Friday, January 20, 2012

Medical Spanish Abroad

Prof.Esquivel is our teacher in the Basic Medical Spanish in our Medical Studies Abroad program in Costa Rica.  It helps that she is very beautiful but that's really secondary to her vast array of expressions.  Her facial expressions and hand communications are an art in themselves.  No doubt Spannish people could understand what she is saying by her body language alone.  Smiles and laughter are a dance unto themselves.  I have thoroughly enjoyed watching her explanations and instructions as well as listening to the actual content of the course.
As a result I've noticed when I try to talk to other Costa Ricans their faces and bodies are doing a similar dance. It makes me feel, in comparison, like the human robot,  DATA, in Startrek.  I think it stems in part from the closeness of family here and the importance of community.  In the north we live much more separate lives with such distances between us.  Here the proximity of relationships gives rise to the subtleties and depth of communications.
The language itself is highly specific for person whereas English is increasingly denuded and increasingly removed from the intimate.  This makes for good science and technology but nothing is gained without loss.  I suspect at an earlier time when people were much more important than things, English too was as familiar.
Profesora Esquival is teaching us as doctors and nurses how best to communicate with patients when they are vulnerable and often afraid.  There are diminutive forms of Spanish words that lessen the fear upon hearing them. There are  imperative forms that clarify actions.  English and Spanish share Latin roots so that much of the vocabulary overlaps amazingly.  I find I understand Spanish far easier than speaking it.  Yet in the class, we talk and share. Much to my surprise all the others are roughly on the same page.  At the start the course was divided into those who were essentially beginners and those who wished to do more advanced study having already learned advanced common spanish in university or elsewhere.
It really has been fun.  After class we discussed how much we'd like to come back and do the same course again but this time having studied what we have now learned. I don't think I'm ready for the advanced class but I've taken great pleasure in coming so far along in my knowledge of basic medical Spanish.  Having to translate English to Spanish in class exercises I've been really surprised at how much I actually have learned.
I'd already taken a Spanish course at Simon Fraser University with Profesora Tejeda.  She was also delightfully expressive and entertaining so I wonder if some of what I  appreciate in process is just a product of the difference in culture.  There is so much more southern colour compared to the relative black and white of functional northern communication.   Profesora Tejedaa's  course increased my vocabulary and helped me understand better sentence structure and tense. I've used that Spanish in the restaurants and getting around here in Costa Rica.
I would certainly never have learned medical procedural Spanish from any of the guide books, what to say when sticking someone with a needle, for instance.
The book, Basic Medical Spanish, by Olimpia Piccardo  is great,  having sections for complete medical history and examination.  Profesora Esquivel has taken us through these correcting our pronunciation and explaining why we might say 'do' whereas in Spanish the word used is 'take'.  The mix of general grammar with specific medical examples has been  extremely helpful.
I am very thankful to have had such a delightful and amusing teacher for this very important study.
Writing now I find myself simplifying my sentences in a way I do when I try to express concepts in Spanish. It's a whole different part of the brain from the now  'automatic' forms learned since childhood in English.
Comparing this course with regular scientific medicine courses I told a colleague that this involved much more exciting learning.  Advanced in my speciality most of what I hear at conferences now is not new.  I could even be accused of being jaded listening to some of the drivel I hear from young academics.  Worse are the pompous pundits promoting some business niche for themselves. I  go though because  I'm still blesed to hear  'pearls of wisdom' that come from experienced colleagues.  I'm also there for  those rarer new breakthroughs that help change my practice of medicine. Here, however,  I feel like a medical student again recapturing all the joy of simple learning because so much of it is new.
The cross section of specialities, obgyn, surgery, ent, er, etc  of all ages plus the nurses with a fair mix of gender and even a spiritual director thrown in makes the class rich in diversity.  The questions asked come from the individual clinical background and the discussions that follow are fascinating.
Profesora Esquival brings knowledge of local culture and idiom into the discussions as well sharing her knowledge as a patient and as a person from a medical family.  I couldn't help but think that the problems facing Costa Rica with it's aging population and mix of social and private medicine were very similar to what Canada is encountering.
I will be sad when the last class finishes later today.  More and more of my patients are from other cultures and many come from Spanish speaking countries. I think all of them speak better English than I speak Spanish so it's unlikely that I'll be conducting my clinics bilingually any time soon.  I have greater empathy for their struggles with language though. I know I will be more attentive to facial and body  expressions.  You really do have to watch to hear Spanish spoken. Who knows, maybe I'll be able to throw in a diminutive spanish word or colloquialism that will improve rapport.
I am thankful to Profesora Esquival and Medical Studies Abroad for this wonderful learning experience in a truly beautiful country.
That said, I thought to take the teacher an apple.  However, thanks to this course, given the complexity of communication and culture  I respect that this particular Canadianism might not apply here.  For all I know Costa Rican children  take their teacher a plantain or orchid.  It's like the words mano, meaning hand, and mono, meaning monkey. We all laughed as Profesora Esquival explained how patients thought it very strange that English doctors learning Spanish always wanted to see or shake their monkeys.

Todo va a salir bien. No tenga miedo.

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