S1E14: English as a “Second” Language

Harjit: Hello. This is so cool.

Bushra: You always do the weirdest voices every time I come up here.

Margaux: I know.

Harjit: I like it.

Margaux: Which is why the music episode will be very interesting.

Leen: We're going to have a music episode?

Harjit: Yeah.

Bushra: I can harmonize like crazy.

Harjit: You can harmonize?

Leen: Unless she backs out.

Harjit: I can do the "ahhh."

Margaux: I can't do anything. I don't sing. I'll lip-sync.

Hey, everyone. This is the "Bundle of Hers." Margaux here, and we have everyone in the studio today, which is exciting.

Harjit: Yay.

Margaux: And today at school, we had a great lunch small group workshop and discussion about microaggressions. One of the examples I brought up in our small group was that when people learn that my mom is Czech or that my husband is Mexican, they usually say, "But you don't have an accent."

And so I wanted to bring this up with you guys, and I wondered if you had had a similar experience or what you guys feel about accents and as it exists to part of your identity.

My second question would be, how do you think accents are perceived in the medical profession, like a doctor that has an accent versus a patient that has an accent?

So I'd just like to kick off the episode with that and hear your stories. Who wants to start? Bushra?

Bushra: I mean, as far as accents go, I had a lot of great teachers in undergrad that had accents, and they weren't very popular teachers because I feel like they had accents. And so I overheard students saying, "Well, their accent makes them very hard to understand." Meanwhile, they're speaking very clearly. They're speaking English. They just have an accent.

And so the problem is then it's easy for the students to, I feel like, tune out or not listen or not care or something along those lines. And maybe I'm . . .

Harjit: Have an excuse?

Bushra: Yeah. Maybe I'm just projecting. I don't know. But that's what it feels like. It's not the content of what they're teaching, but what the students are getting out of that content.

And so I always thought that was an interesting idea that you could be so knowledgeable in a subject and so great at teaching it, but it gets overlooked because of the accent.

Margaux: Interesting. Leen?

Leen: I know with my parents being professors, they're always worried about class enrollment is low because maybe they have an accent, or being a student, and people don't know that they're your parents, and be like, "Oh my gosh, the one person with the Turkish accent," or something, even though it's not Turkish.

I think also for people who have parents with accents in education and in any other field . . . I don't know. I can only speak from my experiences through education. They always come to us saying, "How do you say this word? Am I saying this right? Could you teach me how to say this word?" And so we're actually teaching them how to get over their accent.

I know my parents also have this little joke that they do before they start class saying, "If you don't understand anything, at least you'll enjoy the accent."

It is a real thing through education, and I think it does stem over to medicine. I know a lot of people saying, "Oh my gosh, I won't understand that physician if I go to them because they have an accent or something." I completely hear that from people too.

Harjit: Bushra, what other languages do you speak?

Bushra: So I speak English and I speak Somali at home with my family. And then I minored in Spanish. I won't say I'm fluent in Spanish, but I did spend a semester in Spain.

Margaux: Wow.

Harjit: And Leen, what about you?

Leen: Oh, I speak English and Arabic.

Harjit: And Margaux?

Margaux: English, and then I studied Spanish in school, but I practice with Diego at home.

Harjit: I speak English, Punjabi, and Hindi. Hindi I kind of learned from watching a lot of Bollywood television. Punjabi is my mother tongue. And then I also consider English my mother tongue too sometimes because I grew up here.

I feel like this whole talk of accents is interesting because it's also the perspective you're listening from. Someone would say I have an American accent when I speak English, or I have a Utahn accent when I speak English. I think it's a lot about the context, right?

But I think the assumption is made that if you look out of the norm . . . and by norm, I'm saying what's defined by society as the majority, which is English speaking . . . then the assumption is often made like, "Oh, you have an accent."

I find it interesting how some accents are . . . Is the word romanticized? A British accent versus Indian accent. I mean, the whole popularity of an Indian accent in America came from Apu, a "Simpsons" character, because the Simpsons are a national treasure. And it's so interesting because the person who says that character's voice is actually white.

Margaux: Do you think that that representation of the Indian accent, so to speak, is too comedic, or is it . . .

Harjit: I think it takes certain aspects of the accent and kind of pushes that one boundary of it. And that's where I find this whole conversation about accents really interesting.

Margaux: Leen, you had a comment?

Leen: I can kind of relate to that. I know the puppet Achmed or whatever. So people always assume Arabic is a very harsh language and it's full of khas and dahs and whatever. I don't know what those letters are. But when I speak it, they're like, "Whoa, that's a lot softer than we thought it would be." And I'm like, "Well, don't you realize there can be many accents within a language? You've got your Boston accent, your New York accent, your Texas accent, your Utah accent."

Harjit: Mountain.

Leen: Mountain. There are no Ts.

Margaux: Do you guys feel you have an accent, each of you, about yourselves?

Leen: So people tell me I have an accent.

Margaux: But how do you feel? What do you think?

Leen: The only time I get an accent is when I'm speaking Arabic, and then I go to English real fast, and then I go back to Arabic, and then that English has an accent. That's the only time I can see it.

Margaux: Okay. Harjit?

Harjit: Sometimes people say I do have an accent. Sometimes people are surprised I speak English so well. And in a part of me, I think maybe I do because the way my tongue has been formed, because I've had these three different languages that I speak. I don't know if I would say it's an accent. But actually, no, it is an accent. Isn't an accent just a different way of saying something?

Margaux: Yeah.

Bushra: Yeah.

Harjit: So, yeah, I guess in that sense . . .

Bushra: It's all phonetics.

Leen: I think you have a little bit of an accent.

Harjit: In the broad sense, yeah, I have an accent. But then it's how people use, "You have an accent," that term that really impacts us.

Margaux: Do you feel like you have an accent, Bushra?

Bushra: I've never been told that I have an accent. I don't think so.

Something that you mentioned, Harjit, was that you think English is your mother tongue as well?

Harjit: Yeah.

Bushra: I picked up on that because someone told me a long time ago that the language that you dream in is . . .

Leen: Yeah, I've heard that too.

Bushra: . . . your primary language. And so I find myself dreaming in Somali and in English too, and so I'm like, "So then where do I fit in that grand scheme?"

And then another thing that I wanted to mention is that I have an American accent when I speak English, but when I speak Somali, people always tell me that I also have an accent when I . . .

Leen: Oh, really? Interesting.

Bushra: Yeah. They tell me I have an accent.

Harjit: I get that too when I go to India.

Bushra: Yeah. When I went back home over the summer, everyone was like, "Yeah, you totally have an accent." I'm like, "Literally, I'm saying the same words as you guys."

Margaux: What do you have to say, Leen?

Leen: I know when I went to Dubai, I scared a few people because I had a perfect English accent and a perfect Arabic accent, and they're like, "Who are you? How does this . . ."

Margaux: You're a spy.

Leen: "You're a spy." I got that so much. People would not even want to sell anything to me. They're like, "Where do you even come from?"

But interestingly enough, I consider . . . I know growing up through school, everyone tells me, "English is your second language." But I always felt like they were both my half languages. I'm not proficient in English. I'm not proficient in Arabic. I merge the two sometimes.

Bushra: What do you mean you're not proficient?

Leen: What I mean by proficiency in English, I think it's more reading-wise, sometimes comprehension. I understand it differently than maybe some of my peers would read a certain paragraph or something. The way I go about speaking, the way I go about explaining myself, or basically just the way I talk in a sense, and what message I get across when I talk is sometimes not perceived the same way. So I'm like, "Maybe it's not 100% proficient."

Bushra: I wouldn't say that's a proficiency thing, though. I would say it's a context . . .

Leen: A language communication proficiency. I think it's a proficiency.

Bushra: I don't know. I think if you have a vast vocabulary within a language and you use the grammatical rules . . . Which I believe is flexible, by the way.

Harjit: Same.

Bushra: And you use those rules within the context of that language, then you are proficient. I think there are times where people use a word that I've never heard of before, and I'm like, "I don't know what that word means in English." Meanwhile, I've spoken English since I was a kid, right?

Leen: Yeah.

Bushra: And it doesn't mean that I'm not proficient in the language. It just means that I haven't been around people who use that word.

Leen: But aren't there levels of proficiency in that sense, depending on how vast your vocabulary is?

Bushra: I would say that if someone could explain that word to you using other words and you understand what they're saying, then you're proficient in the language.

Leen: That makes sense. I always felt like maybe I can speak English well and everything, I speak English fine, but I don't have all the vocabulary present. And I think that's something you gain throughout your background. Whether you read a lot of certain books as a kid or whether you grew up in a culture that really emphasized the hard, difficult words you only find in dictionaries, I think that's where you get those vocabularies.

And ironically, I feel like those are the words that come up on the MCAT verbal reasoning section, the whole list of, "These are the words you should know for the ACT, and then here are the words for MCAT, and here are the words for all those."

Harjit: I think, Leen, you actually bring up such a great point, because I feel like it's also the way we shape our thinking. The way you just talked about proficiency in English, I think I was raised to think of English in that sense.

So I actually have a story about this program called ESL, which is English as a Second Language. And you kind of brought this up as well. I was born in India, but I moved here when I was 2.5, and I learned English through watching television.

When I was in second grade, I remember that I was pulled aside and they said, "You need to take ESL." And I was like, "Why?" They're like, "Oh, because it's not your first language. English isn't your first language, so you need to have a certain proficiency in that class." So I took it, and then I think I had passed a certain proficiency level.

Margaux: How old were you when they made you take this class?

Harjit: I was in second grade. I'm not sure what age correlates with that.

Margaux: Eight.

Harjit: Eight.

Margaux: I think.

Harjit: So then what happened was after a year, I was taken out of ESL because I had reached a certain level. In sixth grade, I remember we had to take this test, all of us, and it was basically kind of to see where you were at. And then I remember my English teacher pulling out five of us, and I was one of them, and she said, "You guys scored the best on this test." So I was like, "Oh, I actually know English. I don't even know why I had to take ESL."

So then I went to junior high in seventh grade. They tried to place me in an ESL program, and they said, "To get out of the program, you have to take a test." And I was like, "I just took this test, which I scored the best out of all the kids in sixth grade, and you want me to take another test?" So I think I did and I passed out of it.

And then I was in ninth grade, and I was in this English class. Basically, this teacher taught the Honors English. She taught the gifted and talented English. And from all the classes, I got an award for the best English student. And that was like a really proud moment for me because I think I struggled with this whole idea that, "Oh, I'm not good at English."

And then when I was in 11th grade, you won't believe, but they called me into the office again, and they said, "You haven't passed the ESL language test." And I'm like, "I've taken it already. What do you mean I haven't passed?" They said, "English is your second language. You have to take this test."

I stood there, and I told them, "I'm not going to take this test because I'm taking AP . . ." No, I was taking Honors English. Next year was going to be AP English, which is the highest English. And I was like, "I'm not going to take this test. You can ask my teachers. I'm doing well in this course." And so I left, and they never called me back, so I guess I didn't have to take it.

But the reason I'm talking about this as chronologically is because I want this point to come across that really the way we think about things . . . Again, what Leen had just said, that's how I thought of proficiency in English. I didn't think, "Can people understand me?" I thought it was a thing that I had to get a certain grade on. Does that make sense? And so my whole life, I've been struggling, thinking I'm not good at English.

Margaux: That's because the system was telling you you weren't good in English.

Harjit: Right. And it impacted, literally, my whole life to this point. I think where I really kind of started breaking that down was when I was taking the MCAT. So I actually took the MCAT four times. The first three times, I couldn't even get the minimum score to apply in the verbal reasoning section. And I think that really came out, my low confidence in English. Being proficient in English came out through that.

I think I started the year between when I took, that last time, the MCAT. I literally sat and unconstructed my ideas around proficiency, and finally, I was able to . . . I actually scored pretty well on the English section in that last test. So it wasn't that I couldn't do it, but it was this whole narrative.

Margaux: It was like a mental block.

Harjit: Right. And then I think it's really cool you brought up this microaggression point in the beginning. This is how things like this impact your life. It impacted every single day of my life.

And I know I'm not the only one who has an ESL story. I know Leen and Bushra do as well. So Bushra, do you want to share yours?

Bushra: I think in the same vein, I wasn't born in this country. I came here when I was 3 years old. And so when I started school, it was also around second grade. That's when I was first placed in ESL.

And so I get placed in ESL, and I actually really enjoyed it because they took us out of class. It was just a group of us kids who either came from a different country or had parents who didn't speak English at home. And so they would teach us how to speak English correctly or something, and then they would also incorporate activities with that.

After a certain level, they think, "Okay, you're good. You can be brought back with the rest of your class. You should be good enough to do well in the class." And it was great because I got out of class, I got to do fun things that the rest of the kids didn't get to do, and then after I proved my point of, "Yeah, I can do this," got back into the regular class.

And then in the seventh grade, as I was registering, I saw that I was placed in ESL again. It came to a surprise to me, and it came to a surprise to my mom who basically was like, "Uh-uh. Not today." So she basically was like, "You're not going to get less of an education. They're not going to put you in a class that's not challenging you enough because of what they think is going on with you."

We all took the CRTs, the end-of-the-year exams, and I always did well in them. And so it was like, "There's no reason for you to be in them." She just marched right up to the guidance counselor's office and demanded that I not be placed in those classes.

And so it's kind of interesting because when I look around me, and I look at the people that have the same background as me, it's the same situation. They always get placed in the ESL classes because their parents are immigrants, because the primary language spoken at home is not English. And so the assumption is made that because English is not the primary language spoken, then there must be a lacking in that area of your life.

Margaux: Do you guys know is it a computer algorithm that's putting you into those classes, or is there an actual human being looking at your record . . .

Bushra: I'm not sure.

Margaux: . . . and then deciding? Because it seems like somebody or something made a judgment about you without even knowing previous academic record to place you in that class.

Harjit: I'm not sure how it's done. I would say that the intent is good of these programs, but, again, it's all about impact.

Bushra: Yeah.

Margaux: And it seems like it's not something that's required for you to pass school, because your mom could get you out of it, and you said, "No, I'm not going to take the test," and you didn't and you were able to graduate because of that. So it seems like it's almost just like a barrier or a hurdle that they make people jump, right?

Bushra: Yeah. Like Harjit said, I think their intent is to help students who, because of their lack of proficiency or because of problems with language who would suffer because of that, to kind of bring you up to par.

But the way that they try to implement it is completely out of balance. First of all, I think they make the classes a little bit too simple. And I think they dumb it down, and I think that the kids in those classes get bored. That was my experience in them. They get bored because it's too easy, and so they're not challenged.

And then they don't give them the opportunity for longitudinal movement. It's always . . .

Harjit: I agree.

Bushra: There's no movement upwards.

Harjit: Because you're stuck in that . . .

Bushra: You're stuck.

Harjit: You're stuck in that class, and then you can't take the AP classes or the honors classes.

Bushra: Exactly. Also, it doesn't just impact the English side of it. It impacts the science classes that you take, the math classes. Math is the same in every single language. Just because someone does not understand English does not mean they won't understand math.

And so it just kind of impacts a student's life on a huge level, because in one hand, yeah, you're trying to get these kids to succeed, but on the other hand, you're not allowing these kids to rise up to their full potential.

If I didn't have a mother who knew better, I don't know that I would get the education that my peers have gotten. I had a parent that advocated for me. And some parents don't know any better. They trust the school system that keeps their students in these programs when they simply don't need it.

Margaux: Leen, do you have an ESL experience?

Leen: My ESL experience lasted only for about one week in kindergarten. I guess there's a form you sign or something, so they knew that the primary language spoken at home was Arabic even though growing up . . . I was born in the U.S., so I was seen as a translator for a lot of the Arab students who were coming directly from the Middle East, and so I'd always get paired with them during recess and be like, "You're teaching them."

But I got sent to ESL for one week. And basically, what happened was it was a little closet, if I remember right, and there were cockroaches everywhere. So I made it a goal to learn English in a week. I was like, "I am getting out of here in a week." So, yeah, I memorized those cards, and I got out of there. I never went back.

But that being said, I think for me, just raised in a different cultural context where language can mean two different contexts and things like that, to this day I do struggle with comprehending the way things are written in a certain way that they're supposed to be comprehended versus another way.

The most that I ever really struggled with that is probably in med school when we started doing the vignette kind of questions, where I would read it and be like, "Okay. So this is what I understood from it." And I will overthink it or something, and then I always suffer the consequences.

I remember after our first test in MCC, I went to Rebecca Lish, who's our academic success advisor, and I said, "Rebecca, I need to go back to first grade and learn how to read because, clearly, I don't read the same way other people read."

Harjit: But Leen, how much do you feel that is something you're not good at? Sorry, I'm kind of mirroring my experience. But "I'm not good at," and how much do you feel that's just the way our mind has been set up, that we're not good at this language, so then the outcome is that we're not good at it?

Leen: I think it's a mix of both. I think it builds up over time. The first time you read it, you're like, "Oh, that's not the way I understood it. Why did I read it this way?" And then when it just keeps happening over and over, then you're like, "Clearly, I'm not proficient." And then it builds up from there. And so you kind of have to . . . I don't know. I think it's a mix of both. I really do think it's a mix.

Bushra: I also think that with med school at least, there are test-taking strategies that I feel like I just started learning when I was in med school, and I had no freaking idea beforehand.

But it seems like when I compare notes with our other classmates, they're like, "So this is what I do when I read a question. I look at what the actual question says, and then I'll look at the pertinent information given, and then I'll make sure my answer fits within all of these." Stuff like that. And I'm like, "When did we learn this?"

Leen: Yeah, seriously.

Harjit: Right.

Margaux: That's true.

Bushra: I don't know it's necessarily being proficient at reading the question, but more understanding how a question is written for you to answer it.

Leen: Yeah. And thinking back to it, the only way I was ever tested in comprehension was I'd be taken out of the classroom . . . So they'd do this once or twice a year for me. They would take me out of the classroom and they would give me a big, long paragraph of a story, and they'd give me one minute to read it. And then the lady takes the story away, and she'll say, "What did you get out of the story?"

Bushra: That was the same way for me.

Harjit: Same.

Leen: Exactly. And so now looking back at that, that's not exactly helpful when it comes to reading med school vignettes. I mean, yes, you have less than a minute to comprehend the story, but you're building up a differential as well. It's just a whole different approach than it is, "Tell me what happened in the story." And if you didn't get all the points on her checklist, it's like, "Okay, bad comprehension. Go back and do it again."

Margaux: Interesting.

Harjit: Basically, we've been discussing these experiences that we've had with ESL. So how do you feel like that is going to impact you in the future when you become a physician?

Leen: I know even before becoming a physician, I think a big part of who I want to be as a doctor kind of started before I was even in med school. I want to be able to reach out with other contextual clues. For instance, I know hand gestures, and eye contact, and things like that.

Just understanding how a culture sees a perspective helps you communicate with them. So it's not all about, "Here's this long piece of paper about all these rules that we're . . . Here are the rules in the clinic. Sign the paper. Do you understand everything?"

In Layers of Medicine, we read that book, and I think that was a big . . . What was the book called?

Bushra: "The Spirit . . ."

Harjit: "The Spirit Catches You and You Fall Down."

Leen: Yeah. Language barrier was a huge problem there. And I feel like for us where we understand more than one language and we've been culturally immersed from where that language comes from, we can communicate on different levels that others cannot. And I think that's our place. I think that's very important for us to step up to the plate and be advocates for our patients in that sense.

Harjit: I so agree with you, Leen. I think I took knowing a different language, knowing Punjabi, Hindi, and English for granted, and also I was like, "Oh my gosh, I wish I only knew English." And it wasn't until I later that I grew up that I think it's become a strong point that I know more than one language, because it really helps you see the world in a different way.

Leen: Yeah. We'll suffer through the tests, but when we're doctors, we're going to be great.

Harjit: Yeah. True that.

Bushra: But it also gets better though.

Leen: Crossing fingers. Always.

Bushra: I always take every test as a learning opportunity, like, "This is the mistake I've made. I'm not going to make that mistake again."

Margaux: I feel like in med school, it's learning how to take the test, not learning the material.

Harjit: I agree with that. I think much things that I've grown up . . . One thing I've learned is that a lot of the times, it's all about how you go about something rather than how much you know. We all have that potential within us, right?

Just a side note, a way I resist this whole, "You're not good at English," because I was so angry about it my whole life, is on social media, I don't capitalize anything. I don't put periods at the right places. I feel like that's an outlet for me to show that I can still communicate my ideas, but they don't have to be grammatically correct.

Bushra: Follow the rules. Arbitrary rules, by the way.

Harjit: Yes. Also, I think in that same vein, I feel like for me, the impacts it had is . . . I'm letting them go now because I feel like it's ruled my life long enough. I have been trying to be more confident that I do know this language. This is my language. This is my place here. But it is so amazing that it took me so long to realize how this literally has impacted every single day of my life.

Margaux: Yeah. I think that's a great segue back to the microaggressions we were talking about in the beginning, Harjit. And one thing I wanted to ask you and point out when I was learning Spanish, there was so much emphasis on getting the accent right, because if you didn't have the right accent, you sounded ignorant.

And I wonder if there was any emphasis in your ESL classes on fixing "your accent" to make you sound less or more . . . I don't know what the right word is. But was there an emphasis on accents in ESL?

Bushra: In my experience, yeah. My thought was, since you were so young, they can fix the accent problem at a young age, and it won't impact you when you grow up.

And you know what? I think that has impacted me, because my mom has an accent when she speaks English and I used to be so embarrassed every time she'd try to speak in English. It was such a thick accent and I'm like, "Oh my god, you're so embarrassing, Mom." It impacts your life in a couple of different ways. Yeah, she had an accent. She doesn't wear Western clothing. I was for a long time . . .

Harjit: Embarrassed.

Bushra: . . . embarrassed of her and my culture, and I didn't want any trace of what my culture was.

Harjit: Who you were as a person.

Bushra: Yeah. Things that impact my life every single day, I didn't want . . . I wanted to seem as American as possible or what I perceived to be American or what I've been told to be is American. And so the impact of that, I think, is huge. And it wasn't until recently that I've been more prideful of where I come from.

Harjit: Me too.

Leen: Same.

Bushra: I'm more willing to share with other people my culture, my beliefs, and more just kind of open.

Margaux: Yeah. I think the point that Leen said, having the command of both languages allows you to connect with your patients on a deeper level if they come from that culture. And I think there's something to be said for that with accents too, when a patient can recognize your accent or you can recognize theirs and have that connection. And maybe instead of hiding accents, we should embrace them as we should embrace diversity of all of our cultures in medicine, especially.

Harjit: Also, I just want to re-say that everyone has an accent. And that's something that . . . I think it's just the way we think about it.

I thought we had a great conversation today. I think this is something I've always wanted to talk about and think about often.

I hope our listeners had a great time and you had a great time listening to us talk about our stories. We actually would love to hear yours too, so why don't you come on and see our Facebook page or our Instagram page, Bundle of Hers, and leave your comments? That would be great. Bye.

Bushra: Bye, guys.