Being an interpreter: "I’m with people in their most vulnerable moments"
Deborah is a British Sign Language (BSL) Interpreter who supported Alex Smith’s (AIMS) talk ‘Signs that you want to help: deafness and birth trauma’ at our Annual Birth Trauma Summit this year. Deborah writes about how she became a BSL interpreter and shares what it means to play such an intimate part in both joyful and devastating moments.
My extensive experience as a BSL Interpreter began with the need for me to provide access for my family members who are Deaf, and numerous friends. The requirement for me interpreting for family members and close friends sprang from no interpreter being present for their appointments. This was not ideal at the time, of course. Understandably, when they were unwell they did not want the GP to write things down for them as English was difficult for them. Nor did they appreciate being asked “Can you lipread me”? They just wanted to feel better and get their diagnosis in BSL.
I now work in all domains including education, medical facilitation, religious settings, conferences, social services, theatre performance arts, festivals and concerts. My husband and I also voluntarily run a non-profit charity (Crown Boys Mentoring Academy). Our project focuses on a Deaf School in Jamaica. We partner with a Domestic Violence Mother & Baby Unit, providing support and guidance to the residents.
“Medical interpreting is not for everyone: you can be faced with complex situations”
Complex situations
Medical interpreting is not for everyone: you can be faced with complex situations requiring you to have to know or learn technical terms and medical jargon and modify the language into BSL (modifying the language so that the Deaf person can understand what the consultant is saying). Working in medical settings presents many challenges so it’s good to undertake various training as that helps me when difficult dilemmas come up.
I have embraced the challenge of interpreting in a variety of medical settings, e.g. hospital visits, medical conferences, doctor/patient consultations, births, bereavement, medical procedures, diagnostic tests, and surgery. I can go in with patients into the theatre room before the anaesthetist puts the Deaf patient to sleep. PPE must be worn. It’s great being able to provide this, as it can be very overwhelming and scary not having any one with you. After the procedure, I go into the recovery room as communication is needed for the nursing staff (for explaining pain relief and observation checks questions).
Toolkit
I have been a birthing partner for family members. When I was 16 years old I wanted to become a midwife but I change my mind. Being an interpreter and working in the medical field, I gained lots of experience – also through birthing workshops and parenting classes. Plus my sister-in-law is a midwife and health visitor for the London borough of Lewisham. Any jargon I wasn’t sure about she provided: I created a glossary (A-Z in birthing/C-section and after care). This is my toolkit and it’s so helpful. Knowing what they are saying and explaining to the patient what a procedure involves helps to make the translation smooth, e.g. the midwife will say: “We will need to do a ‘cervical check’ to see how many centimetres you are dilated”, it helps I can explain she will place one/two fingers inside cervix to measure.
“Providing information is as important as having empathy in my role”
Rewarding
What does my day look like? If I’m going to be working with pregnant mums they have a birth plan/a birthing rota. Sometimes I get booked for a 2 hour labour appointment. Of course labour can go on for days. If I don’t have another booking, I’ll stay. I will inform the agency that I’m at a labour booking so that they can organise another interpreter to relieve me if someone is available or if I have worked over my contracted hours.
Being a part of a birthing story is absolutely wonderful. Seeing the excitement of Deaf people becoming new parents, having their first scran, feeling the vibration of the babies heartbeat through the handheld monitor and the joy on their faces when seeing their baby taking form within womb with a head, arms waving, and legs kicking. I remember a special moment when you could clearly see the baby’s silhouette of the face during a scan. Moments like these make my job special and very rewarding.
Empathy
On a sad occasion there was the loss of a baby. The mum was crying but no one (of the nursing staff) even gave her a tissue, so I did. Another time during a procedure, a patient wanted me to hold their hand as this helped them to remain calm since they were nervous. Providing information is as important as having empathy in my role. Being with a regular patient you will build a rapport.
“I came out feeling drained as the appointment brought up trauma I’d faced in the past”
Protection
When doing GP or hospital appointments you don’t know what situation you’re going into. For example, I had a booking for which I was told it was a consultation with a Deaf patient. I didn’t have any prep and came out feeling drained as it brought up trauma that I had to face in a past relationship. I felt a bit down and in a low mood for a couple of days after that. In these scenarios, I have a peer support group of interpreters that I speak with. That time I also had an emergency supervision with my supervisor. It helped me unpack the whole process of my emotions, and think about what I would do or change if I was ever in that situation again. I also spoke with the management of the agency I work for about this instant and the importance of having detailed information (about the booking), which helps protect us as interpreters – so we know what we’re going into and then we have a right to decline/accept the booking.
Lived Experience scenario
Arriving at a hospital appointment, thinking it was for a normal scan, I had to translate the following:
(Doctor) “I am sorry we cannot see heartbeat.”
(Mum): “What?… I can see the baby, I can feel movement.”
(Doctor): “Sorry we can confirm the baby has died.”
(Mum): ”No, no… look again… interpreter tell them to look again.”
The room grows silent… them a very loud scream Nooooooo!
As the interpreter in this situation I can’t cry, I have to suppress my emotions and feelings inside. Meanwhile I am praying that the doctor is wrong. I get a tissue to give to the mum, who is crying. She holds my hand as she has no family member present.
(Doctor): “The baby cannot stay inside you. Here are the options.”
(Mum): “Please look again, you made a mistake.”
Scenarios like this can take its toll on you. I’ve experienced vicarious trauma because of it.
“Looking after my mental health is crucial ”
Interpreters and trauma
Bontempo & Malcolm (2012) explicitly stated that sign language interpreters are “not immune to the effects of trauma exposure”, while Harvey (2003) asserted that signed language interpreters in particular are at risk for “empathetically drowning”.
Demands on an interpreter, as described by Dean & Pollard (2001), are “numerous, dynamic, and interactive and arise from complex linguistic, environmental, interpersonal and intrapersonal factors”. They have suggested that interpreters face linguistic demands related to language translation, environmental demands based on assignment settings, interpersonal demands from all participants in the communication process, and intrapersonal demands regarding physical and psychological factors of the interpreter. Interpreters’ work can have a significant impact, both emotionally and psychologically. This effect is intensified when working with those that are considered “vulnerable client groups”.
Mental health day
What I have implemented for my self-care is a ‘mental health day’ every week. I won’t take on any work, I will have supervision if needed. I have a pampering day, just relax and watch TV, I plan taking regular holiday time, and increasing social support (meeting up with my mentees, cooking a meal for my interpreters group). This is crucial to a successful future for my area of work.
Sources
Bontempo, K. & Malcolm, K. (2012). An ounce of prevention is worth a pound of cure: Educating interpreters about the risk of vicarious trauma in healthcare settings. Washington DC: Gallaudet University Press. 105-130.
Dean & Pollard (2001) Dean, R.K., Pollard R.Q. Jr. (2001). Application of demand-control theory to sign language interpreting: implications for stress and interpreter training. Journal of Deaf Studies and Deaf Education 6 (1), 1-14.
Harvey, M. A. (2003). Shielding yourself from the perils of empathy: The case of sign language interpreters. Journal of Deaf Studies and Deaf Education, 8(2), 207-213.