Extract:
Sickle-Cell Anemia
Healthy red blood cells are shaped like a disc. Each cell contains the protein hemoglobin, which carries oxygen throughout the body. In some people, a crescent shaped cell forms instead of the normal discshaped cell. The crescent-shaped cells contain abnormal hemoglobin. These sickle-shaped cells are fragile and are unable to carry oxygen properly throughout the body.
Sickle-cell anemia is an inherited disease that affects about 72,000 people in the United States. It is more common among people of South American or African descent. The genes for sickle-cell anemia are inherited from both parents. When both parents carry a gene for the trait for sickle-cell, there is a one in four chance that they will pass the disease on to their children.
Symptoms of sickle-cell anemia can include sudden occurrences of extreme abdominal and back pain, bone pain, fever, fatigue, and a rapid heart rate. One patient compared the pain in his back to a jackhammer and said the pain could take over his entire body. Another patient, an eight-year-old girl, described fevers and the feeling of someone squeezing her arms and legs.
Cycles of symptoms are often unpredictable and can occur infrequently or almost constantly. Some people who are affected report weekly occurrences of persistent pain, while others report occurrences once a month. Some report that relief comes only by using powerful painkillers. For others, relief comes with bed rest and a hot-water bottle. Most agree that while the challenges of managing sickle-cell anemia are great, with diligent care, it can be managed.
Identify the overall tone of the essay.
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A
Informal
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B
Insensitive
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C
Grim
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D
Uplifting
The overall tone is grim, conveying the serious, sobering reality of living with a painful inherited condition through vivid symptom descriptions and acknowledgment of lifelong challenges.
A) Informal
The passage maintains clinical precision with proper medical terminology ("hemoglobin," "crescent-shaped cells") and structured presentation, demonstrating formal rather than casual register.
B) Insensitive
The author shows sensitivity by including patient perspectives with empathetic detail ("jackhammer" analogy, eight-year-old's description) that humanizes suffering without exploitation.
C) Grim
The tone consistently emphasizes suffering through: vivid pain descriptions ("extreme abdominal and back pain," "jackhammer" comparison), unpredictable symptom cycles ("infrequently or almost constantly"), severe interventions ("powerful painkillers"), and acknowledgment that "challenges... are great." While ending with manageability, this doesn't override the predominant focus on pain severity.
D) Uplifting
Though the passage concludes that sickle-cell "can be managed," this single positive note is overwhelmed by extensive detailing of pain severity, unpredictability, and treatment challenges, preventing an overall uplifting tone.
Conclusion
Tone analysis requires weighing dominant emotional qualities across an entire passage. While acknowledging manageability, the passage's emphasis on severe pain, unpredictability, and treatment difficulties creates an overall grim portrayal of living with this inherited condition.