As an Asian-American, I’ve become increasingly aware of how the culture I was brought up in has shaped who I am, how Taiwanese culture has melded into my everyday life. My family recently celebrated Lunar New Year together, and I helped my mom prepare all the traditional foods we would eat the night before, including various cakes (fa gao and nian gao), fish, and vegetable dishes (chang nian cai), to ensure we would have a prosperous year. However, when celebrating Thanksgiving in November with my friends, I had to Google “Thanksgiving dishes” to figure out what I could cook for the potluck, because I didn’t have much experience with “traditional” American Thanksgivings. The other day, I was watching Chopped, a cooking competition TV show, and became very indignant when even the judges were bashing on how Thousand Year Egg tastes. Some of the contestants tried to fry the egg, and the contestant that got the most compliments made a mayonnaise out of this delicacy – how outrageous!
I realize that my previous examples are all about food, but that’s not the only area of my life affected. Another major part of who I am is my bilingualism. Growing up in the states, I attended Chinese school and always spoke Chinese at home, so I am comfortable with verbal Chinese. However, my literacy level is probably that of a first grader, and when I speak, it’s still obvious that I’m not a native speaker. This year, I’ve had the unique and amazing opportunity of working on the board of a free clinic that serves patients who predominantly speak Chinese. I always assumed that as a physician, I would tell my patients that I spoke both English and Chinese, and that I could accommodate them if they were more comfortable speaking (Mandarin) Chinese than English. I figured to get there, I would just have to study up on medical Chinese vocabulary. However, my experience as a med student volunteering at this free clinic has helped me realize that since Chinese isn’t my dominant language (even though it was my first language), the situation is much more complex and I would have to make a lot of progress before I could lay such claims.
I’ve learned how frustrating it is to come up against a hard roadblock in terms of communication, to be on the edge of saying something but not finding the right words. I’ll give an example. I was listening to a patient who recently moved here from China talk about going to a community center for tai chi. I perked up. I wanted to say My parents do tai chi as well, because I just wanted to make some light conversation. But what was the verb for “doing” tai chi? Later, I remembered how to say it – da tai ji quan. But at the moment, the mental translation didn’t happen on time, so instead I said nothing and smiled. Besides, it’s not like the comment would have made a difference in the outcome of the visit. But that’s what I’ve found disappointingly difficult on many occasions: making casual conversation, witty banter, or joking around in Chinese to make the patients feel at ease. Without feeling completely at home while speaking the language, I’m unable to have the relaxed, back-and-forth conversations that I could have in English.
Here’s another example. I was speaking to a visiting physician from China with some of my peers during a Medical Chinese session, and she was talking to us in rapid Chinese about the differences between physician compensation in China and in the U.S. I can tell you right now that I understood very little of the conversation. How frustrating – though I may not always be able to respond with completely well-formed thoughts, I can understand everyday conversations in Chinese with little trouble. But here, she was using vocabulary that I had never heard before in my life. I was on the edge of comprehension, but I experienced so many lapses in understanding that I couldn’t piece together exactly what she was saying. It’s a weird feeling, understanding all the sounds of a language and yet not comprehending. It’s very different than, say, if I were to listen to someone speaking Russian, because I have no idea what their vowels sound like, how some of the syllables are even formed, and what kinds of inflections they use in speech. To me, hearing a very technical conversation in Chinese is like when those programs play a sentence in English backwards and suddenly the whole thing doesn’t makes sense anymore. I ended up trying to stay engaged, but I could rarely make meaningful contributions to the conversation.
Being bilingual on a basic level also means that I’ll never be able to create an even playing field with someone who isn’t comfortable with speaking English. Whichever language we choose to speak, one of us will not be able to fully express ourselves. What this means is that at the free clinic I’ll be writing down in English the symptoms the patient is describing in Mandarin Chinese before the interpreter has translated it, or I’ll nod along as the patient is talking. We have an excellent Cantonese interpreter, but since the dialect is different, she once was at a loss for how to translate “numbness” from English to Mandarin. I quietly suggested a phrase, and the patient looked bewildered. Why is this interpreter here if the medical student speaks Chinese? There was a great piece about the issue of doctors believing they can communicate with patients in another language called “The Danger of Knowing ‘Just Enough’ Spanish” that really stuck with me. I know I can’t go without an interpreter, because if there’s even a small gap in the translation, a lot could go wrong.
Still, I don’t think it’s impossible that I can one day speak Chinese in the medical setting well enough to at least make my patients feel more comfortable. I have had two primary care physicians that advertised that they spoke Chinese, and my mom was talking to me about how she liked one much more than the other. “It’s strange, they’re both American-born and their levels of Chinese-speaking are the same,” she commented. I think one factor was that one was much more enthusiastic to talk to us in Chinese, even if she spoke with an American accent, whereas the other was more abrupt and business-like. Beyond learning medical terms, I want to keep practicing speaking Chinese in my everyday life so that I can break out of that shell of reluctance when speaking with patients. It’ll be an active process of learning instead of a passive one, but communication is key in a doctor-patient relationship. If I can make even a small subset of my patients feel more at ease talking to me, then I think the process will be worth it.