¿Feliz....holidays?

In learning to speak better Spanish with my patients, at some point, the conversation in the exam room goes beyond, “Usted tiene cataratas, necesita una cirugia para sacarlas”. In other words, with every patient encounter, there is—as there should be!—some dialogue not involving eyes or medicine or family history, but rather, everyday life!  

 ¿Cómo está USTED hoy?  ¿Cómo está la familia? ¿Fue a México este verano---pense que tenía planes de ir?

(How are YOU today? How is your family? Did you go to Mexico this summer?—I thought you had plans to go?)

It was always this general, everyday conversation—banter, if you will—that would contribute (and at times, still does) to my anxieties when treating a Spanish speaking patient.  

Why—you may ask? Well, it’s easy to get used to the rote dialogue of “¿Por qué Ud. está aquí? ¿Tiene problemas con los ojos? Abra el ojo. Siéntese aquí. Escribo una receta por lentes nuevos.  You memorize these phrases and repeat them.  You carry that cheat sheet (see blog entry, When in Rome) around in your mind and it becomes a part of you.  It’s a script that you can be sure of—one that dictates a certain, predicted response from the patient.  You fear deviating from it, because deviation from this preformed set of questions will invoke responses not expected.  Then you’ll have to really work to listen to understand the response, and in the end, despite your concentration, you may still not understand the patient’s answer completely.  Where do you go from here?  

I am talking about a script you can’t control.  How confident are you in your Spanish that you can talk nonchalantly about the weather?  Or a sports event? Or the patient’s plans for the summer?  After you’ve greeted the patient, and elicited the chief complaint, you find yourself washing your hands—and silence looms in the exam room.  How do you fill it?

I have found time and again that the best thing to do is to just dive right in. Don’t worry about grammatical errors, sentence structure—even incorrect vocabulary.  Don’t let your fear of “sounding foolish” prevent you from being social with your patient!

I’ll talk about the season, the weather, current events, travels, hobbies, interests and family.  When a holiday is approaching, I like asking the patients how they’re spending it, where they’re going, what they’re doing, etc.  Here are a few encounters I recently had with patients where the conversation centered around Thanksgiving:

Me: (while washing my hands and preparing my lenses for the exam) Bueno, ¿tiene Ud. planes para ... el día de pavo?   (my way of saying ‘Thanksgiving’ , the best I could do was “the day of turkey”!)

Patient: ¿el Día de Acción de Gracias? Mi nieta vive cerca de mí—voy a pasar el día con ella.

Me: ¡Qué bueno!

Patient: Y Usted, ¿qué hace?

Me: Mi familia no está lejos de mí. Tendré las festividades en mi casa, con mis padres, los padres de mi esposo, y mi cuñada y su esposo.

                                                                             *

Another example, this was toward the end of an exam-as the patient and his wife were getting ready to leave:

Me: Bueno, disfruten Uds. el... ¡holiday!

Patient:  Gracias, igual, Dios le bendiga y ¡feliz___________pavo!

(This patient happens to be a wonderful man, very kind, but his accent is heavy and he uses dialect phrases, both of which make it difficult for me to understand every word he says completely. But in the end, I heard the two words that mattered: feliz= happy, and pavo=turkey, and that’s all I needed to comprehend his good wishes.

Me: Gracias, como siempre, es un placer-

                                                                             *

And another conversation:

Me: ¿Cocina Ud. para la familia entera el día de Thanksgiving?

Patient:  ¡No—no más! Mi’ja tiene Thanksgiving para la familia. Voy a su casa y le ayuda a ella. Y Ud., ¿qué hace—cocina?

Me: Sí, este año cocino por todo—hago el pavo, y otras comidas tracidionales como... ¿cómo se dice ”candied yams”, “green bean y cebolla casserole” y “stuffing”?

Here, I just injected the English words, because I have never used the word yam or stuffing or green bean in Spanish and just had no idea how to even attempt translating.  Sometimes the patients understand me and may even teach me the correct terms in Spanish. Others may not understand exactly what I’m trying to say, but the basic idea is understood: “I make the turkey, and other traditional meals”.  

Incidentally, at the end of the day I always try to make it a point to look up the words I don’t know in Spanish.  This takes time and effort, but is absolutely necessary to increasing your vocabulary in any language. **You won’t remember a word you never see or use. **

This is what I found for:

Candied yams:    camotes carmelizadas  or batatas carmelizadas or ñames carmelizadas

Green bean and onion casserole:   guiso de ejotes y cebolla  or guiso de judías verdes y cebolla

or  cacerola de ejotes y cebolla or cacerola de judías verdes y cebolla

Stuffing: relleno

Always remember,  for the health care professional,  Spanish conversational vocabulary is just as important as knowledge of the medical terms and exam commands in the language.  I work hard to not let my insecurities about “sounding foolish”or “making mistakes” in Spanish prevent me from making patients feel at home in my exam room.   I want them to know that I am interested not only in their eye health, but in them as people.  People—after all, that’s what this profession is all about.