Blefaritis
1-Tenga que limpiar los párpados cada
mañana y noche con una toalla tibia.
2-Tome 1,000mg
de Omega-3 (dos píldoras con la comida).
3-Ponga dos
gotas de lágrimas artificiales en cada ojo dos veces al día.
One
of the topics that I repeat ad infinitum in this blog is that, no matter the
language or the culture, people are people.
We are all subject to the same concerns, fears, questions, hopes. We all
have the same goals as patients—we want to stay healthy, be well and are
willing to do what we must to keep things that way. Ophthalmology patients want the best for
their most important sense: they want to see the sharpest, maintain their
vision, and continue with their daily routines sans eye irritation or
discomfort. They of course have concerns, having an understanding of what conditions
like ‘macular degeneration’and ‘retinal detachment’are-- they want to make sure
such vision-threatening diseases are preventable or at the very least, caught
early and treated.
It’s
alot to think about, and as a patient in a doctor’s office (a place where many
people have a low-lying level of nervousness to begin with), sometimes it is
difficult for the patient to A) remember all the questions he want to ask his
doctor and B) listen to and remember all the doctor is telling him regarding
his diagnosis and instructions for treatment. And this is assuming that the
doctor is explaining things in plain
language. If technical medical
jargon is being used, then this adds an extra element of confusion to the mix
for patients.
I
have found time and again since my third-year medical school clerkship days,
that even when I explain in my native English a patient’s diagnosis and
treatment to a native English-speaking patient, many times in the end my
patient will still have difficulty remembering everything I’ve said, let alone
the steps to take to treat the condition. I make every effort to use plain language
and not medical terminology. I take as much time as necessary to explain everything
and answer all questions to my ability. Yet, when I ask the patient to repeat
back to me what her understanding of her eye condition is and how I want her to
proceed with the treatment regimen, many times she can’t do it! She nods her head
in understanding, but in the end she still does not fully remember everything
I’ve said. As I mentioned earlier in this post, most of this has to do with a
certain level of anxiety the patient may be experiencing, in addition to having
to take in a large amount of new information which, honestly, takes time to
digest.
Think
about it—if this happens, and it does frequently happen, in my native English language, imagine how much
more convoluted and confusing the story gets when I am attempting to explain
the same diagnosis in my secondary language of Spanish! Sure I have a professional
fluency, but it is not native level, and the native Spanish-speaking patient is
therefore subject to my personal interpretation, my accent, and my linguistic
angle of his language. –Eso es decir, hablo el idioma bien, pero no soy un
hablante nativo de Español, y estoy segura que hay veces cuando mis frases
suenan extrañas. –>Maybe even this sentence! When speaking or listening in a non-native
language, there will always exist misinterpretations or confusing elements. Add
to this scenario the usual time crunch in a busy clinical setting, and we have
the perfect storm which can result in a patient leaving the office frustrated
and not fully understanding his/her diagnosis and what to do about it.
To
make life a little easier and clearer, what I like to do is have written
material available in Spanish which I can give to the patient at the end of his
visit. This serves as a take-home
reminder of what we discussed in the office. The American Academy of
Ophthalmology is one of several sources that offers brochures on their website which thoroughly cover
a variety of eye diseases in Spanish (see below for link). However, I find that sometimes, such
information is a little bit too lengthy.
Even written information, when given in too large a quantity, becomes a
giant ocean where the main points are lost.
During
my residency, when the time crunch really really
mattered, I became master of writing out instructions on small pieces of paper
or index cards of the most common eye maladies I treated: dry eye, blepharitis,
corneal abrasion, bacterial keratitis, open-angle glaucoma, metallic corneal
foreign body removal, the list goes on and on. I would photocopy them and hand
them out at every opportunity. I did
this in both Spanish and English, and I opened this particular blog entry with
an example of my “Blefaritis” treatment information card. A little extra work to prepare these went a
long way in driving home understanding of the disease and/or treatment. It
meant the difference between seeing a patient at follow-up who was fully
recovered versus the patient who was still suffering because he/she couldn’t
remember how many times a day to use the drops.
Of
course, some patients returned the next visit having lost my cards, but I would
hand them another copy and we’d start all over again! In the end, it’s about doing all you can to
make sure there is an understanding between doctor and patient, regardless of
the language in which you communicate.
*
American
Academy of Ophthalmology Patient Education Brochure link:
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