Vol. 13 Issue 2

Washington University Review of Health Spring 2020
cases slip through the cracks”
(Eldred, 2018). There are many gaps
in communication and a lack of
enforcement, and medical professionals
are often unprepared.
Politics of healthcare aside, more
needs to be done to ensure that
patients from all backgrounds are
included, represented and advocated
for in the healthcare system. While
most hospitals have free translation
services for multilingual or non-native
English speaking patients, the
demand will continue to surpass the
available resources given the
upward trajectory of the prevalence
of other languages.
Jose Salinas Valdivia, a Hispanic
Studies Ph.D. candidate at Washington
University in St. Louis, volunteers
at Casa de Salud where he
serves as a qualified Spanish
medical interpreter to the mostly
uninsured patient population, most
of whom are immigrants or refugees.
Jose came to St. Louis for his
academic pursuits, and while he had
always been involved with culture-related
volunteer work at home
in Peru, medical interpreting was
not an activity he had sought out. It
started with curiosity and the desire
to do something meaningful.
Jose is one of many interpreters
who represent a variety of experiences.
Many older medical interpreters
immigrate to the United
States from places of war or persecution.
They come to the United
States with years of field experience
as engineers, physicians and
professors. But given the near
impossibility of validating their
degrees to match U.S. standards,
these individuals provide their
language skills in the humble
profession of medical interpreting
to serve people with the shared
experience of living in a foreign
country.
The effectiveness of medical interpreting
is contingent on the invisibility
of the interpreter. The medical
interpreter’s job is to be the twoway
street for the non-native
English-speaking patient and the
English-speaking physician. The
interpreter’s own voice has no place
in the medical office unless there
are cases of abuse or mismanagement.
Jose conveyed the challenge
of sitting behind the patient and
minimizing his presence even when
he notices something unfair. Jose
argues that the patient has the right
to know if the physician is racist,
for example. For Jose, medical
interpreting is volunteer work, but
it is a matter of life and death for
some patients.
In Medical Spanish class, an undergraduate
introductory course at
Washington University in St. Louis,
we practice medical interpretation
and we role play the doctor, the
patient and the interpreter. The only
correct positions for the medical
interpreter are to the side or behind
either the doctor or the patient.
Medical interpretation provides the
basics of healthcare for non-native
English speaking patients.
Medical interpreting is a self-effacing
profession, but as Jose shares,
“it’s so important to be able to help
the communication between the
patient and the doctor that otherwise
wouldn’t be there.”
While Jose has been interpreting at
Casa de Salud for only a little over
two years for a few hours every
other week, he already has gained
enough experience and exposure to
know that there is an overwhelming
need for and undeniable meaning to
his work. Medical interpreting is
rewarding. Success is measured on
the individual patient level.
Jose knows he has done a good job
when “a patient walks out of the
clinic feeling calmer and more
hopeful than when they walked in.”
As a medical interpreter, his job is
to be the bridge that allows the
patient to know that they are being
cared for and that they can have
hope. This volunteer work has
become one of Jose’s major focuses
during his time in St. Louis. He has
been working on a project proposal
to the Gephardt Institute to establish
a network to connect students
with medical interpreting positions.
Medical interpreting reminds us
that healthcare relies on much more
than what the white coat embodies.
Brittany Jones, a Community
Referral Coordinator with the St.
Louis Integrated Health Network,
understands the power of the white
coat. She strongly voices for greater
participation and integration of
social workers and community
health workers into healthcare,
especially for displaced and at-risk
patients. Physicians have a lot of
influence that can be leveraged for
good, but many times the burden is
too great. This is where the coordination
of care is crucial for the
follow-through and continuity of
healthcare access. Hospitals would
collapse without the support of
janitorial services, technicians,
social workers, administrative
workers, etc. We may see medical
interpreting as another non-essential
administrative role, but without
these dedicated professionals who
faithfully do their jobs behind the
scenes, the physician’s ability to
speak to patients would be utterly
broken. Patients would be left
stranded on a one-way street.
My conversation with Jose ended
with him telling me about his
favorite specialty to interpret:
physical therapy. The minor movements
and posture adjustments that
physical therapists impart to
patients with occupational pains
and chronic suffering can be
life-changing. Small changes that
will not make the patient wealthy
or give the patient a better job,
instead, these changes improve
quality of life little by little. Small
changes can make all the difference.
The less glorified roles in healthcare
are integral to the functioning of
the entire system and the delivery
of services.
Jose concludes, “it’s about going
back to the basics.”
References
Eldred, S. M. (2018, August 15). With Scarce
Access To Interpreters, Immigrants Struggle
To Understand Doctors’ Orders. Retrieved
from https://www.npr.org/sections/healthshots/2018/08/15/638913165/with-scarce-access-to-medical-interpreters-immigrant-patients-struggle-to-unders
Kalanithi, Paul. When Breath Becomes Air.
Random House, 2016.
Title VI of the Civil Rights Act of 1964. (n.d.).
Retrieved from http://www.justice.gov/crt/fcs/
TitleVI
Zeigler, K., & Camarota, S. A. (2019, October
29). 67.3 Million in the United States Spoke a
Foreign Language at Home in 2018. Retrieved
from https://cis.org/Report/673-Million-United-
States-Spoke-Foreign-Language-Home-2018
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