{"id":771,"date":"2009-07-28T13:35:09","date_gmt":"2009-07-28T12:35:09","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=771"},"modified":"2009-10-09T14:45:09","modified_gmt":"2009-10-09T13:45:09","slug":"louise-kenney-lost-for-words","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2009\/07\/28\/louise-kenney-lost-for-words\/","title":{"rendered":"Louise Kenny: Lost for words"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft\" style=\"float: left\" src=\"http:\/\/www.bmj.com\/columns\/icons\/louise_kenney.jpg\" alt=\"\" width=\"160\" height=\"110\" \/>It wasn\u2019t until the last couple of weeks that I began to have terrible, panic-stricken nightmares about my dreadful communication skills.\u00a0 I wake in a trembling state, sweating because I can\u2019t remember how to ask my patient \u2018Does the pain radiate anywhere else? Does it come and go?\u00a0 Is it sharp, stabbing pain?\u2019<br \/>\nIn my night terrors, it\u2019s always the same patient, and me standing open mouthed bubbing like a goldfish. Now don\u2019t worry, this memory problem isn\u2019t pathological, I\u2019m not dementing or growing a tumour, I\u2019m moving to <a href=\"http:\/\/www.lonelyplanet.com\/maps\/central-america\/guatemala\/\">Guatemala<\/a> for work.\u00a0 Despite my 6 months of Spanish lessons slotted in around understaffed rotas, without a doubt I\u2019m going to have some total communication failures.\u00a0 The <a href=\"http:\/\/www.gp-training.net\/training\/communication_skills\/calgary\/guide.htm\">Calgary-Cambridge<\/a> model probably isn\u2019t going to cut it in the event I forget the words for \u2018I need some help, she\u2019s haemorrhaging\u2019.<!--more-->The thought of quite how bad it could be fills me with horror.<\/p>\n<p>Now I\u2019ve been a doctor for 2 years, and I like to think that I am a good communicator, although we do all have our moments.\u00a0 I\u2019ve certainly had positive feedback from colleagues, and indeed patients, regarding my ability to talk, listen, understand, and interpret the frequent subtleties of a patient\u2019s history.\u00a0 Skills that I had taken for granted until my recent awake-sleep moments scrabbling through the Spanish dictionary next to my bed.<\/p>\n<p>During my short career, I\u2019ve sadly been witness to several truly dreadful interactions between doctor and patient.\u00a0 While attitude and mannerism can be blamed for plenty, the language barrier inherently creates a broken, stilted conversation while one or other party thinks, translates, and constructs sentences.\u00a0\u00a0English spoken as a second language can, at times, sound abrupt, as I\u2019m sure any language does.<\/p>\n<p>I met an extremely helpful, lovely Argentinean GP who now works up in the Northeast.\u00a0 We sat in a pub and chatted medical Spanish, identifying those circumstances most terrifying.\u00a0 I said breaking bad news, so we gave it a go:<\/p>\n<p>\u2018Lo siento, pero esta muerte\u2019 was my first attempt, literally translated as \u2018I\u2019m sorry but he\u2019s dead\u2019.\u00a0 Now I recognise in English that this could be said better and I do know more appropriate Spanish tenses to build the sentence, but my grasp of Spanish grammar is too basic to think on my feet.\u00a0 My friendly Argentinean suggested \u2018he has died, or he died, might be better?\u2019<\/p>\n<p>Well of course it would!\u00a0 Precisely demonstrating how I\u2019m dangerously close to being that abrupt, direct, slightly shirty doctor that makes us all wince on ward rounds.\u00a0 He doesn\u2019t mean to omit all the niceties that cushion the blow, he just doesn\u2019t know the grammar!<\/p>\n<p>So here I am, black of the night with sweaty palms and palpitations about imagined interactions that may soon be a reality.\u00a0 Last night it was the operating theatre \u2013 it was a horror flick involving looking up the word for \u2018forceps\u2019 while scrubbed.\u00a0 Simply remembering and writing it gives me pit-of-the-belly anxiety.<\/p>\n<p>With poor communication identified as the primary cause in 70% of malpractice suits, it\u2019s obviously the all important skill to get right for more than just the sake of patient satisfaction.<\/p>\n<p>I\u2019ve been well-informed by someone who has worked in the <a href=\"http:\/\/hospitalitoatitlan.org\/\">Hospitalito Atilan<\/a> before that I really need not panic about the Spanish, that, I quote, \u2018it will be the least of my worries\u2019.<\/p>\n<p>Reassuring.<\/p>\n<p><em><strong>Louise Kenny <\/strong>has completed F2 year in the Northern deanery. She starts work shortly at Hospitalito Atilan in Guatemala<br \/>\n<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>It wasn\u2019t until the last couple of weeks that I began to have terrible, panic-stricken nightmares about my dreadful communication skills.\u00a0 I wake in a trembling state, sweating because I [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2009\/07\/28\/louise-kenney-lost-for-words\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":66,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[223,165],"tags":[635,1329],"class_list":["post-771","post","type-post","status-publish","format-standard","hentry","category-guest-bloggers","category-junior-doctors","tag-communication","tag-guatemala"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Louise Kenny: Lost for words - 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