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PT and the City

En Inglés, Por Favor

Published January 5, 2012 3:45 PM by Lisa Mueller

[Original]

Esta mujer acaba de entrar en mi habitación, gritando a mí y agitando sus manos por todas partes. Acabo de despertar. ¿Qué está pasando? ¿Qué está tratando de decir? Me gustaría poder lavar todas las marcas de cinta adhesiva de los brazos. Ni siquiera puedo recordar la última vez que me duchaba. Ha sido por lo menos cuatro días. ¿Por qué es esta señora todavía aquí? Ella es reordenar mi habitación. Tal vez es la limpieza. Me siento mareado, necesito un poco de agua. Agua? Lo que pido. Ella lo mira confundido. Me gustaría saber cómo se dice la palabra en su idioma. Ahora ella está haciendo un gesto para pasar a la orilla de la cama. Voy a alguna parte? ¿Dónde está ella me llevas? ¿Mi familia sabe lo que está sucediendo? Creo que voy a tratar de sentarse, entonces espero que esta señora me deja en paz.

Estoy sentado. Se pone un andador delante de mí. No tengo idea de lo que ella quiere que yo haga. Sonríe mucho y habla más fuerte. No soy sordo! Yo te escucho! Empezamos a caminar por la habitación. Mi pie se siente raro, ¿por qué seguir arrastrando en el suelo? No estoy tratando de viaje, pero no sé qué hacer. Ella llega a la pierna y empieza a moverlo alrededor. No sé lo que está tratando de lograr. Mi médico nunca me dijo nada acerca de mis piernas, sólo alrededor de mi corazón, pero él nunca me vio caminar. Estaba acostado en la cama cuando él pasó por allí. Por suerte, él trajo un intérprete. Debería haber hecho más preguntas cuando el intérprete está aquí. Tal vez mi hija puede ir a la escuela mañana y hablar para mí aquí.

Me siento como si pudiera gritar. NADIE ME ENTIENDE! ¿Cómo se supone que debo ser más fuerte, se siente mejor, sana mi cuerpo cuando no tengo el lujo de hablar el lenguaje correcto? Yo sé que algo está mal con mi pierna, pero este gesto y el uso de movimientos de la mano no me está enseñando algo. No puedo ir a casa y cuidar de mi familia como ésta.

[Translation]

This woman just walked into my room, screaming loudly at me and waving her hands all around. I just woke up. What is going on? What is she trying to say? I wish I could wash all the tape marks off my arms. I can't even remember the last time I showered. It's been at least four days. Why is this lady still in here? She is rearranging my room. Maybe she is cleaning. I feel dizzy, I need some water. Water? I ask. She looks confused. I wish I knew how to say the word in her language. Now she's gesturing to move to the edge of the bed. Am I going somewhere? Where is she taking me? Does my family know what is happening? I guess I will try to sit up, then hopefully this lady will leave me alone.

I'm sitting up. She puts a walker in front of me. I have no idea what she wants me to do. She is smiling a lot and talking louder. I'm not deaf! I can hear you! We start walking around the room. My foot feels funny, why does it keep dragging on the ground? I'm trying not to trip but I don't know what to do. She reaches for my leg and starts moving it around herself. I don't know what she is trying to accomplish. My doctor never said anything about my legs, only about my heart, but he never saw me walk around. I was just laying in bed when he came by. Luckily, he brought an interpreter. I should have asked more questions when the interpreter was here. Maybe my daughter can skip school tomorrow and talk for me here.

I feel like I could scream. NO ONE UNDERSTANDS ME! How am I supposed to get stronger, feel better, heal my body when I don't have the luxury of speaking the right language? I know something is wrong with my leg, but this gesturing and using hand motions isn't teaching me anything. I can't go home and take care of my family like this. 

[Meaning]

Whether you are a physical therapist working in an acute care setting as the story above describes, or an outpatient setting, or any other facility - I'm sure you have encountered situations with patients who do not speak English. It's hard to have interpreters present at every physical therapy session as PT appointments are usually a lower priority than other emergency or physician appointments. My blog this week is to illustrate that although we can get by with gesturing to our patients, or by performing manual therapy or helping them with exercises - this is no substitute for educating our patients in a language they can understand. Take the time to print off basic translations for common phrases that you can have your patients read when an interpreter is not available. If you find this is a frequent issue in your geographic area, take a CE course in Spanish for the Physical Therapist (or other common language you encounter) or search for some community classes at a local library. Not only can this help you teach your patients more about their injury, it will also help you build rapport with your patients as they will see you trying to speak in words they understand.

4 comments

Well done post! I also like Janey's thoughts on aphasic patients as I treated one today. An unfortunate gentleman that other physios gave up on because of "cognitive deficits". I used simple hand gestures and allowed him to experiment (safely) with a rollator. He walked further and more safely than he had in 5 months.

When I worked in NYC, I had Spanish speaking patients from Puerto Rico, Cuba, Dominican Republic and Mexico. Each dialect different from the others. A generous dose of humor, patience and willingness to allow the patient to view me as "dumb" got me very far beyond my basic spanish for physios.

Σας ευχαριστούμε για μια καλή συζήτηση!

In my other language ;-)

Dean

Dean Metz January 6, 2012 5:41 PM

Excellent topic.  Excellent illustration.

As I was reading my mind went to the aphasic for whom their is no translator.  How horrible it would be to not be able to communicate.

Thanks for the reminder of how frustrating and frightening this kind of situation would have to be.

Jane Goude January 6, 2012 11:26 AM

Excellent point Lisa. Sitting on my desk is a book "Spanish for Health Care Professionals" by William Harvey. I also have one of those plastic study guides you can get in any big bookstore simply called "Spanish Vocabulary" - pretty cheap and real helpful. Also, if you have an Android Smartphone (I'm sure an iPhone does the same thing) there is a Translate app that you type (or speak) and it translates into ANY language! Keep up the good work.

Al DiMicco, Ortho/Sports - Director of PT January 6, 2012 9:15 AM
Bessemer AL

When I worked in the LA area there were so many dialects it was difficult to treat unless you caught someone who had the time to interpret.  Ask the interpreter to write down simple phrases.

After about 5 years of not hearing Armenian I recalled a phrase that essential was "walk" and was able to partially communicate with one patient.  I think my limited Mandarin and Spanish will stay with me for life too. The hardest part is not speaking another language consistently, you have to practice.  Excellent topic.  

Jason Marketti January 6, 2012 1:36 AM

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