Medical Interpretation

Happy Monday, and welcome to Medical Mondays! As some of you may know, I used to volunteer as a medical interpreter and patient advocate at a student-run free clinic in California. Even after I graduated from college, I’d sneak back there on the weekends to help out whenever I was free. :]

My experiences there were what ultimately led me to decide to apply for medical school, and in particular, Family Medicine. It’s actually kindasorta one of my life goals to go back there to volunteer on the weekends as a physician. :] (Tis a part of why I think the Davis/Sacramento area is where I’d most like to work in when I finish my residency.)

Presenting about osteoporosis (that’s a trap poster about menopause) at a PHAC health fair!

As an interpreter, the things we always tried to keep in mind were…

1. Introduce yourself and the health care provider to the patient, and if applicable, find out who the other people in the room are and if the patient is comfortable with having them there during the patient interview.
2. Position yourself in a way that promotes direct eye contact between both the health care provider and the patient.
3. Refrain from starting side conversations with the patient.
4. Use first person, and if speaking as yourself (e.g. to ask for clarification), preface with something along the lines of, “This is the interpreter speaking.”
5. If either the health care provider or the patient get carried away, politely pause them and explain that you need to interpret/explain something to the other party before they continue.

Over the past several years, I haven’t had too many chances to use my Cantonese or Mandarin, and it has unfortunately kindasorta degenerated, but there have been a couple!

When I was working the games at the Little League World Series, I was temporarily on standby as an interpreter for the Taiwan team! I also had a Mandarin-speaking patient when I was doing my Internal Medicine rotation in Modesto, and another one while I was in Neurosurgery.

Truth be told, my Mandarin is pretty terrible at this point, but there’s just something about being able to speak a person’s language when they’re in an unfamiliar place that really helps to ease their fears and to open up to you. While I couldn’t always convey the message in the proper vocabulary, they appreciated my efforts.

The patient I had on Neurosurgery told me that he could understand the interpreter he had coming in the evening just a little better than me. (I’m sure his interpreter was infinitely better. I’ve only ever been delegated to receptionist duties with my Mandarin. :P )

On my Sleep Medicine rotation, I actually had a Cantonese-speaking patient! It was my last day on the rotation, and I overheard one of my preceptors saying that he couldn’t understand his patient because “she spoke some kind of Chinese dialect.”

At the word, “dialect,” I perked up.

F: :O!!! Maybe I can help!?
Dr. G: Do you speak Cantonese?
F: Yes! And I can understand about 60% Toisan/Taishanese! I’ll see what I can do! :]

He and the fellow I was working with were super super happy that I was there, and referred to me as “their star player.” Their patient was a little 75yo granny who had had a world of trouble with her sleep study because she found all the wires and leads too uncomfortable to fall asleep, so she’d spent the entire night walking around the room, exercising, and stretching.

I explained the situation to them, and stuck around to walk her through the home sleep study they were going to do while the nurse explained everything to her grandson. She said she wished I’d been there the night before, and hoped that I’d come back to the bay area to work in the future. <3!

Since I’m so used to being on the interpreter side of the spectrum, my Rural Under-served Family Medicine rotation very much reminded me of my medical service trip to the Dominican Republic. Something I very quickly learned was that…I really need to learn Spanish too.

These are the things I tried to do when I was working with my interpreters:

1. Speak directly to and maintain eye contact with the patient.
2. Use short, simple sentences.
3. Don’t “think out loud” or make comments to the interpreter that you don’t mean to be interpreted.
4. Encourage the interpreter to ask clarifying questions. and confirm understanding/agreement with patient to ensure compliance.
5. Ask the interpreter to explain what was said in any independent/side conversations with the patient.

• Have you ever worked with an interpreter?
• What language would you like to learn? I need to brush up on my Cantonese/Mandarin and learn Spanish!