lect. Enregistrer Fonction non disponible Serveur d'affichage non disponible ration d'appels Sonrie Fn Pse Suiv. Infos Plus Moins Absent Pers. Liste Raccrch Rejndr Part.: Quitter Entr Abandn Part.: Ne Pas D connecter App. Voulez-vous abandonner l'appel appels en attente Appel en attente Pour: Usuario Opciones de usuario m desconocido Nomb desconocido Communicator Enabled Device no registrado Se ha iniciado la ejecuci n del Shoretel Mobility Client en segundo plano El usuario cancel la operaci Error en la operaci n por un motivo no especificado Se ha producido un error temporal: El CV est desconectado.

Algunas operaciones del CV est n en espera hasta que el CV vuelva a estar en l nea. No se puede procesar su solicitud. Llamada est actualmente en espera. Colgar de todos modos? Operaci n realizada correctamente El conmutador no termin la operaci n en el tiempo permitido El dispositivo est fuera de servicio No se puede realizar esta operaci n mientras el tel fono est colgado Operaci n no permitida en esta plataforma. Aparcar Contestar Timbres de No contesta: Ocupado u si no contesta Destino No contesta: Falta etiqueta Destino Ocupado: Selecc timb antes de alerta: No selecc acci n de llam.: Seleccionar funci Seleccionar llamada existente Selecc.

Seleccionar aplicaci Limpiar pantalla y selecc. Guardar Funci n no disponible Servidor visualizaci n no disponible Recuperando llamadas Interfono susurro Coach silencioso Error desconocido Llamada desconocida llamada para liberar: Reanud Timbre No res Opcion Sig.

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Ausent Unir 2 Unir 1 Unirse Resum. Colg 2 Colg 1 Hecho Acept. Marcar Consul Intfon Recup. Salir Entrar Colg partic.: Perdidas llamar para unirse: Unirse a llamada en espera o Error de uni n de llamada: Tono de intercepci Llamada entrante Entrantes llamada en espera en espera. Realmente quiere colgar la llamada? Conferencia Termina transferencia Terminar conferencia Elegir llamada: Seleccione la llamada Seleccione una llamada para liberar: Acceder al buz n de correo: Devolver llamada Llam en espera Mover llamada Hist.

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Translation by Vocabulix

The call signal is therefore implemented in the communication terminal KE and placed on an ultrasonic transmitter US. Even when it is better understood, I doubt that it will ever become the dominant mode of treatment for this or any other society; and indeed if it did, I might possibly lose interest in it. I wish I'd had the presence of mind to ask her what she thought of a state of affairs in which she could lose her job for talking to a bunch of schoolchildren about giving birth to a baby, or indeed what her job was if not that. Would you like to tell us about a lower price? Avslutt Angi Ikke bli med: Once again I obeyed, but the Pathology report confirmed a pregnancy, and the next day we had to take her back and finish the job.

When busy or no answer No Answer Destination: Extrapolating from the modest number of animals sacrificed in my own work, as well as that of my mentors and colleagues, I conjured up a rough estimate of the vastly larger total that we supplied to others for similar purposes, and thus came to appreciate the enormity of this terrible enterprise and my own undeniable. Since then, no argument however subtle or forceful has ever persuaded me that human progress requires the systematic torture and killing of helpless creatures on such a scale and for such a purpose, or that valid standards of science or ethics could ever be built on such foundations.

Most of our clinical work was performed at Bellevue Hospital on the East side of Manhattan, a venerable but antiquated institution that provided the most advanced diagnostic and treatment facilities gratis to anyone who needed them, along with substantial quotas of neglect and abuse from overworked interns and residents, and Attentions both welcome and unwelcome from the students as we rotated through each service. In those days, medical students were initiated into the mysteries of patient care by "drawing the bloods" for the day, a ritual happily long since dispensed with in most places.

In charity hospitals maintained at public expense, indigent patients were routinely taken advantage of by us and the house staff in exchange for their care, and were expected to surrender unlimited quantities of blood for any tests that any of us were even remotely curious about. Even today, more than thirty years later, I can still almost hear the low, mournful wail that greeted us every morning, as the patients saw us coming with our implements down the hall.

After days or weeks of experimentation on veins often weak and traumatized to begin with, our last resort was the dreaded femoral puncture, which took only a few seconds to execute, but left both victim and perpetrator holding our breaths until the huge syringes were filled at last. Accustomed to thinking of illness as a particular episode or life experience that we come down with, work through, and eventually recover or possibly die from, I was wholly unprepared for a reality in which disease was the underlying or default condition, and a vast nexus of goods and services had been created to manipulate and exploit it.

On those rare occasions when the beds were empty and the wards deserted, I could still almost smell the ineradicable miasma that lingered in the air, like the accumulated residuum of all diseases past and present. One of my favorite assignments was night call on the maternity service, where the miracle of birth occasionally squirted out before anybody had the chance to interfere with it. Listening to the chorus of women in labor from my cot in the next room, I often reflected on the word "obstetrics," derived from the Latin preposition ob, meaning "against" or "in the way of," and the root stet, meaning "stand" or "standing: On the medical wards, we were responsible for admitting all lobar pneumonia patients, usually alcoholics from the Bowery, for whom a high fever, productive cough, pleuritic pain, or some equally serious ailment was their only ticket to a warm bed and regular food on cold winter nights.

Before initiating treatment, however, we were required to inoculate the specimen into the peritoneal cavities of two mice, which yielded an almost pure culture of the pneumococci when we sacrificed them two days later. Since the test was largely academic, I only pretended to do it, not daring to raise the issue of animal testing, but unwilling to witness the atrocity myself.

Routinely enlisting us to perform their dirty work, the house staff merely pointed out that we could similarly lord it over our own crop of students when their turn came. In this fraternal spirit an intern once hit on me to pass a Rehfuss tube into the duodenum of a petite Puerto Rican woman whom he was working up for possible pancreatic disease. Basically a stomach tube tipped with a weighted metal ball to carry it through the pylorus into the small intestine, this little devil was practically impossible for an unanesthetized person to swallow without gagging.

Pulling herself up in bed to her full height, this little lady suddenly and improbably grew in bearing and stature before my eyes, proudly rebuking his insolence, and vowing retribution if he ever molested her again. Not long after that, spotting two burly,mustachioed young Latinos lurking about the ward, I made myself scarce, but inwardly wished them well. One such example followed from the belief of a senior Professor of Surgery that the cause of chronic pancreatitis was spasm of the sphincter of Oddi, by producing reflux of bile into the pancreas, and hence chemical inflammation of the gland.

After successfully creating a facsimile of the disease in experimental animals by applying electrical stimulation to the sphincter and clamping off the common bile duct behind it, he developed a protocol for human subjects that blithely crossed the frontier of ethical restraint into a gray zone where the only law was whatever the traffic would bear and whatever a tenured Professor could get away with.

Under his tutelage, Residents at the Surgical Clinic would select a quota of indigent patients with various digestive symptoms for "pancreatic studies," provided they were not yet diagnosed or claimed for other projects, like the Puerto Rican lady described above. While I like many others was slow to put it all together, it should not have been a surprise to anyone that traumatizing these highly delicate structures would often irritate and inflame them, thus provoking spasm of the sphincter, and eventually chronic pancreatitis as well.

In this stepwise and almost imperceptible fashion, his careful methodology not only confirmed the theory that had inspired it, but also provided a continuous supply of experimental material, since once scarring had occurred, it usually proved irreversible. He too succeeded by his willingness to conduct dangerous experiments on individuals without their consent, in this case retarded children at Willowbrook State School, who could not speak for themselves and often lacked parents or guardians who were willing or able to speak for them.

Feeding stool samples from those with known infection to other inmates not yet sick, this doubtless sincere and even dedicated physician soon had irrefutable data regarding the portal of entry, incubation period, clinical course, liver enzymes, and every other known parameter of this major infectious disease.

This was Uptempo Is The Tempo - German edition

Some years later, when a citizens' group tried to blow the whistle on his research, which was conducted largely at public expense, he correctly pointed out that the disease was rampant at the school in any case, because of overcrowding and poor sanitation, and was allowed to continue his work without interruption or even a reprimand. Neither man was intentionally cruel or malicious, in the manner of serial killers who defy social norms, or torturers and war criminals who carry out atrocities or give in to coercion or social pressure under extreme circumstances.

What they did was evil and indeed monstrous for precisely the opposite reason, that they were successful and even illustrious in a system which prizes their work so highly and rewards its achievements so richly that the distinction between valid science and criminal or immoral behavior is far less clear and the legal and moral standards regulating it are correspondingly ambiguous.

By my fourth year, as "matching day" for internships drew near, I realized that I could not bring myself to practice medicine in the way I'd been trained, and accepted a graduate fellowship in philosophy at the University of Colorado, in large part to try to find clarity and meaning in what I had just lived through. Long before I found words to articulate or concepts to explain it, I "knew" on some deeper level that reducing illness to "diseases" and abnormalities and using drugs and surgery to separate or remove them from the patient's body are always fraught with ethical and practical risks that I could not accept on a routine basis, or simply because that was how things were done.

With well over beds and no Residents or permanent clinical Faculty, it was not designed or run as a teaching institution. Our instructors were simply the Attending Physicians using the hospital to admit and care for their private patients, on whose behalf we might be asked to complete an admission workup, insert an IV or venous cutdown, assist in surgery, or carry out any other menial tasks the Attending or Nursing Staff might require. In addition, indigent patients referred in from the ER or Outpatient Clinics, which we also staffed and ran, were assigned to our personal care under the nominal supervision of our Preceptor for each service.

But while generally knowledgeable and helpful if we could find them, our preceptors were often too busy with their own patients to be available when we most needed them. Since the Hospital was owned by the Catholic Archdiocese and closely supervised by nuns, I was surprised when he told me not to bother with a pregnancy test, but I didn't argue.

In the Operating Room, he took all the time in the world to show me how to administer paracervical anesthesia, dilate the cervix, and curette out the endometrial lining, but then grew oddly impatient during the procedure itself.

Once again I obeyed, but the Pathology report confirmed a pregnancy, and the next day we had to take her back and finish the job. Although he continued ever after to deny any prior knowledge or suspicion of it, both the illegality of abortion in those days and the woman's profound gratitude for what had happened pointed to our flawed collaboration as just about the only way for her to get the help she needed.

Far more than any technical information, these were the lessons that stuck. I have yet to hear a convincing rationale for this purely cosmetic procedure, which by removing the superficial veins effectively doubles the load on the deep system, itself already compromised in many cases, and thus often brings about the same kind of chronic venous insufficiency that had more or less crippled this man with little hope of relief. In time we became friends, and one day he invited me to his home in the projects to meet his wife, sample her famous enchiladas, and stay the night.

In the wee hours of the morning, he woke me with an urgent plea to examine his aged father, who lived across the courtyard and was complaining of severe chest pain. As I entered his room, the old man was sitting up in bed, leaning forward with his hands clasped over his heart and a look of mortal terror in his eyes, a textbook picture of acute myocardial infarction. So I gave him a shot of morphine, and within minutes he fell into a deep and peaceful sleep.

By the time I left for work several hours later, he was resting comfortably in bed, obviously feeling much better, at which point his wife told me that he had recovered from at least three such episodes in the past, without any drugs or medical attention whatsoever. That made me wonder whether a lot of patients might not heal better at home, not only from heart attacks, but many other serious ailments as well.

As in most hospitals, the bulk of our instruction actually came from the nurses, who basically ran the place, but knew how to make it look as if they were following our orders, rather than the other way around. Thus on a typical night in the ER, if a patient came in, say, wheezing from an allergic reaction, some version of the following dialogue would most likely ensue:. Along with much practical information of this type, we also learned from the nurses how to "play doctor," to enact the part of a physician in society, including roughly equal parts of bedside manner, educating the patient, and simply "breaking the news.

With no idea of what had happened, his wife walked in just as he was being carted off to the morgue. From then on, the nurses often called me at such times, simply because I would take the time to speak with the relatives and make sure that they too were cared for. Much as I enjoyed the thrill of performing surgery, and admired the technical skill and ingenuity that made it possible, at 6 in the morning it was always a challenge to get down enough breakfast to avoid feeling faint or nauseous at some point during the gastric resection or hysterectomy I was about to scrub in for.

But they were still all I knew. Had anyone brought up acupuncture, homeopathy, or anything equally outlandish at the time, I'm sure I wouldn't have been in the least interested in or hospitable to it. Even so, I worked harder during those four weeks than at any comparable period before or since, beginning with Hospital rounds at 7 a. On top of that, I officiated at eight births, and covered the Emergency Room one night a week, when I could expect to be up into the wee hours admitting, working up, and following new patients without established physicians of their own. Suspecting a kidney stone, I palpated her abdomen and was surprised to find her far along in a pregnancy of which she herself was unaware.

From her husband's very rough translations, I learned that she had never been pregnant before, had had no period for 9 or 10 months, and simply let it go at that, not feeling or suspecting anything out of the ordinary, assuming she was menopausal, refusing to believe her husband when he told her the news, and flying off the handle at both of us for making a joke at her expense. When he returned, I became House Physician at the Beth Israel, a smaller hospital nearby, where my duties were much the same as during my internship, doing chores and little favors for the nurses, the Attending Staff, and their patients, as well as assisting in surgery, being on call for any emergencies or special needs, and supervising the Old Folks' Home out back.

Always a favorite part of my practice, working with the elderly demands mainly personal care and attention, with little expectation of radical cure, yet earns profound gratitude for any relief of pain, suffering, or the accumulated burdens of survivorship. Ever since then, these same priorities have continued to guide me in my search for a method and style of practice that could pass the test of time.

Meanwhile, as the War in Southeast Asia continued to spread and intensify without letup, I began to realize how thoroughly both my medical training and the culture of illness and disease that we all grow up with are steeped in the imagery of warfare and combat.

With drug ads and hospital and charity fund drives all promoting the conventional wisdom that viruses and bacteria are simply invaders to be expelled and diseases enemies to be fought, most people were and indeed still remain ready, willing, and eager to use chemical weapons such as antibiotics, antihypertensives, antimetabolites, and other "magic bullets" against any complaint or abnormality that threatens or merely bothers them.

But when an American General openly boasted of destroying a village in order to save it, his words borrowed almost verbatim from the cancer specialist, the gruesome footage of such exploits transformed what had formerly seemed like a mere figure of speech into a systematic philosophy of militarism for its own sake, with a gratuitous ferocity that began to shock even its own proponents.

In that way it dawned on me that I'd been trained as a soldier to fight in the front lines of an endless war against disease, armed with the latest weapons to shoot down and kill all symptoms and abnormalities whenever and wherever they showed themselves. Once again, as in medical school, I prayed for the courage and opportunity to desert my post and fight no more. By then I was practicing what I would call "minimalist" medicine, that is, giving out liberal helpings of education and advice, while doing as little as possible of a drastic nature, seeing my role as mainly guiding people through the medical system and protecting them from being hurt too badly.

These are still important priorities for me; but back then, with fewer and fewer procedures available that did no harm and made sense to me in other than acute or extreme circumstances, I had little to offer my patients when their illnesses got worse, while my growing estrangement from the profession as a whole made it increasingly difficult and unpleasant for me to practice at all. Applying to a Boulder hospital for admitting privileges, I quickly discovered that my antiwar views and unorthodox style of practice had alienated many of the doctors in town.

On the advice of a friendly internist, I introduced myself to as many of them as were willing, and was narrowly approved for membership by one vote; but the Board of Trustees simply overruled them the next day, evidently alarmed by the fact that what they feared or imagined I stood for had split the Medical Staff right down the middle. Due to give birth in a month, a woman I knew very slightly telephoned to ask if I would come to her house to help with the labor, which none of the obstetricians in town would agree to do. Having never heard of anyone who had done such a thing, or imagined that anyone would even want to, I was also acutely aware of my own feelings of insecurity, with no nurses to hand me instruments and no hospital to back me up.

But in almost the same breath I understood that here at last was something I could do as a physician without doing harm to people or telling them how to live. When her time came, I arrived expecting to perform a vaginal examination right away to assess how the labor was progressing. I'm still not sure if it was the candlelight, or the Bach playing softly, or the rapt expression on all their faces, but somehow I got the message that the exam was a routine procedure I'd been trained to do, rather than anything that Dorothy herself really needed or was asking for.

Without a lot of talk, Dorothy taught me pretty much the whole course that day; and I still haven't a clue about how, where, or from whom she'd learned it, since her first child had been born under general anesthesia nine years before. Her son Adam was born at dawn, when both mother and child were bathed in a soft halo of light that extended for a short distance all around them, like a Madonna of Raphael or Filippo Lippi, and we all saw it and gazed at it and her, the baby, and each other, as human beings have surely always done since the beginning of time.

In no way uncanny, strange, or outside the realm of natural law, Adam's birth was a miracle in precisely the opposite sense, of something happening in full awareness, which only our customary inattention would need to single out and only our remembering what all other animals have never forgotten bespoke a real deliverance. Her daughter Erica announced that she was taking the placenta to school; but when her friends came by and tried to veto the idea, she wrapped it in a plastic bag and stuffed it under her coat, like a reluctant conspirator carrying an oversized bomb.

Less than an hour later, the school nurse telephoned in a panic, so I stopped off to fetch it on my way home. Assuring me that she wasn't really against "this sort of thing," she explained with some embarrassment that they didn't have refrigeration for it; that she'd have had to ask the principal, who happened to be out of town; and that she could lose her job if she acted on her own. I wish I'd had the presence of mind to ask her what she thought of a state of affairs in which she could lose her job for talking to a bunch of schoolchildren about giving birth to a baby, or indeed what her job was if not that.

The holy relic lay in state on my coffee table for a week without the slightest odor or trace of putrefaction, like the dead bodies of certain saints and gurus of popular legend.

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