English - It's Greek to me
English is a strange language. Did you ever notice that a "slim" and "fat" chance are the same thing and that you park your car in a "driveway," drive on the "parkway," and sit bumper to bumper during "rush hour?" Why is it that we duck our heads when someone cries "heads up!" and bring a contract to life when we "execute" it? How is it possible that to be "bad" is to be good or "cool" in some circles, but that being "hot" is also a desirable trait. What about the fact that "rough" is pronounced "ruff," but "dough" is "doo," and that you can buy a "whole" bag of seeds one "week," but be too "weak" to plant them in the "hole" by the time you get home?
If you note these peculiarities of English and add the fact that more than 400 other languages are spoken in the United States today, it becomes clear why good communication, especially in a multicultural health care setting, is a difficult task. Managers are, for example, concerned that immigrant staff do not comprehend instructions, nurses worry about communicating effectively to foreign-born families, and native-born patients can have trouble speaking with foreign-born health care providers.
Idiom, Slang, and Jargon
Idiom, slang, and jargon have long been a part of the English language. In the nineteenth century, the odd query, "How goes the enemy?" was a common way of asking for the time. Around 1900, to inquire, "How's your belly for spots?" usually received a polite, "I'm fine, thank you." In the second half of this century, Americans have been variously concerned with "What's cooking?" "What's up doc?" and "What's shaking?" Some have even been known to ask "What's your poison?" when offering a drink and "What's the damage?" when requesting the cost of a product or service. Clearly it is a fairly simple matter to know the literal translation of English words but much more difficult to grasp the subtleties and shades of meaning in these peculiar phrases. English is riddled with unusual meanings and phrases, many of them difficult to grasp unless one is raised in this culture. The following pairs of sentences, each representing two entirely different meanings, will give a good idea of the complexity of the language:
1a. Barbara did not come to work today.
1b. Barbara did not show up for work today.
2a. My boss is a wise man.
2b. My boss is a wise guy.
3a. Welcome to my home, would you like something to drink?
3b. Welcome to my home, would you like a drink?
Although the words used in these sentences are a part of standard English vocabulary -- the meaning of words like man, drink, and come, are not subject to question -- the idiomatic way in which they are used can create considerable misunderstanding in and out of the workplace. For those of us raised in American culture, it is obvious that the reason for Barbara's absence from work in example 1b is somehow suspect. The difference between a "wise man" and a "wise guy" seems dramatic to the native-English speaker, but would be lost on someone who is unfamiliar with the idiomatic meaning the the phrase "wise guy." In the third example, most Americans realize that the speaker in 3a is offering any type of a beverage whereby 3b is probably referring to something alcoholic.
Idiom and slang create, not only the possibility of misunderstanding, but also the risk of the listener taking a phrase literally. "You can say that again" and "It's just one of those things," for example, are merely cultural commonplaces and are not meant to be acted on or explored further. Cole Porter, the composer who popularized the latter phrase, never intended for the listener to respond by asking, "What things?" nor would it be appropriate to go ahead and "say it again." Similarly, "I have a lot of running around to do," could lead the nonnative speaker to think of you as a dedicated athlete. English is littered with such expressions, many of which can create painful embarrassment if taken literally.
To make matters worse, sometimes the same word can have varying meanings depending on the context. To say, "I believe in this idea" connotes a firm commitment to the concept. On the other hand, to respond "I believe so" to a question implies some doubt about the matter. The use of a question can create still more confusion. The query, "Why don't you read this over?," if taken at face value, might be interpreted as a question to be answered. The response might be, "I can't read it over because I forgot my glasses." In all probability, however, it is not a question, but instead merely a gentle way of inviting the listener to read the material; it might be rephrased, "Please read this over." As you can see, there is a great deal more to understanding what is intended than just knowing the vocabulary.
Occupational and professional jargon is another communication stumbling block that has been with us for centuries. Words we take for granted today were once industry terms designed to meet the needs of a new technology. Typewriter, airplane, and automobile are the most obvious examples. Today's jargon includes print-out, double-digit inflation, input, and telemarketing. If we add to this the proliferation of acronyms in our vocabulary, it is not surprising that even native-English speakers at times have little idea of what is being said. For immigrants the situation is worse. We tend to forget that jargon, slang, and idioms are rarely a part of English-as-a-second-language training nor are they taught in English classes overseas.
The Challenge of Simplifying Your English
The problem with the use of non-standard English is that we use it too often and far too unconsciously. How often do we use phrases like, "I couldn't care less" or "six to one, half dozen another" without stopping to think that they are impossible to decipher without intimate knowledge of the culture? The challenge of being alert to our choice of words is enhanced by the fact that many words are constantly passing from the category of jargon to being considered legitimate parts of the language. Some would argue, for example, that p.c. and videotape are now as much a part of standard English as airplane or steamboat. The point is, not how you categorize an expression, but whether or not it communicates what it is you want to say. Slang is dangerous. It can be readily misunderstood, taken literally, or even be offensive to someone who is unfamiliar with the spirit in which a term is used. Here are some tips for minimizing these dangers.
1. Make a list of idioms, slang, or jargon that are commonly used in your facility.
Include on the list terms such as gurney or stretcher, phrases like "on the floor" or acronyms like A.M.A. or abbreviations such as O.R and L.O.C. Make the list available to every employee regardless of their background -- a great deal of health care jargon varies within the United States as well as overseas. We all find it embarrassing to have to ask the meaning of a term or acronym, particularly if we feel that it is something we ought to know. The list minimizes the risk of embarrassment. It would be most unpleasant, for example, for a hospital worker to become confused over the meaning of L.O.C., a term that in different parts of the country variously means "level of consciousness" or "laxative of choice."
2. For one week, stay alert to the slang, jargon, and idioms you use.
Now that you are aware of how much unconventional English dominates our speech, make an effort to be alert to the terms you use and write them down as they come to mind. Look the list over from time to time. This simple effort will increase your awareness and allow you to communicate more effectively.
3. When you catch yourself using a bit of jargon, slang, or idiom, try to state your message in a more conventional way as well.
If, for example, you say to someone, "I am really up to my neck in paperwork" and you sense that the person did not understand but is reluctant to ask for clarification, simply follow-up the statement by saying something like, "It seems I have a lot more work than I used to." This technique serves a triple function. First, it allows you to get your message across. Second, it keeps the listener from being embarrassed at having to admit lack of understanding and, third, it serves to explain the meaning of the idiomatic phrase.
You will notice that the emphasis in this piece is less on avoiding jargon, slang, and idioms, and more on using this unconventional English in ways that will educate your non-native colleagues and patients. English is fraught with peculiar words and phrases, there is no escaping them. Non-native speakers need to gradually learn the nuances of the language so that they can function successfully in the American health care setting. The trick lies in being aware that not everyone is familiar with the nuances of our language and that it is the native speaker's obligation to help others adjust and learn with as little embarrassment and error as possible.
Sondra Thiederman is a speaker and author on diversity, bias-reduction, and cross-cultural issues. She is the author of Making Diversity Work: Seven Steps for Defeating Bias in the Workplace (Chicago: Dearborn Press, 2003) which is available at her web site or at www.Amazon.com She can be contacted at:
Sondra Thiederman, Ph.D.
4585 48th Street
San Diego, CA 92115
Phones: 619-583-4478 / 800-858-4478
www.Thiederman.com / STPhD@Thiederman.com
The material in this article is based on that found in Sondra Thiederman's Bridging Cultural Barriers for Corporate Success: How to Manage the Multicultural Work Force (New York: Lexington Books, 1990) and in Profiting in America's Multicultural Marketplace: How to Do Business Across Cultural Lines (New York: Lexington Books, 1991). Copyright Cross-Cultural Communications.Should you wish to re-print this article, you may do so as long as long as the current copyright statement and all contact information is included.