Dr. Jessica McCannon reports:

My husband and I are one of a rapidly growing number of dual-language families in the U.S., if the Census Bureau is any indication.

Spanish, in particular, is the second most-common language spoken in households in the U.S.

I don't know how other couples manage two languages, but there are times when either Spanish or English is better suited for a particular activity - arguing, for example.

I can feel somehow liberated to communicate (and am able to match my husband's Mediterranean volume and tone in a way that English doesn't permit).

But, even though we are trying very hard to make our home environment Spanish-only, there are moments with my sons and my husband when I must speak my mother tongue, a phrase that means so much to me now.

For example, when I talk about death - in general or my own - it's just easier for me to do in English. I imagine that's a common phenomenon because it's all in the details… the nuances of each word.

I know from direct observation and experience that even with the best-intentioned health care providers and interpreters, navigating the U.S. health care system when English is not your first language is deeply challenging.

It's hard enough to talk about illnesses and treatments. That difficulty multiplies when thinking and communicating about more deeply personal topics. Spanish - and hundreds of other languages in the U.S. - are spoken by individuals who may not be familiar with the amount of personal input welcomed (and sometimes demanded) by the American health care system, particularly when it comes to end-of-life care.

We have recently posted a Spanish translation of The Conversation Starter Kit and hope that more languages are to come. It's only the tip of the iceberg, but we hope it's a start.

Dr. Jessica McCannon is board-certified in internal medicine, in her final year of Harvard's Clinical and Research Fellowship in Pulmonary and Critical Care Medicine. After completing her internal medicine residency training at Massachusetts General Hospital, she began providing care to adults at the Mass General Hospital Down Syndrome Program. She received her BA from Cornell University. She has been a core member of The Conversation Project since the organization was founded.