The most important advice I can give to anyone learning a foreign language is to try to master the pronunciation at an early stage. This has a double benefit. Not only will you be understood more easily, but you will be better able to identify and retain words and phrases of the foreign language as you hear them. This will greatly accelerate the learning process. As you hear the foreign language being spoken by a native speaker, repeat key phrases over and over in your mind—or even aloud if possible—comparing your pronunciation to the immediate memory of the correctly spoken sounds. Experiment with your tongue, lips, and palate to create sounds which may be unfamiliar to you. Take a deep breath and pronounce the soft ‘i’ of the English word ‘sin,’ then slowly modulate it to the ‘ee’ of ‘seen.’ Go back and forth between these two sounds. Somewhere in between is the ‘i’ as it sounds in Spanish, for example in ‘cinco.’ Pronounce the English ‘d’ sound over and over again and gradually modulate it to the ‘th’ of ‘the.’ Somewhere in between is the Spanish ‘d.’ Pronounce the English ‘h’ sound over and over again and gradually modulate it to the English ‘k.’ Somewhere in between is a close facsimile of the Spanish ‘j.’ Exercises like these will improve your pronunciation rapidly.
On the subject of pronunciation, note that Spanish vowels are short and pure. Never linger on a vowel as in English. Say the sentence, “No way!” with feeling and notice how the vowel sounds are drawn out. This rarely happens in Spanish; Spanish is much more staccato in its delivery. Note also that there is no schwa sound in Spanish. The schwa sound is the ‘uh’ sound so often given to unaccented syllables in English. For example the first, third, and fifth syllables of ‘acetazolamide’ are schwa sounds. In Spanish, vowels retain their characteristic sounds whether or not they are accented. ‘Acetazolamida’ is pronounced ah-ceh-tah-zoh-lah-MEE-dah, not uh-ceh-tuh-zoh-luh-MEE-duh. It is often helpful first to practice a word without consonants. ‘Acetazolamida’ without consonants would be ah-eh-ah-oh-ah-EE-ah. When you have mastered the vowel changes for a given word, it is usually a simple matter to fill in the consonants. Learn to say cah-BEH-sah, not cuh-BEH-suh; meh-dee-SEE-nah, not meh-duh-SEE-nuh.
When referring to a part of the body in Spanish, it is common to use the definite article instead of the possessive adjective, provided it is clear whose body is involved. The Spanish definite articles, recall, are el and la. ¿Le duele la cabeza? is the best translation of “Does your head hurt?” ¿Le duele su cabeza? is redundant in Spanish.
The indirect object* is used much more often in Spanish than in English. Health workers are frequently doing things to patients and this often involves the use of le or, in familiar speech, te.
Quiero tomarle el pulso...I want to take your pulse.
Voy a escucharle el corazón...I’m going to listen to your heart.
Tenemos que operarte la pierna...We need to operate on your leg.
This phrasing often sounds less brusque than Quiero tomar su pulso, Voy a escuchar su corazón, etc.
English-speaking people are often confused by the choices available for the direct object in Spanish. Te is always correct when speaking informally, for instance to a child.
Voy a examinarte, hijo..I’m going to examine you, young man.
When speaking formally, most Spanish speakers use lo for males and la for females.
Voy a examinarlo, señor..I’m going to examine you, sir.
Voy a examinarla, señora..I’m going to examine you, ma’am.
There are a few exceptions to this rule; for instance, the verb pegar, when it means ‘to hit’ takes le for a direct object.
¿Le pegó?..Did it hit you?
Some Spanish speakers will use le for all (formal) second person direct objects, male or female.
Voy a examinarle, señor..I’m going to examine you, sir.
Voy a examinarle, señora..I’m going to examine you, ma’am.
This style is common in Mexico.
Some verbs require that the subject and object be inverted when translating between English and Spanish. The Spanish student is likely to encounter this for the first time when learning to translate the verb ‘to like.’ “I like coffee” would be Me gusta el café. The subject and object are inverted. This particular construction is a stumbling block to fluency and even advanced students often have to think for a couple seconds in order to conjugate the verb correctly and choose the correct object pronouns.
Me falta el aire..I am short of breath.
Les falta el aire..They are short of breath.
Me dieron náuseas..I got nauseated.
¿Le salieron moretones?..Did you get bruised?
Te falta hierro..You’re low on iron.
Notice that the English subject corresponds to the Spanish indirect object in all these cases.
Many Spanish verbs are used in the reflexive form when applied to medicine. The use of the reflexive pronoun se turns the action of the verb back on the verb’s subject.
Se orinó..He urinated on himself.
Puede vestirla..You can dress her.
Puede vestirse..You can get dressed (literally ‘dress yourself’).
La enfermera le va a inyectar..The nurse will give you an injection.
La enfermera le va a enseñar como inyectarse..The nurse will teach you how to inject yourself.
A reflexive construction is often used when an English-speaking person would use the past participle preceded by ‘to get’ or ‘to become.’
Se cansa..He gets tired..He becomes tired.
Se mejoró..She got better.
Se dislocó..It became dislocated.
Se infectó..It became infected..It got infected.
Most Spanish nouns which end in -o are masculine and most which end in -a are feminine; however, there are some important exceptions in medical Spanish. For instance, many Spanish words which end in -ma are derived from Greek and retain their original masculine gender.
un problema médico..a medical problem
el electrocardiograma..the electrocardiogram
Other medical terms which end in -a and are masculine include cólera (the disease), día, herbicida, insecticida, pesticida, raticida, espermaticida and vermicida.
The word mano, which comes from the Latin manus, retains its original feminine gender despite the fact it ends in -o.
Tengo las manos frías..My hands are cold.
A source of confusion to Spanish students is the construction ‘el agua.’ Although agua is feminine (and requires feminine modifiers), el is used instead of la to avoid the awkward double ah sound of ‘la agua.’ This rule applies to any word which begins with an accented ah sound.
tratar el asma..to treat asthma
terapista del habla..speech therapist
This rule also applies to the indefinite article.
un afta dolorosa..a painful canker sore
un arma blanca..a sharp weapon
This rule does not apply to plural forms, since the double ah sound is then broken up by an s sound.
las aftas dolorosas..painful canker sores
las armas blancas..sharp weapons
Other feminine medical Spanish terms which begin with an accented ah sound include ámpula, área, and hambre.
When comparing quantities, use de.
más de dos pastillas..more than two pills
menos de una taza..less than a cup
In all other situations use que.
más alto que tu hermano..taller than your brother
menos que siempre..less than usual
menos que nunca..less than ever
Health practitioners should be aware that the Spanish word alcohol is often considered a synonym for ‘hard liquor.’ Many Hispanic beer and wine drinkers will answer no in all sincerity to the question ¿Toma alcohol? A slightly broader question would be ¿Toma bebidas alcohólicas? And then to avoid all misunderstandings, you could follow a negative answer with ¿cerveza?..¿vino?