The power of

A year ago, my life changed. I had been diagnosed with cancer. Even after reading other people’s testimonials about their lives becoming a whirlwind after their diagnosis, I couldn’t process the meaning behind these words until I started my fight. The whirlwind that I went through wasn’t just emotional, physical or psychological, it was also temporal. For the first few months after finding out, I had to go to three, four or five appointments per week. This included confirming the initial diagnosis, additional diagnoses, test after test, lab after lab. I also had to fight for access, for quality interpreting.

After a while, order emerges from chaos: you’ve gone through different treatments to figure out what works for you and what doesn’t. The same goes for reliable interpreting services.

Thankfully, I am in recovery right now. If I hadn’t found an interpreting solution that worked for me, I am not sure where I would be right now.

Every deaf person knows all too well the frustration of having to fight impassive medical companies for quality interpreting, never mind the frustration and helplessness when onsite interpreters do not show up and you’re left needing to reschedule or try your hardest, when you’re feeling your worst, to understand your doctor.

I had 40 appointments that were serviced by onsite interpreters. Only once did the hospital hire an agency that sent out an interpreter that made me feel like they were my ally, that I could understand, that would express my concern and share with me answers to my questions.

My other, countless appointments were facilitated by Video Relay Interpreting (VRI). If you haven’t had to use VRI before, let me describe it: VRI is provided by a tablet affixed to an IV stand and is wheeled into the exam room or to the bedside without ceremony or dignity. Once the device has arrived, the nurse needs to connect to the VRI, check the video and audio and position it so the interpreter can see you.

As an agency owner, I get it. Finding onsite interpreters isn’t easy, or cheap, anymore. If an interpreter cancels at the last minute, then the client doesn’t have an interpreter during their appointment. VRI is used instead of onsite interpreting as a solution for hospitals that are looking to cut costs, and that’s worse than a no-show interpreter.

As I look back at my journey with medical interpreting, two memories stand out to me.

• I had to go to the emergency room. The hospital couldn’t provide onsite interpreting so we had to use VRI. I was watching the nurse talk for 30 seconds, then I looked at the interpreter on the screen. The interpreter was listening, nodding attentively and all he signed to me was “please sign this form.” This lack of access left me frustrated and bothers me to this day.
• I was getting a surgical procedure. Again, there was no onsite interpreting available. I was in pain this time. They brought in the VRI, remember it’s a tablet on an IV stand that doesn’t always angle well. The VRI was motioning at me to push myself up on the hospital bed so they could see me. I had to push through my pain to sit up, to sign with my interpreter. This wouldn’t be the case if I had an interpreter at my bedside.

Two important points for hospitals and agencies to keep in mind…

• Quality of interpreting?
• When to use onsite interpreting vs when to use VRI

Quality of interpreting

When I use medical VRI, I recognize it’s a quick and efficient way to get an interpreter, especially when there are more interpreters working from home. I also notice that there are glaring differences in quality. Hospitals, as I’ve mentioned, are under pressure to cut costs so they often cheap out on the quality of interpreting and rely on VRI to stanch expenses, especially for telehealth appointments.?

This harms?the patient since their access to important medical information is compromised. It’s one thing for an interpreter to edit 30 seconds of dialogue into “please sign this form,” it’s another for a telehealth appointment to drag out twice as long as it should be because the interpreter isn’t able to understand me or accurately interpret what’s being said.

When to use onsite interpreting and when to use VRI

Emergency room visits should never be accommodated by VRI. A patient may be in so much pain that they are unable to sit up in the hospital bed if the VRI needs to see them. In general, emergency room visits should be facilitated by onsite interpreters.

On the other hand, when I show up for pediatric checkups for my daughter, we’ll get an onsite interpreter.

This tells me that the hospital and agency are not working efficiently with their interpreter allocation. They are not working together to review the appointments being made or making recommendations. If the hospital and agency can make their allocations efficiently, then there will be enough resources for everyone who needs it.

How do we get the deaf community to like medical VRI?

This is a question that Deaf people who have received medical VRI will ask. We have experienced the horrors of bad VRI firsthand.

That’s why I want to share my experiences from my cancer journey.

I made the decision to treat my cancer at Stanford University and I am incredibly grateful to them, not only for helping treat my cancer, but also being willing to try something with me.

When I started my treatment with Stanford, they told me the same thing everyone else had told me, that onsite interpreters were not as plentiful as before the pandemic. I asked if they would be willing to let me work with my preferred interpreters via VRI, and they agreed.

Over the course of my cancer fight, I worked with two of my preferred interpreters for consistency. That was an amazing experience. My appointments and meetings went so smoothly after I made this decision. My doctor even remarked to me at how fast our sessions are going while using medical VRI. I am still using medical VRI today.

If you can make arrangements with the hospital or agency to use VRI with your preferred interpreters in a clinical setting, for checkups and other regular visits, then the experience will be better. This will also free up onsite interpreting for emergent situations, like ER visits.

How can Deaf-owned interpreting agencies help everyone?

Great question. Let me share the how and why:

• Deaf-owned interpreting agencies are more passionate and emotionally invested in your experience. They will work with your hospital to differentiate between the type of visits, emergency, surgical or routine checkup.
• Deaf-owned agencies will evaluate their interpreters, deciding which interpreters are suitable to go to onsite appointments and who needs more experience and place them accordingly.
• Deaf-owned agencies are familiar with the regional accents of the communities they support and can match interpreters. This leads to less misunderstanding onsite and over VRI.

Focusing on the quality of interpreting and evaluating the types of appointment that need onsite or VRI interpreting will lead to shorter appointments, better experiences and improved outcomes for the Deaf community and for hospitals.

I have to thank Stanford University for working with me to develop an ideal solution that met my accessibility needs. I hope that my experience can be applied to the Deaf community. I hope hospitals and interpreting agencies will work with their clients to provide their preferred interpreters for onsite and VRI jobs. I hope they will implement these solutions, I plan to deploy this solution at my agency for our clients’ benefit.