1. a) I believe that in this particular situation, the main problem with the communication had to do with cultural differences with the French language. There are subtleties and different expressions with all languages that vary by region. In this situation, the French speaking doctor was not Acadian and he did not catch Marie-Marthe's expression "foies". I also believe both doctors should have started with the active offer.

b) The doctors should have payed attention to their patient and seen that she was showing symptoms related to her lungs like coughing, wheezing, and shortness of breath. They also should have noticed that she generally looked unwell because she had a fever, and they should have asked more questions.

2. The two doctors could have asked Marie-Marthe to show them where her pain was on her body. This would have helped them understand that there was a misunderstanding. Similarly, they could have asked her to show them where her "foies/livers" were on her body, and then they would have realized that she wasn't actually talking about her liver. I think the doctors should also have asked her why she used the plural of "foies/livers", and they could have discovered the miscommunication. The doctors shouldn't have made any assumptions and investigated more, like for example getting her to explain her symptoms.

3. I think health care professionals should be connected with professional interpreters and be able to call them in when needed. I also think that the providers should have access to posters of the anatomy of the body, so that patients could point to the location that they are talking about.

4. To avoid this type of situation, I think facilities should start with the active offer when the patient is registering for the appointment, and note in their file their preferred language. This way they can plan in advance to have a physician that speaks the preferred language of the patient available. If this is not possible, then they should arrange to have interpretation services.