A Lucky Coin Is What You Make Of It

A Lucky Coin Is What You Make Of It A Lucky Coin Is What You Make Of It By: Joe Tye Paul watched Phyllis walk down the street and wondered at the fact that after all these years of competing with each other she had called today of all days Her board meeting crisis and his bank meeting crisis had brought them together Who knows? Perhaps she’d had a visit from Rafe as well Paul recalled one of Buddha’s sayings: To be awake is to be amazed all the time It was only one thirty, so Paul took the long way around to the lot where he’d parked As he walked along Main Street, the feeling of deja vu that had pervaded his whole day became almost overwhelming It climaxed when he looked down a dark alleyway Just past a big blue garbage Dumpster a man was stretched out on the ground under a makeshift blanket of newspapers Paul’s head spun with the odor of garbage; there was no mistaking that he’d been here before The alcoholic was sound asleep, empty bottle not far from his head, just as it had been in the dream Paul watched the wall for a moment; when no picture appeared, he knelt and pulled another newspaper over the man’s shoulders He knew that if he walked on down the alley, he’d see an old man and a little boy waiting at the bus stop; he also knew there was no need to go look Back out on Main Street Paul stopped at a newsstand for a chocolate bar It was one forty-fi ve He stepped into a phone booth and dialed “Mr Weatherford’s offi ce, please Hi, this is Paul Peterson Would you please let Marty know that I’ll be about fi fteen minutes late Apologize for me, but I’ve been unavoidably detained Thanks Oh, sorry, one more thing Could you check some account balances for me?” Paul read his account numbers into the receiver and waited for a moment Then he smiled and instructed that money be transferred into his two mortgage accounts and a receipt be given to Mr Weatherford prior to their meeting The whole time he talked on the phone, his eyes never left the entrance to the alley In his dream they had been running late for the bank meeting He recalled the dashboard clock reading one fi fty-six when Rafe stopped time for their alleyway sojourn Paul unwrapped his chocolate bar and leaned against a lamppost It was one fi fty-one A 1/2 A Lucky Coin Is What You Make Of It police car coming down Main Street slowed at the alley’s entrance, then accelerated past Paul took a bite of chocolate He never saw the car Not really The image just sort of there in the back of his eyes, like the psychedelic fantasies that fl oat by in the aftermath of a camera fl ash Frozen car, frozen driver, two lines of frozen motion in the alleyway, then nothing Gone Just a fading fl ash at the back of the retinas Or a fi gment of the frontal lobes No telling which Had he been watching himself watching himself? Or buzzing out on chocolate? No telling WHETHER SOMETHING IS A RANDOM COINCIDENCE OR A MEANINGFUL CONNECTION DEPENDS UPON HOW YOU CHOOSE TO INTERPRET IT One thing Paul had grown to believe during his ten years of working with Shay’s Point school was this: There is no such thing as a coincidence Things always happen for a reason Too many times the phone had rung at just the right moment, the caller offering just what he needed to keep it all together, for him to write it off to blind luck It is only blind if you aren’t looking for the connections Serendipity The knack for making neat discoveries without planning to I might not be able to manage a shoeshine stand, Paul thought, but I’ve got serendipity and I’ve got luck He smiled at the thought, but it was true He trusted his luck And the more he trusted his luck, the less he had to rely upon it No matter what happened, things would always work out for the best What was it Rafe had said—with faith fear becomes an ally Paul stopped at his car door There on the ground at his feet was a coin He leaned over and picked up a silver dollar What sign might a guardian angel leave to signify that you’re on the right track? What if it were a guardian angel who knew that the main thing preventing you from achieving some important goal was the fear of running out of money? Rafe had been there WITH FAITH FEAR BECOMES AN ALLY 2/2 I usually catch a bus (Talking About What You Do - Getting To Work - How Often? - Possessive Apostrophe) 1. NÓI VỀ VIỆC LÀM CỦA BẠN - TALKING ABOUT WHAT YOU DO Để hỏi về nghề nghiệp hay công việc của người khác, ta nói: What do you do? Bạn có thể nói tên nghề nghiệp của mình: I’m a student. hay việc bạn làm I study at the university. Dưới đây là một số câu trả lời khác: I’m a builder. or I build houses. ANNE What do you do? STEVE I’m a builder. I build houses. Đôi khi ta thêm er vào các từ để chỉ nghề nghiệp: I bake bread. I’m a baker. I manage a hotel. I’m a hotel manager. Bạn có thể nói nơi làm việc của bạn: I work in a bank. or I work at a bank. Vì thế nếu bạn là giáo viên tiếng Anh: What do you do? Người ấy có thể trả lời: I work at a school. or I work in a school. or I teach English. or I’m a teacher. Bạn có thể nói bạn làm cho 1 đơn vị kinh doanh (for a business). I work for the bank. I work for a restaurant. 2. ĐI LÀM - GETTING TO WORK Dưới đây là một số cách trả lời câu hỏi: How do you get to work? I catch a bus. or I take a bus. or I go by bus I drive to work. or I go by car I walk to work. or I go on foot. ANNE And how do you get to work? STEVE I drive. I have to use my car for work. I never go by bus. Đối với hầu hết các phương tiện giao thông ta dùng by I go by car I go by train I go by bus Nhưng: I go on foot 3. THƯỜNG XUYÊN NHƯ THẾ NÀO - HOW OFTEN Dưới đây là các từ dùng để nói về mức độ thường xuyên thực hiện hành động nào đó: How often do you go to the cinema? occasionally STEVE Where do you go? Nightclubs? ANNE Not really. Occasionally. How often do you exercise? always How often do you watch TV? sometimes STEVE And what do you do on the weekend? ANNE Sometimes I go shopping. How often do you go fishing? never ANNE I never work outside. How often do you study? often 4. DẤU SỞ HỮU CÁCH - POSSESSIVE APOSTROPHE Ta thêm s vào danh từ để chuyển sang số nhiều. one lion two lions Nhưng đôi khi ta thêm s vào danh từ số ít để chỉ sở hữu: ANNE Well, I work in my father’s business, importing wines. That lion’s teeth are yellow. Răng-teeth thuộc về 1 con sư tử. Ta dùng dấu ' khi thêm s để chỉ sự sở hữu. s That lion’s teeth are yellow. Nếu nói về nhiều hơn 1 con sư tử sở hữu cái gì ta thêm dấu ' sau s. Those lions’ teeth are yellow. CAS E REP O R T Open Access A case report of male breast cancer in a very young patient: What is changing? Marcelo Madeira 1,2* , André Mattar 1,3 , Rodrigo José Barata Passos 1 , Caroline Dornelles Mora 3 , Luiz Henrique Beralde Vilar Mamede 2 , Viviane Hatsumi Kishino 2 , Thomas Zurga Markus Torres 2 , Andressa Fernandes Rodrigues de Sá 2 , Roberto Euzébio dos Santos 2,3 , Luiz Henrique Gebrim 1,3 Abstract Male breast cancer accounts for 1% of all breast cancer cases, and men tend to be diagnosed at an older age than women (mean age is about 67 years). Several risk factors have been identified, such as genetic and hormonal abnormalities. The present study reported the case of a 25-year-old man who was diagnosed with an advanced invasive ductal carcinoma; however, he did not have any important risk factors. Even though more data is emerging about this disease, more efforts to understand risk factors, treatment options and survival benefits are needed. In this case, we discussed the risk factors as well as the impaired fertility associated with breast cancer ther apies. Background Breast cancer in men is rare, and it accounts for about 1% of all malignant breast neoplasm cases [1,2]. The estimated incidence is 1 case for each 100,000 m en. In the United States, about 1,910 new cases were diagnosed in 2009, and 440 of these cases resulted in death [3]. Among the histologic types, invasive ductal carcinoma is the most prevalent breast cancer in males, with an inci- dence varying from 65 to 95% [2,4]. Male breast cancer has unimodal age-frequency distri- bution with a pea k incidence at 71 years old. Conver- sely, female breast cancer has a bimodal age-frequency distribution with early-onset and late-onset peak inci- dences at 52 and 72 years old, respectively [5]. This study examined a 25-year-old man without import ant risk factors who was diagnosed with invasiv e ductal carcinoma. Although it is rare, there have been instances of breast cancer in younger males [6]. We evaluated the main aspects of the epidemiology of breast neoplasm in men and the best approach for treatment. Case presentation A 25-year-old Brazilian male was referred to our institu- tion in Au gust 2007 complaining of a breast tumor of progressive growth f or the previous eight months. Pre- vious medical and family history did not appear to con- tribute to the present illness. He denied using drugs or anabolic steroids and did not drink alcohol. The only medication he was taking was phen obarbital, which he had been taking for four years since he presented with two seizure episodes. The patient was a smoker who consumed 10 cigarett es per day. He also reported a nor- mal sexual life, but he did not have children. Physical examination revealed a 3.5 cm tumor located on the right breast. There was a retraction of the nipple; the nodule, which could be moved, had a harde ned con- sistency and did not adhere to deep planes. The armpit s did not present lymphadenopathy. Mammographic find ings consisted of a noncalcified high density mass (Figure 1) and breast ultrasonography revealed a hypoechogenic nodule of irregular shape with partially defined limits measuring 17 × 13 × 11 mm in the right breast. The magnetic nuclear resonance imaging showed a retroareolar nodule in the right b reast, which corresponded to an expansive process. There were also signs of infiltration of the pectoralis muscle and a small area of retroareolar highlight in the left breast. Final * Correspondence: marcemadeira@gmail.com 1 Senology Discipline, São Paulo Federal University, São Paulo, Brazil Full list of author information is available at the end of the article Madeira et al . World Journal of Surgical Oncology 2011, 9:16 http://www.wjso.com/content/9/1/16 WORLD JOURNAL OF SURGICAL ONCOLOGY © 2011 Madeira et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http: //creati vecommons.org/li BioMed Central Page 1 of 5 (page number not for citation purposes) Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Open Access Case report No fate but what we make: a case of full recovery after out-of-hospital cardiac arrest Mafalda Miranda* 1 , Pedro J Sousa 2 , Jorge Ferreira 2 , Maria J Andrade 2 , Pedro A Gonçalves 2 and Cristina Romão 1 Address: 1 Anesthesiology Department, Hospital Curry Cabral, Lisbon, Portugal and 2 Cardiology Department, Hospital de Santa Cruz, Carnaxide, Portugal Email: Mafalda Miranda* - mafalda.miranda@kanguru.pt; Pedro J Sousa - p965675551@gmail.com; Jorge Ferreira - jorge_ferreira@netcabo.pt; Maria J Andrade - mjandrade@netcabo.pt; Pedro A Gonçalves - paraujogoncalves@yahoo.co.uk; Cristina Romão - romaocris@gmail.com * Corresponding author Abstract An 80 years old man suffered a cardiac arrest shortly after arrival to his local health department. Basic Life Support was started promptly and nine minutes later, on evaluation by an Advanced Life Support team, the victim was defibrillated with a 200J shock. When orotracheal intubation was attempted, masseter muscle contraction was noticed: on revaluation, the victim had pulse and spontaneous breathing. Thirty minutes later, the patient had been transferred to an emergency department. As he complained of chest pain, the ECG showed a ST segment depression in leads V4 to V6 and laboratorial tests showed cardiac troponine I slightly elevated. A coronary angiography was performed urgently: significant left main plus three vessel coronary artery disease was disclosed. Eighteen hours after the cardiac arrest, a quadruple coronary artery bypass grafting operation was undertaken. During surgery, a fresh thrombus was removed from the middle left anterior descendent artery. Post-operative course was uneventful and the patient was discharged seven days after the procedure. Twenty four months later, he remains asymptomatic. In this case, the immediate call for the Advanced Life Support team, prompt basic life support and the successful defibrillation, altogether, contributed for the full recovery. Furthermore, the swiftness in the detection and treatment of the acute reversible cause (myocardial ischemia in this case) was crucial for long-term prognosis. Introduction Cardiac arrest is an important cause of death and it is esti- mated that about 50 percent of those deaths occur outside hospitals [1]. The overall rate of successful resuscitation in patients with out-of-hospital cardiac arrest has been poor [1-3], with time to defibrillation being the most important factor for the success [2,4-8]. Basic life support improves survival by Published: 11 December 2009 Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2009, 17:63 doi:10.1186/1757-7241- 17-63 Received: 13 October 2009 Accepted: 11 December 2009 This article is available from: http://www.sjtrem.com/content/17/1/63 © 2009 Miranda et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2009, 17:63 http://www.sjtrem.com/content/17/1/63 Page 2 of 5 (page number not for citation purposes) delaying the degradation of the cardiac rhythm to asys- tole, enhancing the possibility of successful defibrillation [5]. We describe a case of a successful resuscitation after an episode of sudden cardiac arrest, in an old patient with undiagnosed severe coronary artery disease and presuma- ble acute coronary syndrome. Written informed consent was obtained from the patient for publication of this case report and any accompanying images. Clinical report An 80 years old man, with history of hypertension and benign prostatic hypertrophy noted chest pressure for .. .A Lucky Coin Is What You Make Of It police car coming down Main Street slowed at the alley’s entrance, then accelerated past Paul took a bite of chocolate He never saw the car Not really... trusted his luck, the less he had to rely upon it No matter what happened, things would always work out for the best What was it Rafe had said—with faith fear becomes an ally Paul stopped at his car... ground at his feet was a coin He leaned over and picked up a silver dollar What sign might a guardian angel leave to signify that you re on the right track? What if it were a guardian angel who