Doctor-speak

Short White Coat is a blog about learning to be a doctor. Posts appear here as part of White Coat Notes. Joshua U. Klein, MD, is a third-year obstetrics and gynecology resident at Brigham and Women's and Massachusetts General hospitals.

During most of my interviews for medical school, I was asked to explain my decision as an undergraduate to major in English rather than biology or another science, given that I had always intended to become a doctor. My canned answer revolved around the idea that learning to read well and write effectively helped me become a better communicator, and that good communication is the foundation of good doctoring. Despite the fact that at that point in my life the only doctoring I had ever done involved Band-aids and Tylenol, medical school and residency training have demonstrated to me that I was lucky enough to be right.

In Boston, language barriers pose a frequent challenge to good communication with patients. While my passable Hebrew rarely comes in handy (although the one Israeli couple whose baby I delivered loved it), I use my broken Spanish ("como estas?" "dolor?" "sangre?" ... and that's about it) almost daily.

The hospitals where I work provide impressively extensive interpreter services, covering a multitude of languages at all hours of the day or night, weekends and holidays included. I'll never forget one woman who presented with an obstetric emergency -- she was deaf and her husband spoke only Portuguese; only with the help of two simultaneous interpreters were we able to understand each other.

But the most memorable experience I've had with interpreting occurred a few months ago. A Spanish-speaking patient was admitted to Labor and Delivery late one Saturday night. Unfortunately, there wasn't a Spanish interpreter immediately available who could stay with the patient for more than a few minutes. The patient's nurse wisely suggested we use the Interpreter Phone on a Pole (aka IPOP); essentially, this consists of a glorified speakerphone affixed to a four-foot metal pole on wheels. At the push of a button, an operator responds and connects you to an off-site interpreter who is fluent in the language that you need.

From 1 to 6 a.m., the patient was cared for by her labor nurse, her obstetricians and anesthesiologists, and perhaps most importantly, some woman with perfect Spanish whose name and location we never asked and whom none of us may ever meet. With the rising sun peeking its rays through the window of the labor room, the IPOP cried out sympathetically, "Empuje el bebe!" ("Push the baby!")

Handing over the newborn to its mother, I wondered if the interpreter realized just how much she had done to help usher this new life into the world. The new mother was eternally grateful, and so was I.