HM Medical Clinic


Chapter 3: drafting essays

Writing the Essay
Essay writing builds on many of the skills you have already mastered in learning to write a paragraph. Once you know how to write a paragraph, it is not much more difficult to write an essay; an essay is just longer. Simply stated, an essay is a set of paragraphs about a specific subject. Like a paragraph, an essay makes and supports one main point. However, the subject of an essay is too complex to be developed in a few sentences. Several paragraphs are needed to support fully the main point of an essay. A typical essay contains five paragraphs, but many other types of essays are longer or shorter, depending on their purpose. In Chapter 5, you will learn the formula for a five-paragraph essay. Just as knowing the musical scales will help you compose music, understanding basic essay structure will help you write well. Although some essays do not conform to the five-paragraph formula, most follow some pattern of organization. The formula is simply a plan to help you arrange your ideas into a systematic order. It has a recognizable beginning, middle, and end. It is the basic pattern of organization for most academic essays. Parts of an Essay
An essay has three main parts: an introduction, a body, and a
conclusion. Each part has its own special purpose. Briefly, the
introduction provides some background information on the general
subject and states the specific topic in a thesis statement. The body
develops the different main points. The essay ends with a conclusion
that summarizes the main points.
A sample of a five-paragraph essay, "The Mammalian Liver" by Timothy Bell, appears on the next page. The different parts have been labeled for you. The Mammalian Liver The mammalian liver is an organ that performs many important homeostatic functions. It is the largest gland in the body, lying mainly in the upper right abdominal cavity, under the diaphragm. The structure of the liver is closely related to its function. As health sciences students study about this vital organ, they will discover the major functions of the liver are control of sugar, regulation of proteins, and detoxification. The liver uses insulin to remove glucose from or add glucose to the blood. Inside the liver cel s, the glucose is either built up into glycogen for storage or broken down into carbon dioxide and water with the liberation of energy. If in considerable excess, it is converted Likewise, the liver must deal with excess proteins and amino acids since the body is unable to store them. Liver cel s break down excess amino acids, brought to the liver by the hepatic portal vein. In this process the amino group is removed from the amino acid, with the formation of ammonia. Ammonia, which is toxic, enters the ornithine cycle and is converted to urea. Final y, the liver cel s detoxify many poisonous substances by absorbing them and changing them chemical y. For example, hydrogen peroxide, a highly toxic by-product of certain metabolic pathways, is rapidly split into water and oxygen by the enzyme catalase. Catalase is found in large quantities in the liver. In conclusion, health sciences students should be aware that the liver performs many important functions in maintaining a healthy body and, therefore, homeostasis. The liver synthesizes certain vital substances required by the body, and stores compounds which are of no immediate use. In addition, it purifies the blood that passes Most formal essays begin with an introductory paragraph. In some ways, the introduction is the most important paragraph of your essay. Because it is the first one that will be read, it must capture the attention of the audience and create a desire to read the rest of the essay. It should set the stage for what follows and give the reader an idea of what to expect.  Provides background information  Captures the reader's interest  Indicates the pattern of organization  States the thesis While there are no set rules for writing an introduction, there are several techniques that have proven successful. Many introductions use one or a combination of the techniques on the next page to provide background information and capture the reader's attention. What they have in common is the movement from a general statement on the subject that leads the reader to the more specific thesis statement. This type of introduction opens with the definition of a key term and then leads the reader to the more specific thesis statement. Cystic fibrosis (CF) is a severe autosomal recessive disease that results in a patient's inability to breathe. Many patients die before the age of 30. Researchers have discovered the gene responsible for CF by searching for links between inheritance of CF and its known markers. Once they discovered the nucleotide sequence of the CF gene – now known to be chromosome 7 – they were able to look for a mutation. Upon finding the most common mutation, they observed that a codon was missing, which led them to believe that a phenylalanine would also be missing in the CF protein. This discovery, in turn, led them to an understanding of how the body may be harmed by a defective CF protein.  Interesting Story This second type of introduction opens with an interesting story related to the general topic of the essay. It captures the reader's attention before leading to the restricted thesis of the piece. Jeanne Marie Laskas, in "The Doctor Is In," reveals the story of America's oldest physician, Dr. Leila Denmark. At 101 years of age, Dr. Denmark, who has been practicing medicine for over seven decades, continues to see patients in her run-down, simply furnished office not far from Atlanta, Georgia. She became a doctor by chance, needing to fil time while her then-fiancé was working on an overseas assignment. Since her husband supported them both, she never had to "make a dime on medicine." Even today, she only charges eight dol ars a visit. Dr. Denmark claims her longevity is due to her diet – no juice, no junk food, and three meals a day, each five and a half hours apart. This essay examines three benefits of following a diet similar to that of Dr. Denmark.  Fact or Statistic Presenting an interesting fact or statistic on your subject establishes creditability. Cholera is a life-threatening disease first identified in India some 300 years ago. It began to spread throughout Asia and from there to the rest of the world. A number of worldwide outbreaks – each lasting about a decade – occurred in the nineteenth century. After some investigation, it was learned that the bacterium responsible for the disease was spread along trade routes by movements of population. A clear understanding of this highly infectious, and frequently deadly, disease can best be obtained through a study of its causes, symptoms, and treatment. Use of a quotation related to your subject is an easy way to introduce your topic. You can quote an authority on your subject or use an interesting quotation from an article related to your topic. Biologist Joseph Santini writes, "PGD (pre-implantation genetics diagnosis) itself is very controversial, inciting angry cries from politicians, doctors and anti-abortion groups. The particular case of Adam Nash, however, has raised an even greater storm of controversy; Adam Nash was chosen, not only for his disease-free status, but for his bone marrow status and genetic composition." Santini is referring to the test-tube baby born to be a transplant donor thanks to a genetic test original y invented to check whether embryos carry an inherited disease. Doctors used PGD to ensure that Adam, as an embryo, was free of the gene responsible for Franconi anemia, the often fatal disorder affecting his six-year-old sister. Such diagnostic techniques have given rise to debate concerning their ethical use. The debate centers on three major objections to their use. It is sometimes difficult to think how to divide your topic into three or more main points. However, there are a number of common ways to divide a subject into three parts based on the essay's pattern of organization. For example, if your general subject is effects of infectious diseases, there are several possibilities. You might think about time and describe the effects of infectious diseases in the past, present, and future. In addition, you might consider people and write about the effects on children, adults, and the elderly. Still another way would be to analyze the effects of infectious diseases on society, economically, educationally, and socially. A further example is dividing your main points into etiology, symptoms, and treatment if your subject were restricted to a description of malaria. Directions: Discuss how the general topics below could be organized. Based on the particular
pattern of organization, discuss some possible main points. Afterwards, choose one of the
topics and write an introductory paragraph using one of the four types of opening sentences
discussed on page 63.
1. healthy diets 2. diabetes 3. cigarette smoke 4. the overuse of antibiotics 5. digestion A thesis sentence is probably the most important sentence in an essay since it introduces the
specific topic and establishes the main points to be covered. Think of your thesis statement as
the blueprint for a house. Without specific plans, the builder would have no guidelines to
follow as he or she constructs the house. As a result, the completed building might have
structural flaws. Similarly, many beginning writers' essays often have no cohesion and ramble
from topic to topic because of faulty thesis sentences. The problem usually can be traced to
one or more of three specific mistakes: too broad a subject, more than one subject, and vague
or non-parallel main points.
Directions: Analyze the thesis sentences below and on the next page. Are their subjects too
broad? Do they have more than one topic? Are the main points vague or non-parallel? After
discussing the problem areas with your classmates, rewrite the thesis sentences.
1. This paper will examine the alimentary system, the cardiovascular system, and how the systems theory is used in clinical medicine. 2. Everyone has had a common childhood disease. 3. This cause and effect essay covers the cause and effects of hemorrhagic strokes and how they can be prevented. 4. Inflammation of the respiratory mucous membranes – known as the common cold – and dermatomycosis – known as ringworm – have specific causes, effects, and treatments. 5. AIDS is a terrible disease that claims millions of lives each year. 6. Digestion and metamorphosis are processes. The body of an essay consists of several paragraphs that develop and support the thesis. Each body paragraph develops one point from the thesis sentence. These paragraphs all begin with a topic sentence that states the main point. This sentence is followed by one or more major supporting sentences in which the main point is divided into sub-points. Minor supporting sentences support major supports with related details, facts, and examples. When writing body paragraphs, remember that they should be arranged in the order in which they were listed in the thesis sentence. The body paragraphs below, taken from an essay by student Obinna Ezeamuzie, illustrate the principles of body paragraphs. The author's topic is a definition of asthma based on its predisposing factors, symptoms and treatment. Although scientists do not know what causes asthma, they do know it is a disease that may be congenital or it can be triggered by certain substances or events. It can be passed from parent to offspring. In general, there is a one in six chance of a child inheriting the disease from his or her parents if either of them is asthmatic. In addition, asthma can be triggered. These triggers include airborne allergens, viral infections, chemicals, pollutants and emotional upsets. Common examples of these triggers are dust, pol en, certain viruses, cigarette smoke, carbon dioxide and feelings of severe misery or sadness. Once triggered, asthma produces a range of chest/lung-related symptoms associated with breathing. These symptoms start off in the early stage as wheezing and severe coughing, which are usual y the first signs of asthma. Signs of chest retractions may fol ow as it becomes difficult for the patient to draw sufficient air into the lungs, thus causing a change in chest cavity expansion during breathing. Most children breathe noticeably faster than usual during an asthma episode in order to compensate for insufficient airflow. This condition is known as tachypnea. It also causes difficulty in breathing as inhalation and exhalation are affected. In the long run, individuals wil develop longer expiration than usual as a means to combat the difficulty in breathing. Avoidance, immunotherapy and pharmacological management are the three main treatments, or management methods, for asthma. As often stated, prevention is better than cure; thus, asthma patients must avoid the abovementioned triggers whenever possible. Immunotherapy may follow when indicated by a doctor. This may involve al ergy shots where a certain amount of al ergen is injected into the body and increased over time. This wil get the body accustomed to this chemical and, thus, eliminate a reaction to the al ergen over time. Long-term treatment may involve pharmacological management. One method of such treatment is the use of inhalers, which is the most common method of treatment. Inhalers are required to be used on a weekly basis, depending on the intensity of the condition. Anti- inflammatory medications, such as inhaled corticosteroids, can also be used in more severe cases. Explanation: Having divided his subject into three parts – predisposing factors, symptoms, and treatment – the author discusses each main point in the order it was listed in the thesis sentence in his introduction. Each body paragraph begins with a topic sentence stating the main point. Each main point is further divided into sub-points. For example, in the third body paragraph, treatments are divided into avoidance, immunotherapy, and pharmacological management. Additionally, the author is careful to develop each of these major supports in the order he lists them in his topic sentence. In his minor supporting sentences, he adds examples such as allergy shots, inhalers, and corticosteroids to further develop his major supports. Directions: After reading the introductory paragraph below, use relevant information from
the list that follows the introduction to write three body paragraphs. You will not be able to
use all information from the list.
Rheumatoid arthritis (RA) affects approximately 2.1 million Americans, according to the Arthritis Foundation. Most patients diagnosed with RA are between the ages of 35-50 years old. However, some people as young as 20 are also diagnosed with the disease. Women are nearly three times more likely than men to develop RA and typically experience a more severe and debilitating form of the disease. It is a difficult disease to manage due to the increasing and decreasing nature of its symptoms, and prognosis is directly related to onset of the disease. This chronic disease can be described according to effects, symptoms, and 1. Symptomatic medications such as aspirin, analgesics, glucocorticoids 2. Shape and alignment lost by involved joint, resulting in pain and loss of 3. Use of retin A to reduce wrinkles resulting from exposure to sun 4. Symptoms of fatigue, soreness, stiffness, aching 5. Autoimmune disease 6. Smoking linked to cancer 7. Non-pharmacological therapy such as physical therapy 8. Joints closest to the fingernails (except the thumb) usually not affected 9. Disease-modifying medication of biologic agents 10. Unknown cause 11. Joint deformities such as subluxation of the wrists 12. Diagnosed based on overal symptoms, X-rays, laboratory tests 13. Immune system not working as it should 14. Development of RA influenced by some genes 15. Disease-modifying modifications of low doses of methotrexate, leflunomide, sulfasalazine, gold therapy, minocycline 16. Resulting in healthy joint tissue attacked by immune system 17. Costs U.S. economy nearly $65 bil ion per year in medical care and indirect 18. Effects elbows, shoulders, neck, knees, hips, ankles 19. Bone and cartilage digested by enzymes released by inflammatory cel s 20. Over prolonged period of time, results in damage to inflamed joints 21. Triggered by agent-like viruses in people with inherited tendency for RA 22. Influenced by genetic marker called HLA-DR4 23. Prosorba therapy for people with moderate to severe RA who have not responded wel to disease modifying anti-rheumatic drugs (DMARDs) 24. Symptoms of loss of appetite, fever, loss of energy, anemia, rheumatoid nodules (lumps of tissue under the skin) 25. Corticosteroids to rapidly and effectively reduce inflammation and relieve The final paragraph of your essay is the conclusion. This last paragraph summarizes, without using the same words, the main points you have made in the body of your essay. Your concluding paragraph should also leave your reader agreeing, disagreeing, or at least thinking about your thesis. Restates the thesis Restates the purpose Summarizes the main points Depending on the topic, suggests a solution, comes to a conclusion, or makes a prediction Depending on your topic, you may choose to suggest a solution to a problem raised in the thesis. In conclusion, the debate continues over which is the best treatment for patients suffering from rheumatoid arthritis. Some physicians advocate a regimen of symptomatic medications such as glucocoticoids while others argue for the use of a combination therapy of these medications and disease- modifying medications such as low doses of methotrexate. Stil yet a third group, natural care doctors, claim that a balanced diet and exercise is the best option. However, the best answer may be to recommend treatment based on a case-by-case analysis of patients' conditions. Depending on your topic, you can draw a conclusion after you have restated your thesis sentence and summarized your main points. In summary, cocaine and crack may appear similar at first glance, but in fact they have major differences. Their harmful similar effects on the human body range from physiological and psychological damage to addiction and even possible death. However, they differ in form, content of pure cocaine and method of entry into the body. Therefore, it is important that health sciences professionals are aware of these similarities and differences in order to make accurate diagnoses when patients who use these drugs present for Depending on your topic, you may choose to make a prediction related to your topic and its effect on the future. In summary, early clinical studies of neuraminidase inhibitors have suggested tantalizing trends toward reduced frequencies of influenza-related complications in treated patients. Since complications of influenza such as bacterial superinfection and, more rarely, viral pneumonia are directly related to replication of the virus and damage to respiratory epithelial cel s, early antiviral therapy may forestal the development of some of these problems. Thus, if studies in high-risk adults (e.g., the elderly or those with chronic cardiopulmonary conditions) confirm an effect of early therapy on complications, the potential utility of these agents wil be expanded



Dental Traumatology 2009; 25: 541–544; doi: 10.1111/j.1600-9657.2009.00811.x Management of a complicated crown-rootfracture using adhesive fragment reattachmentand orthodontic extrusionCASE REPORT Ce´lia Tomiko Matida Hamata Saito, Abstract – Dental trauma is more common in young patients and its sequelae Marcos Heidy Guskuma, Je´ssica may impair the establishment and accomplishment of an adequate treatment

Scottish Intercollegiate Guidelines NetworkPart of NHS Quality Improvement Scotland Autism spectrum disordersBooklet for parents and carers We would like to thank all the young people who took part in the focus groups to provide us with their ideas and illustrations for this booklet. © Scottish Intercollegiate Guidelines Network ISBN 978 1 905813 27 8