What's your interpretation, doctor?

There was an interesting article on page 1, column 1 of today's Wall Street Journal, having to do with the state (or non-state) of medical interpretation in the country.

To reduce the arguments on both sides to their basics, the doctors maintain that interpretation is not necessary, or can be provided by family members or friends. The president of the AMA says that there is little need for specialized training... of interpreters, since it is a doctor's duty to use words simple enough to roll off any bilingual tongue. In the final analysis, having the Department of Health and Human Services decree that interpreters must be provided at no expense to the patient saddles the medical profession with a "tremendous burden."

(Oh, yes. One hour of interpretation time costs about the same as four doses of Tylenol, based on my last visit as an inpatient... unless you mark it up by the same percentage, but I digress... which is the classical definition of "tremendous burden.")

Come to think of it, there really was no exposition of any other side to the argument, just several anecdotal cases in which the "interpreter" - in one case, an 11-year-old boy - just didn't get the job done, or got it 'kinda' done. The article noted that in one case, after one consultation with a doctor, the patient "wouldn't have known she was headed for a heart test or a stomach x-ray, or that it wasn't certain that she had an infection."

The article ends with an example of a textbook interpretation session, which starts with the interpreter telling a hospital nurse, "Speak directly to her, like I'm not here," and later saying, "The interpreter wishes to interject," in order to clarify some information. A review of a session tape later showed the interpretation to be almost verbatim, with no summarization. Hooray for our side.

You see, I've interpreted for Russian-speakers in hospitals. It's hard, especially if you haven't done it before. Just as in any other interpreting job, an interpreter can't hem or haw when working with a doctor and a patient, or else the confidence that both sides have in that interpreter drops to zero before you can say "gesundheit!"

On the other hand, it's pretty obvious that mistakes won't make an interpreter popular, either. From the article:

"[The patient] had seen the dermatologist earlier for a fungal infection of the fingernails. He had prescribed taking certain pills for a week, but they hadn't worked.

'Maybe it's not enough to take the pills one week a month,' [the patient] said in Russian to the doctor. (A reporter's tape of her visit was later transcribed by an independent interpreter.) 'Maybe I should have taken them for a whole month.'

[Her son] struggled to translate: 'She thinks she needs to take more tablets than one week as a month.'

After more talk in this vein, his mother was still confused, 'Find out whether I should take the pills for a month or a week," she told [her son]. He tried to ask the doctor, 'Does she has to drink the tablets a week for a month--'"

After the patient left, the article quotes the doctor as saying,

"The kid was pretty bright. He seemed to understand quite well. But I'd be curious. I guess I don't know if she really got the story."

Duh!

Something in me struggles against this. It's one thing, perhaps, to screw up a consultation about a fingernail fungus; there's always time - in theory - to go back and review and repeat. (As it turned out, the patient was provided with a detailed prescription, which the kid struggled with, by the way, but again, I digress...) On the other hand, what happens when the interpreter can't handle an exchange that starts with the doctor asking the patient's next of kin, "Is she allergic to any medications?" as one of the first steps in saving said patient's life?

A thin, yet perceptible layer of icing on the cake is that typically, neither side has the foggiest idea of how to interact with the other through an interpreter. A good interpreter, though, can deal with that, as the article illustrated.

Cheers...

Other updates...

The HP DeskJet printer appears to have some kind of nervous disorder, as it is nearly impossible to print two documents on it in a row without having to either recycle the power or send a job or two in its direction for the express purpose of canceling them, which occasionally accomplishes the indirect goal of resetting the unit.

In other printer news, the replacement toner cartridge I bought last year for the Epson ActionLaser appears to have a defect on the drum, which prevents solid black areas from printing properly. It's still usable. Sort of. And better remain that way for a while, too.

In any event, it comes down to this: All three printers are working at sub-optimal levels.

I am so-o-o happy.

* * *I went downtown today to renew my S&R ticket, and was surprised to find that my name was not on the list of people to be renewed. The problem has since been fixed, so either I or Drew can stop by and pick up the ID.

I also got myself fingerprinted and sent paperwork to the CBI for a concealed weapons permit, as a number of folks who have done S&R say that it's generally not a bad idea, when working in the woods, to be armed. Law enforcement would add that, when armed, it's generally not a bad idea to have a concealed weapons permit, so as not to fall afoul of the law on a technicality (e.g., you put on a jacket, which covers your up-to-now openly holstered pistol, which turns it into a concealed weapon, which is a bona fide Bad Thing™ to have on your person without a permit to carry same). I have been told there is a 6-8 week processing cycle.

* * *Healthwise, I teetered on the edge of normalcy today. Aside from some tenderness around my nostrils (failure to use the "gentle" nose wipes) and a couple of involuntary coughs, I felt pretty good. (Wish I could say the same for Sasha, whom I dosed with Valium this morning... she's still loopy.)

I even managed to get three invoices off today, and got started on the next job, which is due on Monday morning, without feeling a tinge of fatigue. One thing is for sure, I've spent more than my fair share of time in front of a computer screen today, so I'm off to do something else for a while.

Cheers...