24 Jan Muddying the Waters of Interpreting
This post was first published in November 2018.
Exactly a week ago today, you would have found me in New Orleans with a colleague at an oyster bar on the banks of the Mississippi, discussing the Dunning-Kruger effect. For those of you who are unfamiliar with the concept, it’s pretty simple. Basically, the more you know, the less you think you know. The idea is that as you come to know a subject extremely well, you begin to understand how much more there is to that subject. You understand the nuances. The subtleties.
The smarter you get…the dumber you think you are.
This has happened to me more than once! I currently teach a 40-hour training on medical interpreting, and as I try to do the topic justice for my students, I am terrified by the vast ocean of my own ignorance. Did you know how much there is to the human body? It is incredibly overwhelming. And I’m fairly knowledgeable on the subject; I read books on biology just for fun! Yet for every concept I master, five more appear that I didn’t even realize were a thing!
But back to the oyster bar: I happened to be in The Big Easy because this year that was the location of the American Translator’s Association’s 59th annual conference. I led several presentations, and during one workshop (Two Roads Diverge: Medical Interpreting versus Legal Interpreting), we abandoned my carefully planned PowerPoint slides. That’s because by minute two, the session had turned into an animated discussion extending to a passionate and opinionated audience. It was the best departure from a lesson plan that I’ve ever had.
We talked about a lot of things, and it seemed that the more we talked, the more confusing everything became.
Know the environment, know the role
Take the concept of “collaborative environment” versus “adversarial environment.” This is the basic premise that guides us when deciding which role we can step into; legal interpreting role for the latter, community interpreting role for the former.
We draw this distinction because in the United States there is a drastic difference in the level of intervention permitted for community interpreters versus legal interpreters. In court, our role is very limited. Do we happen to witness a breakdown in communication due to a cultural difference that we know perfectly well how to resolve? Too bad. We’re in an adversarial situation and must stick to the role of conduit (that is, interpreting exactly what’s said while pretending we’re invisible, even though—and here’s the clincher—we aren’t). We want the LEP individual to have the same experience that an English-speaking person would have if we weren’t there. Essentially, we are facilitating equally imperfect access to justice. On the other hand, in community interpreting (and therefore medical interpreting, which falls under the community umbrella) there is more leeway for cultural mediation and even for advocacy, which carries its own set of difficulties.
Environment vs Purpose
While having our hands tied in legal interpreting encounters can be frustrating, at the very least it seems pretty straightforward: Know the environment, know the role.
Enter the Dunning-Krueger effect.
First of all, how do we define our environments? I’ve been taught that we look to the purpose of the encounter. If we are facilitating access to community services, we are a community interpreter. We should also consider the fact that medical interpreters are part of a team working for the benefit of the LEP patient’s health, whereas in court settings we are a neutral in-betweener. We have to clearly define what role we are performing where, and it’s not all about terminology: You can be a court interpreter diving into complex medical expert witness descriptions, and you may find yourself deciphering high-register legal documents while working as a medical interpreter. So, we don’t look to content necessarily. We look at purpose.
Muddying the waters…
But what if we are interpreting for an attorney and a client in what is very much a collaborative setting, or a probation officer and a defendant, where the goal is not exactly adversarial? It’s kind of collaborative on the one hand, and adversarial on the other. And what about a medical interview in the context of a civil litigation? If we think of our ultimate goal as teaming with the doctor to provide services in the form of a proper diagnosis, then we are obligated to help navigate cultural differences. Yet at the same time, we must keep our mouths shut on the assumption that the encounter is serving an over-arching adversarial goal, so we can’t take sides or do anything but interpret.
Why shouldn’t we be cultural mediators in an adversarial situation? We are supposed to facilitate equal access to justice for those who don’t speak English. However, our LEP clients have an added disadvantage: their cultural backgrounds, and that will almost inevitably impact their access to justice.
Individuals who speak enough English to communicate, regardless of their cultural background, would not benefit from the services of interpreters to help them navigate cultural differences. Therefore, the consensus is that when interpreters act as cultural brokers in a court setting, they are giving LEP individuals an unfair advantage over their opponents. The issue is that, much like in a medical setting, LEP individuals are already at a disadvantage by needing to communicate through an interpreter, and there are times when cultural differences make communication (and therefore interpreting) extremely difficult.
As you can see, we start muddying the interpretation waters really quickly.
So, there you have it. The Dunning-Kruger effect in real-time. I have more questions than answers right now, and that’s why I love this field. It’s young, it’s new, and it’s evolving. We don’t know everything, but there is room for a passionate group of voices to be heard, even as the interpreting waters grow as muddy as the Mississipi.
I’m sure y’all will have opinions too. Feel free to comment below, and maybe we’ll continue the discussion at the NAJIT conference in Nashville this May!
Photo credit: Feature photo via Good Free Photos; small photos by Frans Van Heerden and Tina Nord from Pexels.
Athena Matilsky fell in love with Spanish the year she turned 16. She chose it as her major at Rutgers University and selected a focus in translation and interpreting. After graduation, she taught elementary school in Honduras and then returned home to begin freelancing as a medical and court interpreter. She has since achieved certifications as a Healthcare Interpreter and a Federal Court Interpreter. She was the recent editor-in-chief of Proteus. Currently, she works as a freelance interpreter/translator and trains candidates privately for the state and federal interpreting exams. When she is not writing or interpreting, you may find her practicing acroyoga or studying French. Website: https://athenaskyinterpreting.wordpress.com/
Like Socrates.
I love your inquisitive nature and clear writing, Athena. I have nothing to add to your reflection but just wanted to wish you well in Year 2 at Glendon. I hope things are going well!
Thank you so much! 🙂
Excellent article, and very timely! I highly recommend that court interpreters take one of the 40-hour medical interpreter training classes, whether or not you ever plan to work in the medical field. Why? Because (1) You never know…you could find yourself in an occasional or frequent hospital setting, and (2) This training and experience has saved these buns many times in a court setting.
No, I certainly am no medical “expert”. But just having a basic knowledge of medical terms, diagnoses, and procedures is very valuable today, in many court settings. This is because you simply never know when such terms will suddenly come up, in civil and criminal cases alike.
Thank you Kathleen! I wholeheartedly agree.
I fully agree with Kathleen.
Having a knowledge and background in medical interpreting has saved me many times in court too. (Not to mention that my court certified colleagues on a trial have looked to me quite a few times for help with or confirmation of a medical term.)
Agreed! Having a well-rounded knowledge base can only be helpful. 🙂
You should be ashamed yourself, Athena Matilsky. You and De la Mora charge all that money for a 4o-hour sham training. It’s an outright scam. It’s impossible to generate any kind of professional interpreter in a mere 40 hours; it’s not about ethics, positioning and learning how to introduce yourself to the people you’ll be interpreting for: these are all common sense and logistical matters that have nothing to do with our actual work. If a doctor or group of doctors were to sit down with you for 40 hours and explain what a doctor does and how she does it, does that mean you’re ready to be a doctor, or even ready to be trained as a doctor?? Think about that.
Actual training to become a professional interpreter takes years, hundreds and hundreds of intense hours of practice and study. Learning terminology and mastering techniques/modalities is what makes a solid interpreter, nothing else. The ethics and the smooth, appropriate logistics in dealing with the subjects you work with (in ANY field) are simply the positive side effects of a well-trained, professional, certified interpreter. Does any thoughtful, mature and intelligent adult really need to be told to be confidential and neutral in court or medical situations? No one needs to be trained on ethics and logistics, certainly not charged almost 800 bones for it. You’re squeezing these poor people for their hard-earned money to “teach” them some facile jibber-jabber. You all and these national medical interpretation testing boards should be ashamed of yourselves for almost ruining our profession, mostly by creating an expensive and delusional pipeline of mediocrity.
By the way, this idea of cultural mediation or brokerage is such fallacious nonsense, it would be laughable if it wasn’t so insulting. You’re teaching people to make up for their lackluster interpreter skills by empowering themselves (?) to become experts in culture. Any attempt to mediate or broker communication between two cultures is an endeavor in stereotype and conjecture, as if anyone is able to size up an LEP by sight or a few exchanged words and immediately determine their culture and ken. What indolence. The Latino community in the US and everywhere is so wildly heterogeneous, but you just want to simplify their identity. This is also why you all downplay terminology in your discourse, and why terminology used in and around our profession gets perpetually dumbed down: it is always insultingly assumed that dumb Mexicans (and other working class Chicanos/Latinos) will not understand their own language when it is spoken well. You’re essentially telling would-be interpreters of the future that it is ok not to develop true language skills, that it is ok to tell doctors that a patient probably doesn’t understand how to take their meds because everyone in Guatemala drinks tea when they’re sick and chants in mayan…
And then advocacy…..yet another way to “empower” an underdeveloped interpreter into believing they could possibly intervene in the face of actual medical professionals without any medical training. You all need to stop this greedy nonsense.
That’s why here in California there is a group of us (mostly public servants, staff court interpreters) slowly building a coalition to improve our conditions, and make our training and examination rigorous once again. Further, we are committed to developing outreach programs, apprenticeships, mentorships and academies ourselves for free or for a very low cost. We have the knowledge, the space, the motivation and the drive. California may once again lead the way for our profession, hopefully this time for the better. Join us if you are a court interpreter interested in bringing prestige back to our craft.. 562-665-4620
José, neither Athena nor De la Mora are trying to turn people into interpreters overnight. The courses they offer are for interpreters who want to polish their skills.
Your words are very offensive and disrespectful.
No
A 40 hour training that costs almost 800 bucks: that’s what’s very offensive and disrespectful.
Dear José,
I wish you would actually see for yourself what my classes consist of before being so unkind. I actually agree with much of what you say; interpreting is a craft that takes years to cultivate.. Ethical behavior, likewise, is not something that can be taught so much as developed, through guidance, guidelines and scintillating discussion. (It is, however, extremely important to teach. Students come to me constantly with ethical conundrums. Sure, it’s easy to say to keep something confidential, but what if their life is threatened unless you reveal your prior knowledge of their medical condition? This is simply an example. There are many more.)
All of this is something I stress again and again during my 40-hour training, I tell my students that the work is still ahead of them. I spend hours developing coursework that will give them the most substance as possible during the training, but they know this is not enough. It is just the beginning.
The 40-hour is a prerequisite, and the industry as a whole is actually moving toward a 60-hour requirement, something that I welcome. (I won’t speak here for de la Mora, but it is my understanding that they welcome it as well.)
As for what you say about cultural brokering, you are entitled to your opinion, but I whole-heartedly disagree. Knowledge of culture and an understanding of cultural understandings allows medical interpreters to help patient and doctor work together instead of separately. We are often the only people in the room who understand that a cultural misunderstanding is even occurring. An untrained interpreter would be tempted to speak for the patient, stereotyping and making assumptions. A trained cultural broker will guide the patient and the doctor toward resolution, empowering them to speak for themselves. This is very hard to do and requires training. It has been debated in the medical profession for quite a long time, but the reality is that it is now recognized in our codes of ethics, and I personally believe that is correct. It is precisely in order NOT to “simplify their identity” that we teach this.
As for advocacy? This is the most delicate interpreter role of all, and again, I am most certainly NOT simplifying it to my students. Our discussions on these topics are extremely nuanced and complex, and they are the most difficult but most rewarding moments that I spend teaching. It is unfortunate that you are criticizing me for something that I am actually not doing, and I am somewhat surprised that you would post such a hostile message on the website of a national organization when you have no knowledge of what I actually teach. I believe that your anger is misplaced.
Whether it’s 40 hours or 60 hours, it’s still not enough, Athena. Tell me if I’m wrong: People are being told they need to post 40 hours of “training” to be able to take one of two exams that will allow them to work as certified medical interpreters nationwide. Because if this is correct, then these 40 hours are not just a prerequisite as you say. If an individual passes the exam after taking one of these courses, on the strength of being somewhat bilingual, and able to memorize a list of ethics and duties and decipher contrived ethical conundrums……….they’re certified…….and working in hospitals, clinics, etc……with doctors and nurses and REAL patients. What am I missing?
This is YOUR program description:
“This program is available to speakers of all languages and will serve to meet the education requirements needed to take the medical certification test.” What am I missing?
I’m not angry at all, just disgusted and aghast that you would charge so much money. Again, there is a small, but growing contingent of court interpreters who are working for FREE to bring some prestige back into our profession. My previous message was a call to action, an invitation to those who want progressive change. Anyone and everyone is welcome to join the discussion. I’m glad this is a national platform. Debate is good, and should be encouraged.
You know, back in the day it used to be that our exam was more rigorous, it included the medical aspect (which is why some of us are also recognized as medically certified by the California government code); it included a TRUE bilingual exam that tested your language skills in BOTH languages, as it should be for any professional interpreter; and it truly tested your translation abilities, as any real language professional knows, translation and interpretation go hand in hand. Nowadays everything has been compartmentalized, where medical, scholastic and other ‘sects’ want to create their own little hermetic worlds where no other type of interpreter should be allowed to work. Instead of coming to Court Interpreters (the only hitherto trained, tested and certified spoken language professionals around) for guidance, support and collaboration, they all shut us out.
This whole “40 or 60 hour training” phenomenon that has played out in the last several years seems like one huge act of passive aggression. It almost seems like people were getting angry, tired of failing the old court certification exam, I guess……..and just began breaking up the interpreting world into more pliable pieces of knowledge, under the disingenuous guise of requiring special skills to handle these pieces (the folly of cultural brokering and advocacy). But the fact is that the well-trained certified court interpreter is a universal interpreter by virtue of the vast amount of information that is acquired and processed; moreover, the well-trained court interpreter knows exactly how to adapt to any situation, anywhere– ethically, physically and mentally. If issues come up, you address them accordingly. It’s not that deep. Notwithstanding all recent and future changes to our exam/certification, there is still a generation of us who posses great command in all of community, medical and court interpretation, whether some folks wish to accept it or not. Don’t hate and don’t negate…appreciate!
José, I am writing a former vice-chair of the National Board of Certification for Medical Interpreters, former member of the initial coalition that brought all stakeholders together to create a national certification, and former Administrator of the ATA Interpreters Division. You are mistaken. The 40-hour training is not to prepare an individual to become an interpreter. The 40-hour training is a 3rd or 4th step in the process of becoming a medical interpreter. You need to meet certain criteria, including a number of contact hours. There is a lot of specialized training that goes on, as well as recertification requirements – for both certifying entities, The National Board and CCHI.
Also, I do not know of any court interpreter who has in-depth knowledge of small, non-small cell cancers or chimeric and biological monoclonal antibodies. There is a lot of studying that goes on becoming a medical interpreter.
By the same token, I do not know of any medical interpreters – except those who have been certified state or federal court interpreters – who can talk about pleas, voir dire, misdemeanors and felonies with ease.
Yes, there is an overlap but there are also specializations and training that are different for each one of those professionals.
Do you know all the court interpreters in the US? How would you know what their in-depth knowledge consists of, Gio? There’s a lot of studying that goes into everything, and there is no reason why a court interpreter wouldn’t know about cell cancers, small and non-small or chimeric and biological monoclonal antibodies. A well-rounded interpreter is a well-trained interpreter, one who can acquire different specializations and put them to use when necessary. That’s what we do. That’s why it’s not for everyone.
Steps? Contact hours? That’s not what De la Mora’s literature says. I quoted what they say on their website. If what YOU are saying is correct, then I find the whole system corrupt and disgusting, all the greedy jackals charging up a storm for every step of the process.
ACCESS TO TRULY RIGOROUS INTERPRETER TRAINING PROGRAMS SHOULD BE FREE AND/OR AFFORDABLE. Boom! That’s my declaration.
Interpreters are not anthropologists, sociologists or ethnographers. We don’t have knowledge of culture just because we are bilingual to some degree. None of us is qualified to recognize “cultural understandings” without delving into conjecture and stereotype. Guiding patents and doctors towards resolution is not what we do.
You are looking at the issue under a very narrowly focused microscope. Sorry.
Don’t be sorry. Just please explain how an medical interpreter is supposed to understand culture.
Thank you Jose for highlighting Athena’s well-written conclusion: “The Dunning-Kruger effect in real-time.”
Athena didn’t mention de la mora in this post, so for the curious: https://delamorainstitute.com/signature-medical-training-program/
Thank you, Andrea, but I’m not highlighting any conclusion that points to confusion. Athena said it herself: her presentation only muddied the waters and made things confusing. That’s what Medical Interpretation has become: a facile, unsubstantial ball of confusion.
So far, no one has explained how exactly does one become an expert on culture without stereotyping. How is one supposed to advocate for a patient without any actual medical training?