A Diabetic Condemnation

I don't often describe myself as "flabbergasted." First of all, I think it's an odd word. Second of all, it takes an awful lot to shock me that much. But I was definitely in a state of flabbergast today.

The stimulus? A rather traumatic translating session at the free clinic where I volunteer.

It all started out rather routinely. The patient was a middle-aged woman with unregulated diabetes. Her blood glucose -- which should be around 90 mg per 100 ml of blood -- ranged from the mid-100s to 200, according to the self-checks she did at home. This morning at the clinic, it was quite a bit above 200, and her previous visit it had been above 300. Not good. Really not good. Clearly, her current combination of medication and lifestyle wasn't working. But insulin wasn't an option, as she had tried it previously and suffered side effects that made her afraid to take it again.

The physician I was working with was obviously frustrated at her lack of improvement. He asked me to ask her what she'd eaten for breakfast, thinking that perhaps a sugary meal was to blame for the high blood sugar that morning. Turns out she had a licuado (shake) made of banana, strawberries, and milk, plus an apple. My guess is that she thought she was being healthy, while what she was really doing was causing her blood sugar to skyrocket with all of that natural sugar. (Yes, it's natural, and yes, it's fruit, but it's still sugar.)

The doctor shook his head. "She's eating like she's going to the electric chair," he said, half to himself, half to me. But clearly not to her. "Don't translate that," he hurriedly added.

I just sat there, a plastic smile on my face. What was I supposed to say? As a translator, I'm supposed to repeat everything that is said in the exam room in the other language so that it is as if there were no language barrier. But I couldn't bring myself to repeat those words. Less for fear of angering the physician than for fear of horribly upsetting the patient. But, I will admit, both fears were active.

I'm not saying the physician had any ill will toward the patient. Quite the reverse -- he was vocalizing his frustration at her non-compliance, her lack of improvement, and her potentially grim future. (The complications of diabetes include kidney, heart, vision, and circulation problems, among others.) But he did it in a way that was not inclusive, that didn't engage the patient, but rather left her out of the loop at her own doctor's appointment -- a place where she deserved to understand everything that was going on.

I don't know what I should have done. But I know what I won't be doing when I'm a physician.