Despite growing up in Texas, I only speak English fluently.

I’ve lived in San Antonio for many years. The city is just north of Mexico and the majority of people speak Spanish. With minimal help from an interpreter, I can now communicate effectively with my Spanish-speaking patients.

With that said, I don’t live near China and I can’t speak Mandarin. So, when I met Mr. X from Beijing, I needed the full expertise of an interpreter to communicate effectively with my patient. Mr. X only spoke Mandarin.

I reviewed the chart of Mr. X, a 77-year-old man who came to the U.S. about two months earlier. He had lost weight, had trouble breathing, and was coughing up blood. His chest CT (computerized tomography) scan showed a softball-sized mass in his right lung and a large lymph node in his right neck, just above the collarbone (clavicle).

I arranged for a telephone interpreter who spoke English and Mandarin. This would allow me to both explain my concerns that Mr. X may have cancer and to ask permission to take a sample (biopsy) of the lymph node in his neck.

In our initial meeting, I spoke in short sentences. That way, the interpreter could effectively translate my words to Mr. X so he could understand me.

I asked the interpreter to explain about the large lung and neck masses on the chest CT scan. I explained that we would like to do a biopsy of the lymph node in his neck to look for lung cancer. I also explained the possible risks of the procedure.

Since our conversation was going fine, I didn’t know that things were about to take a turn toward the dramatic side.

I asked if Mr. X had questions and if we could proceed with the biopsy. At this point, Mr. X threw his bed covers back, hopped to his knees on the bed, and started flailing his arms about with great emotion as he started his almost eight-minute reply.

I prepared to listen to more history or questions. When Mr. X stopped speaking, the interpreter simply said, “He say okay.”

I stood there dumbfounded. I thought to myself that I could never learn Mandarin if an eight-minute reply essentially meant “He say okay.”

So I asked the interpreter, “Are you sure that’s all he said?”

She said that Mr. X explained that both his mother and sister had lung problems and neither of them ended up having cancer. Even though he believed that all of the doctors were wrong, he would allow us to do the biopsy — just to prove that he was right.

I asked the interpreter, “Don’t you think that information was important?”

She said, “I thought you only wanted to know if he said okay or not to the biopsy.”

Key Point: You may only get what you ask for.