I have forgotten enough of what I learned in college and medical school to fill a pretty good-sized home library. As a biochemistry major at the University of California, Davis, I spent four years in classrooms and laboratories, studied feverishly until the library closed, and memorized and regurgitated obscene volumes of data on demand. While I received an outstanding education there, not much stuck. I probably know a little bit more than the average citizen about DNA, but if you watched the recent television drama, The People vs. O.J. Simpson, or were gripped by the original trial, you might have me beat. Calculus was interesting, but other than addition and basic geometry, I don’t need to know math in my job. The list goes on and on and I’m sure the same is true for most college graduates who don’t remember much about macroeconomics, political science, sociology, or art history.

In no way am I discounting the merits of a four-year undergraduate education. The experience is invaluable and, in many cases (including my own), the most effective way to take an immature, self-possessed, and sheltered child and turn him or her into a thoughtful, organized, and open-minded adult capable of entering society and helping to solve its problems. I am simply arguing that the actual classes the student takes during this apprenticeship are irrelevant.

The only pre-requisite for medical school, in fact, should be Spanish. Frankly, unless you live in Montreal or Brazil, I don’t know how or why everyone in the western hemisphere doesn’t speak both English and Spanish. Though I am disinclined to blame my parents for my shortcomings – despite several therapists absolving me of responsibility with assurances that my Mother is always to blame – I do resent them allowing me to take five years of French. Other than one time scoring a date with the cute chick from the high school French Club, and understanding the words to a very mediocre Beatles song (“Michelle, ma belle…”), those years seem like a total waste.

It wasn’t until I was standing over the bed of a Spanish speaking woman in apparent distress early in my third year of medical school that I realized, “Oh crap. I have no idea what this patient is saying. I hope it’s nothing serious.” So, I bought a medical Spanish book and crammed it into the overstuffed pocket of my short white coat, the seams of which were already bursting under the strain of manuals about other things a doctor should know, such as: the causes of pancreatitis, which antibiotic covers a snake bite, and what to do if a patient looks dead. Incidentally, and apropos nothing, it turns out that you need to give the snake bite victim an antibiotic that kills the germs that infest whatever creature the snake eats; so gross.

The book was partially helpful. With a thick gringo accent, I was able to ask simple yet relevant questions like, “Are you having chest pain?” And if the answer was either “Si” or “No,” I was in good shape. Unfortunately, as I quickly discovered, regardless of their country of origin, patients rarely respond with one word answers. Moreover, once they hear you use any Spanish words, the erroneous assumption is often made that you actually speak the language, and this misconception inspires them to actually talk back. I struggled through medical school, encouraging laboring women to “¡Empuje!” and “¡Respira profundo!” all the while knowing that I was providing substandard care due to my inability to communicate.

As a resident, I was so unbelievably busy, there was literally no time to flip through the pages of a book in search of a way to tell someone that they needed a rectal exam; I just smiled and went ahead and did one. Fortunately, at a large institution like UC Davis Medical Center, there was almost always someone available to translate when necessary; and therefore, my Spanish did not progress during these five years. Indianapolis – the location of my one-year fellowship in hand surgery– has a relatively small Spanish speaking population, so my ignorance of the language was not really an issue there. Returning to California, however, I finally realized that my monolingual status was unacceptable, and I committed myself to learning Spanish. I have since travelled to Central and South America for immersion into the language and culture, grinded through Rosetta Stone, and buried my head in countless books. Usually, after spending a few weeks in a Spanish speaking country, I am pretty conversant for a short while; but like dieting after New Year’s Day, or an Oakland Raiders football season, promising early results fade and complacency ensues.

Rosetta Stone is pretty good at getting you started with a new language. However, what you immediately realize upon engaging a native Spanish speaker is that the phrase, “El perro es negro (The dog is black)” – even when spoken fluently – does not advance the conversation much. Nothing beats visiting a country where Spanish is the official language such as Costa Rica, Ecuador, or the Miami Airport. I went to Spain, but everyone there speaks English and, despite my efforts to practice my Spanish, I encountered little cooperation. The same was true in Cabo San Lucas, Mexico where American tourism is the essential economic force and English is ubiquitous. I did take one-on-one lessons each day but, besides my instructor, the only locals I could get to talk to me were the guys selling trinkets on the beach; and even they only answered in English despite my Castillian persistence. With resistance to my attempts at discussing the weather, their families, and other such topics that might have helped me practice vocabulary and grammar, our interactions rapidly and inevitably digressed into negotiations on the price of cigars, sombreros, bracelets, and other souvenirs (legal and otherwise) for which I had absolutely no need.

Students from grade school through college ask me advice about becoming a doctor, and I am pleased to provide whatever guidance I can, though my advice is simple: don’t start smoking, be nice to your Mom (she’s your biggest fan), go to the college where you think you’ll thrive, when in doubt take a cab, major in whatever you want to learn about, take Spanish every year, and speak it as much as possible.

Hasta pronto.

3 thoughts on “¿Qué?

  1. Very funny! Whenever we travel where another language is spoken, people more than not can converse in English of some art. Inevitably many of these folks will apologize for their English. We always tell them that we’re so impressed that they’re bilingual (in so many cases multilingual!), explaining that we’re merely monolingists. Sadly, most older Americans are English-only speakers. Good for you to make this effort – more difficult as an adult!!


  2. So true. . .all of it. My devastating encounter was year one (now, 41 years later) in Santa Fe, NM with an ICU patient who was awake, on a ventilator and very frightened. I worked with her all day, in English, and was ashamed when I learned that evening that she only spoke Spanish. Next morning, I declined that patient, stating that I spoke no Spanish. The charge nurse told me that she had specifically asked that I be her nurse on Day 2. I promptly took myself (1976) over to Santa Fe Community College. Five semesters later, I had tons of words memorized, but no handle on tense or reflective pronouns, etc. Now, after nursing for 41 years in Santa Fe, where I am a minority, my dear Spanish-speaking patients have put up with my cursory attempts with great humor and tons of compassion. I’ve learned a great deal. Learn Spanish. . .it will go a long way in developing relationships with wonderful people and assist them immensely with their struggles.


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