I speak, therefore I am

To me, one of the great language-learning mysteries is how and when you reach a point in your non-native language when the words you speak pour forth from feeling, and not from thinking. You don’t have to translate in your head and check sentence structure before reacting to something. I have mentioned before in so many words that, in my native English, I don’t have to think about the words I want to use. I simply feel, and then I speak. But in Spanish, though I have improved immensely over the years, there is still a great deal of thinking associated with every feeling I want to convey.

So the question is, what gets you there? What allows you to achieve this level of fluency? I would imagine, immersion. Constant interaction. Constant listening and making sense of it all. And speaking. Hearing and answering. So you can imagine, here I am everyday in an exam room with the patient, and I’m trying desperately to immerse myself in his language, making it my own. I’m trying not only to hear and answer, but to feel, in Spanish. And at times I push myself to the point where I’m close, and then—I have to look at the computer screen in front of me. The patient’s chart. And it’s written in English. And I’ve got to document in English. And I find that my efforts to attain full submersion only leave me partially submerged. I’m bobbing at the surface between the two languages, never fully achieving either. And my notes end up reflecting that: a mix of the two. A confusion.

I can’t tell you how many of my chart notes over the years are inadvertently written as follows:

She stopped using plaquenil tres años atrás.

Ella sabe poco inglés, but prefers to speak in Spanish.

Historia personal: Él nunca fumaba, bebe casi two or three drinks a week.

Sometimes I just write the physician in-notes (those not transferrable to the medico-legal record) entirely in Spanish. The remainder of the chart stays in English, until I prescribe a medication and remember to write the instructions for the patient in Spanish.

It’s a lot of back and forth, a little of this and that. A constant interchange I imagine would be easy for a bilingual native speaker of the two. But for someone like me, native to one and only a frequent guest of the other, moving between the two languages can be difficult if not at times frustrating.

In the study of ophthalmology, when two eyes are properly aligned and the image of the object in sight falls on the same corresponding areas of retina in each eye, this is known as “retinal correspondence”.  If the eyes are misaligned, then the areas where the image focuses in each eye will not correspond and will result in a condition known as “visual confusion”. In the developing child, when the visual cortex is in its plastic period, visual confusion is not allowed because the image of the misaligned eye to the brain is suppressed. In adults, this suppression is not as active, and misalignment of the eyes leads to double vision.

Well, I was just thinking that, in many ways, when a non-native speaker is trying to juggle between his native and non-native language, I have found that, to a certain extent, there appears to be another type of confusion, a “verbal confusion”.  And the brain, being the excellent brain that it is, tends to suppress the non-native words.  I can say from experience that, years ago when my command of spoken Spanish was not as advanced as it is now, my “verbal confusion center” was active at suppressing those foreign words. It held them back, allowing the English to push through. Today, this suppression doesn’t appear as active. I can balance better, but there is still a stronger pull to the dominant English.

Does one reach a stage in language proficiency, where one can move fluidly between multiple languages, without much thought and with little to no confusion? Converse in one language with the patient, but write notes in another, without so much as a stammer? I don’t know. But the best I can hope for is that one day I will know the answer because I'll be living the answer.  For now, what I have is an eclectic, interesting mix of English and Spanish. If from that mix comes better patient-doctor communication, then the struggle for language harmony is certainly worth a little confusion.

Utah desert. Courtesy: D. Hromin