22 January 2009

Be careful what you say

Some time ago, I was working with one of my partners, Owen, a young and earnest doctor, who possessed some of the best interpersonal skills of any of the doctors it has been my pleasure to work with. He just had a great way with people, and always did a wonderful job of communicating -- explaining what he was doing, what the diagnosis and plan were, and just making people comfortable and putting them at ease.

That evening, it happened that a Hispanic woman came into the ED with her husband; she was pregnant and having some discomfort. They were both extremely apprehensive about losing the baby. Owen went in to do a pelvic exam, and as always, he was kind and reassuring as he went through this uncomfortable procedure with them. They did not speak english, so he explained the process in spanish. He performed the speculum exam, and as he wrapped that up, he explained the next step, which would be a bimanual exam. That involves placing two fingers into the vagina and one hand on the abdomen in order to assess for cervical motion tenderness, uterine size or tenderness, and adnexal masses or tenderness. As he prepared to do so, he reassuringly told them, in Spanish, "And now I am going to feel with my fingers," which is a polite warning for a woman who may not have had this sort of exam before.

"Ahora voy a sentir con mi boca," he said.

This did not have the desired effect. The woman stiffened up, and the husband gasped in horror.

"La boca?" He stammered, "Pero, pero, por que la boca?" He turned to the nurse and pleaded, "Por favor, por que la boca?"

The nurse looked on in befuddlement, while the tech who was assisting with the exam and happened to be fluent in spanish doubled over with laughter and had to leave the room. Poor Owen was beside himself. Truth be told, his spanish was not terribly good (though much better than my own), and while he perceived that he must have not said the right thing he had no clue what his error was, and now he found himself standing between the legs of a patient, with his hands poised to perform the exam, but unable to proceed until the misunderstanding was resolved.

The readers of this blog who are fluent in spanish will have spotted his error, I am sure. After an interminable delay, the tech recovered himself enough to come back into the room and explain to the patient that "El doctor" had intended to say, "Ahora voy a sentir con mis dedos."

"Dedos" means "fingers." "Boca" means "mouth."

I cannot recall ever seeing someone as red as Owen was after that exam, and the nurses called him "Boca-boy" for months thereafter. Each and every time they did, he turned the exact same shade of red.

Owen has returned to his home planet now; he was too good for the likes of us. If he's reading this, he'll recognize himself, and I hope he knows we all still miss him.


  1. Spanish speaker representin'.

    My monitor is now covered in flecks of rice cracker.

  2. What happened to Owen that he "returned to his own planet"?

  3. Non-spanish speaker representin' (French and Chinese, not much use in my part of the country) ... and my monitor's now sprayed liberally with chili.

    Gotta stop reading these blogs over dinner!

  4. I only know a few dozen words of Spanish. I can't form too many sentences. Pointing and other gestures are part of the way I communicate, but even I know that boca is mouth.

    Of course, I have spectacularly messed up the English language at times, and I usually do a tolerable job of faking fluency in English.

  5. It reminds me of this anecdote:
    An Hispanic man runs into the ED saying (in spanish) that his teenage daughter was in the backseat of his car in the process of childbirth. A young intern runs out, and seeing that she was crowning, told her (in his best spanish, of course), "Puta, puta, puta!"

    'Puta' means 'whore', what he meant to say was 'puja', which means 'push'.

  6. rlbates,

    Krypton needed him...