Medical Interpreters vs Untrained Interpreters

Watch the following video:

This is a video from the HBO show Getting On, and as you all could see is all about Language Barrier. First thing I would like to say is that this clip is hilarious! My second point is How much difference would the interpreter had made if he had been present, or if he had been able to talk directly to the patient? Well it would have made a huge difference, maybe the clip would have lost its funniness, but at least the communication would had been better.

The same way the nurse try to interpret what the patient was saying, many family members and friends try to interpret in a health care setting for their friends and family members, and many times the mistakes they make could harm the patient instead of helping them.  First of all I have to say something, there is a difference between interpreting and translating that everyone should know about; interpreting is transmitting a verbal message from and to a language so it can be understood by all the parties.  Translating is re-writing a document from and to a language that could also be understood by the parties involved. Now that this is clear I have to say the following about interpreters, not everyone that speaks more than one language can be an interpreter, same way that a nurse cannot diagnosed patients just because he or she have medical knowledge.

Just because I spoke Spanish it didn’t mean I was able to interpret for other Spanish-speaking people, especially about medical terms that I didn’t know at all. I had to study and work hard to learn the medical terminology and how to interpret.  And even when I was “able” to interpret, it took guts and a lot of practice to learn to understand, and to transmit a message to a patient or a doctor without making mistakes. It is nerve-wracking thinking that I could really mess up somebody’s life just by changing one word in an encounter.

In Miami a young man was taken to a hospital that lack of trained interpreters, and the hospital had to paid over 71 million dollars to the patient, the reason? The providers use a family member to interpret, the person mentioned that the patient was “intoxicado” which they translated to “intoxicated” thinking that the patient was under the influence of drugs or alcohol or maybe both. After two days in a hospital bed, by the time they came to realized that the patient was having a stroke it was too late and the patient became quadriplegic.  Intoxicado in Spanish can also mean food poisoning. The patient was dizzy and was also vomiting which took his family to believe that he ha eaten something that did not agree with him. This person’s life was completely changed just by the miss interpretation of one word.

I won’t get tired of saying a trained medical interpreter can save many lives in many languages. An untrained interpreter may ruin many lives just with one word. Let’s not endangered people’s lives, always help them to request a “Trained interpreter” to make sure everything is understood, and avoid to regret it later.

Here’s a good article about Patient safety and medical interpretation


Medical Interpreters and Cultural Differences

How many times we have been in a hospital, and suddenly we hear someone crying or speaking in another language different from English? many I bet.  Well since the volume of immigrants coming to the United States has been increasing in the last few years more than It had in the last decades, the amount of patients that go to a hospital or clinic that speak little to none English have also increase.

When I talk about immigrants I am not only talking about Latinos, I am talking about Africans (including Morocco, Egypt, etc),, Asians (including those from the Arabic countries), and also Europeans, that speak so many different languages, many of them very unknown in the western hemisphere.  These immigrants come to the United States trying to accomplish a dream or maybe to give their kids better opportunities; and when they get sick they also visit the doctor’s office, so how do they communicate with their health care provider if they don’t speak English and the provider doesn’t speak their language? Well they do it through Medical Interpreters.

Medical Interpreters became a necessity in the United States primarily, due to the amount of patients seeking for medical care and not being able to communicate with their providers. I remember that even 14 years ago, finding interpreters was still an issue, and many providers use housekeeping personal, or family members of the patients or even spouses of the providers, whom had no previous knowledge of medical terminology, which was causing certain issues with accuracy of the translation.  The errors were the main cause of malpractice in non-English speakers and soon the need to trained bilingual personal became a priority. At the beginning there were not that many programs, at least in the Boston area they weren’t a lot of programs for this specialty, nowadays the best program in the area can be found at Boston University, and many other programs in different colleges, universities and community colleges.

After being trained in medical terminology and also in ethic and privacy protocol for hospitals, the medical interpreters became more and more essential in hospitals and clinics. In more recent years, medical interpreters are more accessible and available for all hospitals all over the country; not only providing a face to face service, but also working through the phone and video. Our job as interpreters is to facilitate the communication from patient to provider, provider to patient  by translation from the patient’s primary language to English and vise versa ; and by doing so we are not to change anything on regards of the translation. I do not mean translating word by word, honestly that would be ridiculous since translating word by word may not make sense to the two parties involved in the process.  If I say pain in the mouth of the stomach not many providers will know what the patient means; but if say epigastric pain the providers will immediately know what the problem is. It’s the same way when I doctor uses an English expression that in my language Spanish would mean nothing or something inappropriate or unrelated to the subject.

But Medical Interpreters are not only “translators”, they are also some sort of referee for cultural differences.  Many of the patients come to the hospital when they are very sick, and many health care providers don’t understand why they wait so long. For example a patient with asthma was brought to the emergency room having difficulty breathing, after the emergency room doctor asked the patient about his medicines he answer that he had not used them due to the advised from his “witch doctor”. Apparently the patient born and raised in an indigenous tribe had been in the country only a few days before he was brought to the emergency room, and before he left his village his “doctor” gave him a medicine to cure his asthma, the treatment was drinking blood of an armadillo. The doctor was very offended thinking that the patient was mocking his profession and was getting very angry, and even accused the patient of being drunk, which was not the case.  The interpreter seeing the situation stepped in, and explain to the doctor the patient’s cultural believe and assure him that it was a real “solution” for asthma in many countries. The doctor was puzzled and apologized to the patient, then he explained to the patient how to used his medicines, patient was still refusing the medicines and it was time for the interpreter to explain to the patient the importance of the medicine, keeping the communication with the provider open, and by working as a team the interpreter and doctor were able to help this patient.

Cultural beliefs and slang don’t come with a course, it comes with experience and also by interacting with patients from different cultural backgrounds. I have the fortune to work for different hospitals in the country and get to learn more about both and it is so wonderful to learn at the same time I help those who need my help.

When I came to the U.S. my English was very limited and coming from the city of the eternal spring time in Colombia, the winter got the best out of me, and after only a few weeks into the coldness of New England I got really sick.  When I was in the Emergency Room, I couldn’t explain my symptoms, and the nurse doing my triage was using hand gestures to get information about my medical history without much luck. Thank God there was a doctor that spoke Spanish and since he grew up in Puerto Rico his Spanish was fluent and I didn’t have to struggle to understand what he said. I felt very frustrated not being to communicate and trust I still know how frustrated the nurse was, she reminds me of that every time she sees me, but thanks to that experience I became a Medical Interpreter I know what it takes to do my best for the patients and the providers.

Being a Medical Interpreter is privilege that not many can have. Medical Interpreters are very important in the medical field because Medical Interpreters can save lives in many languages.

Language Barrier in U.S. Health care system

 Every day we hear in the news about the amount of immigrants coming to the United States and how they are fighting for legalization; we also hear about how they managed to cross the border illegally and how they “abuse the system”, etc.  What nobody hears or talks about is how these immigrants take care of themselves, and how they struggle with the changes in their lives. One of those changes is to learn the new language.

Most people coming to Unites States from countries where their primary language is other than English, have a hard time communicating at the beginning, and it takes time to learn just enough English to be able to communicate with others; although I have to say it is not as easy as it sounds. Learning English is difficult, and the fear of mispronouncing a word makes it even more difficult. Imagine how hard it is to go to a hospital and not knowing how to explain the symptoms that one is feeling, I can tell you it’s really hard and makes people feel stupid, well at least I did.  To explain it better imagine traveling to a foreign land for your vacations, and where no one speaks your language, how would you feel if you were lost? how would you get back to your hotel? Well being sick and not being able to communicate in a foreign land where no one speaks your language, not only causes distress for the sick person but also for the health care providers, and could potentially cause health related issues in the community.

The following is an example of how a language barrier can affect a whole community.  A woman with a medical history of Asthma came to the emergency room of the local hospital, complaining about shortness of breath and cough. The woman did not speak English so it took at least 45 minutes to get a person that could help to interpret for this woman. After the improvised interpreter “finished” the woman was send home with medicine for her asthma.  The woman continue going to emergency room almost every day for a year, and every time the doctors treated her symptoms, but never ask her questions about her past medical history or her possible exposure to any illness back in her country; unfortunately the woman died and none of the health care providers she saw knew what was the cause of death.  After a few weeks the family of the 39 year old woman came back to the hospital to report that the woman had died of Tuberculosis and that everyone that had had any interaction with her in the past year was to get tested a few times in the next two years,  just to make sure there was not consequences from the exposure to this illness.

The point is that we have one of the best, if not the best, health care systems in the world, and because of a problem that not only affects the United States but also many other countries called immigration, we tend to forget about what is more important, the health of the people living in the U.S.  Never mind  whether they are legal or not, if they have medicaid, medicare or no insurance.  Every person should be medically treated without an excuse, especially since the issue of a language barrier now days is easy to fix, thanks to the interpreter services available in person, video and phone. When the patient is able to communicate with his health care provider freely and in his own language, the chances of spreading a contagious illness is less, because it can be contained on time.

Many readers will mention the fact that if someone comes to the United States and does not speaks English, should learn to speak English, I agree. But for the sake of our society, people who do not speak English for any reason, should have the right to communicate freely with the help of a trained interpreter, so they can express their concerns and their worrisome especially in a medical facility; because is Better safe than sorry.