PNG: Lost in Translation

My goal for today was to see greater than half as many patients as the ER doc I was working alongside. I was really in the flow and rhythm of seeing patients, when a man with an unusual problem came to my table. He was very short-stature, probably no more than five feet, and his body was childlike while his head was normal-sized and fully-matured. In medicine we would say that he looks “syndromic” meaning that he probably had some sort of genetic or congenital disorder like Down’s or autism. If you’ve ever seen anyone with Down’s you would probably agree that they have a characteristic look. However, since there are hundreds of these syndromes and they are tough to remember, only a few physicians whoa re experts in identifying these disorders remember them all. The rest of us just say the patient looks “syndromic.”

So anyways the patient sits down and I ask him if he takes any medicines. He does not respond, at which point the translator intervenes and tells me that, “This patient is deaf and mute,” and so he cannot speak or understand me.

“OK fine” I say. Then reflexively I switch to using the translator mode. “Can you ask him what medicines he takes?” I say.

The translator then proceeds to act out my question to the patient without using sounds, as if he were playing charades. He motions about putting things in his mouth, presumably to mean taking pills. Satisfied that he was understood next he points his index finger at the patient indicating that he wants to know if the patient takes pills.

The patient nods in understanding and shakes his head “no”.

“He doesn’t take any meds,” says the translator.

--pete