I practice in England where we have a National Health Service that means that medical care is free at the point of care to eligible residents. It is the best thing in the world.....(when it works, but that is a story for another day).
As if this is not enough, people from most parts of the world can see a family doctor without the need to speak English, as an interpreter will be arranged for you. It is awesome!
It has certainly improved my knowledge of geography and languages. I had never heard of Tigrinya, or Pushto! (Google, if you're like I was)
Sometimes though, I wonder about the nuances in the interpretation, because as you know, emotions and sentiment cannot always be effectively conveyed by language. (Try translating Nigerian "Na wa" to English language. )
Anyway, these three-way language consultations are my bugbear today.
Patient 1.
Appropriately booked a double appointment. Good start.
Arrived in foreign attire, enthusiastic non-verbal gestures and limits her conversation to "Interpreter please." with a smile.
The whole consultation goes well, with the interpreter on the other end of the phone. The consultation ends and we both thank the interpreter and my patient stands up to leave.
She gets to the door and suddenly remembers....."Oh doctor sorry I forgot to ask you about this rash which has been bothering me for a few weeks. "
I was stunned. We went on to have a second consultation in English, which she spoke very fluently in an almost English accent! 🤯
Patient 2.
Face to face interpreter. Comes in with the patient, shows me her ID badge and everything then settles down to her job.
The patient gives a rather emotional account of fleeing an abusive husband in her home country, leaving her young child behind, and the effect on her mental health. The patient is very calm and composed but the story comes out in bits as the interpreter pauses several times crying, standing up and sitting down. Tapping her feet and snapping her fingers
The interpreter then enters into a prolonged dialogue for more than three minutes with my patient and it is obvious that she has forgotten why she is here.
"Hello!" I kind of say, butting into their gist.
" Oh yes doctor, she says she is happy to be referred for counselling." The interpreter says.
"Anything else she would like to mention?" I ask, referring to the obvious discrepancy between their long conversation and the few words she has just told me.
"No, thank you doctor. "
🤔
Patient 3.
All introductions made, consultation underway. Interpreter tells me why the patient is here and I start to ask a few more questions.
Suddenly the interpreter says.
"Excuse me Doctor, actually she does not understand what I am saying and she is speaking a different language. You need a different interpreter, sorry. " 🙄🫨
And finally, Patient 4.
After a somewhat long pause, listening to the rather annoying hold music of our usual Language line service provider, I am connected to an interpreter. We're on speaker phone, as is the norm, to allow effective three way communication.
After a couple of minutes, the interpreter suddenly starts whispering.
At first I thought I imagined it, or maybe she had stepped into the room with a sleeping baby or something, but interestingly, the patient starts whispering back!
Even more bizarrely, she conveys the message to me in a normal voice and then goes back to whispering to the patient.
The actual clinical content of the consultation is very ordinary, like a urinary infection or Tonsilitis, nothing exciting.
After a couple of sentences, her voice goes to a harsh tone. The patient starts raising her voice too!
I ask the interpreter what is going on as the whole thing has become a bit distracting.
"Just a minute doctor," she says "I just need to clarify something. "
Next thing I know, they start arguing back and forth. The argument escalates and they are now shouting at each other.
I take the phone off speaker and say "Hello"
"Sorry doctor...." the line cuts off.
The patient gets out of their chair, offers an apology and then leaves my consulting room!🤔🙄😤🥸
The day would come when I would have seen and heard everything to be seen or heard in a consulting room, not quite yet though.
****** ******* *******
I've not written in a while and that's enough to tell me that my work life balance is tipping the scales. I have had other memorable encounters to share, and hopefully I will be able to come up for air again soon. Ciao
