This past summer, six of my classmates and I were part of a surgical team that went to Honduras on a medical mission trip. At the beginning of the summer when I casually called my mom to let her know I’d be venturing forth into the developing world for a week at the end of the summer instead of coming home to Florida, she had a few things to say. “Do you even speak Spanish?” The answer is no. I don’t speak Spanish. I was assured this wouldn’t be a problem as there would be “plenty” of translators, so I ignored this (glaring?) issue and scoffed at her question. That question, however, turned out to foreshadow one of the most poignant lessons I’ve learned in how to interact with patients.
The trip was a surgical trip. We went to a hospital in Guaimaca (which, for those of you rusty in your Honduran geography, is in the northeastern mountainous region of Honduras), and began to prepare to see patients. The initial history and physical of each patient was one of the tasks that we the medical students were charged with handling- no small matter! A history and physical is a daunting task for a second year medical student, especially a second year medical student who has not yet started second year. Let us also recall that I don’t speak Spanish, a fact that jumped to the forefront of my mind as I opened my first patient’s chart and could not read a word. When the translator brought in the patient to whom the chart belonged, we then began the choppy dance of taking a history with a translator. “What brings you in today?” Spanish I don’t understand. More Spanish I don’t understand. A pause as Blanca (the translator-we became great friends by the end of the week) figures out how to tell me in English what the patient said. A confused look from the patient as Blanca and I converse in English, and then a look of recognition as what was said is conveyed to her. As the day went on, Blanca and I improved our dance. I picked up a few words, but not enough to feel comfortable when there was an emergency and Blanca suddenly had to go translate for someone else.
I was left alone with an older woman who had come in to have her gall stones removed. She was in pain, and neither of us had spent long enough in the room with the translator to feel very comfortable with each other yet. She eyed me, and as I looked back at her trying to figure out what I could do with my limited arsenal of Spanish to make her feel better it just kind of made sense to put my hand on her shoulder and give her a smile. She put her head down, grabbed my hand, and we just sat there. As we sat there the lesson hit me: it isn’t just words that make a patient feel better. In fact I realized that I had been hiding behind the words and ignoring a critical aspect of communicating with the patient. A hand on the shoulder, a smile, squatting down and taking their hand, a pat on the back: all of those things convey the message much more convincingly than words that you’re on their side, and you want them to feel better.
“Touch the patient” is a saying we hear on occasion. Third year medical students and residents hear it far more often. It is normally said to chastise someone for looking at a chart and ordering a test without going to see the patient in person, but I find myself going back to that phrase in this context as well. Touch the patient. Comfort the patient. It is unfortunate that it took literally being unable to verbally communicate with a patient to learn this lesson, but it is a lesson I’ll not soon forget.
Copyright 2014 USC School of Medicine Greenville