Wearing my trusty clinical skills outfit, I entered my first day of exchange at a hospital tucked away in East Berlin at 7:30 a.m. sharp, ready to immerse myself in the world of cardiology.
Following the Chefarztbesprechung, a meeting to discuss patients with attending physicians (in German, natürlich), I was kindly redirected to the changerooms for a wardrobe change: a white polo and pant ensemble, with a lab coat completing my look. This was my outfit for the month at the hospital, signalling to staff and patients that I was a medical student.
Along with Luisa*, my favourite resident and guru, I was ready to take on the wards with my new look and eagerness to learn. When I passed by nurses or other staff, I could cooly throw a Guten Morgen without raising suspicion of my non-German speaking status (Danke Duolingo!). Things got complicated when a nurse suddenly would ask about a patient, or even worse, when I could not tell that someone was speaking to me. Luisa would quickly interject – Sie spricht nur Englisch – or I, using my abysmal German pronunciation, would be forced to translate the following, “Sorry, I don’t speak German.”
As word quickly spread about the new medical student from Canada, the staff shifted to accommodate my learning without hesitation.
Most were inexplicably kind to me, stepping up without my asking and sometimes not even speaking a word of English. The nurse who saw that I was lost while trying to find the toilets personally directing me. The medical students, particularly Adele*, who messaged about a free spot in a suturing workshop and accompanied me on a Berlin wall tour. The physicians in the electrophysiology lab and Luisa, who took the time to talk about ablative procedures, patient diagnoses and management while helping me read ECGs and supervising my blood draws. The patients who allowed me to perform physical exams and blood draws, tolerating my rudimentary Deutsch sprinkled with hand gestures.
I was touched by their kindness and their willingness to foster an environment where I could truly learn and grow. Of all the cardiology I learned, the one thing that profoundly stuck with me is this: kindness transcends all barriers. It can be felt in the smallest of gestures and in the patience of those who are willing to meet you halfway.
One thing that profoundly stuck with me is this: kindness transcends all barriers.
This was my first time being on the receiving end of translation services. As a native English speaker, I have been privileged to be in situations where individuals will naturally default to English to accommodate me. However, in a setting in which neither party could speak a common language, I had to resort to two-word phrases, repetition and hand gestures. Unwittingly, this experience gave me some insight into the challenges that non-English- or non-French-speaking patients face when navigating the Canadian health-care system.
It is no surprise that language barriers impede access to adequate health-care services and negatively affect health outcomes. Communication is the hallmark of forging good relationships between health-care providers and patients. With language barriers, discussing diagnoses, treatment plans and understanding patient concerns become a landmine of misinterpretation and miscommunication. Even the use of ad hoc interpreters may cause more harm than benefit, especially in the realm of patient confidentiality. Additionally, health-care providers may be unwilling to accommodate non-English- or non-French-speaking patients and may not be aware of resources at their disposal.
When asking the nurse for a needle I needed for a procedure quickly devolved into an exhausting encounter, I can only imagine the frustration and confusion that patients feel when trying to navigate even more complex conversations. It calls to the need for encouraging cultural competency in health-care providers and advocating for consistent use of interpreter services such as CanTalk.
As I move forward in my medical training, these insights will shape the care that I will provide, ensuring it is tailored to my future patients’ needs. Whether it is through a smile, getting a glass of water or requesting an interpreter, I hope my future patients and colleagues not only view me as competent but also as a kind physician who will listen to them in their preferred mode of communication. And who knows, maybe at the end of our conversation, I may be fluent enough to retort, Tschüss!
*Names have been changed to protect individuals’ privacy.
