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Body language 

Bilingual and bicultural interpreters are on call to assist medical patients in need. Karen Aagaard translates.

Imagine this. You’re new to the country. You don’t speak English—at least, not much. And you’re sitting in the emergency room at the IWK, willing the words “knee” and “fracture” and “pain” to translate themselves into English. But this is South Street, not 34th Street, and there’s not a Christmas miracle in sight.

So who you gonna call? A Community Health Information and Interpreting Service interpreter. Or, more precisely, the hospital will call CHI-IS’s 24-hour dispatch service and request an interpreter on your behalf.

Although your primary concern might be the language barrier that separates you from your doctor, your interpreter—who may have received a phone call from the dispatch service at two in the morning—has concerns and obligations that go beyond pure linguistics. Your interpreter must be well-versed in medical terminology. Your interpreter must be bilingual. And there’s another, less obvious, imperative that informs your interpreter’s interactions: he or she must be “bicultural.”

An interpreter who, culturally speaking, “swings both ways,” is familiar with the cultural mores of your country of origin and can relay these practices and preferences to your doctor. But why not ask a friend or family member to interpret for you? Why wait in your scratchy hospital nightgown for a complete stranger to arrive?

Francine Norveau, CHI-IS’s volunteer president, says it all boils down to bias. “Our interpreters are trained interpreters. They provide the kind of unbiased interpretation that family members probably aren’t going to give. Trained interpreters aren’t tempted to omit information.”

Norveau explains that it isn’t uncommon for a family member to distort the doctor’s diagnosis. “We’re going to have to keep you in the hospital for a few weeks,” can easily turn into “you’ll be getting out of here soon.”

And you—the patient—won’t know what’s been lost in interpretation.

Although CHI-IS has been pairing up patients with interpreters since 1995, this year was the first time that the organization, in conjunction with the International Language Institute, offered a 60-hour training course. Ellen Pilon, a senior teacher at ILI and co-designer of the course, says the curriculum for this pilot program focused on cultural awareness and sensitivity, and interpreting skills, roles and responsibilities.

“It’s not just about the language,” says Pilon. “It’s about ethics. And it’s about confidentiality.

I mean, you can’t get involved with the individual you’re interpreting for. And you’re not supposed to drive the patient home after their appointment at the hospital. Most of all, though, you’re not supposed to put words into anyone’s mouth.”

In lieu of writing an exam, each student is filmed while “mock-interpreting”; he or she demonstrates how he or she would interact with a patient who’s being examined by a doctor. The tape is evaluated by an outside individual who speaks the mock-patient’s language and by CHI-IS—the organization that will, hypothetically, provide the successful student with employment.

Halifax’s Metropolitan Immigrant Settlement Association also offers interpretation services. Although MISA’s interpreters deal primarily with settlement support and translation programs, coordinator Merik Jagilski says MISA’s interpreters are occasionally asked to help out in the hospital as well.

“Most of our interpreters don’t have advanced expertise in heath-related interpretation,” says Jagilski. “But involving friends and family members? That poses a greater potential liability.”

Christina Chiu, who works as an interpreter for MISA and for CHI-IS, remembers what it was like before either interpretation service existed.

“I worked at the hospital as a clinical chemist, and because I was fluent in Mandarin, Cantonese and English, some of the doctors used to page me and say ‘Christina—we need you on the sixth floor,’ because they had a patient who couldn’t speak English very well. And because I worked in the hospital, I knew the medical terminology.”

Chiu also practiced what Norveau, Pilot and Jagilski now preach. “It worked because I knew more than just their language. I came from their culture. I understood.”

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