7 – 10 Page Epidemiology paper – Family Nurse PractitionerRequir

7 – 10 Page Epidemiology paper – Family Nurse Practitioner
Requirements:
This paper should clearly and comprehensively identify the
chronic health disease:
Alcohol Addiction, as this is a chronic disease that is in high
prevalence here in Miami Florida that causes many health
disparities for the community
The paper should be organized into the following sections:
Introduction (Identification of the problem) with a clear
presentation of the problem as well as the significance and a
scholarly overview of the paper’s content. No heading is used
for the Introduction per APA current edition.
Background and Significance of the disease, to include:
Definition, description, signs and symptoms, and current
incidence and/or prevalence statistics by state with a
comparison to national statistics pertaining to the disease. 
Create a table of incidence or prevalence rates by your
geographic county/city or state with a comparison to national
statistics. Use the APA text for formatting guidelines (tables).
This is a table that you create using relevant data, it should not
be a table from another source using copy/paste.
Surveillance and Reporting: Current surveillance methods and
mandated reporting processes as related to the chronic health
condition chosen should be specific.
Epidemiological Analysis: Conduct a descriptive epidemiology
analysis of the health condition. Be sure to include all of the 5
W’s: What, Who, Where, When, Why. Use details associated
with all of the W’s, such as the “Who” which should include an
analysis of the determinants of health. Include costs (both
financial and social) associated with the disease or problem.
Screening and Guidelines: Review how the disease is diagnosed
and current national standards (guidelines). Pick one screening

test (review Week 2 Discussion Board) and review its
sensitivity, specificity, predictive value, and cost.
Plan: Integrating evidence, provide a plan of how a nurse
practitioner will address this chronic health condition after
graduation. Provide three specific interventions that are based
on the evidence and include how you will measure outcomes
(how will you know that the interventions have utility, are
useful?) Note:  Consider primary, secondary, and tertiary
interventions as well as the integration of health policy
advocacy efforts. All interventions should be based on
evidence – connected to a resource such as a scholarly piece of
research.
Summary/Conclusion: Conclude in a clear manner with a brief
overview of the keys points from each section of the paper
utilizing integration of resources.
The paper should be formatted and organized into the following
sections which focus on the chosen chronic health condition.
Preparing the Paper:
Page length: 7-10 pages, excluding title page and references.
APA format current edition
Include scholarly in-text references throughout and a reference
list.
ASSIGNMENT CONTENT
Identification of the Health Problem
Comprehensively and succinctly states the problem/concern.
Clear presentation of the problem as well as the significance
with a scholarly overview of the paper’s content.
Background and Significance of the Health Problem
Background and significance is complete, presents risks, disease
impact and includes a review of incidence and prevalence of the
disease within the student’s state compared to national data.
Evidence supports background. A student created table is
included using APA format.

Current Surveillance and Reporting Methods
Current state and national disease surveillance methods are
reviewed along with currently gathered types of statistics and
information on whether the disease is mandated for reporting.
Supported by evidence.
Descriptive Epidemiological Analysis of Health Problem
Comprehensive review and analysis of descriptive
epidemiological points for the chronic health problem. The 5
W’s of epidemiological analysis should be fully identified.
Supported by scholarly evidence.
Screening, Diagnosis, Guidelines
Review of current guidelines for screening and diagnosis.
Screening tool statistics related to validity, predictive value,
and reliability of screening tests are presented.
Plan of Action
Integrating evidence, provide a plan of how a nurse practitioner
will address this chronic health condition after graduation.
Provide three specific interventions that are based on the
evidence and include how you will measure outcomes (how will
you know that the interventions have utility, are useful?) Note: 
Consider primary, secondary, and tertiary interventions as well
as the integration of health policy advocacy efforts. All
interventions should be based on evidence – connected to a
resource such as a scholarly piece of research.
Conclusion
The conclusion thoroughly, clearly, succinctly, and logically
presents major points of the paper with clear direction for
action. Includes scholarly references

Rubric
Introduction of Healthcare Problem/Concern
Comprehensively and succinctly states the problem/concern.
Clear presentation of the problem as well as the significance
with a scholarly overview of the paper’s content.
Background/Significance
Background and significance is complete, presents risks, disease
impact and includes a review of incidence and prevalence of the
disease within the student’s state compared to national data.
Evidence supports background. A student created table is
included.
Surveillance and Reporting
Current state and national disease surveillance methods are
reviewed along with currently gathered types of statistics and
information on whether the disease is mandated for reporting.
All writing is supported by evidence.
Descriptive Epidemiology
Comprehensive review and analysis of descriptive
epidemiological points for the chronic health problem. The 5
W’s of epidemiological analysis should be fully identifi ed.
Supported by scholarly evidence.
Screening, Diagnosis, Guidelines
Comprehensive review of current guidelines for screening and
diagnosis. Screening tool statistics related to validity,
predictive value, and reliability of screening tests are presented
Plan
Integrating evidence, provide a plan of how a nurse practitioner
will address this chronic health condition after graduation.
Provide three specific interventions that are based on the
evidence and include how you will measure outcomes (how will
you know that the interventions have utility, are useful?) Note: 
Consider primary, secondary, and tertiary interventions as well
as the integration of health policy advocacy efforts. All
interventions should be based on evidence – connected to a
resource such as a scholarly piece of research.
Summary/Conclusion

The conclusion thoroughly, clearly, succinctly, and logically
presents major points of the paper with clear direction for
action. Includes scholarly references.
Format
APA is consistently utilized according to the 6th edition
throughout the paper.
Doctor
Zhivago
BORIS PASTERNAK

A SIGNET BOOK
Published by THE NEW AMERICAN LIBRARY
© 1957 Giangiacomo Feltrinelli Editore, Milano, Italy
© 1958 in the English translation
Wm. Collins Sons & Co., Ltd., London

© 1958 in authorized revisions to the English translation
by Pantheon Books, Inc., New York, New York.
All rights reserved. No part of this book may be
reproduced without permission. For information address
Pantheon Books, Inc., 22 East 51st Street,
New York, New York 10022.
This is an authorized reprint of a hardcover edition
published by Pantheon Books, Inc.
TWENTY-FIRST PRINTING
Translated from the Russian by Max Hayward and
Manya Harari; " The Poems of Yurii Zhivago, "
translated by Bernard Guilbert Guerney.
SIGNET TRADEMARK REG. U.S. PAT. OFF.
AND FOREIGN COUNTRIES

REGISTERED TRADEMARK—MARCA REGISTRADA
HECHO EN CHICAGO, U.S.A.
SIGNET BOOKS are published by
The New American Library , Inc.,
1301 Avenue of the Americas ,
New York , New York 10019
PRINTED IN THE UNITED STATES OF AMERICA
The Principal Characters in This Book
Yurii Andreievich Zhivago (as a child, called Yura;
affectionately, Yurochka) is the son of Andrei Zhivago, a
profligate, and Maria Nikolaievna Zhivago. Evgraf
Andreievich Zhivago, his half-brother, is the son of his father
and Princess Stolbunova-Enrici. Nikolai Nikolaievich
Vedeniapin (Uncle Kolia) is his maternal uncle.
Antonina Alexandrovna Gromeko (Tonia) is the daughter of
Alexander Alexandrovich Gromeko , a professor of
chemistry, and his wife, Anna Ivanovna, whose father was

the landowner and ironmaster Ivan Ernestovich Krueger. As
young people, Yurii Andreievich Zhivago and Misha Gordon,
son of a lawyer, live with the Gromekos.
Larisa Feodorovna Guishar (Lara) is the daughter of a
Russianized, widowed Frenchwoman, Amalia Karlovna
Guishar. Rodion (Rodia) is her younger brother.
Victor Ippolitovich Komarovsky was Andrei Zhivago ' s lawyer
and is Madame Guishar ' s lover and adviser.
Lavrentii Mikhailovich Kologrivov is a rich industrialist; his
wife, Serafima Filippovna; their daughters, Nadia and Lipa.
Pavel Pavlovich Antipov (Pasha, Pashenka) is the son of a
railway worker, Pavel Ferapontovich Antipov. After his father '
s exile to Siberia, he lives with the Tiverzins (Kuprian
Savelievich and his mother, Marfa Gavrilovna), another
revolutionary family of railway workers.
Osip Gimazetdinovich Galiullin (Yusupka), son of Gimazet din,
the janitor at the Tiverzins ' tenement; he is a Moslem.
Innokentii Dudorov (Nika), son of Dementii Dudorov, a
revolutionary terrorist, and a Georgian princess.
Markel Shchapov , porter at the Gromekos ' house, and his
daughter Marina (Marinka).
PART ONE

ONE
The Five-O ' Clock Express
On they went, singing " Rest Eternal, " and whenever they
stopped, their feet, the horses, and the gusts of wind seemed to
carry on their singing.
Passers-by made way for the procession, counted the wreaths,
and crossed themselves. Some joined in out of curiosity and
asked: " Who is being buried? " — " Zhivago, " they were told.
— " Oh, I see. That ' s what it is. " — " It isn ' t him. It ' s his
wife.
" — " Well, it comes to the same thing. May her soul rest in
peace. It ' s a fine funeral. "
The last moments slipped by, one by one, irretrievable. " The
earth is the Lord ' s and the fullness thereof, the earth and
everything that dwells therein. " The priest, with the gesture of
a
cross, scattered earth over the body of Maria Nikolaievna. They
sang " The souls of the righteous. " Then a fearful bustle began.
The coffin was closed, nailed, and lowered into the ground.
Clods of earth rained on the lid as the grave was hurriedly filled
by four spades. A little mound formed. A ten-year-old boy
climbed on it. Only the state of stupor and insensibility which is
gradually induced by all big funerals could have created the
impression that he intended to speak over his mother ' s grave.
He raised his head and from his vantage point absently glanced
about the bare autumn landscape and the domes of the
monastery. His snub-nosed face became contorted and he

stretched out his neck. If a wolf cub had done this, everyone
would have thought that it was about to howl. The boy covered
his face with his hands and burst into sobs. The wind bearing
down on him lashed his hands and face with cold gusts of rain.
A man in black with tightly fitting sleeves went up to the grave.
This was Nikolai Nikolaievich Vedeniapin, the dead woman ' s
brother and the uncle of the weeping boy; a former priest, he
had been unfrocked at his own request. He went up to the boy
and led him out of the graveyard.
2
They spent the night at the monastery, where Uncle Nikolai was
given a room for old times ' sake. It was on the eve of the Feast
of the Intercession of the Holy Virgin. The next day they were
supposed to travel south to a provincial town on the Volga
where Uncle Nikolai worked for the publisher of the local
progressive newspaper. They had bought their tickets and their
things stood packed in the cell. The station was near by, and
they could hear the plaintive hooting of engines shunting in the
distance.
It grew very cold that evening. The two windows of the cell
were
at ground level and looked out on a corner of the neglected
kitchen garden, a stretch of the main road with frozen puddles
on it, and the part of the churchyard where Maria Nikolaievna
had been buried earlier in the day. There was nothing in the
kitchen garden except acacia bushes around the walls and a
few beds of cabbages, wrinkled and blue with cold. With each
blast of wind the leafless acacias danced as if possessed and
then lay flat on the path.

During the night the boy, Yura, was wakened by a knocking at
the window. The dark cell was mysteriously lit up by a
flickering
whiteness. With nothing on but his shirt, he ran to the window
and pressed his face against the cold glass.
Outside there was no trace of the road, the graveyard, or the
kitchen garden, nothing but the blizzard, the air smoking with
snow. It was almost as if the snowstorm had caught sight of
Yura
and, conscious of its power to terrify, roared and howled, doing
everything possible to impress him. Turning over and over in
the
sky, length after length of whiteness unwound over the earth
and
shrouded it. The blizzard was alone in the world; it had no rival.
When he climbed down from the window sill Yura ' s first
impulse was to dress, run outside, and start doing something.
He was afraid that the cabbage patch would be buried so that
no one could dig it out and that his mother would helplessly
sink
deeper and deeper away from him into the ground.
Once more it ended in tears. His uncle woke up, spoke to him
of Christ, and tried to comfort him, then yawned and stood
thoughtfully by the window. Day was breaking. They began to
dress.
3
While his mother was alive Yura did not know that his father
had

abandoned them long ago, leading a dissolute life in Siberia
and abroad and squandering the family millions. He was al ways
told that his father was away on business in Petersburg or at
one of the big fairs, usually at Irbit.
His mother had always been sickly. When she was found to
have consumption she began to go to southern France and
northern Italy for treatment. On two occasions Yura went with
her. He was often left with strangers, different ones each time.
He became accustomed to such changes, and against this
untidy background, surrounded with continual mysteries, he
took his father ' s absence for granted.
He could remember a time in his early childhood when a large
number of things were still known by his family name. There
was
a Zhivago factory, a Zhivago bank, Zhivago buildings, a
Zhivago
necktie pin, even a Zhivago cake which was a kind of baba au
rhum, and at one time if you said " Zhivago " to your sleigh
driver in Moscow, it was as if you had said: " Take me to
Timbuctoo! " and he carried you off to a fairy-tale kingdom.
You
would find yourself transported to a vast, quiet park. Crows
settled on the heavy branches of firs, scattering the hoarfrost;
their cawing echoed and reechoed like crackling wood. Pure-
bred dogs came running across the road out of the clearing
from the recently constructed house. Farther on, lights
appeared in the gathering dusk.
And then suddenly all that was gone. They were poor.
4

One day in the summer of 1903, Yura was driving across fields
in a two-horse open carriage with his Uncle Nikolai. They were
on their way to see Ivan Ivanovich Voskoboinikov, a teacher
and
author of popular textbooks, who lived at Duplyanka, the estate
of Kologrivov, a silk manufacturer, and a great patron of the
arts.
It was the Feast of the Virgin of Kazan. The harvest was in full
swing but, whether because of the feast or because of the
midday break, there was not a soul in sight. The half-reaped
fields under the glaring sun looked like the half-shorn heads of
convicts. Birds were circling overhead. In the hot stillness the
heavy-eared wheat stood straight. Neat sheaves rose above
the stubble in the distance; if you stared at them long enough
they seemed to move, walking along on the horizon like land
surveyors taking notes.
" Whose fields are these? " Nikolai Nikolaievich asked Pavel,
the publisher ' s odd-job man who sat sideways on the box,
shoulders hunched and legs crossed to show that driving was
not his regular job. " The landlord ' s or the peasants ' ? "
" These are the master ' s. " Pavel, who was smoking, after a
long silence jabbed with the end of his whip in another
direction:
" And those are the peasants ' !—Get along, " he shouted at the
horses, keeping an eye on their tails and haunches like an
engineer watching his pressure gauge. The horses were like
horses the world over: the shaft horse pulled with the innate
honesty of a simple soul while the off horse arched its neck like
a swan and seemed to the uninitiated to be an inveterate idler

who thought only of prancing in time to the jangling bells.
Nikolai Nikolaievich had with him the proofs of Voskoboinikov
'
s book on the land question; the publisher had asked the author
to revise it in view of the increasingly strict censorship.
" The people are getting out of hand here, " he told Pavel. " A
merchant in a near-by village has had his throat slit and the
county stud farm has been burned down. What do you make of
it? Any talk of it in your village? "
But evidently Pavel took an even gloomier view than the censor
who urged Voskoboinikov to moderate his passionate views on
the agrarian problem.
" Talk of it? The peasants have been spoiled—treated too well.
That ' s no good for the likes of us. Give the peasants rope and
God knows we ' ll all be at each other ' s throats in no time.
—Get along, there! "
This was Yura ' s second trip with his uncle to Duplyanka. He
thought he remembered the way, and every time the fields
spread out, forming a narrow border around the woods, it
seemed to him he recognized the place where the road would
turn right and disclose briefly a view of the six-mile-long
Kologrivov estate, with the river gleaming in the distance and
the railway beyond it. But each time he was mistaken. Fields
followed fields and were in turn lost in woods. These vast
expanses gave him a feeling of freedom and elation. They
made him think and dream of the future.
Not one of the books that later made Nikolai Nikolaievich
famous was yet written. Although his ideas had taken shape, he

did not know how close was their expression. Soon he was to
take his place among contemporary writers, university
professors, and philosophers of the revolution, a man who
shared their ideological concern but had nothing in common
with them except their terminology. All of them, without
exception, clung to some dogma or other, satisfied with words
and superficialities, but Father Nikolai had gone through
Tolstoyism and revolutionary idealism and was still moving
forward. He passionately sought an idea, inspired, graspable,
which in its movement would clearly point the way toward
change, an idea like a flash of lightning or a roll of thunder
capable of speaking even to a child or an illiterate. He thirsted
for something new.
Yura enjoyed being with his uncle. He reminded him of his
mother. Like hers, his mind moved with freedom and welcomed
the unfamiliar. He had the same aristocratic sense of equality
with all living creatures and the same gift of taking in
everything
at a glance and of expressing his thoughts as they first came to
him and before they had lost their meaning and vitality.
Yura was glad that his uncle was taking him to Duplyanka. It
was
a beautiful place, and this too reminded him of his mother, who
had been fond of nature and had often taken him for country
walks.
He also looked forward to seeing Nika Dudorov again, though
Nika, being two years older, probably despised him. Nika was
a schoolboy who lived at the Voskoboinikovs ' ; when he shook
hands with Yura, he jerked his arm downwards with all his
might

and bowed his head so low that his hair flopped over his
forehead and hid half his face.
5
" The vital nerve of the problem of pauperism, " Nikolai
Nikolaievich read from the revised manuscript.
" Essence would be better, I think, " said Ivan Ivanovich,
making
the correction on the galleys.
They were working in the half-darkness of the glassed-in
veranda. Watering cans and gardening tools lay about, a
raincoat was flung over the back of a broken chair, mud-caked
hip boots stood in a corner, their uppers collapsed on the floor.
" On the other hand, the statistics of births and deaths show, "
dictated Nikolai Nikolaievich.
" Insert ' for the year under review, ' " said Ivan Ivanovich and
made a note. There was a slight draft. Pieces of granite lay on
the sheets as paperweights.
When they finished Nikolai Nikolaievich wanted to leave at
once.
" There ' s a storm coming. We must be off. "
" Nothing of the sort. I won ' t let you. We ' re going to have tea
now. "
" But I must be back in town by night. "

" It ' s no use arguing. I won ' t hear of it. "
From the garden, a whiff of charcoal smoke from the samovar
drifted in, smothering the smell of tobacco plant and heliotrope.
A maid carried out a tray with clotted cream, berries, and
cheese cakes. Then they were told that Pavel had gone off to
bathe in the river and had taken the horses with him. Nikolai
Nikolaievich had to resign himself to staying.
" Let ' s go down to the river while they ' re getting tea ready, "
suggested Ivan Ivanovich.
On the strength of his friendship with Kologrivov, he had the
use
of two rooms in the manager ' s house. The cottage with its own
small garden stood in a neglected corner of the park, near the
old drive, now thickly overgrown with grass and no longer used
except for carting rubbish to the gully, which served as a dump.
Kologrivov, a man of advanced views and a millionaire who
sympathized with the revolution, was abroad with his wife.
Only
his two daughters, Nadia and Lipa, with their governess and a
small staff of servants, were on the estate.
A thick hedge of blackthorn separated the manager ' s house
and garden from the park with its lawns and artificial lakes
which surrounded the main house. As Ivan Ivanovich and
Nikolai
Nikolaievich skirted the hedge, small flocks of sparrows flew
out
at regular intervals. The blackthorn swarmed with them, and
their even chatter accompanied them like water flowing in a

pipe.
They passed the hothouses, the gardener ' s cottage, and the
ruins of some stone structure. They were talking about new
talent in science and literature.
" Yes, there are gifted men, " said Nikolai Nikolaievich; " but
the
fashion nowadays is all for groups and societies of every sort.
Gregariousness is always the refuge of mediocrities, whether
they swear by Solovi ë v or Kant or Marx. Only individuals seek
the truth, and they shun those whose sole concern is not the
truth. How many things in the world deserve our loyalty? Very
few indeed. I think one should be loyal to immortality, which is
another word for life, a stronger word for it. One must be true
to
immortality—true to Christ! Ah, you ' re turning up your nose,
my
poor man. As usual, you haven ' t understood a thing. "
" Hmm, " said Ivan Ivanovich. Thin, fair-haired, restless as an
eel, he had a mocking little beard that made him look like an
American of Lincoln ' s time: he was always bunching it up in
his
hand and nibbling the tip. " I say nothing, of course. As you
know, I look at these things rather differently. But while we ' re
at
it, tell me, what was it like when they unfrocked you? I bet you
were scared. They didn ' t anathematize you, did they? "
" You ' re trying to change the subject. However, why not.…
Anathematize me? No, they don ' t do that any more. It was
unpleasant, and there are certain consequences. For instance,

one is banned from the civil service for quite a long time, and I
was forbidden to go to Moscow or Petersburg. But these are
trifles. As I was saying, one must be true to Christ. I ' ll
explain.
What you don ' t understand is that it is possible to be an
atheist, it is possible not to know whether God exists, or why,
and yet believe that man does not live in a state of nature but in
history, and that history as we know it now began with Christ,
and that Christ ' s Gospel is its foundation. Now what is
history?
It is the centuries of systematic explorations of the riddle of
death, with a view to overcoming death. That ' s why people
discover mathematical infinity and electromagnetic waves, that '
s why they write symphonies. Now, you can ' t advance in this
direction without a certain faith. You can ' t make such
discoveries without spiritual equipment. And the basic elements
of this equipment are in the Gospels. What are they? To begin
with, love of one ' s neighbor, which is the supreme form of
vital
energy. Once it fills the heart of man it has to overflow and
spend itself. And then the two basic ideals of modern man
—without them he is unthinkable—the idea of free personality
and the idea of life as sacrifice. Mind you, all this is still
extraordinarily new. There was no history in this sense among
the ancients. They had blood and beastliness and cruelty and
pockmarked Caligulas who do not suspect how untalented
every enslaver is. They had the boastful dead eternity of bronze
monuments and marble columns. It was not until after the
coming of Christ that time and man could breathe freely. It was
not until after Him that men began to live toward the future.
Man
does not die in a ditch like a dog—but at home in history, while

does not die in a ditch like a dog—but at home in history, while
the work toward the conquest of death is in full swing; he di es
sharing in this work. Ouf! I got quite worked up, didn ' t I? But
I
might as well be talking to a blank wall. "
" That ' s metaphysics, my dear fellow. It ' s forbidden by my
doctors, my stomach won ' t take it. "
" Oh well, you ' re hopeless. Let ' s leave it. Goodness, what a
view, you lucky devil. Though I suppose as you live with it
every
day you don ' t see it. "
It was hard to keep one ' s eyes on the shimmering river, which,
like a sheet of polished metal, reflected the glare of the sun.
Suddenly its surface parted in waves. A big ferry loaded with
carts, horses, and peasants and their women started for the
other shore.
" Just think, it ' s only a little after five, " said Ivan Ivanovich. "
There ' s the express from Syzran. It passes here at five past
five. "
Far out on the plain, crossing it from right to left, came a neat
little yellow and blue train, tiny in the distance. Suddenly they
noticed that it had stopped. White puffs of steam flurried over
the engine, and then came a prolonged whistle. " That ' s
strange, " said Voskoboinikov. " Something ' s wrong. It has no
business to stop in the middle of the marsh out there.
Something must have happened. Let ' s go and have tea. "
6

Nika was neither in the garden nor in the house. Yura guessed
that he was hiding because they bored him, and because Yura
was too young for him. When his uncle and Ivan Ivanovich went
on the veranda to work, Yura was left to wander aimlessly about
the grounds.
How enchanting this place was! Orioles kept making their clear
three-note calls, stopping each time just long enough to let the
countryside suck in the moist fluting sounds down to the last
vibration. A heavy fragrance, motionless, as though having lost
its way in the air, was fixed by the heat above the flower beds.
This brought back memories of Antibes and Bordighera. Yura
turned this way and that. The ghost of his mother ' s voice was
hallucinatingly present in the meadows. He heard it in the
musical phrases of the birds and the buzzing of the bees. Now
and then he imagined with a start that his mother was calling
him, asking him to join her somewhere.
He walked to the gully and climbed from the clear coppice at its
edge into the alder thicket that covered its bottom.
Down there among the litter of fallen branches it was dark and
dank; flowers were few, and the notched stalks of horsetail
looked like the staffs with Egyptian ornaments in his illustrated
Bible.
Yura felt more and more lonely. He wanted to cry. He slumped
to
his knees and burst into tears.
" Angel of God, my holy guardian, " he prayed, " keep me
firmly
on the path of truth and tell Mother I ' m all right, she ' s not to
worry. If there is a life after death, O Lord, receive Mother into

Your heavenly mansions where the faces of the saints and of the
just shine like stars. Mother was so good, she couldn ' t have
been a sinner, have mercy on her, Lord, and please don ' t let
her suffer. Mother! " —in his heart-rending anguish he called to
her as though she were another patron saint, and suddenly,
unable to bear any more, fell down unconscious.
He was not unconscious for long. When he came to, he heard
his uncle calling him from above. He answered and began to
climb. Suddenly he remembered that he had not prayed for his
missing father, as Maria Nikolaievna had taught him to.
But his fainting spell had left him with a sense of lightness and
well-being that he was unwilling to lose. He thought that
nothing
terrible would happen if he prayed for his father some other
time, as if saying to himself, " Let him wait. " Yura did not
remember him at all.
7
In a second-class compartment of the train sat Misha Gordon,
who was travelling with his father, a lawyer from Gorenburg.
Misha was a boy of eleven with a thoughtful face and big dark
eyes; he was in his second year of gymnasium. His father,
Grigory Osipovich Gordon, was being transferred to a new post
in Moscow. His mother and sisters had gone on some time
before to get their apartment ready.
Father and son had been travelling for three days.
Russia, with its fields, steppes, villages, and towns, bleached
lime-white by the sun, flew past them wrapped in hot clouds of

dust. Lines of carts rolled along the highways, occasionally
lumbering off the road to cross the tracks; from the furiously
speeding train it seemed that the carts stood still and the
horses were marking time.
At big stations passengers jumped out and ran to the buffet; the
sun setting behind the station garden lit their feet and shone
under the wheels of the train.
Every motion in the world taken separately was calculated and
purposeful, but, taken together, they were spontaneously
intoxicated with the general stream of life which united them
all.
People worked and struggled, each set in motion by the
mechanism of his own cares. But the mechanisms would not
have worked properly had they not been regulated and
governed by a higher sense of an ultimate freedom from care.
This freedom came from the feeling that all human lives were
interrelated, a certainty that they flowed into each other—a
happy feeling that all events took place not only on the earth, in
which the dead are buried, but also in some other region which
some called the Kingdom of God, others history, and still others
by some other name.
To this general rule Misha was an unhappy, bitter exception. A
feeling of care remained his ultimate mainspring and was not
relieved and ennobled by a sense of security. He knew this
hereditary trait in himself and watched morbidly and self-
consciously for symptoms of it in himself. It distressed him. Its
presence humiliated him.
For as long as he could remember he had never ceased to
wonder why, having arms and legs like everyone else, and a

language and way of life common to all, one could be different
from the others, liked only by few and, moreover, loved by no
one. He could not understand a situation in which if you were
worse than other people you could not make an effort to
improve yourself. What did it mean to be a Jew? What was the
purpose of it? What was the reward or the justification of this
impotent challenge, which brought nothing but grief?
When Misha took the problem to his father he was told that his
premises were absurd, and that such reasonings were wrong,
but he was offered no solution deep enough to attract him or to
make him bow silently to the inevitable.
And making an exception only for his parents, he gradually
became contemptuous of all grownups who had made this
mess and were unable to clear it up. He was sure that when he
was big he would straighten it all out.
Now, for instance, no one had the courage to say that his father
should not have run after that madman when he had rushed out
onto the platform, and should not have stopped the train when,
pushing Grigory Osipovich aside, and flinging open the door , he
had thrown himself head first out of the express like a diver
from
a springboard into a swimming pool.
But since it was his father who had pulled the emergency
release, it looked as if the train had stopped for such an
inexplicably long time because of them.
No one knew the exact cause of the delay. Some said that the
sudden stop had damaged the air brakes, others that they were
on a steep gradient and one engine could not make it. A third
view was that as the suicide was a prominent person, his

lawyer, who had been with him on the train, insisted on officials
being called from the nearest station, Kologrivovka, to draw up
a statement. This was why the assistant engineer had climbed
up the telegraph pole: the inspection handcar must be on its
way.
There was a faint stench from the lavatories, not quite dispelled
by eau de cologne, and a smell of fried chicken, a little high and
wrapped in dirty wax paper. As though nothing had happened,
graying Petersburg ladies with creaking chesty voices, turned
into gypsies by the combination of soot and cosmetics,
powdered their faces and wiped their fingers on their
handkerchiefs. When they passed the door of the Gordons '
compartment, adjusting their shawls and anxious about their
appearance even while squeezing themselves through the
narrow corridor, their pursed lips seemed to Misha to hiss: "
Aren ' t we sensitive! We ' re something special. We ' re
intellectuals. It ' s too much for us. "
The body of the suicide lay on the grass by the embankment. A
little stream of blood had run across his forehead, and, having
dried, it looked like a cancel mark crossing out his face. It did
not look like his blood, which had come from his body, but like
a
foreign appendage, a piece of plaster or a splatter of mud or a
wet birch leaf.
Curious onlookers and sympathizers surrounded the body in a
constantly changing cluster, while his friend and travelling
companion, a thickset, arrogant-looking lawyer, a purebred
animal in a sweaty shirt, stood over him sullenly with an
expressionless face. Overcome by the heat, he was fanning
himself with his hat. In answer to all questions he shrugged his

shoulders and said crossly without even turning around: " He
was an alcoholic. Can ' t you understand? He did it in a fit of
D.T. ' s. "
Once or twice a thin old woman in a woollen dress and lace
kerchief went up to the body. She was the widow Tiverzina,
mother of two engineers, who was travelling third class on a
pass with her two daughters-in-law. Like nuns with their mother
superior, the two quiet women, their shawls pulled low over
their
foreheads, followed her in silence. The crowd made way for
them.
Tiverzina ' s husband had been burned alive in a railway
accident. She stood a little away from the body, where she
could see it through the crowd, and sighed as if comparing the
two cases. " Each according to his fate, " she seemed to say. "
Some die by the Lord ' s will—and look what ' s happened to
him—to die of rich living and mental illness. "
All the passengers came out …
Dr. Zhivago Ch. 10-12
Chapter 10
1. Which military force controls the part of Siberia to which
Yury is taken?
2. Why is Galuzina worried about her son? What has happened
to the population of men in Russia?
3. Who is “lording it” over Khodatskoye?
4. What is the purpose of Lidochka’s speech? What is his real

identity?
Chapter 11
1. How is Yury treated by Liberius Mikulitsin?
2. What diseases does Yury have to treat in addition to tending
to wounded soldiers?
3. Is the partisan army increasing or decreasing in number?
4. What is the Red Cross International Convention rule
regarding medical personnel?
5. As Yury watches the advance of the White Army youth, why
does he sympathize with them?
6. What would have happened to Seryozha if Yury and his
assistant had left him on the battlefield?
7. Who is facing a court martial?
8. What is the outcome of the plot against Liberius?
9. How did Pamphil and others come to be part of the
revolutionary force?
10. What is the act that haunts Pamphil’s memory?
Chapter 12
1. Who has built the new twenty miles of road through the
forest? What danger does it pose for Liberius and his army?
2. What does Kubarikha say about the red banner?
3. How does Pamphil finally deal with his fear for his family?

4. What does Liberius tell Yury about who is winning the war?
5. What is on Yury’s mind just before he decides to make his
escape? What is on his mind when he is outside the camp next
to the rowan berry tree?

7 – 10 Page Epidemiology paper – Family Nurse PractitionerRequir

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7 – 10 Page Epidemiology paper – Family Nurse PractitionerRequir