Saturday, February 23, 2008

"In case of emergency, know your Spanish"

(Published February 23, 2008 in The Guadalajara Reporter)

Several months ago I had one of those life-flashing-before-my-eyes moments: as I stepped off the 622 bus on Agustin YaƱez, a motorcyclist slipped into the bus lane on the right-hand side without a trace of deceleration. A split-second or millimeter difference would have put me in the hospital, or worse.

Thrown into the vertigo of an emergency room without the comfort of my mother tongue or an English-speaking doctor, I can only imagine how I would have reacted. The fact is, communication barriers exist even during scheduled visits with bilingual doctors in Mexico. That alone should be motivation enough to prepare in case of an unpleasant stomach episode on a rural roadtrip or an ill-fated scorpion bite on the Teuchitlan ruins.

I consulted Dr. Carlos Rodriguez Zarate, the medical subdirector of the San Javier Hospital in Guadalajara’s Colonia Providencia, for his advice to English-speaking patients being treated in a Spanish-speaking world. Zarate performs directorial duties in the morning and runs a private cosmetic medicine clinic in the afternoon, often treating native English-speakers.

It is comforting, first of all, that his hospital does much to accommodate bilingual patients: chief members of the nursing staff are required to take a medical English course, and the hospital employs two English speakers to handle administrative tasks, like working out medical insurance. But even so, many English-speakers are not happy to be there.

“Patients are often afraid, especially to be at a Mexican hospital,” Zarate said. “They want to explain their symptoms and they try to find people who speak English.”

Patients are likely to be anxious in the hospital regardless of the language they speak, but surely more so for those left out of the loop. The antidote to fear, he said, is preparation.

“I recommend patients carry a little card with their brief medical history, the medications they take, and any allergies they have. It’s a good idea, especially if they get to a place they don’t know.”

As a doctor, Zarate wants to know specific symptoms a patient is experiencing, when they started, and when they got better or worse. This requires a basic Spanish vocabulary related to time and health quality. There are countless Spanish-English medical dictionaries online that will help you sort out your symptoms, especially if you have a chronic condition like hypertension or diabetes you’ll need to explain to any doctor.

And if you’re experiencing mystery symptoms, Lorenza Ochoa, a second-semester medical student at the Universidad Autonoma, suggested a few helpful phrases to help the doctor divine your affliction. Remember, the doctor is a respected individual and should be referred to as usted.

Me siento mal tells the doctor you don’t feel well: add de + body part to explain where. If the pain is localized you can simply point to where it is and say, me duele aqui.

To ask the doctor what you’re suffering from specifically, say, que es lo que tengo? and, es grave? to inquire if the issue is serious. Next ask usted puede tratarlo? (can you treat it?) and if the answer is no, ask the doctor to explain what other options you have: que otras opciones hay?

Ochoa emphasized the importance of understanding the doctor’s instructions—a confused headshake will not help the doctor solve the problem. Don’t be afraid to jump in and say, puede explicarme otra vez? (can you explain it again?) or, puede explicarmelo lentamente? (can you explain it slowly?)

The doctor is one person who will never judge your bad gringo accent or your nervous stutter. If you still have trouble understanding her directions after several repetitions, try asking her to write down the directions for you: Puede escribir las instrucciones para mi?

Apart from online dictionaries there are great take-along ones for quick reference. Zarate showed me a chunky, colorful book about the size of a billfold called “Medical Spanish Made Incredibly Quick” (by Springhouse). It’s waterproof and washable allowing the user to jot notes on the pages, and separated into categories by bright plastic tabs. The book lists questions in a simple yes-or-no format for easy communication. It’s the perfect bilingual resource for travelers to Mexico or permanent residents who frequent the doctor.

Communication, said Zarate, is the key. If after a doctor’s visit you remain doubtful about any symptoms or medications prescribed, all respectable medical professionals should be available to clarify concerns by phone or email.