Saturday, December 31, 2016

Small Wins, Small Losses

In my last blog entry, Mundane Details, I focused on how speaking Spanish with my patients has its good and bad days. There are the great days when I am able to communicate all of my thoughts very clearly and in turn, the patients understand me. Then there are the bad days, when my conversations are littered with grammar mistakes and I struggle to find the right interpretation. I used to think I was the only one who felt this way,  until I came across the blog of an American ex-pat in Spain who described similar frustrations.  It is comforting to know I’m not alone in this daily tug-of-war to get the language right.

Not long after completing that entry, and along this same vein of thought, I read a very interesting news article about a study that was done regarding unemployed workers.  Princeton economist Alan Krueger (who, incidentally, was chosen in 2001 by then President Barack Obama to chair the White House Council of Economic Advisors) interviewed over 6,000 unemployed workers for over half a year.  Up until this study was done and for the longest time, economists held the belief that when people lost their job, the longer they were out of work, the more vigorous their search for a new job would become. The thinking was that while a person remained unemployed, the absence of a paycheck and the accumulation of bills would spur a person into a greater frenzy to find a new position.  However, Mr. Krueger’s results actually refuted that belief. In fact, he found that the longer people are out of work, the less and less time they spend looking for a job. The reason? It all comes down to small wins and small losses, and their effect on the human psyche.

In the article, Alan Krueger, the Economics of Small Wins and Losses, written by Charles Duhigg,  Krueger explains that as a Cornell professor once appropriately stated in 1984, “Small wins are the steady application of a small advantage.” In other words, small wins (succeeding at something, overcoming a challenge, getting accepted for a job position, etc etc) give a person the confidence he or she needs to take the risk necessary to continue competing and continue moving forward. Small wins “..convince people that bigger achievements are within reach.”

However, just as an accumulation of wins encourages a person and imbues him with confidence, an accumulation of losses has the exact opposite effect. This is what was highlighted in Krueger’s study. As small losses mount up in a person’s life, “...people can become so sensitized to losses that they begin to anticipate them, and become less motivated to try.”  For example, experiencing the constant rejection of  job applications makes the applicant feel greater disappointment. Before long, the applicant begins anticipating rejection before it even happens. These losses have the power of reducing the job applicant's ability to even try to continue the search for employment. New coping mechanisms begin to develop: those of sleeping in later or taking numerous breaks from job hunting altogether.

After reading all of this, I had an epiphany: in many ways, the trials and tribulations one experiences while trying to communicate in a non-native language mimic the results of Alan Krueger’s study. I have said time and again during this blog that earlier on in my Spanish learning days, there were times I didn’t even want to start a conversation with someone in Spanish because I made a lot of mistakes. I was also afraid that I wouldn’t be able to understand the speaker. Either way I would (in my mind) come across looking foolish. This fear of looking or sounding foolish in Spanish made me not even want to try.

Today, things are different.  I have grown in the language- my vocabulary has expanded and I’ve had much more practice speaking and listening. Because I’ve experienced many more successful communications with patients, my confidence in the language has grown.  And it’s because my confidence has grown that I’m not as fearful when talking in Spanish because I know I’ll be able to express myself and, in turn, be able to figure out what the patient is saying. I still have a long way to go—there’s always room for improvement—but I’m much more proactive in Spanish than I was in the past.

 After Alan Krueger’s ground-breaking discovery of the power of small wins and losses, further studies were done by other investigators over the years as to what to do to solve the problem of overcoming the confidence lost from an accumulation of small losses. How can you encourage these disillusioned workers  to reignite their job search and instill confidence in themselves? How can a non-native language learner push herself to communicate when the grammar mistakes build? The answer: you have to reset expectations. In essence, you have to alter a perceived loss into an actual win. Take, for example, the workers in the above scenario.  When sending out a resume, the worker looks upon a callback for an interview as the win, so when he doesn’t get it, he feels he’s lost. If one resets the goal from a callback for an interview to simply sending out the resumes to as many potential employers as possible, then the act of successfully sending them out is the win. Callbacks are irrelevant.

When applying this to my speaking Spanish with patients, instead of me focusing on getting all the grammar and conjugation right, I should set the goal of simple understanding between doctor and patient. Maybe I’ll accidentally turn a feminine noun into a masculine one (potential loss, if I’m focusing on grammar as goal), but if the patient understands the point I was making (win! win! win!), then that’s the only goal that should matter.

As we transition from this eve of 2016 to 2017, let's not be afraid to take on new challenges in the face of failure or potential failure. If we're learning something and moving forward with that knowledge, then we have the potential to turn every 'loss' into a win. Happy New Year, everyone! 


References

Duhigg, Charles. “Alan Krueger, and the Economics of Small Wins (and Losses).” http://charlesduhigg.com/alan-krueger-and-the-economics-of-small-wins-and-losses/ (Accessed December 1, 2016).

Philips, Matthew. “Who is Alan B. Krueger?” Freakonomics. http://freakonomics.com/2011/08/29/who-is-alan-b-krueger/ 29 August 2011. (Accessed December 1, 2016).



Courtesy: Charles McDonald, Charlottesville Real Estate Solutions

Saturday, November 26, 2016

Mundane Details

I always do that. I always mess up some mundane detail.”—Michael Bolton, Office Space


I have said many times before in this blog that I have my good days and my bad days speaking Spanish with my patients. You know by now that I am not a native Spanish speaker. I grew up with English as the sole language of the household. I started learning Spanish in the seventh grade by memorizing simple vocabulary lists. I took more and more advanced studies throughout high school and college, until the real learning began with practical use: speaking with the patients I encountered during medical school. That was my introduction to medical Spanish, which is a unique language in and of itself. It took many years to get where I am today, and still I have told you I am no where near perfect. I have a professional, medical fluency. Any situation outside medicine I can certainly communicate my way through, but a native speaker will know I’m not native.

I don’t know why that bothers me, but it does. There are days when I’ll be talking to a patient, and I’ll incorrectly use a word I’ve used a million times before correctly.  Like, I’ll make a feminine word masculine. Or my verb conjugation will be wrong. Or I’ll say something in the simple present tense that should have been in the subjunctive. I’ll completely miss the tip-off word in the sentence that tells me it should be in the subjunctive.

Or, I’ll mispronounce a word that I’ve said a million times before with the correct pronunciation. Or I’ll forget a word and say it in English. Sometimes I’ll even accidentally say it in Croatian (although, that hasn’t happened recently, as, my studies of my husband’s primary language have fallen to the wayside in recent months).  I recall the other day I said the word one hundred to a patient as ciento. The patient corrected me. Apparently sometimes it’s ciento, but other times it’s cien.  For the longest time I’ve been saying, Ponga la frente contra de la barra to indicate to a patient that he should put his forehead against the slit lamp bar. I figured la frente, or the front/forehead is always la frente, so when I had to tell a patient to hand a slip of paper in at the front desk in the office, I said Puede entregar el papel en la frente.  The patient replied, en el frente. OK. I’ll go with it. But I don’t understand the logic behind it.

I feel like, as far as I’ve come in Spanish, I’m somehow still far behind. Granted, some days are better than others. Some days the words come more fluidly and correctly. But other days my Spanish speaking is like a very slow and painful depilatory session. No anesthetic cream. And no warning when the rips and tears will come.

I thought I was the only person who feels this way, until I came across a blog recently called “Y Mucho Más” by an American from Indiana named Kaley who moved to Spain in 2009 to work as an English teacher and to learn Spanish. In the particular entry that caught my attention, “Some Days I Hate Speaking Spanish”, she describes situations that I talk about repeatedly in my blog, almost as if she read my mind. She remarks: “There are good days, when the words flow and people don’t have to wait for me to spit out the word...” and “..there are days when I feel competent and fluent.” But she goes on to say that, “...lately a lot of my days have been bad days. Why? It’s hard-telling.”  She adds, “Whenever I’m excited or angry or emotional or sad, I want to speak in English--because the words mean more to me.”

It’s comforting to know I’m not the only one who feels this way. Especially when there are many people on the internet and elsewhere, who have written blogs and books which always make language learning seem fun! exciting! easy! and quick! But language learning is like any form of learning. If it’s going to stick with you long-term, then it is going to take time. Time to assimilate it. Hear it-- read, write and speak it. Time to succeed in it and make mistakes in it. Time to learn from those mistakes and sometimes make those mistakes over and over until the learning becomes like a painful badge of linguistic courage.

I have to remind myself of this every time I have a bad day in Spanish and get down on myself about it. I can’t keep criticizing myself for messing up the  “one mundane detail” that differentiates me from the native speaker.  I have to remember that it’s the messing up that’s going to get me where I want to be. I just have to believe it. After all, I’m better today in Spanish than I was years ago. If logic holds true, then I should be better still tomorrow.


References

Kaley. “Some Days I Hate Speaking Spanish.” Web blog post. Y Mucho Más. WordPress. 7 Mar. 2014. Web 26 Nov. 2016.

Courtesy: MemeGenerator.Net

Sunday, November 20, 2016

Word Foundation

In an effort to improve my medical editing skills, I am currently re-studying English grammar, something I studied many years ago in elementary school as a child. I’ve discovered throughout the process that either I have: a) minimal recall or b) maximal forgetfulness as I meander my way through concepts either long-abandoned or never learned. Concepts such as predicate adjective, compound sentences and dangling modifiers. Listen, they are vague memories, but very vague, and I’m working to coax them to the fore.

What surprises me most during this process, however, is that certain grammar rules that I do remember and have relied upon my whole life are apparently themselves set for an overhaul. Things are changing. Rules are changing.  Case-in-point: Remember the verb: to prove? When I was a child growing up, the first, second and third principal parts of this verb were taught as:

prove               proved             proven

To give an example, if you were to use the word had or have before prove, you would have written it:

I had proven my theory at the conference.   Or...

I have proven that I am a worthy opponent.

Well, I’m here to tell you all Generation Xers, grab on to the seat of your pants, because my English-language sources are now telling me that the third principal part proven is being replaced by proved.   
For ex:

I had proved my theory at the conference.  Or..

I have proved that I am a worthy opponent.

My grammar book proceeds to tell me that “..while using proven is not considered incorrect, ...it is considered somewhat old-fashioned.”

Can you believe this? Old-fashioned? When did I become ‘old-fashioned’?

During an English to Spanish translation class I participated in recently, I discovered that the Spanish language is experiencing similar forms of change. For example, there was a time when there was a clear distinction between these two words:

sólo and solo

The accented solo meant ‘only’.  The non-accented form meant ‘alone’.  Now, however, the Real Academia Española (RAE) – or the Royal Spanish Academy – has determined that the accented form of the word should be dropped altogether and the meaning of solo inferred from the word use in the sentence. (Incidentally, the Royal Spanish Academy, founded in 1713, serves the purpose of monitoring, preserving and modifying the Spanish language. Questions regarding a particular word, its meaning, spelling and grammar in the Spanish language are directed to the RAE.)

This evolution of languages reminds me of a time in college when I wrote the word aforementioned in an essay I handed in to my English professor. I thought it sounded regal, stately. But my essay was returned with a lower grade and a red circle around aforementioned, with the comment ‘archaic’. I don’t get it. I spent years being taught that what’s important in English writing is word spelling, sentence structure and grammar. I worked hard to memorize rules and meanings. Now, I choose a veritable English word and it’s not ‘with it’ enough? If I pass my days reading Victorian novels, who is to tell me that words like aforementioned and betwixt are archaic? For me, it would be everyday. It would be standard. I learned that the third principal part of the past tense of to prove is proven and therefore it should always be proven, because it’s been tried, true and, well, proven – to me, in my everyday life.

I think we keep certain words in our word foundation, if you will, that we rely upon every day or almost every day, to communicate with people and to make a point. I am always willing to learn something new, but chip away at my current word foundation, and I feel a bit...lost. I need to have a set of vocabulary and structure upon which I can rely. If that foundation is taken away, what do I have to stand on?

I have built a certain medical word foundation in Spanish over the years while practicing medicine with Spanish-speaking patients. There are certain phrases I use ad infinitum when speaking to patients. They always seemed to work, meaning, they were understood by the patient. But after a conversation I had with a patient recently, my reliance on these comfortable phrases was threatened:

Doctora: <al acabar el examen> Todo está bien. Tiene ojos sanos.

Paciente: <expresión de temor extremo> ¿Qué es lo que tengo?  ¿QUÉ tengo?

Doctora: Tiene ojos sanos. Ojos sanos. SANOS. <elevar la voz en manera obligatoria> Tiene ojos saludables. No tiene una enfermedad del ojo. Todo está bi-

Paciente: <aparecer aliviado> Ay, whew, ¡Pensé que me dijo que tengo ojos con gusanos!!!

Doctora: <sonreír> O, no, ojos sanos. <pensar de qué más un paciente no entiende, dependiendo de mi pronunciación de las palabras, o de mi elección de palabras particulares.>

I rely on particular phrases in Spanish during my conversations. Usted tiene ojos sanos is one of them. The phrase is grammatically correct, You have healthy eyes, but either it’s not commonly used by Spanish-speaking doctors (how does an ophthalmologist in Spain or Nicaragua tell her patient: Everything looks good!) or I’m mispronouncing it, because this patient thought I said, Usted tiene ojos con gusanos, essentially, that he has worms in his eyes! Extreme relief ensued when he found out that’s not what I meant! It was funny at that moment, but after the patient left I got to thinking, how many more Spanish-speaking patients of mine have been misinterpreting this seemingly harmless phrase- or worse- anything else that I’ve been saying?

When I come across these issues: vocabulary words that I’ve come to rely upon tossed aside for more modern expressions; phrases that I’ve become accustomed to that are misinterpreted, and grammar rules that are modified or entirely abandoned, I worry. I worry because these are more than just words or expressions to me. They’re a part of me, in a way. They’re who I am. They’re what I’ve cultivated over the years. How we speak is more than just language. It is personal.  It says something about us as people. Certain expressions and words, like the accent a person has, tell a story about that person’s life. Where she comes from. What her experiences have been. I understand that life evolves, and so does language. And I am willing to go along with the ebb and flow of a language’s evolution.  But I’m not willing to set aside my story (and my way of expressing that story) simply because it’s not en vogue.

To this end, I’ve decided: I’m going to continue to use what works. If I speak to my patients in a certain manner and am understood, then that is all that matters. If they don’t understand me, then I will find an expression that they do comprehend.  That’s not old-fashioned and it’s not archaic. It’s an adaptable uniqueness.  And to me,  it’s beautiful.


References


Witte, Flo, PhD. Basic Grammar and Usage – An Essential Skills Workshop of the American Medical Writers Association. American Medical Writers Association, 2011.


Desert Adaptations, Joshua Tree Nat'l Park

Monday, October 24, 2016

Language Without Borders

“The limits of language mean the limits of my world.” – Ludwig Wittgenstein


El paciente regresa a la oficina hoy para realizarse una visita de seguimiento conmigo.  Después de nuestra última visita, le pide un examen con el cirujano de cataratas.  Años atrás, el paciente perdió la visión en el ojo derecho, tras de un accidente al ojo.  Sucedió una catarata traumática, pero, no sabía yo el alcance del daño por la razón de él no vino con una copia de su médico historial. Sin esta información, no sabía el estado de salud de la retina y, por eso,  no sabía si fuera posible mejorar la visión con cirugía para sacar la catarata.

Doctora (Dra.).: Leí el informe del cirujano de cataratas. Se dice aquí que él ha decidido no hacer la cirugía.

Paciente (P):Sí, lo sé.

Dra.: ¿Comprende usted la razón para la decisión no hacer la cirugía para sacar la catarata?

P: Sí, pero pensé yo que, si existe la posibilidad, no importa cuán remota, de que podamos mejorar la visión con cirugía, entonces, me gustaría tomar el riesgo. ¿Me entiendes?

Dra.: Sí, pero quiero explicarle la razón para la decisión.

P: Está bien.

Dra.: El cirujano recibió el médico historial de su oftalmólogo en su país. Tengo el informe en frente de mí. Se dice <leer las letras en la pantalla> ‘...sufrió el accidente de un clavo dentro del ojo derecho, sucedió una ruptura del globo del ojo y un desprendimiento de la retina’, él añade ‘...el paciente no tuvo cirugía para reparar la retina..’

P: Sí, eso es lo que sucedió.

Dra.: Aunque no hay una agudeza visual escrita aquí, puedo decirle que, con un desprendimiento completo de la retina años atrás, desafortunadamente, no existe la posibilidad de visión viable en ese ojo.

P: ¿Cómo es eso?

Dra.:  Dentro del ojo, las estructuras que son las más importantes son el nervio óptico y la retina. Es por la razón de que ellos transmiten información visual del ojo al cerebro. Si uno de ellos no funciona, no importa lo que hagamos con las otras partes del ojo. Podemos reemplazar la córnea, el cristalino natural (que es la catarata) –pero eso no va a cambiar la visión, porque la línea de vida del ojo, la retina, no funciona.

P: Sí, la entiendo. Pero tengo una pregunta. ¿Es posible, un trasplante de la retina?

Dra.: <pensar, pensativo> Hmm. Bueno, hay experimentos ahora...los médicos están trabajando a encontrar un proceso para crecer de nuevo o reemplazar la retina. Pero ahora, desafortunadamente, son solo eso: experimentos, en las etapas tempranas. Tengo la esperanza de que, en el futuro, vamos a ver la posibilidad muy real de un trasplante de la retina.

P: Entonces, voy a continuar a esperar, a tener esperanza. Mientras hay esperanza, hay también la posibilidad de que, algún día, utilizaré el ojo otra vez.

Dra.: <sonreír> Sí, hay siempre la esperanza, y el trabajo para realizarse los resultados de la esperanza.

                                                                        *

As you have noticed, many times when I write my blog entries in Spanish, I leave them in Spanish, sans translation in English. I choose to do this because it represents my everyday experiences in the office. There is no interpreter when I talk to patients. There is no translation for their words or my instructions. What happens is very real, raw, and always represents a learning experience.

However, I want to translate this particular conversation I had with a patient one day to emphasize a point. I work with other doctors in the medical community at large who do not share my same passion for learning to communicate in Spanish with patients. Sadly, it’s easier for many of these monolingual English-speaking physicians to examine Spanish-speaking patients because they don’t talk to them (because they can’t, there’s a language barrier). This means they can get through the exam faster and they don’t have to bother answering patient questions because the patients can’t ask any – they won’t be understood. Exams are completed in mere minutes and very sadly, many patient concerns go unanswered and unaddressed because there is no communication. The patient may feel embarrassed to push to be understood because they don’t know English or have a rudimentary understanding of it. And there are some doctors who take advantage of this.  These doctors are not only not providing the standard of care for these patients, but at a very basic level, they are missing out on truly hearing these people: what they have to say, their thoughts and fears. This is a grave loss for everyone involved in this patient’s care.

In the above scenario, I had referred my patient to a cataract surgeon, not yet knowing the historical details of the accident the patient had in his eye years ago. I thought, if there is a possibility of vision improvement by removing the traumatic cataract, then I wanted the patient to have the opportunity to explore this option. By the time the patient’s appointment with this cataract surgeon (who does not speak Spanish) came to be, the ocular records were finally received from the patient’s ophthalmologist in his home country.  The cataract surgeon learned that the patient’s eye trauma included a completely detached retina in the right eye, which was never repaired. Knowing there was no chance for visual potential in that eye, the surgeon opted not to perform surgery. This is entirely acceptable, but what bothered me was the extreme brevity and detachment in this surgeon’s note:

  (of importance, the following lines are me paraphrasing the gist of the note, I am not transcribing verbatim here the actual patient note!):

A/P:  h/o ruptured globe right eye, with complete retinal detachment, unrepaired, and  traumatic cataract.
No visual potential. Not amenable to surgery.
Interpreter explained to patient.

The surgeon didn’t take patient questions, there was no explanation to the patient why such a retinal detachment can’t be repaired now, so many years later, and the surgeon didn’t have to break the bad news himself at all- an interpreter did. A quick 3 minute exam, 5 minutes tops, but all the patient’s hopes were riding on this exam.

After speaking myself with the patient, I could see he didn’t understand why this type of trauma could not be repaired and I explained this to him in Spanish. The patient was then able to pose well thought-out  questions to me such as, whether or not retinal transplants exist and if that would be an option for him. You can read my continued explanations to him in my translation, but my point is simply that this patient deserved more attention from the surgeon.  Now, it is possible that this surgeon is short and gruff with all his patients, English-speaking, Spanish-speaking or otherwise. 
However, I have seen this many times before, particularly when a doctor does not speak the patient’s language, it is easier for the exam to be done in minutes and pass any explanations off to an interpreter.

In my opinion, you, as a doctor, can’t avoid the tough questions by claiming not to understand the questions. If you are treating a patient population that speaks a language other than your own, then you are obligated to understand and be understood, and to take whatever extra time is needed to ensure that.

                                                                        *


The patient returns to the office today for a follow-up exam with me. After our last visit, I had requested for him an exam with a cataract surgeon.  Years ago, the patient lost the vision in his right eye after sustaining an accident to the eye.  A traumatic cataract resulted, but, I didn’t know the extent of the damage because the patient did not come with copies of his medical ocular history.  Without this information, I didn’t know the state of health of the retina, and as a result, I didn’t know if it was possible to improve the vision in that eye with cataract surgery.

Doctor (D): I read the cataract surgeon’s report. It says here that he has decided not to do the surgery.

Patient (P): Yes, I know.

D: Do you understand the reason for this decision not to do surgery to remove the cataract?

P: Yes, but I thought that, if there is the possibility, no matter how remote it may be, that we can improve the vision with surgery, then, I would like to take that risk. You understand me?

D: Yes, but I want to explain to you the reason for this decision.

P: Fine.

D: The surgeon received your medical record from your ophthalmologist back in your home country.  I have the report in front of me.  It says <reading from the screen> ‘...he suffered an accident of a nail to the right eye, resulting in a ruptured globe and a retinal detachment’,  he adds, ‘...the patient did not have surgery to repair the retina...’.

P: Yes, that is what occurred.

D: Although there is no visual acuity written here, I can tell you that, with a complete retinal 
detachment so many years ago, unfortunately, there is no possibility of viable vision in that eye.

P: Why is that?

D: Inside the eye, the structures that are the most important are the optic nerve and the retina.  It’s because they transmit visual information from the eye to the brain.  If one of them doesn’t function, it doesn’t matter what we do with the other parts of the eye.  We can replace the cornea, the natural crystalline lens (which is the cataract) –but we are not going to change the vision because the lifeline of the eye, the retina, isn’t functioning.

P: Yes, I understand. But I have a question.  Is a retinal transplant possible?

D: <thinking, pensively> Hmm. Well, there are experiments now...doctors are working to find a process to grow a new retina or replace the retina.  But for now, unfortunately, they are only that: experiments, in the early stages.  I have hope that, in the future, we are going to see the very real possibility of a retinal transplant.

P: Then, I am going to continue to hope, to have hope.  While there is hope, there is also the possibility that, one day, I will use the eye again.

Dr: <smiling> Yes, there is always hope, and the work to bring about the results of that hope.

Adirondack Balloon Festival 2016
'Without Limits'



Saturday, October 8, 2016

The Wow! Signal

Every now and then I enjoy reading about a good mystery. We live in a day and age when very little is left to the imagination. Most questions in life are answered. Most problems, solved. And I think that because we are privileged to live in such a scientifically advanced time, we’ve become used to having the solutions to various problems seemingly at the tips of our fingers. Therefore, when a topic comes to the fore every now and again that we don’t understand and don’t have a solid explanation for, it can indeed be a scary, brow-raising (if not hair-raising) enterprise. I recently read about one such event that I’ll share with you right now.

Humanity has always been curious about space: what’s out there, how far it goes and the inevitable question: does life exist anywhere outside planet Earth in far-away galaxies? Over the years, there seemed little evidence of this potential extraterrestrial life. Mostly hoaxes or elaborate stories, time and again disputed and disproven. However, something wonderful and fantastic occurred that truly piqued everyone’s interest in the possibility of alien life.  In 1977, astronomers were using a radio telescope called Big Ear at Ohio State University to scan radio waves coming into Earth’s atmosphere from space. Most of what filtered in was hum-drum: expected low –frequency blips collected on the recording tape, leading to reams and reams of useless mundane information.  But on one fateful night that year, the telescope picked up 72 seconds worth of high-burst radio waves from the night sky.  Astronomer Jerry Ehman, who found and was analyzing the signal at that time, was so excited by this finding that he circled the radio wave read-out on the recording paper and wrote the word “ Wow !” on it.  This signal (thereafter referred to as ‘the Wow!’ signal) was definitely emanating from interstellar space, from Chi Sagittarii - a group of stars that are a part of the constellation Sagittarius.

The finding was especially exciting because over a decade prior to this, Cornell physicists has speculated that, if alien life truly existed and wanted to send a communication signal out into space, they might choose to utilize a frequency of 1420 megahertz. This is because this frequency is naturally emitted from the element hydrogen, the most common element in the universe and therefore familiar to all living inhabitants. The exact frequency of the Wow! signal was recorded as 1420.46 MHz.

Jerry Ehman and other astronomers worked vigorously to try and detect the signal again. They made countless attempts over the years, but to no avail. No such signal or anything similar was ever recorded again. If someone was trying to communicate with Earth, why wasn’t another attempt made? Over the years, more sophisticated and sensitive radio telescopes were employed, but no new information was found. In 2012, which marked the 35th anniversary of the Wow! signal, a radio telescope in Arecibo, Puerto Rico, was used to send over 10,000 Twitter messages to the same location in Chi Sagittarii where the signal originated.

Because no other signals have been detected since that fateful night in 1977, several theories emerged as to what, other than extraterrestrial life, could have caused such a high frequency wave.  Perhaps the signal really originated from Earth but pinged back after hitting space junk? Could the source be military in origin? Due to various physics explanations beyond the scope of this blog entry, no theory seems to fully explain the phenomenon. Therefore, the origin of the Wow! signal remains a mystery...

...until now, maybe?

In this year 2016, a former analyst with the U.S. Dept. of Defense and astrophysicist Professor Antonio Paris has proposed an interesting and exciting theory that he is prepared to test. When analyzing star charts going back to the 1970’s, two comets happened to be passing through the area of space from which the Wow! signal originated. Their names are  266P/Christensen and 335P/Gibbs and were only themselves discovered in 2006 and 2008, respectively. 

This is an important observation because comets, as it turns out, are surrounded by clouds of hydrogen gas millions of kilometers in diameter. This hydrogen gas could have been the source of the signal detected that night in 1977 by Ehman.  Professor Paris has raised enough funds to build his own radio telescope. Mapping out the comets’ paths, comet Christensen will pass through Chi Sagittarii again on 1/25/17 and Gibbs will return there on 1/7/18.  Should the telescope detect a signal similar to Wow! on either of those dates, then that proves that a comet, and not alien life, is the origin of the signal.

I personally find this extremely fascinating. It is now October 8, 2016. In a few short months, we could potentially have the answer to a 40-year-old mystery!

So what does this all have to do with my blog: Spanish language in medicine? Well, nothing really! Other than this, perhaps: the Wow! signal mystery and its investigations underscore the never-ending curiosity and endurance of the human spirit. We are always looking for answers. We don’t want to leave any stone unturned. We want to believe as the great Marie Curie once said, that “ Nothing in this life is to be feared, only to be  understood.” I have spoken many times before in this blog, about how there are days in my Spanish language learning that I feel fulfilled and unstoppable. And there are days when I get tripped-up trying to express some grammar concept, like past subjunctive or the conditional--uh, how abhorred!--concepts which at times I feel I'll never fully grasp.

But then I read stories like this one and I think, the road may be long and full of twists and turns, but anything is possible. With imagination, a desire and a drive to learn, maybe there really aren’t any such things as mysteries in this life. Maybe all the answers are already out there. They are simply waiting to be found.

References

Clark, Stuart. “Alien ‘Wow!’ Signal Could Be Explained After Almost 40 Years.” The Guardian. https://www.theguardian.com/science/across-the-universe/2016/apr/14/alien-wow-signal-could-be-explained-after-almost-40-years (Accessed October 7, 2016).


“Wow! Signal.” Wikipedia: The Free Encyclopedia. Wikimedia Foundation, Inc. Web. 7 October 2016. 




Monday, September 19, 2016

Single Combat

(Al caminar para llamar al paciente de la sala de espera)

Good morning, Mr. Reyes- (extiende la mano al paciente) I’m Dr. Hromin, we can begin the exam now...

(me mira como un ciervo ante los faros de un coche)

Discúlpeme, pero, ¿cúal es mejor para usted, inglés o español?

Either one, it doesn’t matter to me.

OK! Then let’s get started! Please follow me to the exam room, this way...You can put your things on the side and have a seat in the exam chair when you’re ready.

(el paciente se sienta en la silla)

It’s been a year since your last visit – have you noticed any problems with or changes in your vision?

Bueno, I don’t really have problems with the vision for driving, pero when I read, it’s a problem.

Está bien.  Hay una condición se llama ‘presbicia’ – se ocurre después de la edad de, más o menos, cuarenta años. El cristalino natural dentro del ojo pierde la flexibilidad. Por eso, se necesita lentes para leer.

Sí, he comprado lentes de la farmacia, pero no sé si son buenos para mí. Si tengo el poder incorrecto para los ojos, ¿ello va a causarme daño a los ojos? I don’t know.

Para contestar su pregunta, no, lentes del poder incorrecto no le causarán daño a los ojos. El poder correcto es algo que se siente cómodo para usted. I’ll put the refraction from today into a trial frame. Here, try them on-

(le doy al paciente los lentes para leer y una página de una revista)

¿Puede leer todas las letras en esta revista?

Sí, es cómodo. I’m not having any problems.

Good, now I can write you a prescription for the glasses or you can pick them up over-the-counter.

(me mira con expresión confusa)

No necesita una receta si compra los lentes en la farmacia. Usted solo necesita saber el poder, y para usted, es +1.50. OK, empezamos el examen ahora- es importante examinar la retina, ¿se dice aquí que tiene diabetes?

Sí, pero it’s controlled. I go to the doctor every 3 months. He checks the sugar.

You have an endocrinologist? <pause>  ¿Tiene un endocrinólogo- un médico quien es especialista de diabetes?

No pero, I would like for you to give me names of doctors in the area – nutricionistas, para decirme lo que  puedo comer para mantener un nivel normal de azúcar en la sangre.

(Hago el examen de la retina.)

Bueno, tengo buenas noticias para usted. Tiene ojos sanos, no tiene signos de diabetes en la retina. So you have a clean slate to work with moving forward.

Ay, qué bueno, gracias a Dios. That’s good to hear it.

OK, so I’m going to send a report to your primary doctor, el médico de familia, y escribo el número de los lentes que necesita para leer.

Remember to give me names of –

Oh, sí, los endocrinólogos y nutrici-...nutrition-...er, nutritionists...¿cómo se dice en español otra vez?

Nutricionistas.

Y los nutricionistas también. (le da al paciente la hoja de códigos)

¿La entrego al frente?

Sí, nos vemos de nuevo en un año- pase  un buen día.

Igual. Gracias.

When taking an English to Spanish translation class recently, I recall my professor making a statement one day. He said, “I’m wary of the person who says he’s bilingual. Many ‘bilinguals’ are the worst offenders when it comes to communication in both languages.” I didn’t quite understand him at the time, but when reviewing my own experiences speaking with patients in the office, particularly the sample conversation I just shared, I’m beginning to see his point. 

Sometimes, in an effort to speak one language or another, the conversation devolves into a highly complex mix of the two. My Spanish is advanced- it represents a professional fluency - but it is not at near-native level...yet. If a native Spanish-speaking patient comes into the office with absolutely no experience in English, then the entire dialogue takes place in Spanish. The patient clearly makes all of his symptoms and complaints known, and I work linguistically to find the best way to instruct and explain to him his condition in Spanish.

If a native Spanish-speaking patient comes in for an eye exam, but he studied English previously, or has had experience working with English speakers so he’s reached a point in the language where he can understand and communicate fairly well in English, then I revert to my native English for the exam, and he flexes his linguistic muscle to communicate in his non-native language.

There are times, however, when almost near-native meets almost near-native, and that’s when the single combat begins. I walk out and greet the patient in English. They return my greeting with a confused stare. I assume they don’t understand me and I begin speaking in Spanish. They answer me in English. Now, I am not sure which language they are most comfortable using, even though they’ve answered that they can speak either.

I bring them to the exam room. I continue in English. They answer in English, but with bits and pieces of Spanish mixed in. I don’t want to show preference for either language, so I start to do the same. English with Spanish. Spanish with English. Before you know it, the dialogue becomes an intricate dance between the two. Almost like a couple struggling during a waltz because they both want to lead. Neither wants to be led.

This patient-doctor Spanish-English conflict is a tiny representation of a greater societal issue. In the United States, even native-born Spanish-speakers are in danger of having their Spanish language corrupted in time by English, which surrounds them. And vice-versa, native English-speakers may work to learn an academic Spanish, but never reach full immersion because they live in the United States. So, going back to my professor’s musing, when this “bilingual” person sits down to translate from one language to another – (remember, translation is written communication, not oral, therefore nothing can be hidden and everything is exposed) – one finds great gaps in vocabulary, sentence structure and grammar knowledge than previously imagined.

The question is, what do we do about it? I think the best we can do is dedicate ourselves to frequent reading and study. A dedication to the purity of a language. A pledge to not succumb to the easy verbal corruption that is commonplace in a mixed-language society. During the medical exam when almost near-native meets almost near-native, if the patient doesn’t pick a side, then you pick one for him. One or the other, not a mix of both. Chances are you’ll achieve clearer communication-- if you’re both speaking from the same linguistic side.


The Duel between Hector and Ajax