The Support of an Agency

by Brenda Nicodemus

Translation by Brenda Nicodemus

I can remember one particular incident where I realized the importance of having the support of an interpreting agency. I went to an assignment between a Deaf person and an opthamologist, that is, a doctor who specializes in serious eye problems. The Deaf person had never had an interpreter go with him to this doctor, but things had become more serious in his condition so he wanted an interpreter there to make sure the information was clear.

But the doctor was clearly surprised to see an interpreter there and said to the Deaf person, “You and I have never needed an interpreter before and always got along fine. You lipread me and when it didn’t work out, we just wrote back and forth.” The Deaf person obviously didn’t want to insult the doctor and clearly felt uncomfortable. The Deaf person kept looking at me as if to say, “What should I do?” I didn’t say anything and just kept interpreting. Throughout the appointment the doctor continued to try to get the Deaf person to look at him and the Deaf person continued to steal glances at me as I interpreted. As the appointment came to a close, the doctor said again, “You don’t need an interpreter for our next appointment, right? We’ll do it like we’ve done it all along, with just you and I.” It was an awkward situation.

After the Deaf person and I left the office, the Deaf person said, “Gosh, I didn’t know what to do or how to respond to that situation.” I also felt a little unsure of how to respond because I didn’t want to criticize the doctor or get into the ADA, but I did tell the Deaf person that he had a right to an interpreter when going to a doctor. I also recommended that he contact the agency for further discussion and perhaps get a Deaf advocate to support him. The Deaf person agreed to do that and did make the call later.

That day I realized how much I appreciated the support of the agency so that interpreters don’t have to try to do it all!

Encouraging Words by Mel Deleon-Benham

Translation by Doug Bowen-Bailey

I was asked to share a few encouraging words for new interpreters entering the field. I’ve been interpreting for 15 years now and have done some mentoring with newer interpreters who feel unsure of themselves. Often, I see that they have great skills and attitudes, but the barrier seems to be their own sense of self-esteem and confidence. They feel like they can’t do the job and that they are not good enough, and my job was to let them know that they can do it.So, I think sometimes the biggest barrier to newer interpreters is that they are overly self-critical. So, it’s really important to be gentle with yourself. Good luck.

Communication Access for Family of Patients

by Sharon Clark

Translation by Jeanna Coulliard

About 2 years ago, my aunt Norma came to live with me because she had a lot of health problems, including Alzheimer’s disease where she would forget everything. I would frequently take her to her doctor’s appointments. She and I could communicate well because I could understand her somewhat awkward signing. She and the doctor could also communicate, but the doctor and I could not communicate.

To solve this, an interpreter started to come to all of Norma’s doctor’s appointments so that I could get the information from the doctor that concerned my aunt’s health. With the interpreter present, the doctor, Norma and I could communicate together smoothly.

Another situation presented itself when Norma had a seizure and was rushed to the hospital. When I arrived at the hospital, there was a lot of commotion happening around me, and health providers were rapidly talking back and forth. I was worried because I did not know the status of my aunt. I told one of the doctors that I needed an interpreter. The doctor informed me that since the patient, Norma, is hearing, an interpreter would not be provided.

Even though an interpreter was available to me at the clinic where my aunt had her doctor’s appointments, such was not the case at the hospital. I became frustrated because the commotion and all the talking continued. The only information I received from the healthcare providers was a couple of short written sentences which obviously did not contain all of what they were communicating about.

It was very aggravating that I was not allowed access to information concerning my aunt, seeing as though I was her primary caregiver. I believe that in hospitals, interpreters should to be accessible not only to patients, but also for those who are in relation to, or are caregivers, for the patients.

Perspectives on Family Members as Interpreters

The following two videos have two distinct perspectives on having a family member as an interpreter during a medical situation.

Communication after a Car Accident

by Gerald Olson

Hello, my name is Gerald Olson. I work at Second Harvest. One day on my way to work, I was driving down a two lane road. I came to a part of the road that was a steep decline, followed by a steep incline. As I was going down the hill, my car began to veer to the right, and then suddenly, my car began to spin out.There was another car coming from the opposite direction. I could not steer away from that car, and the two cars collided. After the crash, I was able to get out of my car by I felt extremely dizzy and I had no control over my body movements. Finally I was able to sit down on the side of the road.A police officer arrived at the scene and approached me. He was frantically asking if I was okay. I was able to gesture to him that I am deaf. Then the office took a pad of paper from his shirt pocket and began to write things down in order to communicate with me. However, I was still dizzy after the crash that it was difficult for me to see what he had wrote, and even more difficult to write anything back to him.

Next, an ambulance showed up on the scene. The EMTs immediately transported me into the vehicle. They looked me over to make sure nothing was broken or severely injured. They too tried to communicate with me through writing, but still I was in such a haze that I could not read the notes. I felt trapped because I had no interpreter to facilitate communication. Then, the ambulance rushed me to the hospital.

Once we arrived at the hospital, the pattern continued. The doctor tried to communicate with me using a pen and paper as well. And still, it was difficult for me to read what the doctor was writing. Finally, the doctor called my wife. I waited for more than an hour and a half for my wife to arrive. The doctor wanted my wife to help him write back and forth with me. My wife had brought my son with her and since he was only 12 years old, he could not be in the room.

My wife told the doctor that I needed an interpreter. The doctor disagreed and the two argued about it. Finally an interpreter showed up and I no longer had to communicate through paper and pen. The doctor and I were finally able to communicate with much more ease through the interpreter.

I had to stay in the hospital the rest of the night and into the next day. It was wonderful to have an interpreter present so that I could easily communicate with the doctors and nurses.

That is my car accident story.

Can’t Your Wife Interpret?

by Lee Clark

The next situation that I’m going to tell you comes from a case I worked on that involves a Deaf man who has a DeafBlind wife. The Deaf man had an appointment for a physical. He informed the nurse that he needed to set up another doctor’s appointment, but he informed the nurse that he would need an interpreter. The nurse sternly told him no; she said that he would need to have his wife come with him to interpret the appointment.

He was taken aback by the nurse;’s poor attitude. He left the doctor’s office, then came back another day with his wife for the appointment. When they arrived, the nurse asked, “Where is your interpreter?”

He told her, “This is my wife, you told me to bring her to be my interpreter.”
The nurse became anxious and said, “Your wife is blind! She can’t interpret for you!”

He repeated himself and said, “Well, I asked you for an interpreter and you told me to bring my wife, so here she is.” The nurse was completely bewildered, and the point was made.

“Into the Light” by Lee Clark

English Summary:

Translation by Jenna Coulliard and Doug Bowen-Bailey

I think every interpreter has to use their discretion and experience in these situations. I base my own on several things. Is the consumer DeafBlind? If yes, then I am more apt to stay in the room because the consumer can more easily get my attention. If she/he wants to call for the nurse it is much easier if I am in the room, “on hold” then to try and get my attention if I am out of the room. Also if the patient is elderly or in much pain then I will tend to stay in the room to add to the “comfort” level of the patient. But I always ask what the patient prefers.

Sometimes the patient and I don’t agree. They would prefer that I stay and I would prefer that I am in the hall. Specifically if there are crying and upset children in the room, I will want to wait in the hall simply to give my ears a rest. Sometimes the patient wants someone to keep them company and visit with them. If I am doing an on call, Emergency assignment, I often have interpreted during the day and am on call as an extra assignment for the evening or overnight. I need the break between the nurse, doctor, xray, blood draws to keep myself in top form for the interpreting times. So I often will communicate this with the patient and explain why I prefer to stay in the hall, when they would prefer me in the room.

Where I draw the line and always stay in the hall is for any kind of mental health patient. I believe that the interpreter does not need to be in the room and have a separate relationship with the patient. Especially for mental health situations, I believe that the patient needs to develop a rapport with the hospital staff and I can interfere with that if I am in the room when the staff are not. This can be tricky, especially if I interpret for the patient in other non mental health related settings. What I often do is to explain to the patient, that for this time, when they are being evaluated for mental health reasons, I need to be in the hall. So that in other situations, we might be chatty, for this time, I need to step back and let the hospital staff lead the relationship. This is not because I am scared or wary of the patient. I interpret often in mental health Emergency room situations where patients have gone off their meds or are in a crisis of some sort. I just believe that the doctor, nurse, psychiatrist, therapist etc. are the trained personnel who need to develop the rapport with the patient and not me.

Again, I think this is a very delicate issue and needs to be handled carefully with a lot of thought and care. The medical/mental health assignments deal with very personal issues and an interpreter can add or detract from the comfort level of the patient based on their skillful ability to navigate their needs with the patients wants.

“Health is More than Communication Access” by Matt Starr

English Translation by Doug Bowen-Bailey and Matt Starr

My name is Matt Starr.  I work at the University of Rochester in New York at the National Center for Deaf Health Research.  The focus of the research is on the health of the deaf population.  The focus is not on hearing health research, but on overall health.

About 10 to 15 years ago, our government started to identify that the health of minority populations was not the same as the general population.  For example, African-Americans, Asian Americans, and Latinos did not have the same health outcomes as White Americans.  So, emphasis was given to remove those disparities.  Our center was established to focus on the health of the deaf community.

One of our frustrations came as we were working to engage the Deaf community and learn from their experiences and perspectives.  We often had focus groups to get people to talk about their health or experiences with diseases such as diabetes, heart disease, or arthritis.  While we wanted to find out their experiences with health issues, they frequently only shared concerns about access to health care, whether difficulties communicating with a doctor or having a hard time understanding written information.  We agree with those concerns, but we already know that from years of experience.  We want to learn what people are seeing in the community with issues like diabetes, high blood pressured or obesity.  When we ask this question, people often don’t know how to respond.  They haven’t had the chance to really discuss these topics.

I have seen in my studies of other minority groups that the leadership have started the discussions on these health topics, yet in the Deaf community, we are behind some of these other communities in getting the conversation started.  I just returned from the National Association of the Deaf conference where they were discussing the issues that need to be focused on for the next 3 to 5 years.  They brainstormed a list of issues that, while all important, need to be prioritized.  On that list there was nothing about the health of the deaf community.

I think that is a message that all of us need to bring home and think about focusing on the health of the deaf community – meaning the entirety of health concerns and not just thinking about it in audiological terms.

So, good luck in doing that.

Importance of Certified Interpreters for Medical Appointments

by Jimmy Beldon

Translation by Doug Bowen-Bailey

I have a story to share with you that is so typical of doctor’s offices who claim to have an interpreter working for them when the person isn’t actually qualified and doesn’t hold any certification. Generally, it takes some effort to educate the office about the importance of an interpreter having certification as a measure of competency. Without certification, how can I really know if someone is qualified or not?

Doing that advocacy can be tiring, however, and so with a new doctor that I started going to in a small town, I decided to give them the benefit of the doubt to see what would happen.

I showed up for the appointment and it was with a doctor I selected because of his specialty in sports medicine. I wanted to have his knowledge for this topic, so I decided to just make it through with whatever interpreting service they provided.

When I first went in, I met with the nurse and the so-called interpreter. The “interpreter” made an introduction, signing her name and saying it was nice to meet me, though making a mistake in how she signed “meet.”

Right away, it made me realize that this situation was the same as so many I had experienced before where people think that having a certified interpreter isn’t necessary for a medical appointment.

I decided not to say anything at first, and just tried to sign as slowly and clearly as I could. The “interpreter” was surprised to be able to understand me.

Then the doctor came in. He was a really neat man, but talked rather rapidly. The “interpreter” did her best to keep up.

I didn’t worry so much about understanding the “interpreter”, just waited until she was done and it was my turn. I then signed at a level of native fluency in ASL. The “interpreter” didn’t understand me at all and asked me to slow down. I repeated it again at the same pace, only to be asked to repeat it again and again.

The doctor watched this scene unfold in which there obviously was no communication happening, and I made my frustration extremely clear. The doctor seemed to be starting to understand what was going on. In a few minutes, after expressing my impatience, I finally put pen to paper and wrote, “Reschedule with a new interpreter,” and then left.

The next day I found that my point was clearly made. For all my subsequent appointments, everything was all set with a certified interpreter waiting for me. Because of this, my visits to that doctor’s office went much more smoothly.

The Clothes Make the Interpreter?

English Translation by Jeanna Couillard and Doug Bowen-Bailey

I have gone to many eye doctor appointments and medical doctor appointments where I have had an interpreter present. At one appointment, the interpreter showed up wearing a bright yellow shirt. I am DeafBlind, so when she signed, all that I saw was one big blur. When the interpreter realized that I am DeafBlind, she said she hadn’t know that.

At another doctor appointment, the same thing happened. An interpreter showed up wearing a shirt with a black and white zigzag pattern. Again, it was difficult to see the interpreter’s hands, and once again, the interpreter didn’t know that I was DeafBlind and so didn’t realize that shirt was inappropriate to wear.

There was another incident where the interpreter who showed up for my appointment wore a plain white top. It was difficult for me to see that interpreter’s hands as well. Like the other incidents, the interpreter was unaware of which colors of clothing are most effective to wear when working with a DeafBlind consumer.

These occurrences had me thinking.  Interpreter training programs teach students to wear colors that are opposite of their skin color so that it is easy to differentiate the hands from the shirt. Also, when interpreters take the NIC test (National Interpreter Certification test), they know enough to wear the opposite color from their skin tone. But they seem to ignore that knowledge once they get out in practice and are surprised when they encounter DeafBlind consumers..

It seems as though interpreters’ clothing choices get worse as they spend more time in the field. Interpreters must remember that color choices in clothing are essential for a successful interpreting assignment, especially when a DeafBlind consumer is involved.

Managing Waiting Time

English Summary

We received a question from an interpreter who works often in a hospital setting wondering how to manage the waiting time if a Deaf patient is in a hospital room?  If there is no preference expressed by the patient or hospital staff, should you sit in the room with the patient?  Or sit out in the hallway?

Please share your insights into your own practice with this question.  Recognizing that a situation may depend on many factors, what is your standard mode of operation in this situation?  And what factors does your decision depend on?

One Response

I think every interpreter has to use their discretion and experience in these situations. I base my own on several things. Is the consumer DeafBlind? If yes, then I am more apt to stay in the room because the consumer can more easily get my attention. If she/he wants to call for the nurse it is much easier if I am in the room, “on hold” then to try and get my attention if I am out of the room. Also if the patient is elderly or in much pain then I will tend to stay in the room to add to the “comfort” level of the patient. But I always ask what the patient prefers.

Sometimes the patient and I don’t agree. They would prefer that I stay and I would prefer that I am in the hall. Specifically if there are crying and upset children in the room, I will want to wait in the hall simply to give my ears a rest. Sometimes the patient wants someone to keep them company and visit with them. If I am doing an on call, Emergency assignment, I often have interpreted during the day and am on call as an extra assignment for the evening or overnight. I need the break between the nurse, doctor, x-ray, blood draws to keep myself in top form for the interpreting times. So I often will communicate this with the patient and explain why I prefer to stay in the hall, when they would prefer me in the room.

Where I draw the line and always stay in the hall is for any kind of mental health patient. I believe that the interpreter does not need to be in the room and have a separate relationship with the patient. Especially for mental health situations, I believe that the patient needs to develop a rapport with the hospital staff and I can interfere with that if I am in the room when the staff are not. This can be tricky, especially if I interpret for the patient in other non mental health related settings. What I often do is to explain to the patient, that for this time, when they are being evaluated for mental health reasons, I need to be in the hall. So that in other situations, we might be chatty, for this time, I need to step back and let the hospital staff lead the relationship. This is not because I am scared or wary of the patient. I interpret often in mental health Emergency room situations where patients have gone off their meds or are in a crisis of some sort. I just believe that the doctor, nurse, psychiatrist, therapist etc. are the trained personnel who need to develop the rapport with the patient and not me.

Again, I think this is a very delicate issue and needs to be handled carefully with alot of thought and care. The medical/mental health assignments deal with very personal issues and an interpreter can add or detract from the comfort level of the patient based on their skillful ability to navigate their needs with the patients wants.

The Importance of Explaining How to Work with Interpreters

by Jimmy Beldon

I want to share a story with you that illustrates the importance of having a pre-appointment discussion with health care providers to make sure they know how to work with interpreters.

In many doctors’ offices, a variety of people come in and out of rooms to interact with the patient. In the situation I am going to share, the interpreter did not connect with everyone to make an introduction and explain about how to work with an interpreter.

What happened in this situation is that a nurse came into the room of a Deaf woman. The nurse noticed the interpreter, and proceeded to ask some questions of the patient. The interpreter moved into position just behind the nurse to establish an effective sight line, as is standard practice. The nurse was not comfortable with this proximity and moved away from the interpreter to establish some personal space. The interpreter again moved into a similar position, causing the nurse to move again. This was repeated until the nurse was finally forced into the wall.

All of this took place because the interpreter didn’t recognize the need to explain to the nurse how to work effectively with an interpreter. This simple act of politeness would have allowed the nurse to be more comfortable and thereby stay in position without being pinned against the wall.

Imagine the consequences of this omission on the part of the interpreter.

English Translation by Doug Bowen-Bailey