Saturday, October 16, 2010

My Night as Medical Interpreter - 2

Continued from October 11. Please read this series in the correct order.

I’m not a Medical or Health Care Interpreter, neither Professional nor Expert nor even Native. I'd never done it. I’d heard about it, read about it and watched videos about it; but translating is a practical skill, and learning about it isn’t enough. You have to do it.

Nevertheless, in mid-September, just when symptoms of my incipient flu were becoming manifest, I received an anguished call for help from an elderly English lady who lives with her husband in Cullera. Cullera is a pleasant resort town with a fine beach about 25 km south of where I live near Valencia (see photo). I knew the couple because they previously lived in the same village as me. Let’s call the lady B. and her husband G.

B., like all too many English residents in Spain, though she’s lived here for several years, hasn’t learnt to speak or read a word of Spanish. The Spanish National Health Service has trouble dealing with them. On the other hand, G. does speak some Spanish. He was born in England, but his father was Spanish, a refugee from the Civil War, and when he was a child his father used to send him to spend a few weeks each summer with the family in Spain. So he was an early bilingual and could at times give the impression that he spoke Spanish well. But in reality his Spanish was very limited and uneducated.

Ever since I’d known him, G. had been losing his mind. His English was correct, but his discourse was rambling, highly repetitive and full of fantasies. He continually rehashed memories of Africa and talked about his three houses when he didn't even own one. Now he was getting worse. At moments he was violent. He had knocked B down. and she had broken her hip. She had been operated on successfully at the nearest regional hospital, but they had sent her home with a report and a list of prescriptions that neither of them could read. She couldn’t walk more than a few steps, so she couldn’t go to the doctor’s.

My wife and I drove down to Cullera. Our priority was to get proper medical attention for B. The Spanish National Health Service is well organised and free, but sometimes it's slow and it has its bureaucratic side. To be assigned a doctor, you must be registered at the town hall as a resident of the place where you live (the procedure called empadronamiento). B. and G. were not. We spent the day getting that sorted out, and from the second day onwards B. was well taken care of, and the local Health Centre put her into a rehab programme where the physiotherapist speaks enough English.

The problem of G. was not so easily dealt with.

Not only was he degenerating, but he had lost (or quite likely hidden) his medical identity card (the Tarjeta Sanitaria or SIP). Again the bureaucracy. To obtain service from the National Health, you must present your SIP, and without it you’re in limbo. In the course of negotiating a temporary SIP for G., I had to phone the National Health Service in England for some information. (British residents in Spain are covered for health services as European Union citizens.) The conversation went like this:
Me: “I need some information about G., who’s mentally ill, so he can’t come to the phone himself.”
Them: “Who are you? Are you a close relative?”
Me: “No, I’m a friend trying to help out.”
Them: “Sorry, I'm not allowed to give you any information. Doesn’t he have a relative there?”
Me: “There’s his wife, but she’s been injured and can’t walk to the phone.”
Them: “Sorry, I can’t give you any information. Protection of Personal Data.”
By that time, G. was sprawled on the bedroom floor and refused to budge from there. I called for an ambulance. When the two ambulance men arrived, their first question to me was the first one that every medical assistant asked me from then on: “Has he been drinking?” I assured them that he hadn’t been and that his trouble was mental. At that point G. sat up and talked to the ambulance men in Spanish. They asked him, “How do you feel? Have you got any pain? Do you want us to take you to the Medical Centre?” He replied that he felt fine, had no pains and didn’t want anything to do with the Medical Centre. The ambulance men said they sympathised with me, but G. was conscious and coherent, and in view of his answers they had no right to force him to go. So they left him there.

I now concentrated on getting G. the temporary SIP, and by the end of the day, even without the information from England, he had it.

The following morning, G. was still on the bedroom floor. Armed with his SIP, I went to the emergency section of the Medical Centre. There I happened upon a very helpful doctor who ordered the ambulance to be sent again and G. to be brought in. This was accomplished. I explained what was wrong with G., but it was really the fact that G. had trouble lifting one arm that convinced him to send G. to hospital for tests and observation. The regional hospital is about 15 km from Cullera, so that meant another ambulance journey.

At that point I had to decide what to do myself. I realised that nobody would understand what was really wrong with G. unless they spoke English well enough to diagnose him from his discourse. There is in fact a voluntary interpreter service for medical care along that coast, the Costa Blanca, run by British residents themselves. But it’s based at Denia, a fair distance further south, and there’d be a long delay obtaining somebody from it. In spite of my worsening flu, I went with G. in the ambulance.

To be continued.


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