“Question in, question out:” language resource provision and communicative effort are paramount in moments of urgency and desperation

A guest blog post by Kaitlin E. Thomas, M.A.

A screaming eight-year-old child. A paralyzed collection of staff watching as the emergency response crew hustled to restrain and attend to their young patient. A panicking mother, arriving only seconds before her daughter slipped into a series of seizures, lunging into the ambulance barely able to contain her own sobs of fear, manically grabbing anyone within reach.

Collective disorientation is perhaps the most accurate description that comes to mind when remembering my first experience as an interpreter for a crisis situation at a rural elementary school on the Eastern Shore of Maryland, a location surprisingly rife with non-English speaking immigrants. I was one of two bilingual individuals associated with the school, and the only one on site that afternoon. Having just returned from a home visit with another immigrant family, I happened to be in the school office when the sirens cut through the customary background chatter. Within seconds, the above scene happened seemingly all at once, with one last detail: me leaping into the ambulance behind the mother, reaching for her hands in an attempt to contain her movements so that the crew could get to work. Sensing the mother’s need to know what was happening, I immediately began to facilitate communication between the medics, the child (when possible), and the mother. Question in, question out. Information in, information out. Tranquila Señora, son muy buenos los médicos y pronto llegaremos al hospital. Does she have allergies? Did she suffer a recent accident? Has this happened before? Question in, question out.

Question in, question out. Information in, information out. 

More inquiries, more information, more comfort until finally we pulled up to the emergency room where several nurses were waiting. I didn’t leave the child or the mother’s side for the entire duration of questioning, probing, testing, and more importantly, the interminable waiting. A bond had formed between us, and I could tell that the mother would not consent to having anyone else serve as the intermediary between her, her daughter, and the medical staff. Slowly, as more family members arrived, the information we had gathered was repeated over and over again: each person needed to understand, needed to know what was happening to their hija querida in terms that they could both literally understand and figuratively grapple with. Honest, but human. Medical, but not sterile.

Few professions provide the opportunity to intimately connect seemingly disparate entities during moments of urgency or desperation, instants where each is entirely dependent on the other to achieve an outcome, yet neither possesses the one true tool necessary to do so: mutual communicative ability. 

Particularly in the medical field, bilingual and bicultural skills, education, resources, and training are precisely what attach those disconnected parts that are so vital to assessing a situation, developing a plan of action, and ultimately diagnosing a solution. 

This experience taught me an enormous amount about the power of on-site interpretation. It’s difficult to fully appreciate how the dynamic shifts between doctor and patient when a bilingual intermediary is available. On a smaller scale, I’ve witnessed how much more confidence a patient has, and how much more at ease they become, when a medical practitioner arrives prepared with even a few simple phrases in the patient’s language to use. It may not be adequate for an entire, seamless conversation, but it is sufficient to establish an important rapport during what can often be an impossibly vulnerable moment.

We live in a unique time when many communities are being forced to reevaluate the manner in which they administer services to demographics that present new linguistic and cultural challenges at an unprecedented rate. Too often the solution is to rely on tools that only serve to widen the gap by producing nonsensical text (a challenge for those with low or nonexistent literacy levels) or essentially belittle the patient by speaking “at” them rather than “with” them, or at worst, not speaking to them at all.

The power of bilingual service provision and simple communicative effort are immense. Investing in bilingual resources can be tantamount to achieving improved intercultural relations, spreading wellness education, and ensuring that immigrant families and individuals receive the information and care that is so necessary to thrive, yet often taken for granted. 

Kaitlin E. Thomas, M.A, is a Ph.D. Candidate in Hispanic Studies at the University of Birmingham. She is a lecturer of Spanish at Norwich University and a Spanish Instructor at Johns Hopkins University Center for Talented Youth.