Fall 2021 (Volume 31, Number 3)
Bridging the Gap: Learning Spanish To
Better Help My Patients
By Nancy Keesal, MD, FRCPC
Download PDF
I’ve always been a lover of languages. I was born in
Montreal, and I attended a Jewish elementary school
and high school and learned French, English, Hebrew
and Yiddish, not to mention sign language as I had two
grandparents who were deaf-mutes. That being said, when
I moved to Toronto for my residency, facing the multiculturalism
of the city was daunting, and I soon came to see that
translation was a fundamental and often frustrating part
of medical practice. No matter how good your translator is,
you know you are never getting the full story, and that your
patient is not getting the best of you because of it.
When I started in private practice as a rheumatologist, I spent part of my time in an area of Toronto dominated
by Portuguese and Spanish patients. Every second patient
required a translator, and it was time-consuming and tiring,
so I signed myself up for a Spanish class. I have been
seeing patients without a translator for years now. It has
even helped me learn some Portuguese, not enough to not
require a translator, but enough to know when I am not
being translated well. It is frightening to realize how often
the information we share or the questions we ask our patients
are incorrectly conveyed.
Because of my Spanish, I decided to travel to one of the
poorest parts of Guatemala with a non-governmental organization
(NGO) and offered my services there. The “clinic”
was crude, and we barely had any medical supplies. It
was publicized through the village that a “bone doctor”
was in town. I snuck in a lot of Depo-Medrol in my suitcase
(I found out that to bring it in legally would require
the mayor of the town writing a letter on my behalf and
10 pages of paperwork, so I hid it in my luggage). I listened
to many stories and gave a lot of cortisone injections that
week. I had to ignore the patient with a breast mass I saw,
because she had no money for medical care, and the lice
on a newborn, passed on to her by the only midwife in the
village. There was nothing to do because they can’t wash
all their clothes with clean water.
There are so many barriers to equity; so many cultural
differences that lead to separation instead of celebration.
At the core of relationships within medicine is the ability
to communicate with ones’ patients. Language, at the very
least for me, helps me to cross the first fundamental barrier
at least with some of my patients. Language has brought a
richness and joy to my life and has helped me expand my
world, and now I am trying to teach that to my children.
Nancy Keesal, MD, FRCPC
Rheumatologist,
Toronto, Ontario
|
