Found in Translation
Eesha Dave
Identifying patient information has been changed in this story.
Mrs. Zimi was an elderly woman, who did not want to be in the hospital. She had been admitted overnight for subacute, relentless diarrhea that had wrung her dry. The kind of unforgiving dryness that left black rings around her eyes, and made her cracked skin stick straight up off of her bones. It wasn’t until we got five liters of fluid into her, and her skin swelled and flushed in a life-filled way, that I had a better sense of what she truly looked like.
The first time I met her, I walked into a pale room to find an even paler woman lying on withered sheets in her hospital bed—a sign of a night spent going to and fro to the bathroom. She was cradling a plastic bin full of watery vomit.
Hi there, how are you today?
I am Mrs. Zimi, my English is no good.
Ok, no problem. What is your language?
No English.
What do you speak?
Huh?
Language???
Oh, Urdu!
We broke through. I called the interpreter hotline, and waited fifteen minutes, during which I idled the time by smiling pleasantly at Mrs. Zimi and staring at the rain pummeling down the windows. Eventually, we got through to a gruff man who spoke the language.
That first conversation was one of many that we had. It was a time I learned her initial story. She was a 74-year-old woman, originally from Pakistan, who had had Hepatitis C for decades before receiving treatment just a couple months prior. She had started experiencing watery diarrhea about five weeks ago, which had been chalked up to be “colitis” of an unknown variety. She also had new liver masses, concerning for malignancy given her history, but only her son knew of this.
So Mrs. Zimi, who decided halfway through our conversation that she no longer felt the need to vomit, placed the plastic bin aside and smiled at me, and said, please fix my stomach pain. Because for all she knew, she was having diarrhea and nausea, and her asymptomatic liver, per her astute observations, was “fine”.
As I learned these details about Mrs. Zimi during those first minutes together, I also learned something unexpected: I understood Urdu. Raised by Indian Hindu parents, Urdu—the language of predominantly Muslim Pakistanis—was not what my family spoke. We spoke Gujarati and Hindi. Over the years, I had been told that Urdu was similar to Hindi, but it wasn’t until I heard it for the first time on that rain-splattered day that I believed this. Despite being told for my entire life, that Urdu was not the language of our people, I began to wonder what that meant. Pakistan and India were the same country until 1947, and Hindi and Urdu were now almost the same language to my simple ear.
However, I did not say any of this to Mrs. Zimi. Regardless, she quickly realized that I understood her in Urdu and oscillated between languages depending on her comfort level and urgency. When she spoke in English, she seemed to be doing ok. Yet, when she stopped saying “pain” and instead said “dhukhow”, I understood that her discomfort had superseded our basic scales.
One day, I arrived early in the morning to find her hunched over in bed, the darkness around her eyes had returned. Her skin had wilted again, and was now bruised—a not-so-subtle mark of the DVT prophylaxed. Do something, her eyes screamed. Kuch karo nah? She begged. I nodded and ran back to my team, determined to augment her diarrhea, vomiting and abdominal pain regimen in any way. After a week in the hospital, we only knew one thing about her symptoms—they were getting worse.
Over the following days we spent together, Mrs. Zimi’s bilirubin rose and her skin jaundiced. On our ninth day together, I realized that the hue was truly her skin not an artifact of the fluorescent lights. The yellow spread across her eyes and legs and tongue.
Yet despite all of this, our relationship continued to grow. We used the interpreter phone less. Instead, I had learned to quip and mime and circumlocute with her the way I did with my own grandparents, who spoke broken English. However, I never once ventured saying anything in Hindi or Urdu to her. That seemed too bold. Because while I understood both, I did not feel comfortable speaking either language. I feared that trying to might expose me, make her realize that our bond was not so strong.
On our tenth day together, she told me that I was her friend. As I bid her goodbye over Thanksgiving weekend, she held up her phone and said, “you can call me!” We both laughed. Despite years of wars and cultural differences, I realized that within our two nations and heritages were incredibly similar people. I only have Mrs. Zimi to thank for this.
Eesha Dave, MD, is a resident in Obstetrics and Gynecology in Pittsburgh, PA.