Monday, October 27, 2014


Many dental practices have a culturally diverse patient base. Practicing near Washington, DC, mine is notably varied. Language, the spoken word, is a reflection of culture. Unfortunately, I’m linguistically challenged, often relying on my assistants to help me communicate with foreign nationals. Thankfully, I have had employees who speak Spanish, Portuguese, Farsi, and Danish.

I also rely on interpreters during my overseas trips to provide care for the extremely poor. I once spent time in Belize and thought, “Great, they speak English here.” But their inflection was so different that I still needed assistance. My poor hearing didn’t help either. Maybe if Bob Marley was playing in the background?

I’ve been to Peru and other Latin countries a number of times. Very remote regions lack anything resembling modern facilities, so all I do is extract teeth, which does relieve people of pain, sometimes excruciating pain. Along the way, I’ve learned enough Spanish to ask patients where it hurts and how to tell them to open, close, and spit—“escupir”—while pointing at the bucket away from me. After I have them close on a folded 2x2 gauze, my interpreter provides post-op instructions while I clean up for the next person in line. And there’s always a line.

On one particular occasion, my interpreter, after a couple of hours, realized that I actually wanted pressure for hemostasis. He suggested the word “morder” which means to bite down; I was using “cerrar,” which means to close. Just then, he was called away, but I felt confident enough to try my new word on the next patient. After all, I’d done this any number of times and was adept at grunting and gesturing while stumbling over my poor Spanish.

An incredibly nervous villager sat down in the makeshift clinical chair in the middle of the dusty village square. The old guy’s eyes bulged at the sight of all the gleaming, stainless steel instruments arrayed proudly on a wooden table with open bibs as tray covers. As I spoke gently and confidently, he finally settled down, although everything I said was in English. He flinched when injected but remained relatively still as I manipulated the tooth, which came out with minimal struggle.

I decided to try out my new vocabulary term. When I told him to bite on the gauze, he jerked away and looked wild-eyed at me. He half-stood as if to escape, but I was hovering over him and easily pinned him down. I grasped his chin and, a little louder this time, told him to bite in Spanish. As he frantically struggled to get free of my headlock, I yelled at him to bite down on the gauze that he was desperately trying to spit out. It turned in to a real free-for-all. Just then my interpreter reappeared, looking horrified. He asked what I was doing and I told him I was using my new word.

But I wasn’t. Instead of saying “morder,” I was yelling “muerte,” which means “die.” Pointing and grunting proved to be less upsetting to my patients and I returned to using, “Cerrar su boca,” or close your mouth, along with gentle upward pressure on the jaw.

I studied French in high school and in college and now wish that I’d spent more time on it; it’s the worst grade on my college transcript. It would have helped me with not only other languages, but with understanding other cultures as well. Knowing a little of a person’s native tongue helps you to better understand his or her thought processes. This, in turn, can build trust, which only makes your treatment modality more effective and your practice more personally rewarding. It’s never too late to learn, although I’m a little more careful about pronunciation now.

And Spanish-speakers can feel free to correct me on the finer points of my vocabulary.

Jim Rhea, DMD

1 comment:

Bruce Howell said...

Very interesting story. You have a great way of expressing yourself. Thanks for your service.


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