Actually point 4 is important I think. When I was admitted to hospital in Japan, some of the nurses kept speaking to me in English, even though I could speak Japanese better than they could English. One nurse in particular seemed to want to practice her English on me, which is fair enough until you realize that this was a hospital and mistakes could be quite costly. I remember a few instances when she got things completely wrong and it was only because I spoke Japanese that I didn't get a kidney transplant instead of a blood transfusion Finally one of the doctors pulled her into line by asking her why she was speaking exclusively English to someone from Poland