Advice from An Interpreter

There is a widespread misconception that being bilingual automatically qualifies a person to be an interpreter. This notion leads health care professionals to recruit the patient's family, friends, and even other patients to interpret-a practice that should be relegated to the category of "last resort." For one thing, friends and relatives usually do not have a health care background, and therefore lack, in either language, a knowledge of medical terminology; nor are they familiar with hospital policies, procedures, and routines. In addition, many patients have comwho is familiar with interpreting techniques, patients' rights, and the way the health care system functions. At the University of Iowa Hospitals and Clinics we have had an interpreter program and staff since 1975, and there is general agreement that it has proved useful in facilitating understanding between health care provider and patient. For health professionals to work effectively with interpreters, they need to know the kinds of problems interpreters have, as well as what to expect from them. The principles upon which good translations are based stem from a thorough knowledge of both the language and the culture of the patient, because he doesn't understand. Also, if the interpreter speaks in too learned a register, the patient may fear that the interpreter will find his speech amusing or unpolished. Health professionals (and interpreters) need to be aware of the quick nod, because many of the questions they ask require yes or no answers. For example, are you in pain? Did you have a BM today? Are you allergic to any medications? It may take the staff a long time to realize that even though a patient gives an affirmative nod, he has really not understood much of what was said.