Lost in Translation

This patient has neurofibromatosis. She needs surgery, but Dr. Faile does not think he can manage the surgery.

We have fantastic translators here, and I would say most of the staff speaks about 5 languages. Still there are many tribes, and people travel hundreds of miles to get to BMC, therefore, often it's still difficult to get the message across.

While at Nakpanduri, we visited an American couple doing tree conservation work. They often send patients to us. One of the folks they sent to us to have a cleft lip repaired. The surgery took place last week. After the surgery and recovery, the patient was supposed to go to the pharmacy and get his medicines and pay for his stay. At some point, he was told to find the white lady in the pharmacy (Jane is a full time missionary in the pharmacy), apparently this was explained to him about 5 times. Well the patient did find the white lady., just the wrong one. He traveled over an hour (by car) to Nakpanduri to this couple. He even brought her his chart! Now she is used to bizarre stuff like this happening. She collected the chart, and had it sent back to BMC. I guess she is the only other white lady he knows, so he did as was directed.

My translator calls my patients for me (and all the other volunteers) since no one can understand us. They call the patient and hand me the card with their medical info including the chief complaint. So I have a guy today, whose chief complaint is "anus itching." Laugh as you may, that isn't that crazy of a complaint here because there are alot of parasites, worms. So my translator is talking with him, I'm asking him basic review of systems. It seems like that is what he is here for. So I tell him I need to peek myself, so he drops his pants, I look. I fill out his card and send him to pharmacy. Right then, another man comes angrily in the room, and him and my translator are going back and forth. It turns out I was NOT seeing the patient whose name was on the card! The patient didn't seem to mind I was looking at his rectum, made no mention of it. SO then I had to repeat the entire process with the CORRECT patient! Here's what made it crazier for me, I never saw the first patient again. For all I know, he wasn't even there to see a doctor, but he had no problem dropping his drawers for me.

Daily I get a patient that prefers to sit on the floor instead of the chair. I can't figure that one out either. Actually today (granted this patient was being admitted), but she decided to just lay on the floor.

Tommy picks up and drops off many people on his way to and from church weekly. His basic rule is that mom's with young children can sit in the cab, and everyone is outside. Why is that the rule? Mainly for practicality, most of the people around here cannot figure out how to open a car door. Tommy says after awhile it's just too cumbersome to always be opening the doors for them. I didn't get it at first, until I watched our mom's get stuck in the truck, every one of them. At least 10-15 times a day in clinic, my translator either has to instruct a patient on opening the door, or just go open it for them.

Patients are not used to stethoscopes at all, so when you ask them to breath, they basically hyperventilate, and you frantically try to listen everywhere before you make them faint.

Isn't there alot we take for granted???