Map of life expectancy at birth from Global Education Project.

Friday, May 01, 2009

Now that the apocalypse has been cancelled .. .

(details here) I can get back to more congenial business. Friend Rachel sent this link, about how physicians often fail to call for an interpreter when they don't speak the patient's language.

There are some important points made here, one of the most important being that doctors tend to see the function of communicating with patients as essentially being to meet the physician's need for information. In my own research, I have observed that doctors ask nearly 10 times more questions than do patients, while patients give twice as much information to doctors as doctors do to patients. So who needs an interpreter if you don't need to take a history? Or, maybe you should be a veterinarian.

When I was hospitalized some years ago, I had for a while a Russian roommate who spoke no English. The doctors would come on morning and rounds and stand at the foot of his bed talking about him. He had no idea what they were saying. I knew that he had terminal, inoperable bladder cancer, but he did not. They went to discharge him, and got an interpreter for the nurse. The interpreter said to the nurse, "He wants to know about his disease and his prognosis." The nurse said, "Oh for chrissake, I need the bed." But she sent for a fuzzy-cheeked resident who told the guy, for the first time, as he was being kicked out the door, that he had less than six months to live.

And that's why I'm sitting here today, doing what I do. Just so you know.

3 comments:

C. Corax said...

Maybe I've mentioned this before: A good friend works in Waltham for the DMR, a sort of hellhole in many respects. She told me about a client who had terminal cancer. The doctors were discussing his case in front of him, as though he couldn't understand English (because he couldn't speak very well). They never said a word directly to him. Then they sent him back to the facility, where he began flipping out from terror. My friend was called to his building, because he liked her so much and the direct care staff didn't know why he was acting so irrationally. My friend asked him if the doctors had spoken in front of him and he indicated that that was the case, and cried.

Cervantes said...

Ah hah. I'll take it under advisement.

kathy a. said...

well, i don't usually go that far off-topic, at least....

there are unexpected things that point us in directions. that was truly horrible, what happened to your roomie in the hospital. and you are doing much good by pursuing actual communication between doctors and patients -- which is hugely important to both sides of the professional relationship.