Anatomy of an Assignment

I recently recorded a presentation for the Kentucky Refugee and Immigrant Inclusion Summit (KRIIS) entitled “What Are You Paying For?: Interpreting and Translating.” In it I included some information about what is going through a trained/qualified (and perhaps certified) interpreter’s mind as we begin the encounter with the patient/client and move on to include the various service providers during the assignment. The same day that I finished the recording of the presentation I headed to a medical assignment and jotted down each professional decision I made in providing that service. The following is my experience.
The facility is not too far away. Still, I try to leave the house 30 minutes prior. I find a parking space near the entrance. Yes! I enter the clinic about 925am. Five minutes to spare. As I wait to check-in, I notice that a pre-teen girl and her mom are filling out paperwork, speaking Spanish. I ask the patient’s name and introduce myself, telling them I am here to interpret. Soon after I ask for mom’s name and listen for her accent. It doesn’t sound like the usual Mexican/Guatemalan/Honduran accent I am most used to. I ask her where she is from: El Salvador. Knowing this will inform my vocabulary choices going forward.
They get called in to registration and I purposely use the phrase “seguro medico” for health insurance instead of “aseguranza”, a word widely understood and used by the Mexican population. Mexican Spanish tends to be influenced by both their indigenous populations and the proximity to the United States. Some argue for the use of neutral Spanish that all can understand regardless of country. I tend toward using the regionalisms when I know them.

As we wait for the doctor, I ask mom if she understands some English since I had seen her interacting with the front desk person without an interpreter. She says she understands some but can’t speak much. This information helps me to navigate the appointment knowing that she may respond in English before I have a chance to interpret. And I may need to check for understanding during those interactions.

I ask mom if she has ever worked with an interpreter, and she responds no. I go over how the session will go and stress for her to pause after each 2-3 phrases so that I can repeat everything. The providers at this clinic are well- versed in working with interpreters so I don’t need to do a pre-session with the them unless I am working with someone new.

They are called back by an assistant who gets the weight and height of the child. We are all brought to a room where they are told that the doctor will look at the previous x-rays and will be in to speak to them. I leave as the assistant leaves so that I can wait in the hall for the doctor to arrive. This is best practice so as not to spend unnecessary time with the patient. It allows the interpreter to maintain a professional distance.

The doctor walks down the hall to the patient’s room where I introduce myself to him before we both enter. The 12-year old patient is fully bilingual and that causes me to tweak my role a bit, walking a fine line between being sure that all is repeated accurately and allowing the daughter to express herself in Spanish to her mom. It only takes a few seconds to get into the flow of this dynamic. It adds a layer of complication as I will need to interpret when she speaks English to the provider so that the mom understands and interpret the Spanish to the provider to that he understands.

I have looked up curvature of the spine to be sure I am using the correct medical vocabulary. I like to use the app Linguee because it puts a word or phrase into several contexts. The appointment ends up being fairly short considering the patient is being seen for the first time in this facility. Often additional images are ordered and need to be analyzed in order to create a treatment plan. Sometimes the patient is sent to physical therapy the same day. But today, they are satisfied with the original x-rays and will see the patient again in 6 months for repeat images and further evaluation, if needed. We make the follow up appointment and say our goodbyes.

I usually enjoy orthopedic assignments because there always seems to be something to learn. During this appointment I learned that scoliosis can be seen during the first two years after the female patient starts to menstruate. This is the time when the patient goes through her fastest growth spurt and the scoliosis often resolves itself as she finishes growing.

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