Speaking the Language

Once in awhile, we get patients on the hospital unit where I work who do not speak English. This presents a particular challenge, of course, because simple questions like, “Are you in pain?” are not easily understood or answered. Because of the issues that arise with this, we have translators available to come to the room, 24/7, at the hospital where I work. Still, it’s not very practical to have a translator come to the floor every time the call light is ringing, or a meal tray is delivered. (Who wants to wait for 20 minutes for a translator to arrive, just to get an extra pillow or receive food while it’s hot?) Sometimes, I am left to my own devices, using pictures and some modified form of Charades to solve minor issues quickly. It is at these times that I wonder if my caring shows. I wonder if my expression conveys how much I want this patient to feel better, to feel safe in my care, or to be as comfortable as possible.

Yesterday, as a present to myself, I got a pedicure. The gentleman who gave me the pedicure was Asian, and it was apparent very quickly that he did not speak much English. He held up a bottle of polish with a question in his eyes, as if to say, “This color?” Yes. I smiled and nodded. He would smile, or raise his eyebrows in another question, and we somehow communicated… “No, that’s not too hard,” “No, that doesn’t hurt,” “Yes, that spot is sore.” He worked carefully, and I could tell that he was being particular on my behalf.

Researchers disagree on how much of communication is based on actual words, as opposed to body language, expression, and tone or inflection. Some say 40%, some say only 7%. Regardless, it is well accepted that certainly less than half of all communication between humans relies on language. When I consider that, then I am assured that, just as I understood that my pedicurist cared about my comfort, so are my patients able to tell that I care about theirs.

When I am working, I am very careful to monitor my own tone of voice or body language when I enter patients’ rooms. Whether the patient speaks English or not, I never want them to sense my frustration, and I never want them to sense if I do not think they are doing well. Nothing is as frightening to a patient, I think, as seeing their caregiver display a lack of confidence. They want to see concern without worry, confidence without arrogance, and compassion without pity. I wonder, though, if I am as careful with the other people in my life. Do I huff out an exasperated breath that says, “You are such a burden to me,” when I am behind a woman in the express grocery line, because she has more than 15 items? Do I roll my eyes and look away when a co-worker says something with which I disagree, as if to say, “How ridiculous”? Do I give quick, one word answers when I am impatient and ready to move onto something else, conveying, “Your thoughts do not matter to me”?

Yes. I’m afraid I do all of these things, and more. The things that I would never allow myself to express to a patient, or say out loud to anyone, I communicate pretty regularly to friends, colleagues, and people I love. That is not ok. This week, I’m going to monitor all of my own non-verbal cues, and see if what I am “saying” through those cues is what I want people to hear. Chances are, if I’m not able to say those things directly, then it is not. I may never be an expert in “speaking” the language, but I’m going to keep trying to be better at non-verbally communicating that I care, that people matter, and that I mean to treat them kindly.