Providing Services when the Patient is Bilingual

You have been called in to interpret for a patient and it turns out that he/she is fully bilingual. Are your services still needed? They sure are!


1. Because chances are the patient’s family are either completely monolingual or do not have enough command of English to understand diagnoses, treatment plans, consents (if the patient is a minor or if someone else has medical power of attorney), discharge plans, etc. The patient’s caretaker also needs to understand everything that is going on in order to participate fully in the medical care of their loved one.

2. Depending on what is going on medically with the patient the ability to express himself/herself in one language or the other may be compromised. Brain injuries, whether accidental (a swift kick in the head by a horse) or a medical event (stroke), can radically change ones ability to process language, sometimes temporarily and sometimes permanently. Most bilingual people have a “first” language. A “first” language is the language to which a person is first exposed. A fully bilingual (English/Spanish) teenager was raised in Spanish by her monolingual parents. The language one dreams in is usually your first language. In my experience this is the language that a compromised brain falls back on. Anesthesia can also do strange things to the brain. Someone fully bilingual can wake up after an operation and find they cannot express themselves in both languages. In this case, services would need to match whichever language the brain has decided to produce in the moment.

It’s always a good idea to solicit the answer to the question “in which language do you prefer to receive your care?” in order to provide effective, patient-centered services. One very patient-supportive reason to provide medical services in a preferred language is that the brain does not have to work so hard on producing a second language and can use that effort instead to recuperate.

The brain is a very interesting organ. And so is language acquisition.

What sort of situations have you encountered where the brain and language made your job as interpreter a little harder?

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