Lost In Translation

I’m about to make a statement that’s almost funny to say – and potentially may even sound a bit weird. It’s not something that you would necessarily associate with me, or my background and yet .. here we are.

I am an immigrant.

Granted, I fit a very privileged niche of immigrants. I was awarded a lot more freedom in my assimilation into my new culture than many others because of my background, my heritage, and my nationality. In my interview to start the process of living in this country, I was told I was a “desirable” immigrant. I was a white, western female with an education.

This is not a privilege that many others are given. I still face hurdles, but for the most part, I can live a fairly ordinary existence in my country of residence.

I now have a new language in which I can speak conversationally, and I have embraced some new traditions and celebrations along the way. My children are growing up as third-culture kids who speak two languages fluently and have a good understanding of a third.

stephanie ernst lost in translation

This was not always the case. Looking back to 10 years ago, when I was navigating a difficult pregnancy, premature birth, and the aftermath of that situation, I was in a much different place with my language. I had only lived here for around 18 months when my girls were born. While I was studying the language, I didn’t have anywhere near the fluency required to navigate a complicated pregnancy in technical terms, nor did I have the ability to express myself outside of the basics. 

Communication was virtually impossible, a skill I brag about as one of my finest. I couldn’t put my feelings or thoughts forward – at least not quickly. Processing the trauma of my situation, of what I had been through to get to this point, the highs and lows of the neonatal unit in a second language that I wasn’t fluent in, was exhausting. I constantly translated in my head, and even with patient staff who patiently walked me through daily things in their second language, there were still many unanswered questions and a lot lost in translation.  

The moment that broke my confidence was when a nurse told me I’d lived here long enough and should speak and understand the language, so she refused to speak English with me.

A patient who is a non-native speaker of a language, who is also dealing with stress and anxiety over their situation, who has limited support networks available, and who may not be in optimal health is not thinking about their language lessons. Their primary focus is what is happening right now, and how they can survive the next few minutes and hours.

These patients are overwhelmed by their situation and the volume of information they are processing. They translate this information and try to interpret it when they are not fully capable. They may not want to ask questions or know they can ask for clarification simply because they deal with everything around them.


I will take a moment here to refer back to my position of privilege as a native English speaker – many people speak English, and this is not so much of a challenge as it is with less widely spoken languages. However, it still did not exempt me from the feeling that I didn’t fully understand the situation or that there was a further workload of processing everything in a language I wasn’t comfortable with.

When your patient isn’t a native speaker, it’s essential to acknowledge the additional challenge of navigating the language as a non-native speaker. Give them extra time to process information, ask further questions, and provide resources in their language if possible. It’s essential also to consider if they need additional support, such as translation services, mental health support, and further community resources (for example, community groups or patient organizations). There’s also the opportunity to think outside the box, and use pictograms, etc.

A non-native language speaker in a complex situation can be completely overwhelmed. It is exhausting to constantly think in another language and continually translate in your head. Add in the stress of a neonatal unit or a complicated pregnancy and additional worries and concerns, and being a non-native speaker can be overwhelming.

Care providers, please be considerate in this situation. We must recognize that this is an additional consideration for patients, and take the time for clear communication, with allowances for the circumstances that they’re in. It’s not a time for pushing language classes, or ignoring the needs of a patient who just wants to be heard in the language that they are most comfortable in.  It’s just a tip from a patient who’s been there.

Want to talk more about this? Get in touch.