knowing spanish-how imp?

I'm not sure about Galveston, but in San Antonio, it's extremely helpful. Even the residents who didn't speak spanish at all have had to learn a little bit. There is usually staff around who does... but it slows you down alot, especially in clinic. My guess would be that its not quite as bad in Galveston - in San Antonio, I would estimate at least 50% of the women didn't speak english.