Languages (and Lack Thereof)

One of the best things about the West Midlands is the diversity of people that can be found here; there are slightly more than one million people living in Birmingham and almost a quarter of these were born outside of the UK. I like to think that the small snapshot of Birmingham life I see in the hospitals represents a charming microcosm of the Midlands and, if you allow me a small extrapolation, is something of a model of our terrific multicultural and international planet.

Most recently I’ve been placed in West Birmingham, an area of high ethnic diversity even for the midlands – overall only 53% of Birmingham residents identify as “White British” compared with 92.4% of those from nearby Worcestershire. 

According to a Telegraph article from last year there are over a hundred languages spoken by school children in Birmingham. (As is always the case with internet articles, best to ignore the comments. Here they are even more reactionary, right wing and racist than you might expect given this newspaper.) This rich complex of languages spoken is fascinating,  but occasionally leads to some interesting communication problems.

For example, I have a few Asian friends (see I can’t be x-ist some of my best friends are x), and I’m often jealous when they’re able to whip out some language skills and converse with some of the patients better than I can. However I especially enjoy when patients and staff assume language based upon someone’s appearance or skin tone, so there are a few medical students getting frustrated by their daily apologies and explanations that no, sorry, I only speak English. Now and then I fake offense when patients assume that I won’t be able to speak Urdu just because I’m white(ish), though it would be more convincing if I learnt some phrases to justify this.

Almost always patients will speak very good English even if it is their second language, though occasionally they will require some clarification through a linguistically talented staff member or understanding relative. Sometimes translators are booked too, especially for outpatient’s appointments, though sometimes this seems unnecessary. I remember a series of appointments during my psychiatry placement where a translator was duly booked every week for a completely mute schizoprenic patient, whose partner could speak perfect english anyway.

Occasionally all of these solutions are absent; this week I met a young man who was both completely deaf and completely Polish. Further, he had fallen off a motorbike in Greece and provided his (Greek) medical reports. His mother knew Polish sign language and spoke no English so an additional Polish to English translation step was required. This made for slow progress. Luckily, he was able to read some written English so when I had to take some blood I prepared a few notes to pass him. The notes seemed to be understood and when I waved my sharps bin at him he gave me the thumbs up.  I still gave a pointless running commentary of the whole process though.

I recently was talking to another excellent Polish gentleman with a fairly nasty looking deep leg injury. He couldn't speak perfect English but made sure that his slight lack of comprehension was more than made up for with his compliance and positive attitude. Are you feeling better today? Yes! Is your dressing comfortable? Yes thank you! Yes! Are you in any pain today? Yes! Where is the pain? Yes! No problem!
I am a big fan of this attitude.