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It’s been a rough week, and I’m well past overdue for a solid update to this blog. Still, sometimes it is the little things that stand out in a day, so as a study break I would like to take you for a little behind-the-scenes look at how interpreter call lines work.

In the hospital setting, especially at a big, public hospital, there are often language barriers between doctor and patient. The best way to deal with something like this is to get a family member or friend to translate. The second best scenario is to enlist the help of someone on staff who speaks the language. Still, there will be times when an on-site interpreter cannot be found, and for those occasions many hospitals have hotlines hospital staff can call to gain access to an interpreter.

For our patient presentation this week, we had a doctor interview a gentleman who recounted for us his experience with an illness we had been studying in the past few weeks. He also spoke almost no English

If communicating to your patient through a third party via phone sounds awkward and cumbersome, that’s because it is. And if you happen to think presenting such an awkward and cumbersome activity to an auditorium of 150 medical students sounds like it might present some logistical problems, you would again be right.

The presentation was sent up with the doctor and the patient in the front of the auditorium. A microphone was positioned over a cell phone lying on the table in front of them. The cell phone was on speaker, and the microphone actually managed to pick up most of the call surprisingly well, given the technical difficulties we’ve had with sound during many of our lectures.

On a screen above their heads was a list of basic guidelines for using an interpreter hotline.

  1. Introduce yourself and your patient to the interpreter
  2. Write down the interpreter’s ID in the patient’s chart
  3. Speak directly to the patient and make eye contact
  4. Speak in short, direct sentences

The physician dialed and we listened to the phone ring. Then, like with any hotline, a recording answered.

“Thank you for calling the interpretation hotline. Please enter your ID number and PIN.”

(ID and PIN, I thought. I guess you wouldn’t want just anyone taking advantage. I could picture a lonely patient looking for the sound of a familiar language sneaking a call in the middle of the night.)

I believe a real person picked up then, but it was hard to tell the difference from the recording. “Please state the language you need translated,” she said.

The doctor leaned forward and spoke slowly into the phone and the mic at the same time. He requested the patient’s primary language and then added a backup in case they couldn’t find a translator for the first.

“Please hold while a translator is located,” said the woman on the other end. There was a click followed by the all-too-familiar strains of hold music drifting up through the mic. The class laughed.

The hold music played for a minute. There was another click and recording announced, “All translators are currently busy. Please hold for the next available translator.” Another little laugh passed through the crowd.

A few moments later the operator returned and told us an interpreter for the primary language was available. We were transferred over.

Through all of this, our patient sat…well…patiently, looking down at the phone. I wondered how much of this process he understood; certainly he must have been through it dozens of times. He seemed pretty calm, but I couldn’t help thinking how uncomfortable I would be, sitting in front of so many white-coated students, unable to understand most of what was being said around me.

The interpreter came onto the phone. She introduced herself and gave her ID. The doctor introduced himself and the patient. I waited for him to explain to her that she was on speaker in front of a classroom full of medical students, but he never told her the situation directly. Instead he dove right into the interview, asking the patient if he was nervous to be in front of us all and tell him that we were just kids and didn’t know anything. I wondered what the interpreter was picturing on her end of things. She gave no hint at being surprised or annoyed at being called upon for demonstration purposes.

I don’t know if it was the awkwardness of the set-up, or the convention of such translations, but the doctor was robotic throughout the interview. He spoke slowly and loudly in simple sentences, probably to make the translation as easy as possible, but there was no inflection or emotion in his voice. I found myself looking away when he would ask his question, embarrassed by his stiffness and unsure if the extent of his simplicity was entirely warranted.

The patient spoke in short affirmatives at first–we quickly learned the word for “yes”–as the doctor narrated his background. Eventually he began to answer real questions and fill in the pieces of his tale, the soft flow of his words melodic in contrast to the short, direct sentences of the physician.

Despite my interest, it was hard to sit through. The translation took a long time; even beyond having to wait through the interpretation and reply, there were times when seemingly short answers seemed to necessitate far more words in translation. There were times when I could hear the interpreter struggling to find the right words or phrase in both languages. Sometimes her translations hinted at a nuanced answer that simply couldn’t be conveyed adequately in the given situation.

On the other hand, we were able to find a translator who spoke a very specific language fairly quickly , and went from a complete language barrier to effective communication in a short period of time. Clumsy though it may feel, that is something of a miracle.

For the first summer session and the first semester I had a non-portable laptop.

How can a laptop be unportable, you might ask? Isn’t the primary purpose of a laptop that it can be taken from place to place? Don’t you mean you had a desktop computer?

To spare you the full tale of my computer woes, the short version is that my computer lacked that essential laptop capability to close, and thus be placed into a backpack and transported anywhere useful besides my desk and my bed. So I never took my laptop to class.

I didn’t miss it, for the most part. Very few assignments required me to type anything and I could log onto the Internet at any number of locations in the various libraries on campus. Not to mention that distracting pastimes, such as talking to friends online or checking my email obsessively were restricted to short(ish) breaks between active studying.

However, my beloved laptop, which I still required for distracting myself from school-related activities when at home, had problems beyond its lack of closure and it was easy to get jealous of the very portable computers the other students in my cohort carried around. Eventually it became clear that I was going to need to obtain a new laptop, so over winter break I shelled out far too much money for a shiny new one.

Which brings me to this week’s topic; the dangers of getting what you want. Because now I have a laptop that I can easily slip into my backpack between lab manuals and textbooks, so it comes to school with me every day. Which means that, mid-physics problem, I can tell a good friend about my day or reply to an email about a shadowing opportunity, or, oh yeah, write a blog entry. Laptop portability may have increased, but my productivity has taken a nosedive.

Easy solution, though; just stop bringing it with me to class in the first place, right? But as anyone who has ever acquired a new piece of technology can tell you, once you begin to rely on something, it’s almost impossible to give it up. I’ve forgotten how to be a non-computered student. How do I take notes in bio without my computer? How do I cram for that lab quiz if I can’t access the power point slides from the lecture the other day? What if I get an important email!? I can no longer function without constant connection to the web!

Thus you, dear reader, get an update, and I get a chapter behind in my physics studying. Ah, technology.