Article Text

Download PDFPDF
On the invisible power of language
  1. Pilar Ortega1,2
  1. 1 Emergency Medicine and Medical Education, University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA
  2. 2 Diversity, Equity, and Inclusion, Accreditation Council for Graduate Medical Education, Chicago, Illinois, USA
  1. Correspondence to Dr Pilar Ortega, University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA; portega1{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

As the attending physician in the ED, I have already heard the case presentation from the resident. “Doctor,” the patient says, “there’s something wrong with my blood.” I notice the patient’s gestures, his hand movements. His filler words are ‘eh’ and ‘esto’ rather than ‘um’ or ‘well’, the melody of his speech not unlike the sounds of my own childhood. His facial expression tells me he is searching for a word.

Dígame,” I offer, a Spanish term that is an invitation to tell me more. It takes him a moment to register the change in language, and when he does, he sits back and continues describing his symptoms, but this time in a seamless, natural and effortless rhythm, sometimes in Spanish, sometimes in English, depending on what feels just right.

“Could it be from the veneno in my blood, Doctora?” he asks. Confused by his question about veneno, the Spanish word for poison, I pull up a chair. My mental differential diagnosis starts to churn. Could he be ingesting a toxin? Could he be delusional? Could he be using the word in gest as a reference to one of his medications and its side effects?

Le enseño,” he says, using the word enseñar which means ‘to show’ but also ‘to teach’. He deftly pulls up the electronic health record on his phone and finds the panel of routine blood tests from his last check-up. He points to the term ‘venous blood’. For the next several minutes, I explain what the word ‘venous’ means …

View Full Text


  • Handling editor Ellen J Weber

  • X @pilarortegamd

  • Contributors PO confirms sole responsibility for conceptualising and designing the content, preparing the manuscript and creating the figures.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests PO receives textbook author royalties from Elsevier.

  • Provenance and peer review Not commissioned; internally peer reviewed.