How Language Affects Health
This book excerpt is from Chapter 1 of my upcoming book, A Case of Culture, available for purchase starting January 23, 2022. Learn more about the book here.
Some months ago, I was reading a case study in a Health Literacy textbook in which a young woman had taken her elderly Navajo grandfather to a local internal medicine clinic in a small Arizona town (Health Literacy, 2004). He had an infection on his right leg that was growing larger and larger as the days passed. Unable to bear the pain of his leg and the berating of his granddaughter, he agreed to go to the clinic with her.
During the appointment, the doctor took a look at the infection. It was already pretty severe, and it could have led to the grandfather losing his leg had he waited any longer to come in.
“You came to us at the right time. You need to take this medication if you want to treat this infection. Otherwise, it can get a lot worse,” the doctor said.
The grandfather, who did not know English, couldn’t understand a word that the doctor was telling him. The granddaughter offered to serve as an interpreter for her grandfather, but unfortunately her knowledge of medical terminology in Navajo was limited. As she attempted to convey to her grandfather what the doctor was trying to say, she struggled to translate the word “infection” into Navajo.
Now, language is possibly the most complex and extensive representation of a group’s culture. But when a culture lacks a certain concept or uses different means to explain a concept, there is often no direct translation available to explain said concept. For example, the Hmong culture has no direct word-to-word translation for “chemotherapy” because they have no concept of cancer as a disease. In fact, there is no word for cancer either. The word that they use for cancer translates to “death.” Cancer is viewed as a fatalistic condition, in which cancer marks one’s unchangeable destiny of death. So, in order to translate “chemotherapy,” one would have to resort to a several-pages-long explanation of what cancer is, what chemotherapy treatment does to the body, and what the patient might experience as a result of receiving chemotherapy (Baisch, 2008).
This undoubtedly requires much knowledge of both the culture of the patient and the culture of the Western healthcare system, as well as experience with working within both of these starkly different cultural groups. Inexperience or lack of knowledge of either culture can lead to dire consequences. One inexperienced interpreter attempted to explain the idea of “radiation treatment” to a Hmong patient, who had no concept of cancer as a disease, let alone of radiation as a treatment. “We’re going to put a fire in you,” the interpreter explained poorly. Needless to say, the patient was horrified and refused treatment entirely (Morse, 2003).
This was exactly what happened with the Navajo grandfather. In the Navajo culture, there is no concept of “infection,” since disease is believed to be a result of anything from improper conduction of rituals, to accidental contact with chindis (evil ghosts), to breaking taboos set in place by the Holy People. There is no concept of bacteria or microorganisms that can enter a wound and release toxins and incite an immune system response. The closest Navajo interpretation of infection is “contamination,” or the idea that inappropriate contact with animals, natural phenomena, or witches can cause illness (Csordas, 1989).
The granddaughter struggled to explain the concept of “infection” to her grandfather, who sat there confused about what was going on. The doctor asked one of the nurses to help with interpretation. Though the nurse was well-versed with the patient’s case and understood the basis of his bacterial infection, she too was unsuccessful in conveying this concept into the patient’s own language.
The grandfather grew frustrated from the confusion and lack of clarity. He just wanted to get out of there and find someone who actually knew what was going on and could explain it to him properly. So, he did what most patients do when they don’t understand what the doctor is saying. He nodded as if to say “okay,” pretending to understand what was going on.
In this article series, I share excerpts and stories from my book, A Case of Culture. If you would like to learn more about what happens next, you can find the rest of the story in Chapter 1 of my book, releasing this January 23 on Amazon, Barnes and Noble, and other retailers. If you enjoyed this book excerpt, please consider subscribing to this weekly excerpt series and sharing it with your network. To learn more about the book, visit my website. If you would like to connect, you can reach me here via email at firstname.lastname@example.org or connect with me @snigdhanandiauthor on Instagram and Facebook.