I studied abroad in Paris for a summer when I was in college. I had taken French classes for many years and was well versed in listing vocabulary, conjugating verbs and participating in skits with classmates in which we pretended to rent an apartment, order coffee or give someone directions. I knew that the transition to immersion in a language that was not my own would be challenging, but I imagined that I would be strolling through the city having witty conversations with the Bouquinistes who sell their wares out of the green booths that line the Seine in no time.
When I arrived, though, I realized I had a few barriers to overcome before my idyllic dream could become a reality. First, I had only had conversations in the structured setting of my classroom, where I already knew the topic before I even started listening — household chores one day, leisure activities the next. Second, I had only been speaking French to my peers, people around whom I was comfortable sounding like I had no idea what I was talking about.
Suddenly, the stakes felt much higher as I entered into conversations with my host family, taxi drivers and shop owners which felt anything but predictable and comfortable. I struggled with performing simple tasks like ordering pain au chocolat at the patisserie near my homestay. My mouth felt full of cotton and my face turned beet red, prompting the person taking my order to switch into flawless English out of compassion and, if the sly smile was any hint, a touch of superiority.
I never expected to have such a similar experience of being immersed in a new language while remaining in the United States exactly five years after my summer in France. But the hospital is truly a world of its own, complete with its own vocabulary — rounds, differentials, curbsides, admits. Despite two years of learning the foundations of health and disease in the classroom, discussing topics with classmates in labs and discussion groups and performing exams on standardized patients, it felt like it was once again my first day of medical school when I started my rotations in the middle of May.
This time, the chilly interior of the hospital was my destination for the summer’s adventure. Everything moved so quickly, and it felt like no matter how closely I reviewed a chart or listened in rounds, there were very big glaring details that everyone else had picked up on except for me. After my first day on the rotation, I did not know how I would be able to make it through the rest of my medical training if it required going back to the hospital again. I felt that there was no way I would ever feel comfortable enough in the hospital to understand what was going on and provide any degree of patient care.
Partway through my first week, I was watching a respiratory therapist draw an ABG when he asked me to “please pass a two-by-two.” I froze, wracking my brain for what that word could mean. Based on its place in the sentence, I knew it must be a noun. I followed his line of sight to the cabinet sitting next to me. My heart was racing, but I figured I would know a two-by-two when I saw it, so I started opening drawers, progressing quickly but methodically from top to bottom while keeping one eye on the respiratory therapist in order to gauge his body language as I tried to deduce what I was looking for.
While I thought I was being quite nonchalant about my search, the nurse clearly caught on to my cluelessness quickly. “There, on the left,” he pointed to a small stack of square gauze, two inches long by two inches wide.
That feeling of my brain racing to take in a situation and use context clues to interpret an incomprehensible phrase felt oddly familiar. Suddenly, I was back in my homestay, and my host mother was giving me instructions as I headed out to meet some friends. “N’oublie pas à fermer la porte à clé,” she said as I walked towards the door. I paused. Like in the hospital, I knew most of the sentence. Almost all of it, in fact. “Don’t forget to close the door…” But then what. I did not understand the last word, and I had the sneaking suspicion that it was the most important one. I looked at my host mother. I looked at the door. Still hoping to make a good impression, and optimistic that my host family still had not caught on to the fact that I only understood about 50% of the words they used, I nodded and continued on my way out, fingers crossed that the last word would click into place once I was safely on the other side.
My host mother, however, could see right through my façade and followed me into the hallway. She took my keys from my hand, stuck them in the door, and twisted. “Voilà, c’est fermer à clé,”she smiled, handing them back as I realized that I did know the word clé, or key, and that she had been asking me to lock the door behind me.
Thankfully, that moment with the respiratory therapist came early on, because the sheer shock of not knowing a word in this environment for which I had spent the prior two years training helped me to realize that I truly was learning a new language, one that I was finally being immersed in. And, slowly, things felt a little more familiar each day. I gradually began to understand what was being discussed on rounds and became able to present on my patients without stuttering over every word.
Towards the end of my summer in Paris, I stopped at an outdoor marché to ask a vendor about the scarves he was selling. We chatted for a few minutes, and as I was about to leave, he asked me if I was Canadian. I took this as a huge compliment after spending the entire summer being easily pegged as a language-learning American; I had a different accent, sure, but he thought that I had been speaking the language from a young age. Even more importantly, the satisfaction I got from finally being able to express myself in the language that I had dedicated so much time to was indescribable.
Similarly, at the end of my final week on the wards, I stopped in to see a patient I had been following for a few days. Her family, who had not been present during rounds, had a question about the plan for the day. During the preceding months, I had always deferred to my default answer of “let me go check in with the team and come right back to let you know.” This was only partially because I did not always know the answer; even when I did, I was hesitant to explain things because I was unsure if I would be able to say it correctly.
This time, before I even realized what I was doing, I found myself clarifying a few points about the patient’s treatment and explaining what that would mean for her when she returned home. I had not initially realized that medicine was a foreign language, but the process of immersion is proving effective once again.
Contributing Writer
University of Massachusetts Medical School
Kathryn Norman is a fourth-year medical student at University of Massachusetts Medical School class of 2021. She received her Bachelor of Arts in psychology from Harvard University in 2015. Before starting medical school, she worked as a CDC Public Health Associate in Modesto, CA, where she discovered her love for both local health policy and hiking in the Sierra Nevada mountains.