Translating medicine for Chinatown patients
Sue Ann Ponte slowly raises 4-month-old Alan's shirt -- careful not to frighten an infant accustomed to being wrapped in many layers -- and begins her exam.
The baby is small for his age and needs to get started on solid food, nurse Ponte explains. She steps away from the examining table to write something down, and Alan's mother, a Vietnamese immigrant and first-time parent, also walks away. Ponte immediately jumps back to the baby, and begins a fast lecture on safety and how the mother must stay with Alan at all times.
In Ponte's health clinic, providing care is not just about giving shots and antibiotics. She and her co-workers must also teach families -- some with very little education or background in childrearing -- how to raise healthy children in a foreign culture.
Ponte discourages corporal punishment, a formerly common practice among her patients, warns parents about wrapping babies in too many layers, and discusses traditional Chinese medicine, which she tries to honor, but not at the expense of the family's health.
''We have to bend a little: Sometimes herbal medicine does work," Ponte said, citing a remedy for mononucleosis. There are also times when herbal medicine does no harm, such as when acupuncture is used on an autistic patient after parents learn that Western medicine has no cure. On the other hand, she said, Western medicine is better for deep cuts and fractures.
Ponte, 54, known on the streets as ''Madame Chin" (her maiden name), runs the Asian Pediatric and Adolescent Clinical Services Program at the Floating Hospital for Children at Tufts-New England Medical Center. She has been a nurse practitioner in Chinatown for 30 years -- long enough to have treated the grandparents of her some of her current patients.
''You almost can't find a person who she hasn't seen as a patient, or their kid, or their parent," said Sherry Dong, associate director of the Office of Community Health Programs at the Floating Hospital.
When Ponte eats lunch in Chinatown, the meal comes with extras -- a kiss on the cheek from a passing child, and conversation with the dim sum servers, whose children she treats.
Ponte hails from Toison, in the Guangzhou province of China, and speaks Cantonese and Toisonese. Fellow nurse Lisa Hung is close at hand to translate for patients who speak only Mandarin, such as the father of 9-day-old Katherine.
While Ponte examines Katherine, she explains to the baby's grandmother and father the importance of keeping Katherine's bottles sterile. The bottle sits on a table with a tissue over the nipple, and Ponte explains that salmonella is rampant in Chinatown, that wiping the nipple with a tissue is not enough.
''The hardest work I have is teaching prevention and parenting skills," Ponte said as an aside to a reporter in English, a language the family does not yet understand.
Ponte warns the family not to overdress their baby, speaking in Cantonese while Hung translates for the family. Asian parents are so concerned with keeping their children warm that they often inadvertently cause heat rashes, Ponte explains in English.
While Ponte can sometimes bridge the gap between the East and the West, increasingly she cannot when it comes to teenagers and their parents.
''We have a clash of cultures here," Ponte said. ''The children do not have as much respect for their parents as they should."
Treating children with mental illness can also be tricky. Parents accept medication for their offspring, but reject therapy. Chinese culture values hard-working people, and legitimate medical problems are sometimes viewed as laziness or stupidity, Hung said. Parents use their children's success to compete with their friends, Ponte said, and embarrassment in the community results from any setback.
''Asian people use that as punishment," she said. ''It's a big loss of face to parents if you don't do well."
In advising parents, Ponte cites her experience with her own son, Adam, now 20, and her 25-year-old daughter, Iris.
Iris, Ponte said, was a ''mediocre" performer throughout grade school but ''blossomed" in college.
''There's hope, I tell them," Ponte said.
She takes pride in providing that hope to parents; but the real reason she has worked for so long in Chinatown is to set an example for her patients.
''Kids identify with you because they look like you," Ponte said. ''They go home and play with stethoscopes and pretend to be me."
Sue Ann Ponte
Education: Boston College, 1971; Boston University, master's degree in education; Northeastern University, graduate degree in nursing, 1976.
Duties that aren't in her job description: Reading mail for families who can't read English.
Met husband, Al Ponte: When she was a file girl and he was a mail boy at the same bank. He's Portuguese-Catholic. ''I was such a rebel it didn't bother me," she says.
Family history: Her paternal grandmother selected three potential wives for her American son. Her parents arrived in the United States in the mid-1950s.
Jessica T. Lee can be reached at jtlee@globe.com.
