Me acerco a la paciente, una mujer de 85 años, y su hija
que está aquí para acompañarla.
Doctora: Hola,¿Sra.
López*? Soy Dra. Hromin (sonrie,mira a su
hija)– vengan Uds. conmigo por favor, vamos a empezar el examen ahora.
Sra. L: Mucho
gusto (apoyada en el brazo de su hija)
D: Aquí estamos.
Sra. L, usted puede sentarse ahí (le
muestra la silla de examen). Y usted puede sentarse en el lado, gracias (le muestra a la hija otra silla).
(se enfrenta a la Sra. López)
Se dice aquí que
tiene problemas con los lentes – no funcionan para usted—que quiere usted
lentes nuevos para leer.
Sra. L: (con expresión confusa-le mira a su hija con cejas fruncidas)
¿Qué dice ella?
D: (habla con la hija) ¿Ella no comprende mi
español? ¿Por qué?
La hija: No,
ella la comprende, es solo, ella es vieja....(a su madre) Mama, ella le pregunta si tiene
problemas con los
lentes. Me dijo que ellos no funcionan para leer, ¿no?
*
(Translation:
I’m
approaching the patient, a woman 85 years of age, and her daughter who is here
to accompany her.
Doctor: Hello, Mrs. Lopez? I am Dr. Hromin (smiling, looking at the daughter)-come
with me, please, we are going to start the exam now.
Mrs. L: Pleased to meet you (leaning on the arm of her daughter).
D: Here we are. Mrs. Lopez, you can sit there (shows her the examination chair). And
you can sit on the side, thank you (shows
the daughter the other chair).
D: (faces Mrs.
Lopez) It says here that you have problems with your glasses – they are not
working for you – that you want new glasses for reading.
Mrs. Lopez: (with
a confused expression – she looks at her daughter with furrowed brows) What
is she saying?
D: (talking
with the daughter) She doesn’t understand my Spanish? Why?
The daughter: No, she understands you, it’s just,
she is old...(addressing her mother)
Mama, she is asking you if you have problems with the glasses. You told me they
are not working for you for reading, right?
*
When I was first learning how to communicate in
Spanish, through real, live, conversations with patients during my medical
school days, it was very rough-going for some time. I tend to advance quickly in reading and
writing language skills, but speaking and listening are a unique and different
skill set. Unlike written text, which
can only appear one way on paper, spoken dialogue varies from person to person,
based on accent, rapidity of speech, dialect. Does this person slur his speech
when he talks? Does he drop the final consonant? Does he talk so quickly that a
sentence becomes one, long, continuous word? Native speakers of a language know
the various ways something can be pronounced and still make sense of it. They
know the inflections, the accents, the slang, the dialect. They know when to
listen, and how to listen. And they know how to speak.
In the beginning, when my Spanish vocabulary was
poor, my understanding of grammar was limited and I had minimal previous
interaction with native speakers-- talking in full sentences was painfully slow
and choppy. It took tremendous time and effort to spit out one complete thought
in the language, and it required a listener who was willing to wait to hear
what I had to say-- not get frustrated and complete my sentence for me. Understandably,
because my practice in the language was minimal, my pronunciation of words more
often than not, was incorrect. I would put the emphasis on the wrong syllable,
and native Spanish speakers listening to me would look at me curiously, with
one brow raised.
That’s how it was in the beginning. But now, fast
forward almost 15 years later, and I’ve worked with many Spanish-speaking
patients. Their countries of origin vary, but have included a rich mix of
Dominican, Puerto Rican, Chilean, Guatemalan, Mexican, Salvadoran and Peruvian
patients. As a result, I’ve been exposed to various ways of speaking the
language, including lenguaje llano (plain
language) typical of the regions the speakers are from (known as localization in translation circles). I
know what to listen for now, and I judge myself a pretty good mimic of the
correct pronunciation. I don’t sound like a typical “English speaker learning
Spanish” anymore. I’m proud of that.
Most patients now mistake me for someone of, say, Puerto Rican, descent,
based on my Spanish. I am thrilled. I feel accomplished.
So that is why when I come across a patient like
this older woman in the above dialogue, who needs to look to her daughter to
interpret my Spanish to her Spanish, I am dumbstruck. I listen carefully to the
daughter to see if she’s using any special vocabulary or colloquial phrasing.
She’s not! In fact, oftentimes the daughter says verbatim in Spanish what I
already said- and somehow the mother understands better. ??? In these scenarios
I have no answers to give on what to do when this happens. I only try to speak
more slowly, loudly (if I suspect a senior patient has a hearing problem) and
place more emphasis on proper accent pronunciation.
Out of curiosity, I attempted to look online to see
if anyone else in the healthcare field or elsewhere, wrote about a similar
experience. Not many useful hits came to light, except for one messaging site
where a native Spanish-speaker wrote that when someone non-native speaks
Spanish, if she doesn’t have the right “ritmo”, or rhythm, to her speech, then
he has difficulty understanding her.
It seems the reality of language learning is this: you may have built quite an arsenal of vocabulary.
You may be following all of the grammar rules. You may have excellent reading,
writing and listening skills. But when
you open your mouth and speak, if you
don’t have the right ritmo, then all
of that knowledge is for naught. Your listener won’t understand you. You’re
missing a key component in oral communication. Getting the rhythm right only
comes over time, from interactions with many different native speakers. This is
yet another argument I have against these “be fluent in 3 months” language
programs. It took you a lifetime to get your native language’s ritmo right, why
would you expect anything less from any other language?
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