Abstract

In lieu of an abstract, here is a brief excerpt of the content:Voices in the Shadows:The Hidden Complexities of Being a Medical InterpreterLiliana CraneAs a Spanish interpreter at a Hospital for 16 years, I continue to be surprised at the lack of knowledge regarding the role of a Spanish Interpreter. Often the Spanish interpreter cannot interpret word for word; the interpreter's primary role is to find the best way to culturally convey messages between the provider and the patient so they can understand each other's intended meaning. I have noted a significant change in our patients' literacy and the providers' level of experience. Because of our patients' low literacy level, the providers need to lower the complexity to obtain the answers to many of their questions; however, lowering the complexity may be more challenging than it sounds for some providers.The first question a provider asks when the patient arrives at the Emergency Department (ED) is, "Why you are here?" or "What brought you here to the Emergency Department?" It seems a simple question. However, often I hear these answers: "I am here because my wife/husband brought me in the car" or "Because in 1980, my cousin had similar symptoms and died."As interpreters, we have to repeat the question differently to obtain the answer sought by the provider. If we repeat the question word by word, the answer won't change. That is when experience as an interpreter and cultural knowledge of our patients play a crucial part.The interpreter's experience and familiarity with the target population are as vital to the communication as being proficient in both languages. Our patients often use words made up from a combination of English and Spanish, such as nursa, referring to a nurse, or friza, referring to a blanket, and derived from freezing. Our patients often refer to the leg as the foot, so when the provider asks what is hurting, the patient will sometimes say, "My foot."As an interpreter working extensively with this population, I know that body part clarification is necessary. Pinpointing the body part the patient is referring to through visual confirmation is essential to treating the appropriate ailment. It is similar to doing a dual identifiers; instead of asking for name and date of birth, we ask for location (right or left) and visualization by pinpointing, with one finger, the body part being referenced. The role of clarifier is one of the interpreter's roles, and it has become the main practice for me to make communication accurate. [End Page 167]The provider should know that what the patient verbally expresses may not be what they mean to say based on their literacy levels, mental health, cultural background, and upbringing. Words may have different meanings in different languages despite being spelled the same. For example," Take this medication once daily" may be in discharge instructions, prescriptions, or medication labels. In English, "once" means "one time," but in Spanish, it means "eleven."Communicating using the limited Spanish that a provider may have, or using Google to translate words for a patient with limited English language ability is highly discouraged but often done. The problems with these methods are often overlooked. One cardiologist told an adult male patient, "Te amo," with the patient's mom in the room. I was the interpreter on-call that night. The provider called me because he thought the patient's mother gave him a weird look after telling the patient, "Te amo," which is how Google translated the words "I like you." The provider's intended message was to say that he liked working with the patient. Google does not put the words in context, so the provider told the patient he was in love with him by saying, "Te amo." After a good laugh and an education on why using Google is inappropriate, I clarified with the patient and his mother what the provider intended to say. The provider quickly learned that Googling phrases or using a little Spanish may get you in trouble.I currently work full-time as a physical therapist assistant and Spanish medical interpreter. I have a Master of Business Administration, am certified by the American College of Sports Medicine as a Certified...