text:
 “There are 7 billion of us out there, 7 billion lives, all existing simultaneously. Out there, at this very moment, everything is happening. Someone’s’ falling in love right now, and someone’s’ falling out of it. A child is watching his dad beat his mum while hiding in a cupboard and someone is killing someone else for the very first time.”
I stopped, taking another drag from the poorly rolled joint. I looked more like a sagging cigarette now.
“The sheer number of people on this earth means that statistically whatever you’re going through, whatever shits troubling you, someone’s’ gone through it before. I guess it’s comforting in a way, but it also sort of makes you realize how unimportant you are.”
Jonas looked up and chuckled.
“Frederick, you need to lay off the dope man. You’re sounding like my mum”
 The sun was beginning to set and the last of the light was casting purple and pink splotches across the horizon. I could see some birds in the distance, looked like shorebirds, probably migrating North to Siberia. I slid down the graffiti covered skate ramp and stubbed out the joint on the cement. “C’mon, we’re going to be late.”

The main street of Port Fairy, Victoria was as silent as the deaf school that they built in the southern part of town. That was, of course, apart from the times the folk music festival was here. But other than that, Jonas and I usually had the streets to ourselves. On Fridays’, our parents would meet up for trivia at the local tavern, always stumbling home, drunk on beer and cover bands, at some absurd time of night before laughing their way to bed. Us kids would generally head down to the beach for some bonfire party. It was there we would all drink and smoke till we passed out on the sand. It was like some kind of sick competition as to who could get fucked up the most. As we got closer to the end of school though, the kids would spend less time drinking and more time talking about getting out of here, going to the city, travelling the world and shit like that. My English teacher wanted me to have those dreams, said he saw big things for me. Always going on about some degree at a fancy Melbourne university. To be honest though, I’d be happy just to work on the docks with dad. I put my hands in my pockets and felt the crumpled Melbourne Uni pamphlet I picked up earlier. I pulled it out and threw it into the trash before light-heartedly shoving Jonas.
“Try not to piss yourself this time will you mate.”
He scowled
“Fuck off dickhead, it wasn’t piss, I spilled my drink.” I bowed my head to hide my smile as we walked towards the beach.

“You think Abigail will be there tonight.”
Abigail was Jonas’ Bella. Y’know, Bella, from the 2 excruciating hours that is “Twilight.” Except Jonas didn’t half the charm of Edward, never mind the looks. If he did then perhaps he’d have a chance. But he’s still obsessed, whether it’s a possibility or not. You see, Abigail had moved next door to him when he was 6 and he hasn’t shut up about her since. “
Yeah, she’ll be there, Jocks’ going and she fancies him I reckon.”
Jonas’ expression suddenly turned inwards and his bubbliness instantly went flat. I don’t know why I said that to him, yeah it was true, but I could’ve let him stay in denial. I guess I was just tired of him spending these nights chasing her and leaving me alone by the fire. Trying to get rid of the guilt building slowly inside of me I quickly added,
“But you guys are meant to be together... So she’ll come round I reckon.”
“You really think so?”
He looked up, so committed to the idea of a relationship with her that he would believe anything that promoted its’ cause.
“Yeah mate, I know it. Look there it is, I can see the bonfire.”
I pointed towards the glimmer of light coming from the beach. It was almost dark now and a cool sea breeze carried the smell of salty water. The ambience of it almost overcame me. Regardless of what the other kids thought, for me, this was my home.

The fire flickered and danced as I stood in the warmth emerging from its’ tender fingers. Jonas had gone off to chase Abigail and I was left alone by the fire. Now onto my 6th beer I was definitely feeling the alcohol, finding it difficult to remain focused on one thing. The whole party had long ago turned into a crude display of lust. Everyone had paired up in a desperate attempt to escape the loneliness and deep-seated insecurities that came with being an adolescent in a country town. The lucky ones who had found someone had gone off and now only a spare few remained, some face down in the sand and others just sitting, staring into the waves. As I was considering whether to join the sand people, someone tripped behind me. I turned around to see who the latest victim of alcohol poisoning was and it surprised me to find Jonas. He looked up, wildly distressed with sand all over his face. He didn’t seem too intoxicated but his hands were shaking real bad and he looked pale. My only thought was that he probably took too much of the E he had brought along.
“Big night buddy?”
I asked cynically, smiling to myself. He shook his head quite violently.
 “Nah, nah, Frederick, it’s not that. Something’s happened…”
He paused
“Something bad has happened man, something real bad man, real, real fucked up, and I don’t know what to do. I didn’t mean for this to happen, I promise. I didn't mean it to go like this”
His pupils were dilated and his eyes kept darting from left to right. His thick eyebrows were creased and his messy red hair was tangled. He looked like a right madman. I laughed.
“Yeah, good one mate. Real funny.”
Although I wasn’t in the mood for practical jokes I’d give him this one, his acting was actually pretty good. I waited for him to reveal the prank but he just kept darting his eyes, rubbing his hands together and looking around nervously.
“Real funny Jonas. Now stop it, I’ve had a rough night. I’m going to sleep.” Yet, as I turned to go, he kept shaking his head, and now, looking at him, his expression was one I hadn’t seen on him before. Pure terror. I stopped. Maybe this wasn’t a joke
“Shit mate…”
It was apparent now that he was dead serious.
“What’s going on?”

“What the fuck did you do Jonas?”
He didn’t respond. He was caught up in whatever fucked up mess was going down inside his head. Running over the dunes, every few strides he would stumble then continue with the same hurried angst. I followed close behind him, wondering what could’ve happened to make him like this. Jonas was generally a pretty chilled person so to see him all riled up like this was a bit of a shock. We were getting pretty far away now and the light of the bonfire was growing dim. I pressed my red denim shirt to my body, feeling the cold. My skin was turning slightly pinkish; it always reacted weirdly when the weather got this way. Jonas finally stopped on a tall sand dune. From the bottom of it, he looked sort of like a hero from the novels my mum used to read to me as a kid. Bare feet, wind blowing in his hair, with the moon and the stars above him, he looked like nothing could ever bring him down. I slowly trudged up next to him. Standing there, we must have looked like two giants in the night. The kings of the beach. I kept looking forward, trying to see what was so important he had to bring me all the way out here. Then I looked down, fuck, I shouldn’t have looked down.

I’d always imagined a dead body would be blue. Y’know, blue, bloody, the shit you see in horror movies. But in reality, they just look like a normal person, like they were sleeping just… missing something. There was one thing the movies got right though, his body was cold. As I shuffled the woollen jumper up to see if he had a pulse I was shocked by his iciness. Jonas was still shaking, stricken with paranoia his eyes were still dating rapidly from side to side, scanning the dunes for anyone who might bear witness to his act of sin.
“One minute he’s dancing with me, laughing and having a good time and then he’s face down in the sand.”
He stuttered then coughed quickly to correct himself
“I was out here just, just angry, about Abigail and stuff, so I decided to pop a couple of caps, I got them off my brother. Just a few caps y'know. Anyway he was out here, looked a little lonely, like me, so I asked if he wanted one. I didn’t do anything to him Frederick, you know that right, you believe me... you believe me right? I just gave him some E, that’s all. Just some E.”
It was only after the initial shock faded that I became aware of the repugnant smell. I gagged into my shirt. I’d heard that humans defecated upon death due to the loosening of the bowel muscles. Just thought it was another urban legend, to freak us out. Never thought it was true, not until today.
“I think he’s dead Frederick, I think he’s fucking dead.”
Jonas began to cry, in small bursts at first, but then full-blown sobbing. I had never seen him cry at all, not before tonight.
“Shut up Jonas. Someone’ll hear you.”
He scrunched his t-shirt and put it in his mouth. I stopped, breathing deeply. I had no idea what to do but I couldn’t expect any rational thinking from Jonas so it was sadly on me. I had to deal with the dead guy lying cold in the sand. What the fuck happened to a relaxing bonfire. I checked one more time for witnesses before turning to Jonas, hiding my terror behind a mask of solemn determination.
“Now, Jonas, I need you to listen to me, did anyone else see him? Anyone at all.”

I rolled the body onto its’ front and gagged again. It was Chris. Chris from the private school in the rich part of town. Chris from the football team. Chris who sang in choir. Chris the kid who never was that bright, who was one of those 6-foot tall weightlifters who laughed whenever one of his mates would let rip in the car. Chris who was simple. Chris who never wanted to go to Uni either. Had a construction job lined up he reckoned, with a cousin over in Warrnambool. Of course, none of that mattered now. Now he’d never even get to turn 18. Never have kids. Never get married. Never get to see his mum smiling when she realised her little boy was all grown up. Tragic.

Snapping myself out of lamentation I realised the sun would be up soon. We needed to be quick if we were going to remain unseen. Fact of the matter was, Jonas had given him the E. Didn’t matter he didn’t kill him himself. Everyone knew Jonas was the only one with E and it was the E that caused Chris to end up dead. I had to think of Jonas now. Chris was gone, couldn’t do nothing for him and going to the pigs would just put my mate behind bars. I turned to Jonas, who was still crying,
“We’re going to have to move him.”

Fireman carrying Chris towards the water reminded me of when my dad used to carry me inside after the long car trips back from Melbourne. Funny how the roles reverse so suddenly. I buckled numerous times under Chris’s’ weight as Jonas walked behind me. Although I was the one carrying the body, Jonas was carrying a hell of a lot more, metaphorically of course. As we grew close to the shore I laid Chris with down in the sand, head first. It was easier that way, didn’t have to see his face.
“Frederick”
Jonas stuttered, wiping away snot and tears on his sleeve.
 “What are you going to do?”
I lifted Chris up underneath his shoulders then turned to Jonas.
“He was drunk, he went swimming and he was drunk. A rip carried him out. Do you understand?”
He nodded and then began sobbing again, black circles now forming under his eyes.
“Grab his feet.”
I instructed him sternly while repeating to myself, solemn, stay solemn and distanced, Jonas needs you, he needs this. As we waded out to sea, the water became colder. Without the sun shining against it, it looked as black as the night sky. The foam from the waves broke against our ankles. The Ocean, at this time of night, resembled a moving breathing body, silent and dark. I watched the patterns forming from the breaking of the waves, the break making subtle shapes on the water top. At about chest height, shivering profusely, I looked to Jonas and nodded. He understood. The look in his eyes said enough. After letting go of Chris’s’ feet he looked away, as if by not facing the same direction as the body it would nullify what he had done. Before I let Chris go, I grasped his fingers, feeling the coarseness that had developed from the delivery work he did with his family in the summer. In the dark I could only see the faint outline of his body sinking downwards. The current would take care of the rest. Carry him away from us and away from our quiet country town.

Despite the fact my clothes were soaked and my knees were shaking I became aware of the fact that I could no longer feel the cold. Sitting down next to Jonas I looked out at the ocean, moving methodically, forward then backwards, taking and depositing sand as it came and left. Jonas and I just sat there. Sat there till the sun came up, gripping each other tightly and watching as the new day arrived, knowing nothing of the events of last night. Once again, the light painted the horizon with brilliant colours, but in our distress we were no longer witness to the beauty of the sun.

Ambition, ambition, ambition. They never shut up about it, you get one good mark or read some intellectual book and all of a sudden you have to go to bloody Cambridge. I think I may move to the city after all though. Nothing but bad memories in this town I have to walk past the memorial for Chris every day. His family still drops off flowers like once a month, I see his mum crying sometimes, close to the school. Jonas and I don’t talk much anymore, guess after what happened we just want to forget. Some nights, when things get real bad, I find myself wishing I were like the shorebirds, just able to fly off anywhere, with the cool breeze in my hair and the smell of salt water encasing me.

title: [RF] Ambition

question: What does the story say about Chris?

text: It is not implied that he committed suicide. He was drunk and went swimming. It seems that he drowned.

answer: Chris is a friend of Frederick and Jonas. He is a tall weightlifter who is not too bright. He is on the football team and sings in the choir. He doesn't want to go to university and has a construction job lined up. Chris is killed by Jonas after taking some E.

text: The answer is misleading. Jonas didn't actually kill Chris. Jonas gave Chris the e that killed him.

answer: Chris is a young man that died. He was drunk and went swimming with Jonas and drowned. The narrator and Jones carry him toward the ocean expecting that the current would take him away.

text:
The answer should mention that Chris was from a private school in the rich part of town and was on the football team. He also sang in the choir, never was that bright, and was one of those 6-foot tall weightlifters who laughed whenever one of his mates would fart in the car.
It should state that Chris was simple and never wanted to go to Uni. He also had a construction job lined up with a cousin in Warrnambool.
The answer omits that Jonas gave Chris the E, which took his life.
The answer should state that the narrator told a sobbing Jonas that Chris was drunk, went swimming, and a rip carried him out as a cover-up. Afterward, they dumped Chris's body in the ocean.

text: 'He was drunk and went swimming with Jonas and drowned.' - This sentence is inaccurate. It's what the narrator told Jonas as a cover-up. Correct to this.

answer: Chris is a friend of Frederick and Jonas. He is a tall weightlifter who is not too bright. He is on the football team and sings in the choir. He doesn't want to go to university and has a construction job lined up. Chris is killed by Jonas after taking some E.

text: The answer should mention that Chris is dead.

text: The answer omits that Chris is killed by Jonas after taking some E.

text: The answer omits that Frederick and Jonas hide Chris's death by making it look like an accident.

text: The answer omits that Chris was killed by Jonas after taking some E.

text: The answer should mention that Chris's body is found by Frederick and Jonas.

text: The answer should mention that Chris's body was dumped into the ocean.

text: The phrasing regarding Jonas's involvement can be more nuanced.

answer: Chriss is a young man that committed suicide.

text: The passage contains more information about Chris than what is listed here.

answer: Chris is a young man that died. He was drunk and went swimming with Jonas and drowned. The narrator and Jones carry him toward the ocean expecting that the current would take him away.

text: The answer omits that Chris was a friend of the narrator and Jonas.

text: The answer should mention that Chris was killed by Jonas.

text: The answer omits that Chris was a popular kid who was going to work in construction with his cousin after school.

text: The answer omits the fact that Chris was a popular kid who was going to graduate soon.

text: The response is missing key details about Chris.

text: The story doesn't mention whether or not Chris was swimming with Jonas. It just mentions that he was drunk.

text: The answer omits the fact that Chris was Chris was on E when he passed away.

text: The response is incorrect. Chris didn't drown. He died of a drug overdose.

text: The response should mention other important details about Chris.

answer: Chriss is a young man that committed suicide.

text: The answer is incorrect. Chris did not commit suicide. He died after taking E.

text: The answer is incorrect. Chris didn't commit suicide. He died after taking E.

text: The answer is completely inaccurate.

text: The response is incorrect. Chris did not commit suicide.

text: The answer is incorrect. Chris was killed by Jonas, who gave him E.

text: Wrong

text: There is no evidence in the story to say thatCriss committed suicide.

text: The answer is incorrect and needs to be rewritten. Chris did not commit suicide. He died after taking E given to him by Jonas.

text: This should mention how Chris was a simple boy who went to a rich private school and was involved in a lot of extracurriculars.

text: This should mention how they dump Chris's body in the ocean.


text:
[Taste of Excellence Food and Drink Awards 2020 - WINNERS]

Announcing our 2020 Award Winners.

Understandably, this year, we have had to adapt how we champion and highlight the region’s food, drink and hospitality sectors but we still wanted to celebrate the fantastic businesses on our doorstep.

We devised new categories highlighting our current challenging times and how businesses have adapted to cope. We were especially interested to hear your reasons for nominating your heroes, favourites and those who have gone above and beyond your expectations.

Here are some of the wonderful and appreciative comments we received about these businesses and others who were nominated. In our January issue we will bring you some of the back stories to these and other top 10 nominated businesses in each category.

Our congratulations and heartfelt respect to all these businesses. Keep calm and carry on – you are doing a great job!

BEST DINING EXPERIENCE TO GO
We were looking for where you had the most wonderful meal, collected from your favourite eatery which branched out into meals to go.

WINNER: HEALING MANOR HOTEL, HEALING

Customers said:
“Although I live in Healing I had never thought about visiting Healing Manor. They put themselves out there in lockdown, helping our community and wider afield. Lived for their take out Sunday Lunches. Went in nervously for the Eat Out to Help Out Campaign and was impressed with their precautions. Always good food and drinks and lovely atmosphere.”

“This is a truly wonderful hotel and restaurant. It has helped the community whilst in lockdown and still managed to provide excellent take away food. Once reopened the Covid safety measures have been fantastic too.”

“The chef and staff did an amazing job during lockdown. Villagers were also given a treat of freshly baked bread that was free. Meals as delicious as ever. Very well organised.”

BEST AFTERNOON TEA
We were looking for the classic British treat which lifts the spirits.

WINNER: DODDINGTON TEA ROOM, DODDINGTON HALL, DODDINGTON

Customers said:
“Loved the newly created tea room and the choice of menus, especially the savoury option! Doddington never disappoints.”

“Excellent service! Brilliant idea to transform what was the wedding venue into a tea room in these times! Very safe environment too!”

“Superb food, all locally sourced for their tearoom, and an unbeatable high quality range of produce in the farm shop.”

BEST COMMUNITY FOOD OR SHOPPING SERVICE
We wanted to know who has risen to the challenge to serve their community and the vulnerable during the pandemic?

WINNER: GELSTON LAMB, GELSTON

Customers said:
“Great service provided through these difficult times and lovely to support the small independent farm. Good quality meat and love following them on social media where there are regular updates.”

“A truly home grown Lincolnshire business where the owners clearly have a passion for providing a top quality product and service, and all at a reasonable price point too. A real boon as well to be able to access Gelston Lamb for home deliveries during recent months in lockdown. We have had a range of products over a period of time now and all have been to a consistent high quality and with a great customer experience from ordering to delivery, and of course the eating!”

“Outstanding lamb, exceptional service. Chris and Louise of Gelston Lamb provide a reliable, quality service, always delivering high quality, tasty lamb – always delivered on time and with a cheeriness that warms the heart, greatly appreciated in these times. Having the lamb delivered means we don’t have to risk catching Covid-19 in a shop. A very highly valued service.”

BEST DRINKS PRODUCT
Tea, coffee or an artisan tipple – sales have soared recently. We wanted to know which is your local favourite.

WINNER: FIVE FATHOMS SPIRIT, BARTON-UPON-HUMBER

Customers said:
“Five Fathoms dry gin is just sublime and her shop and customer service outstanding.”

“Great little distillery. Best tasting gin we’ve had in ages, always drop in when passing to stock up our drinks cupboard.”

“Emma runs her craft micro-distillery singlehanded. She has created a range of beautiful gins. Her Humber Dry Gin is truly fantastic.”

BEST LINCOLNSHIRE STAYCATION
Lincolnshire offers some of the best staycation options. We asked you to nominate your holiday choice.

WINNER: SALTFLEET MANOR HOUSE, SALTFLEET

Customers said:
“We stayed at this amazing B&B earlier in the year and were amazed by the history of the manor which was only surpassed by the welcome and professionalism of the owners. The B&B is of the highest standard both in terms of facilities and breakfasts.”

“Only just started up when Covid arrived, still managed to open up on time, the B&B is exceptional, fantastic rooms, great breakfast, even had a pool and hot tub.”

“They have got everything right, modernisation of a Grade II listed building, thinking of everything that people need and then some. A breakfast to die for. They deserve a massive gold star for their efforts in this year of upheaval.”

BEST ‘EAT OUT TO HELP OUT’ EXPERIENCE
Throughout August this scheme gave the hospitality sector a boost. You told us where you enjoyed most.

WINNER: PUCCINIS, CONINGSBY

Customers said:
“We’ve had the most incredible take away, meal in and a meal on the Eat Out to Help Out! Always amazing!”

“The food and service is second to none. Lockdown happened and these guys stepped up to the plate. Nothing is ever to much trouble and the food is amazing.”

“Truly wonderful food at this gem of a restaurant: with great care taken to cope with Covid-19 and to continue to provide superb food for their customers.”

BEST CAKES OR BAKES
We wanted to hear which cake makers and bakers have been an inspiration.

WINNER: LADY B’S CUPCAKERY, MABLETHORPE

Customers said:
“Always excellent food, treats, cupcakes and cheesecakes. Exceptional service from staff but especially during such hard times during lockdown, they even adapted their business so we could have our treats delivered to our door, so no special occasion was missed. Then the best service I had throughout the Eat Out to Help Out scheme came from them. One amazing business and a group of wonderful people!”

“Cheesecakes to die for. Whenever I visit my relatives I have to take cheesecake, what more can I say. Lovely staff too.”

“I have been in Mablethorpe for nearly five years and from day one this business has been outstanding. We have held birthdays, anniversaries, even afternoon tea in memory of our mum who loved this place, always they go above and beyond in service and amazing food.”

BEST SWEET TREAT
Whether yours is chocolate, fudge, marshmallows or jams we asked for your nominations.

WINNER: THE GARDEN TEA ROOM, NORTH HYKEHAM

Customers said:
“I live in Grantham but love going to the Garden Tea Room whenever I am in Lincoln. You are spoilt for choice of their delicious cakes, cheesecakes and muffins! Such a broad selection in their afternoon tea, and the teapot can be never ending! You always get good value for money, but even more so when the Eat Out to Help Out scheme came in and Jade and her staff make you feel so welcome and so, so helpful if you have dietary problems. They have ‘specials’ on and a good choice of food on their menu. All produce is fresh and prepared on site. This place is a must to eat in or out at and have kept going all through the lockdown adapting their menu and delivering where possible. They deserve to win!”

“The tea rooms through lockdown offered delivery, all through lockdown they have been amazing! I have been housebound and heavily pregnant. These lovely ladies helped arrange surprise afternoon tea and cakes during pregnancy and after!! Amazing value for money too!”

“The Garden Tea Room has always been a fantastic place to enjoy and relax with a treat. Throughout lockdown, they’ve adapted and found ways to continue to spread joy with their products.”

BEST INDEPENDENT FARM OR LOCAL SHOP
Locally yours, these businesses have provided innovative services and quality products on your doorstep.

WINNER: WILLIAMSONS FARM SHOP, GAINSBOROUGH

Customers said:
“All have provided an absolutely fantastic, friendly service during difficult times with quality goods and products making lockdown bearable.”

“Staff worked really hard in these strange times and put the people of Gainsborough and surrounding areas first before themselves in times of adversity. They deserve to be recognised for their kindness and hard work this year.”

“Excellent service. Great range of fresh products. Excellent diversity! A life-saver during Covid!”

BEST NEWCOMER OF THE YEAR
Who or which business made their mark despite the challenging times?

WINNER: EMILY PAGE OF EMZ BAKZ

Customers said:
“Inspirational young girl, made the most out of lockdown and her skills to make truly delicious cakes, cupcakes and treats.”

“Tried several of Emily’s bakes and they are all amazing. She deserves recognition! Best brownies I’ve ever tasted.”

“We have had an amazing treat box from Emily, really tasty, lots of choice and good value for money.”

question: What are the common features among the businesses recognized for distinguished service?

text: The specific businesses that won aren't necessary to list since the question only asks for the common qualities between them.

category: coherence

answer: They are praised for their excellence throughout the Covid lockdown period, either with their precautions or with their delivery services to ensure homebound people can buy the food and drinks they like.

answer_source: Human

text: The answer should be more specific. They are also praised for food quality, the choice of menus, and professionalism.

category: coverage

answer: They are praised for their excellence throughout the Covid lockdown period, either with their precautions or with their delivery services to ensure homebound people can buy the food and drinks they like. The shops are Healing Manor Hotel, Doddington Tea Room, Gelston Lamb, Saltfleet Manor House, Puccinis, Lady B's Cupcakery, Williamsons Farm Shop, The Garden Tea Room, and EMZ BKZ.

answer_source: Human misleading

text: It's omitted that they are also praised for their great food.

text: It's omitted that they are praised for excellent service.

text: It's omitted that staff is also complimented.

answer: They are all locally based, they are all small businesses, and they all provided excellent service during the pandemic.

answer_source: Model

answer: They are praised for their excellence throughout the Covid lockdown period, either with their precautions or with their delivery services to ensure homebound people can buy the food and drinks they like.

text: The answer should mention the Eat Out to Help Out campaign.

text: The answer should mention the Eat Out to Help Out scheme.

text: The answer should mention that the businesses are also praised for their excellent service during the Eat Out to Help Out campaign.

text: The answer should mention that the businesses are all from Lincolnshire.

text: The answer should mention the services they offer.

text: The answer should mention the common features among the winners.

text: The answer is too vague and unclear by referencing what each business has done to be deserving of such recognition in the award ceremony.

answer: They are all locally based, they are all small businesses, and they all provided excellent service during the pandemic.

text: The answer should mention that the businesses also provided support to the community.

text: The answer should mention that the businesses also provided excellent service during the pandemic.

text: The answer should mention that the businesses all went above and beyond to serve their community.

text: The answer should mention the categories.

text: The highlighted portion of the answer is a bit redundant. It's already mentioned that the businesses are locally based.

text: The answer should be more specific about the pandemic, since the award-giving institution specifically states that they are interested in how the businesses have coped with the pandemic.

text: The answer should mention the specific services they provided.

text: The second one should be more specific that they are all small businesses in Lincolnshire.


text:
[Binyam Mohamed]

Mr Mohamed claims he was brutally tortured in Morocco

THE GOVERNMENT SAYS IT WILL APPEAL AGAINST A RULING THAT US INTELLIGENCE DOCUMENTS DETAILING THE ALLEGED TORTURE OF AN EX-UK RESIDENT CAN BE RELEASED.

Ethiopian-born Binyam Mohamed, 31, who spent four years in Guantanamo Bay, claims British authorities colluded in his torture while he was in Morocco.

The UK government, which stopped judges publishing the claims on national security grounds, denies any collusion.

A US State Department spokesman said it was "not pleased" by the court ruling.

Any publication of the material will be delayed until an appeal takes place.

The key document in the case is a summary of abuse allegations that US intelligence officers shared with their counterparts in London.

When the High Court gave its original judgement on the case last year, a seven-paragraph summary of Mr Mohamed's torture claims was removed on the orders of Foreign Secretary David Miliband.

+-----------------------------------+-----------------------------------+
| []                                | BINYAM MOHAMED                    |
|                                   |                                   |
|                                   | Detained in Pakistan in 2002,     |
|                                   | questioned there by MI5 officer   |
|                                   |                                   |
|                                   | Transferred to Morocco, claims he |
|                                   | was tortured in US custody and    |
|                                   | asked questions supplied by MI5   |
|                                   |                                   |
|                                   | Later interred in Guantanamo Bay  |
|                                   | and eventually released in 2009   |
|                                   |                                   |
|                                   | []                                |
+-----------------------------------+-----------------------------------+

Mr Miliband argued that releasing the material would threaten Britain's national security because future intelligence sharing with the US could be compromised.

But at the High Court on Friday, Lord Justice Thomas and Mr Justice Lloyd Jones ruled that the risk to national security was "not a serious one" and there was "overwhelming" public interest in disclosing the material.

Their judgement was also delayed on Friday because MI5 insisted part of it - explaining why there was such a significant public interest in the case - should be redacted.

Ex-shadow home secretary David Davis - who first raised the case in the House of Commons - said it was "time for the government to accept the ruling of the court and stop trying to delay proceedings with further futile appeals".

Mr Davis added: "The British public have a right to know the judges' assessment of the extent of complicity of the UK and US Intelligence services in torture, and to determine for themselves why the government has tried for so long to cover up this assessment."

David Miliband: "If we give away other people's secrets, they will give us less information"

But Mr Miliband told the BBC's Newsnight that the court had breached a "fundamental principle" of intelligence sharing.

He said: "I have absolutely no objection to this material being put into the public domain by the US."

But, he added, "the principle is that one country's intelligence secrets belong to that country.

"If I give you my secrets, you don't put them into the public domain."

He said that if the court's ruling were upheld, "every other country that works with us on security issues will have to think again because they will have to be confident that the intelligence material that they share with us is safe with us".

Kurt Volker, former US ambassador to Nato, told the BBC this argument went "right to the heart of the issue".

He said: "If it is US intelligence information shared with the UK, and then that is released on the order of a UK court, then I think it calls into question what future intelligence can be shared.

'NOT A THREAT'

"Please don't understand that as a threat that the US would seek to retaliate, but rather more an observation of how intelligence organisations are going to have to try to protect their own information if there is a risk it is going to be released."

The US also denies any allegations of torture concerning Mr Mohamed and a former senior official in the Bush administration told the BBC releasing the material would have an "enormous chilling effect" on US-UK relations.

Ian Kelly, a spokesman for the US State Department, praised Mr Miliband for his decision to appeal.

Asked at a press conference for his reaction to the court's verdict, Mr Kelly told reporters: "We are not pleased - and this has nothing to do with due process here.

"This has everything to do with the importance of protecting sensitive national security information and protecting this confidential channel that we have with our allies."

'DIRTY WORK'

Mr Mohamed, who once lived in north Kensington, London, was first detained in Pakistan in 2002. He was questioned there by an MI5 officer before being transferred to Morocco.

He says while in US custody in Morocco he was tortured at the behest of the CIA and asked questions supplied by British intelligence agency MI5.

Mr Mohamed was later transferred to Guantanamo Bay and eventually released in February this year.

Before Friday's judgment, Mr Mohamed told BBC the material should be released.

+-----------------------------------+-----------------------------------+
| []                                | [] OUR COURTS SHOULD BE GAGGED NO |
|                                   | LONGER AND THE CRUCIAL            |
|                                   | INCRIMINATING PARAGRAPHS          |
|                                   | PUBLISHED WITHOUT DELAY []        |
+-----------------------------------+-----------------------------------+

He said: "The public needs to know what their government has been up to for the last seven years.

"There's information in there, which I'm 99% sure, states that the US sub-contracted the UK government to do its dirty work."

Liberal Democrat foreign affairs spokesman Ed Davey said the court was right to argue that publication would not jeopardise British-American security co-operation.

In March, Attorney General Baroness Scotland confirmed the police would investigate whether an MI5 officer had been complicit in the alleged torture of Mr Mohamed.

question: Explain Binyam Mohamed's claims.

text: The answer incorrectly mentions that Mohamed was detained in Afghanistan, it was actually in Pakistan.

category: accuracy

answer: When Binyam Mohamed was detained in Afghanistan in 2002, he was transferred to Morocco where he claims to have been tortured. The tortures occurred while in US custody whom colluded with the British authorities. When the information was revealed, UK and US intelligence services tried to cover it up.

text: Mohamed was detained in Pakistan, not Afghanistan.

text: The article does not mention Afghanistan.

text: Mohamed was not detained in Afghanistan.

text: The first sentence states that Mohamed was detained in Afghanistan and then later Morocco, which is inaccurate. The initial detainment and questioning was done in Pakistan by a British intelligence officer, there was no mention of Afghanistan in the passage, which made this inaccurate and information was most likely found from an external source which was inserted into the summary.

answer: When Binyam Mohamed was detained in Afghanistan in 2002, he was transferred to Morocco where he claims to have been tortured. The tortures occurred while in US custody whom colluded with the British authorities. When the information was revealed, UK and US intelligence services tried to cover it up.

text: This does not discuss his claims and needs to be rewritten. This should mention how Mohamed claimed British authorities colluded in his torture while he was in Morocco.

answer: When Binyam Mohamed was detained in Pakistan in 2002, he was transferred to Morocco where he claims to have been tortured. The tortures occurred while in US custody whom colluded with the British authorities. When the information was revealed, UK and US intelligence services tried to cover it up.

text: It is omitted that he claims that he was tortured at the behest of the CIA and asked questions supplied by British intelligence agency MI5.

answer: He claims British authorities colluded in his torture while he was in Morocco.

answer: When Binyam Mohamed was detained in Pakistan in 2002, he was transferred to Morocco where he claims to have been tortured. The tortures occurred while in US custody whom colluded with the British authorities. When the information was revealed, UK and US intelligence services tried to cover it up.

text: The last sentence is not relevant to the question.

text: The last sentence is unnecessary.

text: "When the information was revealed, UK and US intelligence services tried to cover it up" is not part of Mohamed's claims.

text: The first sentence is not relevant.

text: The last sentence is unattested.


text:
On Tuesday, NASA announced that it completed its first full-power test of the Kilopower reactor, an experimental portable nuclear power plant that the agency hopes will one day power permanent settlements on Mars and the Moon. It’s a major milestone in the quest to establish a permanent human presence on other celestial bodies and launch energy intensive robotic missions to the outer solar system.

About the size of a refrigerator, each Kilopower reactor will be capable of delivering up to 10 kilowatts of energy when they are ready to be deployed in space. To put this in perspective, this means each Kilopower reactor produces enough energy to power about 10 average American homes on Earth. NASA estimates that an array of four Kilopower reactors would be enough to sustain a decent-sized outpost on the moon or Mars for about a decade.

Although the Kilopower reactor has been in development since 2012, testing on a 1- kilowatt prototype only began in November. The testing program, called the Kilopower Reactor Using Stirling Technology (KRUSTY), was undertaken at the Nevada National Security Site and meant to study the integrity of the reactor design in conditions similar to those in deep space. After placing the reactor in a vacuum chamber, researchers subjected the device to all kinds of critical failure scenarios, like power reduction, engine failure, and heat pipe failure. The experiments culminated in a full-power test that kept the reactor online for 28 hours.

Everything worked flawlessly, even when the reactor was dealing with several failures at once.

“We put the system through its paces,” Marc Gibson, the lead Kilopower engineer at NASA Glenn, said in a statement. “We understand the reactor very well, and this test proved that the system works the way we designed it to work. No matter what environment we expose it to, the reactor performs very well.”

This is great news for NASA, which has struggled since its inception to integrate nuclear reactors and space exploration. After billions of dollars spent on nuclear reactor designs that never made it to orbit, much less the moon, the KRUSTY program was the first successful test of a nuclear reactor intended for space applications over half-a-century. In fact, it is the first new operable fission reactor concept designed in the US in over 40 years. It heralds the beginning of a nuclear-powered era of space exploration, which will open the door to previously impossible missions into deep space, whether this is powering settlements on Mars or using robotic submarines to explore the icy oceans of Jovian moons.

On the moon and Mars, the most likely candidates for future human settlements, sources of energy are hard to come by. Unless Mars was once home to organic life, we’re not going to find any oil or coal there since these fossil fuels are mostly formed from dead plant matter. (Although Mars may harbor pockets of methane gas.) If Mars ever had an ocean or rivers, they have long since dried up, so no hydropower. The moon has no atmosphere and thus no way to harvest wind energy. Parts of the face of the moon can be shaded from the sun for stretches lasting up to 14 days, whereas Mars’ distance from the sun makes it hard to harvest enough solar power on the surface to power a rover, much less an entire settlement.

“When we start sending astronauts for long stays on the Moon and to other planets, that’s going to require a new class of power that we’ve never needed before,” Gibson said.

An artist's depiction of a Kilopower reactor on the lunar surface. Image: NASA

Shipping oil, coal, or the components for vast solar arrays to the moon or Mars is far too resource intensive to be practical—that stuff is heavy, and every pound sent to space costs about $10,000 to get there. NASA needed a relatively lightweight, yet highly efficient energy source if it ever hoped to establish a long-term human presence on the moon or Mars.

Enter uranium-235, the radioactive material that powers nuclear power plants around the world and is one of the most energy dense materials known on Earth. In fact, just one pound of enriched uranium fuel can produce as much energy as about 3 million pounds of coal.

  READ MORE: WHAT IS URANIUM?

NASA only needs a few dozen kilowatts worth of power for its initial lunar or Martian outposts. Since most nuclear power plants on Earth are designed to produce hundreds of kilowatts electricity, this meant that Gibson and his colleagues would have to come up with a new fission reactor design. Not only would it have to be compact enough to fit in a rocket fairing, it would also have to be powerful enough to host a settlement and designed in such a way that it could withstand the harsh space environment. If Gibson and his colleagues were successful, it would be an unprecedented feat of nuclear engineering.

In the last half century, over 40 nuclear reactors have been sent to space and almost all of them were Soviet. The only nuclear reactor that the US has ever sent to space was the SNAP-10A, a reactor developed by the Atomic Energy Agency and launched in 1965 to test its feasibility as a power supply for the CORONA satellite spy program. The reactor was able to produce 500 watts of power and was in low earth orbit for 43 days before the Air Force decommissioned the satellite. It is still in orbit as a piece of space junk and is predicted to remain there for another 4,000 years. Nevertheless, nuclear power continued to play a major role in US space exploration, even if reactors had been tossed to the wayside.

[]

Since the 1960s, almost every major NASA mission into deep space has relied on electricity produced by radioisotope thermoelectric generators (RTGs). These types of electric generators have no moving parts and don’t rely on nuclear fission. Instead, an array of electric conductors harvest the heat released by the natural decay of radioactive material (usually plutonium) and convert this heat into electrical energy.

RTGs powered the Voyager 1, the first spacecraft to enter interstellar space; they powered the Cassini mission to Saturn for 20 years; they powered the New Horizons mission to Pluto and beyond; and continue to power a number of satellites and rovers on and around Mars. They are an ideal power supply for spacecraft insofar as they can produce a steady supply of electrical energy for decades with a relatively small amount of fuel. RTGs are, however, limited to an output of a few hundred watts. While this is enough to meet the demands of most spacecraft, which need to take measurements and communicate with Earth, more demanding robotic missions, like sending a submarine into the oceans of Europa, will demand a lot more energy.

Nuclear fission is the process of splitting the nucleus of an atom, usually with a neutron, which releases a tremendous amount of energy. At the same time, the split knocks other neutrons loose from the nucleus, which themselves split other atoms. This results in a cascading process of nuclear fission and a constant supply of heat energy. This process has been used to make the most destructive weapons ever created, as well as providing a relatively clean source of energy for civilian applications. (The downside of nuclear energy is that we still don’t know how to properly dispose of the waste, which remains radioactive for tens of thousands of years.) In a nuclear reactor, the heat released by splitting the nucleus of an atom—usually uranium-235—is used to heat water and generate steam, which turns a turbine to generate electricity.

While this works well enough on Earth, conventional power plants are too big to build on the moon or Mars, and definitely wouldn’t fit inside a spacecraft. Smaller fission reactors are found on naval vessels like aircraft carriers and submarines, but these types of reactors also use steam to generate electricity. This precludes them from being adapted to space applications because they require a lot of water to work and water is a precious commodity in space.

NASA considered various reactor designs for space applications after launching its only reactor in 1965, but most of these designs were considered too expensive to make and would require too much of a runway to ever be made in time for particular missions. The SP-100 reactor prototype developed in the 1980s was terminated after a decade and more than a billion dollars was spent on research. NASA’s Project Prometheus began in the early 2000s to investigate the use of nuclear reactors in space for propulsion and powering flight systems, but was terminated after nearly $400 million was spent on research and development.

The Kilopower reactor is put in a vacuum chamber for the KRUSTY project. Image: NASA

BUILDING A BETTER NUCLEAR REACTOR

After decades of failing to take a reactor design from paper into orbit, NASA joined forces with the Department of Energy and Lockheed Martin in 2008 to pursue a nuclear power source called an advanced Stirling radioisotope generator (ASRG) that would be four times as efficient as RTGs. The efficiency gains result from using a Stirling converter, a type of engine that relies on the heating and cooling of a gas to convert heat energy into electricity. The basic idea was that energy released by natural radioactive decay would be used to heat a gas, which would then expand. This pressure created by the expanding gas would be used to power an electric generator to produce electricity for a spacecraft. It was a novel design, but the research program on ASRG was mothballed in 2012 after costs began to drift tens of millions of dollars over budget without an end in sight.

That same year, however, researchers at NASA Glenn and the DOE’s Los Alamos National Laboratory achieved a breakthrough in a different type of nuclear power source that also relied on a Stirling converter. Keeping with the _Simpsons_ themed acronyms, the Demonstration Using Flattop Fissions (DUFF) used nuclear fission, rather than natural radioactive decay, as an energy source for a Stirling converter. The energy produced during fission is used to heat a sodium fluid in a “heat pipe,” and this heat is used to drive a Stirling converter which converts the heat energy into the mechanical motion needed to drive an electrical generator.

Although DUFF only produced about 24 watts of power during its tests—not enough to power most light bulbs—it was the first successful test of a nuclear reactor intended for space applications made by NASA in nearly half-a-century. Its design prefigured Kilopower, which built on insights gleaned from the experiment to create a working prototype.

The Kilowatt reactor prototype that has been tested over the last few months uses two Stirling converters (the reactors that will eventually be sent to space will have eight converters) to produce up to 1 kilowatt of power. It’s core is a solid piece of uranium-235 that is about the size of a paper towel roll and a rod of boron carbide acts as a neutron moderator to control the bombardment of the uranium by neutrons. Before flight, the boron carbide would be fully inserted into the reactor to prevent a fission reaction. Once it is extracted, however, the fission reaction will begin and cannot be stopped completely, although the rate of fission—and hence heat output—can be controlled by the depth of the boron rod in the reactor. The heat from the fission reaction is used to heat liquid sodium, which transfers this heat to eight Stirling engines that convert the heat into mechanical motion to drive electric generators and produce electricity. The StirlingStriling engines used in the prototype were repurposed from the failed ASRG experiments, although McClure said custom Stirling engines will be developed for missions in the future.

One of the most staggering things about this design, however, is that this working nuclear reactor prototype was produced for only $18 million, an order of magnitude less than previous designs that never made it beyond the drawing board.

“When we got started, we looked at all the projects that had gone on before us,” Patrick McClure, the lead Kilopower engineer at Los Alamos National Laboratory told me on the phone. “We felt they made some mistakes by trying to build what I’m going to call a ‘sporty’ reactor. By sporty I mean they’re trying to get a lot of power for as low of a weight as possible. Some of their design choices were really pushing the bounds of engineering.”

An artist conception of four Kilopower units on Mars. NASA estimates that four reactors could power an initial outpost for a decade. Image: NASA

Rather than trying to reinvent the wheel, McClure said he and his colleagues working on Kilopower opted for more simple, cost effective reactor designs.

“We’d much rather have a reactor that’s real then one that’s a great design, but only exists on paper," McClure said. "We don’t want this to die.”

McClure told me that he and his colleagues are excited that the reactor works, but that there’s still a lot of work to do before it gets to space, much less a lunar or Martian colony. In addition to a safety review by NASA and an “ independent, interagency nuclear safety review panel,” it will need to be integrated into a specific mission so that the prototype can be designed to accommodate that mission’s needs. He said the Kilopower team is working with NASA management to determine the future of Kilopower, which will need to be tested in space before it's brought to the surface of the moon or Mars.

“We're excited and relieved that we got the test done, but anxious about where we go next,” McClure said. “Our ultimate goal is to get a nuclear reactor back in space, and if NASA’s ever going to use the reactor, you have to prove to the folks doing missions that it will really work in space.”

“There's clearly a desire to try to put one on the moon, but that might not happen until the mid-2020s,” McClure added. “The team would like to get one in space before then, but in the meantime we’ve got to convince some people.”

question: What does the text say about the relationship between a settlement on Mars  and the Kilopower reactor?

text: Specify that the four reactors could only sustain the outpost for a decade.

answer: Mars is one of the most likely candidates for future human settlements. However, sources of energy are hard to come by there. Fossil fuel, hydropower, and solar power cannot be obtained on Mars. Additionally, shipping oil or coal would be too resource intensive. This is where the reactor and uranium-235 come into play, as it's a lightweight and highly efficient energy source. The reactor also needed to be compact enough to fit a rocket fairing, powerful enough to host a settlement, and able to withstand the harsh space environment. Four of the Kilopower reactors would be enough to sustain a decent sized outpost on Mars for about a decade.

text: The answer should mention the Kilopower reactor's power output.

text: The answer should mention that the Kilopower reactor is the first new operable fission reactor concept designed in the US in over 40 years.

text: The answer should mention the power output of the reactor.

text: The answer omits the necessity of the Kilopower reactor for the establishment of a human presence on Mars.

text: The answer should mention the KRUSTY program.

text: The answer should mention that the Kilopower reactor will allow for the establishment of a permanent human presence on Mars.

text: The answer can be more specific about the reactor.

text: The piece of information about the Kilopower reactor "able to withstand the harsh space environment" is not relevant.

answer: The Kilopower reactor is an experimental portable nuclear power plant that can deliver 10 kilowatts of energy. It is the size of a refrigerator and would be capable of powering 10 American homes on Earth. An array of four Kilopower reactors would be enough to sustain a decent-sized outpost on the moon or Mars for about a decade.

text: The question is asking for the relationship, so it wants to define the connection between the reactor and the settlement. The current response touches briefly on this but focuses more on explaining what the reactor is. Provide additional details related to how the reactor will be used in the Mars settlement.

answer: Mars is one of the most likely candidates for future human settlements. However, sources of energy are hard to come by there. Fossil fuel, hydropower, and solar power cannot be obtained on Mars. Additionally, shipping oil or coal would be too resource intensive. This is where the reactor and uranium-235 come into play, as it's a lightweight and highly efficient energy source. The reactor also needed to be compact enough to fit a rocket fairing, powerful enough to host a settlement, and able to withstand the harsh space environment. Four of the Kilopower reactors would be enough to sustain a decent sized outpost on Mars for about a decade.

text: The answer contains irrelevant information.

answer: Mars is one of the most likely candidates for future human settlements. However, sources of energy are hard to come by there. Fossil fuel, hydropower, and solar power cannot be obtained on Mars. Additionally, shipping oil or coal would be too resource intensive. This is where the reactor and uranium-235 come into play, as it's a lightweight and highly efficient energy source. The reactor also needed to be compact enough to fit a rocket fairing, powerful enough to host a settlement, and able to withstand the harsh space environment. Four of the Kilopower reactors would be enough to sustain a decent sized outpost on Mars.

text: The answer should mention the specific energy output of the Kilopower reactor.

text: The answer should mention the Kilopower's ability to produce 10 kilowatts of energy.

text: The answer should mention that the Kilopower reactor is a nuclear reactor.

text: The answer should mention that the reactor is currently being tested.

text: The highlighted section seems redundant and should be removed.

answer: Mars is one of the most likely candidates for future human settlements. However, sources of energy are hard to come by there. Fossil fuel, hydropower, and solar power cannot be obtained on Mars. Additionally, shipping oil or coal would be too resource intensive. This is where the reactor and uranium-235 come into play, as it's a lightweight and highly efficient energy source. The reactor also needed to be compact enough to fit a rocket fairing, powerful enough to host a settlement, and able to withstand the harsh space environment. Four of the Kilopower reactors would be enough to sustain a decent sized outpost on Mars.

text: The response should be consolidated into a shorter summary. The first sentence is unnecessary.

answer: The Kilopower reactor is an experimental portable nuclear power plant that can deliver 10 kilowatts of energy. It is the size of a refrigerator and would be capable of powering 10 American homes on Earth. An array of four Kilopower reactors would be enough to sustain a decent-sized outpost on the moon or Mars for about a decade.

text: The answer should mention the power source on Mars.

text: The answer is irrelevant.

text: The answer should mention the problems with other power sources on Mars.

text: The answer is not related.

text: The answer includes unnecessary information

text: The answer does not explain the relationship between the Kilopower reactor and a settlement on Mars.

text: The text does not discuss a pyramid or its construction.


text:
_HOW DOCTORS THINK_ is a book released in March 2007 by Jerome Groopman, the Dina and Raphael Recanati Chair of Medicine at Harvard Medical School, chief of experimental medicine at Beth Israel Deaconess Medical Center in Boston, and staff writer for _The New Yorker_ magazine.[1]

The book opens with a discussion of a woman in her thirties who suffered daily stomach cramps and serious weight loss, and who visited some 30 doctors over a period of 15 years. Several misdiagnoses were made before she was finally found to have celiac disease.[2] Groopman explains that no one can expect a physician to be infallible, as medicine is an uncertain science, and every doctor sometimes makes mistakes in diagnosis and treatment. But the frequency and seriousness of those mistakes can be reduced by “understanding how a doctor thinks and how he or she can think better”.[3]

The book includes Groopman's own experiences both as an oncologist and as a patient, as well as interviews by Groopman of prominent physicians in the medical community. Notably, he describes his difficulties with a number of orthopedic surgeons as he sought treatment for a debilitating ligament laxity he suffered in his right hand, which over several years had led to the formation of cysts in the bones of his wrist.[4]

Salem's challenge

Groopman spends a great deal of the book discussing the challenge posed to him by Dr. Deeb Salem, chairman of the Department of Internal Medicine at Tufts-New England Medical Center, during a presentation the author made at their hospital grand rounds. During the presentation, Groopman was discussing the importance of compassion and communication in providing medical care when Salem posed the following question:

  There are primary care physicians in every hospital who speak with great sensitivity and concern, and their longtime patients love them, but clinically they are incompetent--how is a patient to know this?[5]

At the time of the presentation, Groopman was unable to provide a satisfactory response. Salem's question reminded Groopman of his experiences with physicians at the Phillips House of the world-renowned Massachusetts General Hospital, where he trained as a resident in the 1970s. Per his account:

  A few of [the physicians at Philips House] were highly skilled, but several were, at best, marginal in their clinical acumen. Nonetheless, their patients were devoted to them. It was the job of the residents to plug the holes in these marginal doctors' care. Just as a physician has to be wary of his first impression of a patient's condition, as a patient you have to be careful of your first impression of a physician...Thankfully, fewer students are admitted to medical school now because of social standing and family connections than at the time of my training. America has become more of a meritocracy in the professions. Medical school admissions committees no longer accept a record of gentlemen's C's at an Ivy League college.
  At best, I said to Salem, a layman should inquire of friends and, if possible, other physicians as well as nurses about the clinical qualities of a doctor beyond his personality. His credentials can be found on the Internet or by contacting a local medical board...Salem's query required a much more comprehensive answer, which I hope this book will help provide.[6]

The availability heuristic

Early in the work, Groopman discusses the work of Amos Tversky and Nobel laureate Daniel Kahneman, psychologists from Hebrew University in Jerusalem. Specifically, he explores their development in the early 1980s of a concept known as the availability heuristic.[7]

In the theory, “availability” is defined as the tendency to judge the likelihood of explanation for an event by the ease with which relevant examples come to mind. In a clinical situation a diagnosis may be made because the physician often sees similar cases in his practice — for example, the misclassification of aspirin toxicity as a viral pneumonia, or the improper recognition of an essential tremor as _delirium tremens_ due to alcohol withdrawal in an indigent urban setting. Groopman argues that a clinician will misattribute a general symptom as specific to a certain disease based on the frequency he encounters that disease in his practice.[8]

Kahneman won the Nobel Prize in economics in 2002 for his work on heuristics, an honor that Groopman believes Tversky would have shared had he not died in 1996.[9]

Lack of recognition for gatekeepers

Groopman also serves as an advocate for primary care physicians in his book. He argues that gatekeeper physicians are underreimbursed for their work, believing this to be a legacy of the period earlier this century when surgeons headed the medical societies that negotiated with insurers about what a 'customary' payment for services was to be.[10]

He suggests that the poor reimbursement and lack of recognition for primary care physicians is fundamentally flawed. He quotes Dr. Eric J. Cassell's book, _Doctoring: The Nature of Primary Care Medicine_, to defend his assertion:

  A common error in thinking about primary care is to see it as entry-level medicine...and, because of this, rudimentary medicine...This is a false notion. One should not confuse highly technical, even complicated, medical knowledge--special practical knowledge about an unusual disease, treatment, condition, or technology--with the complex, many-sided worldly-wise knowledge we expect of the best physicians.
  The narrowest subspecialist, the reasoning goes, should also be able to provide this [broad] range of medical services. This naive idea arises, as do so many other wrong beliefs about primary care, because of the concept that doctors take care of diseases. Diseases, the idea goes on, form a hierarchy from simple to difficult. Specialists take care of difficult diseases, so, of course, they will naturally do a good job on simple diseases. Wrong. Doctors take care of people, some of whom have diseases and all of whom have some problem. People used to doing complicated things usually do complicated things in simple situations--for example, ordering tests or x-rays when waiting a few days might suffice--thus overtreating people with simple illnesses and overlooking the clues about other problems that might have brought the patient to the doctor.[11]

The fallacy of logic

In a later chapter Groopman reports a frank discussion with Dr. James E. Lock, chief of cardiology at Boston Children's Hospital. During their conversation, Groopman asks the world-renowned cardiologist about the times in his career when he made mistakes in patient treatment.[12]

To the query, Lock gives the cryptic response, “All my mistakes have the same things in common.”[13]

Lock then elaborates, discussing recommendations he made to repair specific heart defects in neonates that ultimately led to worse clinical outcomes and potentially avoidable deaths. The recommendations he made were based on a purely logical understanding of cardiac physiology.[14] The crucial point of Lock's discussion came with his confession:

  Impeccable logic doesn't always suffice. My mistake was that I reasoned from first principles when there was no prior experience. I turned out to be wrong because there are variables that you can't factor in until you actually do it. And you make the wrong recommendation, and the patient doesn't survive. I didn't leave enough room for what seems [sic] like minor effects--the small fluctuations in oxygen levels, which might amount to one or two or three percent but actually can signal major problems in the heart....[The proposed treatment] is very sound logic. But it's wrong...These children developed right heart failure and clinically they became worse. There are aspects to human biology and human physiology that you just can't predict. Deductive reasoning doesn't work for every case. Sherlock Holmes is a model detective, but human biology is not a theft or a murder where all the cues can add up neatly.[15]

Groopman goes on to write, “Lock averted his gaze and his face fell; to be wrong about a child is a form of suffering unique to his profession [as a pediatrician].”[16]

Disregard of uncertainty

Groopman also discusses the work of Renee Fox, a physician and occupational sociologist who observed residents and attendings in a hospital ward setting, noting their various ways of coping with the uncertainties of medical treatment. The mechanisms to cope that Fox observed included, for example, black humor, making bets about who would be right about a patient's prognosis, and engaging in magical thinking to maintain a sense of poise and competence in front of patients while performing circumspect procedures.[17]

Jay Katz, a clinical instructor at Yale Law School has since termed these coping mechanisms under the rubric 'disregard of uncertainty', which he believes physicians develop to deal with the anxiety of shifting from the certainty of theoretical discussions of medicine early in their training to its more happenstance practical application.[18]

Groopman recalls that in situations where he had been hesitant to take clinical action based on incomplete data, it had been wisest at times to follow the advice of his mentor Dr. Linda A. Lewis: “Don't just do something, stand there.” Groopman asserts that there exist situations in which inaction may be the wisest course of action.[19]

Suggestions for patients

Groopman closes with an epilogue giving advice for patients. He gives the following tools that patients can use to help reduce or rectify cognitive errors:

-   Ask WHAT ELSE COULD IT BE?, combating satisfaction of search bias and leading the doctor to consider a broader range of possibilities.
-   Ask IS THERE ANYTHING THAT DOESN'T FIT?, combatting confirmation bias and again leading the doctor to think broadly.
-   Ask IS IT POSSIBLE I HAVE MORE THAN ONE PROBLEM?, because multiple simultaneous disorders do exist and frequently cause confusing symptoms.
-   TELL WHAT YOU ARE MOST WORRIED ABOUT, opening discussion and leading either to reassurance (if the worry is unlikely) or careful analysis (if the worry is plausible).
-   RETELL THE STORY FROM THE BEGINNING. Details that were omitted in the initial telling may be recalled, or different wording or the different context may make clues more salient. (This is most appropriate when the condition has not responded to treatment or there is other reason to believe that a misdiagnosis is possible.)

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

[9]

[10]

[11]

[12]

[13]

[14]

[15]

[16]

[17]

[18]

[19]

title: How Doctors Think

question: What does the text say about Jerome Groopman?

text: Groopman did not have a child patient dying following a wrong recommendation. It was Dr. James Lock's confession to Groopman.

answer: Jerome Groopman is the Dina and Raphael Recanati Chair of Medicine at Harvard Medical School, chief of experimental medicine at Beth Israel Deaconess Medical Center in Boston, and staff writer for The New Yorker magazine. He is the author of How Doctors Think. He is an oncologist.

text: Groopman is also a patient.

text: Groopman's book, How Doctors Think, is the main focus of the article, so the answer should mention that the book is about doctors' thinking processes.

text: Omits including Groopman's career as a patient.

text:
The answer omits Groopman's experience as a patient.
The answer should mention that Groopman had difficulties with several orthopedic surgeons as he sought treatment for a debilitating ligament laxity he suffered in his right hand, which had led to the formation of cysts in the bones of his wrist over several years.

answer: Jerome Groopman is an oncologist who writes the book How Doctors Think. He interviews other physicians and concludes that physicians sometimes make mistakes, but understanding how a doctor thinks can help them think better. One time, he gave the wrong recommendation for his patient, who a child, and the child died. Groopman advises patients to know their doctor's credentials, and he gives them tips on how to help their doctor rectify or reduce cognitive errors.

text: The third and fourth sentences are not accurate or relevant so they should be omitted from the answer.

text: "but understanding how a doctor thinks can help them think better." - this does not make sense and should be omitted.

text: "concludes that physicians sometimes make mistakes" - should add that they make mistakes in diagnosis and treatment.

text: It should be mentioned that Gropman, in his book, goes over some beliefs he holds as to why these mistakes are being made by doctors and other things like how primary care doctors are not appreciated enough in the medical system.

text: In the book's epilogue, he gives the readers some tools to help reduce or rectify doctors cognitive errors.

answer: Jerome Groopman is an oncologist who writes the book How Doctors Think. He interviews other physicians and concludes that physicians sometimes make mistakes, but understanding how a doctor thinks can help them think better. He advises patients to know their doctor's credentials, and he gives them tips on how to help their doctor rectify or reduce cognitive errors.

text: The response is missing other key points like Groopman's advocacy for primary care physicians and his inability to provide an answer to the problem of clinically incompetent physicians.

answer: Jerome Groopman is the Dina and Raphael Recanati Chair of Medicine at Harvard Medical School, chief of experimental medicine at Beth Israel Deaconess Medical Center in Boston, and staff writer for The New Yorker magazine. He is the author of How Doctors Think. He is an oncologist.

answer: Jerome Groopman is an oncologist who writes the book How Doctors Think. He interviews other physicians and concludes that physicians sometimes make mistakes, but understanding how a doctor thinks can help them think better. He advises patients to know their doctor's credentials, and he gives them tips on how to help their doctor rectify or reduce cognitive errors.

text: Groopman is also the Dina and Raphael Recanati Chair of Medicine at Harvard Medical School, chief of experimental medicine at Beth Israel Deaconess Medical Center in Boston, and staff writer for The New Yorker magazine.

text: The answer omits Groopman's professional affiliations.

text: The answer omits Groopman's professional background.

text: Groopman is also a professor at Harvard Medical School.

text: Groopman's background is omitted.

text: Groopman is also a writer for The New Yorker.

text: The final sentence is not relevant.

answer: Jerome Groopman is an oncologist who writes the book How Doctors Think. He interviews other physicians and concludes that physicians sometimes make mistakes, but understanding how a doctor thinks can help them think better. One time, he gave the wrong recommendation for his patient, who a child, and the child died. Groopman advises patients to know their doctor's credentials, and he gives them tips on how to help their doctor rectify or reduce cognitive errors.

text: Groopman is not the one who gave the wrong recommendation.

text: Groopman is not the one who made the mistake.

text: Groopman is not a doctor who made a mistake in his practice. He is the author of the book.

text: Groopman is not the one who made mistakes. He is the author of the book.

text: It is not stated that Groopman concludes that physicians sometimes make mistakes.