Make sure you pay attention to your medical interpreter

During my flight from Denver to Japan, I watched a movie called Un Traductor. It is a true story directed by the children of the couple who are the main characters in the movie. The reason why I chose this movie was that there was a Brazilian actor in it. Even so, I was not expecting to enjoy it as much as I did.

The story takes place in Cuba, and a university professor who teaches Russian is suddenly assigned and forced to work as an interpreter in a children’s ward of a hospital receiving patients from the Chernobyl nuclear disaster. Little did he know how that experience would change his life for good or that this is how we feel when working with sick children in our daily lives. And little did I know about the feelings that our medical interpreters may have when helping us care for our patients.

I was first exposed to medical interpreters while doing my residency and fellowship in Brazil. Indigenous peoples were treated in our hospital and because they did not speak the language an interpreter would come with them. These indigenous people live in the forest away from civilization and are not big fans of hospitals. They firmly believe that this is the place where they come to die. It is true that sometimes they come in so late to the hospital that we can’t save them anymore — and that perpetuates their beliefs.

At that time, my trust in medical interpreters was not very high, based on simple observations. I would ask a question, the mother of the patient would speak for 20 minutes, and the interpreter got back to me with three words only. Out of common sense, I always felt that I was receiving a very limited version of the original story. While practicing in the U.S., I was introduced to many amazing medical interpreters for different languages and cultures. But after watching this movie, I cannot help but wonder if I have always acknowledged them as properly as I should.

Communication is a very important element for trust in any type of relationship, including the medical-patient one, and choosing the right words is essential when communicating difficult news. By definition, if an interpreter is in the room it means that the doctor and the patient do not speak the same language. And we depend upon the interpreter to assure that everybody is, at least, on the same page. The moment we enter the room, we become part of the same story. Medical interpreters, like doctors, will face the deepest emotions of that family and will probably change everybody in the room without anyone even noticing it. How hard it must be for the interpreter when they find rude doctor giving difficult news to a family or when during a consultation sad emotions arise.

Did I always make sure that the medical interpreter understood what I was trying to tell that family? I depended upon them to build a strong relationship with my patient and his family. Have I done my best? Did I always give them time to do their job properly? Did I let them feel that they are welcome? I know that simultaneous translation adds a lot of noise in the room and allows for very little thinking, but I also noticed that when pausing after each phrase doubles the time of the consultation, I will now advocate that it is worth it.

For me, the words “translator” and “interpreter” have different meanings — even when they are frequently used interchangeably. By the “translator,” understand that the person is just changing the words into another language, which will not necessarily have the right meaning. By “interpreter,” I think that it allows room for adaptation, for changing to another word when appropriate. I will certainly from now on pay more attention to the interpreter in the room. I really hope that the interpreters in my room have the sensibility to interpret my words and transmit them in a way that meets that family needs, I hope my words will feel like a strong hug, that they will come with the proper tone and kindness. Words have a huge impact and power, and once they come out, they may stay in someone’s heart forever. I hope I will always do my part to assist the interpreter in delivering the right words. I will count on them to help me too.

Andrea Bischoff is a colorectal pediatric surgeon and can be reached on Twitter @drspenabischoff.

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