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.

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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.

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