When Medical Interpreters Must Share Bad News

1.When the Interpreter must give Bad News!

I was interpreting for a patient at a doctor’s appointment. The doctor entered the room and in a very clear, straight forward way, told the patient that he had tried everything he reasonably knows and there is nothing more he can do for the patient. The patient would be sent for a functional capacity test and his impairment rating would be calculated.

The news was devastating for the patient. He shook his head and gasped. His daughter began to cry. She begged the doctor saying “Is that it? I see how much pain he has to live with every day! You can’t do anything else? You’re a doctor! You’re supposed to help people!”

The doctor simply repeated what he said and pointed out that he did not need surgery. The family was in shock, devastated.

My job as an interpreter is to communicate what is being said in an unbiased manner. My training and knowledge of the importance to maintain neutrality helped me to do my job. That didn’t make it any easier. Most of the time I love my work, but that was not one of those moments. I am a human being, not a robot, and so I could not escape feeling compassion for this grieving family.

It is not my place, nor am I qualified, to question the medical professional’s decision or bedside manner. I am aware that my service helps all parties involved to make decisions based on knowledge, and I cannot interfere with that process. I do wish at times though that I could turn off my emotions like Data (the android) in Star Trek

As I mentioned, at times I have had to interpret bad news to patients.

2.When the doctor has to give bad news.

I have had many conversations with different doctors, some of whom have been accused of being in the insurance company’s pocket. After long conversations, my feeling is that these doctors are doing what they judge to be right. Some might say that they are not trying every possible solution. The defense is that they are being realistic. I have heard complaints of doctors being cold, harsh and rude. The doctors feel that they are honest and do not gloss over bad news. They are trying to help the patient see the truth.

People are driven to become doctors in order to help others. Just like the country is politically fractured into two opposing philosophies, conservative and liberal, democrat and republican, doctors also have different views on how to best treat a patient. They will always have critics. I’m sure no doctor enjoys giving the patient bad news. As an interpreter, my job is to facilitate vital communication. It is not my place to voice my opinion about how a doctor practices medicine. When the patient is given bad news, I feel bad for the doctor also, the one having to give the bad news.

3.The Nurse case Manager and Bad News

Just like doctors, nurses have a code of ethics. They are advocates for the patient. Their goal is to help the patient recover. Case managers work for the insurance company. They are somewhat like mediators for the insurance company. They coordinate all the services the patient will need, a vital service for recovery. They help the insurance company make decisions as to whether or not a course of treatment is appropriate. They can only make recommendations. Although they must face it on a regular basis, nurse case managers do not enjoy seeing the patient get bad news.
Imagine if this system of workers’ comp was not in place. Without insurance there is no money. Without money, treatment from a doctor cannot be sought. There would be no nurses or case managers and no interpreters. In some countries, when a person is injured, there is no help whatsoever or any type of compensation. The workers comp system might be perceived as unjust but at least something is in place to help the injured worker.

It can be quite easy to judge medical professionals and attribute bad motives; the challenge is to stay impartial. We all have a vital role to play.