"Que?"

This little clinic at which I'm finishing out my family practice rotation does a lot of IMEs - independent medical examinations for insurance companies. They also do bus-driver physicals, and one gets sick of the rigmarole after a while - however the doc who's supervising gives a lot of leeway, which I like. Instead of being so pressed for time that he has to move at lightning pace through the patients, he allows us to sit and think about the best course of action, whether it be simply a lifestyle modification, adding a drug, changing a dose, or referring, and discuss it with him. With every patient I get more comfortable with the mental algorithm necessary to plot a favorable outcome, and with every physical exam, I hone my skills.

My Spanish has gotten a little better every time I've been back to Miami, though I dislike being forced to speak a different language in my own country. More than that, I dislike it when people can understand some English, and just say they can't; it's very frustrating. Roughly half of the patients in this clinic speak English - another quarter only speak Spanish, and another quarter only speak Creole (somehow, this close to little Haiti, we only have one medical assistant who is able to translate for us. She's kind of the boss). I can't imagine going to a foreign country and getting medical care without knowing how to communicate - especially if I was planning to live in that country. Forever. However, when two guys in short-sleeve shirts and ties come to my door on a Saturday morning with pamphlets and ask if I speak Spanish, I don't.