Jonathan Woo
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January 27, 2025
Speaking a patient’s language bridges gaps, fosters empathy, and ensures no one is left unheard in our complex healthcare system.
The labyrinth that is America’s healthcare system consists of endless twists and turns that invoke frustration from all ends. Patients face challenges determining the care they need, can afford, or is available. Obstacles such as insurance claims, health inequities, and the laundry list of healthcare policies and regulations all contribute to the extensive and arduous pathway of obtaining proper care. This process leaves Americans perplexed; now, imagine navigating the healthcare system without knowing any of the aforementioned terms or having English literacy at all.
Many challenges that immigrants and novice citizens face when assimilating into a new country stem from the language barrier, with one of the major challenges being access to healthcare. Healthcare literacy is defined as the ability to understand and utilize information and services available to make informed decisions about one’s health and care. The coupling of English and healthcare illiteracies leads to a domino effect of ignorance and inexperience. The Asian population is the fastest-growing minority group in the country, with 57% of all Asians—about 6 in 10—being foreign-born, all of whom come from a plethora of different cultural backgrounds and ethnicities1. Countries like Japan provide universal healthcare to their citizens, in which most, if not all, of the cost is covered by the government. With a larger land and population like China, a variety of private and public options for healthcare is available to its residents2. Regardless of their previous knowledge of healthcare, immigrants must eradicate all of their existing experiences and learn to adopt the American system, which can feel overwhelming, to say the least. Translator services are available in larger corporations and settings, but they are not always offered, nor are they always the most convenient or timely.
Having healthcare providers that speak their language eliminates one of the biggest obstacles between them and their care. Being able to communicate freely and effectively can make a world of difference. Healthcare workers fluent in the native tongues of their patients can provide culturally competent care that addresses patient concerns effectively and creates a trusting and therapeutic relationship with their patients, thereby reducing health disparities and inequities.
During clinical rotations as a nursing student, an instructor will pair you with an experienced nurse to assist with the care of their patients for the day. My nurse and I were assigned to rooms 1 and 2, so I went about my day completing the tasks and care for those two patients. Coincidentally, my classmate was assigned to rooms 3 and 4. I caught a quick glance of the patient in room 3 who was lying there, intubated, sedated, ventilated—seemingly lifeless. There was an older Asian man, who I later found out was the patient’s fiancé, video chatting with the patient’s family with a Chinese song playing in the background.
We were only about an hour into the shift when I saw several people gathered outside the patient’s room. The man stood over her, crying, as she was extubated. It was then I realized she was lifeless and had passed away in silence. Another nurse who spoke Korean tried to assist, as the fiancé, though Chinese, also spoke Korean. Despite her efforts, she grew frustrated, unable to fully translate the medical jargon. The Korean nurse moved in and out of the room, visibly frustrated by her inability to fully translate the medical jargon with her limited Korean. Eventually, another nurse retrieved the translator phone to call an interpreter, a process notoriously marked by long wait times to connect with the right representative.
The patient was trying to say something in the best possible English, but the sentences were incoherent from a mix of grief and illiteracy. I, myself, spoke Chinese, and I felt compelled to speak up so he would feel less alone. “我們明白。我們會幫助你,” I said, meaning, “We understand, and we will help you.” He looked at me, stunned, with widened eyes and said, “So you made me use English when you spoke Chinese this entire time?” We shared a laugh, which I was happy to evoke to alleviate some of his sorrows. He quickly gestured for me to speak to the nurse that was originally responsible for the patient. From this point on, it was pretty much established that I would be letting go of my original patient assignment to help facilitate communication and translation for this man and the deceased patient.
With me, he was able to share both his sorrows and frustrations. Since they were not yet married, he had no legal authority over the patient’s end-of-life wishes, including cremation and returning her remains to South Korea. As a non-citizen, the process felt overwhelming and unfamiliar. He needed a lawyer because her last wishes were recorded on his phone without legal documentation. Helpless and unsure how to proceed, he struggled to find a mortuary or lawyer. The nurses, unfamiliar with the process, assured him he could manage as her fiancé but stated they couldn’t assist further.
I helped the fiancé call the mortuary, only to discover that the nurses had been misinformed—he could not request cremation or move the body without legal authority, as he had explained from the start. To make matters worse, it was a Saturday, and most law offices were closed. Despite my limited experience with such legalities, I took it upon myself to assist, knowing my ability to speak Chinese could bridge the communication gap. After hours of Google searches and phone calls, I found a Chinese-speaking law office open and helped him schedule an appointment for Monday. I also coordinated logistics, teaching him how to use rideshare apps, documenting important details, and providing emergency contacts—all in Chinese.
After I explained the entire process for the late patient, I offered him the chance to ask questions. Instead, he did something unexpected—he hugged me. In that moment, his embrace conveyed a universal language—one that required no words to be understood. Being able to connect and communicate with this man illuminated the impact that language can have as a healthcare provider to foster true empathy, advocacy, and trust.
During my brief time with the patient and her fiancé, I uncovered details that were crucial to our interaction yet unknown to others. The patient’s son, her next of kin, lived in Germany, too far away to assist in time. The fiancé, born in South Korea and raised in China, had returned to his homeland with the patient, explaining his fluency in both languages. I also learned that the patient had been a passionate, celebrated singer in China before her battle with leukemia, a legacy reflected in the melodies that filled her room as she passed.
Language is an essential thread in the fabric of our daily lives—often unnoticed until it is absent. In seeking medical care, the ability to communicate effectively empowers patients to articulate their needs and collaborate on solutions. Without this ability, expressing emotions, desires, and requirements becomes a struggle, unraveling the entire process and creating a chasm between patient and care.
The ability to communicate in a patient's native language can mean the difference between life and death—or, as in this case, bridging the gap to navigate complex processes. Multilingual practitioners hold the power to dismantle barriers, restore dignity, and ensure that no patient is left unheard or unsupported.
Sources
Jonathan is a Chinese-American nurse from Southern California.
jon.woo33@gmail.com
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At AAPI Chronicles: Voices in Medicine, we are committed to fostering a supportive and inclusive environment where the AAPI medical community can share their stories, celebrate their achievements, and advocate for a more equitable and compassionate healthcare system.
