Editor's Note
The Language of Medicine
As a high school student contemplating a career in medicine, I was advised to take Latin because it would help me in my career, presumably to dissect the roots of medical terms and speak the mystical argot of the brotherhood of physicians. The prospect of studying a language spoken by no living person seemed silly to me. After all, I was going to take care of people. So I took German. Now, decades into my medical practice, I don’t regret my decision. I’ve learned enough Latin and Greek roots to master medical-ese, and I have yet to encounter any toga-clad Romans. But I also have met very few German-speaking patients. English continues to be the lingua franca of most of my medical encounters; but that is changing as a diverse world moves into Minnesota and as Minnesota medical providers venture out into the world.
This widening diversity strikes anybody who walks the halls of Twin Cities’ hospitals, where the previously uniform collection of Scandinavian employees has blossomed into an ethnic potpourri. Phone calls to nursing homes are rarely answered by somebody who doesn’t have an accent, lending extra challenges to important communications. And those same accents are being heard more frequently in the exam room, adding tricky complexity to doctor-patient talk.
Communication with patients is the foundation of the healing process. If we don’t understand our patients, medical care falters. If they don’t understand us, the process hardly gets started. And that is why the internationalization of medicine in Minnesota can be bumpy. Local doctors who travel to post-earthquake Haiti and don’t speak Creole wade through seemingly insurmountable medical challenges made tougher by the language gap (p. 22). Foreign-trained immigrant doctors already beset by bureaucracy and green-card tangles have to try to pass exams and then treat patients using their second language (p. 8).
And any physician who has taken a history through an interpreter knows that uneasy feeling of perhaps not getting the whole picture, of missing the nuances that are so important to all human communication and especially that between doctor and patient (p. 42). Minnesota physicians face a veritable Babel of languages.
The language confusion described in story of the Tower of Babel has always been a danger in medical encounters. Physicians’ verbal orders to nurses can be misheard or misinterpreted. Physician comments offered in English can sound like Swahili to patients if we don’t actively search for common linguistic ground. Language is all about understanding, and whether it’s interpreting the body language of a Somali patient or helping an 86-year-old struggle to remember what she wanted to say, the translation needed to achieve understanding takes patience and time.
Doctors have always been translators, for we do speak a special language. As Minnesota becomes more polyglottal, the complexities of making sure our messages are understood will mount. But in any language there is a fundamental message described by medical student Kelsey Shelton-Dodge in her reflection on her experience in Haiti following the earthquake (p. 64) that is always understood—caring and taking time.
Charles R. Meyer, M.D., editor in chief Dr. Meyer can be reached at cmeyer1@fairview.org