In the Absence of Words

A new compilation of stories about the impact of interpreting on access health care services has been published by PALS for Health, funded by the California Endowment.

The project is titled In the Absence of Words, and includes some truly wonderful stories. Here are a few quotes:

"The interpreter was able to accurately relay all
of the doctor’s questions and thoroughly explain what I needed to know about my illness. I finally gained an understanding of my medical condition and progress, the treatment plan, and what I needed to be cautious about. This crucial understanding helped dispel my fears and drastically strengthened my faith in my own ability to recover and conquer the disease."

- Testimony of Mrs. Yong-Nan Wu, Language Ambassador, Chinese

"I wasn’t sure if I would be able to express myself, what I was going through, and whether I would be able to receive the care I needed. But my anxiety quickly turned into joy and hope when I learned that the staff had arranged for a professional interpreter to assist me. [...] Many of us, as patients, don’t know that we are entitled to interpretation services when we go to the doctor. Some providers and administrators may know that they need to provide this service, and yet they use untrained staff or anyone else to interpret matters about health that can be about life and death. The solution to these problems, I believe, is to have more training for medical interpreters and to educate the public as well as the providers."

- Testimony of an anonymous client, Japanese

"What I find most rewarding as a health care interpreter is seeing the look of relief on people’s faces when they know they are able to communicate and understand everything during the session with their doctor. They leave their appointment feeling assured that no question is left unanswered."

- Testimony of Ms. Ana Maria Garcia, PALS interpreter, Spanish

How To Be An Interpreter

Several weeks ago, I stumbled across a masterpiece called, "How To Be An Interpreter." I am pleased to report that the author of this brilliant work, a fellow interpreter and blogger who goes by the name of Chameleon for purposes of confidentiality, has given me permission to share her wonderful essay here. In the interests of space, I am sharing the condensed version. The full version is available at her website, here.

Not only that, but she has kindly granted permission to publish an abbreviated version of this in the From Our Lips to Your Ears book.

This essay contains an entertaining mixture of humor, sarcasm and insight. Since the readers of this blog come from all "walks of life" in the interpreting field, I want to remind readers that the rules of engagement for interpreting depend greatly on the type of interpreting one is providing. It is obvious from the context provided that this piece refers to conference interpreting (simultaneous mode).

So, without further ado, please enjoy this essay, which, I believe not only accurately reflects many of the subtleties and difficulties of an interpreter's daily life, but truly enables non-interpreters to gain a gritty and honest, yet educated glimpse of what this work frequently entails.

How To Be An Interpreter

Develop a magpie instinct, picking up pieces of knowledge no matter how obscure, from Middle High German proverbs to solar panel technology, from condom thicknesses to mother boards.

Have a few stock quotes from the Bible and Shakespeare at your fingertips, as clients are fond of displaying their erudition (King Lear, Act One, Scene Four’s “Striving to better, oft we mar what’s well” an excellent solution for the perennial brain bender “the good is the enemy of the best”) and a few innocuous “filler” phrases when you need to play for time, taking that split second to dredge up the choice piece of vocabulary from the depths of your memory (a favourite of some being “We ignore this at our peril”). Avoid Spoonerism-prone expressions, such as “shed light on”. Once the penny has dropped, you will experience a pre-emptive shudder of mental mortification every time you contemplate using it.

Be prepared for the frustration of outsiders (especially those who should know better as they depend on your services on a daily basis) assuming that anyone with the most superficial of nodding acquaintances with languages being capable of doing your job. You may have a doctorate in nuclear physics (one of my colleagues does), but you are still pigeonholed as a linguist and looked down on accordingly. Of course, they are secretly jealous that they have been excluded from such a “cushy number”. Whereas in truth even the perfectly bilingual are less likely to possess the rarefied aptitude than those brought up without such an advantage. This attitude is exacerbated by the fatuous claims printed as a marketing ploy on learning discs (“Learn Hausa in a week!”) so popular at the moment as holidaymakers contemplate alternative sunny climes.

Worse, you are a parasite, an expensive frippery, a drain on taxpayers’ money, a glorified secretary, a menial to be shunted off to a cheap hotel miles away from the venue whilst those on an equal (or greatly inferior) footing in the official hierarchy are allocated doubles in situ (the cost of hiring fleets of coaches to ferry you back and forth is somehow mysteriously omitted from the calculation, what counts is the genuflection towards economising).

Always respect the Magnus Magnusson principle (“I’ve started so I’ll finish”). If you embark on a sentence you are committed to finishing it or else you will undermine the confidence of your listeners. This is why it is never a good idea to echo the speaker when she or he says “We have a saying in Estonian that goes something like this and I’m not sure about the English equivalent…” (the advice in paragraph one notwithstanding). Waiting for a few seconds will allow you to determine whether a similar phrase does indeed exist in the target language and save you much grief. However, your voice must not waver in the meantime. Waiting just long enough without creating the impression you have lost the plot is a skill that can only be acquired with practice. Hesitation is not automatically equated with incompetence, but the line between keeping and losing your audience’s faith is fine indeed.

Judicious editing is one of the most important aptitudes at your disposal and should be nurtured accordingly. Interpretation is not a mere slavish rendition of every word, but a distillation of the message, a processed essence purified of all extraneous verbiage, a concentrate of the speaker’s intentions. Ideally every utterance should be faithfully rendered (and the true interpreter will capture the speaker’s style and delivery as well as content), but this is not always possible. In that sense, interpretation is a highly pragmatic art.

No matter how repugnant the views articulated might be to you personally, your presence is required as a conduit, a filter of concepts, a role, which does not entitle you to distort or maliciously interfere with the original message. The phrase “says the speaker” is handy in two instances: firstly as an exclamation mark to dissociate yourself with the content when the speaker has made a glaring error of substance (so that listeners are alerted to the fact that a lack of comprehension on your part is not to blame) and secondly to distance yourself from the most repellent of statements (although the latter should be used sparingly and many would argue that it is never acceptable to deploy it to voice a distaste, which is incompatible with our professional ethos).

You communicate the thoughts and thought processes of others: you are only a participant in proceedings by default or proxy, an impartial witness, an arbiter of content at a linguistic level, but not a judge. If all else fails and you really have not understood either because the acoustics were poor (the sound cuts out with monotonous regularity or the expatiating customer has an irritating habit of turning round to joke with his friend in the row behind and the mike does not pick up the words clearly) or the point genuinely went over your head, there are two fallback tactics, leaving the offending word or phrase out altogether (which can prove fatal or impossible if everything hinged on that one component – all too often the case) or bluffing with a meaningless substitute (the indispensable padding phrase again). Clarification can always be requested by the delegates themselves. They have the advantage of being in a position to ask. You don’t.

The true last resort is tactical mumbling. Speaking indistinctly won’t endear you to colleagues depending on your for relay, but mumbling the names (the problem usually arises because the individual giving the floor mangles the pronunciation so badly that only the most mentally agile, seasoned interpreter who can reel off the list of members of the body in question has a remote hope of deciphering them) or making a valiant attempt to mimic accurately the sound emanating from the chairperson’s lips at least opens the possibility that someone out there might be able to put two and two together.

Always modulate. There is nothing more dreary than hearing a bored voice drone on through the headphones. Even if the topic is accrual-based accounting systems remember it is your duty to make it sound interesting. It will warm the cockles of some little stuffed shirt’s heart. You are the speaker for the duration. If she is angry, you must convey that rage. If she speaks with passion, you must reflect that enthusiasm. Your voice is your precious instrument, your greatest asset. Flaunt it.

Resign yourself to never being able to read a newspaper again (not even in your mother tongue) without underlining interesting or unfamiliar words. Tabloids are every bit as useful as broadsheets in this respect, as you can stripmine them of vocabulary items in a different register. The printed columns are a tool, not only in terms of gathering information, but also in terms of providing you with the basic raw materials of your craft.

Do not be alarmed at the shift in perceptions that comes from being exposed to an uninterrupted stream of sound day in day out. A person’s attractiveness will be conditional on the quality of their voice. Nothing will put you off a person more than a shrill, hash or in any way grating vocalisation. Your tolerance for extraneous noise will gradually diminish the longer you are bombarded with other people’s utterances. This is an occupational disease and will sneak up on you unnoticed. It may even extend to music.

Finally, one ineluctable paradox is built into the very nature of our art. We have to process complex information instantaneously. We must have honed analytical skills. We must have a flair for communicating across cultural barriers. In order to perform our job well we must possess an innate creativity that must always be harnessed in the service of those who by definition cannot appreciate our flashes of brilliance. We might pull off a linguistic salto mortale every second sentence without the reward of applause. We might unravel the most tortuous logic with perfect clarity yet our efforts go unnoticed. The brutal truth is that if they could appreciate us they wouldn’t need us. We only ever impinge on their consciousness if something goes wrong.

If you are expecting gratitude or admiration in exchange for your intellectual fireworks, for the sheer amount of mental and emotional energy expended you will be sorely disappointed. The primary compensations are to be found in being present whilst history is made (or at least having a ringside seat whilst the swarms of journalists hang around the bar for the merest scrap of what you have heard in detail, and the more modest consolation of being able to walk away at the end of the session and leave the day’s work behind you.

The "Right" Answer

As an interpreter trainer, I've been fortunate to share many stories with fellow trainers and interpreters over the years. Recently, I was asked by a colleague for permission to write up a story that I had previously shared with her in person regarding an experience related to medical interpreting and cultural differences, for publication in a newsletter.

This turned out to be perfect timing, because I was just getting ready to publish a sample story to the From Our Lips to Your Ears project website, at the request of many individuals who wanted to see an example of a story that would be in keeping with the project mission. The sample story I will share below is now available on the project website (http://www.fromourlips.com/sample.html).

Stories can be wonderful teaching tools, and I can already tell from the submissions received so far that the book will be overflowing with rich examples of this nature.

So, here is a story from the archives of my own interpreting experiences, one that I've shared many times with interpreters to demonstrate the role of culture in communication.

The “Right” Answer

As medical interpreters, we often serve as bridges, not just between languages, but between cultures. One experience in particular demonstrated this to me in a way that I will never forget.

I was interpreting during a speech therapy session. The patient was an elderly Spanish-speaking female stroke victim, most likely in her late 70’s or 80’s. Like many stroke victims, she had to put forth her utmost concentration and make a tremendous effort to pronounce each word. Her speech was slow, and many letters were difficult for her to say, but she was clearly committed to doing the very best she could. In spite of the obvious strain, her voice projected a sense of pride in what she was able to accomplish. Her determined attitude was admirable.

One speech exercise required the patient to answer basic questions about different job functions in society. For example, the therapist would ask, “Who drives the bus?” The patient knowingly replied, “The bus driver.” When asked, “Who brings you the food in a restaurant?” The patient proudly responded with the correct answer, “The waiter.” Each time, the therapist would respond with encouraging words, and the patient seemed increasingly confident in her abilities to produce the right answers, albeit with slow and painstaking attention to each syllable.

However, the patient’s steady pattern of providing the correct answers came to a halt when she was asked, "Who do you borrow a cup of sugar from?" Those of us familiar with mainstream US culture know that the answer the therapist expected to hear was, “the neighbor”, but this concept was a source of utter confusion for the patient. Instead of answering the question with the typical one-word answer, she patiently put together a question of her own. With long pauses between each word, she asked, “Why--would--I--want--to--borrow--a--cup--of—sugar…?” There was a hint of frustration in her voice. Her steady string of correct answers had suddenly come to an unexpected stop.

After interpreting the patient’s response, I explained to the provider that, in many cultures, the typical diet might not include recipes that call for a cup of sugar, and that this unit of measure may not be customary either. I also explained that the standard definition of “neighbor” in many cultures might not be likely to include the borrowing of grocery staples.

The therapist said, “Fine, we’ll just skip that question and move on.” After I interpreted this explanation to the patient, the exercise continued as before. Only now, even though she was able to provide the right answers to all of the questions being asked, it seemed to me that she was frustrated or nervous. The excitement and confidence she had experienced by being a “good student” had suddenly diminished slightly. With each question asked by the therapist, I silently hoped for concepts that would be culturally relevant, to facilitate the communication process.

We asked several questions to which the patient provided the expected answers. Then, the therapist asked a seemingly simple and straightforward question, "Who grows the food?" The correct answer, according to U.S. culture, would be, “the farmer”. I interpreted this sentence slowly and clearly, taking special care to choose the verb equivalent for “grow” that would be most closely associated with crops and farming, to eliminate confusion. The patient seemed confident that she knew the right answer to this question. Without skipping a beat, she said, in a somewhat louder voice, “The mother.”

I interpreted her answer into English, prepared to follow the interpretation by explaining to the provider that, in some places, large-scale farming might be less common, and that it might be more common for families to plant their own supply of food in a garden, usually tended to by the mother of the household. I wanted the provider to understand that the patient’s answer was correct, at least, within a different cultural framework.

But before I even had a chance to finish the explanation, the therapist interrupted and rephrased the question, “Who grows the food for a lot of people?” I felt a sense of apprehension, mixed with hope that perhaps these additional words might help the patient come up with the “right” answer to this question.

She seemed to think that this was an easy question. More confidently than ever, the patient immediately answered, “God.” Just as swiftly, I rendered her answer in English.

All three of us just sat there in silence for a few moments, although it seemed like an eternity. The provider seemed to be processing this response and trying to figure out how to proceed. The patient just stayed silent, waiting for the next question. With no words to interpret from either party, I too stayed quiet.

Finally, the provider thanked the patient, told her she had done a good job in the session, and that she looked forward to seeing her the following week.

I will never know how this experience might have impacted the therapist, or what she was thinking during those drawn-out moments of silence. It may be that she continued to use the same questions with every patient, without regard for cultural differences. Or, it may be that this moment served to enlighten her, prompting her to begin a campaign to develop more culturally relevant materials for speech therapists everywhere. I will never know.

But I do believe I know how it impacted the patient. She walked out of the office that day with a firm belief that she was making progress, and that she had ended the session by conquering the final question with what she believed to be the only logical and appropriate answer.

After all, according to her view of the world, it most definitely was the "right" answer.

(c) 2007 Nataly Kelly. All Rights Reserved.

Nataly Kelly is currently collecting anecdotes and stories about interpreting for publication in the book, "From Our Lips to Your Ears: How Interpreters Are Changing the World." To learn more, please visit the project website, www.fromourlips.com.

Trainers, educators, interpreters and others - if you would like to use this story for training or educational purposes, feel free to do so. If you are providing it as a handout or in another written format, please just make sure that all of the italicized text is copied in its entirety, including the copyright information and website listed above. If you would like to publish the story for broader distribution in a newsletter or other publication, please send an email to editor@fromourlips.com to request permission.