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Talking to a patient, without a translator, in mutual non-native languages

Danielle Ofri, MD, PhD
Patient
January 22, 2010
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“Je m’a…,” I stuttered to Aristede Mezondes, the serious young man in a grey wool overcoat, standing before me with ramrod posture. “Je m’appelle Dr. Ofri.”

There. I’d gotten it out.

The language of Descartes, Voltaire, and Balzac had clearly vacated my cortex. Despite those years of French classes and one brief visit to Paris, “Je m’appelle” was the best I could come up with. And even that was a struggle. Pushed aside by the overwhelming necessity for Spanish in our clinic, further dilapidated by decades of disuse, I could not conjure up a single word in French beyond stating my name. I was appalled at my brain’s porosity.

Mr. Mezondes smiled politely. No doubt he was accustomed, and perhaps resigned, to the challenges of communication here in America. I gestured for him to sit down, and tried to signal a polite, “just a moment,” as I started down the list of options. First was calling the office of our volunteer interpreters.

“Sorry,” the person answered, “our French interpreter is no longer with us.” I hoped he had merely quit his job and not reached an untimely end.

I asked around in the waiting room, but nobody spoke French. I surveyed the clinic staff—only Spanish and Chinese to be found. Back at my office, I resorted to the final option and called AT&T.  When a French-accented voice graced my ear, I exhaled a sigh of relief.

Mr. Mezondes and I took turns on the phone, and I learned that he was a 24 year-old man from Braazaville in Congo. He spent an extra cycle of translation ensuring that I understood that this was the Congo that used to be French Congo, not the Congo that used to be Zaire. He was generally healthy, but his main concern was a burning in his stomach, especially after he ate.

Even though we smiled gamely at each other as we handed the phone back and forth, it was hard to say that we were really having a conversation together. It was more like we were each having a conversation with the polite but business-like interpreter. And that’s what our conversation was: polite and business-like. I asked the questions, he supplied the answers. I kept my utterances brief, not wishing to overload the operator and I sensed Mr. Mezondes doing the same. I was also cognizant of the cost of the services, so I tried to be as efficient as possible. I even ventured to tell my patient his diagnosis and treatment during this initial conversation, something I normally would never do before the physical exam. But I didn’t want to have to call the operator back again, so I explained that he most likely had acid reflux, and—barring any information to the contrary that I might glean from the physical exam—that I would give him a medicine for acid and see him again in my clinic in one month.

We said goodbye to our AT&T friend and I gestured him up onto the exam table. As I palpated his abdomen and listened to his heart, Mr. Mezondes asked in halting English, “You speak little français?”

No.” I shook my head, regretting the years of study that had never succeeded in cementing my French. “Solamente español.”

“Español?” he said with a broad grin. “Yo hablo español.”

Spanish? He spoke Spanish?!?

For the rest of our visit, we chatted happily, if a bit awkwardly, in our mutual non-native languages. I learned that he’d studied Spanish at his university in Congo, and I told him that I’d studied on trips to Latin America.

He told me how he had emigrated from Africa two years ago, but first lived in Canada, and how different Canada was from America. I told him that I had once lived in Montreal, and how I’d struggled with the Québécois French. We laughed over our common difficulties with the slang street-Spanish in New York. And then we were able to review his medical issues and treatment, and I could be confidant that he understood.

It had never dawned on me that Mr. Mezondes would speak Spanish. I had assumed that, like most West Africans, Mr. Mezondes would only speak French in addition to his native language in Congo. It never dawned on Mr. Mezondes that I might speak Spanish. I guess he assumed that most white Americans didn’t speak anything but English.

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“Hasta luego,” he said, shaking my hand.

“Ojalá que pasa un buen día,” I replied, with a small surge of pride that I’d nailed the subjunctive. I knew that Mr. Mezondes could appreciate the linguistic leap that grammatical construct entailed.

Mr. Mezondes left my office to make his appointment with the front-desk staff. Most of the Bellevue clerks were Hispanic, bilingual in Spanish and English. Mr. Mezondes—a native Congolese who spoke scant English—would have no trouble at all arranging his health care.

Danielle Ofri is an internal medicine physician and author of What Doctors Feel: How Emotions Affect the Practice of Medicine.

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