GALVESTON, Texas - Ines Gutierrez hurts all over. She gets around with a four-pronged walker; she has arthritis in her hands and a severe pain in her left shoulder which flashes down into her elbow. She may need surgery for the cataract in her left eye. On top of all that, she's clinically depressed. All in all, she has to carry around a toiletries bag full of pills just to get through the day. But her news isn't all bad. Here in a UTMB Family Medicine Clinic examination room, the 73-year-old appears to bask in the warmth of Dr. Ana-Catalina Triana's attention...

particularly in the doctor's soothing use of Spanish and in her cultural comprehension. From Dr. Triana's greeting, "¿Cuénteme - como se ha sentido?" (Tell me, how have you been feeling?) to her "que le vaya bien, senora" (that things go well for you) farewell, the doctor connects with her patient, who immigrated to the United States in the early 1980s.

She's been treating Gutierrez for eight months, but you'd think they'd known each other for years. When Gutierrez says that she's stopped taking her Prozac because it makes her feel bad, Dr. Triana suggests they try another medicine, then adds, "I remember the last time we changed antidepressants, you felt better right away." When Gutierrez says that her stomach no longer hurts when she takes her medicines, Triana warmly replies, "Cuanto me alegra." (That makes me very happy.)

Gutierrez says that she is pleased to have a doctor who not only speaks Spanish, but who also understands her culture. "I can explain myself better," she said, "and get better treatment."

"Breaking the language barrier makes it easier to focus beyond the biomedical aspects of the encounter and connect with the patient as a whole," Triana said. "Then you can use the doctor-patient relationship as a therapeutic tool.

Dr. Triana is from Colombia, and she sometimes has to do a bit of cultural juggling to translate Mexican concepts to those of her native land. But the differences are trivial, while her connections with her Hispanic patients are profound.

"I feel a sense of community and belonging with them that goes beyond language," she says. "I'm doing something for my own culture."