Language barriers are a contributing factor in health care disparities.
-Donald J. Hernandez, PhD
Years ago, I sat in clinic with a new patient, her family, and a Hmong translator. I studied the biopsy report from another doctor’s office. This would be difficult. I asked about her symptoms.
The mass had been there for a while, I learned. She had pain but they were trying some medicines from their traditional healer. She hoped that I could help her.
Then I discussed the report. "She has cancer," I told the daughter. The daughter nodded and turned to tell her mother, speaking at length and re-working my three-word phrase into something much, much longer. The translator helped, as well.
The mother sat quietly, searching her daughter’s face, hearing the words but saying nothing. I tried to learn more about her life. She had been born in Laos. She had never seen a Western physician before developing the mass.
"Do your siblings have any health problems?" I asked.
"We don’t know," her daughter replied. "They were all killed during the war. We haven’t seen most of our relatives since we came to this country."
The woman’s facial expression did not vary. Gradually, the questions came out. "What will this mean?" "Will the treatments make the sore go away?" "Can this wait?"
I did my best to answer. Then I asked, "What other questions does she have?"
"Doctor, it is hard to ask questions," her daughter told me. I waited. "You see, in our language, there is no word for ‘cancer.’ She does not know what that means. It is very hard to explain."
Indeed.
The following is feedback received for this blog:
Thank you for this touching post. I've never thought about what it would be like to try and explain cancer to a patient who comes from a part of the world where it is a foreign idea.
- Theodore Diktaban, MD
