Medical interpreters ease health-care stress for patients in the NorthlandKor Xiong was working at a convenience store one evening when he was called to his other job.
By: John Lundy, Duluth News Tribune
Kor Xiong was working at a convenience store one evening when he was called to his other job.
“They said we’ve got to have someone at Miller-Dwan; the doctor comes in at 3 or 4 in the morning for the checkup,” said Xiong, 29, who is Hmong. “The doctor needs someone to be there to make sure this patient is OK and able to take certain kind of meds.”
Xiong works part time as a medical interpreter, one of between 80 and 85 freelance bilingual speakers assigned by Clarity Interpreting Services of Duluth to surmount language barriers in medical situations throughout the Northland. They serve a small but significant block of local residents.
In Duluth, 4.8 percent of residents speak a language other than English at home, according to the most recent U.S. Census Bureau figures. The percentage is slightly less in St. Louis County, Superior and Douglas County.
Karen Arthur, a retired nurse, serves those residents by directing Clarity Interpreting, which was founded by Elisa Troiani in the early 1990s.
Although Arthur speaks only English, she said she’s fascinated by the different cultures, customs and languages that come together in the Northland. And she knows the work of medical interpreters involves more than translation.
“It’s more than just the words that are spoken; it’s how people are treated in that experience in the exam room,” Arthur said. “It’s good to have people who have a sense of that native custom.”
A sense of native custom came to play for Cecilia Ramon, a native of Argentina, when she was interpreting between English and Spanish for a patient from Mexico. The patient had a large tattoo of the Virgin of Guadalupe, and the caregiver wondered if that indicated a psychological issue. Ramon was able to assure the caregiver that it didn’t.
“It was not a sign of stress in any way or a psychological issue,” said Ramon, 46. “It was a part of the culture to have a huge tattoo of the Virgin of Guadalupe.”
The freelance interpreters who contract with Clarity Interpreting Services speak a total 33 languages, Arthur said. It’s her job to match the language needed with an available interpreter, sometimes on short notice.
“People are either in school or they have another job or they’re raising kids or they’re retired,” Arthur said of the interpreters. “Those are the four biggies. So I have a directory with all kinds of notes: what days are not good days to call. Some people don’t want to work weekends or nights. Some people say anytime in the afternoon. It’s all over the map.”
If there’s an “oddball language” with no local match, Arthur can arrange for national services in Chicago, Los Angeles and New York to provide interpretation via telephone. Working by phone can happen even with local interpreters.
“Sometimes I’ll have a local interpreter on the phone who couldn’t get out of the driveway,” Arthur said. “Or somebody who gets a call at 2 in the morning, and they’re a single parent, and what are they going to do with their kids? But they can do a phone interpretation.”
But 80-year-old Oscar Giulivi said he’ll answer the call any time. “If it’s 3 a.m. in the morning, I must go,” Giulivi said. “People are waiting.”
Like Ramon, Giulivi is a native of Argentina. He interprets in both Spanish and Italian and said he has a compelling reason to work as an interpreter: “For me, it’s a pleasure to help people.”
Anatomy book as a guide
The two most important attributes of interpreters are accuracy and confidentiality, Arthur said.
“Don’t try to fake it,” she said. “You’ve got to be OK with saying, ‘I don’t know what that means.’ Some people can’t say that. I don’t want them.”
John Atella, who interprets in Mandarin, brings a Google translator, a medical terminology book and an anatomy book to assignments, the latter allowing patients to point to the site of their problem. Although he said 95 percent of the conversation is nontechnical, he’s not afraid to slow things down until he understands what’s being said.
“I tell everybody: ‘Wait. Wait. Don’t go on. I need an interpreter moment,’ ” said Atella, an Illinois native who studied Mandarin in China.
Invariably, appointments with an interpreter will take longer, Arthur said.
But Dr. Matt Penning of Duluth’s Family Practice Center, said appointments in which he has been assisted by a Hmong interpreter haven’t noticeably slowed him down.
“The one that I’ve had has been very professional and very nice,” Penning said. “There hasn’t been, as far as I’ve experienced, any difficulty with communication.”
Lisa Spooner, an Essentia Health dietitian, said she adds 15 minutes to her normal 30-minute appointment when working with a client who needs help from Essentia’s in-house sign-language interpreter. The Spanish interpreter she uses with another client doesn’t add any time to the session.
Not a living wage
None of the freelancers makes a living wage just from interpreting, Arthur said. She estimated the most active interpreters make between $500 and $600 in a month. The business is profitable, she said, although costs of pay, overhead and insurance keep it from being lucrative.
“You do have to cover stuff that goes wrong,” she said. “So far in my watch, nothing’s gone wrong.”
But the service is free to patients.
“I’ve had some of them say: ‘Can I pay you now for this?’ ” Atella related. “ ‘No. No. No. This is free.’ … The provider by law has to provide this. I hope the patients know that.”
People shouldn’t feel they have to rely on family members for interpretation, Atella said.
Dr. Sarah Manney, an Essentia Health pediatrician, said she has been in situations in which a family has used a child as its interpreter.
“That doesn’t always go well,” Manney said. “It’s hard to put the kids in that situation.”
In Duluth, Manney uses a Spanish interpreter with a family that has three children. The interpreter was present for the births of the younger two, Manney said.
“It’s a unique experience,” she said. “I feel more confident with that particular patient or family. I’m actually hearing their concerns correctly.”
Xiong said he knows almost everyone in the small Hmong community in the Twin Ports. He sees using his language ability to interpret for them when they have health needs as more of a calling than a job.
“I look at it this way: I spent more than half of my life learning the English language,” Xiong said. “So I want to do something useful for the community.”