Sunday, June 27, 2010

5 “Bueno” Tips on How to Learn Medical Spanish

Spanish matador Cayetano Rivera performs a pass to a bull during a bullfight in The Ventas bullring in Madrid May 25, 2010. REUTERS/Andrea Comas (SPAIN - Tags: SOCIETY)

I work in a clinic located in a primarily Spanish-speaking-only community in Southern California. When I started working in this clinic approximately three years ago, I knew perhaps at the most a total of five Spanish words (no joke):

Hola!” = Hello!
Como esta?” = How are you?
Gracias” = Thank you
Adios” = Goodbye

And truly, that’s about it. No kidding. I did not take Spanish in high school, I took French. Mais, oui. I grew up on the East coast; no one speaks Spanish there, do they?! And my entire family spoke French and I wanted to use them to help me with my homework in school. Plus, I had a great French teacher in high school who I still keep in touch with today. How should I have known that I would move within hours of the U.S./Mexico border and would one day be unable to function without Spanish later in life?!

When I first started working there, almost every single patient encounter required an interpreter. Thankfully, every member of our super talented staff is also gifted with the Spanish language. I was so envious. Granted, it was their native tongue. But I was still envious at how easy they made it seem.

My typical day was as such: I would knock on the exam room door, enter and introduce myself. I very quickly learned the phrase “Habla ingles?” (Do you speak English?), and was almost always given a head-shake “no” in response. Then, with a “Con permiso” (which I later learned is “excuse me”), I would leave the exam room and search all over the clinic for a staff member looking not-busy-enough to help me interpret. That was truly a pain in the “nalgas” (behind), and caused me to waste a lot of “tiempo” (time).

This made me very motivated – I wanted to learn Spanish just so I can avoid having to search for an interpreter. And it was a challenge that really got my juices flowing. I was done with college, done with medical school, done with residency, and now I needed a “nuevo” (new) challenge to keep me going. I love a challenge. So I set my sights on learning Spanish. I was determined.

Thankfully, and perhaps somewhat miraculously, I now very rarely need an interpreter. Seriously, I think the last time I used one was “meses” (months) ago. I cannot even remember when.

So “como” (how) did I do it? Here’s my advice:

1. Find a good medical Spanish book: There are not that many. Buy the best one. And read the entire thing, word-for-word. Underline as you go. Then, re-read the underlined items from the first round. If you want to know which book I used, you can email me:

2. Make note cards: I bought some large index cards, and made one for each “tipo” (type) of visit. For instance, since I see a lot of women, I made one for the “Papanicolau” (the Pap Smear). I would then literally whip it out of my pocket each time I had a pap.

Que metodo usa para evitar el embarazo?” = What contraceptive method do you use?
Por favor, acuestese y muevese hacia mi – mucho mas.” = Please lie back and move towards the bottom of the exam table – much more.
"Muy bien. Es todo. Por favor, levantase.” = Very good. That’s all. Please sit up.

As another example, I made one for “gripas” (head colds), and I’d whip that one out each time I had a patient who complained of a sniffle.

Tiene tos? Nariz tapada? Dolor de garganta?” = Do you have a cough? Stuffy nose? Sore throat?”

You get the idea.

Soon, I realized, I don’t even need the note card because I whipped it out so many times that it was all bent around the edges (you may want to laminate yours).

3. Ask “mucho” (a lot) of questions: I was shameless. Seriously, shameless. I did not care if I sounded like an idiot. I pronounced everything wrong in the beginning. But I made sure to ask my patients to repeat everything “otra vez, por favor” (one more time please), and asked them to repeat it “mas dispacio” (more slowly). And the poor things, they did “todos” (everything) I asked. If they used a word or phrase I did not understand, I made sure to ask them what it meant.  My patients became my teachers.  I also learned to ask the following three important phrases:

Como se dice ____, en Espanol?“ = How do you say ___, in Spanish?
Que quiere decir ____?” = What does it mean ____?
Disculpe, no entiendo” = I’m sorry, I don’t understand.

4. Learn the culture: There are many cultural beliefs and values when it comes to my Mexican patients, and many may pertain to their health. I tried to learn as much as I can about why they believe what they believe so that I can better educate my patients. For instance, I learned that many Latinos believe that insulin causes blindness. Not uncontrolled sugars, but insulin. I learned this while I was trying to understand why my patients were so reluctant to start the insulin I prescribed. Now, every time I want to start insulin, before they even say anything, I tell them from the get-go that there is a “mito” (a myth) out there about insulin causing blindness, but that it’s the opposite; it’s the uncontrolled sugars that may cause this to happen (they all nod their heads when I say this). I’m on to them, and they know it!  Submerge yourselves in their culture. Go to Mexico. Visit Barcelona. Listen to the Gypsy Kings. Wear a sombrero. Eat tamales (no, eating at Taco Bell does not count). Ask questions. Learn the culture. It will help you to understand and appreciate the language even more.

5. Work on the accent: If they can’t understand what you are saying, even if you are saying the right words, it’s not going to work. So I bought myself some Spanish CD’s for every day conversational phrases. I bought the ones that designed different real-life scenarios all in “song.” It was totally cheesy, but it worked! I played it in my car every day. And I repeated and repeated, while singing along out loud (thankfully I drove alone to work and back every day).

And there you go – 5 "bueno" (good) tips to learn medical Spanish. Ok, so I have been mostly living in the present tense when I speak to my patients. But they understand me. And most importantly, I don’t need to waste so much time looking for an interpreter. And, I have built a closer connection to my patients because I have made such an effort to learn their language. They never made fun of me, not even once (at least to my face). In fact, they have been so supportive. They know I understand them, and they understand me. It’s a priceless connection.

My next step: I bought a verb tense book, and now I’m learning the past and future tenses.

Hasta luego, Amigos!” (Until later, friends).

And “bon chance!” (good luck) – oh, wait, no...that’s French.


Jay Bakhru said...

This is a great blog post - and very relevant for many medical professionals. One other suggestion for learning medical Spanish is to study online with a live tutor using Skype, GoToMeeting, or WebEx. I work for a company called Language Tailor ( and we offer a live online course in Medical Spanish. The course has been very popular with medical professionals and medical students and may be helpful to your readers. Thanks for the great post!

WarmSocks said...

I'm so impressed that you're learning another language in order to provide the best care possible to your patients. Wow!

My kids are using Visual Link Spanish to learn the language. You're probably beyond level 1; levels 2&3 deal with verb tenses. I think the company's website has free online demos. (I'm not selling the program, just thought you might be interested).

Jill of All Trades, MD said...

WarmSocks, thanks for the "warm" and "fuzzy" sentiments! And for reading!