During my Family Medicine clerkship in medical school, I worked with a free mobile primary care clinic dedicated to serving uninsured patients. Parked outside a church in a large city, the clinic was a large blue bus standing in stark contrast to the gray asphalt parking lot around it. It was often surrounded by families and people of all ages. The same parking lot hosted a food bank every other week, too. Here was a hub of essential services for the community.
The steep stairs leading up to the clinic’s entrance were a challenge for many patients, but on the inside, the bus was a welcoming medical space. At the top of the stairs, patients were greeted by the team: a faculty physician, a resident, two medical students and a medical assistant. This area was also the narrow hallway separating the two small exam rooms. Each exam room, though compact, was efficiently organized with modest exam tables, a sink and basic medical equipment. This mobile clinic provided a unique window into the challenges faced by those with limited access to health care.
On one of my days working here, I met a woman in her mid-40s who had recently moved from Haiti and spoke Haitian Creole. When she entered the clinic and sat beside the medical assistant’s desk, I noticed her demeanor. She seemed strained and visibly anxious. As we led her into one of the exam rooms, the bus’s gentle vibration seemingly amplified the tension in the small space. While she sat on the exam table, I picked up on signs from a longstanding stalemate with her condition. Her brows remained furrowed, her shoulders were tense and her body language was closed. Her faded, oversized clothing highlighted her thin frame and, despite her stated age, she appeared older due to visible signs of fatigue and stress.
I don’t speak Haitian Creole and, initially, the language barrier felt like a significant hurdle to the encounter. With the help of a telephone interpreter, however, we navigated the conversation with increasing ease. The interpreter’s calm and steady voice was a lifeline, bridging our communication gap. As we spoke, I noticed our patient’s initially guarded posture relax. Her shoulders softened and her crossed arms fell to her sides. As she communicated through the interpreter, her voice carried a mix of frustration and desperation. “I can’t get care,” she said. To me, her words reflected a year of anxiety about what she told us she was experiencing: palpitations, weight loss and tremors exacerbated by her inability to see a specialist due to uninsured status. Her eyes bulged, her hands trembled noticeably and her heart rate was alarmingly fast. Her skin was warm and moist to the touch, and she mentioned experiencing constant nervousness and irritability.
This wasn’t her first visit to our mobile clinic; she had been trying to schedule an appointment with an endocrinologist for the past year. Another nearby community health clinic providing affordable, low-cost specialty care, however, had been perpetually overbooked. The language barrier further complicated her ability to secure an appointment.
Our connection deepened through small, meaningful gestures. Sensing her discomfort, I offered iced water from the small refrigerator in the adjacent hallway. She accepted it with a smile, a small sign of relief in her otherwise tense demeanor. Leaning forward, I gently placed my hand on her shoulder to convey my concern. The interpreter’s voice was met with nods, and her eyes, clouded with worry, slowly began to show a glimmer of trust. As she shared her fears about her health, her voice trembled and tears welled up in her eyes. She was anxious about her worsening symptoms and concerned about living like this forever. Her tone was less desperate and more reflective when she spoke now.
When she asked, “will I get back to normal?” her vulnerability was raw and transparent. As I waited for the interpretation, I reached out to hold her hand and nodded vigorously. As we went back and forth through the interpreter, she held onto my reassuring words, and a thin, hopeful smile emerged. My patient was cautiously opening up and revealing parts of herself that went beyond her illness. I sought to reinforce a sense of safety and empathy through steady eye contact and mirroring her emotions with my expressions. While I knew that simply listening meant a lot to this patient, I still struggled to formulate a plan to help her. We had no imaging, limited medication access and only one overbooked endocrinologist who accepted referrals for uninsured patients.
After consulting with the faculty physician and telemedicine endocrinology consult from the MAVEN Project, we devised a treatment plan. I began, “we’ll start you on a medicine called propranolol to help with your fast heart rate and another medicine called methimazole to help your thyroid function better by reducing the extra hormones made by your thyroid.” I was careful to use clear, straightforward terms and to pause after every few sentences. The interpreter ensured these explanations were clear and understood. As our appointment concluded, the patient’s smile, tinged with relief, and her heartfelt “thank you” reminded me of the positive impact of compassionate care.
Reflecting on this experience, I recognize the importance of using professional interpreters, nonverbal communication, and intently listening to patients in overcoming language barriers in medicine. Professional interpreters ensure accurate communication, while nonverbal cues and active listening help build trust and understanding. My medical education emphasized the value of empathy, advocacy and cultural competence in providing equitable care. This experience taught me how these skills can bridge gaps and ensure all patients receive the care they need. The treatment plan we devised, facilitated by clear communication and compassionate care, helped address the patient’s medical needs and helped ease her anxieties. As a future physician, I am committed to applying these lessons to provide equitable and affordable care for all patients, regardless of their background or language.
Acknowledgements: I would like to express my gratitude to Dr. Stumbar for inspiring me to write this narrative medicine piece and for her support and time in reviewing my story. I also want to thank Dr. Anderson for his invaluable mentorship and guidance at the mobile clinic.
Contributing Writer
Herbert Wertheim College of Medicine, Florida International University
Mona is a medical student at the Herbert Wertheim College of Medicine, Florida International University in Miami, FL class of 2025. She graduated from University of California, San Diego with a Bachelor of Science in biochemistry and cell biology with summa cum laude latin honors in 2020 and a Master of Science in biology in 2021. She has been inducted into Phi Beta Kappa, the Gold Humanism Honor Society, and Sigma Xi, The Scientific Research Honor Society. She enjoys working out, cooking, and spending time with friends and family in her free time. After graduating medical school, Mona would like to pursue a career in diagnostic radiology.
