A Rose by any other name…well, except for ischemia

Medicine is its own language.  Walking into an exam room and using every Latin or Greek root word learned along the way from undergrad through residency is not advisable.   Coronary infarction!  Diabetic retinopathy!  Retinal ischemia!  Non-arteritic anterior ischemic optic neuropathy! 

The implications of these diagnoses physicians well know spell trouble for the patient. But for the patient, the words themselves are troublesome and scary!  Even in English we have our own layman’s speak for medical terminology. And this is true in every other language, not only English. Case in point: the technical term for a dark, harmless growth on the skin is a “nevus”. But how many people do you hear saying, “I have a nevus” in English?? Not many. Maybe a medical student. Maybe they’ll go as far as to say “compound nevus”. (Insert geek.  I am allowed to say that—I was a medical student once myself and studied dermatologic pathology)  

But that’s an exception to the rule. Most people call it a mole.  And one day, when I was examining a sweet grandmotherly-like lady, she referred to a nevus as “lunar” in Spanish. ‘El lunar’ is the Spanish equivalent for ‘mole’.  What is a ‘mole’ anyway? Well, depending on the day (and context) it can be a small, ground-burrowing animal or a spy who plays an important role in the security of a country or 6.023 x 10²³ or, well, a nevus. 

When I talk to my English speaking patients who have poorly controlled diabetes, I will tell them:

“As a result of your poorly controlled sugar, you have something called, ‘non-proliferative diabetic retinopathy’ which means you have leaky blood vessels in your retina. This happens because high blood sugar makes your blood vessels weak. Blood leaks out.”

If you do this in English, you have to expect to explain it in a similar way in Spanish for the non-medical layman:

“Porque el azúcar no es controlado, tiene Ud. algo se llama “retinopía diabética” –significa que las arterias y venas en la retina son débiles y, por eso, están fugando sangre y fluido. Este fluido afecta a la  visión.”

I’ve heard other substitutions for medical vocabulary used as well:

Tela (cloth; cover) for a pterygium or a cataract

Nube (cloud) for cataract

Carne (meat) for pterygium/pingueculum

Polvo (dust) to describe a sandy sensation in the eye

The above represent a few examples in Spanish. Remember, there are technical Spanish terms for these words, ie catarata for cataract. But not everyone knows that word, or what it means. Nube, a cloud, something that blocks the vision and makes it blurry, is more universal and understandable to the layman.

Just as you do in English, tailor the conversation to the patient. You’ll speak to an 86 year old retired banker differently than you would to a local mid-forties pediatrician. You’ll assess who has some medical knowledge background and who needs the terminology broken down a bit. I have always liked educating my patients on medical vocabulary. I do introduce them to it all the time. But I also want the patient to understand what I’ve said, and I adjust the dialogue accordingly.

Me: ¿Por qué está Ud. en la clínica hoy?

Patient: Estoy aquí por un examen general.  Pero tengo problema. Tengo una tela aquí en el ojo izquierdo (points to nasal corner of left eye).  Me molesta.

Me: Sí , esa tela, se llama “pterigión” es algo muy común en el ojo.  Es muy común particularmente en personas quienes viven en países cerca de la línea ecuatorial. La piel crece cerca de la córnea.

Patient: ¿Puedo ser ciego?

Me: No! Si la piel crece a cubrir la córnea, hay un procedimiento lo que podemos hacer a sacarlo. Pero el suyo es pequeño. Use Ud. lágrimas artificiales dos o tres veces durante el día para lubricar el ojo.  Eso es todo que necesita.

Patient: Gracias. Ud. es muy amable. 

Courtesy: D.Hromin