Didn’t I get myself all turned around today? During a presentation to a group of first-year residents (we were talking about phrasing questions to elicit good responses from patients) I tried to give an example of what not to do. I tried to start a sentence with a negative and then show its potential for confusion. Well, I did create an example of confusion. Shouldn’t I now try to clarify what I meant?

It is common for non-native speakers of English, especially those who speak an Asian language as their mother tongue, to respond to negative questions in a way that reverses the meaning of their answer. For example, if I ask, “She didn’t eat breakfast this morning?” a native English speaker would say “no” meaning, no she didn’t eat breakfast this morning. But a Chinese person learning English, for example, might answer as if there was no negation: “Yes, that is correct. She didn’t eat breakfast this morning.”

Another Example: “Didn’t you take the medicine?” If I answer with “yes” it means “Yes, I took the medicine.” But some non-native speakers of English will answer: “No, it is not true that I didn’t take the medicine”.

A question tag is the “mini-question” at the end of a phrase like: “Snow isn’t black, is it?” Again, non-native speakers often will answer with “Yes” (meaning “Yes, I agree with you that snow is not black.”

It is best when communicating across cultures to avoid negation in forming questions. In some instances, the context of the questions will immediately prove there’s been missed communication between two people: “Men don’t have babies, do they?” Yes. (Huh???) But in other situations, context won’t help: “Didn’t you give the child the medicine as I explained?” Yes! (It is true that I didn’t.)

The Better Way To Ask: “When did you give the child the medication? (notice I did not start that question with DID because that can lead to a head nod and we want a full answer. “Is snow black?” No. (Unless, of course, you’ve lived through a winter in Chicago where the snow stays on the ground so long it does turn black. Isn’t that true?)