Rounding

By Carla Stern

“Ask him if he’s worried about his wife and children in Mexico.”

Looking at the patient, I saw the corners of his mouth trembling. The haunted look in his eyes keenly reflected the horror of what had happened to him. I averted my own eyes, not wanting to share his misery.

I repeated the question in Spanish, leaning into him so I could hear his answer. With a breathing tube he could only speak in a low rasp, making my job as medical interpreter precarious. I hated asking for repetition, especially when the patient was making such a supreme effort to get the words out. Then there was the problem of the question itself. Why did the nurse need to ask the obvious? She knew that the Mexican consulate had had no success in getting his wife a temporary visa to come here. He would be alone in the ICU, trying to make sense of his misfortune with no family to comfort him. Worse, he would no longer be able to send them money.

Sometimes the nurses’ questions veered into the land of the surreal. Once I was called into the ER for a patient who had been run over by a tractor on a farm several hours away. He had been life-flighted to the hospital and sent immediately to trauma. As he lay writhing in agony on the gurney, the nurse asked him, “On a scale of zero to ten, what is your pain level?” I fought the urge to leave out the patient, turn to her and shout, “Ten! It’s a ten!” However, I understood that the nurse was only following protocol, so I interpreted the question into Spanish for him, internally rolling my eyes.

¿Está preocupado por su esposa y sus hijos en México?” The man with the broken body nodded. I looked at the nurse and nodded reflexively, even though she could see the answer. Then the surgeon came in, a grim expression on his face, and stood there for a few seconds, perhaps assessing how he was going to say what he needed to say. “We tried very, very hard to save your leg. We performed multiple surgeries. Unfortunately, we had to amputate it. You might feel pain in the leg that isn’t there. We call that ‘phantom pain’.”

He stopped and again stood there silently before telling the patient that he would be back in the morning to check on his wound. After he left, the nurse said, “Do you have any questions?”

Agua” the patient croaked. “Quiero agua.

“Water” I repeated. “I want water.”

Interpreters are supposed to use the first person to lessen their own presence and make communication more direct. At first it felt bizarre, but I quickly got used to hearing other people’s voices in my own.

“I’m sorry. You can’t have water. You have a breathing tube and the water will go right to your lungs. As soon as the tube is taken out, we’ll give you water.”

I explained this and then stood quietly, looking down at the list of all the other patients I had to see that day.

“We know that your stay here has been difficult and we know that you’re having a hard time coming to grips with your accident. We’ll be starting you on an anti-depressant called Gabapentin. It will take a few weeks before it starts working.”

The patient looked from me to the nurse and back again to me, his mouth a rictus of despair. In my mind’s eye I saw him on the steamroller and then suddenly on the ground, flattened beneath it. At least the accident happened at work, I reasoned. That meant the medical bills would be paid by worker’s compensation. This might give him a measure of comfort, but I doubted it.

Carla Stern is a nationally certified Spanish and French medical interpreter. She has worked in this field for the past five years at a hospital in Boise, Idaho. She also works as a court interpreter in Spanish. Her story “Tilt Test” is forthcoming in Sinister Wisdom in 2016. She can be found on the web at carlastern.tumblr.com.

Photo Credit: West Hospital Emergency Room from “Historic VCU: A VCU Images Special Collection

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