How To: Be Awkward

There is nothing more awkward on this island than when the Portuguese doctor you are following for the day leaves you, the American, alone in the room with a Portuguese-only speaking patient while they run an errand or see another patient. An ethnic chameleon, I am frequently (and wrongly) perceived as Indian, Pakistani, Armenian, or Spanish - to name a few - and it is not always so apparent that I am not, in fact, a native Azorean. So what to do when the doctor exits the room and I know that I'm about to be hit with a stream of rapid-fire Portuguese? Option 1: Avoid eye contact with the patient. Become suddenly fascinated with the laces of my sneakers, the cloudy sky outside the window, or the antibacterial soap container in the corner and hope this is enough to stave off conversation. Option 1, however, really should not be employed as the patient then thinks I am an entirely disinterested, disrespectful medical student. Therefore, the usual resort is Option 2: start laughing with the patients whenever they start to laugh at their own stories, randomly interspersing smiles and head nods wherever possible. The key to successful application of Option 2, however, is laughing only when the patient laughs. I don't want to laugh, for example, if they are telling me about the uncontrollable gas they have been having. Then it would blow my cover that I do not, in fact, understand Portuguese or the lively stories the patients typically seem inclined to share to with their doctors! Either that or they will assume I have a sick sense of humor and become offended. Option 2 tends to run out of steam quickly if the doctor is gone too long, though, resulting in a last resort: Option 3. The deer in the headlights look, which I like to think I have perfected pretty well. During which I hope the patient finally has a silent understanding that I have not understood a word of what they said for the past however many minutes.

On Tuesday, I was shadowing in the emergency room when, no surprise, I found myself alone in one of the examination rooms with a patient. But lo and behold! This patient spoke only English - just like me! SO EXCITING. It was one of the first times in the hospital that I felt like I was actually able to connect with a patient and put him at ease while he was awaiting his intramuscular injection. He was an elderly man and mostly we talked about his Azorean-American heritage and what finally inspired him in his old age to move to San Jorge, another one of the islands. He even gave me some tips of what to do while the group is visiting Sao Miguel (the big island) this weekend. It was so great not to be staring up at a mile-high language barrier for once and to be provided the opportunity to work on patient-doctor interaction, a skill that it has been difficult to cultivate during this internship simply because I do not speak the native language at all. Hopefully I will interact with a few more English-speaking patients during my time here but in the meantime, I've still got Options 1, 2, and 3 in my back pocket.

Until next time,
Vanessa