Monday, November 27, 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

Thursday, November 9, 2017

Patient Correspondence Letter

There are times when physicians cannot rely on pre-printed translated office material. Particularly when it comes to communicating important information to patients, personalized letters tailored to the patient in question are required. Here is an example of an actual letter* directed to a patient from his general ophthalmologist. You will see the original English version first and then my translation into Spanish (*all names and locations have been changed to protect anonymity). This letter in particular was sent to the patient because he never followed up with setting up an appointment with a glaucoma specialist—something that was recommended to him during a recent office visit.


Dear Sir:

Your last visit to our office was October 21, 2015.  During that exam, I had explained to you that you have a diagnosis of advanced glaucoma and that you are going to need medication in the form of eye drops to treat it.  I also told you that you are going to need a glaucoma specialist and that you have the opportunity to see Dr. Smith, located in Springfield, or Dr. Jacobs in West County. You told me that you would make a decision as to which office to visit, and that you would call me with this information.

Since that time, I have not heard from you.  My secretaries have tried contacting you, but you have not answered.  Please remember that a diagnosis of advanced glaucoma is very serious.  In your case, eye drops are not enough to maintain a stable eye pressure—you need the help of a specialist.  If not, it is possible that you are going to lose your vision completely.

Please, when you receive this letter, call the office to schedule an appointment with the glaucoma specialist.  The number here is:

(123) 456-7890

Remember, if you do not call to make this appointment with the specialist, you are in danger of going blind.

Thank you for your time.

Sincerely,

Dr. Jones


                                                                        *


Estimado Señor,

Su última visita en nuestra oficina fue el 21 de octubre, 2015.  Durante ese examen, le expliqué a usted que tiene un diagnóstico de glaucoma bien avanzado, y que va a necesitar medicamentos en la forma de gotas para curarlo.  También, le dije a usted que necesita un especialista de glaucoma, y tiene la oportunidad de ver al Dr. Smith, ubicado en Springfield, o al Dr. Jacobs en el Condado de West.  Usted me dijo que haría una decisión cual oficina podría visitar, y que me llamaría con esta información. 

Desde ese tiempo, no he oído de usted.  Las secretarias han tratado de llamarlo, pero no nos ha contestado.  Por favor, recuerda usted que el diagnóstico de glaucoma avanzado es muy grave.  En su caso, los colirios no son bastante para mantener una presión estable del globo del ojo—necesita usted la ayuda de un especialista.  Si no, es posible que pierda la visión completamente.

Por favor, cuando recibe usted esta carta, llame la oficina aquí para hacer la cita con el especialista.  El número aquí es:

(123) 456-7890

Recuerda, si no llama para hacer esta cita con el especialista, usted está en peligro de la ceguera.

Gracias por su tiempo.

Sinceramente,

Dr. Jones
 
NYC Bird Murals 2017. Artist: Key Detail




Thursday, October 26, 2017

Reverse Translation

For health care providers working with a low English-proficient patient population, emphasis is oftentimes focused on providing translation services only in one direction: from our source language, English, into the goal target language of the patient.  As a clinical ophthalmologist serving a community of Spanish-speaking patients, I have provided this to my patients: written translation of English into Spanish of various forms of office documentation, including patient referral information, correspondence letters, educational pamphlets, surgical consent forms, etc.

However, I discovered over the years during my clinical encounters that there can be just as much of a need for translation in the opposite direction, from Spanish to English, in order to provide proper continuity of care. Many of these patients maintain close ties with extended family and friends in their home countries, and travel to those countries often as they possibly can. Therefore, many of them continue to receive care from their personal doctors serving them back home.

In order to properly coordinate care for these patients, particularly for chronic conditions, such as glaucoma care or diabetic retinopathy monitoring, I provide a summary of exam findings for my patients to take to their doctor. They, in turn, return with reports from their physician written to me, often written in their native language. Below I have copied one such report, which was furnished from the patient’s ophthalmologist in her home country. It is an Optical Coherence Tomography (OCT) scan of her optic nerves and retinal nerve fiber layer, routinely performed by ophthalmologists to monitor for glaucoma progression. After the original letter, you will find my translation into English. I then touch on some keys points in the letter.**

**The patient and doctor’s name have been removed for privacy reasons.

Original letter:

Informe de OCT – NIDEK
Tomografía de Coherencia Óptica

Fecha: 09 Febrero del 2017
Paciente:
Referido por: Dra. --

Resultados:

Utilizando el RNFL and ONH: Optic Disc Map 256 x 256 y
realizando un análisis del promedio del grosor de la capa de fibras
nerviosas, encontramos valores en OD 101 micras y OS 93 micras. Presenta
una curva comparativa simétrica 87%. En cuanto al estudio de la cabeza del
nervio óptico, resaltamos que se aprecian un radio promedio excavaciones
en OD 0.46 y OS 0.54, con una relación C/D vertical en OD 0.44 y OS 0.58,
con un disco total de 2.18 mm2 y 2.10 mm2 , respectivamente. El TSNIT
muestra alteración en cuadrantes temporales AO.

Realizamos análisis de células ganglionares las cuales se encuentran
disminuidas en AO.

Estos resultados tomográficos muestran un conteo de fibras nerviosas
bajo con alteración en las células ganglionares, por lo que este estudio
podría considerarse sospechoso de Neuropatía Glaucomatosa Inicial,
recomendamos realizar Gonioscopía, correlacionar con la paquimetría y
repetir estudio diagnóstico dentro de 1 año para control y seguimiento.

Gracias por su gentil referimiento,

Dra. --
Cirujano Oftalmóloga

                                                                        *
OCT-NIDEK report
Optical Coherence Tomography

Date: February 9, 2017
Patient:
Referred by: Dr. --

Results:
Using the retinal nerve fiber layer and optic nerve head Optic Disc Map 256x256 and performing an analysis of the average thickness of the nerve fiber layer, we found the following values: 101 microns in the OD and 93 microns in the OS.  This presents a symmetric comparison curve of 87%.  In relation to the optic nerve head study, we note that we can appreciate average optic nerve cupping of 0.46 OD and 0.54 OS, with a vertical C/D ratio of 0.44 OD and 0.58 OS, with a total disc area measuring 2.18mm² and 2.10mm², respectively.  The temporal-superior-nasal-inferior-temporal (TSNIT) analysis shows an alteration in the temporal quadrants of both eyes (OU).

We performed an analysis of the ganglion cells which were found to be diminished in both eyes.

These tomographic results show a decreased nerve fiber layer count with alterations in the ganglion cell layer, and therefore should be considered suspect for Early Glaucomatous Neuropathy, we recommend doing a gonioscopy, to correlate with the pachymetry and repeat of this diagnostic study within one year for maintenance and follow-up.

Thank you for your kind referral,

Dr. --
Ophthalmic surgeon
                                                                        *

During the course of my translating this article from its original Spanish into English, I noticed that some of the ophthalmic abbreviations that we ophthalmologists and optometrists use here in the US  are the same as those used by eye care specialists in Spanish-speaking countries. Others, however, are different. Therefore, I did some research and found a very helpful website online: Vistaláser Oftalmología, which happens to be the website for a group of practicing ophthalmologists in Málaga, Marbella and Granada, Spain. The address is as follows:  https://www.vista-laser.com/abreviaturas-optometria-oftalmologia/
The page is broken into the following groups:

Abreviaturas médicas sobre la salud ocular, or Medical Abbreviations regarding Ocular Health

Abreviaturas de oftalmología, or Ophthalmology Abbreviations

Abreviaciones de óptica-optometría, or Optical-Optometry Abbreviations

Abreviaciones médicas habituales, or Common Medical Abbreviations

Sometimes, doctors in Spanish-speaking countries will use some of the same abbreviations we doctors in the US are familiar with because they both come from the Latin language. An example of this is the abbreviation:

OU, Latin for oculus uterque, and what we know as both eyes
OS, Latin for oculus sinister, and what we know as left eye
OD, Latin for oculus dexter, and what we know as right eye

In this particular report, what I found interesting was that the author used the familiar OD and OS, but then used the abbreviation:  AO, which I had never seen before.

If you peruse the list of abbreviations on the VistaLáser Oftalmología website, you will find that AO is the Spanish way of saying OU, or both eyes:

AO, from Ambos Ojos=both eyes.

To summarize, English and Spanish-speaking doctors will likely be able to use several ocular abbreviations interchangeably, due to the common use of Latin in medicine. However, there will also be special means of referring to a disease state or an ocular structure that is unique to the language of origin. As is the case with any translation, continue to be a sleuth – try to find parallel texts or resources such as the VistaLáser Oftalmología web page to help explain and clarify any uncertainties. In this way, your translated text will reflect the intent and meaning of the original as closely as possible.


References

Abreviaturas en optometría y oftalmología. Retrieved October 24, 2017 from  https://www.vista-laser.com/abreviaturas-optometria-oftalmologia/ 

NYC mural by Lunar New Year, October 2017