From the given options, choose the sentence that completes the paragraph in the most appropriate way.

Most people at their first consultation take a furtive look at the surgeon’s hands in the hope of reassurance. Prospective patients look for delicacy, sensitivity, steadiness, perhaps unblemished pallor. On this basis, Hendry Perowne loses a number of cases each year. Generally, he knows it’s about to happen before the patient does: the downward glance repeated, the prepared questions beginning to falter, the overemphatic thanks during the retreat to the door.

  1. Other people do not communicate due to their poor observation.
  2. Other patients don’t like what they see but are ignorant of their right to go elsewhere.
  3. But Perowne himself is not concerned.
  4. But others will take their place, he thought.
  5. These hands are steady enough, but they are large.

I feel the answer should be 3 as it is a continuation of the context related to Perowne. But the answer book reasons it out to be 2. Can someone help me understand the issue? The explanation in the answer book is as follows.

The paragraph is about what indications patients look for in a doctor, with particular reference to his hands. Hence, the last sentence must be about this. The theme is about what the patients do when they notice a doctor’s hand. So 1 & 4 are ruled out. What Perowne thinks is sequential, but will belong early in the next para, not here. Hence, 3 & 4 are eliminated. On testing through reading, 2 uses the same kind of language as the para, continues the idea of the previous sentence and is in keeping with the theme sentence.

  • 2
    Suggested migration to writersSE.
    – Kris
    Oct 2, 2012 at 8:48
  • 1
    They lost me at para. Twice.
    – RegDwigнt
    Oct 2, 2012 at 8:52
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    Also, #2 introduces material extraneous to the text, so it belongs to a separate paragraph. This is one more example of how test-makers fool themselves and test-takers because they don't take meaning into account, but believe they can abstract English to its linguistic skeleton and that the ability to play this game actually means something valuable.
    – Robusto
    Oct 2, 2012 at 9:53
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    This test prep book contains a question from the actual test, and what is undoubtedly the "correct" answer, but I suspect the book is guessing at the reason that the answer is correct. I believe you were supposed to eliminate number 3 because it's not a complete sentence. In the short story this was taken from, the next paragraph begins "Perowne himself is not concerned." The test creators added a "But" to make this a sentence fragment, and thus an unacceptable answer. Oct 3, 2012 at 19:30
  • @Kris - The way this question is structured makes it a bad fit for any SE site, I think. It would probably get closed on Writers, or at least downvoted. I think question would be more answerable here if it were concerned with grammatical solutions. Oct 5, 2012 at 14:31

4 Answers 4


The paragraph is about what indications patients look for in a doctor, with particular reference to his hands. Hence, the last sentence must be about this.

This points to a large difference between "real" English, and English found in a standardized test. Thankfully, in real English, not every paragraph ends with a sentence that summarizes what a paragraph is about; I would hate to endure an entire novel where the author wrote every paragraph in accordance with such silly rules.

The key to getting these questions correct is to understand what the test makers are looking for. Fortunately for you, a test prep book can help you do that. But a test prep book is not a writing guide! I recommend that you thoroughly understand such guidelines in preparation for the test – and then purge them from your memory as soon as you are done. If your goal is to become a proficient writer, some of those inane rules can do as much harm as good.

P.S. I'm inclined to agree with you; #3 sounds like a better option than #2. Rather than enlightening me, the book's explanation merely gave me an eye-roll.

  • Where does the text for these tests come from? I haven't seen any such thing in academic texts, fictions, or classics. I haven't graduated yet, but going to a good school I guess requires you to have good marks in SAT, ACT, etc. And I am not sure if any of the good writers(e.g: Stephen King, J.K Rowling, just to name a few) had ever taken these tests before they embarked on their writing careers.
    – Noah
    Oct 2, 2012 at 9:36
  • To be accurate, the notion of a closing sentence that summarises a paragraph applies only to academic or formal writing, and I have never seen it suggested that every closing sentence should do that. It is just one of several options. Oct 2, 2012 at 10:40
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    Entirely agree with this. Peter Shor tracked the text down to a New Yorker short story, and it appears that the test setter knows more about 'what is most appropriate' than the original author. Says it all, really Oct 2, 2012 at 21:57

How should you go about figuring the answer to this type of question on a test? For this one, three of the answers contain a fatal flaw which makes them impossible to be correct. This leaves two remaining, one of which is clearly superior.

1: Other people do not communicate due to their poor observation.

This doesn't really make any sense. They may not notice the hands because of their poor observation, but why would that mean that they don't communicate?

2: Other patients don’t like what they see but are ignorant of their right to go elsewhere.

The correct answer.

3: But Perowne himself is not concerned.

Not a complete sentence. While this sentence fragment would be perfectly fine in a piece of fiction writing, it is disqualified from being a correct answer to this test question.

4: But others will take their place, he thought.

This has the wrong verb tense. If it were to fit in the paragraph, it would have to be "But others will take their place, he thinks."

5: These hands are steady enough, but they are large.

There is no easy way to disqualify this sentence, but it doesn't really continue the train of thoughts that precede it. Sentence 2 fits much better.

This is clearly the reasoning that the test designers wanted you to use. Why do I say this? Because the next paragraph in the actual story this passage is from starts "Perowne himself is not concerned." The test designers seem to have added the "But" to make this ineligible to be the correct answer. The test designers also took answer (4) from the next paragraph, and put in the wrong verb tense to make that answer ineligible to be correct.

  • 1
    Your justification against #3 presumes that a sentence never begins with "but". But not everyone agrees with that. :^)
    – J.R.
    Oct 4, 2012 at 8:40
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    Frankly, I don't agree with it either. But this is a standardized test of English, and the correct answers may be presumed to use standard formal English grammar. Oct 8, 2012 at 17:57

My professor said "When confronted with either/or questions, the correct answer is always "neither" or "both"".

The paragraph as it stands is much superior to adding any of these tiresome perorations. These test writers don't seem to care about prose style, they just want you to check the right boxes.


The answer book is correct.

What you need to pin down is what the paragraph is about. The answer to that is that it is about 'people' - you get that from the first sentence - who look at a surgeons hands.

That eliminates answer 3 because it is about Perowne; answer 4 because it is about Perowne's thought; and answer 5 because it is about Perowne's hands.

That leaves only answers 1 and 2, which are both about 'people'.

Answer 1 doesn't work because the idea of 'communicate' is not relevant to a paragraph about looking. By elimination that leaves only answer 2, which continues the theme of seeing the surgeons hands.

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    I disagree. The paragraph is obviously about Perowne; it doesn't matter that he is not mentioned in the introductory sentence. Perowne has become the subject of the third sentence and fourth sentences. Switching back to the patients for the fifth sentence is an awkward jump in topic. Oct 2, 2012 at 11:18
  • @PeterShor: But Peter, how can the sentence be about Perowne, if the first sentence of the paragraph doesn't mention him directly? (I'm speaking from the point of view of the test maker – and being sarcastic, of course)
    – J.R.
    Oct 2, 2012 at 11:25
  • The first sentence is people looking at hands. The second sentence is what prospective patients look for. The third sentence Perowne losing patients as a result of sentence two. The fourth sentence is Perowne reacting to what patients do - the downward glance, faltering questions, overemphatic thanks. This is not a paragraph about Perowne. That is clearly what is being tested here, which is why the answers offered split into three 'it is about Perowne' wrong answers, and two 'it is about 'people' answers with one correct answer and one nearly correct. Oct 2, 2012 at 11:49
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    Actually, the final sentence proposed is an awful sentence to end the paragraph with. It's only the first clause of the real final sentence of the first paragraph from the story the test designers got the passage from, and if you look at it in toto, the real final sentence is quite a bit better, as the last part indirectly indicates Perowne's specialty, bringing the paragraph to a conclusion which involves both looking at hands and Perowne. Oct 2, 2012 at 14:53
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    This paragraph is the first paragraph of a short story in which Perowne is a major character, so one of the points of the first paragraph is indeed to introduce Perowne (in a paragraph talking about hands). The final sentence that the test designers propose would fail miserably at that. So what the test designers have done is take the final sentence from a quite brilliant first paragraph, and by lopping the last half off this sentence, come up with a paragraph which doesn't work very well at all. Oct 2, 2012 at 14:57

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