Misa, a 75-year-old Akha-speaking woman, was admitted to the emergency department of a public hospital in northern Thailand for progressive abdominal pain of several weeks' duration. Unlike many people of the Akha ethnicity in Thailand, she lived in a physically accessible village and had a Thai ID card that allowed her access to Thailand's universal health care system. Misa's children were gone, so an acquaintance brought her to the hospital. The patient was examined by Dr. Ann, an emergency physician of Northern Thai ethnicity. The article focuses on linguistic pragmatism in the context of this clinical situation.