In
earlier blog entries, I’ve written about how using Spanish with my patients in
the office has lead to positive, successful interactions with great opportunity
to learn and become more versatile in the language. I’ve also discussed the
days when having to speak in something other than my native English has been at
times challenging, grueling and frustrating. Everyday I am trying to examine
patients, explain complicated medical concepts, answer questions, carry on
‘small-talk’, create and explain a treatment plan, --all in Spanish and all
within a span of about 5-10 minutes, the max time that is allotted me per patient.
I don’t want any of my patients waiting too long for their appointments, but if
a patient has an active ocular problem that needs attending to, this in and of
itself takes more time than 10 minutes. Factor in having to then mentally
translate everything I am saying and doing does add another element of pressure
to the mix.
The
only way to improve in a language is to keep using it. Use it, make mistakes,
learn from them. Make mistakes again, continue learning. Because I have been
working with a large community of Spanish-speaking patients, my Spanish skills
have greatly improved. As a result of this, I don’t feel the same sense of
worry or tension that I had when initially practicing ophthalmology in Spanish.
It’s better now, but what I have found helps immensely is to break down patient
cases into diagnosis topics that I’ll preemptively find myself preparing
vocabulary for so that I don’t waste time opening my mental thesaurus when
speaking with patients.
To
give you an example of what I’m talking about, I wrote down a quick synopsis of
various patient cases I’ll see in the office. I then isolate the diagnoses and
start by thinking about them in Spanish. For reference, I use material provided
by the American Academy of Ophthalmology on their website: ojossanos.org. With
each subject topic I compile a list of medical vocabulary in Spanish that I can
build upon. The more frequently I encounter these eye problems in Spanish, the
better equipped I become in anticipating the kinds of questions patients will
ask and how I will answer using plain language, or lenguaje llano. This process
helps ensure that for these patient exams, and future ones like them, the communication
moves along fluidly. For example:
Patient 1: 45 yo coming in for first time
eye exam. C/o problems seeing at near, occasional burning sensation in
eyes.
(la
presbicia, ojos secos)
Patient 2: 52 yo comes in for annual exam,
first time patient to the practice, DV & NV worsening, on exam optic nerves
suspicious for glaucoma. Mild cataracts noted.
(la
presbicia, las cataratas, nervios ópticos
sospechosos por glaucoma)
Patient 3: 23 yo CL over-wearer. Comes in
with red, irritated eyes. Exam shows significant pannus and dry eye. Patient
adamant that he does not want glasses and wants to continue in CL.
(el
abuso de las lentillas, ojos secos, educación como cuidarse las lentillas)
Patient 4: 42 yo woman with a diagnosis of
moderate to severe dry eye, started on restasis last visit. Follow up
appointment is now 6 weeks later. Upon asking how she’s tolerating the new
medication, pt states she couldn’t tolerate it. It burned. So she stopped it
three weeks ago and wants to know what else could be done for her dry eye.
(ojos secos, la educación del uso del medicamento, palabras de aliento)
Patient 5: 51yo diagnosed with advanced
open angle glaucoma at the last visit, was given a sample of lumigan to use 1
gtt OU qhs and is now here 4 weeks later for an IOP check. However, pt admits
to “running out” of the drops and therefore hasn’t been using them for two
weeks.
(el
glaucoma del ángulo abierto, el incumplimiento del paciente, la educación de la importancía del glaucoma)
Patient 6: 36 yo with poor uncorrected
vision OU, told years ago he had cataracts, exam shows extreme anisometropia
and anisometropic amblyopia, one eye correctable to 20/20 with significant
cylinder, optic nerves suspect for glaucoma. Pt interested in CL for his good
eye.
(la
ambliopía, discusión del protección monocular)
Patient 7: 85 yo woman, first-time patient
to the office, had cataract surgery with PCIOL OU 8 years ago at another
practice, comes in today with VAcc 20/30 OD, 20/150 OS. When asked if her
vision OS had always been poor or just started immediately after or sometime
after her surgery, the patient states she can’t remember. Dense PCO OS found on
exam. Macular drusen noted OD.
(la
cirugía para sacar la catarata y las
complicaciones, la opacificación del implante de lente, la
degeneración macular relacionada con
la edad)
Patient 8: 54yo deaf patient with limited speech. Vision stable
over the course of his life except for the last 2 years, after patient
diagnosed with and treated for meningitis (suspect viral). 20/30 with
correction one eye, CF other eye. Wants glasses to fix everything.
(la
neuropatía óptica infecciosa,
discusión del protección monocular)
Even
for the cases that I do not see as frequently, I still try to maintain a
general working vocabulary in Spanish through my on-line tools like www.ojossanos.org when teaching the patient about
his/her condition. But again, with more experience in a language, with repeated
exposure to certain topics, my understanding of Spanish and my ability to express
myself in Spanish become better and better. Each patient adds to my
understanding and learning. And don’t be afraid to include your patient in on
your learning process! I have found patients to be more than happy to teach me what
they know when I ask them vocabulary, language and cultural questions. Doing
this really makes them feel like I care enough to make sure that they fully understand all aspects of
their eye health.
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| Riomaggiore, Italy. Courtesy: D. Hromin |
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