Interpretations

I drove to a new clinic, parked my car, and braced myself for the freezing wind before I walked out. There isn’t a big Arab population on this side of town, I thought, but if I have learned anything from being a medical interpreter - and a Palestinian Arab - it is that we go as far as it takes to make it work.

“Good morning, I’m the Arabic medical interpreter for your 9 AM patient.”

“You can wait for her in this room. She’s probably still on her way.”

Her shy entrance made me look up from my phone before she could explain to the receptionist how difficult parking was. She was adjusting her hijab and removing her neck scarf when we made eye contact. We were instantly familiar with one another: the other hijabi in the clinic. I got up from my seat and walked toward her as we shared a smile, silently recognizing that we were expecting each other.

“Salaam”

“Salaam”

Upon introducing ourselves, I immediately knew that there had been a mistake. My patient does not speak Arabic.

Z was a young Turkish woman, coming in for reasons she wasn’t entirely sure of: “Maybe just checkup” she explained in broken English. I was not sure what to do, but she seemed to not be fazed by the fact that she was assigned an interpreter that doesn’t speak her language. “Because I wear a hijab, they assume I’m Arab”. When I asked if she has clarified her preferred language, she explained that there are not many Turkish interpreters available and she got used to getting by with someone who speaks Arabic because she has Arab friends, not because the two languages are in any way similar.

As a child, I was introduced to English and Arabic around the same time. I often mixed English verbs with Arabic nouns in the same sentence. Even my prefixes and harakaat* at times. What was a source of laughter in my childhood home foreshadowed this patient interaction. To get through the appointment, we both had to use a mixture of English, frequent nods, specific hand motions, and a sprinkle of Arabic vocabulary.

When Dr. O walked in, she seemed to be in a rush. “Has my nurse not told you to remove your clothing?” .We were both confused, Z nodded in disagreement. “Well, I’m going to step out again and please remove your clothes by the time I’m back. You can keep your shirt on.” I understood the look in Z’s eyes to ask “Why?” but I could not say it before she did. As a medical interpreter, I had to follow very clear rules about what I can say on behalf of the patient - it had to be literal quotations spoken in first person unless indicated otherwise. The rules were clear, but they became blurry once the cultural nuances - that shape the quality of healthcare - were considered. With time, I became skilled at balancing the rules and the needs of my patients. Awkward silence was my friend more times than not. When Z recognized this, I was able to ask the physician to explain why her patient was there in the first place. “We left you a voicemail about this. I must perform a transvaginal ultrasound and a pap smear. Now if you could help me out here, I can get it done and you’ll be home in no time.” blaming the patient for scheduling an appointment with little understanding of why she had to do so.

The rest of the encounter was an uncomfortable -emotionally for me, both emotionally and physically for Z- fifteen minutes. Almost as if she was pleading guilty to not understanding a voicemail left for her in a language she doesn’t speak, Z remained silent as her face expressed her pain and discomfort. Before leaving, the doctor asked if Z understood when her follow up appointment was. Z nodded.

“We’ll see.” Dr. O said before she walked out.

Years later, I carry this story with me in medical school. I often wonder how much I can do as a student physician now that I am free of the confines of interpretation. Thanks to my colleagues’ bravery and dedication to calling out discrimination that I myself face, I know that medical education is in good hands. I am on the path to having the resources and coworkers that would put someone like Z at ease.

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*Short vowels in the Arabic language

Nooralhuda Alhashim; Northeast Ohio Medical University