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Dr. Joseph Sirven: When Medicine Gets Lost In Translation

Dr. Joseph Sirven
Dr. Joseph Sirven
Dr. Joseph Sirven

I was running behind so I knocked on the exam room door without looking at the chart of my new patient. 

As I walked in I was greeted by a multigenerational family of five with the patient seated closest to my desk.
 
“My name is Dr. Sirven, how can I help you today?”
 
The whole family looked at me quizzically with nervous smiles. 

I started again: “Hi, how can I help you today? What seems to be the problem?” 

Again, smiles, shuffling and … silence.

I looked at the family for a moment, and took a leap of faith.

“¡Buenos días!  Soy Dr. Sirven.  ¿Como te puedo ayudar hoy?”

The family smiled and proceeded to explain their problem to me — in Spanish.
 
We were all relieved, as I spoke their language and avoided a high-stakes version of medical charades. I helped them and they went on their way. 

Although this turned out well, there could easily have been a different outcome. If they’d been speaking a different language, say Chinese, or Arabic, I’d still be there wondering what was going on.  

According to U.S. Census Data, almost 25 million Americans admit limited English proficiency. 

Our country is a melting pot and that can have a huge bearing on health.

According to an Institute of Medicine report, individuals who didn’t speak English got worse care than others because patients and doctors simply didn’t understand one another.  

Sadly, and I know this from personal experience, patients who don’t understand English are often erroneously dismissed without an answer.

With so much pressure to spend less time with my patients, how do doctors like me spend more time explaining an issue to folks that don’t speak the language?
     
You see, fluency strikes at the very heart of what medicine is all about: listening to your patient and trying to solve their problem. 

We in medicine are in dire need of medical Rosetta Stones, if you will. We could use easy access to competent translators either in person or on a mobile device. And we need recognition by insurers and public health officials that when we don’t speak the same language, patients need more time to be evaluated.

When we fail to comprehend one another, we’re forced to rely on kindly gestures such as eye contact or a smile, which are nice, but not enough — especially when details lost in translation can be fatal.