WEBVTT 00:00:17.589 --> 00:00:20.050 Welcome to Our Voices, Our Future, the podcast 00:00:20.050 --> 00:00:22.329 where we amplify the voices driving change and 00:00:22.329 --> 00:00:24.809 equity within medicine and beyond. Brought to 00:00:24.809 --> 00:00:26.809 you by the Gender Equity Task Force, a committee 00:00:26.809 --> 00:00:29.030 of the American Medical Women's Association. 00:00:29.550 --> 00:00:31.989 We're here to challenge norms, break barriers, 00:00:32.149 --> 00:00:34.750 and ignite conversations that matter. I'm Rhea 00:00:34.750 --> 00:00:37.009 Manohar and each episode will bring you candid 00:00:37.009 --> 00:00:39.189 discussions with leaders, change makers, and 00:00:39.189 --> 00:00:41.670 advocates working to create a more inclusive 00:00:41.670 --> 00:00:44.829 and just world. No more silence, no more waiting. 00:00:45.159 --> 00:00:47.700 you are listening to our voices, our future. 00:00:48.140 --> 00:00:51.399 Let's get into it. Today we're welcoming Gabriella 00:00:51.399 --> 00:00:55.320 Berger or Gabby Berger. She is a first -generation 00:00:55.320 --> 00:00:58.539 third -year medical student at St. George's University. 00:00:58.859 --> 00:01:01.200 Growing up as the daughter of Venezuelan immigrants, 00:01:01.479 --> 00:01:03.939 navigating cultural barriers has shaped her strong 00:01:03.939 --> 00:01:06.400 interest in health equity and her commitment 00:01:06.400 --> 00:01:09.000 to creating more inclusive patient -centered 00:01:09.000 --> 00:01:11.299 care. Thanks so much for being with us today. 00:01:12.250 --> 00:01:15.069 Thanks for having me, Ria. I'm happy to be here 00:01:15.069 --> 00:01:17.969 and excited to talk about, you know, some of 00:01:17.969 --> 00:01:20.069 the stuff we're going to talk about. Great. So 00:01:20.069 --> 00:01:22.469 let's jump in. Can you share with us your medical 00:01:22.469 --> 00:01:24.650 journey and what fueled your drive to become 00:01:24.650 --> 00:01:29.030 a physician? Okay. Well, I always tell people 00:01:29.030 --> 00:01:32.230 when they ask, like, why medicine, that my journey 00:01:32.230 --> 00:01:34.510 was sort of unconventional. You know, I wasn't 00:01:34.510 --> 00:01:38.349 the kid that from a young age knew that I wanted 00:01:38.349 --> 00:01:44.260 to be a doctor when I got older. So, you know, 00:01:44.340 --> 00:01:47.799 like you said, I'm the daughter of Venezuelan 00:01:47.799 --> 00:01:50.659 immigrants, and I'm sure you understand, you 00:01:50.659 --> 00:01:53.659 know, coming from an immigrant household as well, 00:01:54.780 --> 00:01:57.540 sort of an unspoken pressure where it's like, 00:01:57.540 --> 00:02:02.319 you know, you got to do something big. So there's 00:02:02.319 --> 00:02:05.079 a family friend of mine that was in dentistry. 00:02:06.540 --> 00:02:08.939 that's kind of where I started out growing up 00:02:08.939 --> 00:02:11.860 this family friend and I was always into the 00:02:11.860 --> 00:02:15.800 sciences so I started shadowing there and I felt 00:02:15.800 --> 00:02:19.479 like it wasn't as impactful as I wanted it to 00:02:19.479 --> 00:02:23.340 be so I said you know let me try another sciency 00:02:23.340 --> 00:02:28.400 field and I took a part -time job scribing for 00:02:28.400 --> 00:02:32.340 a cardiologist in my hometown in south Florida 00:02:32.340 --> 00:02:38.539 and his population was predominantly Hispanic 00:02:38.539 --> 00:02:42.979 and Latino in the community. So after working 00:02:42.979 --> 00:02:45.599 with him, I loved being in the hospital, loved 00:02:45.599 --> 00:02:47.740 the population we served, and that's kind of 00:02:47.740 --> 00:02:51.639 where it all began. Great. So thanks for kind 00:02:51.639 --> 00:02:54.340 of walking us through that. I kind of want to 00:02:54.340 --> 00:02:56.960 take it one step back. So you shared with us 00:02:56.960 --> 00:03:00.199 your medical journey overall, but take us back 00:03:00.199 --> 00:03:02.960 to your earliest experience navigating the health 00:03:02.960 --> 00:03:06.020 care system across a language barrier. I know 00:03:06.020 --> 00:03:08.419 this is something that you're really passionate 00:03:08.419 --> 00:03:11.879 about. So talking about it as a patient or a 00:03:11.879 --> 00:03:14.840 family member and how that really shaped how 00:03:14.840 --> 00:03:20.469 you view medicine now. Yeah, of course. Being 00:03:20.469 --> 00:03:24.310 my mom's English is not the greatest. You know, 00:03:24.310 --> 00:03:26.250 I would say her preferred language is Spanish 00:03:26.250 --> 00:03:30.789 That's kind of where my first experiences were 00:03:30.789 --> 00:03:36.669 with language barriers in medicine The first 00:03:36.669 --> 00:03:39.270 things that I can think about my mom has had 00:03:39.270 --> 00:03:44.080 chronic migraines since I can remember. And we 00:03:44.080 --> 00:03:47.020 used to go to a neurologist, when I say we is 00:03:47.020 --> 00:03:50.060 because I had to join her at most visits. This 00:03:50.060 --> 00:03:53.280 neurologist, great doctor, great physician, but 00:03:53.280 --> 00:03:58.300 he did not speak an inch of Spanish. So I would 00:03:58.300 --> 00:03:59.759 go and I would be the translator. I remember 00:03:59.759 --> 00:04:03.759 thinking sometimes like, I'm not, I'm too young. 00:04:03.780 --> 00:04:06.419 And I'm not sure like, we're getting all of this. 00:04:06.460 --> 00:04:10.039 And then Growing up, I had my own things going 00:04:10.039 --> 00:04:13.199 on. So there were visits where I couldn't attend. 00:04:13.300 --> 00:04:15.500 And I remember coming back home and asking my 00:04:15.500 --> 00:04:18.560 mom how it went. And she'd be like, oh, he said 00:04:18.560 --> 00:04:22.980 everything was fine. And I was thinking, I know 00:04:22.980 --> 00:04:25.759 she kind of just tried to handle it herself, 00:04:25.800 --> 00:04:27.560 but I'm not sure if she understood what the whole 00:04:27.560 --> 00:04:32.060 visit looked like or what her treatment plan 00:04:32.060 --> 00:04:34.339 was going to look like moving forward after that 00:04:34.339 --> 00:04:38.240 visit. um another thing I can remember you know 00:04:38.240 --> 00:04:40.860 women how they start getting mammograms same 00:04:40.860 --> 00:04:43.360 thing with my mom she would go to her mammogram 00:04:43.360 --> 00:04:47.660 visits and I remember um there was one time that 00:04:47.660 --> 00:04:50.000 she came back home and she said oh they found 00:04:50.000 --> 00:04:53.240 something weird in my breast and they want me 00:04:53.240 --> 00:04:55.779 to come back in a couple weeks and I'm like well 00:04:55.779 --> 00:04:58.220 what did they find and she couldn't really tell 00:04:58.220 --> 00:05:00.740 me exactly what they found she said ah something 00:05:00.740 --> 00:05:03.839 abnormal and I'm like but they were like, oh, 00:05:03.959 --> 00:05:07.439 I just told them that I'd come back, didn't really 00:05:07.439 --> 00:05:09.939 ask any more questions, kind of had like, I guess, 00:05:10.180 --> 00:05:14.980 anxiety from what we learn now that a lot of 00:05:14.980 --> 00:05:18.360 limited English proficient patients encounter 00:05:18.360 --> 00:05:24.240 at their visits. Yeah, so kind of now that you've 00:05:24.240 --> 00:05:28.500 taken a different role from being a family member, 00:05:28.560 --> 00:05:31.680 a patient, and now going into your third year 00:05:31.680 --> 00:05:37.040 medical student, have there been moments on rotations 00:05:37.040 --> 00:05:40.620 where those earlier experiences resurfaced or 00:05:40.620 --> 00:05:43.060 it changes how you interact with these patients? 00:05:44.420 --> 00:05:47.819 Yeah, yeah, actually now that I'm doing rotations 00:05:47.819 --> 00:05:54.879 in New York, you know, it's not only a big Latino 00:05:54.879 --> 00:05:58.829 population, I see people from all over, which 00:05:58.829 --> 00:06:02.110 is nice to see, but also you see more of the 00:06:02.110 --> 00:06:07.290 gaps. I can give a couple examples, but immediately 00:06:07.290 --> 00:06:12.449 my first overnight shift in surgery, we were 00:06:12.449 --> 00:06:15.110 called down to the ED. We had a patient there 00:06:15.110 --> 00:06:18.750 and she was Spanish speaking and the whole team 00:06:18.750 --> 00:06:21.870 was there. They were like, when you're in the 00:06:21.870 --> 00:06:24.370 ED, everything's a rush. So they're trying to 00:06:24.370 --> 00:06:25.769 get in and out with this patient. They said, 00:06:26.529 --> 00:06:29.329 oh, who here can translate for us as anyone who 00:06:29.329 --> 00:06:31.050 speaks Spanish so we don't have to get the machine? 00:06:31.529 --> 00:06:35.209 And I was like, of course, yeah, I can help out. 00:06:35.730 --> 00:06:38.170 So then the doctor starts telling me what we're 00:06:38.170 --> 00:06:40.449 translating. And basically, he wants me to tell 00:06:40.449 --> 00:06:44.129 her that she has this huge hernia that they need 00:06:44.129 --> 00:06:48.569 to operate. She also has heart failure and the 00:06:48.569 --> 00:06:50.769 surgery could go bad. There was a lot of risk 00:06:50.769 --> 00:06:52.949 with the procedure and he wanted me to make sure 00:06:52.949 --> 00:06:55.129 that she understood that death was one of the 00:06:55.129 --> 00:06:58.129 possibilities of this procedure. So I started 00:06:58.129 --> 00:07:00.529 explaining and she's kind of confused because 00:07:00.529 --> 00:07:03.009 she had no idea that she had heart failure, which 00:07:03.009 --> 00:07:06.269 is a pretty big thing to not know that you have, 00:07:06.350 --> 00:07:10.589 you know. So at that point I felt a little uncomfortable. 00:07:11.359 --> 00:07:14.860 And I asked the physician if we could speak outside 00:07:14.860 --> 00:07:18.000 for a second. And I told him, I said, hey, you 00:07:18.000 --> 00:07:21.600 know, I'm not sure I feel 100 % comfortable with 00:07:21.600 --> 00:07:25.439 this encounter. I feel like someone with better 00:07:25.439 --> 00:07:30.240 training in medical terminology in Spanish should 00:07:30.240 --> 00:07:32.160 handle this. Like, I think you should get the 00:07:32.160 --> 00:07:37.899 interpreter machine. That was the first encounter 00:07:37.899 --> 00:07:40.959 and then after that it kind of became easier 00:07:40.959 --> 00:07:44.579 Every time I had a similar encounter. For example, 00:07:44.579 --> 00:07:47.920 we had to do a bedside ultrasound for a patient 00:07:47.920 --> 00:07:54.060 that had you know, uh Some sort of urinary incontinence 00:07:54.060 --> 00:07:56.519 in their bladder and the doctor was like tell 00:07:56.519 --> 00:07:59.920 them that we're gonna put a probe on their stomach 00:07:59.920 --> 00:08:03.300 and I was like I'm not even sure my mother knows 00:08:03.300 --> 00:08:05.339 how to say probe in Spanish, you know, like these 00:08:05.339 --> 00:08:09.720 are terms that, you know, you speak a language 00:08:09.720 --> 00:08:14.800 at home, but you're not speaking medical terminology. 00:08:14.800 --> 00:08:17.240 And there are people that are trained for this. 00:08:17.980 --> 00:08:22.540 So that was these are very humbling experiences 00:08:22.540 --> 00:08:25.120 that one goes through, you know, but it's it 00:08:25.120 --> 00:08:28.100 gets easier when you can take a step back and 00:08:28.100 --> 00:08:31.519 say like, this is I'm not comfortable with this 00:08:31.519 --> 00:08:34.240 and you're thinking of the patient first you 00:08:34.240 --> 00:08:38.500 know so definitely and I think that's a brave 00:08:38.500 --> 00:08:41.299 thing I think particularly as medical students 00:08:41.299 --> 00:08:44.419 we all want to fill as many of the gaps as possible 00:08:44.419 --> 00:08:50.059 take those opportunities to like have those individual 00:08:50.059 --> 00:08:52.440 moments with patients and with attendings and 00:08:52.440 --> 00:08:56.639 it's hard particularly as a trainee to be like 00:08:56.840 --> 00:08:59.860 I'm not prepared for this right now. And you're 00:08:59.860 --> 00:09:02.360 right, a lot of people who don't have formal 00:09:02.360 --> 00:09:06.159 training don't know these medical terminology 00:09:06.159 --> 00:09:09.299 specific words. And it even makes you wonder 00:09:09.299 --> 00:09:12.899 like, do the patients know it even if a translator 00:09:12.899 --> 00:09:16.600 is using those words? Right, yeah, you hit a 00:09:16.600 --> 00:09:18.860 good point that I didn't mention too, like having 00:09:18.860 --> 00:09:23.419 the anxiety to say, you know, I'm wrong here, 00:09:23.419 --> 00:09:25.419 especially in front of your superiors, you don't 00:09:25.419 --> 00:09:31.399 want to give a bad look. Sure. I think you talked 00:09:31.399 --> 00:09:33.419 about two really interesting things that I want 00:09:33.419 --> 00:09:36.059 to dive into a little bit more. Do you find that 00:09:36.059 --> 00:09:40.120 there is a hesitance or a reluctance to call 00:09:40.120 --> 00:09:45.000 the translator in these instances? Yeah, I feel 00:09:45.000 --> 00:09:49.639 like, you know, it's either the machine's too 00:09:49.639 --> 00:09:53.960 far away, it takes too long to get through, because, 00:09:53.960 --> 00:09:56.360 you know, you have to talk to them, have to save 00:09:56.360 --> 00:10:00.519 back. Just calling them takes a couple minutes 00:10:00.519 --> 00:10:04.559 and you know someone else could be using the 00:10:04.559 --> 00:10:06.799 machine they're just trying to get through you 00:10:06.799 --> 00:10:10.620 know and you kind of lose the patient -centered 00:10:10.620 --> 00:10:13.360 care and you're just kind of like trying to get 00:10:13.360 --> 00:10:16.700 through all the patients as quickly as possible. 00:10:17.059 --> 00:10:20.580 So I've definitely seen that um just instead 00:10:20.580 --> 00:10:24.500 of taking the time to Step back and making sure 00:10:24.500 --> 00:10:27.100 that the patient is comfortable in their situation 00:10:27.100 --> 00:10:31.840 Since you have both experiences both on the family 00:10:31.840 --> 00:10:37.279 side and the medical provider side Do you find 00:10:37.279 --> 00:10:41.940 that maybe patients don't want to ask for a translator 00:10:41.940 --> 00:10:46.220 or Maybe a little hesitant to be like, hey, I 00:10:46.220 --> 00:10:50.340 don't understand what's going on Yeah, yeah exactly. 00:10:50.399 --> 00:10:54.259 So going back to my mom, you know I see it in 00:10:54.259 --> 00:10:57.299 her sometimes. She can understand and she'll 00:10:57.299 --> 00:11:01.019 say, oh yeah, don't worry, I understand. But 00:11:01.019 --> 00:11:06.740 I think it's important to know that these patients 00:11:06.740 --> 00:11:10.500 are having those anxieties because there are 00:11:10.500 --> 00:11:14.139 research studies that show that patients do experience 00:11:14.139 --> 00:11:17.919 more anxiety, those with limited English proficiency. 00:11:19.080 --> 00:11:22.559 and fears and they're not asking the questions 00:11:22.559 --> 00:11:26.059 to get a full context on their treatment plans 00:11:26.059 --> 00:11:34.580 or any new diagnoses for example but yeah I feel 00:11:34.580 --> 00:11:38.000 like there definitely is hesitancy but as a provider 00:11:38.000 --> 00:11:43.039 you should know when you know you got to make 00:11:43.039 --> 00:11:47.700 a right move to in the best interest of your 00:11:47.700 --> 00:11:52.220 patient. Of course. So looking forward, what 00:11:52.220 --> 00:11:55.539 gaps have you noticed in how medical education 00:11:55.539 --> 00:11:58.779 prepares students to care for these patients 00:11:58.779 --> 00:12:03.080 with limited English proficiency? And what kind 00:12:03.080 --> 00:12:07.539 of changes would you like to see? Yeah, so I 00:12:07.539 --> 00:12:10.740 feel like in our training, they do a good job 00:12:10.740 --> 00:12:17.570 of getting a history from the patient. about 00:12:17.570 --> 00:12:22.029 what they're here for and as well in our training 00:12:22.029 --> 00:12:26.769 they made it a big deal about how the people 00:12:26.769 --> 00:12:30.090 prefer to be addressed and pronouns and I feel 00:12:30.090 --> 00:12:34.710 like that should be that's not something that 00:12:34.710 --> 00:12:39.490 is standardized such as asking what language 00:12:39.490 --> 00:12:42.470 is preferred and I feel like that's something 00:12:42.470 --> 00:12:45.389 that should be included in medical education, 00:12:45.590 --> 00:12:47.450 not just med students, but you know, nursing, 00:12:47.750 --> 00:12:50.409 anyone that any one that has direct interactions 00:12:50.409 --> 00:12:52.889 with patients as far as you know, to go from 00:12:52.889 --> 00:12:55.070 how would you prefer to be addressed today? And 00:12:55.070 --> 00:12:57.769 what is your preferred language? Even if, you 00:12:57.769 --> 00:13:00.970 know, not making any assumptions if it's English 00:13:00.970 --> 00:13:03.490 or not, I feel like that should be a standard 00:13:03.490 --> 00:13:06.909 question. And as far as when you're training 00:13:06.909 --> 00:13:10.090 for those patient interactions, I feel like it 00:13:10.090 --> 00:13:15.259 shouldn't be an elective question, but more of 00:13:15.259 --> 00:13:18.639 like into the standard protocol. I love that. 00:13:18.639 --> 00:13:21.600 I think it also helps probably take that burden 00:13:21.600 --> 00:13:27.879 off of patients to ask for a translator or let 00:13:27.879 --> 00:13:31.259 a doctor or medical provider know that, hey, 00:13:31.340 --> 00:13:34.340 they're not comfortable continuing this interaction 00:13:34.340 --> 00:13:40.460 in English. Right. So I have one last question 00:13:40.460 --> 00:13:43.659 for you. How do you envision integrating language 00:13:43.659 --> 00:13:46.480 equity and patient advocacy into your future 00:13:46.480 --> 00:13:54.919 career as a physician? So I have kind of started 00:13:54.919 --> 00:13:59.419 a little bit. I took a medical Spanish terminology 00:13:59.419 --> 00:14:04.789 elective and school recently and I feel like 00:14:04.789 --> 00:14:07.570 that helped a lot and I remember a lot of people 00:14:07.570 --> 00:14:09.190 were like well you already speak Spanish what 00:14:09.190 --> 00:14:11.870 are you doing in this class but like I said you 00:14:11.870 --> 00:14:16.129 know you're not talking about hernias and heart 00:14:16.129 --> 00:14:19.009 failure at home you know so these are things 00:14:19.009 --> 00:14:22.929 that you know we're learning the medical terminology 00:14:22.929 --> 00:14:26.809 ourselves as we're going through school and through 00:14:26.809 --> 00:14:30.179 life everyone keeps um studying medicine and 00:14:30.179 --> 00:14:32.440 i feel like the same way we have to keep doing 00:14:32.440 --> 00:14:37.379 that um with languages of people that we interact 00:14:37.379 --> 00:14:42.379 with especially more specialty specific for example 00:14:42.379 --> 00:14:45.360 if you're in cardiology then you want to make 00:14:45.360 --> 00:14:49.019 sure you know how to say ekg in spanish and stuff 00:14:49.019 --> 00:14:52.580 like that um specifically for me i have been 00:14:52.580 --> 00:14:57.139 looking into ways to further my training so there's 00:14:57.149 --> 00:15:01.929 looking into courses that I can do, just making 00:15:01.929 --> 00:15:06.269 sure that I stand up for that patient that can 00:15:06.269 --> 00:15:10.190 be reminds me of my mom, you know, or someone's 00:15:10.190 --> 00:15:13.110 family member that goes home and you want them 00:15:13.110 --> 00:15:16.750 to understand fully. So just making sure that 00:15:16.750 --> 00:15:20.169 you're able to step up even in front of your 00:15:20.169 --> 00:15:22.570 superior and say, hey, maybe we should use the 00:15:22.570 --> 00:15:27.740 machine, the interpretive machine here. And yeah, 00:15:27.980 --> 00:15:32.360 just becoming more aware with the people in your 00:15:32.360 --> 00:15:35.220 region, I guess. For example, we have a lot of 00:15:35.220 --> 00:15:39.820 people here that speak French, Creole, Arabic. 00:15:40.659 --> 00:15:44.159 And I feel like just learning the basic terms 00:15:44.159 --> 00:15:46.659 in the area that you work with will also help. 00:15:48.240 --> 00:15:51.360 Well, thank you so much for sharing your journey 00:15:51.360 --> 00:15:54.539 as well as some insight into your experiences. 00:15:55.299 --> 00:15:57.480 That's a wrap on this episode of Our Voices, 00:15:57.519 --> 00:16:00.200 Our Future. We hope today's conversation inspired 00:16:00.200 --> 00:16:02.620 you, challenged you, and reminded you of the 00:16:02.620 --> 00:16:05.179 power of raising your voice. The fight for equity 00:16:05.179 --> 00:16:07.879 doesn't stop here. Join us in the movement. Subscribe 00:16:07.879 --> 00:16:10.220 wherever you get your podcasts. And if you loved 00:16:10.220 --> 00:16:12.419 this episode, share it with someone who needs 00:16:12.419 --> 00:16:15.590 to hear it. Until next time, stay bold, stay 00:16:15.590 --> 00:16:18.309 vocal, and keep the conversation going. This 00:16:18.309 --> 00:16:19.950 is our voices, our future.