Latest / Found in Interpretation Podcast / Ep. 53 - Marisa Rueda Will

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Ep. 53 - Marisa Rueda Will · Found in Interpretation Podcast

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Hello, hello and welcome to another episode of found in
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Interpretation podcast, the podcast that talks about
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interpretation, translation and I and everything else.
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Once again, I'm one of your Co host and I'm here Brian.
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Brian, how you doing? Fantastic.
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Thanks. Thanks for asking.
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And we're also here with Marissa.
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Will how are you? I'm doing wonderful.
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I'm so grateful to be here with you all.
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Excited to chat with you for the next hour ish.
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Absolutely. It's gonna be great, yeah.
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It's gonna be great. Let's kick it.
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OK. So we're welcoming Marissa
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Retta. He is a CCH High Commissioner
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and has been a medical interpreter at a major US
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medical centre since 2006. She's a trained Certified
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Healthcare interpreters in Spanish and she's a licensed
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interpreter through Cross Cultural Communications and 2020
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she became a Simulation Centre instructor.
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She's a member of the National Council on Interpreting and
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Healthcares work group. She has provided a workshops in
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all kinds of organizations. She's currently getting a
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masters in interpreting studies at Western Oregon University.
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I really want to hear about that.
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And her company, Tika Interpreter Training Translation
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focuses on training educating medical interpreters.
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If you're nervous advance, you know it's always based on real
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life patient experiences. Did I miss anything?
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That sounds like enough to me. Wow, you're still young, so your
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career, you know, it's not over. It's definitely not over, but I,
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I think that's a great place to start, especially since you like
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to, to talk about people from different areas of interpreting.
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And I'm one of just a couple of people about healthcare that
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you've had on. So I'm excited.
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Absolutely, Yeah, No, we're really excited about the whole
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healthcare thing and also the the whole education part where
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you're for your company. Is this more like a a mentorship
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kind of thing or is it are you teaching them interpretation
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techniques or how is that? How does that work?
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Great question. So part of what I do and have
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done for a long time just within my healthcare organization is
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train our staff. So training newcomers, coming in
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one-on-one, mentoring and then also providing one of our
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standard screenings, which in healthcare you may have heard of
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like a 40 hour training. OK, so a bridging the gap or
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another program that teaches interpreting protocols, ethics
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skills, professionalism, etc. And gives just a broad overview
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of what can you can expect. So I give that.
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So is that like you said, it was 40 hours, Is it all like
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condensed into one? Week, so 40 hours the way that
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doing it now. It used to be maybe like one day
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a week. We've done different differently
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over the years, but now it's hybrid because COVID.
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Have you heard of it? Big deal.
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So no, never heard of it. Well, I am a healthcare
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interpreter, so you're to tell you about code and how it
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affects education. One of the ways that it affected
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it is they wanted to try to continue these classes online.
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So it's a hybrid model now. So I created a lot of
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asynchronous content, about 20 hours of which is now online and
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then 20 hours of synchronous, which is really important to do
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group work, have conversations about ethical decision making,
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etcetera, which is a lot of what I'm studying plan.
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You sounded interested in that through for my masters program.
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So it's really cool to be able to put those principles into
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practice with my students. So your masters is in what
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exactly? Great question.
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I get this. And then I want to see your
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faces afterwards because people are like.
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Hmm, still. Trying to take that in.
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So it's a specialized program out of Western Oregon University
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that is designed for practitioners, so interpreters
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who later want to go on and practice and then also for
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educators. It's called an interpreting
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studies masters program. So unlike conference
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interpreters or the you know, Monterey Maize program, you know
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that exists, this is focus on a lot of pedagogies focused on
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research. So I'm going to be doing a
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research IRB approved project as a result of this.
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With the help of my instructors, I'm learning and reading a lot
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about the different models of interpreting, you know, like
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Giles's efforts, models of interpreting, different ethical
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decision making frameworks, the normative ethics with like Dean
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and Pollard, lots of nerdy things I could talk to you about
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and that. Well, that's why we haven't
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podcast. We like nerdy things.
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And, and, and actually this work, this, a lot of the ideas
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that I've had to work through in this program have been already
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contributing, I think, to our profession.
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Because you may or may not have seen recently that CCHI, one of
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the organizations that I work with, is broadening their
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continuing education credentials to now require 2 ethics specific
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continuing education credits. Can you explain what seat with
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CCHI is for our? Listeners, you haven't heard of
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CHI need to figure that out right now, especially if you
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want to become a certified healthcare interpreter, because
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it. Is all over the US or just in
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the state of Minnesota? This is national, so it says
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it's called the Certification Commission for Healthcare for
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interpreters in healthcare. So sorry, Certification
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Commission for healthcare interpreter CHICC high 5.
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My husband says and like no one says that.
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Like that's not. That's not a thing.
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Whatever. Doug.
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Exactly. So full of dad jokes and it's
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the only nationally accredited testing company, meaning they
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had to go through the process of getting accredited with the MC.
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Think of the is the acronym for it where they basically they
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accredit all different types of tests, right?
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And so they had to go through inter rater reliability.
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Like is this test reliable? Which as you can imagine, doing
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this with an organization that's not used to working with
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interpreter type tests was quite a feat for them to actually get
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it accredited. And Natalia, the director is on
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their board now. Like they love working with her
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so much. They're like hey come work
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there's an accreditation like you know your stuff.
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So basically what it is before. OK, for all y'all working out
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there and conference or other realms in healthcare
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interpreting, like we're kind of in our infancy in a lot of ways
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because we didn't even have a code of ethics or standards of
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practice at a national level before 2004, 2005.
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And like these certification tests started rolling out in
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2010, I want to say 2011. So I got mine in 2012.
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So little over, you know, only 10 years coming up on like 15
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years of being certified prior to that.
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Like if you were a healthcare interpreter, basically you got
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some maybe a little bit of training, but you just had to
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say like, hey, I'm bilingual. Well, and I'm breathing and here
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I am and I'm OK working in your hospital, which of course.
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Well, sometimes when it's a rare languages, that's what happens,
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right? Because if you're combinations
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with Spanish more, there are more Spanish speakers.
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So there can be a structure. But if you need, let's say
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someone who speaks Vietnamese must be must be a bit more rare.
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So does the certification go that?
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Far so Vietnamese is actually, I would say, not necessarily a
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rare language. Like when I think of rare
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languages, I think of like. I'm in Quebec City.
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Sorry, yeah, it depends right on your where you're located in
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your population and things like that.
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But the point is of what you're talking about is yes, like there
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aren't even language proficiency tests for certain languages.
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So how can you really vet those sorts of skills, right if the
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testing isn't even there to do that?
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So absolutely. Like you have to provide
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language access for people without having those tools in
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place. So you get people who are who
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self like a self attestation, you could say to say like, yes,
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I am able to speak these languages and then learn the
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medical vernacular, which is a whole other language, right?
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As we know in our different specialties, like the language
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of medicine is its own language in and of itself.
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To be able to do that work roundabout way to say like
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certification is a big deal because it's a test.
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Finally, they came out of the test to be able to say, at least
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for me as a Spanish interpreter, Spanish, Arabic and Mandarin
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with CHI. And then there's another
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organization, NBC CMI that does national tests, which offers I
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believe for Vietnamese as well and maybe Korean or something
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like that. So to be able to say I took a
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test and yes, I can interpret accurately at this level.
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Now, is this a navigate that the hospitals are looking for in
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order for you to be able to work at a hospital, or are you able
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to work at a hospital without having that?
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Oh, that's a really great question.
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And I think it depends on the structure within that hospital.
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A lot of places will do some training in house, but they're
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really wanna try to minimize having to train you.
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And So what they do look for is OHT, are you certified or aren't
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you certified? Because if you're certified, we
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at least know that you're at this level.
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That being said, we are in a huge shortage right now of
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interpreters. So people are I think hiring and
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with like VRI&OPI coming in with different LSP providers out
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there, a lot of the work is coming from different sources
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just because hospitals need that like on demand feature, right?
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VR is a virtual remote interpretation.
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Video remote, sorry, video remote interpreting and then
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Opis over the phone interpreting.
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So what we're seeing right now in the industry is just a huge
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influx of different language service providers also competing
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for that market, right? You know, language line propio
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for the rare languages. You know, you see some like
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Mayan language Bridge, I think Cyracom just got eaten by
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another company good for lack of saying like there's a lot going
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on in that market and Healthcare is a big one.
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I think AMN Healthcare is another big one so.
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They yeah, my mom was My mom was working for Circom for a.
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Bit ohk OK there you. Go Yeah.
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Over the phone interpreting. Yeah, it's they, it.
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It pays peanuts to be. It's has it does in, in a lot of
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those sectors, right, Especially if you're working for a large
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company. This is what I hear.
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Like as a staff interpreter, what we're seeing now is if you
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would have asked me like 5 years ago or something, as far as like
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my wages compared to let's say the freelance market, what
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interpreters in a larger metropolitan area we're making
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for like contractor work in hospitals.
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They would have been getting $20 more an hour right, than I would
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be getting for my salary at the hospital.
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But now we're kind of seeing that there's been this switch
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and like contract interpreters are making less than I'm making
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and I've got like dependable hours, I've got benefits through
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my hospital system, etcetera. So it, it's a lot of really
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market dependent on like where your area is and whether or not
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you're, you know, are you working for a larger company and
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what do they value or take into consideration right when
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negotiating these contracts? So do you see different because
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this shift is done because of technology, because of remote
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interpretation or over the phone interpretation, do you see these
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other interpreters coming in to provide some services as
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competition or you you just see it as basically filling the
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gaps? I think that for me personally,
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like for for like if I'm working.
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You mean an IC like AVRI or an OPI or like a contractor or
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something? I have great respect for that
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work because I know, like Brian was saying, a lot of them are
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aren't making what they should be making.
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I know they're taking calls back-to-back to back.
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I know that they're being watched, right, for their
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quality of service for the number of calls that they're
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taking. Like that is not an easy job.
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And I don't think people really realize, like, when they're
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contracting these companies, what the environment is like for
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those interpreters or what their background or training is, if
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you know any, to be able to take those calls.
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So I'm always like, thank you so much, whatever.
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Treat them like a person because I've been on the other end of
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the screen as well. COVID, again, I know you said
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you didn't hear about it, but I'm guessing that wasn't true,
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right? I spent my fair share of time on
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the phone over the screen. And let me tell you, it's a
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different experience. Like I've been advocating
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hardcore to make interpreters a visible part of the healthcare
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team through my work and through my training and education and
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just presence at the hospital and with different initiatives
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and also through my business. That's one of my main focus
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areas is I just really want to promote and empower people to
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send that message in, in whatever their space of work.
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Because you get treated differently when you're on the
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other side of the screen. There's this vernacular used to
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describe interpreters even in person.
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Like, can I use you for a minute?
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OK. People say.
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All the time, all the time. Like I even hear it like amongst
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my college. Do you, do you ask, do you get
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asked this question? Like can I use you for this?
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I'm just wondering, can I borrow?
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Yeah, not in conference. Can I borrow you for a minute to
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help me with this patient? Can I use you?
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And I think that stems from just lack of awareness of the
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profession in general, right? We're now, as I said, kind of an
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infancy. Somebody told me it's in
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diapers, all these infancy, I like them.
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But we're still promoting ourselves.
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We're getting out there. We're saying, no, we do have
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specialized training to do this. This isn't a job that you should
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be delegating to family members. And family members are doing
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this work, you know, regularly unfortunately due to lack of I
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think awareness due to lack of infrastructure, pause direction
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etcetera as to best. Practice, you're saying
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basically is that you want to be treated inside the profession
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with the same level of respect then a nurse or a doctor would
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be or any other staff. But people because you are an
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interpreter, people don't seem to see to see you in the same.
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Way. Amen.
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Correct SO. And I feel it's the same thing
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for the legal system, like with the lawyers and the judges who
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make big salaries. And then they expect the
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interpreters to be, you know, repeating what they're saying in
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the other language like as quickly and like to their
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liking, not the way that interpretation should be done.
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And it's it's hard to change that culture.
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It's hard to integrate yourself and show your value.
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And it's even harder now that, you know, we have AI coming into
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the mix. We've got VRI, we've got OPI.
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So what do I do? I double down like I'm going to
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get my masters in interpreting and education, whatever.
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Like I'm doing the research that we need out there, which is, and
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the point of my research is to really show the hidden roles of
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healthcare interpreters. So what are the things that
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we're bringing to those appointments as members of the
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healthcare team that aren't necessarily linguistic, right?
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That are extra linguistic that are noticing, for instance, this
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patient is holding back. Like this patient isn't
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comfortable speaking in front of like their male family or their
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family or like the nurse told me before this that she had a
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conversation and that the patient didn't want anymore
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treatment, right? And now the providers are coming
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in and they're talking about, hey, do you want treatment?
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And the patients kind of reluctantly, like, yeah, I'm no.
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And then kind of wish you. And so there's an advocacy.
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And so you step out and you say, hey, you know, Interstate.
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Just so you know, this is the situation.
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This is the report that I got from the nurse.
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And it's not uncommon for patients to feel uncomfortable
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saying no to their medical providers, right?
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Or like feeling like they're not, they're not fulfilling,
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right? They're duty to their providers
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who are working so hard to care for them and really share.
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And so you it's, it takes a lot of time and trust with patients
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who come from different cultures to have those conversations and
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really get to the bottom of like, what are the patients
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wishes here? You.
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Know it's, it's difficult for some people from some cultures
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also to a contradict, like a person in authority.
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And to them a doctor is a person of authority.
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So yeah, when a provider comes in says you should have this
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treatment, it's very difficult for them to say no because, oh,
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this is the the expert that should know what I need.
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And so maybe I even though I don't want to, I should say yes.
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Absolutely. Or like vice versa.
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And some cultures like being very wary of medicine and not
19:04
getting in to do like your mammogram or Pap smear or
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regular routine treatment because you aren't you don't
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trust right the medical system or you don't see it as
19:15
necessary. Like there have been projects
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going on in my system with Somali speaking patients, for
19:21
instance, where they're trying to get education out there and
19:24
really kind of demystify like the point of doing some of these
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tests to get people a better chance of finding these diseases
19:33
at a stage where they're still treatable or to be willing to
19:37
accept treatment or make an informed decision about
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treatment. So they're just, if there's so
19:41
many layers that go into it and it's not a one-size-fits-all.
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That being said, like I'm really hopeful that as we all have to
19:54
adapt and find our way through this maze of technology and
20:00
what's going to ultimately be kept and what's not is.
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Hope that it really shines a light on the importance of
20:08
communication in general and just how much technology has
20:14
disrupted our society in a way that we have to learn how to
20:19
communicate with each other. Like we're going to have to be
20:22
very intentional. Like I used to ride the bus, you
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know, this is like 15 years ago and you start a conversation
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with somebody next to you or whatever.
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People are kind of talking with one another now it's silent and
20:35
everyone's on their phone, right?
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Everyone's on their phone or everyone's online and people are
20:44
having a harder time just having basic conversations with with
20:49
one another, not even throwing in the cultural, cultural
20:52
component. We're losing collectively a.
20:57
Basically, we really are. And in order to really improve
21:02
health care outcomes, at least in this instance and with the
21:05
populations that I'm talking about, you have to provide them
21:10
the ability to speak you, you have to provide them not only
21:17
like a medium to do that, but you also have to provide it in
21:20
such a way that that there's that extra layer of, OK, but if
21:26
something's not right, or I sense that this patient maybe
21:30
isn't getting it, or this approach isn't working or
21:34
they're uncomfortable, right? Like what There's something else
21:37
going on in this situation and using a different approach or
21:40
just building up that trust. Like sometimes I've seen a
21:43
patient a few times and finally they start to kind of open up
21:48
and share more about what's really going on with them
21:51
because they finally feel safe enough to be able to do that.
21:57
And time? Time is a precious commodity in
21:59
our society, doesn't. It it's this, this advocacy
22:04
aspect that you're talking about, this is something I don't
22:07
see at all in conference interpretation.
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So it's a completely new, it's completely new knowledge.
22:12
For me. And yeah, absolutely.
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And my question is, does is that basic training for all medical
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interpreters to have this advocacy part or is it more
22:27
through your own training that you developed this?
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Really great question and that's something that I continue to
22:33
learn more about. And then I think ASL has done a
22:38
lot more work with. They got more established and I
22:41
would say the 1960s was their code of professional conduct was
22:45
written and it has been revised several times since then.
22:49
So instead of like just having a conduit model, which is kind of
22:52
an input output model, which is where spoken language is right
22:57
now. I feel like the 40 hour training
23:00
that I was talking about at a very basic level really
23:03
discourages interpreters from going outside anything other
23:08
than a linguistic role, right? And using advocacy very little
23:13
because we want to preserve that autonomy, that commutative
23:17
autonomy for our patients. We want to make sure that our
23:19
own biases, you know, that our own beliefs, that our own issues
23:24
right from our personal life aren't interfering with that
23:27
communication or being pushed on that patient.
23:29
So the message that people get is kind of when in doubt, stay
23:33
out. It's a key phrase right from a
23:35
training program that I use, which I think can be helpful to
23:40
a point, but it also isn't empowering in the sense that you
23:46
don't really learn to trust when that cultural capital, right?
23:52
Also being in healthcare, you adhere to medical ethics, right?
23:56
So the the principle of beneficence not just do you no
24:00
harm, but overall act in a way that promotes well-being for
24:05
your patient. OK, This isn't something that
24:08
you see in legal. It's a different.
24:11
It's a different framework. It's surprised by your answer
24:13
because in the beginning I thought you were focusing more
24:17
on the advocacy part in order not to have any blind spots, but
24:21
now you're telling me that your training is telling you to hold.
24:24
Back, but here I am. So which one?
24:27
Is it correct? Is it that fine line between say
24:30
like advocacy and interference or intruding too much into the
24:34
the process? It comes down to ethical
24:39
decision making. It it comes down to being
24:46
skilled at weighing the consequences of any given action
24:53
within an encounter. OK, which is very difficult for
24:57
interpreters to do when they're first starting.
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And to some sense, to some degree, I see why that conduit
25:05
model of just like when in doubt, stay out, like don't add
25:08
anything extra, like you don't have anything valuable to add
25:13
and that could disrupt the autonomy make some sense To
25:18
another degree. What we see coming out through
25:20
the research is that late limited language proficiency in
25:26
English. The country where I work, right
25:28
the US, is a social determinant of health.
25:31
Which means if you don't speak English, just that factor in and
25:36
of itself means that you are much more likely to have poor
25:41
health outcomes. Just like if you don't make
25:44
enough money to be able to have reliable electricity or water in
25:50
your home, or you don't have transportation to be able to get
25:53
from one place to the other, you don't have enough money to buy
25:56
food to eat, etc. Another one of those is just
26:00
limited language proficiency. And as interpreters, what I see
26:08
kind of coming out of all of this is instead of maybe more of
26:11
like a conduit model is one of my classmates actually coined
26:15
this, I don't even know if it's in the literature yet, but
26:18
something that's called a reflective practitioner, meaning
26:23
that you in the appointment are constantly aware of what's going
26:30
on and you are doing your best to make the best decision.
26:37
Let the patient be in control and also, if you feel so
26:42
compelled, point out things that might be limiting their access
26:48
to healthcare to let those two parties resolve it, for
26:51
instance, OK. For instance, let's.
26:54
This is theoretical. Come on, Marisa, give me an
26:57
example. Theoretically speaking, at the
27:01
beginning of my career, I might have very strictly been in an
27:04
appointment where the doctor was going to prescribe a medication
27:07
for a patient. They didn't do that.
27:11
You know, they said they were gonna do that.
27:12
They didn't do that. We were gonna leave the
27:15
appointment and that prescription wasn't gonna get
27:18
sent to the pharmacy. Now, if you're strictly staying
27:23
out of the appointment, you don't say anything about that.
27:25
Like, that's on the doctor. That's on the patient to resolve
27:28
it. But in real life, like this
27:32
patient wasn't going to be seeing that doctor again.
27:34
They came from another country specifically for this care.
27:38
Like they needed to pick up that medicine before they left to go
27:42
home. Now I have no qualms.
27:47
It was the doctor forgot. So the doctor, So then you have
27:50
to wait those consequences. What happened?
27:52
Did the doctor forget? What if I say something, but the
27:55
doctor was going to go to their office and do it right after
27:57
this? That's a risk.
28:00
But what if they forgot? And so I just said in that
28:03
appointment, like, at the beginning of my career, I would
28:06
have worried. I probably would have not said
28:07
anything. Now I'm like, you know what?
28:10
What if they forgot? OK, what is the risk here?
28:13
OK, maybe they were gonna do it after the appointment.
28:16
Fine. Is that really going to change
28:18
anything as far as, like, outcomes are concerned?
28:20
Probably not. It's just a point of learning
28:22
for me. So I said, hey, we're speaking,
28:27
mentioned prescribing such and such a medication and they said
28:31
thank you so much. Thank you so much.
28:35
I forgot to prescribe that. I'm going to do that right now,
28:39
you know, and send it to the pharmacy or you know, this
28:43
conversation that I was telling you about where the patient was
28:49
holding back a little bit, seemed like they were hesitant,
28:52
didn't want treatment. You know, the nurse had shared
28:54
this information with me prior to going in.
28:56
I stepped out into the hall and just told the doctors like,
28:59
listen, this is the report that I got from the nurse.
29:02
This is what I'm sensing from the patient as well, adding on
29:06
that cultural layer of lap patients like from this culture
29:10
have a hard time like saying no to like as you were saying, like
29:14
to authority figures or, you know, disagreeing with doctors
29:17
orders, these sorts of things. And we had a conversation like I
29:21
truly felt like part of the healthcare team, like they
29:24
included me. They were looking to me for
29:26
input about next best steps and I think that's what
29:30
collaborative health care looks like, right?
29:35
Are those couple good examples or should I keep thinking about
29:39
like, no, no, OK. Yeah, that's great.
29:41
I thought. What?
29:42
You know, like what that means, right?
29:45
Like I'm not going to be giving a patient a ride anywhere.
29:47
Like that's not happening. Like I'm not giving them my
29:50
WhatsApp or my private like no thank you, right.
29:53
Like, we keep it professional, but at the same time really do a
29:58
lot. And these are just, I would say,
30:01
pretty innocent examples. You would be shocked.
30:04
And what I hope is that my research really shows what
30:06
healthcare interpreters are out there doing.
30:08
Like we're helping people navigate what is the complexity
30:13
of the US healthcare system from insurance, from getting to point
30:18
A to point B, from understanding what the heck did that doctor
30:21
just say? Like nodding yes yes.
30:23
I don't understand any of it though.
30:24
American healthcare system I'm. Ohe yeah the.
30:28
ER, that you've been fucking. OK, I'll.
30:30
Share that Canada. You just, you walk in with the
30:32
card and then you leave and you don't.
30:34
Have to pay for anything in Canada.
30:36
The biggest thing is, is divided by province, which is the
30:39
equivalent of a state. It's managed by the province.
30:42
You've got a card to go to the hospital, you give the card, you
30:44
meet the doctor and you leave. It's pretty.
30:47
Wow. Yeah, Yeah.
30:48
No, here it's like everybody's got a different type of
30:52
insurance, and that insurance covers a certain percentage.
30:56
Each insurance company makes deals with the hospitals about
30:59
how much they're going to reimburse and how much they're
31:01
not. And it's a mess.
31:05
And patients don't always know. About I don't think even people
31:07
that you with insurance, no, they don't always know about it
31:09
or they don't understand like the medical system in general.
31:13
Like I had a pretty low understanding of medicine, the
31:17
language of medicine. I started doing this job.
31:19
It was something that I had. To learn, do you think that some
31:22
of the hesitation is due to the complexity of the system?
31:25
Some people might not want to go ahead on certain treatments or
31:30
certain things because they might not even sure that they're
31:32
insured. Yeah, they're like, oh, this
31:34
sounds really expensive, Maybe I'm not even going to bother.
31:37
Absolutely. And when you see that, like in
31:39
certain populations, like people I work with, if they don't have
31:44
insurance, they don't go in until they're very seriously
31:48
ill, right? So then you get a lot of people
31:50
going straight to the intensive care unit where if they had had
31:54
access to insurance, they could have had like a primary doctor.
31:57
It's something that could have gotten treated before it reached
32:00
that point. But when you don't have
32:02
insurance, you think, oh, this, this little chest pain and it's
32:06
just. It's this long.
32:07
It's here. Yeah, exactly.
32:09
It's gonna disappear. It's gonna walk away.
32:12
That that colour of discharge coming out of my body, it's
32:16
gonna be a little clear up on its own.
32:20
It's yeah, it's I've seen every colour of the rainbow on this my
32:24
arm. So of course, and plus, I mean,
32:27
there are a lot of layers to it if you, I don't know how much
32:29
you want to get into that here, but people are fearful to be in
32:34
public spaces even if they look a certain way or they have an
32:38
accent. So it's not easy depending on
32:42
the time that you're living in either, just to feel safe going
32:46
into a hospital. Describe what your day looks
32:50
like at a hospital. Yeah, absolutely.
32:52
You start like at is it like a nine to five job or how how does
32:56
it work? So I usually start at about 8:00
32:59
and we do like we have a real time schedule, which means we
33:04
have coordinators who are looking at what are the
33:06
appointments for that day for each language.
33:08
And they'll tell me, OK, you're the next interpreter available,
33:12
here's your appointment. So before that moment, I don't
33:15
really know what I'm getting for that day unless it's something
33:19
special that needs to be scheduled in advance.
33:21
Like for certain child abuse cases and things like that, we
33:26
have special interpreters dedicated to that and like
33:28
appointment times, etcetera. So I'll get an appointment and
33:32
it just really varies. Like sometimes I'm starting out
33:35
my day in labour and delivery and then going to endocrinology
33:39
and talking about a thyroid. And then, you know, after that,
33:42
maybe I'm going out to the hospital and working with an
33:45
inpatient, or maybe I'm watching a cataract surgery because that
33:49
patient only gets conscious sedation, so they still need to
33:52
hear certain instructions. So I get to actually see them
33:55
doing the cataract surgery, which is really cool.
33:59
Or a biopsy. You know, just it, really.
34:02
Depends. If not for you, I left you a.
34:04
Lot and not for me. I would be running away like
34:07
your eye your. Eyes you're.
34:09
Gonna take out your. Eye.
34:11
This is not there anymore, but I should not be going in that
34:15
direction. It's.
34:16
Really funny, I feel like I've become such like a hypochondriac
34:19
and this job also because you see like the worst things that
34:25
happen to people along with the colds, the common colds and
34:30
things like that. So like any little thing that
34:33
happens with myself or anyone in my family, I'm like the doctor
34:38
of the family and I'm like, let me take my exam.
34:41
On this is this is a question that I have mainly for everyone
34:45
working. At hospital.
34:47
How do you not catch everything? Or do you develop a really
34:51
strong immune? System.
34:53
Great question. I have to say I don't think my
34:57
immune systems that's wrong because at least a couple times
35:01
a year I get like a doozy of a cold and I'm like in a mask and
35:05
like I recently lost my voice, right, which is my body saying,
35:09
hey, maybe you need to take a little break from life right
35:13
now. So I also have children, right?
35:17
I think it just depends. You do have to like build up a
35:20
lot of that and then I will say like now everybody's a lot more
35:26
like mask conscious. So even if you do have a cold, I
35:29
think people are doing a great job of just keeping the
35:32
environment healthier for everyone in general.
35:38
But yeah, like I don't, I don't know what the rates on that
35:42
would be. I'd be interested to see.
35:45
Now I'm curious, when say for example, you have patients who
35:49
have to be in the hospital for several days, say like they're
35:52
in palliative care or or what not, do they try to assign the
35:55
same interpreter from beginning to end?
35:57
Or do they have to you just go wherever the work is and they
36:02
get whatever interpreters available at the time?
36:05
Yeah, I would say it was like a real time interpreting system.
36:08
It's hard to do just because of different schedules, but we do
36:13
try to as a team, like let each other know like, hey, this is
36:17
what's going on with this patient just so that you're
36:20
aware when you see them again. So for like home visits, if
36:26
there's a patient, for instance, who's getting visited by like
36:29
Hospice or palliative care, like in their home, they're probably
36:32
trying to keep it to, you know, two or three interpreters if
36:36
they can and send them for continuity of care.
36:40
And in reality, I think we'd always love to have the same
36:43
interpreter, but it's just not like, at least where I'm at,
36:46
like that's not our system. So I'm sure in some hospitals
36:51
where they have interpreters designated, for instance, to
36:54
certain units, right? So they're like, you specialize
36:57
in cardiology, right? So you're going to be on the
37:00
cardiology floor. My guess would be then that
37:03
there's more like continuity in those contexts just because they
37:08
already have that specialized model.
37:10
Yeah, because I assume if you're like in palliative care, like
37:13
say you have Alzheimer's and you get visited by a whole bunch of
37:16
different people, you could get so confused.
37:18
Absolutely. Like who are you?
37:20
You're new. I've never seen you before so.
37:23
Yeah, yeah, but you forgot. Oh my gosh, yeah.
37:29
And we see everything. Oh my gosh.
37:32
Healthcare interpreters, I feel like we have to be some of the
37:34
toughest people, right? Like.
37:37
I think. You really have to be there for
37:39
people at the worst moments of their life, at the best moments
37:43
of their life. You have to keep it together.
37:46
You have to interpret what they're saying.
37:48
It's such an emotional experience and and you carry
37:54
those stories. It's not like you're just the
37:56
palliative care person and you only see them for palliative
37:58
care, right? Some of the patients that I've
38:00
worked with, like I was there when they were bored and now
38:04
they have a driver's license, right?
38:06
And I see their pair. It's the weirdest thing, right?
38:10
And I'm interpreting for. Their.
38:11
Students like their parents, right?
38:13
Yes, they still do like and to feel comfortable, like some of
38:17
them have progressed a lot, but they still are like, I just want
38:20
to be sure, right? Like, but I still know
38:22
everything that's going on. It's pretty cool that they
38:25
remember you. For sure.
38:27
Oh, my gosh, just this week alone, I went to an appointment
38:31
and this one lady, she like, remember my like my last name.
38:35
I was like, seriously. I was like, yeah, because you
38:38
interpreted for like my husband so many times I did.
38:42
I remembered them, you know? And so then I asked, right.
38:45
Like I asked after him. I was like, oh, yeah, how's he
38:48
doing, by the way? You know, like I'm human.
38:52
I care about these people. It's like, oh, yeah, he's doing
38:55
great. You know, like some, some people
38:58
who need like specialized therapy, like they could be in
39:01
the hospital for months at a time, right?
39:04
So you really get to know them or their story.
39:07
They remember you. Like, I think one of the most
39:11
salient examples of that for me was I was working with this
39:17
family of this young girl. It was just like the doctors
39:21
didn't know what was going on at first.
39:23
They couldn't really pin down a diagnosis.
39:26
I don't think they ever really did.
39:28
And unfortunately, you know, the child started to just
39:31
deteriorate and the treatments weren't working.
39:34
And I was working with this family to one of their wishes
39:40
was to get home, right? Was they wanted to go back to,
39:43
you know, I think it was Mexico. I can't remember exactly so that
39:48
their child could be there, right, and, and be buried there.
39:51
And they could see their family because the child was going to
39:54
pass away. And there's a lot of paperwork
39:57
and immigration related things that need to happen.
40:00
And I think they were working with the embassy or something.
40:02
And it was just a heart wrenching situation.
40:06
And I remember that. That little girl passed away.
40:11
Well, I wasn't there like it was after, you know, my shift had
40:15
ended or something and another interpreter went and was there
40:18
for there for that moment. And and they came back the next
40:21
day and they said like Marissa, like, you know, so and so's mom
40:26
just wanted me to tell you thank you like so much for everything
40:31
that you did for them. And I was like what like this
40:37
ladies kid just died And like she's thinking about like saying
40:41
like sending this message to me through my colleague, like, wow,
40:47
you know, like that speaks volumes.
40:51
I don't think I would be thinking about anything, you
40:53
know, if my child just died, let alone have the presence of mind
40:56
to say like, please pass this message along to your colleague
41:00
for me. You know, so it's, it really
41:04
does like touch peoples lives in a profound way that we don't
41:08
even realize or I think get to hear about.
41:12
But um, like, I remember I was sitting at lunch one day too,
41:16
and a patients like family came came up because they also worked
41:21
in the hospital and I haven't seen them in a long time.
41:25
And anyway, it was like a chronic disease.
41:27
And through the course of this exchange, I realized that that
41:31
family member had passed away and I was like shocked.
41:35
And I was like, Oh my gosh, like I didn't know that that
41:38
happened. And so I'm having these feelings
41:39
of grief. And also they're like telling me
41:42
like, you know, we just be like, how much care and how much, you
41:48
know, dedication you put into your work or whatever.
41:51
And thank you so much for the way that you served my relative
41:57
while they were sick. And I was just such an emotional
42:01
experience finding out not only that somebody had like, passed
42:04
away, you know, that I had grown to care about as a patient, but
42:08
also like, here was this person who stopped by to just say thank
42:11
you to me for, you know, doing my job and being there for them.
42:17
It's such a rewarding, rewarding profession.
42:21
I, I love it so much. I don't see myself ever like at
42:25
any point completely stopping, no matter what that life has in.
42:30
Store for. Me.
42:31
But when you see people going through these kinds of
42:35
suffering, when we get home after such assignments, we need
42:40
to wind down. What do you do?
42:44
Well. I I drink wine, play video games
42:47
and watch porn. And you watch what, wrestling?
42:54
Wow. Excellent wrestling, nothing
42:56
like a cage match to forget everything.
43:00
Yeah, the numbing techniques can be helpful.
43:03
Alcohol plus, you know, like a Netflix or whatever.
43:09
It's interesting because one of my areas of interest is also
43:13
just learning more about vicarious trauma and how we as
43:17
interpreters are affected deeply by the work that we do.
43:20
Like vicarious trauma, our secondary trauma is experiencing
43:24
trauma as if it were actually happening to you, even though
43:27
it's happening to someone else. Which is even more likely for
43:31
interpreters because we have these things called mirror
43:34
neurons in our brain, which allow us to feel empathy for one
43:38
another. OK?
43:39
They're called mirror neurons. So like, you see somebody going
43:43
through something, right? And that allows you to empathize
43:46
with them. Like you can imagine, like
43:48
feeling it, like going through it.
43:49
Yourself. Your teenage boys don't.
43:51
I'm sure teenage boys don't have this.
43:53
I've checked my 12 year olds see what his feelings are for.
44:00
They're crying about something and see if she can hear.
44:03
I feel like my kids are so empathetic but we'll see if that
44:06
changes. But yes. 17 I don't see much of
44:10
that. OK.
44:13
Give it a couple of years. But I think you're kind of like,
44:17
you're born with it almost, because I think like some like
44:19
babies too, like they could feel.
44:21
You like you're taking the hope away.
44:22
They. They're taking the hope, no?
44:24
No, I think they can feel what you feel is as like when you're
44:27
a parent and like they they do empathize with you.
44:29
So I think it's something that's ingrained in us.
44:31
But yeah, I think also being having to use the eye, like
44:35
having to be in the. Place of the person.
44:38
You know this, I'm feeling this. Yeah, do you know what I've
44:43
learned lately? OK, I'll start of the things
44:45
that I've learned over the years because I feel like the things
44:48
that I did earlier on were maybe not so helpful for vicarious
44:51
trauma. But actually got this tip from a
44:54
colleague who attended a workshop about like carriers
44:57
training, which was now when I get those appointments that I
45:00
say like stick, right, that I feel like like I'm feeling this
45:05
really intensely as if like it were happening to me.
45:08
I go to a bathroom and I just shake.
45:11
I shake my whole body like I move my body around, like flap
45:16
my arms right and jump up and down and like do a little dance
45:19
because it helps to disconnect like physically like reset from
45:25
that situation. It's amazing like how helpful
45:29
that has been. So just right away in that
45:31
moment, I try to do that. And then unfortunately, Alan,
45:35
what the trauma specialists say is we actually have to
45:40
acknowledge our feelings about what's going on instead of just
45:44
numbing and trying to hide them and stuff them down like they
45:48
don't exist. And find a good mentor or friend
45:51
like Brian to talk to you and say like, hey, I had a hard day.
45:54
Who's actually going to validate you, right?
45:58
Like and support you through that time and just, you know,
46:00
listen so. Yeah, yeah, we've.
46:04
We all men, we have no feelings, you know.
46:07
OK. I see marriage counseling.
46:08
I was, I was, I was about to say that before the wine drinking
46:14
and pro wrestling, we've called each other a few times, like
46:18
after a conference. I've been like, just like, oh,
46:21
like what just happened so. Exactly what did I just say?
46:24
Yeah, like, I mean, yeah, because we do like a lot of
46:28
different branches that are like criminal law and, you know,
46:32
sexual assault cases and stuff like that.
46:34
And, and, and yeah, we, we have to live those things.
46:37
Too. You can shake it off together,
46:39
right? Like.
46:40
Just yeah. Now you're gonna just pick it
46:43
up. But we're gonna be Swifties, and
46:45
they're taking it. Out you're like.
46:49
I'm going to start South Pole dancing.
46:50
There you go. Perfect, perfect.
46:54
But. Yeah.
46:54
Now we can. We can end this part.
46:56
Yeah. So they were talking about your
46:58
company? Oh my gosh, yes.
47:00
Yeah, that's finish up with that.
47:02
Cause yeah, no, Yeah. Well, here's what I'll say about
47:05
that is, you know, there are times in life when we don't see
47:08
things in ourselves that other people see in us.
47:11
I kind of have this aha moment with a coworker who was
47:14
shadowing me just regular day doing my appointment.
47:17
I think it was Pete's appointment.
47:18
We come out of that room and he's like.
47:20
Wow, he's. That was, I've never seen
47:23
anybody interpret like that before.
47:25
I'm like, wow, like this is like a piece appointment we're
47:29
talking about like diaper rash, like what is happening right
47:31
now. It was just the way that I
47:33
worked, right? Like it was the way that the
47:36
session flowed, how fluid it was.
47:39
You know how natural, like when you get really good at
47:42
interpreting dialogue, interpreting you, you really
47:47
show the speech patterns and the emotion behind the speakers and
47:51
really let them connect in that way, which is instrumental to
47:56
the communication in general. And so he's like, yeah, he's
48:00
like, do you have, did you like write a book or do you have a
48:03
podcast or something? I'm like, dude, like, no, I
48:07
don't. I just come here and I do my
48:09
job. Interpreters are too busy to.
48:11
Have like a. Family.
48:13
Exactly. So anyway, um, it was kind of
48:20
like this aha moment and I already really enjoyed like just
48:24
teaching. And I said, you know what, I
48:29
wow, I want to do something. I want to try something and like
48:33
let myself be a creative and kind of create something on my
48:37
own. And so I created an interpreter
48:40
training company which also provide translations because I'm
48:43
like, I don't know where this is going.
48:45
Like I do some translations here and there, but I'm mainly now
48:49
focused on like the interpreter training portion of it and
48:53
specializing in continuing education because when I was
48:57
learning, I, I didn't have this education available to me.
49:02
It was kind of like, what do they call that?
49:07
Like testing you by fire? There's a saying about that,
49:11
right? Like.
49:11
They just. Yeah, that doesn't buy fire,
49:14
right. Like they throw in, they give
49:16
you a little training and then they're like, and this is the
49:18
job. And then you're like on your
49:20
own. Exactly.
49:21
This is the pool. Skin in there and it's hard, OK?
49:28
Like it's such a difficult job to have somebody just throw you
49:32
in there and try to survive and you've got it.
49:35
That's why I say like we are some of the toughest people
49:38
because you've got to have grit and determination and just like
49:44
backbone to stand up to all of the pressure that's put on you
49:48
and expectations about how you're supposed to drop do to do
49:51
your job and then actually be able to do your job in the way
49:54
that it's supposed to be done and provide that service.
49:57
Anyway, Long story short, like I, I got out of my hospital
50:02
system in the sense that I started investing in myself.
50:05
I started traveling to conferences, I started speaking.
50:08
I love speaking in public, you know, Hence somehow I got here
50:12
connected with you. All right, Telling stories, just
50:16
speaking to people in a way that whoever is listening to this,
50:20
like I'm not speaking to 1000 people, like I'm speaking to
50:22
you, right? Like, I'm hoping that something
50:25
of all of this information I've spoken to you and that it
50:28
encourages you to take action on something in your life in some
50:31
way. And so I started getting these
50:34
jobs from different organizations being like, hey,
50:36
can you come and train our interpreters?
50:38
Like I really love your approach to like OBGYN upset tricks and
50:43
gynecology education and how you like weave in real patient
50:47
stories and give examples and provide us glossaries.
50:50
So this last year I was like, OK, I've done a lot of creation
50:54
for other people. I'm gonna do my own stuff now.
50:56
Like I'm really gonna do it and I'm not gonna sleep or eat.
51:00
I don't know how I made it through this last year you all,
51:02
but like I created 12 new courses plus top for a lot of
51:07
other organizations that are continuing Ed related.
51:12
So about different specialty areas I'm really proud of and
51:16
that I'm really excited to see where it goes in the future
51:19
because we're passionate about what we do, right?
51:22
Like you find that niche and you just speak to those people.
51:26
And I'm really, I'm really excited about building this
51:30
community and just learning together.
51:32
So take in timber training and translations.
51:35
Check it out if you want some continuing at people.
51:39
Both ask how does that just? Wouldn't do this?
51:42
Well, a friend of mine told me my website was too long so I had
51:45
to change it. So now I made it simple.
51:47
It's Tika. tnt.com. That's it.
51:51
Ticket TNT. Boom, that's it.
51:53
Like just. Thinking so TICATT dot.
51:56
TICA and then tnt.com. TNT.
52:00
Alright, yeah, like dot. Com.
52:03
Like the ACDC? ACDC song correct.
52:07
So training and translation. So yeah no this is been a great
52:11
conversation you all. So anything else you want to
52:13
know about like healthcare interpreting or?
52:18
So much, a lot, but where we will have to invite you again in
52:24
the near future to continue all of these.
52:26
Wonderful stories, and we'll have to put Tick a TNT on our
52:29
description too so that people know how to access.
52:32
It real quick. And.
52:34
I'll make sure. That I bring stories.
52:36
That don't involve any blood. Well, just make sure see who's
52:41
attending, the fans not attending then you can put all
52:44
the. OK, when I do training now, I'm
52:46
like, let's do something with blood simulation.
52:49
We want blood everywhere. So excited anyway.
52:52
Blood is only OK and occasionally.
52:55
Hopefully you choose the pro math pro wrestling too I've
52:58
seen. That coming together.
53:01
Alright everyone, thank you again, Marissa, and thank you
53:06
Brian. Everyone don't forget, like,
53:10
share, subscribe and go to tikatnt.com and to get all of
53:17
these wonderful workshops to train and give and get better in
53:21
your career. All right, Brian, I'll leave
53:24
your last word. Thank you so much, Maria said.
53:26
It's been so great to have you on our podcast here.
53:29
You've reminded us of how what a noble profession we it is to be
53:33
a medical interpreter and your source of inspiration.
53:36
So thank you so much for coming on today.
53:39
And maybe this will be the beginning of, of, of many more
53:43
medical interpreters on our podcast because this has been
53:47
fascinating for, for, for me at least.
53:52
Yes, awesome. I hope you do.
53:54
We have lots of stories. That's our jam.
53:56
Absolutely. Yeah.
53:58
All right. Well, thanks so much for having.
54:00
Me appreciate it. Alright, take care.