Note: This spring, a proposed requirement that all physicians at Jacobi Hospital in the Bronx learn Spanish aroused the teapot tempest, with denunciatory headlines and self-serving soundbites from our locals pols, New York State Sen. John Marchi's among them. The following commentary was published in the June '97 issue of a Staten Island newspaper chain, the Star Reporter group, as an Op-Ed piece. (Marchi's home base is Staten Island.)

Sirs:

While aspects of the proposed language requirement for doctors may seem ill-considered, I think that both Sen. John Marchi's response and yours entirely miss the point by standing on principle.

The Senator's position reflects his startling ignorance of the Bible. "After all," he wrote in his letter to Senate Majority Leader Joseph L. Bruno, "this is the United States of America, not the Tower of Babel." Quite right, Senator. And, as the Good Book informs us, in the Tower of Babel everyone spoke "one language with uniform words," until God "descend[ed] and confuse[d] their speech" and "scattered them all over the face of the earth." (Genesis, Chap. 11.) So, if you believe this story, the multiplicity of languages is God's will; who are you, and the Senator, to stand against it?

And, to take a more secular view of the matter, if humankind ever did speak a single tongue . . . well, Toto, we're not in Babel anymore; we are indeed in the U.S.A. And, in a polylingual city like New York -- and in the thousands of multi-lingual cities and towns across the country -- language differences constitute an identifiable problem in medical treatment.

Surely the crucial issue at stake is this: if doctors and patients can't communicate clearly with each other, the quality of patient care suffers. Defining any language except English as "a language of choice," as your editorial did, only confuses the issue. One's native tongue is acquired by imposition, beginning at an age at which one hardly has any choice in the matter. Young children can learn a second language with relative ease; after the age of twelve or so, acquisition of a second language becomes progressively more difficult. Of course we can encourage citizens, immigrants and long-term residents to learn basic English for everyday functioning -- and most of them try to do so. But it certainly makes sense that they'd want to convey to their doctors something as important and complex as their medical histories and symptomologies in the language in which they're most articulate. Not to mention the fact that, if they've immigrated here, their prior medical records will probably be in that language as well.

So how is a recent arrival who (to use one of your examples) speaks excellent Albanian but only broken English to inform a doctor about what's going on in his or her body? And how is a physician to heal someone without hearing that person's first-hand account of the condition and, in many cases, reading the case history they brought with them from their country of origin? The intelligent and humane solution to this practical and urgent problem cannot possibly be to tell all patients to hire professional translators, or to not get sick or injured until they've learned to speak a version of U.S. English that a college-educated physician can understand -- or else suffer the medical consequences. How, then, could this problem be addressed effectively?

No one should mandate which second language a doctor should speak, of course. However, since physicians in New York State now predictably encounter patients speaking most fluently some language other than English, would it not make sense to require that all state-subsidized and state-certified medical schools make the acquisition of conversational fluency in any second language a med-school requirement, and make two years of such study and a passing grade therein (or in an equivalency test for such skill) a condition for granting of a state license to practice?

And wouldn't it seem logical to recommend that any hospital in this state should poll its staff to identify the range of existing fluencies among its current employees, and be entitled to consider such skills -- especially in relation to the linguistic diversity of the local population -- as relevant qualifications in searches for staff at all levels? And might it not seem appropriate to suggest that every hospital in the state create a supplemental list of volunteer foreign-language speakers in the immediate neighborhood to assist in such situations? And what about calling for the creation of a federally subsidized hotline (which, by the way, means the creation of needed and useful jobs) enabling anyone to talk in his or her native tongue to someone who could translate that information and feed it back to the physician in charge, especially in emergency situations?

None of those proposals may prove feasible. But at least they address the actual problem of running an effective health-care system in a perenially polylingual metropolis, which neither Sen. Marchi nor your paper have yet done. That's bad politics, and less than useful editorializing.

Yours,
A. D. Coleman
Executive Director
The Nearby Café