medical student named Ahmed sat down at his computer, looked into the camera, and began reciting spices. “Cinnamon, turmeric, cloves, and garlic powder,” the 23-year-old said from his dim Saudi Arabian apartment. “These spices were chosen because they had high antioxidant activity.”

Nearly 8,000 miles away, in Addison, Karen Yates sat in her office, listening. His rhythm is improving, she tells him, transitioning from an Arabic rhythm to an English one.

And for Yates, who runs Vireo Accent Reduction, rhythm is everything.  “You can forgive some sounds, but you can’t get past rhythm,” she says. “I’ve had some speakers, they have everything but the rhythm. And you can’t get past it.”

Yates’ company provides doctors, priests, flight attendants, and even Dallas Mavericks with “quality” accent and English training. She employs four instructors, and has more than 100 clients. Because most of those clients are fluent in the language itself, she focuses not on the actual words, but on how the words fall out of her clients’ mouths.

Native Chinese speakers, for instance, drop the consonants at the ends of words and syllables, while Indian speakers switch the letters “W” and “V.” The pacing of Japanese speakers differs greatly from English speakers, Yates says, as she taps out “ko-ni-chi-wa” on the desk.

Where letters and comprehension matter the most, perhaps, is the doctor’s office. Prior to launching Vireo (initially called Global English Training) in 2006, Yates worked for five years at UT Southwestern, teaching English pronunciation to researchers and doctors. Medicines sound similar, she says, and the difference between “fifteen” and “fifty” can be disastrous for a patient.

“I feel like if I can help any doctor communicate with a patient better, I’ve helped the world,” Yates says. “Given the amount of errors that can cause deaths in a hospital, that’s important.”

Most of her students are eager, hoping to communicate better in the pulpit or the exam room or the airplane. But for those nervous about losing their culture, the rhythm of who they are, Yates has some advice: Just fake it.

“If a person begins to feel like they are losing their core identity, I tell them to pretend they’re an actor,” she says. “If you can feel the English in your body, and can feel the difference, and become an actor, that will release people from that tendency to draw back.”