I dare say that everyone expects the interpreter will repeat (aka interpret) all medical things that the patient says to the doctor and all medical things that the doctor says to the patient.
What I’ve noticed among interpreting circles and among non-interpreters is that not everyone expects the interpreter to repeat everything else that people say during the encounter. You know, like when the mom tells the child to put the books away or the nurse tells the doctor that the flu vaccine is in-stock now.
Even among aspiring interpreters and practicing interpreters, this concept (or protocol or expectation) is not always understood or applied consistently.
The question from the interpreters is, “Do I really have to interpret that stuff?”
The simple answer is, “Yes.”
Well, because it is pretty clearly stated as an expectation in the National Standards of Practice for Interpreters in Health Care:
The interpreter renders all messages accurately and completely, without adding, omitting, or substituting.
For example, an interpreter repeats all that is said, even if it seems redundant, irrelevant, or rude.
The interpreter does not allow personal judgments or cultural values to influence objectivity.
For example, the interpreter does not reveal personal feelings through words, tone of voice, or body language.
In the first point (Accuracy), that really short word, “all,” is really demanding and clear.
In the second point (Impartiality), the interpreter doesn’t get to judge what is important or not. To be extra clear, choosing not to interpret something is a way of revealing a judgement on the interpreter’s part that the message or statement isn’t important, which violates impartiality.
Well, because doing so allows for a few things to happen:
1) The participants get the complete and full picture of what is being said, without editing or editorializing from the interpreter.
2) It keeps the speakers and the listeners on the same playing field, and no one is left in the dark.
3) The interpreter doesn’t have to guess at what messages are important or relevant, which is way too much pressure and well beyond the professional skill set of the interpreter. If it was said, it is interpreted. It is for the participants to decide if it is relevant or not. . . just like they would if everyone in the encounter spoke the same language.
Let me share a specific example that supports the value and importance of these professional expectations.
I was interpreting in a pediatric clinic. The patient was about 4 months old. The doctor was on one side of the room finishing up some written notes. The parents were on the other side of the room dressing the baby and talking between each other about stopping by the store on the way home, shopping lists, etc. Completely irrelevant information and the doctor wasn’t really paying attention, but. . . If they had been speaking in English, the doctor would have been able to overhear them, so. . . I was interpreting their seemingly irrelevant conversation, which the doctor, of course ignored, but that’s fine. Then, the parent’s conversation turned to a discussion about a cough that the child was having. . .
Parent 1: Weren’t you going to ask the doctor about the baby’s cough?
Parent 2: No, we’re just about done here. I’ll just give the baby some honey.
At that point, the doctor stopped documenting, turned to the family, and discussed the cough and treatment options. Honey was not recommended.
Okay, I know I said just one example, but here is one more. . .
The adult female patient was in the emergency room due to pelvic pain and bleeding. The doctor said he would do a pelvic exam. The patient acknowledged this. The doctor left the room while the nurse stayed to get everything set up for the pelvic exam. The nurse was on one side of the room getting things out of the cabinets and setting them on the tray. Meanwhile, the patient was commenting to her husband about how she was nervous, she’s heard that these exams hurt, and that she’d never had a pelvic exam before. At that moment, the nurse stopped what she was doing, went to the patient’s bedside, and explained that she (and the doctor) didn’t realize that she hadn’t had a pelvic exam before. The nurse then explained how the exam is done, that it shouldn’t hurt too badly, but if she (the patient) wanted the doctor to stop at any time, she would just need to say so. The nurse also let the doctor know that this was the patient’s first pelvic exam, and the doctor addressed the points again with the patient, emphasizing to let him know if he should stop.
As the interpreter, what sticks with me in both of these scenarios is how the outcome and experience was for those involved was directly impacted because everything was interpreted. In the first situation, the doctor was able to address relevant medical care and potentially prevent an adverse reaction to the honey. In the second situation, the care team was able to address the whole person (not just the physical presentation), and the patient was empowered to have control over what was being done to her body. I get teary just thinking about it. These are moments that matter.
Having presented the profession’s expectation of interpreters, which is enough in and of itself, let me also just add a few personal insights.
Why wouldn’t you, the interpreter, want to interpret all of that “extra” stuff? After all, that’s where the “fun” stuff happens!
It’s where people get beyond symptoms, diagnoses, and treatment plans and connect on a human, person-to-person level. The patient gets to be a person, not a specimen, and the physician gets to be a person, not a dispensary. People talk about things like, the weather, sports, back-to-school, and other daily life things. It’s what makes humanity and rapport possible in otherwise sterile and intimidating situations.
Is it hard sometimes to interpret everything that everyone says? Absolutely. People don’t want to take turns speaking. It’s impractical or inappropriate to pause a speaker. At times people simply don’t want you to interpret everything. These are points worth exploring in greater detail, but I’ll save that for a different time.
For now, I’ll just add one more little “pep talk” for any interpreter who is hesitant to interpret all messages. . .
You’re there, so you might as well do your job completely, and let your clients get their money’s worth. Make sure your clients get the deluxe package (And by “deluxe package” I mean the basic and standard expectation for all interpreters in every encounter). No slacker interpreters here! (I say that with a delicate combination of humor and sincerity.)
Interpreters, please use the comment box below to share your examples of when interpreting everything made a difference in the outcome or the experience for the participants.
© Connecting Cultures Inc. 2018