Preoperative education and postoperative pain scores in the paediatric patients

Table of Contents Introduction Data collection Methods Measurement tool Method of Data Analysis Evaluation Methods Annotated bibliography References Introduction According to Gehdoo (2004), medical practitioners have historically undertreated children for pain and painful procedures on the assumption that they do not feel the pain or that they forget the painful experiences faster than adults do. Advertising We will write a custom essay sample on Preoperative education and postoperative pain scores in the paediatric patients specifically for you for only $16.05 $11/page Learn More Gehdoo (2004) further adds that it is absolutely necessary for children to be given an effective pain therapy before and after surgery and as such, it has become an integral part of paediatric practice. The research will seek to find out if preoperative education does in fact decrease postoperative pain scores in paediatric patients. Data collection Methods Like in social s ciences, medicine employs the use of simple data collection methods like direct interviews. The basic collection methods in medicine are the interviews and conversations doctors carry out with their patients. Triangulation is also valuable in medical research but considering the age of the patients and the subtlety of the research, its not very applicable (Abramson et al, 1999). In this case, data will be collected from children on all trials that are conducted with them during their pre and post counselling sessions. Most important here will be the collection of data using the â€Å"cold probe† technique. This will involve collecting data during the first session that paediatric surgeons will have with the patients. The first session when the cold probe is conducted is good because the child will be fresh from surgery hence easier for behaviour analysis to determine if preoperative education did help. Measurement tool Multiple-choice questions will be used in this case. No rman (2002) contends that multiple-choice questions in medical research help in allowing straightforward sampling of the subject under research. The questions will help researchers to fairly and evenly distribute their probe thought the subject under study. They are also efficient in terms of cost and time. Given that patients will have mixed feelings, multiple-choice questions are better placed to capture all data in totality. Norman (2002) adds that they maximize the information attained per unit time in research. Again, the questions are more engaging and will make it easier for patients to express themselves on the subject being discussed.Advertising Looking for essay on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More Method of Data Analysis Descriptive statistics will be used in this research. According to Lang Secic (2006), descriptive statistics are useful because they help in reducing large amounts of data to small descriptive measures. The experiences that these children will go through will be captured through interviews structured to bring out the descriptive element. Though inferential statics may come in handy, their absolute necessity is diminished by the nature of the research. Summary that is guaranteed from descriptive statistics will especially precision in reporting the findings. Evaluation Methods According to Swanwick (2007), evaluation in medicine is the collection analysis and interpretation of information about any aspect in medicine. In this kind of research, Kirkpatrick’s Hierarchy and Evaluation Cycle methods come in handy. However, the evaluation cycle method will be used. The method suits this research since it is all encompassing starting with planning of the activity, preparation, teaching and learning of the activity and most importantly reflection and analysis. However, the Kirkpatrick method may be used as well in analysing this data if necessary. This is b ecause it takes to account the completion of learning or participation of a patient in a program which applies to this research. Its use will be limited though. Annotated bibliography Morton, N.S. (2005). Management of postoperative pain in children. Arch Dis Child Educ Pract Ed 2007; vol. 92:ep14-ep19. Morton outlines various principles that he believes if followed will help in reducing preoperative pan in children. According to him, medical practitioners need to recognise that children feel pain during surgery hence they need to put in place measure to minimise and moderate it. According to him, doctors need to prevent pain where it is predictable, control the pain and continue controlling it even after discharge from hospital.Advertising We will write a custom essay sample on Preoperative education and postoperative pain scores in the paediatric patients specifically for you for only $16.05 $11/page Learn More On a larger scale, some of the approache s he recommends in reducing preoperative pain in children. Individualised child centre approach, using the least invasive techniques for he anticipated level of pain, matching technique complexity of surgery and holistic care of emotional and physical attributes of pain. Some of the techniques he advises be used in pre and postoperative pan management include local and regional anaesthesia, systemic analgesia non-steroidal anti-inflammatory drugs and the use of paracetamol. He concludes that an integrated use of the above methods and principles in the past has proven successful in reducing pain in paediatric surgery. References Abramson, H.J. (1999). Abramson Survey methods in community medicine: epidemiological research, programme Evaluation Clinical Trials. London: Elsevier Limited. Gehdoo, R. P. (2004) Postoperative pain management in Pediatric patients. Indian J. Anaesth. 2004; 48 (5) :406-414 Lang, A.T. Secic, M. (2006). How to report statistics in medicine: annotated guideli nes for authors. New York: Tom Hartman. Norman, R.G. (2006). International handbook of research in medical education. London: Kluwer Academic Publishers. Morton, N.S. (2005). Management of postoperative pain in children. Arch Dis ChildAdvertising Looking for essay on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More Educ Pract Ed 2007; vol. 92:ep14-ep19. Swanwick, T. (2007). Understanding Medical Education: Evidence, Theory and Practice. Oxford UK:  John Wiley Sons. This essay on Preoperative education and postoperative pain scores in the paediatric patients was written and submitted by user Levi Noel to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Reflexive pronoun Essay Example

Reflexive pronoun Essay Example Reflexive pronoun Essay Reflexive pronoun Essay The students will give advice to he senders letter using reflexive pronouns. Materials and Equipment Projector and laptop Whiteboard pen Copies of the interviews page Mirror Copies of the senders letter Papers Candies Carolina Procedures Warm-up T (Bring a mirror to class and hold it up to a student and ask) What do you see As (answers will vary) T (If they dont prompt them) Do you see yourself (Elicit a response that uses a reflexive pronoun) Yes, see myself. T If I put this mirror in front of Zulu, do you think she will see herself As Yes T Would you agree that a mirror itself is fragile, even though its frame might be strong As Yes T Why do you think people like to look at themselves in a mirror As (gnawer will vary) T When we look in a mirror, do we tend to be critical or positive about ourselves (Do this a few times until curiosity is piqued). T Have you notice the words myself, yourself, themselves, etc. What part of speech they are (Write the term reflexive pronoun on the board. Underneath the word reflexive, write the word reflects as a mnemonic and state, A reflexive pronoun reflects back on its antecedent noun or pronoun). Grammar Focus T What comes into your mind when you ear the word reflexive pronouns As (Vary their answers) T (The teacher will define reflexive pronouns and mention the singular and plural reflexive pronouns. It will be posted in the board. Also the teacher will discuss thoroughly when to use reflexive pronouns ) During the Speaking (As warm- up, these questions will be written on a Carolina). T What the best kind of job for you What the best kind of work environment What the best type of boss to have As (Let the students think about jobs they have now or jobs they hope to have in the future as they discuss their answers to the questions on he board). T This afternoon, wanton to group yourselves into two groups based on the candy that you picked. (Two kinds of candies are placed at the entrance of the room and each student should pick one candy at the beginning of the session). You will conduct an interview within your group. (Give the paper to each group) I will give you 7 miss. O answer the questions). (After the activity) T Cathy, what job do you imagine yourself ten years from now As (Cathy will answer) T (The teacher writes Catchy answer). T Now, its your turn to share your dreams based from your answers in the given interviews page. Who wants to volunteer As (The students will participate) T Good job everyone I hope that 5-10 years from now you will fulfill your drea ms. Reading and Writing Activity T At this point, we will read about a letter of a call center agent seeking for an advice. In pairs, want you to read the letter silently. Then, in the second time, read the letter with a sad voice (chorally and with background music). (Distributes the senders letter) As (The students will read the letter aloud) T What advice can you give to the sender In the same group write your advice to the sender using reflexive pronouns thin 5 miss. As (They will group themselves and share their pieces of advice to their group mates) T In your group select the best advice and have a representative to share it in class. As (Present their advice to the class) T Good job class I hope you learn now how to use reflexive pronouns correctly. Assignment Work with pair and write a problem about your lovelier and let your partner give the advice. Be sure to apply what youve learned in reflexive pronouns. Appendix A Reflexive pronouns are used when a person or thing is referring to the same person or thing. The reflexive pronouns are Singular yesess lam disfranchisement play the piano. Be careful with that knife. Horrifying stressful. Reflexive pronoun can be used as direct object with most transitive verbs, but these are the most common. amusebIamecutdryenjoyhelphurtintroducekillpreparesatisfyteachBut some overbalances their meaninglessly when they have a reflexive pronoun as direct object Examples Would you like to help yourself to another drink Would you like to take another drink wish the children would behave themselves-I wish the children would behave well. He found himself lying by the side of the road. He was surprised when he realized that he was at the side of the road. Take Note We denotes a reflexive pronoun after verbs which describe things people usually for themselves, such swash, shave,and dress Examples He washed himself in cold water. He always shaved himself before going out in the evenings He dressed himself spite of his injuries. She old enough wash herself. Sincerest objectives tinctured objects Thessaly outstretches the verb. (Projected on the board) Examples Would you like to pour-yourself drinkers broughtourselvessomething to eat. As Thebes of a prepositions the objectifies outstretches clause. (Projected on the board) Examples They had to coffer themselves. He was feeling very sorry himself. Warning But we use personal pronouns, not reflexives, petrifactions of place Examples He had a suitableness him. And featherweight it unaccompanied by She had a few friendships her. With the propositioning we want toyshop that someone did something alone and/or without any help Examples He lividly himself an enormous house. She walked homeboy herself. Give more examples class. Deemphasize person or thing we are referring to Examples Kendal itself quite a small town. Especially if we are talking about someone very famous Sir Paul McCarty whimsicalness the final song. We often put the reflexive pronoun at the end of the clause when we are using it for emphasis Examples Baked the breastfeeds. Segmented the car herself Appendix B Interviews Page Student A Gem, what job do you imagine yourself ten years from now Student B I imagine myself being the dean of College of Arts and Sciences in Sicilian University ten years from now. Student A Gem imagines herself being the dean of College of Arts and Sciences in Sicilian University ten years from now. Questions Name Sentences . What job do you imagine yourself having someday. What kind of work environment do you see yourself inn. Would you like a job where you can give yourself time off whenever you need tit. Would you rather work by yourself or work on a team. Do you want a job here you constantly challenge yourself. What kind of work would make you feel proud of yourself. Can you push yourself to work hard, or do you need someone else to push you.

Causes and Analysis Of Eating Disorders and The Theory of Social Learning

Causes and Analysis Of Eating Disorders and The Theory of Social Learning I was going to write this exercise as a study or a list of facts about the problems caused by eating disorders, and how they effect people of my age. However, I have to decide to give the real facts and feeling that the glossy magazines exclude. For about a year I have had an obsession with my weight and appearances, in many ways it has gradually over take my life, controlling what I do and how I think. Just after the school Christmas holidays I started treading on the â€Å"day deciders†. These small objects would decided whether my day would go well or not, to a person with an eating disorder this block of metal and plastic that tell your weight, controls their day, week and even their month. The text book definition of anorexia is â€Å"A persons who intentionally stave themselves to loss weight†. The text book definition of bulimia is â€Å"A person that removes food from their body with out letting it be thoroughly digested this can be by making themselves sick, using laxatives and over exercising (this can be seen in anorexics as well). They may be the texts books version but they are not anywhere near the truth of the problem. This is my story it is full of the fact and experiences that the books will not tell you. Do not judge me before you have read this. I used to that to people with an eating disorder before, I only hope people will not do that to me. In the beginning, it started with missing the odd breakfast. I had always hated the smell of a cooked breakfast and I stopped touching then at the age of twelve. It was the whole idea of eating the droplets of fat on the plate and what they might do to me when I ate them. Eventually I in had stopped eating anything up to eleven o’clock by the age of fourteen. I used to pretend to have eaten something by swishing a bit of milk and cereal around the bowl – this would fool my mum and it still does. After Christmas 2000 I went on the scales, I notice that my weight had reason to ten stone! The day before we had been talking about our weights at school, my friends were only eight to seven and a half stone, I felt like a freak. In addition, I close friend had call me fat as a joke but it went straight to my heart. So I decide to loss some weight. At this time I just controlled what I ate, I missed lunch a few times and deliberately made myself late for school so I could miss breakfast. By February Half Term, I had lost about a stone. I got talking to a friend who was telling me about her weight and how she felt over weigh, as well. She was going to loss it sensibly though by dieting. People started to come up to me at school and say â€Å"why are you not eating lunch† and â€Å"look at yourself Emily you don’t need to loss weight†. The school had started to notice as my fellow pupils told teaches and they started to hassle me. By the Easter holidays, I had made myself ill. I had caught severe tonsillitis because my immune system was low. I was ill for about three weeks. I decided to stop trying to loss weight. I had internal exams and course work to do; I had to be my best. All this time my parents had not noticed. When the summer holidays had started, I start going out and getting self conscious about my self again. I felt that people saw me as fat. I went away on holiday and I wore a bikini, I again felt that people view me as fat and ugly. When I came back, I promised myself to loss weigh. This is when it stared to get bad. This time I wanted to loss weight without people finding out or bothering me could not stand the attention. In the last term we had, had personal and social education lessons, I knew the two different ways to loss weight anorexia and bulimia. I decided bulimia was the best option. I would be seen eating and psychologically I would see myself as eating. I also started I new eating pattern. I again missed breakfast, but to be seen at school as eating I would occasionally go to lunch (about three times a week) at home I would eat a usual family meal. The key to being bulimic was to drink lots of water. That way it came back up easier as the weight came of a started to feel more comterble about me. I was happier when I was being sick, it gave me a sense of relieve when there was nothing inside me. After about two months, it became an obsession. I would have schedule that I would follow nightly. So my parents would here I turned my music up and the bath water on then, I would then spray p erfume, and after that, I would be sick. After I was sick I would bush my teeth and wash my face this happen for six months and I still do. Just before Christmas, my mum became seriously ill, my life became very emotionally confusing. This did not help with my eating disorder I began to feel that the food I put into my month became he only thing that I could control. My grandparents came up to stay, this inflamed the situation because my grandmother life revolves around food. She did not know about the eating disorder nobody did. The only conversations that the family could have were about food and this was at the dinner table. I soon developed a phobia of eating at the dinner table at home. This phobia still is with me. I also developed a phobia of my grandmother visiting I am afraid that whenever she stay I have to be forced to eat. As my mother stayed in hospital, I became very depressed, and I stopped sleeping as well, this emotional rollercoaster that I went though will be with me for my life. By February my mother had come out of hospital and she was recovering. I began to take control of my life but I could not stop being sick. I did try to stop but it made me angry and irritable. Eventually I broke down at school and I told the friend who had tried to loss weigh by dieting, she had since become anorexia. She told me to tell my mother. I was afraid and ashamed of what she might think of me. I feared that she would see me a failure or attention seeking. I do not want the help. It is up to me to change myself and I do not feel that I am ready to do that. Yet. By writing this down, I wish to tell people that by telling anorexia people to eat or telling bulimic people â€Å"they look great any way† and †that they don’t need to change†. This does not help it just hinders them. People who go round eating chocolate and then say well I will be sick later or say I am anorexia are not the true anorexics and bulimics they are the ones tha t keep quite. I hope this will allow people not to judge people as being strange for having these problems, but to help them and encourage them to sort themselves out. On this page are some facts about eating disorders. Anorexia Surfers intentionally starve themselves. It is commonly found young people around the time of puberty. It involves weight lossat least 15 percent below normal body weight. Many people with the disorder are convinced they are overweight. they become terrified of gaining any weight. People with anorexia continue to think they are overweight even when they are bone-thin. The person suffering from anorexia believes that their body Weight, shape and size is related to how good they feel about themselves and their worth as a human being They refusal to eat in front of others. They often do to strict exercise routines to keep off weight. Not menstruating is a common sign. Men with anorexia often become impotent. Bulimia Bulimia is an eating disorder characterized by binge eating. It appears to be relatively uncommon in men and is common in girls between fifteen to twenty. Dieting behavior usually starts before it. A complex lifestyle may cause an eating disorder behavior There are feelings of isolation, self-deprecating thoughts, depression, and low self-esteem. There is full recognition of the behavior as abnormal.

What is the role of celebrity endorsement in marketing communication Essay

What is the role of celebrity endorsement in marketing communication - Essay Example Celebrity endorsement is a method of brand communication whereby a celebrity uses his or her popularity and acts as a spokesperson for a particular product. Celebrity endorsements are seen to have a long lasting impact upon minds of consumers. A celebrity is an individual who enjoys public attention and are famous for their achievements. In celebrity endorsement, celebrities use their recognition on behalf of a product and appear alongside it. While choosing celebrities for endorsing products, firms should keep in mind that there must be an adequate match between characteristics of the product, personality of the celebrity and nature of target consumers. It is necessary for the target market to have adequate familiarity with the celebrity endorsing a product. There should be a symbolic match between brand image and that of the celebrity (Nelson, Tunji and Gloria, 2012). For instance, a brand selling sports shoes can endorse its products through a famous sports personality. Companies try to associate qualities of a celebrity with that of the product. Through celebrity endorsements, it becomes easier for consumers to recall ads while viewing the product. In order to gain these kinds of advantages, companies pay huge sums of money to celebrities and align their products and brand with the endorsers (Kansu and Mamuti, 2013). The contract between celebrities and the brand for the purpose of endorsing products are generally made for a considerably long time. Firms that choose celebrity endorsement for their products are not seen to frequently change face of the brand. This helps in establishing stronger identity and brand image. Celebrity endorsements are largely viewed as a long-term strategic decision, which affects brand’s value in the market (Academia.edu, 2013). The individual who endorse a product helps in creating strong perceptions about the brand. When consumers view the

A Proposed Health Promotion Campaign Against Obesity Assignment

A Proposed Health Promotion Campaign Against Obesity - Assignment Example The factors of the accessibility of junk foods and the trend of â€Å"supersizing† meals, not to mention the availability of high caloric foods of low nutritional value but are highly appealing to children because of its rich taste are mainly responsible for them getting less physically fit (Buchholz, 2005). Also, the environmental progress of eradicating some parks and natural playgrounds for children to build buildings for industry and residences may not benefit the physical health of children due to the fact that they have less access to locations where they can expend their excess physical energy (Frieden, Galvez. & Landrigan, 2003). However, the most common cause of the decrease in physical activity of children is that technology has made it easier to fall into a sedentary life. Children are more than adequately entertained by the multitude of choices on television shows, internet sites, computer games, etc. Nowadays, most children are homebound, engrossed in computer games, watching videos, surfing the web for hours, etc. Children find less need to play outside because there are a lot of available conveniences and entertainment indoors for them. Hence, playing games, running around, climbing trees, bicycling, etc. are slowly becoming activities of the past. Physical exercise for these children is not given much priority anymore. Many parents enroll their children in dance classes, sports, etc. just for them to have physical activity. Obesity in children has been on the rise and one factor is lack of physical activity. Experts agree that the combination of the availability of energy-dense processed foods and lack of physical activity may be the culprit of obesity. The Centers for Disease Control and Prevention (CDC) provide data that suggest that the number of children attending daily physical education classes declined from 18.3% in 1995 to 12% in 2001.

The Jamestown Settlement Essay -- American America History

The Jamestown Settlement A group of Europeans, headed by Bartholomew Gosnold, began planning a possible business venture that would send a group of colonists to what was already known as Virginia. Gosnold was apparently the driving force behind getting this operation in place. Gosnold was referred to as "the first mover of this plantation" by Captain John Smith."(Ward) Merchants from London, Bristol and Plymouth sponsored the voyage and persuaded King James to grant a charter and letters of patent to create the Virginia Company. A strange twist to the story was that the man who worked so hard to get this Company started, Gosnold, was unable to become a member but he did manage to become appointed to the resident council. Their job was to work with Virginia associates and be involved in local affairs for the new colony. The Susan Constant, Discovery, and Godspeed were the three ships that set sail for Virginia, from England in February of 1606. The commander of the three ships was Christopher Newport and not John Smith. "In the early evening of May 13, the expedition reached a narrow pear-shaped peninsula about sixty miles up the river, here on the 1500-acre peninsula, it was decided to erect a fortified town to be called Jamestown."(Ward) They decided to give it the name Jamestown in honor of their king. As soon as they landed they began to build a fort in the form of a triangle. They constructed the fort in this manner for purposes of safety against the natives. A triangular fort gave them one less side that they could get attacked from. The land that they decided to build Jamestown on came with many problems. "They could hardly have made a worse selection. The situation was extremely unhealthful, being low and expos... ...uperior weapons. In 1644, Opechancanough organized another mass attack, which would be his last attempt to drive the English away. 500 settlers were killed but the English, in effect won the war. Opechancanough was captured and killed. The Powhatan villages were literally whipped out. "By 1700, the Powhatan tribesman numbered only 1200 when in 1607 their population was estimated at 9000"(Ward) Works Cited: Pryor, Roger. (1907). The Birth of the Nation. New York, New York. The MacMillan Company. Ward, Harry. (1991). Colonial America, 1607-1763. Englewood, New Jersey. Prentice Hall, Inc. Bridenbaugh, Carl. (1980). Jamestown 1544-1699. Oxford. Oxford University Press. Wertenbaker, Thomas. (1929). The First Americans. New York, New York. The MacMillan Company. Eggleston, Edward. (1930). Pocahontas. New York, New York. Dodd, Mead and Company.

Drayton 61 Structure Essay

There are many different ways to approach the structure of a poem, a piece of fiction, a play. In what follows I’m going to make some suggestions about the structure of Michael Drayton’s poem beginning â€Å"Since there’s no help, come let us kiss and part,† a sonnet from his collection titled Idea, first published in 1593. It’s important for you to understand that there are many valuable and illuminating ways to talk about this poem’s structure, not any one, single, right way. That’s why I’m writing suggestions, not prescriptions. When I say â€Å"the structure† of Drayton’s poem, I mean not only how it’s put together but also the way it works. Learning how something is put together shows us what the parts are. Learning how those â€Å"put-together† parts work shows us the thing in action. And a short lyric poem like Drayton’s (any work of literature that we’re reading, for that matter) is a thing in action, a dynamic process. Here is Drayton’s poem. Since there’s no help, come let us kiss and part; Nay, I have done, you get no more of me, And I am glad, yea glad with all my heart That thus so cleanly I myself can free;4 Shake hands forever, cancel all our vows, And when we meet at any time again, Be it not seen in either of our brows That we one jot of love retain. 8 Now at the last gasp of love’s latest breath, When, his pulse failing, passion speechless lies, When faith is kneeling by his bed of death, And innocence is closing up his eyes, 12 Now if thou wouldst, when all have given him over, From death to life thou mightst him yet recover. Well, what are the parts of this poem? Words in lines. Specifically, words in lines which usually add up to ten syllables each. Words put together so that they make a rhythm as we say them, a sort of di-da di-da di-da di-da di-da rhythm, with emphasis usually on the â€Å"da† syllable, like this: And I am glad, yea glad with all my heart or this: And when we meet at any time again. And the poem is made up of lines whose end words rhyme (that is, chime together) in a certain pattern throughout the poem, like this: part / me / heart / free(abab)lines 1-4 vows /again / brows / retain (cdcd)lines 5-8 breath / lies / death / eyes (efef)lines 9-12 over / recover(gg)lines 13-14 This pattern creates groups of lines (they have technical English-teacher terms), which go together because their end-word rhymes link them together: lines 1-4=first quatrain lines 5-8=second quatrain  lines 9-12=third quatrain lines 13-14=final couplet The words in this poem are also organized grammatically, in several ways: sentences–the first (a cumulative sentence—check out the term in a handbook or do a Google search) consisting of the poem’s first and second quatrains and the second (a periodic sentence) consisting of the third quatrain and the final couplet; clauses–a bunc h; notice, for example, the first line of the poem– Since there’s no help, come let us kiss and part— a subordinate clause followed by a main clause in a combination showing a cause-and-effect relationship;  verbs—significant mood shifts within the poem (another technical English-teacher term—verbs come in â€Å"moods,† namely the indicative, subjunctive, or imperative, which, if you can’t recognize, you’d better get a grammar/composition handbook), with the imperative and indicative dominating the first eight lines and the indicative and subjunctive the last six (note especially â€Å"wouldst† and â€Å"mightst† in ll. 13-14); subjects—all personal pronouns in the first eight lines (â€Å"us,† â€Å"I,† â€Å"you,† â€Å"we†), nouns in the next four (â€Å"passion,† â€Å"faith,† â€Å"innocence†), and a return to pronouns in the final couplet (â€Å"thou ,† â€Å"all†); adverbs expressing time—â€Å"when† X 4, â€Å"Now† X 2, â€Å"again,† and â€Å"yet†; adjectives—there are very few: why Well, despite the fact that GRAMMAR IS REALITY, we probably should get off the grammar wagon for the time being. There are other ways to look at how words in a poem are organized. Consider the way they get sounded when you read them. Listen carefully as you say the first two quatrains of the poem: Since there’s no help, come let us kiss and part; Nay, I have done, you get no more of me, And I am glad, yea glad with all my heart That thus so cleanly I myself can free;4 Shake hands forever, cancel all our vows, And when we meet at any time again, Be it not seen in either of our brows That we one jot of love retain. 8 I’m hearing a lot of one-syllable words. The first three lines consist entirely of one-syllable words, and there are only seven two-syllable words in all of the eight lines. I’m also hearing a kind of clipped, short way of speaking in these lines. Partly this is due to (ALERT-ALERT: another technical term) alliteration, as in the hard â€Å"c† sounds—come, kiss, cleanly, can, Shake, cancel—and â€Å"t† sounds—let, part, get, heart, That, meet, time, it, not, That, jot, retain. Now listen to the way you’re sounding the words in the third quatrain: Now at the last gasp of love’s latest breath, When, his pulse failing, passion speechless lies, When faith is kneeling by his bed of death, And innocence is closing up his eyes 12 I’m hearing a lot more two- and even a three-syllable word now, especially in ll. 10-12. Also, I’m more aware of a kind of â€Å"breathiness† than I was when saying the first eight lines. Partly this is due to the fact that I’m saying words here that require more breath than one-syllable words. There’s another reason for the â€Å"breathiness,† and, yup, there’s a technical term for this, too, but let’s skip over it and listen to what’s causing this â€Å"breathiness. † What do you notice when you say these words: gasp, breath, pulse, failing, passion, faith, bed, death? Feel a little puff of breath coming out of your mouth, a kind of â€Å"uh,† after you say the initial consonant of the word? That’s what I’m getting. I think there’s another reason I’m feeling this â€Å"breathiness,† a reason not related to the sounds of words but to what they’re saying. The speaker in this poem is painting a picture in the third quatrain by using images. LOOK OUT (another technical term): â€Å"imagery† or â€Å"images† can refer to literal, descriptive pictures in a piece of writing, as well as to figurative language like (technical alert) similes, metaphors, personifications, etc. , or to both. In the present case, the speaker’s imagery is both literal and figurative. S/he’s creating a deathbed scene: there’s a â€Å"last gasp of . . . breath,† a â€Å"pulse failing,† a â€Å"bed of death,† even the â€Å"closing up† of the dying person’s eyes by an attendant. All this is vivid, literal imagery. But who’s dying? Someone named â€Å"love. † Who else is present in the scene? Persons named â€Å"passion,† â€Å"faith,† and â€Å"innocence† (in some printed versions of the poem these names are capitalized). These â€Å"persons† are abstract nouns that are being given the characteristics of humans—hence the term personification. So I’m getting both literal and figurative images, a double-whammy deathbed scene that strongly conveys the idea of the dying person’s final expiration. How does the imagery of the end of the poem compare with imagery at the beginning of the poem? I can’t see any figurative language at all in the first two quatrains, except for â€Å"you get no more of me† in l. 2, which suggests the idea of possession in a love relationship, and â€Å"Be it not seen in either of our brows† in l. 7, a (you got it) metonymy or figure of speech in which a part is substituted for the whole (brow for face). But for these exceptions, I can take more or less literally everything the speaker is saying. S/he and her/his partner are going to kiss and separate—that’s all that can be done. The speaker is finished with the partner, and s/he’s glad that s/he can make this separation so neatly. It’s simply a case of shaking hands goodbye, freeing each other of any obligation created by what the lovers might have said in the past (â€Å"I swear I’ll love you forever,† â€Å"There’ll never be another person in my life,† â€Å"You’re the center of my world,† etc. ), and making sure that, whenever they meet in the future, no bystander will be able to detect the slightest trace of their former love. I think it’s time to start asking how these put-together parts work in action, that is, to see what dynamic process is operating in the poem. If the structure of this poem is a dynamic process, then you ought to be able to see changes, differences, shifts, as you move through the poem. In fact, if you compare the beginning of the poem with the end, you can see major shifts. I’ve already noted some—for example, the change in verb moods from imperative and indicative in the first eight lines to indicative and subjunctive in the last six. Then there’s the difference in the sounds the words make and the style of speaking you can hear, from the direct, concise, controlled tone of ll. 1-8 to the breathy, drawn out speech of the last part of the poem, where the speaker creates a vivid picture of Love at the point of death. How do these grammatical and tonal differences work together to reinforce the changes you can hear as the speaker confronts his/her soon-to-be-ex partner? In the first part of the poem the speaker is giving orders to his/her partner, using imperative verbs (â€Å"come let us kiss and part,† â€Å"Shake hands,† â€Å"cancel,† â€Å"be it not seen†) and making statements s/he intends the partner to take as true and literal, using indicative verbs (â€Å"there’s no help,† â€Å"I have done,† â€Å"you get,† â€Å"I am glad,† â€Å"I .  can free†). Then there’s the alliteration of hard â€Å"c† and â€Å"t† sounds and the dominance of one-syllable words, creating a sense of directness. It’s almost as if the speaker is trying to maintain emotional contr ol of the situation, as if s/he needed to suppress feelings of regret over the breakup. You can even see this in the use of â€Å"you† in l. 2, a formal style of address in early modern English. (In a similar situation, why would you formally address your soon-to-be-ex? ) There is also an effort at matter-of-factness here, evident in the avoidance of figurative language. All this is accomplished in a cumulative sentence, where you get the main message at the beginning (we know we’re breaking up, so let’s get on with it). In the last part of the poem the speaker is painting a vivid picture of Love at the point of death, surrounded by mourning figures (those personifications) attending at the bedside, and maybe, if s/he were willing, the speaker’s partner. Note that indicative verbs are used in ll. 10-12 (in the subordinate â€Å"when† clauses), then subjunctive verbs in the final couplet (â€Å"if thou wouldst† and â€Å"mightst .. recover†). The important thing to know about the subjunctive mood here is that it expresses an action that might take place, not one that does take place. Note also that in this final couplet the speaker addresses his/her partner by using the informal, intimate form â€Å"thou† instead of the formal â€Å"you. † In addition to the figurative language and significant gr ammatical differences between the beginning of the poem and this part, you now get longer words and the breathiness I noted. It’s as if the speaker is encouraging his/her partner to imagine, to see, to feel what the death of their love is going to be like, complete with mourners and last gasps. This invitation to participate is clearly intended to have an emotional impact on the partner. The speaker is also feeling some emotion, I think. You can see this in something I haven’t spoken of before. It’s the shift from a regular di-da di-da rhythm in the first part of the poem to some pretty strong, off-beat rhythms in the last six lines. Look, for instance, at the beats in ll. 9-10 or l. 13. Something different is going on here, not the regular di-da di-da amble you’ve gotten used to. Why this shift? I think it may have to do with the emotion the speaker is starting to feel as s/he describes the deathbed scene. S/he is getting near the end of the poem, and if anything is going to happen other than shaking hands and saying goodbye, it had better happen soon. I’m sensing that emotions are getting much more noticeable. S/he even makes his/her partner the central figure, on whom love’s life or death depends: Now if thou wouldst, when all have given him over, From death to life thou mightst him yet recover. All this happens in a periodic sentence, where you get the main message at the end, here in the final couplet (it’s up to you dear, if you want to bring love back . . . ) Well, I could go on, but I won’t—not for much longer, anyway. I’ve been trying to show you that the closer you look at a piece of literature, the more things happen. Drayton’s poem—any good poem—is super dynamic. However, you can’t capture this dynamic quality just by taking a photograph or making a list of the poem’s parts. You’ve got to experience the dynamic quality of the poem in order to know its structure.