Santa Claus at the Hospital Ward

Medical Interpreters are like Santa Claus for doctors and nurses. They see who is naughty, and they see who is nice. And sometimes with their subtle presence, just like a radio knob, they are even capable of tuning “not-so-nice” behavior until it’s “just right.”

To be fair, I have not seen much pure “naughty” behavior; but I’ve seen plenty of the stuff that falls  nicely into the category of indifference.

This story took place on a cold, normal Sunday morning. My pager emitted its characteristic miniature ambulance sound for the first time that day, at exactly four o’clock. "Finally!" I thought. I had been waiting inside the interpreters’ office for a long time, and I was stir crazy.

The office smelled of old, dusty nylon carpet, apparently no longer mildew-resistant. Its walls were lined with hanging bookshelves filled with medical dictionaries, and cardboard bulletins with pinned foreign money from Colombia and Venezuela, old photos and postcards. Pinned to the same bulletin, there was a squared-shaped piece of paper across which a single word had been written in bold black magic marker: “Impertérrito” --- a word in Spanish describing a person who reacts to any situation without being surprised at anything, no matter the circumstances.

I was then really new at my job---still excited and impressionable. So when the pager sounded its electronic squeal, impertérrito wasn’t a word anyone would have used to describe me. Waiting inside that place since eleven o'clock the night before, I had wanted to make sure that should the pager go off, I would be able to make it wherever I was needed in less than three minutes. It was a personal goal – devoid of any deeper meaning but an idiosyncratic one to help me pass the time. 


The patient's name was Rosa, and she was nine months pregnant. Her husband was standing by, stroking her arm and holding her hand when needed. They were both short in stature, young and baby-faced, and their accent assured me they were Mexican. They were the kind of people whose round, and cute faces, and sweet, soft Spanish-speaking voices that many non-Spanish speaking providers seldom seem to mind helping --- because "they're just really cute.” They were really cute---I, too, found myself thinking. (Funny, catching oneself on a stereotype one would steadfastly criticize in someone else.)

As soon as I pushed into the labor department corridor a succession of nurses directed me to the physician -- a blond woman in her late thirties. The urgency with which I was received made me break yet another record. How many words can one fit into a two seconds glance from the physician? Of all the details I was taught to include during my introduction to a  doctor (name, language to be interpreted, privacy guarantee issues, first-person interpreting details, the "talk-to-the-hand" slowing-down signal, among other things), all I have ever been able to fit, so far, is a "Hi!" 


So after spitting my name at lighting speed to the doctor, I directed my attention to the couple, a bit more leisurely.

“Hello, how are you? I’m your Spanish interpreter. They’ve sent me here to help with the language so you can have a better experience during your care,” I said. The young man extended his hand to me. The woman tried to smile but was visibly in pain from her contractions, even though her contractions, and thus her pain, were not yet as frequent as they needed to be. The medical team would likely administer Rosa some medication (hormones) intravenously to trigger contractions.

"Will those hormones affect my baby?" Rosa asked in a worried tone.  "These are things your body would normally produce by itself. We're just trying to speed up the process." Else, the physician said, a cesarean section would have to be performed.

"What are the probabilities of a cesarean section?" Rosa asked. "We like to say that every time there's someone giving birth there's a possibility of cesarean section, but so far everything here looks okay," the physician replied.

Somewhere after the okay, the medication caused Rosa’s contractions to gather frequency,  her blood pressure dropped, and her arms and legs started to feel numb. The medical team didn't want Rosa to get tired soon, or sleepy. As the anesthesiologist lowered the flow of the epidural anesthesia, Rosa’s husband reached to stroke the arm and hold the hand of a nervous first-time mother-to-be.  The pace inside the room had changed, however slightly to the medical team, and Rosa was starting to feel it.

Whenever she didn’t have contractions to occupy her attention, her eyes, as if following an intense tennis match, shifted attentively from the obstetrician to the anesthesiologist then again to the nurse. Her entire body language seemed to suggest that she wondered what the medical team was saying when they spoke amongst each other. I didn’t know, though, whether to attempt to translate the jargon. Would it even help, or would it only serve to make Rosa feel more nervous? While I was supposed to do this, I had thought it better to leave that kind of detail out so as not to stress her more than she seemed to be.

“Do you want me to translate those conversations as well?” I finally asked her, against  discussions of degree of dilation, types of contractions, and the possible effects of this or that on the baby, as background. Rosa glanced at me, her eyes wide open, her face nodding. 

I turned to the obstetrician, “Excuse me, I don’t mean to  interrupt you… I just need to say that, from now on, I’m going to have to interpret everything that you say amongst yourselves too. It’s just that Rosa is a bit nervous and she wants to know what you’re talking about.” 


It wasn’t my intention to place the medical team members on any spot, but I knew that at that moment, Rosa was the one needing my service. In principle, I was supposed to interpret everything; in reality, as opposed to theory, that, too, was tricky. Within a real medical setting, in contrast to the context of a scripted training exercise inside a classroom, interpreting becomes a juggling act between judgment, common sense, intuition, and negotiation --- a delicate equilibrium between 'what to do' versus 'what not to do'.

At that moment, Rosa needed to understand; at that moment, I needed to do my part of the job to help her understand. And anyway, I kept asking myself, what if Rosa had been a native English speaker? Would that have made any difference? Would the nurse and doctor be talking, as they were, amongst each other; or would they have felt compelled to pause and explain to her what they were doing or planning to do, what all that mysterious-seeming chatter was about?

The nurse gave me a look that I felt was telling me something like, “I thought you were on our side?” After having previously scored some smiles from her part, a couple hellos, and a few jokes here and there, I couldn’t help feeling a bit like a traitor of sorts. But I couldn’t be on anyone’s side. I had to remain alert and neutral.  Occasionally, I had to lean towards the side of whoever needed my help communicating.  

The next few minutes were strange. I found myself as if watching a film that is being fast-forwarded. The nurse and doctors picked up the pace of their speech. The nurse, the obstetrician and the anesthesiologist spoke amongst each other in rapid-fire medical lingo, a specialized language they knew I couldn’t understand, let alone interpret at such hurried cadence. I felt as if I had been left out, on the side of a long and deserted road, along with Rosa.

Then, suddenly, as if they had only been warming up to the idea, an idea they were now ready to embrace, as if all along they had silently planned to give in and concede something but only in their own terms, at their own time, the pattern changed. The "Play" button was clicked, and the movie returned to its normal pace.

The physicians and nurse began summarizing their talk to Rosa after each small semi-private chat they held. Rosa’s face quickly softened. Her demands shifted as well. No longer did she seem to need to be given information about each step the medical team took. She now looked satisfied---as if, all along, all that she had really wanted was to merely have the option of receiving the information in her own language, or even of receiving it at all.

I remembered last year, during Christmas eve when my oldest niece Gabriella* was misbehaving --- like any six-year-old does from time to time. The mere mention of Santa Claus and the Reyes Magos (Three Magic Kings) caused her demeanor to adapt almost instantaneously.

Perhaps this is what my job can do, I thought. On an average day, I can help physicians and patients understand each other. On the best of days, I can possibly help straighten a line by merely bearing witness to its drawing. I cannot tell a physician how to do their job: That is neither my job nor my purview. I cannot soften a voice I deem too harsh; or modify an angry or an indifferent tone.

What I can do is tweak my own into the right warmth – one that is as honest and compassionate as possible to offer to a patient and a physician, both of whom I must help to communicate.

That night Rosa gave birth to her daughter Amanda, a baby girl who had her meconium (first bowel movement) inside her mother’s womb, and as a consequence of that, had to be placed under supervision until her respiration normalized and she finally got used to breathing air instead of water.

“Do you have any questions for me?” the physician asked to the tired but happy parents. “When will the baby be able to be here with us?” was the new daddy’s question. “She’ll let us know. Whenever she’s ready. We’ll monitor her for a while, and she’ll get used to the transition. She’ll let us know when she’s ready,” the doctor replied. “You both did a wonderful job,” she added.

After congratulating them myself, I left the room feeling proud of the work we all do when we work as a team. And as I stepped out of the elevator into the long, white corridor leading outside the hospital, I wondered how many other interactions in life would benefit from the simple eye of Santa (Wink).


Photo: Wikipedia Commons

[Note: details about people have been changed to protect people's identities.]