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Interpreters of Maladies

Reaching Out: BU trained, they work in hospitals, courts, schools

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Interpreter Juan Carlos Huertas interprets a medical form for a patient at Boston Medical Center. Photo by Jared Charney. Michael O’Laughlin (below), director of MET’s interpreter certificate program, leads a class in medical interpreting. Photo by Frank Curran

Starting this week, BU Today revisits some favorite features and series from the past year, running one each week through the summer.

First up is “Reaching Out.” Originally published in January, these stories examine the many ways the Boston University community works to ease the hardships of immigrants and refugees in the Boston area.

It’s 9 a.m. on a Saturday morning, and instructor Michael O’Laughlin is leading a class of seven students, reading from a script in Spanish. He recites the lines of a judge charged with determining the fate of an immigrant trying to gain legal status, while a student translates his words into English. Next, O’Laughlin plays the part of the attorney representing the hopeful immigrant. The student echoes his argument en español.

The students, all bilingual speakers, practice phrases that will be needed for work in immigration courts. “Residente permanente legal (lawful permanent resident),” they say, and “circunstancias excepcionales (exceptional circumstances).”

O’Laughlin, who is the director of the interpreter certificate program at Metropolitan College’s Center for Professional Education, has been teaching interpreters for more than 15 years. In that time, he has prepared hundreds of people for work as interpreters in courts, in hospitals, and for other community service. His classroom exercises take students through scenarios ranging from helping a middle schooler understand a teacher to explaining to union members a management team’s bottom line to warning parents of the dangers of lead paint. The 12-to-18-month program prepares interpreters in three languages—Chinese, Portuguese, and Spanish—for work in three settings: medical, legal, and general community service. To qualify for the program, students must have a fluent command of English, as well as one of these three languages.

O’Laughlin’s class teaches much more than vocabulary. Students who hope to work in immigration court, for example, learn to help clients talk about the kind of things that will help them obtain legal residency: their jobs, bank accounts, and church and community involvement.

“The immigration court tells a story,” he says. “These are normal people who come here for economic reasons. They aren’t criminals.”

The demand for interpreters in immigration court is steady, he says, because interpreters are required by law, and the need is likely to grow. According to a 2009 report by the Transactional Records Access Clearinghouse, which gathers, researches, and distributes data, 78 percent of the immigrants who have come before the nation’s courts since 2006 have required a translator. And in the last 12 years, according to O’Laughlin, the atmosphere in the immigration courts has really changed. “The odds of getting deported are now much higher,” he says, making the need for interpreters more critical than ever.

Despite the demand, only 10 percent of O’Laughlin’s students choose to work in courts. Many more find work in hospitals, and most work on a freelance basis for a variety of social services.

Interpreter certificate program graduate Malvina Gregory is the interpreter services manager for Catholic Charities Maine, a social services program with interpreters in more than 25 languages. She enrolled in the program, she says, because even after studying Spanish and working as a bilingual case manager, she lacked the vocabulary to interpret in either a medical or a legal setting.

Gregory says she finds her work emotionally rewarding, especially when it takes her to a world of tribulations that most Americans can only imagine, a world where she is able to help. She cites as an example a patient from Mexico who lost an arm in a work accident and was reeling from post-traumatic stress.

“I enjoyed coming up with ways to communicate his very descriptive street language and rich stories,” she says, “as well as his descriptions of his nightmares and ghost pain symptoms, into English equivalents that captured all that he was suffering.”

In the courts, interpreters save people from deportation and other legal consequences; in hospitals, they can literally help save lives.

Lawrence Salas, the manager of interpreter services at Boston Medical Center, says studies have shown that interpreters can also save money by reducing repeat visits and testing and by bolstering patient satisfaction. At BMC, interpreters translate from as many as 18 languages for the largely English-speaking medical professionals, and put the professional staff’s advice into language that the patient can fully comprehend. In 2009 alone, they helped doctors understand the afflictions of more than 275,000 patients, up sharply from 170,000 in 2006.

“When many patients first come into BMC, they find that not everyone speaks their language, like at security or the information desk,” says BMC interpreter Juan Carlos Huertas, who is not a graduate of the BU program. “It may even be hard for them to do something like ask for directions.”

Huertas points out that a language barrier can complicate every aspect of medical treatment. Without interpreters, many patients wouldn’t know what to ask, even if they knew how to ask it. Anything short of full comprehension increases the chances that patients will leave the hospital with less information than they need.

He says that many people who need medical help don’t understand the health care system in this country, which is often vastly different from health care in their home country, and that doctors don’t have the time to explain the differences to them. That’s where interpreters come in.

“Timewise, a doctor has maybe 30 minutes to see patients,” says Huertas. “Patients wonder why their appointment has to go so quickly, and you have to explain that the doctors are very busy, and they don’t have a lot of time. Or some doctors only use medical terms when talking to a patient, which confuses them.”

Huertas turns to a male patient from the Dominican Republic and asks how important it is to have an interpreter on hand. The man looks at Huertas, smiles, and answers in a word that doesn’t need translation: “Mucho,” he says.

Amy Laskowski can be reached at amlaskow@bu.edu.

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