Lost in translation?

How perfect and astutely said, and by a doctor no less: Jeffrey Borkan, in his intro to the book 'Patients and Doctors: Life-changing stories from Primary Care', points out that "Every encounter between doctor and patient is a cross-cultural event."

You said it, doc! Think about it: whether in the doctor's office, clinic, lab, hospital, long term care or hospice, we're the immigrants. We have to learn their language, protocols, processes and expectations. Then, we each have to figure out our role and how we're going to negotiate the terrain.

Like a country with many dialects, healthcare has many languages. Each condition and each disease has its own acronyms, jargon and short-hand. We have to quickly get up to speed after landing on these foreign shores. Unlike the health-care professional 'natives', who've had years of acculturation and training, we're expected not only to understand - if not speak - the language, but also be able to assess, evaluate, analyze and come to an informed conclusion about our care.

It's a tall order that has little to do with literacy.  Even seemingly simple words and concepts can be baffling. In the lobby of a business building, a Portuguese woman in her mid-50's was manning reception. During a lull, she sighed heavily and loudly enough that we all asked what was wrong. In accented but perfect English, she explained, "My husband is going for heart surgery. Last year, the doctor told us he was at risk and should take a coated asprin every day. We didn't know what he meant, 'coated' or why. So we didn't. And now he's in surgery."

Whether or not there's a link between not taking the asprin and the surgery isn't the point here. Why were they expected to know the meaning and importance of  'coated'.  Why didn't she/they ask - if not the doctor, then the pharmacist. Or the doctor's receptionist, or someone in their own community? Because they thought, somehow, they should know what the heck coated meant. They were stupid for not knowing. The repercussions of that exchange being lost in translation go beyond the (possible) physical result. Guilt, anxiety, diminished self-worth, having to answer to other relatives. 

Is it up to we, who are not feeling well and are emotionally embattled, to ensure we understand the way we're supposed to?

The answer may not seem right or fair, but increasingly demands another question: whose health is it anyway?

Kathy Kastner is the editor of Ability4Life.com, for adult children caring for their parents, and is very involved in patient-centered education, and its many interpretations. She is also a CareToKnow.org community member.

More of Kathy's recent blog posts:

Walk for a Cure: When my daughter asked me to join her, why didn't I just say yes?
Father Kate and the un-anticipated aspects of community involvement
New Guest Blogger: What was said, and what we hear