Friday, October 1, 2010

Lost & Found In Translation

It's allergy season -- especially for those sensitive to ragweed, like Maria Juarez. * She came in to see the nurse practitioner at a local free clinic reporting a runny nose, itchy throat, sneezing, and wheezing -- all of which had lasted for weeks. She used to take an inhaler, but had run out. Over-the-counter allergy medications made her sleepy. Maria wanted to know if there were any better ways of controlling her symptoms.

Sounds like an easy enough clinical encounter, right? Except that Maria spoke only Spanish, while the nurse spoke only English. That's where Mark * and I, Spanish medical translators at that free clinic, came in. Our job was to translate everything that was said from one person to the other to make sure the appointment went smoothly. 

For people who live outside their native countries and who aren't fluent in the second language, this happens all the time. But for those of us born and raised within the same borders, it's something we rarely, if ever, have to think about. But while you read this blog post, it's something I want you to actively consider.

It's so easy to take verbal communication for granted: understanding, being understood. That is, until you can't understand, or be understood. I know from experience that this position -- especially in the medical context -- feels like one of powerlessness, of vulerability. And it is. You feel at the mercy of those around you because you can no longer fend for yourself. Nor defend yourself, for that matter. You must take others at their word. What other choice do you have? 

I had no other choice. I was 15, in a foreign country. And we're not talking on the other side of the border here. We're talking across the ocean, across continents. In China. Beijing, to be more precise. I had a fever, sore throat, reduced appetite, and was generally miserable. Was it an infection? Some rare disease? My high school chaperone thought not, but took me to a doctor to be on the safe side. 

While many of the young students we encountered in Beijing spoke English, this doctor evidently did not. Gestures and body language will only get you so far. Fortunately, there was someone to translate the Mandarin to English. This was more than a dozen years ago, so I don't remember whether the translator was a member of the doctor's staff or had come with my chaperone and me, but no matter. She was able to make the situation clear: I had a throat infection, and should take antibiotics for a week or so. I remember the doctor handing me a bottle with lots of Chinese characters printed on it, which was a little frightening (not being able to read for myself what was in the bottle). But again, the translator came to the rescue and explained the dosing instructions and contents. We thanked the doctor and made our way back to our hotel, much relieved. 

Looking back on the situation, I completely took that translator for granted. Very Eurocentric of me, expecting there to be someone who could speak English (although I can hardly hold that against myself at 15). But what if there had been no translator? I doubt very much that the Chinese doctor's message would have gotten through, and I certainly would not have taken any of that medication without knowing exactly what it was and when (and how often) I was supposed to take it. 

And now I find myself in the translator's role. A human cultural-linguistic bridge. I am helping to transform that feeling of powerlessness into one of power, into ownership of one's health care. And that feels like a job very much worth doing.





* Names have been changed to protect people's privacy.

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