Without language, the doctor can't diagnose. But what happens when the doctor has to switch languages?
John Bruzzi, an Irish radiologist, recently spent time on a fellowship in France. In a surprisingly well-written essay for the New England Journal of Medicine, he describes what it was like to translate his painstakingly honed diagnostician's vocabulary into his not-quite-perfect French.
When I arrived, I was proficient enough in French to formulate a radiology report, though it involved a long, painful process of interpreting the images and mentally translating my thoughts into French. My reports were short and full of curt, declarative sentences that read like barked military orders. ("The right lung is normal. In the left upper lobe there is a mass. A big mass. 5x6 cm. Probably lung cancer.") Subordinate clauses, subjunctives, and commas went out the window. When asked my opinion about something, I could only point to the relevant images and describe abnormalities as "cancer" or "infection," "big" or "small." There were no gray areas, no doubts, no conjectures. Sitting on the fence — a radiologist's stock in trade — necessitates using words for balance, weighing diagnostic probabilities, and leaning toward the heavier side. But because I couldn't use the subjunctive mood, I was forced into the realm of apparent diagnostic certainty.
The Journal requires subscription for full-text access. Far be it from me to steal a dollar from the Cambridge biomedical establishment -- I'm not going to post the whole article here. Ask someone to get it for you, since it's well worth reading.