It was a normal-ish Saturday. I was on my own, one interpreter for 16 floors of hospital, and I had someone in the ICU who was going to be disconnected, whose grieving family needed to sign paperwork and needed help understanding it. The MD was breathing down my back to get it done in a hurry and - what was worse - the hospice agency nurse was dismissive of the language barrier and blithely went right in to start without me. And then I got a call to go to an occupational therapy session on another floor. So like I said... normal-ish. The attitudes, at least, were normal, the characters behaving as expected. I figure, OT can probably use the phones, but since I had a minute, I decide to go check out the situation.
When I arrive, the therapist says they already tried the phones, but the interpreter was having some trouble understanding the patient. So, as so often happens when a patient tries to talk and no one understands them, instead of wondering what other barriers might exist to communication, someone decided to ask 'is he thinking clearly?' Of course, once the question is asked, they have to check, and that was what this OT had been asked to do. Fortunately, the therapist was gracious, and declared herself perfectly happy to see another patient on the same floor first while I went and finished up with my ICU patient. "Thanks dear, just come find me when you're done." So I went and took care of the paperwork, sat with the grieving, but capable family in the ICU, and headed on back to the other ward.
The patient was in one of two beds in a room partitioned by a thin pink plastic curtain. I looked to the clunky hospital bed, surrounded by awkward, dingily colored hospital furniture and found it empty. The OT, Louisa, knocked on the door. There was a faint reply, so we waited. Louisa turned to me, "I have no idea how to say his name," she said, and pointed it out to me on a piece of paper with cramped little boxes denoting patient's names, locations, medical record numbers, and some scribbled notes. The name read like something that wasn't quite Spanish, and I wondered aloud if perhaps this man was from Guatemala, with a name of indigenous origin. Just then, our patient came out of the bathroom. He was a short, solidly built man with a square face, wrinkled and weathered a warm brown, and the dignified way he carried himself made me like him immediately.
We introduced ourselves, she in English, I repeating both our names in Spanish, and he waved his hands "No spikee Eenglish" he said. I felt a pang of sadness as I realized how well practiced that particular phrase was, and that he hadn't heard us. I spoke louder. "Sí señor, para eso estoy yo. Voy a ser su interprete." "Yes sir, that's why I'm here. I'm going to be your interpreter." He got it, but said, "I'm sorry miss, I don't hear very well out of this ear." 'Aha,' I thought, 'THAT's why the phone interpreter had trouble understanding him.' So I readjusted my position in the room, and my speaking volume, and we got going.
We asked him what his plans were once he was discharged. Where did he live? As he answered, I began to notice that he spoke Spanish like it was his second language, like other people I've worked with who were speakers of indigenous languages from Guatemala, southern Mexico and Belize. Strike two against the phone interpreter. In answer to Louisa's question he told us he lived in a shelter, and named a homeless shelter in the city. "So what do you do during the day, when the shelter closes?" Louisa asked "In the summer when it's warm, I'm just on the street. When it's cold out, there are other shelters I go to." The story that began to emerge as we asked questions and listened to the man's answers was one I was familiar with. Several of my neighbors, the ones from when I lived one of the most impoverished, abandoned neighborhoods in my city, had told similar stories. They explained to me that shelters kicked you out early, by 5:30 or 6 in the morning; that you have to be in line at the shelter by early afternoon to secure your spot; that there are a lot of churches that hand out meals, and soup. But one of his answers to the questions we were asking added a whole new dimension to this homeless lifestyle.
"Sir, do you have any friends, or family in the area that you could stay with?" Louisa continued. Just about every homeless man I've known has had "people," meaning family, living somewhere. But before I could even finish getting the question out in Spanish, he started shaking his head. "No, estoy yo solo." "No, I'm all by myself." He continued: "Yo vivo con 250 negros," he made a wide, cirlcling gesture with his hands, as if he were surrounded, "yo soy el único hispano. Hay un cubano negro que habla un poquito de Español, pero no mucho." I interpreted: "I live with 250 black men, and I'm the only hispanic. There's one black cuban guy who speaks a little Spanish, but not much." In my mind, I could clearly see him, the only short, solidly built, hispanic man, among his black roommates, line-mates, and dinner companions, not a friend among them. I imagined him in the shelter, his warm, worn brown skin so light it might not even register as brown compared to those around him. I tried to comprehend how isolating it must be for him among his 250 roommates, streetmates, if his best English phrase was what he had given us before: "No spikee Eenglish" No wonder he shook his head so quickly, with such gravity.
She asked another question, and we had some trouble getting it across, so I intervened. My professional curiosity was getting to me, and I decided it was time to find out. I couldn't tell if the problem was the fact that Spanish was his second language, or if it was because, as he had told us earlier, he was hard of hearing. Turning to Louisa I said, "I'd like to ask him where he's from, because it sounds to me like Spanish might be his second language." She gave me the go-ahead, so I asked. "Guatemala," came the reply, which I relayed, and then followed it up with "Ah, ok, I wondered. Sir, you speak Spanish very well. Is it possible, though, that you speak another language as well?" "Yes," he said, "I speak K'itch'e." Bingo, I thought. Between that and being hard of hearing, it was no wonder communication had been difficult. So we asked the OT's question in a different way, and continued "evaluating his mental clarity". She had him take off a sock and put it back on again, just to cover all her bases.
We had finished the evaluation, and were about to leave, when I realized I wanted to do one more thing. I knew that admitting to being indigenous, admitting to Spanish not being your native language, is something many Guatemalans are reluctant to do. The indigenous people of Guatemala have not been well treated by their government, and in many cases fled north to escape the Guatemalan genocide of the 80's. From what I have been able to learn so far, reaching Mexico did not mean safety. Mexico, too, has a certain amount of racism against its indigenous peoples, seeing them as backward and uneducated, and they were not happy to receive the wave of refugees. All of which are powerful reasons to keep your mouth shut and try to blend in as much as possible, and deny, deny, deny that you speak anything but Spanish. So to thank this man for his bravery, and to show that I didn't think any less of him, I decided to ask him if he would teach me a simple word in his mother tongue.
This would be the furthest I had gone out of my role as a conduit between OT and patient, which is my main role as an interpreter. Although I had intervened to clarify his linguistic history, that still fell within the bounds of maintaining good communication in the interest of quality care. But this was a little different. I looked at Louisa, and asked her if it she minded the question. As I'd expected, she said no, that's fine. Louisa knows a good bit about Hispanic people who speak "dialects" herself, having worked exclusively with that population for a while. So I asked. "Excuse me sir, how do you say hello in K'itch'e?" He was taken aback by the question. "What?" "How would you say 'hello' in your language, in K'itch'e?" He hesitated. Looked away. Swung himself back from the edge of the bed. I started to worry that K'itch'e might be one of those languages where you have to know the gender of the speaker, and the right honorific to be able to decide how to form a simple "hello". When he finally spoke, he said something that took me by surprise. "You know, I haven't spoken K'itch'e in 10 years, so I'm not sure." "Oh," I stammered. Then tried to cover up the embarrassment for both of us. "Oh, ok, that's fine. I just wondered, you know, but don't worry about it, that's ok." He rallied. "But I can tell you to say 'how are you?'" So he did, and I tried my best to imitate him. He said it several times, and I knew I hadn't said it well, but I was so grateful he'd managed to save face and hadn't gotten offended that I didn't mind.
Later I tried to recall and memorize his face as he spoke to me, teaching me that simple phrase as if I was a child. I could only imagine how many people had surely talked to him just like that over the years, trying to teach him simple phrases in the language that had swallowed him whole when he entered this country.
The interaction left me with so many questions. How come he has been here for so long, yet not connected with the Maya community here? How does he feel about not having spoken his mother tongue with anyone for the last 10 years? How does he get by in the city, on the streets, without being able to talk to anyone around him? Was he content with his situation? How did he get here? How does a pebble feel in an ocean? I had so many questions that I couldn't ask.
