Saturday, February 18, 2006


I still remember my first experiences in the hospital setting. I was entering the medical field, but as a novice trainee, I still had the eyes and mind of a non-medical person. Back then, the "cultural" gap between doctors and patients was very clear. Maybe the best example of this was morning hospital rounds. The team would bustle into a patient's room where the intern or the senior resident would update the patient on their medical condition. Even though the M.D. attempted to simplify the description of what was going on, he was often too steeped into the medical culture and medical jargon to make much sense to the patient.

"Sir, your white count is coming down. The IV fluids are helping your kidneys, and we're going to give you another bolus today. "

I could just imagine the questions running through Mr. S's mind. What is white count? What does coming down mean? Down an elevator? What do intravenous fluids have to do with my kidneys? What in the world is a bolus? Patients may have questions, but few ever ask. Most nod and smile, and the medical team whisks off to another room, proud that they were efficient and effective. It's only the medical student that finds out, because he had the time to go back and chat, that while the morning interaction was conducted in English, it might as well have been done in another language - the patient never understood what the resident said.

I remember reminding myself that I would try not to forget these experiences. That the same words used in the medical framework does not mean the same thing in common English. Or that there is no "English" equivalent for certain medical jargon.

It's hard to remember, because you get immersed in a culture that is so different. As it starts to make sense, your language and thought processes are changed to become a part of it. And one day you catch yourself making the same mistake. It's embarrasing. Here's to all the patients out there - if you don't understand, just ask. We'd be happy to explain, if we knew we weren't making sense.


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