Day Five: Polyglot Medicine

When I was doing my rotation in the Dominican Republic, I remember how difficult it was to understand the residents as they would round on the patients in rapid-fire Spanish. So it is with no small degree of admiration that I observe the Cambodian residents go about their duties, as they both write and speak about their patients in English.

I spent most of today hanging out in the Outpatient Department, sitting beside a resident named B as he saw patient after patient in his busy clinic. B, who had attended medical school in Phnom Penh, said that he had to learn everything in French. He said that coming to AHC was the first time that he had to communicate in English since high school, and that furthermore, he wasn’t provided any support as he assumed his duties as a resident. I also learned that there are others in the group of residents who received scholarships to go to medical school in Vietnam. They had to learn everything in Vietnamese—which obviously is VERY different from English. It made me very humble about my own half-baked success of being able to speak little pieces of many languages.

The residents’ relative unfamiliarity with English does make for some interesting events, though. For example, a significant amount of time during rounds is devoted to clarifying English terms (e.g., dyspnea vs. apnea). In addition, their written H&Ps tend to be very minimal. Perhaps my favorite anecdote related to this involves a resident describing a chest x-ray of a patient with severe ARDS. In his note, there was no mention of the pleural effusions or the lung infiltrates present on the actual x-ray. Instead, he just used the following phrase: “Chest X-ray = Bad.”

What can I say? He definitely got the point across!

Indeed, there is talk about making the admissions forms contain more checkboxes so the residents wouldn’t have to struggle with writing English paragraphs. Hopefully this will help too with the history taking. But in the meantime, it’s forcing me to improve my Khmer so I can fill in the bits and pieces of missing history in the chart!

Meanwhile, it seems like the residents are finally catching on to the fact that I want them to speak to me in Khmer rather than English. Right now, I think my Khmer is at “Soap-Note” level with the patients. I definitely don’t have enough Khmer under my belt for a full H&P however. Oh well, baby steps, I guess!