You'd think that, if you get a call to go interpret in the trauma center in the emergency room, you'd be walking into a crazy, dire situation every time. Turns out that's not necessarily the case. Because of this, I've come to understand the word "trauma" not as "intense dramatic event" but more like "physical ailment that's not a disease process;" in other words, some kind of impact or accident that caused the person harm... like falling from something, or having something fall on you, getting mugged, or shot, or cut, or stabbed, or hit by a car, or sometimes even just having fallen down. One time I interpreted for a guy, a cook, who had shaved off some of his finger with a knife; but another time there was a mother/daughter pair who'd been in a bad car accident and held hands across their stretchers - which I say to point to the fact that, although it's all trauma, how chaotic and scary a case is can vary dramatically. The guy who chopped his finger had rigged his own tourniquet with a rubber band, and the surgeon was super impressed, so half the time I was interpreting compliments. You just never know what you're going to get.
Most recently my favorite encounter in the trauma center was with an older man (a patient) and the younger doctor who was admitting him to the hospital after a bad fall.
I had been bouncing back and forth between interpreting for this same patient and a couple others all afternoon, and they eventually made the decision to admit him. Over the course of several hours, with different technicians and providers, I had discovered him to be decorous, good-humored, and patient. He knew his own health problems well, and was a deliberate, clear storyteller; full of fancy words, jokes and good manners. So when the admitting doctor arrived, I was pleased to realize that he was a clear communicator as well.
He made eye contact with the man on the stretcher. Shook his hand. Asked what had happened to bring him to the hospital. He maintained eye contact and took notes as I first listened to the story (my third time), and then told it to him in English. He paused before asking his next question, then looked the man in the eye and spoke clearly, despite the fact that he was speaking English and couldn't be sure how much the patient would understand. He was even able to use gesture to great effect, something a surprising amount of people don't do well intuitively. As he went through his series of questions, I became gradually less and less of an obvious presence in their communication. It was one of those golden moments, the ones you always angle for, where you've actually faded to the background and the people you're serving have formed their own connection. It was beautiful to see. And the MD continued to ask clear, thorough questions and get clear, well-worded answers.
At the end of the interaction, they shook hands, the MD turned to thank me, and we both began to walk away. Then suddenly, the man on the stretcher said, "Le felicito!" I wasn't sure what he meant, so I looked at him, brow furrowed, and repeated it in English with a questioning tone "Con...gratulations?" He took the hint. "Le felicito, doctor, excelente trabajo. Muy cientifico!" Aha, I thought, that's what he means. "I congratulate you, doctor, excellent work. Very scientific!" At which the MD smiled and said "Thank you very much!" - which the patient understood. He then turned and thanked me, and we said our goodbyes.
The German-English dictionary I use tells me that the German word "sich verabschieden" is "to bid farewell" or "take your leave" or "say goodbye". The Spanish "despedirse" comes to about the same thing, but I wish there were a noun in English for the closing at the end of an interaction. Like "greeting" but for goodbyes. I've noticed that these types of formalities are much more important in hispanic/latinx culture than in US culture (although the US varies a lot, and so do hispanic/latinx cultures). An example, though, would be how when you enter a room, you have to greet every person in it. At a party or gathering, saludar can be quite an ordeal, especially if you're an introvert! But it's equally important when you leave, to take leave of every person. Not to do so can be insulting. But I digress.
The thing that was interesting and beautiful about this despedida interaction between patient and provider was that what the patient really meant with his "Le felicito, muy cientifico!" was "You were very thorough, I feel heard by you, I trust you, and think you'll do a good job of taking care of me." It was proof, to me, that it had really happened for these two: a therapeutic relationship, that bond of trust and mutual respect, had been established - in just minutes! It was a privilege to take part in that.
Sunday, July 9, 2017
Friday, June 30, 2017
place of healing or collection of sick?
It has occurred to me recently that a lot of people say they "hate hospitals." I guess people who feel that way see hospitals mainly as a collection of sick people and a reminder that they, too, are mortal. But I firmly believe that hospitals are places of healing and recovery, full of people who are caring and wise. And maybe it's because I work in them day in and day out that I have such a positive view, but I don't think so. Hospitals are devoted to healing. That is their purpose. And healing requires love and collaboration and wisdom. Despite all the sad things that happen here, hospitals don't depress me: they give me hope. Let's bind up the brokenhearted and proclaim freedom for the captives.
Thursday, June 8, 2017
what filter are you using?
We were in a tiny room in the emergency department. Or maybe it just felt tiny from being so jam-packed. The stuff alone would have made it seem smaller than it actually was: two computers, a giant bed, some cabinets, an armchair, a sink, a regular chair, not to mention plenty of gadgets poking out from the walls. So having 5 adults and an almost-toddler crammed into corners around the furniture didn't help.
No-one sat on the bed, since the patient was in his mother's arms. I stood on one side of it, backed up to a computer, my presence backing Dad into a corner. Dr. K sat in the armchair, next to Mom, his legs crossed, his gestures confident, reassuring. Her face was like the sun on a windy, cloudy day: now a bright smile for her baby, now drawn and serious with worry. Two other doctors stood at the foot of the bed, on her other side, awkwardly, with their backs to the door, and we talked.
I was in conduit mode: that normal ping-pong from one language to another that we medical interpreters always do. At first I thought I'd only be batting the ball from Spanish to English for Dad, no need to go back from English to Spanish, since seemed to understand what he was being told. But at a questioning look from Mom, I realized it would be a full back-and-forth, so I went for it, all the while trying to play that eye-contact game that doesn't leave the family to stare into space when they hear someone they can understand, but still indicates that the speaker isn't where the words are coming from. Add that to the mental gymnastics.
The room probably wouldn't have felt quite as cramped if emotions on the family's side hadn't been quite so amped. Dad stood, defensive, speaking for both of them, asking if there was no other way. Mom let him speak, her worried face eloquent enough, until they started pleading, toward the end of the encounter, to try medicine for just a little while longer, instead of what the medical team was suggesting.
If you've ever worked with a speech therapist, you might know that swallowing isn't as easy as it seems. If you've never heard of a speech therapist, don't worry, I don't blame you. I hadn't either until I started hospital work. Apparently, in order to swallow, humans have to coordinate a bunch of different muscles, and this is something that can be hard to do after, say, an illness that affects the nerves, or a stroke. It can also be hard to learn in the first place - babies, especially those who have other problems, often have trouble learning how to swallow.
This isn't just problematic from a nutritional standpoint (although there is that aspect to it, too), it's also a problem because it turns out that letting food or liquid get into your lungs (which is called aspiration) can cause pneumonia. So you can end up hungry, dehydrated AND pretty seriously ill.
Of course, the medical world being what it is, they've come up with ways to help people who can't swallow correctly: basically different ways of bypassing the mouth and putting food directly into the stomach or intestines. One option is to thread a small flexible plastic tube up your nostril, down your throat and esophagus, and into your stomach (or further down into your small intestine). That was what the medical staff wanted to do for this baby so he could rest from the stress of not being able to figure out how to coordinate his insides, and try again later.
The staff was doing their absolute best to explain to the family that this wouldn't bother the child once it was in, wouldn't hurt him, and would prevent him from getting seriously ill with aspiration pneumonia. That he would, in time, learn to swallow and be able to live a normal life. To them, it really wasn't a big deal. An easy fix, minimally invasive, cost-effective, cheap... and they were doing their best to reassure the parents that it really was nothing to worry about. But the family wasn't having it.
Whenever I tell people that I'm an interpreter, their first reaction is usually "Wow, so you have to know all that medical vocabulary!" And the truth is, as much as the profession's current 40-h training course does teach some vocabulary and concepts, working in the hospital puts you through a necessary, intensely steep learning curve. (Just as an example, everything I explained above about speech therapy, swallowing difficulties, and NG tubes, I learned while working.) Interpreters are not trained as clinicians, but we do work with them every day, and so learn from them. In this way, interpreters become cross-cultural. Our work requires us to perpetually bridge the medical world and the layperson world, and the result is that we no longer truly belonging to either. We are part of the hospital system, work closely with clinicians, and understand much of what goes on from long observation and a healthy dose of inquisitiveness; but our training is in communication rather than medicine, and what medical knowledge we have is gathered, like wild berries on a walk, from random encounters. I've often said it feels like having a backstage pass to the world of medicine. If I had to hazard a guess, I would say that the frustration that results from this tension is one important reason why many of my colleagues choose to go on to become nurses or PAs.
So as usual, in this situation I was straddling the divide. But this time I was inclined to see things more from the medical providers' perspective. I work with lots of very sick children, and often an NG tube (naso-gastric, for "nose to stomach") or some variation of one is just one of many things they have in for weeks at a time. Standard equipment, you might say. And this baby wasn't even ill. The tube WAS the solution, so to my mind, the idea that this and some therapy was all the baby would need was good news.
For this family, though, it was a BIG DEAL. Their dearest wish was to take their child home and keep trying to help him eat. Maybe with some medicine. As I listened to them, I thought about how Hispanic/Latino culture puts a lot of emphasis on eating. For example, "Eating well," or "comer bien" has become a set phrase with connotations of health, correctness, and plenty, and "comer de todo" or, liking/eating all foods is considered a virtue. And I've noticed, working with families where it's come into question, that eating must involve food, chewing, and swallowing. So the idea that their baby might not be able to eat was very distressing for these parents.
In the end, I don't know what agreement the family and the medical staff came to. But it was a good reminder to me to keep both feet firmly in both worlds, to resist the temptation to align myself with the clinicians. I often identify most strongly with the patients, who are transplants not only to American culture, but to medical culture as well. I remember what that feels like, and want to make the interactions as seamless for them as possible: to make it easier. But this time, I found myself almost amused at the intensity of the family's worries. Didn't they know how simple this would be? ...at which point, I had to check myself.
It made me think about just how much I have acculturated to this wacky medical world of inventions and interventions, apparatus and operations. Just because I saw NG tubes on a daily basis doesn't mean that in regular every day life, having one of those tubes in your child's nose and taking him or her to therapies would be easy to deal with, or in any way normal. It would likely end up being one of the family stories, just like the time uncle Bob set a bush on fire when he was 6 and tried to put it out with Dixie cups of water, or that other time aunt Julia jumped off the bed and cracked her head open on the rocking chair, and Grandpa had to sew her up in the bathroom.
And that's kind of how it is, being cross cultural... your perspective fluctuates in and out. If life really looked like instagram, it'd be like having 5 or 8 color filters on all the time, all blending into each other randomly (or as you chose to focus on them). Sometimes one fades slightly as another comes to the fore, changing the scene, and something's always shifting. One minute you're in the patient's shoes, the next you're adding in the nurse's point of view, then layering it with your own as a part of interpreter culture, but by that time the patient's viewpoint has faded a little, so you revisit it... you never quite fully embody any one of them. No one color every fully saturates your lens.
No-one sat on the bed, since the patient was in his mother's arms. I stood on one side of it, backed up to a computer, my presence backing Dad into a corner. Dr. K sat in the armchair, next to Mom, his legs crossed, his gestures confident, reassuring. Her face was like the sun on a windy, cloudy day: now a bright smile for her baby, now drawn and serious with worry. Two other doctors stood at the foot of the bed, on her other side, awkwardly, with their backs to the door, and we talked.
I was in conduit mode: that normal ping-pong from one language to another that we medical interpreters always do. At first I thought I'd only be batting the ball from Spanish to English for Dad, no need to go back from English to Spanish, since seemed to understand what he was being told. But at a questioning look from Mom, I realized it would be a full back-and-forth, so I went for it, all the while trying to play that eye-contact game that doesn't leave the family to stare into space when they hear someone they can understand, but still indicates that the speaker isn't where the words are coming from. Add that to the mental gymnastics.
The room probably wouldn't have felt quite as cramped if emotions on the family's side hadn't been quite so amped. Dad stood, defensive, speaking for both of them, asking if there was no other way. Mom let him speak, her worried face eloquent enough, until they started pleading, toward the end of the encounter, to try medicine for just a little while longer, instead of what the medical team was suggesting.
* * *
If you've ever worked with a speech therapist, you might know that swallowing isn't as easy as it seems. If you've never heard of a speech therapist, don't worry, I don't blame you. I hadn't either until I started hospital work. Apparently, in order to swallow, humans have to coordinate a bunch of different muscles, and this is something that can be hard to do after, say, an illness that affects the nerves, or a stroke. It can also be hard to learn in the first place - babies, especially those who have other problems, often have trouble learning how to swallow.
This isn't just problematic from a nutritional standpoint (although there is that aspect to it, too), it's also a problem because it turns out that letting food or liquid get into your lungs (which is called aspiration) can cause pneumonia. So you can end up hungry, dehydrated AND pretty seriously ill.
Of course, the medical world being what it is, they've come up with ways to help people who can't swallow correctly: basically different ways of bypassing the mouth and putting food directly into the stomach or intestines. One option is to thread a small flexible plastic tube up your nostril, down your throat and esophagus, and into your stomach (or further down into your small intestine). That was what the medical staff wanted to do for this baby so he could rest from the stress of not being able to figure out how to coordinate his insides, and try again later.
* * *
The staff was doing their absolute best to explain to the family that this wouldn't bother the child once it was in, wouldn't hurt him, and would prevent him from getting seriously ill with aspiration pneumonia. That he would, in time, learn to swallow and be able to live a normal life. To them, it really wasn't a big deal. An easy fix, minimally invasive, cost-effective, cheap... and they were doing their best to reassure the parents that it really was nothing to worry about. But the family wasn't having it.
Whenever I tell people that I'm an interpreter, their first reaction is usually "Wow, so you have to know all that medical vocabulary!" And the truth is, as much as the profession's current 40-h training course does teach some vocabulary and concepts, working in the hospital puts you through a necessary, intensely steep learning curve. (Just as an example, everything I explained above about speech therapy, swallowing difficulties, and NG tubes, I learned while working.) Interpreters are not trained as clinicians, but we do work with them every day, and so learn from them. In this way, interpreters become cross-cultural. Our work requires us to perpetually bridge the medical world and the layperson world, and the result is that we no longer truly belonging to either. We are part of the hospital system, work closely with clinicians, and understand much of what goes on from long observation and a healthy dose of inquisitiveness; but our training is in communication rather than medicine, and what medical knowledge we have is gathered, like wild berries on a walk, from random encounters. I've often said it feels like having a backstage pass to the world of medicine. If I had to hazard a guess, I would say that the frustration that results from this tension is one important reason why many of my colleagues choose to go on to become nurses or PAs.
So as usual, in this situation I was straddling the divide. But this time I was inclined to see things more from the medical providers' perspective. I work with lots of very sick children, and often an NG tube (naso-gastric, for "nose to stomach") or some variation of one is just one of many things they have in for weeks at a time. Standard equipment, you might say. And this baby wasn't even ill. The tube WAS the solution, so to my mind, the idea that this and some therapy was all the baby would need was good news.
For this family, though, it was a BIG DEAL. Their dearest wish was to take their child home and keep trying to help him eat. Maybe with some medicine. As I listened to them, I thought about how Hispanic/Latino culture puts a lot of emphasis on eating. For example, "Eating well," or "comer bien" has become a set phrase with connotations of health, correctness, and plenty, and "comer de todo" or, liking/eating all foods is considered a virtue. And I've noticed, working with families where it's come into question, that eating must involve food, chewing, and swallowing. So the idea that their baby might not be able to eat was very distressing for these parents.
In the end, I don't know what agreement the family and the medical staff came to. But it was a good reminder to me to keep both feet firmly in both worlds, to resist the temptation to align myself with the clinicians. I often identify most strongly with the patients, who are transplants not only to American culture, but to medical culture as well. I remember what that feels like, and want to make the interactions as seamless for them as possible: to make it easier. But this time, I found myself almost amused at the intensity of the family's worries. Didn't they know how simple this would be? ...at which point, I had to check myself.
It made me think about just how much I have acculturated to this wacky medical world of inventions and interventions, apparatus and operations. Just because I saw NG tubes on a daily basis doesn't mean that in regular every day life, having one of those tubes in your child's nose and taking him or her to therapies would be easy to deal with, or in any way normal. It would likely end up being one of the family stories, just like the time uncle Bob set a bush on fire when he was 6 and tried to put it out with Dixie cups of water, or that other time aunt Julia jumped off the bed and cracked her head open on the rocking chair, and Grandpa had to sew her up in the bathroom.
And that's kind of how it is, being cross cultural... your perspective fluctuates in and out. If life really looked like instagram, it'd be like having 5 or 8 color filters on all the time, all blending into each other randomly (or as you chose to focus on them). Sometimes one fades slightly as another comes to the fore, changing the scene, and something's always shifting. One minute you're in the patient's shoes, the next you're adding in the nurse's point of view, then layering it with your own as a part of interpreter culture, but by that time the patient's viewpoint has faded a little, so you revisit it... you never quite fully embody any one of them. No one color every fully saturates your lens.
Thursday, June 1, 2017
aqui estoy
As we sat in her basement office at the hospital, my aunt looked me straight in the eyes and said in her friendly but challenging way: "Yeah, I bet they didn't prepare you for THAT in interpreter training!" I had paid her a rare visit, the first person to ever mention medical interpreting to me as a profession, to pick up some things she'd brought me, and we ended up chatting about our respective professional lives. She's been an attending MD at a teaching hospital ever since I can remember, and it's been nice, in recent years, to have more access to and understanding of this part of her life.
And she was right. They definitely did NOT prepare me for the experience I'd told her about in interpreter training. Turns out, no one had prepared her for it back in medical school, either. She'd had to stagger from the sheer weight of it too, just like me. "They do it much better now," she said, and I wished my profession had grown as much.
You see, they don't tell you in that ever-so-crammed 40 hour course that sometimes medical professionals won't be able to stop a disease process. Sometimes your patients, despite the team's best efforts, or for reasons they can't explain, will die.
Today, one of my patients died. Right in front of me, effortlessly. Barely discernibly, she closed this chapter of her existence and let go. (I'm sorry to be so cliche. It's just that it was such a big deal that the two-word sentence that states the fact, "She died," is too bare and bald and can't carry the weight of what just happened. There should be poetry.)
Allow me to tell you the story. Or, if you'd rather not read it, you can skip to the end by looking for the * break.
****************************
It was genetic, so we knew it was coming. When I walked into the office this morning, the whiteboard where we put patient updates said "[this child] is dying." So I looked her up, to see what disease she had, and tried to understand. But since my expertise is in communication and culture, not medicine, it honestly went over my head. Then I got the call, and the dispatcher said, please go to this child's bedside. So I went.
Although I knew that she was sick I didn't know before I went just how bad it was. When I arrived the sounds of distress were already coming from the room. The respiratory therapist sitting outside said, "you can go ahead and go in," so I did. There was a contact precautions sign on the door, so I put on the disposable yellow gown, blue gloves, and teal face mask the hospital provides in order to protect its staff from getting the diseases they're treating for. It feels a little like wearing a costume, and though I'm always glad for the protection, I also can't help feeling a little ridiculous.
When I went in, the sobs had quieted. The child was in her mother's arms, her father standing, pacing, looking utterly lost in the crowded little 6x8 room. My attention closed on that core family focal point, and everything else took several minutes to come into focus for me: the nurse, the tech and MD, grandparents and uncle, chairs, tables, beds, and medical machines. A couple people wore masks, but I was the only one all suited up. Oops. The doc found a chair for Dad, and had him sit next to his wife and child.
"Her oxygen is very low," the doctor said, "and so is her heart rate. I think... I think we only have a little bit of time left with her." "Su oxigeno esta bien bajo, y su ritmo cardiaco tambien," I said, being sure to imitate her intentionally calm voice and the respectful, sorrowful hesitation "Creo... pienso que ya solo nos queda un poquito de tiempo con ella." Dad, who had bowed his head over his little girl with his wife, all three of them together, raised his head. "Minutos?" he asked. "Minutes?" I repeated. "Yes, I think so." "Creo que si." At which there was more sobbing.
We waited. I felt so silly in my yellow paper get-up. I felt almost disrespectful... but taking it off during this solemn encounter would have been far worse. So I waited. We waited. A few minutes passed, as the nurse turned off most of the monitors, leaving just one little one blinking away. Then the doctor motioned for her to hand her the stethoscope, and gestured to ask if she could listen to the child's heart. She listened, heard what she needed, and pronounced this child's death. More sobbing. I kept concentrating on holding back the tears from my voice in every small thing I had to pass back and forth. I kept watching with all my might, thinking how the medical staff was responding to the events of the moment, wondering how they were feeling and how they would handle it themselves later, wondering how they had prepared for this moment.
I watched the family, but not too closely, from respect and for fear of breaking down. They were calling their dead child by every pet name they could think of, a last declaration of love, like roses or desperate lifelines thrown after her retreating consciousness and falling short. I chose not to interpret those names. For one thing, it was clear as day what they were doing, and so needed no translation. For another, it would have been inapproapriate. Those words were so intimate and private; they weren't intended for the medical team, and to interpret them would made them sterile. (Can you imagine repeating the words of freshest parental grief? Could you do them justice?) And in addition to those factors, to repeat those words, to try to take on that role, would have hurt more than I was willing to bear in that moment. If I had felt it necessary, I would have done my best, but I was grateful that it seemed not to be.
We asked if they needed anything, and then gave them some time to themselves. I went on to interpret for the nurse, a couple staff who came by to give condolences, and for a child life specialist who came in to help the family make tangible memories of their baby girl. I watched Dad's pacing become more purposeful as he informed family members of the event, and discussed funeral arrangements. Gradually, they walked out of the intensity of immediate grief and into the practicalities of the moment, as we must. But they kept randomly sobbing, as it would strike them afresh that their baby daughter was no longer with them.
****************************
And she was right. They definitely did NOT prepare me for the experience I'd told her about in interpreter training. Turns out, no one had prepared her for it back in medical school, either. She'd had to stagger from the sheer weight of it too, just like me. "They do it much better now," she said, and I wished my profession had grown as much.
You see, they don't tell you in that ever-so-crammed 40 hour course that sometimes medical professionals won't be able to stop a disease process. Sometimes your patients, despite the team's best efforts, or for reasons they can't explain, will die.
Today, one of my patients died. Right in front of me, effortlessly. Barely discernibly, she closed this chapter of her existence and let go. (I'm sorry to be so cliche. It's just that it was such a big deal that the two-word sentence that states the fact, "She died," is too bare and bald and can't carry the weight of what just happened. There should be poetry.)
Allow me to tell you the story. Or, if you'd rather not read it, you can skip to the end by looking for the * break.
****************************
It was genetic, so we knew it was coming. When I walked into the office this morning, the whiteboard where we put patient updates said "[this child] is dying." So I looked her up, to see what disease she had, and tried to understand. But since my expertise is in communication and culture, not medicine, it honestly went over my head. Then I got the call, and the dispatcher said, please go to this child's bedside. So I went.
Although I knew that she was sick I didn't know before I went just how bad it was. When I arrived the sounds of distress were already coming from the room. The respiratory therapist sitting outside said, "you can go ahead and go in," so I did. There was a contact precautions sign on the door, so I put on the disposable yellow gown, blue gloves, and teal face mask the hospital provides in order to protect its staff from getting the diseases they're treating for. It feels a little like wearing a costume, and though I'm always glad for the protection, I also can't help feeling a little ridiculous.
When I went in, the sobs had quieted. The child was in her mother's arms, her father standing, pacing, looking utterly lost in the crowded little 6x8 room. My attention closed on that core family focal point, and everything else took several minutes to come into focus for me: the nurse, the tech and MD, grandparents and uncle, chairs, tables, beds, and medical machines. A couple people wore masks, but I was the only one all suited up. Oops. The doc found a chair for Dad, and had him sit next to his wife and child.
"Her oxygen is very low," the doctor said, "and so is her heart rate. I think... I think we only have a little bit of time left with her." "Su oxigeno esta bien bajo, y su ritmo cardiaco tambien," I said, being sure to imitate her intentionally calm voice and the respectful, sorrowful hesitation "Creo... pienso que ya solo nos queda un poquito de tiempo con ella." Dad, who had bowed his head over his little girl with his wife, all three of them together, raised his head. "Minutos?" he asked. "Minutes?" I repeated. "Yes, I think so." "Creo que si." At which there was more sobbing.
We waited. I felt so silly in my yellow paper get-up. I felt almost disrespectful... but taking it off during this solemn encounter would have been far worse. So I waited. We waited. A few minutes passed, as the nurse turned off most of the monitors, leaving just one little one blinking away. Then the doctor motioned for her to hand her the stethoscope, and gestured to ask if she could listen to the child's heart. She listened, heard what she needed, and pronounced this child's death. More sobbing. I kept concentrating on holding back the tears from my voice in every small thing I had to pass back and forth. I kept watching with all my might, thinking how the medical staff was responding to the events of the moment, wondering how they were feeling and how they would handle it themselves later, wondering how they had prepared for this moment.
I watched the family, but not too closely, from respect and for fear of breaking down. They were calling their dead child by every pet name they could think of, a last declaration of love, like roses or desperate lifelines thrown after her retreating consciousness and falling short. I chose not to interpret those names. For one thing, it was clear as day what they were doing, and so needed no translation. For another, it would have been inapproapriate. Those words were so intimate and private; they weren't intended for the medical team, and to interpret them would made them sterile. (Can you imagine repeating the words of freshest parental grief? Could you do them justice?) And in addition to those factors, to repeat those words, to try to take on that role, would have hurt more than I was willing to bear in that moment. If I had felt it necessary, I would have done my best, but I was grateful that it seemed not to be.
We asked if they needed anything, and then gave them some time to themselves. I went on to interpret for the nurse, a couple staff who came by to give condolences, and for a child life specialist who came in to help the family make tangible memories of their baby girl. I watched Dad's pacing become more purposeful as he informed family members of the event, and discussed funeral arrangements. Gradually, they walked out of the intensity of immediate grief and into the practicalities of the moment, as we must. But they kept randomly sobbing, as it would strike them afresh that their baby daughter was no longer with them.
****************************
Today, after this
child’s passing, the family wanted to make molds of her feet and
imprints of her hands, so a child life specialist was called to the
room to help them make these tangible memories. We had a moment to
wait outside the room, so we were talking and she said, “I know it
sounds weird, but although it’s hard, I like the work I do with
bereavements. When I leave, I know I have helped them and done
something for them.” I understood what she was saying. I don’t
make anything tangible for people, and don’t do anything
clinical/medical with the patients, but there is something else I do.
I empathize with them.
I have been an interpreter for two and a half years now, and as everyone in the profession will tell you, the hard or sad things are easier to remember than the good or beautiful ones. I've seen a lot of things now that come easily to mind.A woman dying of cancer, fully prepared to face her fate; a mother who fainted dead away because the pressure to emotionally support her son (who was in a coma) overwhelmed her; a newly delivered baby with her organs inside-out and her grieving, half-sedated mother and inarticulate father; a mother who refused to believe her son would suffer any negative side effects from the chemo he needed to prepare him for a bone marrow transplant; a mother who's son was dying declaring she'd give her life for him if she could... those are the hard ones. Not to mention the parents I've seen fight impossibly challenging circumstances to make sure their babies survived.
I have seen and known these people, and I have spoken their words. Those people, and many more, are part of me now; their voices have shaped who I am and will become. I'm so glad they have. And I'm honored to be with them in those moments.
In Spanish, when you say, "I am here," or "I'm going to stay with her," it means more than it means when we say it in English. It carries this extra layer of meaning that says, "I am going to make sure you're not alone. I am here to make sure you're not surrounded by strangers. I am here as someone who cares about you." It's this really beautiful thing about Spanish and Latino culture that you always to your best to make sure no one you care about has to face anything alone - whether it's driving to the bank to make a deposit or walking through cancer. I love the opportunity to make it so that people don't have to face healthcare alone, both by being with them myself, as a Spanish speaker, and by helping them form bonds with the rest of the healthcare team. I think probably a lot of interpreters do.
From what I understand about grief, what people need most in those seasons is for someone to be with them, on a soul level. We need people to say, "I've been there, I get it. It sucks." I don't empathize exactly like that, by expressing my own thoughts; in a lot of ways, I don't get to be an active participant in what happens. But somehow in speaking the words they speak, in transmitting them to the rest of the care team, I do form a bond of empathy with them. When I say their words, transmit their jokes, or their anger, or their confusion, I am in a sense acting them out. It's like being in a play where you get the script in real time (but in the wrong language. Ha.). I get to BE them in English or Spanish, and in so doing I get to be WITH them in a powerful way. To use Christianese, I come alongside them, walk with them. Nothing more, nothing less. I don’t add or take away anything, no meaning originates in me. But in those moments, in the real nitty-gritty bits of life, I am with them in a very profound way: as someone who understands them, and makes a bridge for others to do the same. So I like that. It is satisfying. It’s active love.
And that is what I enjoy the most about my job. I get to love people in that active way every day.
I have been an interpreter for two and a half years now, and as everyone in the profession will tell you, the hard or sad things are easier to remember than the good or beautiful ones. I've seen a lot of things now that come easily to mind.A woman dying of cancer, fully prepared to face her fate; a mother who fainted dead away because the pressure to emotionally support her son (who was in a coma) overwhelmed her; a newly delivered baby with her organs inside-out and her grieving, half-sedated mother and inarticulate father; a mother who refused to believe her son would suffer any negative side effects from the chemo he needed to prepare him for a bone marrow transplant; a mother who's son was dying declaring she'd give her life for him if she could... those are the hard ones. Not to mention the parents I've seen fight impossibly challenging circumstances to make sure their babies survived.
I have seen and known these people, and I have spoken their words. Those people, and many more, are part of me now; their voices have shaped who I am and will become. I'm so glad they have. And I'm honored to be with them in those moments.
In Spanish, when you say, "I am here," or "I'm going to stay with her," it means more than it means when we say it in English. It carries this extra layer of meaning that says, "I am going to make sure you're not alone. I am here to make sure you're not surrounded by strangers. I am here as someone who cares about you." It's this really beautiful thing about Spanish and Latino culture that you always to your best to make sure no one you care about has to face anything alone - whether it's driving to the bank to make a deposit or walking through cancer. I love the opportunity to make it so that people don't have to face healthcare alone, both by being with them myself, as a Spanish speaker, and by helping them form bonds with the rest of the healthcare team. I think probably a lot of interpreters do.
From what I understand about grief, what people need most in those seasons is for someone to be with them, on a soul level. We need people to say, "I've been there, I get it. It sucks." I don't empathize exactly like that, by expressing my own thoughts; in a lot of ways, I don't get to be an active participant in what happens. But somehow in speaking the words they speak, in transmitting them to the rest of the care team, I do form a bond of empathy with them. When I say their words, transmit their jokes, or their anger, or their confusion, I am in a sense acting them out. It's like being in a play where you get the script in real time (but in the wrong language. Ha.). I get to BE them in English or Spanish, and in so doing I get to be WITH them in a powerful way. To use Christianese, I come alongside them, walk with them. Nothing more, nothing less. I don’t add or take away anything, no meaning originates in me. But in those moments, in the real nitty-gritty bits of life, I am with them in a very profound way: as someone who understands them, and makes a bridge for others to do the same. So I like that. It is satisfying. It’s active love.
And that is what I enjoy the most about my job. I get to love people in that active way every day.
Thursday, March 2, 2017
the bonds we (interpreters) form
It's a sad case. I remembered halfway through the ethics meeting that the child had a metabolic disorder. That she came from Central America just for her, much like a coworker of mine. This mother is so beautiful. Seeing her cry nearly brought me to tears. Her face is weathered and wrinkled and brown, one side less expressive than the other. Her eyes have so many smile lines, they're like little triangles. She's determined and loving and hard-working. Tuechtig, would be the German word. And I love her. Somehow. I wish I knew her name, not just her daughter's. I wish I understood her disease better... or could form a bond with the family. I'm glad I'll get to be around to hear what happens with them.
Another beautiful mom. I was glad to hear (and 2 seconds later, relay) that her baby had her surgery and is doing well. I wonder what kind of person she is. Today she was VERY nicely dressed. Like another coworker of mine, or her friends. She always gives me the impression of being well-nurtured and happy. Rich in the best sense of the word.
Goliath's* mom too, he's one of our cancer patients. She was happy and less worried in clinic today, which was nice to see. And Goliath was less sullen/more talkative than I've ever seen him. Things must be getting better.
It's such a privilege to see mother-love like this, all day. To get to say what they say, and in saying it, empathize with them, as if I were an actor playing their role, but in English. I am struck by how beautiful they are as they care for their kids; how they love them with all practicality, dealing with the ins and outs of a foreign healthcare system - all its procedures and people and red tape - in a non-Spanish-speaking country, so that their kid can just be sick. So they can get better.
I never know what to say when they look me in the eyes and say thank you, "gracias" or "gracias a usted por interpreter," "thank you for interpreting." It's like suddenly, when I have to speak my own words instead of everyone else's, I'm tongue-tied, jammed with the traffic of all the things I want to say to them for myself, all the things I've been thinking and feeling as I feel and speak for others. I'm not the doctor anymore, or the social worker imparting knowledge and wisdom. Neither am I a mother looking to the interests of her child. I am me. And I... mumble and stumble, and forget to smile. I run away in an embarrassed hurry of unspoken thoughts.
Maybe I just haven't found the version of "you're welcome" that I like. Maybe I need to intentionally pause and say something meaningful. Something about how glad I am to do this work. Even though it costs me my self.
Maybe I'll smile, look right back, and say:
"It was a pleasure to work with you." - "Me dio mucho gusto trabajar con usted(es)."
Because no matter what I've had to say, it almost always is.
*Goliath must obviously be a fake name. Privacy and all that.
Another beautiful mom. I was glad to hear (and 2 seconds later, relay) that her baby had her surgery and is doing well. I wonder what kind of person she is. Today she was VERY nicely dressed. Like another coworker of mine, or her friends. She always gives me the impression of being well-nurtured and happy. Rich in the best sense of the word.
Goliath's* mom too, he's one of our cancer patients. She was happy and less worried in clinic today, which was nice to see. And Goliath was less sullen/more talkative than I've ever seen him. Things must be getting better.
It's such a privilege to see mother-love like this, all day. To get to say what they say, and in saying it, empathize with them, as if I were an actor playing their role, but in English. I am struck by how beautiful they are as they care for their kids; how they love them with all practicality, dealing with the ins and outs of a foreign healthcare system - all its procedures and people and red tape - in a non-Spanish-speaking country, so that their kid can just be sick. So they can get better.
I never know what to say when they look me in the eyes and say thank you, "gracias" or "gracias a usted por interpreter," "thank you for interpreting." It's like suddenly, when I have to speak my own words instead of everyone else's, I'm tongue-tied, jammed with the traffic of all the things I want to say to them for myself, all the things I've been thinking and feeling as I feel and speak for others. I'm not the doctor anymore, or the social worker imparting knowledge and wisdom. Neither am I a mother looking to the interests of her child. I am me. And I... mumble and stumble, and forget to smile. I run away in an embarrassed hurry of unspoken thoughts.
Maybe I just haven't found the version of "you're welcome" that I like. Maybe I need to intentionally pause and say something meaningful. Something about how glad I am to do this work. Even though it costs me my self.
Maybe I'll smile, look right back, and say:
"It was a pleasure to work with you." - "Me dio mucho gusto trabajar con usted(es)."
Because no matter what I've had to say, it almost always is.
*Goliath must obviously be a fake name. Privacy and all that.
Saturday, February 4, 2017
how does a pebble feel in an ocean?
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.
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.
Thursday, December 15, 2016
curve ball
One thing I love about interpreting is all the quirky, amazing, fascinating people you get to work with: both patients and medical staff of all kinds. And sometimes, if you're lucky and you work in a teaching hospital, you get to walk around with legendary doctors just exactly when they happen to be sharing their laboriously gathered wisdom with their med students, residents, and fellows.
I think about these people sometimes - the old, snow-haired men with hearing aids and slow purposeful movements that go with their slow, thoughtful words - and feel both honored to work with them, and just a wee bit nervous about what kind of curve balls they're going to throw me. Because there is ALWAYS a curve ball.
The other day, I went into a patient's room with just such a team. The boy's diagnosis was a passing illness, on the upswing, and medically there wasn't much to do but prod at his belly a bit and declare he was to be watched and given medicine a little while longer. This I learned as the team gathered around his bed and did exactly that - almost to the point of ignoring his dad, who, I noticed, nodded vigorously at everything anyone said to him, and spoke in an octave much higher than your average man. "Perhaps," I thought, "he's nervous," so I did what I could to include him in the conversation as much as possible, despite the team's focus on his boy.
Then, out of the blue, our attending snowbird looked me straight in the eyes, pointed his index finger right at me and said, "Can I ask you something outside?" Confused, I assumed he meant the boy's father, so I addressed the question to him. But almost before I finished my first phrase, I heard the words that bring any interpreter's smooth attempt to maintain transparency to a screeching halt: "No. I meant you." Uh oh.
So I made my apologies, discombobulated, "We'll be right back sir, just a moment, I'm sorry," and we all filed out. The big man made a big show of glancing seriously behind him and shutting the door. I was sure I was in trouble, or there was some serious issue afoot with the patient that needed to be discussed - but why he should want to ask ME a question, I couldn't fathom.
Fortunately, the answer came soon enough. As it turned out, the attending wanted me to go back and ask, in as culturally sensitive a way as possible, whether or not the boy and his father had been getting enough to eat. Apparently, there had been a problem with/confusion around ordering food or paying for it. In the explanations that followed, I learned that this doctor was prepared to pull whatever strings were necessary with social work or the kitchen to make sure everyone got enough to eat: to the point that when one of the residents said that they could probably get a discount for the father, the attending replied, rather darkly, "Or we could just give him some."
So, not only was this attending physician taking precious time out of everything to make sure the family was eating: he made a clear effort to make sure it was done without causing offense or embarrassment, and he was prepared to find unorthodox solutions to that problem. He was so invested in the answer, in fact, that when I came back, I had to report my conversation word for word before the tension in his face eased, his concern abated.
So, not only was this attending physician taking precious time out of everything to make sure the family was eating: he made a clear effort to make sure it was done without causing offense or embarrassment, and he was prepared to find unorthodox solutions to that problem. He was so invested in the answer, in fact, that when I came back, I had to report my conversation word for word before the tension in his face eased, his concern abated.
When I got back to the office and told of my adventure, my colleague said, "oh yes, I know that doctor. He's terrible at speaking directly to the patient, because he thinks too collaboratively, but he really, deeply cares. He is one who investigates and uses his influence to really make sure that all of the families' needs are taken care of. And then he teaches that to his students."
It's such a privilege to see medical staff fighting in this way for the patient demographic that I serve: poor, with low health literacy, sometimes poor literacy in general, refugees. So often in my line of work we worry about the times we weren't called to interpret for someone, and the staff just "got by" on "my crappy Spanish and his broken English." We worry they'll come back to the hospital because they didn't know how to take their medicines, or because they missed some key piece of information. We worry they might not know what they were diagnosed with or treated for (yes, that happens). So it does my heart good to know that there are influential people like this attending who will use their position and the resilient, good character they've developed over the years to make sure that their patients, at least, get excellent service.
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