Talking To The Trini Patient; The Language Barrier

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Hi there! This is Dr. Louella. I’m literally stealing time here (hope I don’t get caught). But I was just thinking how I am not sure I can be a doctor anywhere in the world besides Trinidad because of the language. Yes! The language.

Of course, we speak English here, as a first (and practically only) language, although Spanish is our second. But these patients!!! It’s pure ‘Tringlish’ (Trinidadian English; ok fine, that isn’t a word; pure ‘creole’ then).

That was the strangest part of newly becoming a doctor, for me… the communication barrier! These people used different terms and different sentence construction from me.

I was raised in central Trinidad but honestly, my family didn’t mix much.  My mum sent me to a private primary school, then I passed for a convent for my secondary education, then off to university. So I was not well exposed.

I’m frequently asked by patients, “You’re not from here?” I still want to knock  someone’s head off every time I hear that. I bet them that I am more from here than they are, because I work three minutes from where I grew up.

Some say it’s because I have some sort of an accent. What accent??? I’ve never lived anywhere else!!! One or two have tried to explain it’s just that I speak well. Ok, I can accept that.

But it’s been sixteen years and by now I can understand the patients. I also ensure that they understand me.

I understand when a granny has ‘junjuni’ (parasthesiae; i.e. pins and needles) and when her head ‘hutting’ her (i.e. is hurting her). Maybe she has an ‘inside fever’ (is feeling feverish) or perhaps the poor old dear was ‘waking’ all night (probably went to a ‘prayers’ or wake or something and got to bed fairly late.

I can even interpret when an old man says he is ‘whizzing,’ ‘Ah only whizzing doctor!’ because the elderly gentleman is wheezing constantly. I start calling it ‘whizzing’ too so he’ll have no confusion.

A real classic in Trinidad is ‘gas,’ a nuisance that reaches up as far as the shoulders and head in some patients. I explain to some that ‘gas’ resides in the stomach and intestine only, but not to everyone, because they would not believe me if I tried.

One thing that still gets me is the ‘bad feeling’. When a patient is getting a ‘bad feeling’ I don’t know if they mean nausea,  dizziness or some other symptom, so I enquire.

I sometimes come across the unpleasant cases where they are differences in terminology, such as a grandmother being distressed that her  grandson was ‘interfering’ with her little granddaughter’s ‘bajina’ (i.e vagina, i.e. a case of incest).

When you ask a Trini patient how long he or she has had an ailment, say a pain, the answer is usually, ‘A while now,’ or better yet, ‘A long while now.’ They then need to be  asked for clarification because their ‘while’ and your ‘while’ may be very different (like weeks and years!)

When someone says their ‘stomach’ is hurting I insist they point to the area. In Trinidad the stomach seems  to be anywhere from the neck to the pelvis and I don’t pretend like I know where they mean.

Recently a clerk was laughing at a patient who was saying ‘CDAT’ for ‘CDAP’ (Chronic Disease Assistance Programme, where our patients get free medicines). I couldn’t join her because that was old news for me. As far as I see, more than half of them call it CDAT and I am cool with that.

What about the (mis)-pronunciation of drugs?  Does not bother me. Sometimes I correct them but if they are elderly, I am just glad they were able to come up with something identifiable.

So! The one who has changed in all this is me. I’m quite used to their language so there is usually a smooth flow of  Trini talk between the patient and me, except when they want to know if, ‘I’m not from here!!!’

Dr. Louella, over and out. Enjoy the season y’alls!!!!