The Language Divide_Narrative

The Language Divide_Narrative - Narrative Matters Doctoring...

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Doctoring Across The Language Divide Trained medical interpreters can be the key to communication between physicians and patients. b y A l i c e C h e n T he first time i met Mrs. Haddad, I was running late. She was sitting on the exam room’s metal folding chair, covered head to toe in the black hijab worn by some Mus- lim women. Her face was exposed but expres- sionless and didn’t change when I walked into the room. A man seated beside her stood up im- mediately. Because most of my patients don’t speak much English, my usual routine is to walk into the room, introduce myself, and ask what language the patient speaks. In addition to English, I speak Mandarin and Spanish, but as often as not, I leave to find an interpreter. Fortunately, this commu- nity health center has professional interpreters who speak Cantonese, Korean, Toisanese, and Vietnamese, as well as bilingual staff members who have been trained to serve as medical inter- preters for Cambodian, Lao, Mien, and Tagalog. “Hi, I’m Dr. Chen. I’m sorry to have kept you waiting. What language do you speak?” Mrs. Haddad said nothing. The man—her husband, as it turned out—answered instead, “She speaks Arabic. But I speak English.” Mr. Haddad was slender with an open, animated face, wearing a dark blue T-shirt and dark pants and holding a cell phone. 8 0 8 M a y / J u n e 2 0 0 6 N a r r a t i v e M a t t e r s DOI 10.1377/hlthaff.25.3.808 ©2006 Project HOPE–The People-to-People Health Foundation, Inc. Alice Chen ([email protected]) is the medical director of the General Medical Clinic at San Francisco General Hospital in San Francisco, California, and an assistant clinical professor of medicine at the University of California, San Francisco. She was at Asian Health Services, a community health center in Oakland, California, when these events took place. The names of the patient and her husband have been changed, as have some details. PREFACE: It’s fortuitous that “patients” and “patience” are pronounced the same. Their link as homophones continually reminds us that physicians’ communicating with their pa- tients—and the patience it involves—is essen- tial to good doctoring. When one factors in dif- ferent languages and different cultures, communicating becomes an even more layered process requiring additional patience—and perseverance. California physician Alice Chen speaks three languages; nonetheless, she found herself one language short with a patient who spoke only Arabic. As Chen details in her essay, the only communication with her patient that she could trust was provided by a trained medi- cal interpreter; she finds it inexplicable that de- spite the growing need for this important spe- cialized service and its proven effectiveness, the need for trained medical interpreters is often swept under the carpet by policymakers. Then, too, although people from two different cultures ostensibly speak the same language, it doesn’t mean that they truly understand one another. In his essay, physician-professor Jack Coulehan
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