Abstract

In lieu of an abstract, here is a brief excerpt of the content:Translating Care for the Voiceless PatientLeo AlmazanUndocumented immigrants do not have the luxury of having a professional interpreter by their bedside to help them navigate the complexities of their often-dire situation. Most of the time, they have to rely on the kindness of volunteers or untrained medical personnel to help them. In 2001, I was a non-clinical student in training at a level 1 trauma hospital in the Midwest. The night in question, one of the residents asked me to go to the infectious diseases unit to translate for a newly admitted undocumented patient. [End Page 152]The patient was in his early twenties. This was the second time he had arrived in the US after walking through the desert. His diagnosis was dire—he drank stagnant water during his journey, and he had acquired an aggressive type of infection whose origin (viral? bacterial?) the specialists could not as yet determine. After initial testing, the doctors discovered that he was also suffering from full-blown AIDS.When I entered the room where the young man was lying, shaking violently due to a high fever, I felt deep anger and profound sadness. People looked at the young man with a mixture of disdain and anger. He was, after all, "wasting" the hospital's precious resources. At the same time, his immediate reaction after hearing me speak to him in his native language and sensing that I understood him, that is, that I could empathize with his fears, made me decide that I would do whatever I could to help him.After a brief initial conversation, it became painfully clear that he neither had any formal education nor did he understand the gravity of his medical condition, aggravated by AIDS. Besides that, he did not comprehend what was being done to him, which included the use of experimental drugs that he had not consented to take.My task then morphed from an untrained translator trying to help someone understand a foreign language to a new ally trying to help someone navigate the short-, mid-, and long-term life-altering decisions he would have to make without full knowledge or understanding of his actual circumstances. In short, I quickly transition from interpreter to advocate.It was probably the result of the stress and pressure I suddenly found myself experiencing, but I remember thinking back to my high school etymologies class and realizing that the verb "to advocate," from ad-vocare, means to support, defend, or protect someone. "When did I commit to any of those things?" I thought to myself. And then I immediately remember thinking, "Not at all! I did not commit to any of those things! All I said "yes" to was to lend my voice for a couple of minutes so that a doctor and a patient could understand each other. I surely did not intend to lend my voice to someone who has no voice!"A second and even bigger surprise for me, however, was that, in the process of translating, I could hear what the young man and the physician were truly saying to each other. In other words, as my mouth moved to speak, now in Spanish and now in English, I was able to capture and translate not only the words being said but also the feelings and emotions and the deeper meaning of what was being communicated. For example, when the young man asked, "¿Voy a estar bien?" ["Am I going to be OK?"] I could "hear" his real question, "Am I dying?" When the doctor said, "Your CD4+ cell count is less than 200," I heard him say, "Couldn't you have chosen another place to die?" Conscious of my role, however, I limited myself to performing my duties as professionally and precisely as possible.The following day, I consulted with a professional interpreter who worked at the same hospital, and I asked her how I could be more helpful to the young man. As she advised me how to proceed, I could tell she was truly torn.On the one hand, she wanted me to proceed with the outmost professionalism, to remain "neutral," "objective," and to avoid, at all...