Four skills of a medical interpreter that will help you be a better writer

I’ve been moonlighting occasionally as a medical interpreter, while running my own business, writing my memoir, and blogging.

When I studied the Code of Ethics for healthcare interpreters, I was struck by how many of the skills and qualities required in this profession are essential for a writer. It gave me food for thought, and I think it will also help you reflect on your craft.

Here are the skills, as well as some suggestions on how you can repurpose them for writing. I will also comment on two qualities medical interpreters need which can help a writer survive.

1. Active listening

According to extensive research done at the University of Minnesota, 

...immediately after the average person has listened to someone talk, he remembers only about half of what he has heard — no matter how carefully he thought he was listening.

As time passes, the average listener remembers only about 25% of what he heard.

I can attest this is true. As I was practicing at home and taping myself, I realized that whenever a sentence was longer than 12 or so seconds, I would forget something when I interpreted, even though I did it immediately after: an expression, one of the five symptoms the doctor mentioned, the name of a medicine. Sometimes I would change a preposition or a conjunction for another. These omissions and changes may not be very important in another situation, but in a medical setting, accuracy is critical.

I had to quickly improve my retention through active listening, and that’s when I realized it’s a very useful skill for any serious writer.

How active listening applies to a writer:

You think you will remember that great idea that popped up in your mind while driving, or woke you up in the middle of the night. But, most of the time, you won’t. How about that juicy dialogue you overheard in the dog park while watching Fido sniffing butts? Nope. You may remember a shred or two, but definitely not all.

There’s nothing more frustrating than sitting down with a scene and realizing that you have forgotten the details that mesmerized you and that would make it come alive.

You could jot those gold nuggets down in a notebook or in your phone, but sometimes this isn’t practical. You can’t write while you drive, while you are talking to the cashier at the grocery store and there are five people behind you, or while being lectured by your boss at work.

What you can do is sharpen your active listening skills, so most of the vibrant details and dialogue that will make your writing pop stay safely tucked in your brain until you can put them to good use in your writing.

Try these tips that medical interpreters learn to improve retention:

• Concentrate fully on what the speaker says, with no distractions of any kind (it’s more difficult than it sounds!)
• Identify the main idea, the meaning of the message, so you can paraphrase it later.
• Visualize what she’s saying. An image will jumpstart your memory.
• Learn effective note-taking, which often means writing only one or two words per sentence that capture the main idea, or precise data that you’re bound to forget, such as quantities, dates or names. If you can’t take notes at all, practice remembering only these crucial words or data to bring the rest to mind.
• Practice, practice, practice. Not just with conversations, but with everything. The breeze whispering in the willow trees. The twilight reflecting on the metal railing of the bridge. The crumpling face of a kid who’s being yelled at. As you see it, write about it in your mind, and then practice remembering what you wrote using the techniques above.
• Walk and repeat. Theatre actors swear by this technique to learn their lines by heart. Don’t just repeat it in your mind. Walk while repeating it in your mind a few times.

Talk about mindfulness! A writer has to be mindful. Being fully focused on the present moment so you’re able to recall it in all its richness will make your writing much more vibrant.

2. Respect the register

A good medical interpreter respects the register of the speaker. For example, if the doctor speaks jargon and you know that the patient will not understand it, you are not supposed to use simpler language in your interpretation. You interpret in jargon and let the patient say “I don’t understand.” Then you interpret the doctor’s more down-to-earth explanation.

Conversely, if the patient uses slang, you try to find equivalent slang in English. For example, if she says “?Sin chamba, no hay feria!” you interpret “No work, no dough” instead of “When I don’t work, I don’t make any money.”

Also, if a doctor speaks rudely or a patient swears or speaks angrily, you interpret it in the exact same register, so you speak rudely as the doctor or you swear like the patient in the target language. You don’t take decisions for them or change their oral style. You are just a conduit for their meaning and words.

How it applies to a writer:

This technique is especially useful for creative fiction and non-fiction writers, who have several characters in a piece.

• When you start to develop a character, spend a good amount of time thinking about his or her register. And if you have already written the piece, re-examine it thinking specifically about the characters’s register.
• Be ruthless. Do most of the characters speak like you or do they really speak like themselves? Is there certain vocabulary, tone or style that could identify them as surely as their facial features, clothes or situation? Perhaps one has a verbal tic, and the other tends to speak in monosyllables.
• Study authors who write great dialogue and the tricks they use to differentiate characters through their speech alone.
• Read your dialogue aloud to see if it sounds natural for each character.
• Economize. There’s no need to reproduce speech as it really happens in life, because we are not efficient speakers most of the time. You will need to edit and polish, to make sure that a character speaks in a distinct way that reflects who he or she is, without boring your reader to tears.

Keep in mind that a writer is a conduit for her characters, and needs to let them speak their own truth in their own register.

3. Impartiality and respect

An interpreter does not judge the participants in the medical encounter. He accepts their right to make their own decisions. He does not take sides. He treats every person with equal respect.

How it applies to a writer:

As a writer, you owe respect not only to the characters in your story, but also to your reader. Here are some things that came to mind when I thought about this:

• Pay respect to your characters. Go deep when you think about them. A character on the page should be the tip of the iceberg. You, as an author, should know a lot more about him than you tell the reader. How do they look? Where do they live? How did they grow up? What do they believe in? What is their favorite food? You may not fully explain all these traits in your story, but they will transpire in a peculiar adjective, in the turn of a phrase or in a small detail that helps bring your character to life.
• If a character only shows up in a circumstantial way, for example, she’s the guide in a visit to a museum, don’t give her a name. If you name a character, she should have some room and weight in the story (I have to thank Joyce Maynard for this tip.)
• Don’t over explain or interpret the meaning of the story. Respect the intelligence of your reader and her passion for reaching her own conclusions.
• Cut to the chase. Don’t weigh down your narrative with superfluous words.
• Don’t distract your reader with unnecessary side stories. They may be fascinating, but if they don’t relate to the main plot, they can make your story confusing. This is especially important if you are writing a short personal essay or short story. You can pay respect to these side plots by giving them their own space in a new piece.

I don’t mean that digressions are bad per se. A favorite book of mine is The Life and Opinions of Tristram Shandy, by Laurence Sterne, which is primarily based on the protagonist’s digressions. But they make sense in the context of that novel.

Ultimately, you need to respect your story, and let her tell you what it needs.

4. Professional Development

A medical interpreter has to keep learning. In fact, you have to prove that you have pursued continued education in order to renew your certification. There’s new medical terminology, treatments and medicines that you should know about. Languages keep evolving.

You are expected to take courses and to join professional associations so you can continue growing your competency.

How it applies to a writer:

It’s quite self-explanatory.  As a writer, there’s always more to learn.

Stephen King said it well:

If you want to be a writer, you must do two things above all others: read a lot and write a lot.

Here are some specific tips to keep growing as a writer:

• Read your genre like a writer. Pay special attention to whatever is more challenging for you. It can be dialogue, narrative arc, an irresistible beginning, a perfect ending, musing in memoir… Read and reflect on techniques that other writers have used and you can apply as well. It may be a good idea to keep a reading journal where you capture what impacted you or what you learned.
• Read the theory of writing your genre. Since I started writing memoir, I have read many books about it. Two that were useful to me are Judith Barrington’s Writing the Memoir — From Truth to Art, and Mary Karr’s The Art of Memoir.
• Take a class: There are many online classes that can keep you motivated. I took several Stanford online courses about memoir writing.
• Choose a writing pal, writing group or any other form of getting feedback about your pieces. No, you never write a perfect piece. It can always be improved, mostly by cutting.
• Write, write and write more. None of the above can substitute the actual practice of the art.

Two qualities that will help a writer survive

Interpreting in a healthcare environment involves a lot of waiting around. Sometimes you wait (with the patient) almost an hour, and then the visit is over in ten minutes. You need a lot of patience.

Then, as you interpret, you need an enormous dose of humility. The medical encounter is not about you. In fact, you should be as invisible as possible, because your only role is to facilitate the communication between doctor and patient.

Any writer needs both these qualities in spades.

You need to be patient because you’ll spend hours, days or years working on a piece. You need to be humble because you may be doing this herculean effort without any recognition whatsoever for a very long time. Let alone recognition, sometimes you cannot even get published!

We writers put up with all of this because we can’t do otherwise. We hope that, as interpreters of life, we will sometimes achieve the difficult task of helping a reader understand it —or himself— just a little bit better.

(This article was previously published in The Writing Cooperative, in Medium)