Background:
A lot of factors are involved in an effective health care. In our geographic situation, several cultures live together, so language barriers are a real difficult which is not well studied in the literature. Though the hospital usually have translators, it is usually difficult to find someone that helps us to communicate with our patients in the moment that we need, especially in a context of budget cuts due to the economical crisis.

Case report:
We present the case of a Chinese 43 year old patient, in her first visit with the anaesthesiologist. She was scheduled for hysterectomy. The patient came alone, and there was not any possibility of communication with her, except by using gestures. Clinical antecedents were not possible to be investigated. The only thing we could get was a bag full of boxes of medication written in Chinese, all them bought in her country, that she showed us (see photographs 1 and 2). We tried to find a Chinese translator in the hospital, but there was no one available to help us. We even tried the use of tools like Google Translator and Chinese dictionary, uneffectively. The patient had to be re-scheduled, so the anaesthetic valuation had to be delayed until a translator was available, but she did not come back to the hospital again. The patient, in addition, reported a complain to the Hospital, due to this situation.

Discussions and conclusion:
Several studies have demonstrated that the language barrier is an independent variable responsible of having worse health status in immigrants. The health outcome is positively correlated with the physician-patient communication, as some studies have demonstrated. In our case, a language barrier is an obvious challenge to be overcome during a discussion regarding medications, which is indispensable information in order to plan a proper anaesthetic act. The absence of translators and other logistic facts, especially in context of economic crisis, gets worse the health care.

Learning points:
1. The foundation of primary care is the physician-patient relationship, especially in pre-anaesthetic visits.
2. Language barrier is a great obstacle to the therapeutic bond, so more attention needs to be given to the process of communication between both.
3. This logistic problem could carry iatrogenic consequences: anaesthesia in patient taking medications that we cannot determine may be fatal for the patient.



11 / ¡Perdón, doctor, no le entiendo! (I Am Sorry, Doctor, I Don't Understand You!)