I can almost guarantee you this situation is happening in some hospital, somewhere, with some patient: the medical team walks in, asks a few simple questions in English, and gets the correct answers. The team then proceeds to explain the entire treatment plan in English, assuming that if the patient can respond to basic questions, they must have a grasp of the entire language.
My experiences this week have made me acutely aware of how dangerous this situation can actually be. When speaking to Guatemalans, I can demonstrate a reasonable grasp of Spanish, and often receive responses that are far more complex than I can fully understand. Sometimes, I just get the general gist of things. Other times, I make incorrect assumptions and miss the point altogether. Or worse, I may not have even the slightest idea what was said, but don’t feel comfortable enough (or can’t remember the words!) to ask them to slow down. But typically, I’m only trying to buy a bus ticket or understand my host brother’s new job, so a few words lost in translation are usually not a huge deal.
But when explaining a cancer diagnosis or the risks and benefits of a surgery, losing words in translation is not an option we can afford. I have no doubt there are patients for whom English is a struggle, but they may be too embarrassed or respectful to interrupt to remind us that they can only handle the basics. No wonder patients have difficulty complying with treatments, or even articulating what exactly their medical problems are.
Though I came to Guatemala to learn Spanish via cultural immersion, this trip is also a firsthand experience confirming the importance of using interpreters, avoiding assumptions, and checking to ensure patients are understanding their providers, regardless of language.