Day 2 of the symposium started off with a fascinating presentation by Dr. Elaine Hsieh. She brought her wealth of experience in researching bilingual health communication for the past 15 years, and demonstrated that spoken language and signed language interpreters have much to share and learn together. She spoke about the conduit model, and how interpreters know it doesn’t work all the time, and that we are not invisible. We are constantly making decisions…a point which she illustrated with a dramatic example. She was walking with a patient who had a severe spinal malformation, when a new resident spotted him and said excitedly, “this is the worst case I’ve ever seen!” What would you do if you were the interpreter? Of course she had the ability linguistically to interpret the message, but what impact would that have on the patient’s care and relationship to the doctor?
Dr. Hsieh illustrated many of her points with clear, and convincing examples. Her emphasis was on the ways that we as interpreters touch a patient’s life. She noted that in her research with health care providers, there were many times that they cited a preference to use a family interpreter instead of a professional interpreter. One of the reasons cited was that in emotional situations, the family interpreter often provides more emotional support than the professional does. It led me to thinking of times I’ve been interpreting when a family member is present. They may not sign fluently, but they understand the patient well, and can also provide context that I am lacking. If we are able to work together cooperatively, we can foster the goal of ensuring quality health care.
An interesting point to me was her comment that interpreters don’t take time to pre-conference with the patient, only with the doctor. In my experience in health care, I find the opposite. I often have the opportunity to meet with the patient pre-appointment, and get a general idea of their purpose for the visit, and their concerns, but don’t get the chance for the same pre-conference with the doctor.
Dr. Hsieh also noted that different settings require different decisions from the interpreter, so our actions in pediatrics, compared to the ER, compared to mental health settings, may be very different–in face, SHOULD be different. She noted how interpreters may conceive of themselves as a friend to the patient, and ask them questions that are contrary to the mental health clinician’s goal. As an example, she noted that an interpreter may ask a refugee where they’re from, and who is in their family, when that person has recently fled a war torn country and seen their family members killed, and thus trigger a reaction which the mental health clinician definitely did not want.
She has a book in press with Routledge, expected publication 2016, entitled Bilingual Health Communication: Working with interpreters in cross-cultural care. I’m looking forward to its publication. She has much to offer to signed language interpreters.