Saturday, July 14, 2018

Barriers to caring.

"She doesn't speak English," my resident said.
"Okay," I replied. "Let's call the interpreter and then go see another patient until they are ready for us."
"We can use the phone line or the video chat interpreters."

That's what the med student said. And honestly, it was a very good suggestion considering how busy we were that morning.


See, I had never met this patient. And though I am deeply appreciative of the technology that affords us easy, prompt ways to close language barriers, whenever I can help it, I like everybody talking on that first meeting to have a pulse that I can feel.

Our Grady interpreters are so amazing. They have this way of melting away during a discussion and allowing you and your patient to really, truly connect. And again--sometimes I have no choice but to use the phone or video interpreter. On this day, though? I had a choice, man. I did.


And so. With the help of Maria, one of our exceptional Spanish interpreters, I listened to the story of this patient. And not just the story of her present illness. The story of her life outside of the hospital. Of her six children who make her very, very proud. Of the tiny details of her symptoms that only come out when feeling unhurried. I also loved that her fluent-in-English son and daughter didn't have to interpret but instead got to sit there and just do what every single other family with a matriarch in the hospital l gets to do: Love their mama, ask their questions, and worry as only they can.


The next day she felt better. And, again, I called that human-being interpreter even though the technology and bilingual family member options were readily available. And since she didn't feel sick anymore, this time I learned even more about my patient.

Here's what I learned:

We both have a spoiled labradoodle.
We both have danced all night at a wedding in Mexico City.
We both wish we'd worked harder in school to learn the native tongue of the other.
Neither of us like cheese. (Yuck.)

She's never been to my hometown so I told her all about southern California. I've never been to or even heard of hers so I listened to her paint a vibrant picture of her hometown in Mexico--a place with breathtaking waterfalls and rivers so blue they make you want to cry. "Agua turquesa!" she said with closed eyes for emphasis. Her kids nodded in agreement. Then her English-speaking son insisted that me and his mom Google image it right then and there. Which we did. And she was right--words didn't do those turquoise waters justice. No, they did not.

And I want you to know that that human-being interpreter shared everything we said word-for-word. And none of it took long but all of it made my patient feel better. Which made me feel better, too.

Here's what I know for sure:

Barriers to care can create barriers to caring. Every single time I call and wait for an interpreter to come, it honors my patient. Now more than ever, I want to do that. And though I (always) feel slightly annoyed with myself for being a Los Angelino who doesn't hablás español and though I'm (always) impatient with the time (no matter how short) I have to wait for the human-being interpreter to come, not one single time have I ever regretted it after the fact.


I'm really thankful for our interpreters at Grady.
#mejortrabajodelahistoria #elamoresloque #bestjobever #loveisthewhat #amazinggrady #iwanttogotosanluispotosinow #herhometownisdope #nowaterfallsininglewood


  1. There are so many ways to do the best job you are capable of and this illustrates one of them beautifully.

  2. Thank. You. I cannot thank you enough for writing this. As hospital interpreters, we are inevitably somewhat at the mercy of others' choices: what to say and how to say it. That part is hard to handle sometimes, but it's part of the job. Saying other people's words, taking on their personal for a little while is what we signed up for, and we're glad to do it because it helps folks connect, just like you described. But we're also at the mercy of providers' choice to use us or not. We're there to facilitate conversation, but we can't force you to accept our offer, and so, so often, people choose rougshod, potentially pretty shaky communication over any wait time, long or short. It means more than I can say for you to see the value in-person, hospital trained interpreters bring to the table. Thank you.

    1. It is always my preference. Thank you for all that you do. I love our hospital interpreters and am grateful every single time they come to help me.

  3. I've had a few patients lately with oropharyngeal cancers. Treatments have left them unable to speak and it's so difficult to care for people who can't talk. We make assumptions. It takes time. It reminds me how important communication is. It also reminds me of my daughter who has receptive language but cannot talk. People think she's stupid. They're wrong.

  4. Patient experience at its best!Thank you for taking the time to provide this patient excellent care, acknowledging her language and culture, given the family space to be there to support their loved one, and for showing the resident best practices in patient care and communication.

  5. I'm the Maryland Refugee Mental Health Coordinator and I do a lot of provider training in Language Access. Thank you thank you thank you for taking the time to care...taking the time to treat this person like all people should be treated. You ROCK!


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