One of the most painful aspects of clinic, at least where I work, is that nine out of ten patients I see daily do not speak English. While I feel that I’m reaching my limit at broadening my linguistic abilities, it is disheartening not to be able to communicate fully with your patients. I occasionally use the interpreter lines only when necessary, because it adds an insurmountable delay to the schedule that cannot possibly be regained. At times, even the interpreters have difficulty understanding a patient’s native tongue.

Today a patient came into emergency triage stating that she had lost vision suddenly in one eye a month ago, but only decided to come to the clinic today. She also denied ever being here in the clinic. To no surprise, we did not have any records of their encounters in the clinic either.

I spent the next hour toiling around to find an egregious cause for her vision loss, only to find non-specific drusen in her fundus. When my attending, who was fluent in Spanish, questioned the patient again, the story was relayed in a different manner than I gathered. She had GRADUAL vision loss over a month, and she also “lost” her glasses 20 days ago. Her chart also magically appeared underneath my progress note–I suppose one of the techs found it 4 hours later–and a workup of AMD  was suggested in her plan.

Lesson learned: you can’t win.

medicine life