Canku Ota

(Many Paths)

An Online Newsletter Celebrating Native America

March 22, 2003 - Issue 83

FMC values Certified Medical Interpreters

Flagstaff - Twenty-six hospital Flagstaff Medical Center employees spent 40 hours in the classroom during the week of February 24 learning the clinical background and medical terminology that will give them the title of Navajo Medical Interpreters.

Hospital employees and volunteers who had indicated an interest in interpreting for FMC's Navajo patients attended the program entitled Bridging the Gap. FMC's Navajo patients comprise approximately 10 percent of the hospital's clientele. In all, an estimated 25 percent of all patients at FMC are Native American, according to Public Affairs Specialist Keli Openshaw.

Ida Bradley, a registered nurse and patient advocate, and seven other instructors from Northern Navajo Medical Center in Shiprock taught their Navajo-speaking students — all Navajo — about such sensitive matters as care and assistance to the terminally ill patient and his or her family, the Patients' Bill of Rights and advance directive issues such as life support.

Posters line the classroom. One reads: "The basic purpose of a medical interpreter is to facilitate understanding in communication between people who are speaking different languages."

This definition seems inadequate as one listens to Bradley talk about assisting the dying.

"We Navajos tend to say, ‘Be brave, be brave,'" she said. "Give these people a right to cry. Some people just want someone to be with them. A lot of times you don't have to say anything."

She has often sat in a bedside chair and simply held the hand of a terminally ill person.

"Terminally ill people have rights," Bradley told her class. "They have the right to be dressed as they wish and not be disrobed. A lot of times people come into the emergency room and what's the first thing we do? We cut off their clothes and lay them on the table like a piece of meat."

She said these patients also have the right to refuse visitors, the right to be clean, the right to have their hair washed.

"I tell myself, if this was my family member, I wouldn't want to come in and smell a dirty body," Bradley said.
Although the hospital is required by law to inquire about advance directives – instructions of a patient's wishes regarding the level of life support received for example, Bradley instructed her students to be very careful in explaining what those are.

Another sensitive area to the Navajo patient is organ donation.

"Doctors want to be culturally sensitive, they don't want to upset the family, but where organ donation has been indicated, there is the need to approach," Bradley said.

Advising families to designate one or two representatives who will be advised of the patient's care and communicating his or her condition is another topic of discussion. Bradley said that this practice is helpful to medical staff, patients and family.

For the average American, it might be hard to imagine the position of a Navajo-only speaking patient or family trying to understand the often-alien environment of a hospital. To bring it into perspective, imagine waking from an accident and finding yourself in a hospital in China. Listening to Bradley, one can easily picture the fear, anxiety and confusion this would cause.

An interpreter is often referred to as a translator, and there is a big difference between the two, Bradley pointed out. Many English terms have no actual word in Navajo, a language full of literal descriptions. One example Bradley offered was the word "tank."

"Tank is just a four letter word," she said. "In Navajo, a military tank is described as a ‘big car that crawls' or ‘Chidi na'nahitso.'"

Henrietta "Henri" Wilson has served FMC as the only certified Navajo Medical Interpreter for more than a year. She also served in that capacity in Phoenix before accepting the position in Flagstaff.

"In my role as interpreter, I make them [patients] feel more comfortable about talking about subjects that are taboo," Wilson said.

It is taboo, she explained, for Navajos to discuss death and dying with anyone other than traditional healers who deal with this area.

The satisfaction she receives from her work is obvious. People are very thankful for her services, Wilson said.

"They call me daughter or granddaughter," she said. "They cling to me, follow me. It's difficult to be in a situation where one cannot understand English. And I am on constantly on call — my beeper is always going off, my cell phone is always ringing. I go from one room to the next, but as I am leaving one family, they'll say, ‘you won't forget about me, promise me.'"

Wilson also describes her job as a cultural clarifier.

There are three different kinds of interpretation, Wilson said. There is the simultaneous interpretation, where the doctor, for example, is speaking, and she interprets what he says, then the family member talks, and she interprets for the doctor. Sight interpretation is where the interpreter reads medical forms, for example, and tells the patient what the paper means. Finally, there is summarization, where the interpreter will listen to an entire statement and then relay the information in a summary.

The hard part of her job, Wilson said, is the knowledge that her own feelings cannot get in between the speaker and the listener. She is a woman full of compassion for her patients – and in fact on top of her very busy schedule at FMC, Wilson is training to be a certified Hospice volunteer.

"I really enjoy my job and working with all of the patients and employees at FMC," she said.

Wilson comes from a tradition of healers. Both her mother and grandmother were respected healers and herbalists who were sought for their skills. Wilson also pointed out that her grandmother served as an interpreter for missionaries.

Openshaw explained that the 26 individuals who will receive their certificate in Medical Interpretation were all people who had assisted families in that capacity in the past and that they will be compensated for their services to the hospital.

"I've come in the past three days, and everyone is excited and talking eagerly when they arrive," Openshaw said. "This experience is totally oriented toward taking care of the patient."

"We do have a telephone translation service available to us at FMC through a company called Cyracom, which has more than 100 dialects available on it. However, with our proximity to the reservation, we have a high volume of Navajo patients and often need interpreters. This will give us more options for interpretive services."

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