Kenneth Brooks
“Donde te deule”?
It’s a Thursday in September, the first Thursday in fact and I’m volunteering
with St. Andrews Clinic in Nogales Arizona. Perhaps it was my overconfidence or
perhaps it was the lack of St. Andrew Clinic volunteers that spoke Spanish, that
allowed me to pose as a translator for physical therapists treating the children. Flat
feet, auditory and visual deficiencies, loss of limbs, all of these conditions were
prevalent and daunting feats to overcome, not only for the doctors treating them
within the half hour time allotted per patient, but for the patients, who not only
were experiencing their first doctor in months but were also suddenly enthralled in
a language barrier they had never experienced in the past. “Mira me por favor?” as I
check their visual motor functions, “Puedes lavanto sus manos?” The parents sat
back, waiting for the small comfort in knowing that the day long walk from their
homes in mexico, to the daunting American border were not in vain, they would be
reassured of the health of their child. “Es importante que tu hablar con el medico en
un momento sobre la salud de su hijo,” I would try to articulate with the few spanish
words in my memory from past classes. Although in many instances the parents
would simply nod their heads and smile in appreciation, it was obvious that they
were just as uncomfortable being in an environment where they were not familiar
with the language as I was, and as a result, they felt like spectators looking through
a glass windows as the future of their children was decided by foreign doctors. The
education of medical Spanish to the American medical community is of crucial
importance to better secure a future that will bridge the gap between
communication and care between doctors and their patients.
Why is sufficient communication between a doctor and their patient
important? Doctors have evolved over time as people who were once considered to
simply ease the passing of individuals who could not otherwise be taken care of, to
being solley responsible for the life and death of patients. If a patient should pass
away, it has been common place to place the blame on the doctor rather than
understanding that everyone eventually dies. As such, communication between
doctors and their patients has also increased greatly as the responsibilities of the
doctors to take care of their patients has also increased exponentially. It is a
physicians responsibility to not only ask where the pain comes from, but to explain
what the pain may suggest and the possible forms of treatment available. However,
when there is a language barrier between the doctor and their patient, the patient
must soley rely on the expertise of the physician and must also pray that the doctor
understands the symptoms and conditions correctly, considering that a foreign
speaker may not be able to express in words what is wrong.
Every patient requires a different degree of care and level of
consideration because not all patients experience the same conditions and
symptoms. Such basic information has been used continually in the care of
individuals for many years. However, if a doctor only has the capability to ask ,
“Donde te Duele” the level of care may be compromised due to lack of
communication. Between two English speakers, a clear understanding of the causes,
previous conditions and various symptoms are known very well and as such have a
higher probability of successful treatment. However, if a doctor who does not speak
Spanish relies heavily on a patients ability to point where it hurts, rather than clear
communication between physician and patient, the probability of accidental
diagnosis or a mistreatment in care are very high. This reasoning is one of many that
illustrate the necessity to educate physicians in Spanish, especially in Spanish
speaking states because the people who do not speak English do not deserve subpar care because of their cultural background.
Within the medical community, it has become increasingly important
to encourage the education of Spanish to new medical students and residents alike.
For instance, in the New York Sun article, “More doctors encouraged to learn
Spanish,” a common theme that is expressed is that without knowing fundamental
Spanish terms that pertain to medicine, the ability of a physician to take care of their
patient is at a great disadvantage. “If you cant elicit what the patient is feeling, your
going to lose a lot,” said the director of medical Spanish program at the Albert
Einstein College of Medicine of Yeshiva University. This represents a key point in
that it illustrates the barriers that are clearly evident between a doctor and their
patient as they battle language barriers. In terms of multilingualism, a fundamental
theme that can be found within the study is the overall useful ness of knowing
multiple languages and the connection that may be made through the education of
two languages. However, it is evident that in some hospitals it is required by law to
provide language assistance to those who use Spanish as their first language.
Within New York City, a large population of the community use
Spanish as their first language and as such, the need to implement Spanish learning
skills within surrounding hospitals has been of incredible importance. “ By law, the
states Department of Health requires hospitals to provide a certain level of language
assistance to patients who do not speak English. Most hospitals have translators on
site, or special telephone hookups that provide translation services.” (Solomont) Is
this enough? Are telephone extensions and a few translators located throughout the
hospital enough to provide adequate attention to the patients that deserve care and
do these extensions accommodate physicians who primarily work during the night
shift or do they favor physicians during the day? Although there may be resources
that support translation and help the physician communicate on some level with
their patient, the middle man interaction takes away from the connection that is
created through the doctor patient relationship and hinders the trust that one
another have in each other during primary care.
“The main reason we’re in medical school is to learn how to treat patients,”
says a fourth year student at the Mount Sinai School of medicine. Without the
appropriate education, doctors may not be able to accommodate the needs of their
patients. Albeit Spanish education in hospital setting is of crucial importance, the
need for Spanish speaking physicians is also important when working in
underpriveledged communities as well.
St. Andrews Clinic is a non-profit organization in Nogales Arizona that sees
approximately 200-250 children the first Thursday of each month where food,
clothes, and medical care are presented to underpriveledged Mexican families
suffering from loss of limbs, cleft palets, eye site and hearing deficiency’s amongst
other medical conditions as well. In many instances, the families that travel from
their homes in mexico are seeing their physician for the first time in months,
endlessly hoping that their doctor, who has a half an hour per patient, will be able to
cure substantial problems in these children. Since its establishment in 1977, the
clinic has facilitated the travel and surgical expenses of countless patients who
would not otherwise been able to obtain care. The experience has been one of the
most humbling of my life and has introduced me to the absolute necessity of
learning Spanish to facilitate the help towards the needy.