When I was younger, I would sometimes take over a phone call for my parents, perhaps with the cable company or our phone service, if the conversation moved too fast or became too technical. They never asked me to do so in person, but occasionally, when I was feeling frustrated after tagging along on a trip to the bank or the store, I would interject a few words in Chinese to move things along. I didn’t realize until much later what it might have felt like for them, or why they might not have wanted their son to translate for them.
At home, we spoke a pidgin Chinglish unique to our house, with English words filling in for Chinese ones I never learned after my English began to outpace my Chinese. It wasn’t perfect, but it was enough for us to understand each other. Still, I remember moments when it wasn’t quite enough. There were times when what my parents understood and what was being asked of them didn’t quite align, and what followed was either going along and hoping things would work out, or the frustration of asking me to find another way to help them understand.
I sometimes think about this in my work at the free clinic. We see mostly Spanish-speaking patients, and I make my best attempt to speak with them directly in Spanish, with a fluent translator listening in and on standby if needed. My Spanish is passable, but not fluent. I rely heavily on the present and present progressive tenses, look for words that are not always there, and regularly produce Spanglish, which I like to think of as creative uses of the words I happen to have in my vocabulary, and which I consider a success if my patient and I manage to understand each other.
I’ve found that this work can happen in the background too. With some patients who speak English quite well, they still unconsciously rely on placeholder words like que, porque, and pero, and moments that might have broken our connection and conversation pass without notice. But more noticeable is the active work of understanding.
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My patients correct me when they can by helping me find the right words, and in doing so we become partners in fixing my broken Spanish. I think this sets the stage for us to become partners in managing their health, too. I also think that the effort itself, even if imperfect, communicates something the right words alone do not.
When I was younger, I didn’t fully understand what was happening. Translating for my parents was just part of my daily life, without much context at the time. Now, seeing my patients navigate a system that isn’t designed for them and working to address the gaps it leaves, I better understand. I can’t remember going to the doctor with either of them, but now I wonder what those visits were like and if there were times they went along without fully understanding.
Sometimes I do rely on a translator. At those times, even though my Spanish is not as fluent as theirs, I can tell if the translation of my words isn’t quite right, if something about my intent hasn’t quite carried over, or if my patient has said something that hasn’t made it to me in English. I wonder what got left behind in the parts I can’t understand, and with that uncertainty, I think about what it might have been like on my parents’ side of those phone calls all those years ago.
So I try to speak directly to my patients whenever I can, even if imperfectly, because I think the act of trying speaks volumes. When I try and they help me get it right, we are navigating language together. Being willing to be imperfect in front of a patient, to let them see that you are trying, can create an openness that a perfectly translated exchange does not always convey. It helps create the sense that we are working toward understanding together and that we are both trying to get it right, even if our resources are limited.
My Chinglish and Spanglish both remain works in progress, and I think that is OK. Neither is fluent, but both serve their purpose just fine. Being fluent enough still serves to bridge barriers and build connections.
John Wei is an internal medicine physician.
