Sunday, July 19, 2020

In Her Words: On the Front Lines

A medical interpreter becomes even more essential during a pandemic.
Sol Cotti

“I felt like we were disposable.”

— Marta Rodriguez, a medical interpreter

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For Marta Rodriguez, a hospital interpreter, helping very sick patients understand their prognosis has become routine — but it hasn’t become any easier. She has a trick when she thinks she is about to cry: “I’ll dig my nails into my hand,” she said. “I’ll do something to stop the tears, because if I fall apart then I won’t do a good job.”

Ms. Rodriguez has worked in the role for more than 30 years, caring for 20 to 30 patients each week by interpreting what their doctors and nurses say. On any given day she might help deliver a diabetes diagnosis, or respond to a trauma code in the emergency room. On the toughest days, she calls a patient’s non-English speaking relatives on behalf of the doctor to tell them that their mother, son or husband has died of Covid-19.

The group of interpreters she works with serves patients who speak all different languages: Spanish and Mandarin, French and Haitian Creole.

The coronavirus pandemic has shown Ms. Rodriguez how urgently her work is needed. The death rate for Hispanic people because of the coronavirus is at least six times as high as the death rate among white Americans, for adults ages 45 to 54. And studies have shown that patients with limited English proficiency experience adverse health outcomes at rates markedly higher than English speakers, so they rely on interpreters like Ms. Rodriguez to help close that gap.

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Ms. Rodriguez’s family moved from Costa Rica to the Jamaica Plains neighborhood in Boston when she was 10. Her father washed dishes at a restaurant and her mother worked as a nanny. Ms. Rodriguez learned English the first summer she arrived in America, because a nun at her Catholic school, Sister Louise, told her to make sure she was fluent by the start of the school year.

Although her parents came to America seeking economic opportunities for their children, Ms. Rodriguez believes that if she had stayed in Costa Rica, she could have become a physician, which was initially her dream job. In America, a medical education was too expensive; even decades ago, when she considered it, the mean debt of medical school graduates was $18,652, with at least three more years of training to complete after that.

When she first started at the hospital, Ms. Rodriguez served as a lab technician, working with patients in gynecology and obstetrics. Many of them were navigating the complexities of childbirth on their own and without much income. These were conditions that Ms. Rodriguez could relate to; she had her first child at 19, and divorced her husband at 25 because of domestic violence.

“I didn’t know anything about the world,” Ms. Rodriguez said. “I wanted my patients to have a better chance than I had.”

She recalled caring for a Spanish-speaking woman who had been raped and was trying to decide whether to carry her child to term. Ms. Rodriguez helped the patient to understand her medical options, but took it a step beyond, drawing on her understanding of the young woman’s cultural and religious values.

“She was struggling with the language barrier, but also the simple fact that she was brought up thinking abortion was sinful,” Ms. Rodriguez said.

Ms. Rodriguez became known by her patients and relatives as “the birth control queen” because she spoke openly about contraception and birth control, breaking social taboos at a time when abortion was just becoming legal.

While she spent many years tending to all kinds of diseases and injuries, working across hospital specialties, her recent months have focused mainly on Covid-19 care. And of course, the coronavirus outbreak has made her and her colleagues worry about their own health, as well as that of their patients. In early March, Ms. Rodriguez learned that there were not enough masks for all members of the hospital staff; like so many institutions across the country, the hospital struggled to secure adequate levels of personal protective equipment, known as P.P.E.

“I felt like we were disposable,” Ms. Rodriguez said. Two of her colleagues got sick with Covid-19. While both survived, she said the sense of fear was palpable among her co-workers, especially as they watched members of their own families and communities get sick.

“I’m doing everything I can to not get Covid, but if it’s God’s will then it’s God’s will,” Ms. Rodriguez said. “But I don’t want to take it home. I have too many people depending on me.”

The experience of working without P.P.E. has reminded Ms. Rodriguez that medical practitioners often devalue the work of interpreters. But this is a reality she has faced many times in the hospital. She teaches a course for medical interpreters at the Harvard Pilgrim Health Care Foundation, and she remembered once grading the students’ exams at the hospital next to a nurse, who turned to her and asked, “You guys go to school for this?”

“I told her we need to learn medical terminology and how the body works,” Ms. Rodriguez said. “If we don’t understand it ourselves, how are we going to break it down for patients?”

Recently, Ms. Rodriguez’s hospital purchased iPads, so she has been using the device to interpret for patients remotely, joining their doctor appointments by video. The virtual work has brought its own challenges. It is hard to hear the patients above the noise of the hospital machinery, and when Covid-19 patients try to raise their voices, they cough because of the disease’s symptoms.

But the pandemic has also strengthened bonds in Ms. Rodriguez’s community of 35 interpreters, as they provide one another with emotional support. “There’s a liquor store on the corner, and on the worst days we say, ‘Let’s go to the corner,’” Ms. Rodriguez said. “We’re scared, not knowing if we are going to get the virus, but we’re holding those feelings in.”

What else is happening

Here are three articles from The Times you may have missed.

Jessica McDonald brought her 8-year-old son into the N.W.S.L. bubble.Kyle McCue/North Carolina Courage
  • “This is mom’s job. You have to work with me.” As sports return, some female athletes have entered restricted environments with their children in tow, placing them courtside for practices or taking them to live in hotels with the rest of the team. Their leagues have taken steps to make it easier. [Read the story]
  • “Searches of digital devices should not be automatic.” The police in England and Wales said on Thursday that they would stop routinely asking victims of crime to allow checks of their electronic devices, after critics said the practice discouraged people from reporting offenses, particularly in sex cases. [Read the story]
  • “When a child needs help, they go to mommy first.” Several new studies lay bare how the pandemic is disrupting mothers’ careers. [Read the story]

In Her Words is edited by Francesca Donner. Our art director is Catherine Gilmore-Barnes, and our photo editor is Sandra Stevenson.

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