Elderly patient delivered to the critical care area by EMS after collapsing in a shopping mall. Confused and disoriented, he wasn't responding to questions or following commands appropriately upon arrival. I got him hooked up to oxygen, placed on a portable monitor, and checked a finger stick while neuro was paged for a stat rule out CVA and CT was told to clear their table. We were ready to scan him for a brain bleed when one of the doctors passing by pointed out that the patient was speaking Polish, not gibberish.
A few nights ago, an older gentleman arrived in severe respiratory distress with a neighbor's son in tow to translate the rare African dialect that he spoke. After a couple neb treatments relaxed his breathing, we brought out the state-of-the-art audio-visual translation doohickey that never works and spent half an hour wheeling the poor man up and down the hallways of the department in a futile search for a wireless signal. Every time the translation service put us through to their expert, the screen would freeze and the call would cut off. We ended up relying on the kid, even though it wasn't ideal.
Language barriers can be a big problem in medicine, especially in the ED. While many situations are handled by simply muddling through, as this New York Times piece discusses, speaking the patient's language can sometimes mean the difference prepping tPA and giving an icepack to a visiting Polish grandpa who tripped at the mall.