Friday, November 14, 2014

Our Common Language

Mary Huff, MD

Dr. Huff (far right) with staff in the mammography dept at Pontificia Universidad Católica de Chile


I was fortunate enough to receive the Goldberg-Reeder Resident Travel Grant in 2012 where I studied the barriers and facilitators for mammography screening compliance in Chilean women alongside the Departments of Family Medicine and Radiology at the esteemed Pontificia Universidad de Chile in Santiago, Chile.  The radiology program director was kind enough to allow me to rotate through the department with his radiology residents to gain a better understanding of the practice of radiology in Chile.  I learned more than I ever anticipated.  I am including here an excerpt from my journal from my first day in the department.  I hope other international travellers can relate to my experience.

My main mission the first day was survival. I had an appointment with my supervisor at 09:00 at the university hospital, and I didn't want to be late. My first tasks of the day including riding the metro, finding the hospital and navigating to the office were remarkably easy. In fact I arrived about 30 minutes early. At the entrance to the office was a call box. This was my first anticipated challenge. I had been rehearsing how to introduce myself and ask to speak with my supervisor in Spanish. I must have sounded legitimate because the secretary let me in right away and started talking to me at full speed in Español. I almost immediately went into system overload. All of the words blended together into an incomprehensible song punctuated by a silence anticipating my response, “te entiendo” (do you understand)?

Uuuh, uuh...no.

Habla Español?

Solo un poquito.

She spoke again, slower, and I again did not understand. She just smiled at me and gave me a big hug. Then she said something else that an onlooker in the hall translated for me, "Wait."

Soon one of the residents came to give me a tour of the hospital and the department. She was very kind and spoke perfect English—to my delight. She introduced me to all of the residents in various stations throughout the department. That went well because all I had to say was, "Hola!" However then came the scariest part: she had to leave to go to work. I was on my own.

I quickly learned to follow the advice of my father, "Better to remain silent and be thought a fool than to open your mouth and remove all doubt."

I sat down at the reading station and began to listen to the conversations surrounding me and to observe the images on the monitor. Finally some common ground! CAT scans (called TAC here) look the same in Chile as the do in the United States. Moreover the medical vocabulary is very similar. For example:

pancreas = páncreas
lungs = pulmones
hypoattenuation = hipoatenuación
scattered diverticulosis = diverticulosis dispersos
adenopathy = adenopatía

Surprisingly, the laborious task of learning an entirely new vocabulary in medical school was useful. It was a common language. I found a safe haven surrounded by diagnostic imaging and medical jargon. Finally a foreign language that I could understand! It was quite a revelation for me.

The remainder of the day I listened intently to conversations. Despite the fact that the medical terminology was similar, the sentence construction was scrambled and there were many intervening words that I did not understand. Still, by the end of the exhausting day I was proud of myself for the ability to point to the images and recognize diagnoses:

Apendicitis!

Quiste renal Bosniak dos!

Lemierres!