Mr. V was one of my first primary care patients. He arrived at my outpatient clinic with a complex array of medical problems, having recently been discharged from the hospital following a massive heart attack and still undergoing treatment for cancer. An elderly gentleman who had spent much of his life abroad without medical care, he was thrust abruptly into the American health care system filled with doctors’ visits, tests, and treatments. As if his medical history wasn’t overwhelming enough, Mr. V spoke no English — like many patients under my care.

Over the next few months, he came to see me frequently, always with a medical interpreter who translated while I examined, explained, and prescribed. Waiting for her to repeat everything that Mr. V or I had said was cumbersome at times, but the interpreter’s presence was invaluable. When I changed a dose or suggested a new treatment option, Mr. V would smile and nod, seemingly in agreement. I felt that we had established a rapport.