When I graduated from medicine, back in 1985, I started working as an intern at Royal Prince Alfred Hospital in Sydney. It was a fairly terrifying experience, and within the first few hours I realised I was far out of my depth, and that despite five years of study at Sydney University I knew almost nothing about being a doctor. Sharing my feelings of floundering some years later with one of my medical mentors, he smiled and said simply, “Ah, when you finish medical school, all you really know is the vocabulary!” There was still so much to learn, still so much experience to accumulate, before I could really say I was a doctor.
Yet the vocabulary is not to be underestimated in its importance. Now, four weeks after starting as a general practitioner (allmänsläkare, or distriktsläkare in Swedish), I begin to see that one of my biggest problems is that I don’t even know the vocabulary. Medical Swedish was not covered in my Swedish course, despite the fact that Socialstyrelsen, (the Medical Board), was satisfied that I had achieved the necessary level of language training to start working as a doctor. How was I to know that a vrist was actually an ankle and not a wrist (handled)? I quickly discovered that I didn’t even have the verbal ability of a five year old when it came to medical explanations.
Thankfully my comprehension is better than my speaking, so at least I generally know what they are talking about, even if they don’t know what I am trying to say. Patients are, well, patient, and some of them can laugh about it. I have now settled into the pattern of introducing myself as follows. “Hello. My name is… I am from Australia and my Swedish is rather bad, so we must take it rather slowly.” The problem is, I can now say this sentence so fluently and fast that no-one believes I am hopeless at Swedish, responding usually with, “It sound’s OK to me,” then launching into a detailed explanation of their symptoms most of which flows right over my head.
It doesn’t take long for them to realise that I am telling the truth… I’ve tried the nodding and smiling approach, but it doesn’t always work…