Why do people have accents? - (2/12/2019)

By Dr. Ron Gasbarro

Mrs. Miller came into the pharmacy with a prescription for a new medication. “Did your doctor tell you anything about this medication?” asked the pharmacist. “The doctor has a very heavy accent,” she replied. “And he talks very fast, so I could barely understand him!” Understanding one’s doctor is important in making sure one correctly takes the medicine one is prescribed. A thick foreign accent or even a regional one can be an impediment in communicating information.  

To most Americans, an accent is something that only “other people” have, those other people usually being in New York (“Forghedaboudit!”), Boston (“Paak the caa in Haavaad Yahd”), and the South ("Ain’t choo got anymo Sebmup?”). Even Canadians have their own way of speaking (“You left your serviette on the davenport, hay mum!). Most people will swear they do not have an accent. Technically, the only way not to have an accent is not to speak.

Why do people have accents? For example, if Spanish is a person’s primary language and he learns English, why does it often sound like he is still speaking Spanish? We start to learn our native language as infants, a time when the muscles in our voice box – the larynx – are undeveloped in terms of forming words. (Crying is a different matter!). Inside the larynx is the glottis, which contains the vocal cords. These muscles develop exactly like any other muscle in the body – the more they are used, the bigger they get.  

An infant will spend his first 18 to 24 months listening to others speak before he starts forming utterances. As he learns more words, the speech organs grow and adapt to the tonal structure of his mother language. Every language has a unique tonal structure. Hence, when we study a second language, we undertake the laborious task of accommodating our speech organs to a completely different set of sounds. Think of how some Spanish-speaking people can roll their “Rs” (e.g., R-r-r-r-r-ruffles have r-r-r-r-ridges), while most English-speaking people cannot. 

Linguists claim that people do not develop accents. Rather, language patterns drift and morph over time in isolated populations, whether it is East Timor or the East Side of Manhattan. When people who have been geographically divided for some time encounter each other again, their speech patterns will be slightly dissimilar and interpreted as an “accent” by each group because it is different. In other cases, people may be divided by social class (“Let them eat cake!”), by religion (“Oy vey!”), or by level of education (“Ostensibly, Einstein’s Quantum Riddle will utterly revolutionize cryptography.”).

Phobic about foreigners? Having a clinician who comes from a different country can be life-saving. A 2017 study published in the British Medical Journal revealed that older hospitalized patients treated by doctors who graduated from non-US medical schools are less likely to die within 30 days of hospitalization than those treated by graduates of US medical schools.
Mrs. Miller asked the pharmacist about how to deal with a healthcare provider who has a heavy accent. Bring pen and paper to your next appointment. Write everything down and ask him how to spell the words you cannot understand. This will slow down the speed of the doctor’s speech and allow you to come away with more information than you would have gotten. Then, have the pharmacist fill in the blanks for you.  

Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Read more at 

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