Language Barriers: An Obstacle That Can Be Overcome
In the summer of 2024, I had the opportunity to intern at Prisma Health Ophthalmology and work as an ophthalmology technician. There were so many interesting patients during my time at Prisma, but some of the patients that had the most impact on me were the ones who were losing their sight. Being the person to discover that kind of information about someone was very difficult especially after building a relationship with the patient. Having to inform the patients of this news was even harder. Add a language barrier on top of that and you have an unbelievably difficult situation.
Having a language barrier between health care providers and patients is a big issue and can lead to a lot of problems in health care. In many cases it can erode the trust between patients and their healthcare providers. In even worse cases it can lead to miscommunication and the patient becoming confused and, in some cases, not receiving the care that they need.
A lot of the patients we had in the optometry department were recurring patients with chronic eye conditions such as: glaucoma, macular degeneration, and retinal detachment. One man in particular came in complaining that he was seeing dark spots in one of his eyes. The man spoke Spanish and very limited English, so we had to use a translator on the computer. We went through the whole routine of his eye exam where we asked him to read the Snellen chart (measures visual acuity) with his eye of concern, took his intraocular pressures, etc. After all of this was done, the doctor ordered an OCT scan (a picture of the back of his eye) in order to find out what was causing the darkness in his vision.
I was the one who was sent to do his OCT scan because I was still learning how to use the machine, and they wanted me to practice using it. When I brought the man to the OCT machine I began to take a scan of his eye. The language barrier was not a problem at the OCT machine because he knew enough English to understand when I was asking him to move his head to the left or right. There was one problem however and that was that I could see nothing. The screen was completely black no matter how much I adjusted the camera. I thought that I had done something wrong at first, so I went to grab one of the other technicians to check for me. She also could not get the screen to show anything but black.
This is what a regular OCT scan should look like.
At this point we gave up on trying to get the scan done because it became evident that we weren’t going to see anything. We told the man he could return to his room and then we went to ask the doctor what was going on. She informed us that it was likely a retinal detachment and that the retina had fallen to the point where it was covering the camera.
Retinal detachment is exactly what it sounds like; it’s a condition where the light-sensitive layer, the retina, detaches from the back of the eye and begins to pull apart from the layer it’s connected to. There is a partial retinal detachment, this can be fixed easily through a very simple surgery. There is another form of retinal detachment where the retina has completely detached from the back of the eye, this is much harder to fix with surgery and has a much lower success rate. The man who I had to get an OCT scan for unfortunately had a full retinal detachment. Otherwise, the camera wouldn’t have been completely blocked.
After making this discovery, it was time to tell the man the bad news. I felt that I should be in the room with the doctor when she told the man this news as I had been the one to discover the issue. The only problem was that optometry terms don’t always translate over very well from English to Spanish. While the doctor was trying to explain the situation to the patient and his family, there were many issues with translating certain words into Spanish even with the help of the translator. Despite the struggles with translation, the doctor was able to explain the situation to the man and refer him to a specialist that could help him with retinal detachment surgery.
Witnessing a situation where there was a communication barrier between the healthcare providers and the patient made me think differently about what it’s like to live in a country where few people speak the same language as you. I felt sad for the man that he had to receive such detrimental news through someone talking to him on a computer. It made me think about how isolated it must feel to live in a country where you can have something go wrong with your health and your doctor can’t speak with you directly about what’s going on.
It also made me feel grateful for the ability to use technology in order to bridge the communication gap between healthcare workers in America and those that can’t speak English. If there had been no translator there then that man would’ve never known that he had retinal detachment, and he would’ve literally been left in the dark. I can’t imagine how scary it would be to go into a medical office and not be able to understand what is happening. I’d imagine it’s even scarier to get bad results and not be able to know what those results are.
In my future practice I hope to always have access to a translator so that my patients are never left in the dark and can receive the health education that they need. I would also like to learn Spanish since it’s so widely spoken in the United States. This way I can help bridge the communication barrier between patient and provider. Language barriers between the patient and their physician will never be easy, but with the right resources this obstacle can be overcome.
Leslie Parker is from Lexington, SC. She will graduate in May 2025 with a Bachelor of Science in Biology. She did her internship with Prisma Health Ophthalmology in Columbia, SC. Following graduation, she hopes to attend PA school at the University of South Carolina.