Connecting to My Culture

Interpersonal Communication CEO 4.2: Understand how human diversity may influence or interfere with exchange of information.

As a Chinese-born immigrant who also grew up in a predominantly Asian community, I often take pride in the fact that I retained my fluency in my native language of Mandarin. I’ve always considered my Chinese heritage to be an integral part of myself, and I aspire to incorporate my bilingualism into my practice of medicine. At the Ohio State University College of Medicine, I am very fortunate to have been afforded the opportunity to use my skills throughout my years of training as a medical student.

Beginning in my first year of medical school, I volunteered at the Asian Free Clinic (AFC), which has a significant population of Mandarin-only speaking patients. During my many experiences as a volunteer at the clinic, I’ve had multiple opportunities to speak with patients strictly in Mandarin, translate for physicians or other students, and practice my medical Mandarin. I found it incredibly rewarding to be able to better provide health care to patients simply because I possess such a skill set, and each patient interaction, be it with someone who spoke English, Mandarin, or a language I did not know, only reaffirmed my decision to pursue a career in medicine.

My most memorable encounter at AFC was with a new patient who, albeit very friendly, came with a laundry list of medical problems including poorly-controlled cardiovascular disease (largely due to non-compliance to medication that I suspect was caused by language barriers), potential ophthalmic disease, and long-standing untreated malignancy. Simply performing the initial patient interview took almost 45 minutes, and I often had to stop and google medical terms because many of his conditions were ones that I had not learned in the curriculum yet, much less recognized in Mandarin. I felt a bit embarrassed that I kept having to stop and search online or ask the patient to re-explain himself, and was worried that he would be annoyed at my inexperience, but he was incredibly kind and understanding. Rather, he was simply relieved that he had someone with whom he could communicate comfortably and to whom he could express his concerns. As we slowly worked through all his conditions, he would also ask me about myself and my motivations and goals for becoming a doctor, which helped remind me that any discomfort I may feel is invariably inconsequential if I could provide effective care to my patient.

At the end of the visit, he asked for my surname. When I stated that it was ‘冼’ (Xian), he responded with ‘谢谢,冼大夫’ (Thank you, Dr. Xian). Even as a pre-clinical medical student, I made such a profound impact on someone’s life that he already considered me to be a physician for him. His words motivated me to continue improving my medical Mandarin, which led to purchase a Mandarin-English medical dictionary that I could study and reference.

Two years later, during the middle of my Obstetrics and Gynecology clerkship, I found myself using my improved medical Mandarin skills. I was at the end of a 2-week Labor and Delivery rotation, and one morning, my resident asked if I could speak Mandarin and if I would be willing to converse in Mandarin with a patient. Last night, after I’d gone home for the day, a patient arrived already in labor. Both she and her husband understood only minimal English and primarily spoke Mandarin. Although she successfully delivered her baby overnight (with help from Interpretive Services who translated for the night resident and attending), the delivery was complicated by a shoulder dystocia resulting in a fractured humerus in the baby and an umbilical cord avulsion. Moreover, the language barrier also resulted in delays in care.

My bilingual capacity enabled me to help two patients that day: the mother and her child. The mother understood that her baby had a broken bone, but she had many questions about the implications of that injury on her child’s health outcomes. How severe was the break? What should they do to care for the fracture? Would there be any lasting neurologic damage? I briefly reviewed my medical Mandarin before entering the room with my resident, and was able to serve as interpreter without needing to consult any online resources. I translated these questions for my resident into English, and the answers for my patient into Mandarin.

The mother also required a transfusion due to significant intrapartum blood loss and avulsion of the umbilical cord. I explained the procedure to her, helped translate during the informed consent, and monitored her for any adverse transfusion reactions. When she reported feeling discomfort at her IV site, I worked with my patient’s nurse to readjust the transfusion rate until my patient could tolerate the transfusion.

I spent most of my day with this patient. In doing so, I provided a significant and crucial service for her. My patient told me that she felt very reassured that she was speaking to a medical provider who understood her language and could communicate directly with her. As such, she felt comfortable asking me all her questions and relying on me to translate when speaking with her doctors. Additionally, the rest of my team also noticed the effort that I put into caring for this patient, and the results reflected in my evaluations.

At the end of the ring, I received a Letter of Commendation for my Obstetrics and Gynecology rotation, which was the highest score I’d received for a clerkship. I was very happy to have performed well on my rotations, but I was even more proud that I had successfully taken a skill from my earlier years of medical training and developed it such that I could apply it as a practicing physician-in-training. To my patients, I hope to be both Dr. Xian and 冼大夫.