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Medicine’s real language barrier

A Turkish friend of mine told me that he had saved for several years to bring his grandmother to America for a visit. His pre-teen son had met her only twice in his life (via trips to Istanbul) but they corresponded frequently and had a very close bond. My friend said he wanted to surprise his son by having his grandma at home when he came back from school on his 14th birthday. The only hesitation, my friend said, was that his mom didn’t speak any English and he was worried that she might get lost during an airplane transfer or in the airport. He worried that she would be afraid and alone.

Being in a foreign country where you don’t speak the language can be a frightening experience. When I was a teenager, I flew to Zaragoza, Spain to visit a friend of my mother’s. I felt excited at take off from the US, but as the plane approached the unfamiliar red soil of our destination, a sense of uneasiness settled in. The flight attendants started messaging in Spanish, and as we touched down I knew that I wasn’t home anymore. All I knew how to say was “hola.”

As I made my way through the airport, all the signs were in Spanish, I knew I needed to get a cab, but I wasn’t sure where to wait – and the Spaniards didn’t seem to respect queues. Once I fought my way to the front of a gaggle of natives, I realized that the cab driver needed to ask me clarifying questions about my friend’s address. I responded in English, to which he repeated his question with increased volume. I felt really stupid and quite helpless.

My experience was kind of similar to the feeling that patients have when they are thrust into a medical situation with a sudden, life threatening illness. Healthcare professionals can forget how foreign everything is to the patient, and go about their activities without explanation, or with jargon-rich “medicalese” that is virtually inscrutable to the person with the illness. When questioned, they repeat the jargon, raising their voice for emphasis and “clarity.”

Hospitals spend lots of money on translator services for foreign languages, but many healthcare professionals forget that medicine itself is a kind of unique language that requires translation. As the consumer driven healthcare movement takes wing, it will be more and more important to provide a kind of translator service for those who need to make educated decisions about their medical options. The accuracy of the translation can be a matter of life or death, and so healthcare consumers need to be very selective in where they get their information. Considering the source of your information has never been more important. Don’t let your health be lost in translation.

This post originally appeared on Dr. Val’s blog at

The art of being different – a girl scout’s story

Girl scout cookie season is upon us, and recently our office was swarming with youngsters taking cookie orders. I wasn’t sure which girl I should order from (one can’t really order from each of them and expect to maintain any semblance of a normal BMI) and as I was considering how to choose, one energetic little girl simply walked right up to me and asked if I’d like some cookies.

She was slim and blonde, with bright eyes and an honest face. I knew the “sales pitch” didn’t come naturally to her, and I tried to make it easier by joking a bit. She was shy, but on a mission. I asked her which type of cookie she liked best, and if her daddy ate too many of them. She was innocently pleased with the interaction and disappeared down a hallway near some cubicles.

Many weeks later a large delivery of girl scout cookies arrived. There was a mass distribution strategy in place with moms and girls cutting open cardboard boxes of cookies and delivering them to buyers. I asked if my cookies were on the list. They told me that they didn’t sell me the cookies, so I’d need to wait for the specific little girl who sold them to me to stop by.

About a week later, when I had assumed that my little girl scout had forgotten about my order (and the rest of our staff had well and truly gorged themselves on thin mints), her dad came into my office with a pretty bag tied with a ribbon and a hand written card from his daughter. He told me she asked him to deliver it personally, because she wanted her service to be different than the other girls. Her dad joked that he was trying to train her about “differentiators” but I was quite touched by the effort she had made to make me feel like a special customer.

Later that afternoon I sat down to write a thank-you card to the girl. I wanted her to know that her efforts made a difference, and that I noticed her hard work in making my cookie purchase a personalized experience (not just part of a bulk delivery service). I put some stickers on the card, I used colorful paper, and a big red envelope.

A few days later I asked her dad if she liked the card. This is what he wrote to me:

“She loved it. She saw it at breakfast and came screaming upstairs to show it to everybody. Thanks!”

That really made my day. I hope in some way that I’ve encouraged this little girl to continue to reach for excellence, to stand out in the crowd, and to know that her work is appreciated. It is this sort of attitude toward life that will help her grow up to be… a revolutionary.

This post originally appeared on Dr. Val’s blog at

Does “aging gracefully” require plastic surgery?

In this latest report from the BBC, we see that our friends across the pond are just as obsessed with appearance as we are in America. Apparently, women in their 70’s and 80’s are getting cosmetic breast surgery and face lifts.

One surgeon is quoted as saying:

“We have a growing population of pensioners – and for those who want to maintain a good appearance, ageing gracefully, the surgical options are there.”

Since when did gracefulness have anything to do with surgery?

I wonder if we’re missing the more important things in life (friendship, love, kindness, charity) by focusing on our exteriors? Beauty is a matter of the heart, I think.

Sophia Lauren once said, “Nothing makes a woman more beautiful than the belief that she is beautiful…” but then again, it looks as if she’s chosen to have extensive cosmetic work done as well.

What do you make of the growing trend in plastic surgery among seniors?

This post originally appeared on Dr. Val’s blog at

Food Labels: Brits Vote to “Keep It Simple”

In a recent poll, 80% of consumers (along with the British Medical Association) preferred a simple “stop light” food label to a long list of percentage figures of recommended daily amounts. The stop light icon simply categorizes food as containing low (green), medium (yellow), or high (red) levels of the following ingredients:

  • Fat
  • Saturated Fats
  • Sugar
  • Salt

The guideline daily amounts (GDA – the rough equivalent of America’s RDA system) supporters argue that the stop light is an oversimplification, and does not effectively convey all the important nutritional value of food.

What do you think? Would you like to see this sort of labeling in the US?

This post originally appeared on Dr. Val’s blog at

What does a twinkie have in common with your car?

Well, twinkies are made of petroleum (among 38 other ingredients), and gasoline is also a type of petroleum product! This gives “food as fuel” a new meaning.

Dr. Charles, a young family physician, reviews the ingredients of twinkies in his recent blog post amusingly called “Reduce Twinkie Consumption and Dependence on Foreign Oil.”

This reminded me of the shock I felt when watching a documentary about America’s oldest citizens recently. I clearly remember them interviewing a man who was about 105 years old, who lived alone and used a golf cart to get around outdoors. The interviewer couldn’t resist asking the man why he thought he had lived so long in such good health.

The man said, “Well, I eat pretty good, get enough sleep, and I don’t worry about much.”

The interviewer then asked a probing question, “What do you eat?”

And I leaned in towards the TV screen, curious as could be.

And the elderly gentleman said, “Well, I eat a bowl of cornflakes for breakfast and then I usually eat a twinkie later on…”

Either the segment didn’t plan enough seconds for further investigation, or that was the sum total of his nutritional advice.

I was dumbfounded. For some people, it seems, good genes and good luck take them a long way.

But I’m still not going to eat petroleum products.

This post originally appeared on Dr. Val’s blog at

Latest Interviews

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I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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Unaccountable: A Book About The Underbelly Of Hospital Care

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