Patients with patience

It wasn’t until I went to medical school that a breakthrough came for me.  Well, a semi-breakthrough.  It was 2002 and I was doing my third year clinical rotations.  I became smitten with a certain Puerto Rican family medicine resident, and we started dating.  For purposes of this blog, I will refer to him as ‘Carlos’, partially for privacy reasons, and partially because I don’t remember his name (!)  But when we dated, Carlos made it a point to talk to me only in Spanish, and the deal was I had to answer back in Spanish.  It was so difficult at first—I would partially understand what he was asking me, or telling me, but when I had to respond, uh! It was so difficult.  I would take minutes to sputter out grammatically incorrect fragmented sentences. The best I could say many times was, “Lo siento, no comprendo.” (I’m sorry, I don’t understand) Or “No te entiendo” (I don’t understand you)  Or “Por  favor, repitelo” (Please repeat it).  I got VERY good at using these phrases—phrases that excused my ineptness.  But he was patient, thankfully, he spoke VERY slowly and the very act of forcing me to speak back actually made me more comfortable answering in Spanish. It was still very difficult—and would be difficult for years to come. 

Carlos:  “Qué hiciste hoy?”

Me: (To myself:  Think!!   ‘What you did today?’  Hmmmm … What DID I do today??   I went to class, later I went for a walk in the neighborhood. “Uh,….Yo” (think: ‘I went’, now  conjugate it!   Yo fui) ”…yo fui a clase, ..uh…. luego, yo…” (think!  Is it ‘fui al paseo’? No, it’s dar un paseo, can’t be literally translated) fui a dar un paseo en el vecindario.” (Still a few grammatical errors here and there, but at least it was an intelligible, complete sentence!)

So, a question that, in English, would take me a millisecond, no, a nanosecond, NO! a femtosecond, to understand and answer, would take me approximately one to two minutes in Spanish.  Too much thinking, and the thinking slowed me down.

I would wonder to myself, why is this so hard?  I know a good amount of Spanish vocabulary.  What do I do when I speak English that’s so different?  How do I teach myself to feel in Spanish, and not think? When do I reach a point (or will I ever reach a point) when the sounds mean more to me than the actual words?  

I went to medical school in Pennsylvania Dutch country, so the opportunities to use Spanish in the clinic were few and far between.  But there were occasions when I was able to interpret a bit.  There was a small women’s health clinic just outside of Bethlehem, PA.  I found that the most frustrating aspect of attempting to speak to the patients there in Spanish was that, in my head, I would be quickly translating as I was speaking.  In other words, as I spoke, I could see my answers in English and would be translating them, almost verbatim, into Spanish. So talking, in essence, became a huge grammar lesson. I just couldn’t answer fluidly and comfortably. I had to THINK. I had to TRANSLATE. I had to recall conjugation rules and feminine vs. masculine and how to make a singular noun plural all as FAST as possible. But the thinking took forever. It didn’t feel normal or natural.  And in my mind, this is how I always perceived my language experience would be since I missed that precious window of opportunity to hear Spanish as an infant. Still, I forged on.  This is an example of the simple intakes I would do on patients visiting the clinic for prenatal checks:

Me: Toma medicina? Vitaminas?

Patient: Si, vitaminas para el embarazo. Eso es todo.

Me: Es su primer embarazo?

Patient: No, el segundo. Tengo niña.

Me: Tiene algunos problemas hoy? Resfriado? Tos? Se siente débil?

Patient: No, todo está bien.

Me: Tengo que obtener las dimensiones del bebé ahora.

Patient: Está bien…<pause>…hablas español bien.

Me: (with a smile, knowing the patient was just being nice regarding her linguistically challenged doctor)         Gracias. Tengo que practicarlo.

Honestly, that is what has made the learning journey easier all along. Patience. Understanding. Gratitude--from patients who have appreciated my efforts at better communication.

It felt good, even then, with the few words I was able to muster, to be able to walk into an exam room and communicate on some level—without a third party translator interrupting the doctor-patient bond.  Don’t misunderstand me!---translators and/or interpreters absolutely serve a vital role in health care.  It’s just, when it comes to something as private AND personal as a person’s health, if you can serve as the sole listening ear in such a conversation and give the patient the privacy that he/she deserves,  the doctor-patient relationship is strengthened all the more.

Courtesy D. Hromin