From the Wards
Leave a comment

Words Unspoken: Overcoming Challenges in Patient Communication 

There I was, face to face with a middle-aged Korean man, blood still dripping from a gash in his forehead. Disoriented, erratic, agitated … and rightfully so. Slowly regaining his consciousness, the patient found himself in a bright room with endlessly beeping monitors. He awoke from some unknown head trauma in a small, unfamiliar room packed with people, some of whom wanted to poke at him with sharp needles.

To add to the chaos, it was unclear if he could speak or understand English. All of these factors combined to create the perfect storm of confusion. With every attempt to draw his blood he pushed and shoved; ultimately, to ensure his safety and that of the staff, the emergency room providers resorted to tying him down with physical restraints. 

The paramedics had just brought the patient into the ER, and any attempts at communicating were to no avail, in large part due to the ever-present language barrier. “Hello, what is your name? … How did you get that gash in your head? … We need to draw blood from you…” Only more confusion. In another hopeless effort, one of the medical staff brought in a Latino custodian from the hallway as if, by stroke of magic, the custodian’s fluent Spanish would translate to Korean. After witnessing this fruitless attempt, the significance of communicating with patients in their preferred language became more apparent than ever.  

Over the next several minutes, nurses and staff entered and exited the patient’s room as one of the technicians tried to connect to the hospital’s virtual interpreting service. However, in a hospital, every passing second can bring a patient closer to death. While our patient seemed to be stable and the gash in his forehead was not life-threatening, the staff was responsible for an entire floor of patients, many of whom were possibly in more critical conditions. As such, this patient’s medical team was already rounding on other patients while they waited for the interpreting service to be ready. 

During this time, there was a brief moment when I was the only other person in the room with the patient. I was naturally a bit tense, as only minutes ago the patient was deemed a serious enough risk to my safety to justify the use of restraints. Now it was just him and me. To say that this was not how I imagined my first clinical experience to unfold would be an understatement.

As part of one of my courses aimed at better understanding the patient perspective in medicine, we were tasked with sitting with a patient from the time they entered the ER until their discharge or transfer, which is often at least four hours. While this “patient shadowing” ended up proving an insightful twist from the traditional “physician shadowing” experience, I recognized that such insight could only be achieved if I stepped beyond my comfort zone — so I dove right in.

Imagining how the next four hours would unfold, I decided to make the best of the situation and try to comfort the patient. As I did not speak a word of Korean, I relied upon hand signs and facial expressions to try to communicate. I looked into his eyes with a warm smile on my face, waved and then placed my hand on my heart. I knew he probably did not understand the words I said but that did not stop me from saying, “You’ll be alright,” hoping at least the tone of my voice would translate … and it looked like it worked!

Now he was smiling from ear to ear as he enthusiastically responded in Korean. I nodded and smiled once again, still not understanding a word he said, but now we had bonded. The moment was powerful. While the exact meaning of our words was lost in translation, we were able to connect on a deeper, more personal level. 

By the time the medical team came back, the interpreting service was still not ready. The physician I was shadowing sent me off to another patient in hopes I would learn more from a patient I could actually understand — a patient who spoke English. Ironically, this first patient encounter left a greater mark on me than any other that day, as it showed how impactful my efforts to communicate with patients could be. I learned that as physicians, striving to connect with patients, regardless of language barriers, will create a better patient-physician connection that is at the center of quality patient care.

Kareem Zuhdi Kareem Zuhdi (1 Posts)

Contributing Writer

Morsani College of Medicine

Kareem Zuhdi is a first year medical student passionate about narrative medicine, quality improvement and mental and physical well-being. Studying to get his MD at the Morsani College of Medicine, he also works on the side as a volunteer crisis counselor for a suicide and crisis hotline as well as on the Lancet’s Child and Adolescent Health International Youth Advisory Panel. In his free time, Kareem loves kayaking, playing tennis and exploring new restaurants.