Despedirse

(Aviso legal: los siguientes párrafos representan mi opinión y se escriben en mi español – el español de una hablante nativa de inglés, quien trata todos los días a aprender un poco más de español que lo que ella conocío el día anterior.)

Doctora: (después de acabar el examen) Me complace ver que el medicamento funcione para usted. Debe regresar en seis meses para otra revisión de los ojos.

Paciente: Sí, gracias, los colirios me hicieron sentir mejor de los ojos. Los ojos no me queman o pican no más.

D: Está bien. Pero una cosa, cuando regresa para la cita en seis meses, desafortunadamente, no estaré en esta oficina.

P: ¿No trabajará aquí? ¿Qué, se muda?

D: No sé todavía. Quiero pasar el tiempo afuera del ámbito médico para un rato.

P: Me hace decepcionada oír estas noticias. Usted era la sola médica que me ayudaba  con la sequedad de los ojos. Y porque tengo confianza en usted, llevé a mí mamá para verla también. Tenía yo muchos otros doctores en el pasado, pero ellos no estaban dispuestos a dedicarles el tiempo necesario para ayudarme y a mí mamá.

D: Estoy agradecida oír sus palabras simpáticas. No sé, tal vez un día, regresaré al mundo de medicina, pero por ahora, tengo que utilizar el tiempo para explorar otras oportunidades. No sé lo que traiga el futuro. Dile a su mamá un saludo de mí. Les deseo a ustedes todo el mejor, especialmente la salud buena – para el cuerpo, incluir los ojos – y la mente.

P: Gracias, (mientras irse), le diré a ella. Buena suerte.

                                                                        *

Algunos meses atrás, bueno, en realidad algunos años atrás, hice la decisión irme del ámbito médico. Bueno, no de la especialización de medicina completamente, solo medicina clínica. Por diez años después de la residencia médica (y la residencia duró tres años), yo trabajaba siempre para otros médicos – para sus practicas, según sus reglas. Aunque yo tenía el control de los casos de mis pacientes, no podía hacer muchos de mis decisiones propias en su cuidado. Yo debía someterme al gobierno, a los seguros médicos y a los jefes de la oficina. Normalmente, por ejemplo, un examen completo de los ojos – particularmente uno donde se han dilatado las pupilas – requiere a menos veinte minutos para realizar.  Pero, las clínicas médicas donde yo trabajaba me obligaron realizar un examen completo en no más que cinco a siete minutos. ¿Por qué? Un examen más corto significa hay espacio en el horario para más pacientes. Para mí, y para la mayoría de los médicos, eso no es bastante tiempo para pasar con el paciente: para oírle, para escucharle, para examinarle, para explicarle lo que tiene, para asegurarle. Los días de la relación tradicional (donde el médico, y no el gobierno, o el director de la oficina, o la compañía de seguros médicos, hizo las decisiones para el paciente) entre del médico y del paciente se acaban.

Ahora, hay un éxodo de médicos de la especialidad de medicina en los EEUU. Y, si el médico no puede funcionar en una manera independiente, para tener el control total sobre las decisiones de la salud de una persona, para ordenar las pruebas necesarias para diagnosticar correctamente, para recetar los medicamentos que son vitales para la supervivencia, entonces ella está obligada dejar de ser médico. Si no, ella continua funcionar como marioneta del sistema.

Yo continuo a dedicarme al aprendizaje, a la palabra escrita, a la edición de informes y artículos eruditos de médicos y científicos destinados para publicación en los diarios académicos. En esta manera, puedo continuar con la cultivación de conocimientos médicos en la forma más pura – sin obstrucciones de “la autoridad” y según mis principios y mi horario en mi propio tiempo.

Y, un día, si hay una revolución (y sí, es completamente posible con el sistema en su estado actual) y la practica de medicina vuelve al método original, tal vez volveré al mundo de medicine. Pero por ahora, no. Solo el futuro nos dirá lo que va a pasar.

                                                                        *

(Disclaimer: the following paragraphs represent my opinion and are written in my Spanish – the Spanish of a native English-speaker, who tries every day to learn a little more Spanish than she knew the day before.)

Doctor: (after finishing the exam) I’m happy to see that this medication is working for you. You should return in six months for another eye checkup.

Patient: Yes, thank you. The drops have made my eyes feel better. My eyes don’t burn or sting anymore.

D: Fine. But one thing, when you return in six months for your appointment, unfortunately I will not be in this office.

P: You won’t be working here? What, are you moving?

D: I don’t know yet. I want to spend some time outside the medical arena for a while.

P: I’m disappointed to hear this news. You were the only doctor that helped me with my dry eyes. And because I have faith in you, I brought my mother in to see you also. I’ve  had many other doctors in the past, but they weren’t able to dedicate the time necessary to help me or my mother.

D: I am grateful to hear your kind words. I don’t know, perhaps one day I will return to medical, but for now, I have to use this time to explore other opportunities. I don’t know what the future will bring. Say hello to your mother for me. I wish you both all the best, especially good health – for the body, including the eyes – and the mind.

P: Thank you, (while leaving), I will tell her. Good luck.

                                                                        *

Some months ago, well, truthfully some years ago, I made the decision to leave the medical field. Well, not completely from the specialty of medicine, only clinical practice.  For ten years after my medical residency (and the residency lasted three years), I always worked for other doctors – for their practices, according to their rules.  Although I had control over my patient cases, I couldn’t make many of my own decisions in their care. Normally, for example, a complete eye exam, particularly one that involves pupil dilation, requires at least twenty minutes to perform. But the practices where I worked forced me to do a complete exam in no more than five to seven minutes. Why? A shorter exam means there is room in the schedule for more patients. For me, and for the majority of doctors, that isn’t enough time to spend with the patient: to hear him, to listen to him, to examine him, to explain to him what he has and to reassure him. The days of the traditional relationship (where the doctor, and not the government, or the office manager or the medical insurance company, made the decisions for the patient) between a doctor and her patient are over.

Now, there is an exodus of physicians from the medical field in the United States. And, if the doctor cannot function in an independent manner, to have total control over decisions regarding the health of a person, to order the tests necessary to correctly diagnose, to write prescriptions for the medications that are vital to the person’s survival, then she is forced to cease being a physician. If not, she continues to function as a marionette of the system.

I continue to dedicate myself to learning, to the written word, to the editing of reports and scholarly articles by physicians and scientists meant for publication in academic journals. In this way, I can continue to cultivate medical knowledge in its purest form – without obstacles of the “authorities” and according to my principles and my schedule in my own time.

One day, if there is a revolution (and yes, it is completely possible with the system in its current state) and the practice of medicine returns to its original methods, perhaps I will return to the medical arena. But for now, no. Only time will tell what is going to happen.

NYC mural by Ashli Sisk

Courage

“Whatever you do, you need courage. Whatever course you decide upon, there will always be someone to tell you that you are wrong.” ― Ralph Waldo Emerson

At any given time when I am preparing an entry for the readers of this blog, I’m usually working on two (or more) potential entries at the same time. My thoughts will shift from one topic to the next. I dedicate some time to one and then some to the other and before I know it, a month has gone by! A month that could have had four (or more) good, seminal blog entries, but due to my procrastination and topic-jumping, I squeak out one or two at best.

Well, this month of January 2018 is no exception. I was in the middle of writing a Spanish conversation I had with a patient for one of my Una conversación con un paciente series while balancing another entry meant to reflect on the growth and dominance of the Spanish language over the years in Miami-Dade County, Florida. I was set to complete one (or both) of them, and then, a set-back occurred.

It’s the kind of set-back that is painful for me to write about, but I feel it is important to share what happened with my readers. Important enough to stall my completion of the up and coming entries on which I’ve been working.

You know that I talk ad infinitum in this blog about certain recurring themes:

“Don’t be afraid to make mistakes when learning a language, your efforts will be appreciated.”

“Don’t worry if your language skills aren’t perfect, it’s better to make an effort than not at all.”

“If a person sees you make an effort to speak his language, that person may be inspired to make efforts to communicate in your native language, too.”

“Language doesn’t have to be dividing, it can be uniting as it helps us learn a little bit more about each other with every communication.”

And so on and so on. I try to be encouraging. I try, even through my own moments of frustration with language learning, to show how I pick up and move on, learn from the situation, and hopefully grow.

I know that I’ve shared with you how the vast majority of my Spanish-speaking patients have appreciated my language efforts over the years. This is true—they’ve told me in Spanish! Again, my Spanish may not be perfect, but it is understandable and coherent enough to elicit the responses I have needed to provide exacting care to my patients. And, as proof that it works, my patients have done well.

Because of my successes using Spanish language with my ophthalmology patients, during my residency, I decided that I wanted to be helpful to the larger community of doctors, nurses and staff (for whom Spanish is not a native language) that provide care to Spanish-speaking patients and might benefit from some of the language tips and phrases I’ve acquired over the years.

One of the ways I’ve attempted to accomplish this is through this blog. But, in addition,  I wanted to make the Spanish I learned through daily patient interactions available in a guide form. I thought it would be a good idea to compile actual doctor-patient conversations I’ve had with patients while treating various eye problems and make those conversations available to other health care providers. It’s easier, in my opinion, to learn this way. Instead of memorizing lists of vocabulary, reading the back and forth speech between doctor and patient seems more realistic. This way, a doctor in an urgent care facility, when confronted with a Spanish-speaking patient with a corneal abrasion, would know what descriptive words to listen for and be able to faster hone in on the problem and its cause. Better communication equals better diagnosing, better  treatment and better patient.

So, I started this guide as a resident at NYU back in 2007. Then I graduated residency and entered a private practice in a suburban community. During this time,  I continued to add to the vocabulary/ conversations/ phrases that I had initially gathered as a resident. Before I knew it, I had compiled a complete set of doctor-patient dialogues – enough to be able to put a usable guide together for other eye care providers. I had my guidebook reviewed and edited by a bilingual (English/Spanish) medical editor. And then I self-published the book through Amazon Kindle KDP.

Almost immediately, I received a 5-star review from an appreciative doctor working with Spanish-speaking patients. And though the book is not a best-seller, listen, it was never meant to be! – it has been read and used by various readers over the last three years that it has been available online. It’s simply another reference made available to health care providers who want to expand their language and cultural repertoire. And the book’s 5-star rating has held. No one has had anything negative to say about my piece – well, up until now, anyway.

The other day I was updating my resume and wanted to include the Amazon link to this guide that I wrote (incidentally it is called “Eye,MD Dialogue: Ophthalmology in Spanish ~ Oftalmología en Español”). However, when I went to the actual site to copy the link, I noticed that the book rating had dropped significantly. It went from 5 stars to 2.5. I saw that someone left a 1-star review, and even before I read it, chills went down my spine and I felt an immediate sense of dread. This is a short and simple guidebook of acquired phrases I’ve gleaned directly from patient experiences meant for an audience of doctors. Who could possibly find something wrong with my experiences and, honestly, why?

The person’s review was short but not sweet. She said something to the effect of, ‘don’t buy this book, the Spanish is wrong, the author used Google translate, this is not how Spanish people talk, don’t waste your money’. Smug, full of ill-will and honestly, totally wrong. I thought to myself, if I had used Google translate to produce this guide, I would have completed it a long time ago! It would have been written, edited and published when I was a resident and not taken the 8 years that it actually took to compile all that I learned from patients.

When I got up the courage to read the review again, I saw that it was given by an unverified purchaser. In Amazon Kindle terminology, that’s pretty much akin to a bogus review. But bogus review or not, it brought down my ratings. The review is full of lies, but the thing that scares me is that people, for some reason, believe lies. Some people believe lies before they believe the truth, if they ever believe the truth. The bottom line is, reading that review was like being hit with a bullet. Anyone with a gunshot wound stops right in her tracks, not moving forward or backward. Not moving at all.

It really hurt me. Especially when I’ve been trying so earnestly to improve my Spanish language skills everyday. Worse yet, it made me begin to doubt myself. Before that review, I was feeling confident. My Spanish is great! Maybe not perfect all of the time, but I have learned how to communicate effectively! I can help others communicate in Spanish, too! After that review, I wanted to crawl up in a hole and hide. Am I really that bad? I know not all the phrases sound like a native Spanish-speaker, but they’re not meant to sound that way. I even explicitly say this in the book’s prologue. They are written from the perspective of a native English-speaker trying to communicate with her Spanish-speaking patients. It’s not meant to be soap opera dialogue or a movie script.

I am writing this blog entry because I want to give you, my readers, powerful advice on what to do when you encounter set-backs like this during language learning, how to shake it off, how to not care about it. But I couldn’t think of any good advice. I even stepped away from this particular entry for a time, to see if I could make sense of it all. I’ve come back today to complete this entry not having found any great wisdom to impart. I don’t have sage words that will cloak you in a protective armament. The conclusion I have come to is simply: people will criticize your language skills and it will hurt. It’s ok that it hurts. But that hurt (or embarrassment or disappointment or anger) shouldn’t stop us from moving forward toward our goals. There will be those who appreciate our efforts along the way, and those that choose to criticize those efforts.

Sadly, it’s not uncommon in any language-learning scenario. I took the following criticism left for a Slovak-speaker directly from the comment section of a YouTube video:

“I, as a Slovak, can tell that the Slovak guy felt way more comfortable while speaking in English, probably because, as he said, he grew up in America. His Slovak was kind of awkward, actually. The structure of sentences sometimes felt like those of non-native speaker of Slovak.”

My response to his statement is, So? And? You call his speech ‘awkward’, but you understood him, didn’t you?

And I remember one time when I was in college, native Spanish-speakers criticized the Spanish of an American student (who was bilingual and Latina). They were basically telling her in Spanish that her Spanish didn’t sound ‘like a native’. She answered by saying she knew enough to have a conversation – to understand and be understood – but it didn’t satisfy them.

I don’t know why this is. What makes these native speakers feel so perfect, so pure, so wonderful that they and only they hold exclusive rights to speak their language? Why don’t they respect someone for learning, for trying? Do they feel it’s an attack on their culture? Do they fear losing language exclusivity? I don’t know the answer to these questions, but would appreciate input from my blog readers.

I’ve decided the next time I hear someone tell me, You don’t sound like a native speaker, I’m going to answer something like this: Well, I’m not a native speaker, and I don’t want to be. I’m a native English-speaker who is learning everyday, and you can understand me, so, I must be doing something right.

References

irisoidis.(2017). Re: How mutually intelligible is Polish and Slovak? Polish Slovak conversation.[Video file]. Retrieved from: https://www.youtube.com/watch?v=dRTuxDtzYCc

Courtesy: Ostdrossel 2018 from American Bird Conservancy
Red-Bellied Woodpecker

Listen First, Read Later: Back at the Beginning

It’s hard to speak fluently if you spend all your time reading in silence.

                                                                                                            -Denis Ivanov

When you’re first learning a language, it is better to hear it first before you see it in written form. You want to be able to associate the objects in your environment with the sounds that represent them. Otherwise, when you see something around you or hear something,  you will first have to think of the word in your mind, then you must translate it, then lastly you think of the object being referenced.

Did that make sense?! Let me explain...

To give you an example, I’ll start with my own experience. My primary language is English. When I started learning Spanish at age eleven in school, I learned the Spanish words that coincided with English words, usually presented in long vocabulary lists like this:

the table=la mesa

the couch=el sofá

the chair=la silla

and so on and so forth.

I read the words in a vocabulary book. And, yes, we (the other students and I) read them aloud, too, but seeing the lists was the first introduction to these words. It’s not as if the teacher pointed to a chair and said simply, “silla”. We didn’t look at a chair and see in our mind’s eye “silla” and hear in our inner ear “silla”.  Instead this is what we saw:

silla ---> chair

I’m thinking back to some of the first English words I remember learning as a young child. No, it wasn’t “mom”, or “dad”, or a color of the rainbow, or a barnyard animal. It was “George Washington”!

I mentioned early on in this blog (see the entry Beginnings)  that I grew up in a two-family home with my parents and my grandparents (maternal). When I was a preschool-age baby, my parents and grandmother were working full-time, but my grandfather was retired. He was home and took care of me until my mother got home from work. My grandparents were very big on colonial America. They had some form of yester-year memorabilia in every square inch of their house: a Paul Revere statue, a Thomas Jefferson decanter, a replica of the Liberty Bell, and, of course, a rather large wall plaque of George Washington. My grandfather carried me on his shoulders, pointed to the objects and said their names. “George Washington. George Washington.” But remember, every time he said those words, I wasn’t seeing the actual words “George Washington”. I saw this:

 

The fact of the matter is, when we are exposed to language before we start school, we never see the words we learn. We learn the sounds that describe the things in our environment. We hear a sound and we know instinctively and immediately what it is. We can see the object, and practically taste and feel the object. That’s language. That’s communication.

But later on in school, we see what these sounds look like on paper and we learn to read and write. And we continue to read and we continue to pick up new vocabulary this way.

The problem is, this is not true language communication. This is why it is so hard for students learning a second or third language in school to communicate with native speakers of that language – even after years of school-based study.

Donovan Nagel, creator of The Mezzofanti Guild, a website dedicated to linguistics and language learning, explains this concept more in-depth in his blog article, “How important is reading for learning to speak a language? Not very. Here’s why...”. He states that, “Language is 100% spoken. What we read...on paper is a representation of those sounds.” As a result of this, he goes on to say that simply reading words will not make you a fluent speaker (and I’m adding here, will not make you a good listener, either).

Mr. Nagel continues in the article, encouraging language-learners to practice a skill known as “chunking”.  This means, listening to audio conversations in the target language repeatedly (without reading!) and trying to use what you hear before you even understand the grammar or every vocabulary word. He insists people would have much more success on the road to fluency using this method instead of reading and memorizing the written word.

What Mr. Nagel has to say in this article rings very true to me, and I’ll explain why. As I said, I started my Spanish studies at about age 10 or 11. I learned vocabulary by reading long lists of words written in Spanish, along with their English counterpart. My studies continued that way- all with written text in Spanish- throughout junior high, high school and college.  I had memorized quite a bit of vocabulary and felt that I really knew the language well. But the moment people started speaking Spanish, I could barely understand them. Instead of understanding the foreign sounds coming out of their mouths, I saw a few words here and there that I could pick out. Words that I had to first translate in my head into English before I could understand. Said a different way, the sounds had no meaning to me, even though I knew what the words meant. This is because my language education focused too much on what was written down, and not enough on oral expression.

Frustrated, I often thought to myself, “When will I reach a point when I won’t have to think so hard when I’m having a conversation in Spanish? When will I understand naturally? When will I respond only with my thoughts and feelings and not have to think about the words and the sentence structure?” Well, after reading Mr. Nagel’s article and reflecting on my own experiences,  I finally have the answer to those queries: never.

...at least not until I let go of what is written down and instead simply listen to what is being said.

This is truly a eureka moment for me! In essence, I’ve been studying Spanish (written, written, written) for 31 years and though I communicate better now in my 31^st year than in my 1^st year, I still feel at a loss in some spoken conversations. I always felt more comfortable reading and writing the language, which is why I feel much more competent as a Spanish translator rather than a Spanish interpreter. And I spent years thinking it was because my brain was wired to understand written language better. I blamed a genetic flaw. A genetic tendency.  (There were for a time –now disproven- education theories that stated that some people learn better by reading/writing vs. speaking/listening. No study has ever proven this to be true. Now we know the reason.).

Granted, during our first few years of life, ie. birth through 3 yrs of age or so, our brain is pruning away unnecessary connections, removing redundancies and leaving behind neuron connections that serve in our survival. When we grow up around one language, our brain maintains neurological connections to understanding the sounds involved in communicating in that language, and eliminates foreign sound connections. This is the reason why learning a language after this neurological “plastic” period – as older children or adults – is difficult to become accustomed to hearing new and different sounds and conversation flow of a foreign language. But this can be overcome, simply by doing more listening and more familiarizing oneself with these new and different sounds. It is not the primary reason why communicating in a non-native language is difficult. The real reason is: we must associate objects with sound first before we associate them with their written representations.

It is now the end of 2017, a time when we make our new year’s resolutions. In 2018, I am going to resolve to do much more listening and speaking to increase my communication skills in Spanish and the other languages I want to learn. It is my hope to add French to that list, as well as Croatian, the language of my husband and his family.  Linguistically, I am going to turn back the hands of time and be a child again, doing the only thing a child can do in an effort to interact with her environment: hear, listen, mimic and speak.

What are your language goals for 2018?  

References

Ivanov, D. (2015, July 9). 9 beliefs 99 percent unsuccessful language learners have. [Web log post]. Retrieved December 30, 2017, from http://www.learningtoknowrussian.com/2015/06/9-beliefs-learning-russian-marathon.html

Nagel, D. (2015, July 2). How important is reading for learning to speak a language? Not very. Here’s why... [Web log post]. Retrieved December 30, 2017, from https://www.mezzoguild.com/reading/#

Patient Correspondence Letter 2

This is an example of a letter I wrote on behalf of a fellow general ophthalmologist, my practice colleague, for his patient. The patient, a young woman, was found to have papilledema during a routine eye exam.  For any non-MD readers of my blog, papilledema describes a condition of bilateral swollen optic nerves as a result of increased intracranial pressure. This is a dangerous condition that if left untreated has very negative implications on not only the patient’s sight but on the patient’s life. As a result of this finding, she was promptly referred to a neurologist for the appropriate testing and management. Unfortunately, the patient never kept the neurology appointment and the administrative staff  made the referring ophthalmologist aware of this.

In these cases, it is very important to reach out to the patient and explain, once again, the importance of following up with the treatment and management of such conditions. The patient here needed to understand that her eyes—and her health—were at grave risk.

When sending such correspondence letters, the communication should be done in a language the patient understands. As this patient was Spanish-speaking with limited English proficiency, this letter was written in Spanish plain language (aka non-technical Spanish language).  For purposes of this blog entry, I have provided a translation of the letter in English as well.

*names have been changed for privacy purposes

Estimada Sra. Méndez*:

Recibí recientemente un informe de la Dra. Smith*, la neuróloga.  La carta me informó que usted se suponía tener una cita de revisión con ella después del examen conmigo, pero le faltó la cita.  Usted recuerda nuestra conversación durante su examen aquí, cuando le dije que usted tiene nervios ópticos bien inflamados y hinchados.  Esto significa que usted tiene alta presión dentro del cráneo y necesita más pruebas por la neuróloga (incluye una punción lumbar) y medicamentos para tratar y curar esta condición.

También, la Dra. Smith me dijo que usted no ha recogido de la farmacia las pastillas que ella le recetó. Ella me dijo que ella ha tratado llamarla muchas veces, pero no podía contactar a usted.

Esta presión que tiene en el cerebro es muy peligrosa para su salud y la salud de sus nervios ópticos.  Si no recibe el tratamiento para bajar la presión del cráneo, puede quedar ciega por esta condición.  Por favor, le ruego que llame usted la oficina de la neuróloga inmediatamente cuando recibe esta carta, para hacer el examen de la espina y la punción lumbar y también, le solicito que recoja los medicamentos de la farmacia.

Después de que empieza usted el medicamento y tiene el examen de la espina, necesita regresar aquí por otro campo visual para hacer un examen de seguimiento de los nervios ópticos. Si tiene preguntas, llame esta oficina en cualquier momento. Si nos necesita para hacer la cita para usted con la neuróloga, nos complace hacer esto para usted.

Gracias por su paciencia y atención en este sentido. Recuerda, la salud de los ojos y del cuerpo están en juego.

Sinceramente,

Dr. Johnson  

                                                                        *

Dear Mrs. Méndez:

Recently I received a report from Dr. Smith, the neurologist.  The letter informed me that you were supposed to have a follow-up appointment with her after your exam with me, but you missed that appointment.  You remember our conversation during your exam here, when I told you that you have very inflamed and swollen optic nerves.  This means that you have elevated pressure inside your head and you need more tests by the neurologist (including a lumbar puncture) and medication to treat and correct this condition.

Also, Dr. Smith told me that you have not yet picked up the tablets from the pharmacy that she prescribed for you. She told me that she has tried many times to call you, but has been unable to contact you.

This pressure that you have inside your head is very dangerous for your health and the health of your optic nerves.  If you do not receive treatment to lower this pressure, you can become blind from this condition.  Please, I ask you to call the neurologist’s office immediately when you receive this letter, to have the spinal exam and lumbar puncture, and I ask that you also pick up the medications from your pharmacy.

After you begin the medication and you have your spinal exam, you need to return here for another visual field test to follow up on the optic nerves.  If you have questions, call this office at any time. If you need us to make the appointment with the neurologist for you, it would give us pleasure to do so.

Thank you for your patience and attention in this matter.  Remember, the health of your eyes and your body are at stake.

Sincerely,

Dr. Johnson

The Eye Exam 2017

Spanish Confetti

A man who knows two languages is worth two men.—French proverb

In keeping with my high school Spanish teacher’s, Mr. Jondee’s, advice, I continue to write down Spanish words or phrases  I come across in conversation, books, TV, etc, that I don’t know or understand. Then I look up their meaning and every now and again, I try to peruse the list to remind myself and remember.  As the years grow longer, so do the lists! Of course, as an ophthalmologist, I make sure to write down any medical expression in Spanish I’m not familiar with, but during this process I don’t limit myself to medical terms. You may be asking yourself, particularly if you are a health care provider with Spanish-speaking patients: Why should I bother learning vocabulary beyond medical terminology? What does, for example, the word columpio – a playground swing – have anything to do with heath care? Well, it doesn’t. But it may be important to know that word if a child is brought into the ophthalmologist’s office with a gash on her brow. When you ask how she got it, her mother may tell you, “Ella estaba jugando y la golpeó el columpio”.  If you have dedicated yourself to learning a language or expanding knowledge of a language due to patients you work with,  don’t limit yourself to memorizing only specialty-based vocabulary.  You need to know words of expression. You need to know words of the objects in your environment.  Particularly as a doctor, you need to move beyond the basic, “¿Qué le duele?” or  “Tome dos tabletas y llámame por la mañana.” Although this list (and it is only a fraction of the words I have written down over the years!) may seem overwhelming at first glance, don’t subscribe to the “I’ll memorize only what I need to know” mentality. Never stop learning – your patients will appreciate your efforts toward better communication.

I made a Spanish language folder on my hard drive dedicated to this vocabulary. I made a page in my iPhone notepad. Sometimes, when I don’t have access to my phone or my computer, I just scribble the words on little pieces of paper- whatever I can get my hands on at the time- so I don’t forget the word! So, my house, desk, and car all have a light layer of this “Spanish confetti” at any given time.  Sometimes I look upon this confetti as a sign of progress and think to myself: look at how much vocabulary I know! Sometimes it frustrates me: I’ve studied Spanish for 30 years and LOOK how much I don’t know! But moving forward is all we can do. In keeping with that philosophy, I’m dedicating today’s blog entry to vocabulary lists. Occasionally over the course of the blog, I will introduce new lists.  I’m thinking it may give you a head start on yours, or at least help you tackle some of your Spanish confetti. 

Me atendió la última vez.         You helped (attended to) me the last time.

Está relacionado con...             It is related to... (as in linked to or connected to)

¿Qué parentesco hay con-?      What is the relationship-? (ie blood line, genetic/family background)?

Los conservadores                   conservatives; (I have seen used for condoms, too)

Los preservativos                     preservatives, (I have seen this used for condoms as well)

El encargo                                assignment, job (alt. por encargo de – at the request of)

El expediente                           record, file (ie el expediente administrativo – administrative record)

Se le enganchó                         he was hooked (as in, captivated, interested)

*don’t confuse enganchar (to hook) with engañar (to deceive)

Deberían haberlo hecho           they should have done it

Aprobar                                   to approve

Hay que ver                             must see, should see , lit. there is to see

El tiroteo                                  gunfire; shooting

El tropiezo                               stumble; stumbling block; trip

Albergar                                   to shelter, to refuge

Los vejetales salteados             stir-fry vegetables

El jengibre                               ginger

Un ingreso fijo                         fixed income

Hablantes                                 speakers

Los encargados                        the managers

El concejo                                council

El consejo                                advice

Actuar                                      to perform

Cautela                                     caution

Los emprendedores                 the entrepreneurs

Un hallazgo                             a finding

Ronquido                                 snore (noun)

Cifra                                        number, figure

Vincular                                   to link (ie link stories or ideas)

El peor de los casos                 worse comes to worse

Tacón                                       heel (of a shoe) tacones altos-high heels

Con el dedo de pie destapado  open toe (use with zapato)

Suplicar                                   to appeal to

Aplacar                                    to appease

Tener ganas de                         to have a yearning for, desire to...

Calzado con tirantes                footwear with straps

Silvestres                                 wild

Ahondar                                  to delve (deeper)

Desdicha                                  misfortune; misery

Aplastar                                   to crush

Eje                                           axis,like visual axis

Sanidad                                    health

Vinculado                                linked

Difundir                                   to spread; disseminate

Brindar                                    to offer; provide

Encajar                                     to fit

Encajar con perfección            to fit perfectly

Zarpar                                      to set sail

Un naúfrago                            a castaway

Rehusarse                                to refuse

Desgaste                                  wear and tear

Demacración                           emaciation

Abejorro                                  bumblebee

Delito                                       crime

Conseguir                                to get, obtain

Soler                                        to usually do

Agredir                                    to insult, to attack

Entramado de alambres           mesh of wires

Prometadora                            promising

Se ha convertido                      has become

Verja                                        gate

Ordenador                               computer

Resbalar                                   to slip; to slide off

una pista                                  a clue, a track

La procedencia                        origin

Un tiro                                     shot (from a bullet)

Un balazo                                gunshot

Cefalea                                     headache

Cuando menos lo esperamos       when we least expect it

Al pasar por un período difícil     when going through a difficult period

El meollo del asunto es...             the bottom line is...

Lo que mal empieza, mala acaba  What begins badly ends badly (Euripídes)

¡Ni a palos!                               No way!

Rejilla de amsler                       Amsler grid

Perjudicado                                injured; handicapped

Holgada                                      loose

Nueces (nueces picadas)             nuts (chopped nuts)

Historial clínico; registro médico   medical record

Hoja clínica; récord médico;

Expediente médico                         medical chart

Calzar/calzando                              to wear (shoes); wearing

Obrar recíprocamente                     to interact

Entreacto                                         intermission; interval

La carpeta                                       a folder

El lista                                             a list

Juntar                                              to piece together

Pegar                                               to glue; to paste           

Conocimiento- familiaridad           knowledge- familiarity

Esperar; suponer; aguardar             to expect

Exhaustivo; a fondo                       exhaustive; in-depth

Frustrada                                        frustrated

Sonidos; ruidos                              sounds; noises

Significación; sentido                    meaning

Nunca me los han de vuelto           they never returned it to me

Cobrar                                             to charge; to recover it

Ingresar universidad                       to matriculate in university

Conseguir un trabajo                      to get a job

El primer puesto                             first prize

Logro                                              achievement

Tiza                                                 chalk

A ahora nos toca a nosotros           Now it’s our turn

Costearse                                        to afford

Labor social                                    social work

Troglodita                                       cave dweller

Un nudo en la garganta                   lump in the throat

Al borde de la muerte                     at the brink of death

Garrote                                            a club; a stick

Una bola de....                                 a bunch of...

Piscinazo                                         to take a dive (fake hurt in game)

Comprobar (compruebas)               to check (ie. checking the eye pressure)

Comprometidos                              committed (to)...

Apuntarse                                        to sign up (me apunto: I’m in!)

Dar de baja                                      unsubsribe

Montura de gafas                            eyeglass frame

Ventas                                             sales (ie. increase sales)

Remos                                       oars

Balseros                                    rafters (people who ride a raft)

Multas                                      fines; tickets (ie traffic ticket)

Ganga                                      bargain

Planta cara                               confronts

Plato; platillo                            dish(as in, a food specialty)

Sampedrana                             St. Peter (from San Pedro)

Hacerse                                    to gain; to become

Tiene que ver                           has to do with

Becas                                       scholarship

Pasantías                                  internship        

Destacar                                   to stand out; to distinguish

Lanzar                                     to spearhead; to start

Apretar (aprieta)                      to tighten (tight)

Realizar                                   to accomplish; to perform                   

Alcanzar                                  to reach; to attain

Medioambiente                       environment

No obstante                             however

Sin embargo                             however

De ninguna manera                  no way; by no means

Ceñida                                     tight; girded; clining

Hay que mirarla                       to have a look at

Volcar(se)                                to overthrow, fall over oneself

Los colirios                              eyedrops

Sobresalir                                 to excel; to shine

Pulgada de altura                     an inch high

El grosor del trazo                    stroke (as in brush stroke)

Administrar                              to manage

Creador(a)                               creator

Acobardar(se)                          to be daunted by

Borrador                                  draft

Modismo                                 idiom

Caracol                                    snail

Penumbra                                semi-darkness

Delito                                       crime

Soez                                         filthiness; badness

Abordaje                                  an approach; a collision

Te escuecen                             they sting you (eyes)

El foro                                     the forum

El liguero                                 the garter belt

desamparados                          helpless; homeless

caseta de billete(de metro)       ticket-booth

taquilla                                     ticket-booth

que hacer que                          that make; cause that

emocionante                            exciting

entregar                                    to submit; to hand in

pulir                                         to polish (as in polish up a draft)

esmerar(se)                              to strive; to do your best

notar                                        to notice; to note

el reto                                      the challenge

destrezas                                  skills; dexterity

empeño                                   determination

predicar                                   to preach

predecir                                   to predict

notablemente                           noticeably; greatly; sharply

facilidades                               ability to learn to do something; facilities; aptitude

propiedades                             properties

la policía                                  the police

sugerencia                                suggestion

impulsar                                   to drive (as in, push something/idea forward)

espesor                                     thick

llevarse a cabo                         carry out

tratar(se)                                  to try (to treat)

¿por qué hay que operar?        why operate?

constatar                                  to confirm; to verify; to prove

            

Courtesy: Inside-CRM Death of the Sticky Note