“Don’t worry,”
the nurse told us, “Looks like the doctor can communicate with her just fine!” Much as I wished this to be true, I was also
a bit skeptical that the doctor just so happened to be conversant in Sango.[1] A follow-up question quickly affirmed this
hunch, and soon the patient’s husband and I were ushered back to the screening
room!
That comic
moment aside, this morning was pretty darn hard. I accompanied a young couple to the OB/GYN, a
couple who, after over a decade of trying and a series of complications, have
been unable to have a child. Resettled from
a country in central Africa only a few months ago, the husband is a regular at
our Friday computer classes and is part of the group of French-speaking men whom
I’ve had the chance to really get to know.
If you’d asked me yesterday, I probably would have said that having some
sort of relationship with the people I’m interpreting alongside is more or less
a positive thing. However, today, as I
was called upon to ask some painfully sensitive questions and be present during
an altogether delicate situation, well, I couldn’t help but wonder if it might
not have been better for everyone involved had I instead been some “detached”
professional they’d never see again…I’m not entirely sure whether I think that’s
true, but it sure got me thinking about the ethics involved in interpretation,
not to mention in cross-cultural medical visits at large.
In the past
month, I’ve had the chance to meet, translate for, and interact with a wide
array of doctors. As someone who has
chosen a rather different path, I obviously am in no place to offer authoritative
advice to anyone in/ going into the medical profession. To my friends in med, nursing, and PA school
currently, let’s be real—I could never do
what you can and will do, and I am so thankful that you’re doing it! However, simply as someone who has now sat
with refugees in an assortment of doctors’ offices, I have noticed that I’m in
a somewhat unusual position to observe, seeing as I am neither patient nor
medical staff, yet by necessity still caught in the midst of it all. I’ve been humbled and stretched by watching
medical professionals demonstrate remarkable cultural awareness and sensitivity
towards Lutheran Services’ refugee clients.
I’ve seen nurses go out of their way to receive special permission for a
young Muslim girl to stay in her street clothes rather than change into the
hospital gown for her outpatient procedure.
I’ve laughed as a young doctor wracked his brain for any Swahili he
might know, jubilantly landing on the greeting “Jambo!” before hitting the end
of his vocabulary. And then there’s the
doctor I met today, who— once he was made aware that the patient could not in
fact understand him, that is— did everything he could to communicate through
his body language, eye contact, and occasional attempts at French that he was
still speaking to the couple and not
just to me.
But I’ve also
seen the underside of cross-cultural care, if only in quick glimpses. Constrained, inevitably, by time and
resources, doctors have zoomed in and out at such a frenetic pace that even
introductions have been skipped over— a thing which, though rude in our
culture, is unheard of and distinctly rattling in so many others. Thrown off, I suppose, by one patient’s
seemingly divergent understanding of his symptoms, one doctor I watched brusquely
dismissed an elderly client repeatedly, leaving him feeling convinced that he had neither
been heard nor understood. I’ve also sat
with a young refugee man at an appointment, which, come to find out, was
actually a pre-op for a procedure that he was entirely unaware of and which was happening in
a mere three days! Asked to sign consent
forms by staff who could not even tell us the purpose of the procedure
(“So-and-so will go into that later,” we kept being told), he finally burst out
in frustration: “I am smiling, don’t
you see? I don’t need this! Why is no one listening?”[2]
While I realize
that I am surely unaware of whole hosts of challenges that doctors must face on
a daily basis, I do know that this is an important one. I know that patients who feel seen are patients who are cooperative,
patients who go along with important follow-up instructions; whereas failure to
see can result in a certain mistrust of the diagnosis and instructions that can
undercut the value of the care given and received. And it’s true, seeing—really, truly
seeing—takes time. Goodness knows, it’s
something I have not yet figured out how to do consistently myself (in the
slightest)! When working in the refugee
community, how quickly I forget to look beyond the label of “refugee” to see
the person that used to be before resettlement, noticing the rich aspects of
the person that are still visible today if only I remember to take off my
blinders! But the good news is that, at
least from my limited perspective, there are many small yet meaningful ways that we
can begin to engage in the practice of seeing, both in doctors’
offices and elsewhere, right now: whether it’s pausing to shake hands with
everyone in the room, taking a second to ask a patient where she’s from and
learning to pronounce her name properly, or simply making it a point to always
acknowledge (if not necessarily defer to) perspectives on health and medicine
that don’t line up with our Western understanding of things, these small things
make a difference!
Today I had to turn
to my friend and his wife and tell them that, for the moment at least, the
doctor has no explanation for why they haven’t been able to have a baby. And that was hard. Really hard.
But, it was made so, so much
easier by the doctor who, in simply taking time to pause regularly and allow me
to translate, in extending his hand in welcome to all three of us, and in
making space for questions to be asked and re-asked, communicated to the couple
a message of confidence and care.
So, please, my
kind and brilliant friends, be this kind
of doctor. Indeed, let us doctors and
nurses, teachers and social workers, ministers and nonprofit workers,
counselors and mentors (and the list goes on)— may we all be caregivers who see!
[1] Sango: the language I knew
to be the only one the patient speaks, meaning that today was another practice
in indirect interpretation— I translated the doctor’s words to the husband, who
in turn passed them onto his wife, the patient.
[2] Thankfully, it turned out to just be an exploratory
procedure, but boy were those tense moments leading up to that disclosure!
