But I’m fluent in English, I swear

I am absolutely going to write a post about how not having a skilled interpreter sucks.  And how people get sub-par health care as a result.  But in any event, I just thought I’d let you know that I tried three times before I could tell a doctor that someone had an appendectomy.

Appendixotomy.

Appendicitisotomy.

Removal of the appendectomy (oh, so close!).

I’m a shitty interpreter, in case you can’t tell.  What’s even worse is that in the past, I’ve been the best that someone has gotten.

8 thoughts on “But I’m fluent in English, I swear

  1. I had a uterine issue once that required me being in the hospital emergency room on Christmas day a few years ago, waiting for an ultrasound. They had to call an ultrasound tech to come from home, and there was just me and one other woman waiting. She and I started talking; English was her second language, but we could communicate as long as we went slowly and occasionally rephrased things. We talked about our families, our history, etc; she was then two months pregnant, and having a bit of bleeding, which was why she was there.

    The tech arrived and took me for my ultrasound, and then her for hers. Eventually she returned to the ultrasound-floor waiting room and sat with me again. She said, “The doctor told me what is happening but he used too many strange words that I don’t know – can you help me?” and held her chart out to me hopefully. (It was so quiet, we didn’t even have nurses to handle the charts – the docs just had us carrying our own. Being in a hospital on Christmas is a really weird experience.) I said, “Sure,” and took the chart and read it, and my heart sank when I got to “ectopic pregnancy”. I thought about it for a moment then said, “You know how there’s your uterus, where the baby grows?” She nodded and I continued, “Well, your baby isn’t in the uterus, it’s outside, where there isn’t enough room for the baby to grow.” She thought about this then said softly, “Oh.” We sat in silence for a moment. Then she said, “That happened to a friend of mine back in [home country]. She was bleeding everywhere, she almost died.” I nodded and told her that these kind of pregnancies can kill a woman when they aren’t found in time, but hers was found early enough that they can fix it before she gets to be in danger. She said, “But the baby can’t live,” and I shook my head, told her I was sorry, and put my hand on her shoulder for comfort. There wasn’t really anything else I could say, and I remember at the time all I felt was gratitude that I was there at that moment and could help her. But the more I thought about it later, the angrier I got. The doctors obviously just assumed that she understood everything that had been said, and they didn’t bother having an interpreter – ANY interpreter, even a shitty one! – there. If I hadn’t happened to be there at that exact time, would she have been wheeled into surgery and anesthetized still wondering what was going to happen to her and her baby? Would she have woken up afterward wondering if her baby was okay now, and finding out the truth at some awful moment afterward, not even having any time to reconcile herself to it first?

    The lack of consideration and thought still makes me seethe, and it’s been several years since that incident. So yeah, I agree, not having a skilled interpreter really sucks. But not even having a shitty interpreter is even worse. *Anything* is better than nothing, and it’s bullshit when a doctor assumes that a patient understands just because she’s nodding her head and not asking questions. Even though you’re not as good as you’d like to be and you struggle to fulfill the interpreter role, I’m still damn glad you’re out there doing that, because as you said, sometimes you’re still the best available.

  2. (Oh, and I realized the above comment might have sounded like I was angry at you or something. I’m not. It’s just the situation that makes me angry, and the thought that people have to settle for substandard care because they aren’t given the resources – such as skilled interpreters – that they need. Consider my comment a great big “co-signed” to your post, basically.)

  3. fyi, in the u.s., ALL medical practicioners that accept any federal funding of any kind (yes, if they accept medicaid or medicare) are REQUIRED by law to provide professional qualified interpreters for ANY patient (regardless if that patient is private insurance or otherwise) that requests one or that they realize might need one (even if the patient doesn’t know to request it). And they are required to post that they provide interpreters (it must be posted in a variety of languages) at no charge. and they are required to frown on family/friend interpreters and get a professional to do the job. so next time, just say “this patient needs an interpreter of this language”. :)

  4. Robin, I’m glad you were there. I think a lot of times that if monolingual people use a lot of strategies, they can make themselves understood with people who don’t speak that language well.

    aaminah, my experience has been similar to the way people react to disability law. And I have sometimes been able to get an interpreter.

  5. I volunteer as a medical student at a free clinic that serves the the uninsured, and we have a lot of Spanish and Polish-speaking clients (I speak neither language, though I really want to learn Spanish). We usually have 1 interpreter for each language on a given clinic night, which we share with volunteers from other institutions who serve on the same night as us. The interpreters are also volunteers, so it’s the best we can do, usually. Many of the students and doctors speak Spanish, some more fluently than others. Anyway, one incident that comes to mind that was problematic was when I saw a Polish-speaking patient who brought her teenage daughter with her. We didn’t have a Polish interpreter available, so I was instructed to use the daughter as an interpreter and that the patient had okay’d it. I began the interview, only to find that the problem was her depression and difficulty with family issues and bereavement. It was clearly highly inappropriate for her daughter to be in the room, especially when she told me that trouble with her husband was a major source of stress. I went to the clinic coordinator and demanded an interpreter because I knew I needed to ask this woman about domestic violence but there was no way in heck I was asking through her 13 year-old.

    As a general note, even if a hospital cannot physically provide an interpreter, there are systems in place where they can call a phone line and request interpreters for more rare languages in the U.S., and although it’s not ideal, the conversation can be interpreted over the phone like a conference call.

  6. I’m a medical social worker and it is absolutely appalling how many times MDs and RNs use family, even young kids, as interpreters. We have interpreter phones available but instead of getting them they will just use family members.

    And even if those laws are in place and even if there are signs posted it is still the responsiblity of the facility to provide an interpreter which very rarely gets done. Just one more way our health care system is flawed and we disrespect non-native English speakers.

  7. @resistance, who said I think a lot of times that if monolingual people use a lot of strategies, they can make themselves understood with people who don’t speak that language well.: Exactly, and there’s no reason why the doctor couldn’t have made himself/herself understood in that situation. If I could figure out the words to say it, the doc could have as well. But they just didn’t take the time to do so, or didn’t realize they needed to do so (which suggests to me that they weren’t paying attention).

    @thesciencegirl: Your comment brings up an issue I’d never even thought about. I used to work in the hospital system and I occasionally saw situations where teenagers would be brought in under iffy circumstances, and the staff would find some excuse to get the teenager alone so they could ask if the teen were being mistreated at home (obviously, this is not a question you can ask in front of the parents, who are almost certainly the abusers if abuse is occurring). There’d be no possible way to broach that topic if it’s a situation where a family member is translating.

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