Welcome to Our Voices, Our Future, the podcast
where we amplify the voices driving change and
equity within medicine and beyond. Brought to
you by the Gender Equity Task Force, a committee
of the American Medical Women's Association.
We're here to challenge norms, break barriers,
and ignite conversations that matter. I'm Rhea
Manohar and each episode will bring you candid
discussions with leaders, change makers, and
advocates working to create a more inclusive
and just world. No more silence, no more waiting.
you are listening to our voices, our future.
Let's get into it. Today we're welcoming Gabriella
Berger or Gabby Berger. She is a first -generation
third -year medical student at St. George's University.
Growing up as the daughter of Venezuelan immigrants,
navigating cultural barriers has shaped her strong
interest in health equity and her commitment
to creating more inclusive patient -centered
care. Thanks so much for being with us today.
Thanks for having me, Ria. I'm happy to be here
and excited to talk about, you know, some of
the stuff we're going to talk about. Great. So
let's jump in. Can you share with us your medical
journey and what fueled your drive to become
a physician? Okay. Well, I always tell people
when they ask, like, why medicine, that my journey
was sort of unconventional. You know, I wasn't
the kid that from a young age knew that I wanted
to be a doctor when I got older. So, you know,
like you said, I'm the daughter of Venezuelan
immigrants, and I'm sure you understand, you
know, coming from an immigrant household as well,
sort of an unspoken pressure where it's like,
you know, you got to do something big. So there's
a family friend of mine that was in dentistry.
that's kind of where I started out growing up
this family friend and I was always into the
sciences so I started shadowing there and I felt
like it wasn't as impactful as I wanted it to
be so I said you know let me try another sciency
field and I took a part -time job scribing for
a cardiologist in my hometown in south Florida
and his population was predominantly Hispanic
and Latino in the community. So after working
with him, I loved being in the hospital, loved
the population we served, and that's kind of
where it all began. Great. So thanks for kind
of walking us through that. I kind of want to
take it one step back. So you shared with us
your medical journey overall, but take us back
to your earliest experience navigating the health
care system across a language barrier. I know
this is something that you're really passionate
about. So talking about it as a patient or a
family member and how that really shaped how
you view medicine now. Yeah, of course. Being
my mom's English is not the greatest. You know,
I would say her preferred language is Spanish
That's kind of where my first experiences were
with language barriers in medicine The first
things that I can think about my mom has had
chronic migraines since I can remember. And we
used to go to a neurologist, when I say we is
because I had to join her at most visits. This
neurologist, great doctor, great physician, but
he did not speak an inch of Spanish. So I would
go and I would be the translator. I remember
thinking sometimes like, I'm not, I'm too young.
And I'm not sure like, we're getting all of this.
And then Growing up, I had my own things going
on. So there were visits where I couldn't attend.
And I remember coming back home and asking my
mom how it went. And she'd be like, oh, he said
everything was fine. And I was thinking, I know
she kind of just tried to handle it herself,
but I'm not sure if she understood what the whole
visit looked like or what her treatment plan
was going to look like moving forward after that
visit. um another thing I can remember you know
women how they start getting mammograms same
thing with my mom she would go to her mammogram
visits and I remember um there was one time that
she came back home and she said oh they found
something weird in my breast and they want me
to come back in a couple weeks and I'm like well
what did they find and she couldn't really tell
me exactly what they found she said ah something
abnormal and I'm like but they were like, oh,
I just told them that I'd come back, didn't really
ask any more questions, kind of had like, I guess,
anxiety from what we learn now that a lot of
limited English proficient patients encounter
at their visits. Yeah, so kind of now that you've
taken a different role from being a family member,
a patient, and now going into your third year
medical student, have there been moments on rotations
where those earlier experiences resurfaced or
it changes how you interact with these patients?
Yeah, yeah, actually now that I'm doing rotations
in New York, you know, it's not only a big Latino
population, I see people from all over, which
is nice to see, but also you see more of the
gaps. I can give a couple examples, but immediately
my first overnight shift in surgery, we were
called down to the ED. We had a patient there
and she was Spanish speaking and the whole team
was there. They were like, when you're in the
ED, everything's a rush. So they're trying to
get in and out with this patient. They said,
oh, who here can translate for us as anyone who
speaks Spanish so we don't have to get the machine?
And I was like, of course, yeah, I can help out.
So then the doctor starts telling me what we're
translating. And basically, he wants me to tell
her that she has this huge hernia that they need
to operate. She also has heart failure and the
surgery could go bad. There was a lot of risk
with the procedure and he wanted me to make sure
that she understood that death was one of the
possibilities of this procedure. So I started
explaining and she's kind of confused because
she had no idea that she had heart failure, which
is a pretty big thing to not know that you have,
you know. So at that point I felt a little uncomfortable.
And I asked the physician if we could speak outside
for a second. And I told him, I said, hey, you
know, I'm not sure I feel 100 % comfortable with
this encounter. I feel like someone with better
training in medical terminology in Spanish should
handle this. Like, I think you should get the
interpreter machine. That was the first encounter
and then after that it kind of became easier
Every time I had a similar encounter. For example,
we had to do a bedside ultrasound for a patient
that had you know, uh Some sort of urinary incontinence
in their bladder and the doctor was like tell
them that we're gonna put a probe on their stomach
and I was like I'm not even sure my mother knows
how to say probe in Spanish, you know, like these
are terms that, you know, you speak a language
at home, but you're not speaking medical terminology.
And there are people that are trained for this.
So that was these are very humbling experiences
that one goes through, you know, but it's it
gets easier when you can take a step back and
say like, this is I'm not comfortable with this
and you're thinking of the patient first you
know so definitely and I think that's a brave
thing I think particularly as medical students
we all want to fill as many of the gaps as possible
take those opportunities to like have those individual
moments with patients and with attendings and
it's hard particularly as a trainee to be like
I'm not prepared for this right now. And you're
right, a lot of people who don't have formal
training don't know these medical terminology
specific words. And it even makes you wonder
like, do the patients know it even if a translator
is using those words? Right, yeah, you hit a
good point that I didn't mention too, like having
the anxiety to say, you know, I'm wrong here,
especially in front of your superiors, you don't
want to give a bad look. Sure. I think you talked
about two really interesting things that I want
to dive into a little bit more. Do you find that
there is a hesitance or a reluctance to call
the translator in these instances? Yeah, I feel
like, you know, it's either the machine's too
far away, it takes too long to get through, because,
you know, you have to talk to them, have to save
back. Just calling them takes a couple minutes
and you know someone else could be using the
machine they're just trying to get through you
know and you kind of lose the patient -centered
care and you're just kind of like trying to get
through all the patients as quickly as possible.
So I've definitely seen that um just instead
of taking the time to Step back and making sure
that the patient is comfortable in their situation
Since you have both experiences both on the family
side and the medical provider side Do you find
that maybe patients don't want to ask for a translator
or Maybe a little hesitant to be like, hey, I
don't understand what's going on Yeah, yeah exactly.
So going back to my mom, you know I see it in
her sometimes. She can understand and she'll
say, oh yeah, don't worry, I understand. But
I think it's important to know that these patients
are having those anxieties because there are
research studies that show that patients do experience
more anxiety, those with limited English proficiency.
and fears and they're not asking the questions
to get a full context on their treatment plans
or any new diagnoses for example but yeah I feel
like there definitely is hesitancy but as a provider
you should know when you know you got to make
a right move to in the best interest of your
patient. Of course. So looking forward, what
gaps have you noticed in how medical education
prepares students to care for these patients
with limited English proficiency? And what kind
of changes would you like to see? Yeah, so I
feel like in our training, they do a good job
of getting a history from the patient. about
what they're here for and as well in our training
they made it a big deal about how the people
prefer to be addressed and pronouns and I feel
like that should be that's not something that
is standardized such as asking what language
is preferred and I feel like that's something
that should be included in medical education,
not just med students, but you know, nursing,
anyone that any one that has direct interactions
with patients as far as you know, to go from
how would you prefer to be addressed today? And
what is your preferred language? Even if, you
know, not making any assumptions if it's English
or not, I feel like that should be a standard
question. And as far as when you're training
for those patient interactions, I feel like it
shouldn't be an elective question, but more of
like into the standard protocol. I love that.
I think it also helps probably take that burden
off of patients to ask for a translator or let
a doctor or medical provider know that, hey,
they're not comfortable continuing this interaction
in English. Right. So I have one last question
for you. How do you envision integrating language
equity and patient advocacy into your future
career as a physician? So I have kind of started
a little bit. I took a medical Spanish terminology
elective and school recently and I feel like
that helped a lot and I remember a lot of people
were like well you already speak Spanish what
are you doing in this class but like I said you
know you're not talking about hernias and heart
failure at home you know so these are things
that you know we're learning the medical terminology
ourselves as we're going through school and through
life everyone keeps um studying medicine and
i feel like the same way we have to keep doing
that um with languages of people that we interact
with especially more specialty specific for example
if you're in cardiology then you want to make
sure you know how to say ekg in spanish and stuff
like that um specifically for me i have been
looking into ways to further my training so there's
looking into courses that I can do, just making
sure that I stand up for that patient that can
be reminds me of my mom, you know, or someone's
family member that goes home and you want them
to understand fully. So just making sure that
you're able to step up even in front of your
superior and say, hey, maybe we should use the
machine, the interpretive machine here. And yeah,
just becoming more aware with the people in your
region, I guess. For example, we have a lot of
people here that speak French, Creole, Arabic.
And I feel like just learning the basic terms
in the area that you work with will also help.
Well, thank you so much for sharing your journey
as well as some insight into your experiences.
That's a wrap on this episode of Our Voices,
Our Future. We hope today's conversation inspired
you, challenged you, and reminded you of the
power of raising your voice. The fight for equity
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