Hongos

Though many of you (all 5 people who read this) have heard this story, it’s worth putting down on paper.

One of my favorite places in the ER is the GYN room. Some of the nurses call this the “Pussy Room,” and look at me with grave suspicion when they see me going over there willingly. “It smeeeeellllllls. I don’t want to look at those stank pussies!” is the general reaction. Yes, vaginas smell sometimes – but often they don’t. Sometimes gross things come out of them – but certainly no grosser than the piss/shit/puke that runs like a river through the main ED.

I’ll take a nice 26 year old woman with a yeast infection, stinky vagina, and pain on urination over a beligerant drunk ANY DAY.

Pussy Room?

The most popular GYN patient comes in with: vaginal bleeding and/or vaginal itching, and/or vaginal discharge. I suppose some nurses have good reason to stay clear of the GYN rooms, but if you can get past a fear of vaginal discharge, it is actually a great place to do a lot of health promotion and patient teaching. So many women in the community we serve are TOTALLY out of touch with their vaginas, anatomy, and reproductive powers (mostly how to stop having babies when they don’t want them).

One day, as I was passing by the GYN room, one of the Physician’s Assistants (PA) called me over and asked me to translate. Usually, the PA or doctor will give me a summary of the patient and a run-down of the treatment instructions and then send me in to talk to the patient.

Though my Spanish is not perfect, it’s usually more than good enough. 99% of the time, my translating is a good plan. 1% of the time, my patient has a nervous breakdown for good reason.

This particular patient had a urinary tract infection (UTI), explaining her pain on urination, urinary frequency, and nitrites and leukocytes in the urinalysis. She also had a yeast infection, explaining the yellowish-white (cheese) discharge, and the itching. All I needed to do was tell her about her infections. The doctor had already given her Diflucan (fluconazole) for the yeast infection and she could use some over-the-counter remedy to treat her itchiness. I was also to give her the prescription for antibiotics to treat her UTI. Easy. Right?

I started:

“Ok. Tienes dos infecciónes. La primera es de la orina y este es receto para antibióticos que van a curar la infección de la orina. Es muy importante que tomas todas las pastillas, aunque se quite las síntomas después de un día. Lo que pasa es que la infección se puede empeorar si no tomes todas las pastillas. OK?”

Ok. You have two infection. The first one is an infection in your urine and this prescription for antibiotics will take care of the UTI. You have to take all of the pills they give you, even if your symptoms get better after one day. What happens is that the infection can get worse if you don’t take all the pills.

Simple explanation. No problem. She looked passive enough and was taking the news well. So I continued:

“La segunda infección es de la vagina. . . . Shit. How do you say ‘yeast?’” I started to mumble to myself, realizing I was unprepared for this part of the explanation.

She looked confused that I was now speaking English to her and gasped, “Es CANCER!!!???”

Now in my own flustered Spanglish: “Jesus no! No tienes cancer! No tienes ninguna cosa grave. You don’t have anything serious. Este infección que tienes es una infección que todas las mujeres tiene de vez en cuando. Es algo que se puede tratar con medicina SIN receto!”

This infection that you have is not serious! It is an infection that ALL women get sometimes and it is easy to treat with over the counter medicine!

I told her to wait for me while I escaped from the room in search of real-life Spanish speakers. I found one – an IV tech from Puerto Rico – and asked her how to say “yeast.” She looked puzzled for a second and rallied round a group of ED Techs – from Columbia, Puerto Rico, and Mexico. They discussed the matter for awhile while I waited and soon came to me with an answer.

You should tell her, “infeccion vaginal.” I explained to them that that is what I said and now she thinks she has cancer. I needed the word for “yeast.”

They returned to their huddle and after another couple of minutes, their spokeswoman emerged:

“We don’t know about this “yeast” you say. But there is something like “hongos?”

I looked doubtfully at her. When I learned Spanish, hongos meant mushrooms, not yeast.

She nodded saying that she knew, she knew, but hongos was the best word they could come up with right now.

I marched back to my patient, hoping she was not envisioning her future with chemotherapy.

“Ok. Escucha. No tienes NINGUNA cosa grave (You don’t have ANYTHING serious) Tienes una infección de la vagina que es muy común (You have a very common vaginal infection). Si lo puedo explicar bien (If I can explain this well) : La infección no es bacteria (The infection is not a bacteria), No es virus (It’s not a virus), Es algo diferente (It’s something different).

At this point, I paused and took a deep breath. I already had a premonition this was not going to go well. With my best inquisitive look, and in a very low voice:

“Es algo como (It’s something like) . . . como . . . (like) . . . hongos (mushrooms) ?”

“TENGO HONGOS!!!! HONGOS!!! HONGOS EN MI VAGINA!???? (I have mushrooms in my vagina!?)” She roared.

“Damnit. NO! NO! No tienes hongos. No son hongos. Forget everything I’ve said!! Please!”

At this point, I returned to assuring her that this was, in fact, an infection that everyone gets. Really common. Not serious. Easy to treat. Over the counter. No prescription necessary. No tserious. We have already treated it with Diflucan. Not serious. Go to the pharmacy. Buy Monistat. NOT SERIOUS. Not Cancer.

Repeat after me: All. Women. Sometimes. Get. Mushrooms. In. Their. Vagina.

*** Post Script ***

I finally figured out a solution. I got a piece of paper and wrote:

Infeccion vaginal = “yeast infection” en íngles.

To the pharmacist: I have a yeast infection. Please show me where to find Monistat or another related treatment for my yeast infection.

I told her to show this to her pharmacist and then keep it for herself, in case she is in the ER again with the same symptoms. In case she has another case of the hongos.