By Lisa M. Belisle, MD, MPH
Originally published October 4, 2007, The Maine Switch

I have a friend who wants to be a writer. He is a thoughtful, well educated physician who has practiced medicine for many years. Yet he hesitates to commit his thoughts to paper because English is his second language (he was born and raised in Argentina). My friend worries that when he finally shares his story something will be ‘lost in translation.’

Last spring I spent some time experiencing the ‘lost in translation’ phenomenon firsthand—and I mean truly lost. Having never strayed far from my native land, I believed my globe-trotting acquaintances who assured me that “you don’t need to speak Italian to go to Italy.” This was good news from my standpoint: my background consisted of a fair number of French courses with a smattering of Spanish and Latin thrown in. I did try to master a few Italian phrases before leaving the states. Ultimately none of this was overly relevant as my friends and I attempted to navigate the country in our rental car. At various times we ended up

• at unmanned toll booths, with incorrect change going in the wrong direction,
• taking prolonged detours through the Tuscan hill country, and
• circling Siena in the dark for hours on end.

We also discovered that although ‘all roads lead to Rome,’ some take MUCH longer than others. What did I learn from all of this? That it didn’t matter how well I could communicate in my own country: my skills were inadequate elsewhere. I felt vulnerable, confused and occasionally ashamed—and I wasn’t even trying to write in a different language, I was just trying to vacation.

More than 40 million Americans experience these feelings of vulnerability and confusion on a regular basis. Some of these individuals are non-English speaking. Others are English speaking, but they are considered ‘functionally illiterate.’ These people have difficulty interpreting road maps, grocery store packaging, job applications, medication instructions and health information. They have difficulty comprehending the world in which they live.

An inability to comprehend one’s world can have sobering consequences. In Anne Fadiman’s book The Spirit Catches You and You Fall Down, a Hmong family fails to follow through with medical care for their severely seizure-disordered child. They believe that she has been embodied by evil spirits, a notion that her health care providers have difficulty disproving.

Health care providers have become increasingly aware of the need to breach barriers caused by a lack of common language—and they have started to take action. MaineHealth is sponsoring the “Health, Culture and Literacy” conference on October 28. Anne Fadiman will be the keynote speaker. MaineHealth has also worked diligently with the statewide literacy program Raising Readers to provide books to children (birth to age five) at all well child visits. Founded seven years ago by the Libra Foundation, Raising Readers will celebrate the distribution of its one millionth book this month.

Whether it is sharing books with babies or endeavoring to navigate foreign byways, improving communication is a critical (and rewarding) pastime. My physician friend obviously agrees: he recently sent me the beginning of his future bestseller. I can’t wait to read more. But first, I need to brush up on some skills of my own. Arrivederci!