High stakes: The experience of medical interpreting

Jeff Severns Guntzel
Senior reporter
Public Insight Network

It’s difficult enough for a native English speaker to navigate the American health care system. Entering a doctor’s office or the emergency room with limited English (or none at all) is like walking blindfolded and with ears plugged into a construction site rumbling with heavy machinery: You know something is happening, but you don’t know what it is.

That’s where medical interpreters come in. In my first look at medical interpreting, I focused broadly on a field that is slowly professionalizing and on the obstacles patients and families face — state by state and provider by provider — in finding a competent interpreter.

Part of my reporting was asking the people who do the work of medical interpreting about the unique challenges of the job, and what it takes to do it right. I’m opening up my notebook here to share some of what I learned:



“Every day in the life of an interpreter is different. We never know what kind of situation we are going to walk into.

“An ‘average’ day for me may start with a woman in labor, witnessing the miracle of birth. Or working with a neonatal specialist, explaining to a young mother and father that their unborn baby has spina bifida and may never walk or talk. Or working with hospice at home with a family surrounding their dying 4-year-old child, in the room as the child takes his or her last breath. Or at a mental health facility, interpreting for a 26-year-old man who fell from scaffolding at a work site and has such severe brain damage that he is forced to live in a caged bed. Or notifying a family of five that they are all HIV positive.

“I could go on… clearly these are all extremely challenging situations, and if there was no interpreter, or even worse, an untrained interpreter, things could have gone very wrong.”

- Ingrid Christensen (St. Paul, Minn.)
More than 13 years as a medical interpreter



“My training was informal. I attended medical school in Mexico and started studying English as a second language.

“I first saw the need for medical interpreters when we did an exchange program with a university in Houston. We had to rotate through the emergency room of a hospital and we’d get a significant amount of patients with limited English proficiency.

“The look on their faces and the sense of relief when they would hear somebody speaking their own language and helping them communicate with the physician was an experience that left a profound impression on me.”

- Cynthia Holbrook (Duluth, Ga.)
Ten years as a medical interpreter



“I once overheard a child interpreting for her father. When asked if her father had ever had an MRI, the child turned and asked him if he had ever had hemorrhoids!”

- Ellen De La Torre (Mankato, Minn.)
15 years as a medical interpreter



“I am a trainer, professor, researcher and interpreter and I work in a Trauma I hospital. When you think you have seen it all, a new challenge appears.

“Interpreting in difficult situations is always challenging — from death to profanity — because as an interpreter I have to maintain accuracy, impartiality, and without omissions or additions. Sometimes it is simply impossible to find the perfect or the most appropriate equivalent, especially when dealing with profanity, but you have to say something and it feels like everyone is waiting and looking at you.

“Many times, it is through the interpreter that we find out that the hospital staff has explained the wrong surgical procedure to the wrong patient. Doctors have tried the Spanish they learned in two weeks in Cancun, or as missionaries in Peru and that does not work — it is not informed consent.”

- Alvaro Vergara-Mery (Las Vegas)
More than 10 years as a medical interpreter



“Patients believe we can help with anything and everything, including transportation and sometimes financial assistance. Providers think we are just bilingual people who help ‘translate.’ Other providers believe that with hand gestures and some Spanish words they can do it themselves.

“In the area where I live, we get Hispanic patients who do not speak Spanish, or speak Spanish as a second language (very broken) — they speak a dialect. They show up at our hospital and will never volunteer that because it is embarrassing to them. They will always choose a Spanish interpreter even when we offer an interpreter in their dialect.

“Many providers think that dialects are just ‘Spanish slang’ and sometimes they do not believe us when we do not understand each other. In some cases, the interpretation is complex and we can tell the patient does not understand. We ask patients to give us permission to show them how we can get an interpreter in their dialect over the phone and we also offer to stay in case the patient still prefers Spanish.

“A friend of mine, who is conversational in English, was not offered an interpreter because the nurse thought the patient was understanding. I happened to see the patient’s name on the list and decided to go for a quick visit to offer my services. When I got to the room, he had had surgery — his gallbladder had been removed.

“He told me he had not understood what he had done and that he did not know what a gallbladder was. He was signing consents without having a clue what he was signing. I called the doctor and interpreted what the doctor said. My friend smiled and said in Spanish ‘Ohhhh…now I get it. So I no longer have a gallbladder!’ I felt happy he had everything clear, but it was scary — it could’ve been a bad situation of malpractice if it had been a mistake.”

- Aleyda Campos (Canton, Ga.)
Seven years as a medical interpreter


Help inform our ongoing reporting on medical interpreters by sharing your experiences. Click on the link below that best describes you:

>> Interpreters: What is your experience as a medical interpreter?

>> Health care providers: What are your experiences working with medical interpreters?

>> Patients: Have you needed or used a medical interpreter?