Model stories written by young professionals/students.



Anybody Up for Lex-mex?

Observing a medical interpreter leads a student to reflect on cultural barriers in medicine.


Being in a country where you don’t speak the language can be quite a daunting experience. Just asking for directions can be a difficult task. Now imagine that you or a loved one suddenly falls ill or gets injured. How are you going to get help, explain what happened or understand what treatment medical professionals are trying to provide? This is the reality for many Spanish speakers here in Lexington. Fifteen percent of Lexington residents speak Spanish and not all of them know how to speak English so when they go to the hospital they require the services of medical interpreters.

Medical interpreters are trained to mediate dialogue between medical professionals and non-native speakers such as immigrants who cannot speak English. I shadowed at Bing Hospital this past week where they have a little over a dozen medical interpreters, nine of whom are nationally certified. I spoke to the Language Coordinator there who explained to me that most of the laws are fairly lax in regards to medical interpretation, which explains why not all of them are nationally certified. Furthermore, the medical interpreter I shadowed described the process of getting nationally certified as a “hassle” and since it isn’t required by law not everyone decides to get certified. That’s not to say they aren’t qualified, but there just isn’t much regulation around medical interpreting, which I find surprising.

The majority of the medical interpreters at Bing Hospital are native speakers of whatever language they interpret. On average they see about 7 patients each day, but can see anywhere from one to twenty. Medical interpreting generally involves directly translating what each speaker says. They speak as if they were the person they are translating. The only time you wouldn’t directly translate would be when speaking to a child or when there are several people speaking at once. A child isn’t going to understand why an interpreter is speaking as though they were the doctor, nor is a non-English speaker going to be able to keep up with who the interpreter is currently translating for. In these instances an interpreter would indicate who they are translating for as to avoid confusion. Medical interpreters are not supposed to touch the patients or alter the content of the translation in any way. Their job is to translate what the speakers say and to bridge cultural gaps.

 A cultural barrier to treatment for many Hispanics is the reluctance to speak with a non-Spanish speaker. Healthcare professionals need to get the confianza of their Spanish-speaking patients. This essentially means you need to obtain their trust and the best way to do that is by speaking their language. Even saying simple terms or phrases like “hola” or “me llamo Dr. Smith y mi español es malo (my name is Dr. Smith and my Spanish is bad)” can put Latino patients at ease. However, there are apparently some doctors who think they know how to speak Spanish, but really don’t. This can lead to miscommunication, which could have drastic health impacts. This is why doctors must be certified in order to speak to their patients in Spanish, and even then, they aren’t allowed to interpret for others. There are several ways to obtain a medical interpreter, including on-staff interpreters or via a call center where both the patient and the healthcare professional use telephones and essentially conference call with a certified interpreter.

Another common cultural aspect amongst Latino cultures that sometimes affects healthcare is machismo, which is the idea that men need to be as manly as possible. This often leads to Latino men putting off getting healthcare until they absolutely have to. This is made worse when they don’t have medical insurance to help them pay for the necessary treatment. Machismo also often times presents with sexual promiscuity. While I was studying abroad in Ecuador, they discussed the danger machismo presents since it facilitates the spread of dangerous sexually transmitted diseases. I asked the medical interpreter how much machismo she sees in her profession to which she indicated that it doesn’t happen too often. She usually noticed it when male patients would come on to her or when the father of a patient had to be brought in to make the final decision on how the family wanted their child to be treated.

Shadowing a medical interpreter was very fascinating for me since I study Spanish at the University. I even considered getting a job as a medical interpreter as I prepare to get into medical school and this was a great opportunity to familiarize myself with the career. Seeing and listening to the Latino patients reminded me of my experience with the clinic in Honduras and also made me realize my Spanish-speaking skills have a long way to go before they can be reliably used in the medical field. I am glad to see that there are those who are trying to bridge the gap between cultures.

-Michael Cunningham