I am a doctor, having been raised in Chicago, so I am a native English speaker. I am bilingual. I am like most immigrants who immigrated to the US. I grew up speaking my native language at home (which is Spanish) and then outside or with my friends, I spoke English.
There are lots of people here in Chapala and Ajijic who have a very good grasp of the English language. Most people have a grasp of about 80% fluency. Most of the doctors from the offices located north of Chapala, in the lakeside area, have had training north of the border in some way, shape, or form. This would include a fellowship, partial residency, or going to conferences. I like to work with doctors who have continuing medical education in the US and in Canada. This is very important to me because we try to keep the same standards of care and more or less we follow the same steps and algorithms.
We have other physicians here in Mexico and in the area that have gone to South America, Europe, Spain, Germany, and other countries for their training. It’s not that they do things wrong; it’s just that they do things in a different way and it might take a little bit more getting used to. For example, a US-trained doctor may recommend certain steps and a doctor from Canada, Europe or South America may take different steps. I would like to think that all of us doctors would like to ease our patient’s suffering and improve their well-being, so the particular way we go about it is the main difference.
Relative to how well their grasp of the English language is, a good majority of the physicians here have a good grasp of the language at a conversational level. Many of them may have different technical English but may have trouble with the colloquialisms. For example, if somebody comes in and says, “Doc, geez, I just feel tuckered out!” the doctor may not know what that means or they might have to look it up.
I practiced in Chicago with Spanish-speaking communities and we would have the same cultural and language barriers up there that you would find here in Mexico, but in reverse. In my practice, the cultural and language barriers between my English-speaking patients and me are almost non-existent, whereas, other doctors have to catch up. The other doctors who may have traveled north of the border more and who watch more North American TV can relate more.
To take a reverse example, if a child were brought to a clinic in Chicago with the Spanish-speaking parents saying, “My child is empachado” (which means “plugged up in their digestive system”), a doctor, who studied high school or college Spanish would not know what that meant. Having been more exposed to the Hispanic or the Mexican population, and the rural population, I am more familiar with this kind of colloquialism.
When you come into Mexico, and you are in any profession or any job that provides service, you have to be able to learn some of the cultural barriers that are reflected in the language. For example, for something to be done at a particular time here, Mexicans have a hard time saying no and they have a hard time of providing something on time. There is always the mañana culture. They like saying “al ratito”, which means “ little later.” They find it difficult to give you a definite day for a deadline when they will deliver you service or some results. They will say, “Ya veremos” or “We’ll see…” and they can beat around the bush and put you on hold for a while with those answers. It has taken me a while to get used to. In contrast, and from my point of view, I try to provide my patients the type of service they are used to and give them straight answers. Some doctors who have been successful with the expat communities tend to focus more on that aspect of their customer service.
In general, a great majority of the doctors here have a really laid back way living their lives, which is really attractive about the Mexican culture. However, from my point of view, when you are dealing with something as important as your health, you have to get a clear answer. You must get a “yes” or a “no”, and deliver on time.
(Dr. Santiago Hernandez with a patient, Chapala, Mexico, pictured.)