True Stories – “Medicine in Translation”

by Elaine Zimbel

In person Dr. Danielle Ofri is an impressive woman with a healthy respect for the doctor/patient relationship.  She was guest speaker at a McGill University seminar entitled “Singular Intimacies: literature as a bridge between doctor and patient”, a topic which particularly interested me since I had given courses of my own design at the McGill Institute for Learning in Retirement about “The Literature of Doctors”.

Her message was about how important it is for doctors to listen to their patients’ stories, and of course I couldn’t agree more.  I mean, duh!   But where was the literature? I was disappointed.  I was thinking of Hippocrates, Rabelais, Chekhov, Maughm, William Carlos Williams, Conan Doyle,  and the many contemporary doctors like Perri Klass, Ethan Kanin, Jerome Groopman, Vincent Lam. Doctors who write.

I hadn’t read any of Danielle Ofri’s three books, and, my enthusiasm somewhat dampened,  I almost forgot that I had one on reserve at the library.

Then I had an annual check-up with a doctor whom I treasure.   He is a person who treats me like a person, a person he remembers from one visit to the next.  He is a man who reads books, always asks what I’m reading, and  though he is a  very busy man, he  is never rushed.  He listens.  He asked me if I had heard Dr. Ofri – he had attended an earlier lecture – and asked if I had read her latest book.  When I told him I was waiting for it at the library, he took note of that and before our visit was over, he put a copy of it in my hands and told me to return it next year.  It was a gift!  I mean, to read it!

Danielle Ofri is an amazing writer.  She can tell a story, she can keep you turning the pages, she can touch your heart, wring your soul, make you embrace her patients, even the difficult ones.  She never hides inside her white coat, she is always there, a person with feelings, with knowledge and doubts, anxieties, family responsibilities right along side her professional ones. (How can she get to the daycare to pick up the kids by six o’clock – $1.00 a minute late fee, tick tick tick –  and this patient’s visit is growing longer  and longer.)

Most important, perhaps, is her gift of generosity – how she willingly extends herself to find a context from her own experience, from that of her grandparents who landed in the United States from Europe, her father who came from Israel, to help her understand her patients, most of them immigrants from all over the world.

Bellevue Hospital in New York City, where she is attending physician, is the oldest public hospital in the United States, “witness to 276 years of human drama”.  It’s huge and awesome, a mix of old and new, and is, of course, up to date in all the high tech necessities modern medicine requires, and more:

“..in the last few years, Bellevue had leaped into the modern age of language interpretation….all I had to do was pick up my phone and dial extension 1800.    ‘Welcome to the Medical Interpretation Service,’ the recorded voice would say.  ‘Press one for Spanish. Press two for Mandarin.  Press three for Cantonese.  Press four for Fukianese.  Press five for Bengali.  Press pound one for Polish.  Press pound two for French.  Press pound three for Creole.’ “

With two phones on her desk, Dr. Ofri on one presses the required button and conducts her interview in English while the patient, on the other, responds to the simultaneous interpreter speaking from a remote location, and round they go.  It’s not great, but it works when there is no common language.

And sometimes even when there is.   Dr. Ofri’s Spanish comprehension is sometimes challenged.  Spanish, she explains, comes in many versions: there is the carefully articulated Spanish of the Mexican, Colombian, and Argentine patients, and then there is the “tsunami of pebble-strewn water” of the Dominicans and Puerto Ricans where “words rattled and flew, with barely a space for breath…l’s, r’s, and other..letters (are) casually dropped like excess baggage…(and)…unnecessary words, such as pronouns and articles, (are) shrugged off….. “

Inevitably  she gets  “lost in a verbal torrent….(as)…Senora Estrella kept up her avalanche of a monologue.  Her son was coming in from Santo Domingo to live with them, and the apartment was too small.  Her husband wasn’t working now, or maybe he was working now but hadn’t been working  before.  Or maybe it was the son who hadn’t been working but was now working.  The son and the husband didn’t get along, or maybe they used to not get along but now they did, or now they didn’t, or wouldn’t, or couldn’t, or shouldn’t.”
Ofri’s masterly account of her “losing battle to keep track of which thread of the story was going to turn out to be the critical one…”made me smile and at  the same time writhe in familiar discomfort (as a sometimes challenged English/French bilingual).

These stories are not written for medical students or for other medical practitioners.  They are written by an honest woman who needs to put it all together, all that she sees, all that she hears, all that she needs to understand.  Some of it is difficult indeed, impossible perhaps.  The very first story in the book concerns Samuel Chuks Nwanko, a young African man who for no apparent reason is so badly beaten that it is in her one pm Monday slot reserved for Survivors of Torture that Dr. Ofri first comes to know him.

I worried a bit about the ethics of Dr. Ofri telling these stories, but in small print it is explained that names and identifying details of her patients have been changed, expertly and convincingly, I must add.  And in the text she mentions that she has asked the permission of her patients – Samuel, Julia Barquero, Dr. Chan and Mrs. Geng, Senora Estrella, Jade Collier, Azad Aptekin, and more.  I will not attempt to paraphrase their stories – I must let Dr. Ofri do it her way, not as in “case studies”  but in threads woven throughout the whole book along with her own story, as vital and real as theirs.

So what is literature, anyway?  Fiction, yes, imagination, yes, the author discretely hidden behind the characters she has created.  And also true stories told with incredible skill by an actor in the drama, a bit-player perhaps, and yet the one with the most important role of all – not that of doctor but of messenger, the one who tells the tale to the rest of us.

by Elaine Zimbel

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