Me: “Hola, Soy Dra. Hromin, vamos a
empezar el examen.”
Patient: “ Hi. How are you? I’m fine.”
(spoken with little to no accent)
Me. “You can have a seat right
there. So, I see you’re here today for a general eye exam and follow up from
the last visit. Do you have any particular concerns you’d like to tell me
about?”
Patient: (looking confused) “Sorry,
not much English”.
Me: “Oh, está bien – puedo hablar en
español – Usted habló inglés tanto bien antés, pensé que Usted querría conducir
el examen en inglés. Pero está bien, ¡sólo tiene que decirme!”
Patient: (looking serious and
somewhat angry) “Bueno estoy aquí por lentes nuevos.”
For anyone who’s been reading my
blog and following my blog, you know that the purpose of my entries is
primarily to educate and to share. You know that I’m a practicing
ophthalmologist who grew up speaking only English in my family’s household. You
already know it wasn’t until I started the 7th grade that I was
given an introduction to basic Spanish in school and that over the years as I
grew, my Spanish grew with me. I took Spanish learning to every level of my
education, high school, college, medical school. I’ve documented for you that
just as conversation English and English medical terminology are two very different
elements, so too are medical and conversational Spanish. You know that I want
to help other physicians who learned Spanish secondarily to use it proficiently
in their communications with Spanish speaking patients. My opinion of language
learning is that it is fun—though it requires work and dedication – at the core
it is fun, cool even!, to be able to converse with someone who you otherwise
wouldn’t be able to if you didn’t speak their language.
There is on-going controversy here
in the U.S. regarding whether it should be a requirement of doctors to learn
Spanish to communicate with their patients. My feeling is that, though it
shouldn’t be a requirement, doctors should attempt to communicate (or find
services that can) in their patient’s language while patients too should take
responsibility for their U.S. health care and attempt to learn some English.
Over my last 10 years of
ophthalmology practice, my overall experience with my Spanish speaking patients
is that they have been nothing but grateful at my communication skills with
them. There is relief, gratitude, happiness and a true sharing and learning
that has taken place between doctor and patient. However, every now and again
during that time period, I do come across a patient who is not grateful and
friendly, but rather has a very arrogant attitude about Spanish language use in
this country. Fortunately, I have had so few of these encounters I can count
them on one hand, but negative experiences stand out most in our minds,
unfortunately. And though these experiences were so few, they will not be
forgotten.
The earlier conversation in this
entry documents one of these interactions. I return to it now:
Me: “Se dice aquí que la última vez,
cuando estaba aquí, el oftalmólogo empezó un tratamiento nuevo para Usted. ¿Por
qué no lo ha continuado?
Patient: (somewhat heated) “El otro
medico no me dijo lo que tenía yo, o que tuve que continuar con el tratamiento.”
Me: “Ok, está bien, bueno, voy a
examinar sus ojos hoy, y despues podemos discutir lo que tiene que hacer.”
After the exam, having explained the
patient’s diagnosis and treatment, I turned to the computer to print out his
new eyeglass prescription:
Me: “Déme un momentito a escribir su
receta por lentes-“
Patient: (talking to me, as I’m
typing out his prescription) “Es bueno que habla español,--debe hablar español. Hay veintiseis milliones de personas quien
habla español en este país. Usted debe
tener la abilidad hablar con ellos.Yo vine aquí demasiado viejo a aprender inglés. No puedo aprenderlo. Mis hijas, aunque, son bilingues.”
Me: “Oh.”
There were so many things I felt
like saying, but I realized any retort would be provocation for an argument and
to be honest, I wanted to finish up my prescription and get the patient on his
way. His presence and words made me uncomfortable.
For the first time ever, at that
moment I regretted knowing Spanish. If I didn’t know it, then I wouldn’t have
understood his arrogant remarks. He felt that I “should” know how to speak and
understand Spanish, to make up for his (and anyone else’s) choice not to learn
enough English to at least interact with the larger community living outside
his family/friends.
I didn’t learn Spanish to satisfy
this man or to make up for his short-comings. I learned Spanish because I like
to learn, I love language, and because I recognize that the United States is an
immigrant nation, the largest immigrant group of which happens to be Spanish
speakers (the latest census of which documents 45 million Hispanophones). I
knew that in my medical career there would be a very good chance I would be
interacting and caring for these patients, and I wanted a personal way of
communicating, more personal than a telephone line or interpreter service.
The United States has no official
language. English is primarily spoken, followed by Spanish, followed by
Chinese, Tagalog, Vietnamese and French, followed by an even smaller array of
Slavic, European, Middle Eastern and Indian languages. With so many languages,
unless one is a gifted polyglot, it is impossible to know them all fluently,
let alone medical vocabulary in all of them. So, we have to find a way to work
together to communicate with each other. For me, it makes sense to know the
business language of the world, English, primarily but then to learn
secondarily the language of the community of people I interact most often with.
For anything else, I need the services of an interpreter. But I think if
everyone made an attempt at learning something beyond their native tongue, this
would work toward better communication and a stronger bond between one another.
After all, we are citizens of a beautiful, culturally diverse nation. We should
embrace that – not use it to make more divisions.
In the end, I actually felt sorry
for my patient. I hope I never reach a stage in my life when I deem myself “too
old” to learn something. And I hope when faced with a choice, I choose the path
that unites, not divides.
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| Political Opinions, Preko, Croatia |
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