I finished my emergency medicine rotation and am now readjusting to being back in the inpatient medicine setting. Of our patients, we currently have a Korean man and his wife who speak very limited English, a Spanish-only spouse of a man rendered stuporous, a Romanian-only, and an Arabic-only speaking patient.
I am constantly surprised by otherwise very intelligent and caring medical professionals, who don't seem to be able to relate to English learners. Even if they are nice people who aren't purposely being mean toward a patient for not speaking English well, they don't seem to be able to modify their rate of speech or vocabulary. The same happens even with native English speakers that just have less education. The doctors continue to use idioms or phrases and words that are more advanced, like saying, "we anticipate he will leave soon" instead of just saying, "we think he will leave soon." Sometimes the low-level English speaker glazes over when they are faced with a few difficult words like this in a row, and I can tell they have lost the thread of the conversation. But the doctor will continue on, oblivious that the person isn't making obvious his or her confusion, perhaps due to embarrassment over suboptimal English skills.
This happens to me all the time in Spanish. I appreciate Spanish speakers who have lived in the U.S. for a while compared to Mexicans at the clinic I used to go to in Mexico through the Flying Samaritans. Even though both groups spoke only Spanish, the ones who had come to the U.S. generally knew to use simpler Spanish words and slow down so I could follow along. The ones without experience with non-native Spanish speakers would just chatter along at the speed of light, or use colloquialisms I had never heard.
I think I'm a pretty good contextual comprehender; it's how I blended into American life as a teenager without knowing teenage lingo or many swear words when I came here. It helped when I was in the fire department, whether it was banter in the firehouse or with the public out in the non-standard English-speaking neighborhoods. It's proven helpful when I traveled in Europe and South America where I often understood the gist of what was being said even if I didn't catch all the words perfectly. But tourist conversations hardly compare to the gravity of medical explanations and decision-making. It's hard enough for the lay person to understand medicine as it is, without a language barrier to compound problems.
In any case, all my non-English speaking patients and their families seemed happy at the end of the day. In particular, the Spanish-speaking spouse was adamant yesterday that we call an interpreter when they transferred him to our service. My Spanish isn't great, but the translator was going to take a while to arrive, so we tried her out anyway in the interim. At first she was dubious, but by today, she was appreciative, smiling and waving at me as I walked by the room. Her otherwise healthy husband has been gorked out for a month, the doctors at the prior hospital hadn't been able to fix him or even tell her what the problem was, and she was freaked out. The Koreans too, they were sad that they were stuck out here in California when all they wanted was to get back home to the Midwest, but they were a little happier when they had a better grasp of their care.
In a place like California, no one is going to learn every language spoken and there just aren't enough translators. But I think simply slowing down and using simpler words so people can understand really helps them cope with their medical issues.
