As most of my patients are exclusively Spanish speaking... I often play a funny little head game of speaking in Spanish while writing in English simultaneously during each visit... I like to think of it as my mental training to stave off Alzheimer's well before its time. This being said, it's rare that I speak English with a patient, and often find myself translating my common "medical discussions" from Spanish to English in my head as I spout of frequently used patient education, medication instructions, the occasional diabetic threat and the like.
Yesterday, I had the unique opportunity to examen a patient who spoke no English or Spanish. This was a lovely Turkish patient, who was complaining of cold symptoms. This patient arrived wearing hijab with a floor length black non-descript coat, and a dark head covering and I was immediately conscious of respecting the personal privacy such attire suggested. At her request, the kind son translated the subjective portion of the visit, but the exam involved slight disrobing, and thus, son was kicked to the waiting room till the diagnostic portion of the visit.
In community health, it's best to ask patients to bring all their bottles to the visit... resulting in large crumpled plastic bags, totes, and coolers full of random pill bottles which the provider arranges precariously on the side of their desk, attempting to create a med list from nondescript worn labels and foreign medication names ... but hey, it beats "I take a green pill for blood pressure sometimes, and a birth control pill in a pink box" which is the normal "med list" we can otherwise expect. This patient had brought her pills with her, true to our request... and when she pointed at a bottle of thyroid medication, she then looked me in the eye tenderly, and pointed at my neck and then hers.
Caveat... this NP is a thyroid cancer survivor, a badge I proudly wear, and truly do not mind the frequent inquiry as to the origin of my thyroidectomy scar (albeit.. if the comment is along the lines of "why did you try to kill yourself like that" or "are you in a cult"... both of which I have heard several times... my answer will certainly be directed at directly embarrassing the ignorantly inquisitive small mind behind such questioning).
As I pulled open the black fabric of my patient's covering, I noted the same thyroidectomy scar... sisters in experience... we gave each other a hug, and a kiss on the cheek, and embraced for a few moments, before, with a deep sigh, settling into a visit of no words, many gestures, and a deep shared trust. A positive strep test, and some amoxicillin later, she was on her way.... and I was left with the kindness of her gesture and a deep sense of place, satisfaction, and acceptance.
These are the moments I love my job... when the unspoken language between two people is so audible, it is impossible not to hear and connect to the essence of being human.