One woman, whom I will call Gail for privacy, showed me her lab test instructions for her medical appointment. The instructions were replete with negatives and conditional statements. The pages even referred to “normal amounts,” to which Gail wondered, “What is a ‘normal amount’ in USA?

Gail went to the international office and the information was explained to her in her native language. She understood it then, but because there were so many details and nothing was written down, she did not remember. Upon looking at her English instructions later, she was stuck! She asked me what the instructions meant. Her confusion was not limited to the underlined words:

  • avoid foods containing high quantities of grease, oil, or saturated fat… “
  • “you must fast for at least 8 hours prior to having your blood drawn”
  • “…unless your doctor tells you otherwise…”
  • Unless fasting is required for your test, eat breakfast to help keep your blood sugar up.”
  • “Do not eat or drink anything except normal amounts of plain water for 8-10 hours before the blood draw (8 hours for glucose testing). You may drink normal amounts of water, but no coffee, decaffeinated coffee, tea, or juice.”

I tried to answer her question and explain the test instructions. This was impossible for her to understand! Finally, Gail asked me, “What CAN I eat?” This was exactly what she needed. She did not need to know all the conditions and negatives, which can even be confusing to native English speakers. She needed to know what she is able to eat and drink, and when she can do it. Together, we made a menu of foods she likes and met the requirements on the instructions. Then, we wrote that menu onto a timeline. This way, she knew what to eat and drink at what time of day.

Having the issue resolved and this difficult stress removed, she was much happier and able to do other things. Another day, we spent some time on negative words and sentences and conditional words and sentences, including the underlined words above.