USA: Language Confidential
A Nation Built by Immigrants
I am very passionate about language access. Since a very young age, I remember having to interpret for my family members. I am first generation Greek-American. From a very young age, I learned to embrace the ability to communicate. So much, that no matter where I went, what I did — even my studies in medicine-led me back to communication.
Today, for the first time in my life I learned that my Great-Grandfather from my mother’s side of the family was a linguist. He was actually the interpreter assisting communication between Europeans and the Chinese when they were building the railways in the USA in the late 1800s! So, I guess it is genetic?
I remember that every summer when I would board the direct flight from JFK to Athens, Greece when school was out — I would look forward to learning languages. See there, they have summer schools that teach French, German, English, Spanish, Italian etc. I would go and dabble. Nothing serious — just gathering certifications as milestones.
Fast Forward
Since the age of 16 I have worked in one way or another directly or indirectly in the field of linguistics. I consider myself an expert- and with the globe hopping I have done — at the age of 36. I feel like I have seen the world. Today, I find myself in the position where I am very active and very vocal about language access to our non-English speaking American citizens. It is 2014 — and this issue has not been taken care of. The costs are high — and in a sense- I get very very angry and make it a point to make it known when I see a non-English speaker with a child, friend or relative at the hospital or a doc visit. It is not fair that they don’t have the right to health privacy as English speakers do. Really, if Gustaf had some kinky shenanigans that got him sick — would he really be able to be honest with the doctor about it with his relative or child with him?
There are many people that I encounter that say “They are in America. They should learn English”. Well, my response to that is: No one said they don’t know how to speak English, they just don’t know it that well to discuss intricacies of health or financial small print. The United States of American was built by immigrants. This is a country with no official language. Keep that in mind next time you think of blurting out “This is America” (with a red-neck accent).
Troy Manning
Here is a little story about a man I will call Troy Manning. Troy is from Chicago. He is married with two children. He lost his job and has been on unemployment for 3 months. His wife works from home as a medical biller. They decide with her income and his IT skills, they could move to Mexico for a better life. None of them speak Spanish — but they took some in High School and decided to move there.
They moved. Soon after arriving he got himself a job — the kids went to a local school and picked up Spanish. He found work quite quickly, enough to make ends meet. They were alot happier than they were in Chicago. When asked why he moved to Mexico he would say : “Moving to Mexico gave my kids a better quality of life, helped me get to work when I couldn’t back home and experience the Mexican life and culture which I love.”
Ten Years Later
Troy is sick and goes to the doctor. His Spanish was good enough to kind of explain what was wrong- but no matter how much the medical staff tried to dumb down their Spanish and use their broken English and even bring a bilingual nurse…information was still missing. Troy went into surgery to remove his raging appendix. When surgery was over they began him a treatment of antibiotics, to be exact cephalosporins. Immediately, Troy went into arrest and died. He was allergic to cephalosporins. No liability here — the country of Mexico has an official language. It is your health insurance’s or the patient’s obligation to ensure effective communication.
John Katsis
John Katsis moved to the USA in 1975 from Greece. He situated himself in Manhattan and had a small diner that served the commuters at Penn Station fresh coffee every morning in the famous Greek coffee cups. He was married had two children and was living the dream of every immigrant. When asked once why he came to America he responded: “ I came for a change, a better opportunity and to provide a better life for my kids. I love the American culture and what it has to offer to me and my family”.
Thirty Years Later
John is taken to the hospital in an ambulance. He had a heartattack. In the ER, they quickly gave him a run through using his children as interpreters to explain to him intricacies of the situation. The children were not medical professionals. They omitted to ask if he had allergies and in panic just said NO to the nurse as they knew their father had no food allergies. John was allergic to latex. They prepped him for an angiogram during the procedure he suffered a severe allergic reaction and they did not know the cause until he had passed on. There was a malpractice suit filed — and the family won. Bottom line Title VI violation. The USA has no official language, thus all institutions receiving any federal funds are obliged to facilitate communication.
These are all very real situations (though the names in this post are fictional for anonymity), they happen everyday in our hospitals, clinics, and in other healthcare and non-healthcare settings. These people spoke the language … just not that good enough to save their lives.How many of you reading this blog have a friend or relative that have to go to the doctor with a relative or friend to speak for them — because they don't understand what is going on?
I am going to guess all of you!! It’s kind of like how we all have that one “UNCLE” in the family. That just gives you an idea how often this happens.
In the USA Title VI ensures that people who do not speak English as a first language have access to interpreters. This mandates that all institutions within the USA that have received or will receive ANY federal money must have language access services in place. This pretty much covers almost any place of business.
I am a multi-lingual. I speak many languages and have credentials that indicate my proficiency in Italian, German, French, Pashto and Spanish. Though, I will only say I am comfortable in speaking English and Greek when it comes to intricate conversations such as that of health, finance, legal or other specified industries. Why? A person who considers themselves a multi-lingual should ask themselves. If you were on an operating table and the doctor asked you very specific questions that could mean life or death—would you feel comfortable answering them?
Now let’s take a step back. It is 2008, and I am looking for work to help me work my way through medical school. I apply for a remote interpreter position. Many companies quickly got back to me. The first company (I will not name) tested me on all languages and of course I passed. So I started working.
On my first day at work — I got a call for Italian, it was a simple insurance question. I was fine with it — and did my job well, though I quickly emailed the HR person and said — I am labeled as an ALL CALL interpreter for Greek, Italian, French, German, Spanish and Pashto and I am not comfortable with taking calls other than for Greek.
The next call came in — it was a medical call in Pashto. I immediately said “Dr. Z. I am not qualified to handle this call. Please call the switchboard again and request another interpreter.” They patched the call through to me 6 times until I got a call from HR. HR said “You passed our tests, this means you are capable of taking such calls. I understand you are new, but we are the call center and they rely on us. We are paying you too much money per minute ($0.80 is alot?) to be picky.” I was shocked — that all they thought about was the money and obviously they did not know who they were speaking with. The SUPER ADVOCATE for Limited English Speaking Citizen rights!
My response “I was a linguist for the US military and know very well, what it means to be qualified for all calls. I stated in my application that I am a Greek linguist that has knowledge in the languages you have assigned to me. I am certified in all those languages but that does not mean that I claim to be a certified interpreter for those languages. I will only take calls for Greek. Your tests simply indicate that I have good working knowledge of a language — but not enough to ensure patient safety and in any matters that pertain to damages, litigation or death! Please ensure that I will no longer be accepting calls in other languages except for Greek”Needless to say I was fired. ( I am sure the company I am writing about is reading this #shameonyou )
Since then, I have been working for different companies and government agencies on the side as an interpreter for Greek. My day job during and after med school was very different to my on the side calls for interpreting. Due to my career and experience the very same companies that funneled calls to me when they needed a Greek Interpreter were the ones contacting me to consult and test their interpreters. I can say hands down that out of 100 people I have tested for the position of Greek interpreting 1 would pass by my standards…. but almost all of them passed by the call centers that call themselves Language Service Providers (LSPs). It is very sad , that these companies are allowed to operate. They are taking peoples lives in their hands and playing Russian Roulette.
An interpreter I know in California once said “Tore, I showed up for the interpreting session for the research subjects participating. They had two Greek interpreters — me and some Albanian woman that spoke the typical broken Greek. I feel so sorry for those patients. You know what company sent her right? They should be called death brokers.”
Death Brokers
We will talk about that on my next blog post. Though, for legal reasons, I won’t be able to name companies — BUT I will post testimonials anonymously by interpreters to give you an inside of how these companies work and function. Keep in mind your hospital, your clinic and your government employ these companies.
Food for thought.
Why do we have National Board Certification for Healthcare Interpreting if … you can work without the costs of studies and certification and work for these companies?
Short answer
Why do we manufacture in China?
Why do we outsource call centers to India?
