Chapter 1 Introduction

By the end of this module, students should be able to:

•Describe the world of medical interpreting

Cultural aspects

-More preventative medicine

Describe interpreting in the US

-Practice interpreting 1

Welcome to the medical interpreting and medical Spanish combined. This book will offer you opportunities to learn about the medical interpreting process in the USA, how to become a certified medical interpreter, and what to expect in an encounter.

Before diving into cultural differences or similarities, let’s clarify the difference between interpreting and translating: Interpreting is the rendering of the verbal message and the written translation.  

We will also navigate culture and cultural awareness, and humility.

One of the first resources I want to learn about is the culturally and linguistically appropriate services you can expect when going into medical encounters in the USA.

One of the first things I would like to invite you to do is to check where your state stands in terms of CLAS. clas-tracking-map

The main goal of the CLAS standards is to reduce disparities and add equity to the medical encounter.

Now for this first Chapter, I want to share my story. So you can picture the difference in culture in the medical field between a country like Argentina and one like the USA.

First, Argentina offers free healthcare to its citizens and anyone who needs help. 

My father, Dr. Rizzo, was a medical doctor, a clinician who had the practice at home.

We lived in Ituzaingó, in the province of Buenos Aires, on the west side.

He was a kind man who cared for his patients. He would never turn down anyone in need and often did not charge for his consultation. He also found a way to avoid prescribing medications that were extreme side effects but rather homeopathic remedies.

He started to do acupuncture, laser, teas, and other treatments. He also focused on preventive medicine, ways for people to avoid seeing him! I know he was not interested in the money but in the well-being of his patients.

My dad was a great human being; while he respected the ethics and laws of the medical profession, he was always kind and caring to others.

I always strived to be like him, and I started medical school when I arrived in the USA.

But something shocking prevented me from continuing with my career. I did not understand the healthcare system in the USA, and to be honest, I did not enjoy it very much. Regardless, I lived here, so I had to adapt.

Little after that, I fell in love with teaching languages, and it all was a perfect fit: teaching Spanish for medical purposes was a natural fit.

But going back to my dad, how could I even see medicine not as I saw it growing up.

My dad had a small practice. I helped the patients in the waiting room, gave them water, and chatted with them to welcome them. Sometimes they even felt better by talking to me, and when they went to see my dad, they were like, “I feel better already; I love your daughter.”

And this is what is crucial: how the medical encounter occurs. Going to the Doctor is already traumatic. Not to mention the protocol you must go through when you go to the hospitals and clinics in the USA. Here is what you can expect. You enter the waiting room, a desk with ladies behind it and a paper clipboard with the name of the Doctor you are about to see. Then, you are supposed to write your name and then sit down immediately; you are also supposed to know the name of the Doctor who will see you. There is no sign to explain this to you nor anybody to welcome you. Nothing happens. You are supposed to know this. There is a pen to sign or an iPad, which, BTW, when the pandemic is on, you are supposed to constantly touch on and on (keeps the clients coming back!)

It would help if you also recorded the time you arrived. Yes, there is usually a giant clock; you must write it down when you come.

In the waiting area, there is a huge plasma TV. It is playing issues with health that end up recommending a specific drug for you to ask the Doctor to prescribe you. Yes, the drug companies want the patient to ask the doctors to prescribe medications, not the other way around. Some of the ads are very general but persuasive. 

 Then, right after you sit down, maybe after a second, the lady behind the desk gets the clipboard and will call your name. With names like mine, the case is they won’t be able to pronounce it right, so instead of saying your last name, they say your first name.

 Now your information is required: your medical insurance and your payment. Nothing else matters at this point. After providing the medical insurance, you’ll wait for the nurse to call you. She gets you in and starts the triage: taking your vitals and asking why you want to see the Doctor. Your vitals are your temperature, weight, and blood pressure. An old-school weight scale sometimes requires the nurse to move with her hand to establish your weight. And they usually do not tell what they find out, the number, or even if it is average or not. Nothing said. Now, they put you in a room and wait for the Doctor, whom you might see for seconds at a time.

 Now let me walk you into my dad’s practice. When you arrive at the house, a sign reads, “Welcome to Dr. Rizzo’s clinic.”

 When you come to the office, I will open the door, and my dog and I will greet you while you walk in and help you into the waiting room, full of flowers and pleasant smells. I will also have soft music playing, like classical music.

 I have water, coffee, tea, and pastries for you, of course, considering those with cardiac issues or diabetes, which I have on record, and I know every patient by first and last name. I not only know who they are, but they are also my neighbors, their kids go to school with me, or we know each other because they own a local shop, like a grocery or bread (Panadería)

One cultural thing to note is that in Argentina, at least during the time I lived there and in this particular situation, people greet each other with a kiss. And the Doctor’s office is no exception. We welcome you with a cheek kiss. So I did this for each patient, and I also hugged them.

When my father, Dr. Rizzo, would come to take them to the office, he would kiss them and hug them.

He will perform the temperature test, blood pressure, or weight only if needed, not at the routine. He did not have a nurse to do this for him; he did it himself. Now consider this is a small clinic.

My dad tried very hard to remove a person from medication hurting their health and find an alternative solution. Sometimes the answer was as simple as diet and exercise or changing the diet to plant-based (which was in the 80s).

Another thing my father did was to encourage people to be in a state of gratitude and a positive mindset. To not only love their bodies but their diseases. Bless the whole experience. Dr. Rizzo used to say, “Try to see what this disease is trying to tell you; it is here for you to learn something.”

 As an immigrant in the United States, coming from this family, and having Dr. Rizzo as my father, it is tough to go into a medical system; for legitimate reasons, you are just another number. 

What are the experiences you had with the medical system across the globe? Have you experienced similar situations in the USA or abroad? Again, this is my humble experience, and I tell it this way, with flaws, exaggerating at times, and with a bit of heart because, of course, I love my father. What is your story?

Activity:

Before you watch the video: think about how the healthcare system in the USA works.

What are 3 aspects you are aware of?

Watch the video, while you compare and contrast what Alejandro explains to about the Argentinian healthcare system vs the USA

Reflect upon one aspect you learned today you did not know before