An Exit

  

I remember one time during residency,  I was rotating through the VA Hospital in Manhattan. The office I worked out of was right next door to the senior resident’s room.  He was seeing his post-op day 1 cataract surgery patient and during the evaluation, he asked the patient how he felt about the results of the surgery.

The patient spoke in English, but his primary language was Spanish.  I listened intently, and heard him say, “I feel O.K. The surgery was a.....an.....an exit!”

The senior resident responsed: “An exit?”

I laughed to myself and went into his room interrupting the conversation. 

“He is trying to tell you that the surgery was a success!  He is using ‘exit‘ from the Spanish word for success, ‘éxito’!”

“Oh.” 

And on the exam went.

I thought it was funny how this patient, not remembering the English word for “success”, tried to use the Spanish word in its place, imagining English speakers use the same root word “exit”.   How many times have you done the same in Spanish and the meaning of intent was completely changed?!

“Estoy embarazado.”  Trying to saying you’re embarrassed, but instead saying you’re pregnant.

Correct translation: Tengo verguenza.

“Me pasé un grande tiempo.” Trying to say you’ve had a grand time, but in fact you’ve had a big time.

Correct translation: Me pasé un buen tiempo.

“No puedo esperar a ver la película, estoy excitada.”  You’re excited to go see the movie, but “excited” has different implications in Spanish.

Correct translation: No puedo esperar a ver la película, ¡estoy muy emocionada!

“Cuando llueve, es obvio que tenemos problemas con el roofo.” Surely the word for ‘roof’can’t be too different in Spanish? It is: Techo.

Correct translation: Cuando llueve, es obvio que tenemos problemas con el techo. 

To highlight my point about using word roots to make an educated guess as to the equivalent vocaculary word in another language, I came across the blog Íngles Latinos which has the goal of teaching English vocabulary to Spanish speakers:  http://duplicatuinglesya.com/blog/2026.html

 

This wonderfully helpful blog opens by telling the Spanish speaking reader that understanding the origin of a word in Spanish helps in learning English vocabulary words because many words in both languages share the same root. Therefore, all one needs is to learn the key word root and apply that knowledge to decoding the meaning of other English words.    It goes on to say that many English and Spanish words have the same origins. An example is the word ‘unilateral’ which not only has the same meaning in each language, but also the same spelling.  

Medical English and Spanish vocabulary are very similar as well. Take the following examples from ophthalmology:

Retinopatía diabética for Diabetic Retinopathy

Cristalino or lente  for Crystalline Lens 

Catarata for Cataract

Retina for Retina

Degeneración macular for macular degeneration

Estrabismo for strabismus

Conjuntivitis for conjunctivitis, and the list goes on...

So the patient's surgery was indeed an éxito--a success! And after his exam, the patient left by means of the exit, or el salido.  Obviously, not all words between the two languages share similar roots, but when they do, it makes learning and using new vocabulary all the more easy. 

                                                                    

                                                                  The end.  El Fin :)

Courtesy: D. Hromin

Calling all Opinions!

Most of my knowledge of medical Spanish did not come from books.  I could speak and understand conversationally by the time I reached my residency years. It was there that I picked up a more sophisticated medical Spanish through real patient interactions.  

One of the major complaints I have heard from medical students, residents and attending physicians alike is that there is no language learning material available in Spanish for doctors that gives them the sense of how a patient would respond in any given medical encounter.  So many of the books available today are written for the person who doesn’t know any Spanish and has to start with the very basics of “hello”and “goodbye”.  And these books are usually organized by chapters of phrases that a doctor might say to a patient during an exam.  But there is no material out there to my knowledge that gives a true sense of a patient-doctor interaction—how he or she might answer you when you ask:

“¿Por qué Ud. está aquí en la clínica hoy?”

Or

“¿Cuándo empezó el dolor en el ojo derecho?

I have been working on an informational guide for ophthalmologists and optometrists based on my experiences with patients over the years that seeks to provide real dialogue between patient and doctor.  Below is a small excerpt from my guide, which has been written with the uveitis patient in mind.  The conversation is initially written in Spanish and is then followed by the English translation.  Obviously to make good use of this information, a person needs to have a good foundation in the Spanish language.  

I encourage you to add your comments at the end of this blog entry. Please let me know what you think—if you feel this information would be helpful to you in the clinical setting and/or how I can improve upon it.  ¡Sí, se puede!

Uveitís--Uveitis

The patient with uveitis complains of a red (rojo), painful (doloroso), usually light-sensitive eye (sensible a la luz) and the vision may be decreased (disminución de la visión).  It is important to know how long the patient has had symptoms (¿Cuánto tiempo ha tenido Ud. las síntomas?) and if this is the first episode or not (¿Ha tenido síntomas similares en el pasado?).

Doctor: ¿Qué le pasa con Ud.?

Paciente:  (ojos cubiertos con las manos) Tengo dolor muy fuerte en el ojo izquierdo. No puedo soportar la luz. Me duele—es un dolor constante. Pero cuando la luz brilla en los ojos, el dolor es insoportable. 

D: ¿Cuándo empezaron las síntomas?

P: Ayer, anoche. Me sentí algo, un dolor leve de vez en cuando. Pero no me podía dormir. Y esta mañana, el dolor ha aumentado enormemente.

D: Ponga la barba aquí, vamos a ver…(después de pocos minutos). Bueno, siéntese atrás. Voy a explicar lo que tiene. Es una condición muy común, se llama “iritis”. Significa que tiene Ud. inflamación en la frente del ojo, la cámara anterior del ojo.

P: ¿Inflamación? ¿Estoy contagiosa?

D: No, no es infección. Inflamación. Por ejemplo, cuando una persona tiene artritis reumática.  Hay inflamación en la articulación—esta condición en el ojo es muy similar. De hecho, hay muchas causas de iritis, y artritis reumática es una de ellas.

P: Espero que no tengo artritis reumática. ¿Cómo curamos iritis?

D: Va a tomar una gota, es un esteroide, cada dos horas durante el día. También, va a poner una gota de agente midriático dos veces al día a prevenir la formación de cicatrices a hacer el iris inmovíl. 

P: Está bien. Entonces, ¿cómo sabemos la causa?

D: (escribe una receta) Voy a mandarle para una muestra de sangre, a buscar diversas etiologías. Por ejemplo, la enfermedad de Lyme, lupus eritematoso sistémico,  la artritis reumática, a decir los menos. Pero tengo que decirte, muchas veces, los resultados del laboratorio son normales.

P: ¿Qué? ¿Cómo es posible?

D: Sí, la mayoría del tiempo, no sabremos la causa. Pero, todavía, podemos tratarlo. Bueno, empiece los medicamentos y vaya al laboratorio para dar una muestra de sangre. Voy a hacer una cita con Ud. en una semana.

P: Está bien. Gracias, Doctor.

D: De nada. 

*

Doctor: What happened to you?

Patient: (eyes covered with his hands) I have a terrible pain in my left eye.  I can’t stand the light.  It hurts—it’s a constant pain.  But when the light shines on my eyes,  the pain is insufferable.

D: When did the symptoms begin?

P: Yesterday, last night.  I felt something, a light pain once in a while.  But I couldn’t sleep.  And this morning the pain increased exponentially.  

D: Put your chin here, let’s see (after a few minutes).  Alright, sit back.  I am going to explain what you have.  It is very common condition, it’s called “iritis”.  It means you have inflammation in the front of the eye, in the anterior chamber.

P: Inflammation? Am I contagious?

D: No, it’s not an infection.  Inflammation.  For example, when a person has rheumatoid arthritis there is inflammation in the joint—this condition in the eye is very similar.  The fact is, there are many causes of iritis and rheumatoid arthritis is one of them.

P: I hope I do not have rheumatoid arthritis. How do we treat ‘iritis’?

D: You are going to take a drop, it’s a steroid, every two hours during the day.  Also, you are going to put a mydriatic eye drop two times a day to prevent the formation of scars which prevent the iris from moving.

P: Fine.  Then how do we know the cause?

D: (writing a prescription) I am going to send you for a blood sample, to look for various potential etiologies.  For example, Lyme disease, systemic lupus erythematosis, rheumatoid arthritis, to name a few.  But I have to tell you—many times the lab results are normal.

P: What? How is this possible?

D: Yes, the majority of the time, we will not know the cause.  But we can still treat it.  Alright, begin the medications and go to the lab to give a blood sample.  I am going to make an appointment for you in one week.

P: That’s fine.  Thank you, Doctor.

Gates to Zadar City, Courtesy: D. Hromin