5am on a Friday morning, during a lull in my overnight shift, I got a text from my friend Julie*. “Steve had a massive heart attack.” Me back: “OMG, what happened.” Julie: “Not sure, he called my mom, he thought he was going to die. Now they are doing a CT scan.” And so it went on. As I waded through the information Julie thought she understood I realized that she had completely misunderstood. I asked her more pointed questions and we got to the real diagnosis; Steve was having an aortic dissection not a heart attack. Shortly thereafter we (me, Julie, her husband and Steve’s brother) had an hour-long “family conference call.” I walked them through what a dissection was, what they could expect from surgery and how much information they should give the Steve’s granddaughters (ages 6 and 9). After we got off the phone, Julie texted me back: “You are wicked smart. I love how you explained that and helped us all out.”
I field calls and texts like this on a nearly daily basis. From pinworms, to zika virus to broken bones and rashes, I can answer the first couple of questions on almost any disease. I am the first call from other moms, my parents, their friends and virtually every connection on Facebook. Most of the time it’s a quick question, followed by some general explanation of why an ER or antibiotics are not necessary (Let’s face it, I am practically doing public service work here). Unfortunately, other times it is a more extensive conversation about how cancer is actually diagnosed or what to expect from an unexpected surgery. No matter the disease, I serve as a sort of “medical translator” for my friends and family: translating medicine in to English and demystifying the process of being a patient in our health care system.
My training in emergency medicine has prepared me to translate almost any language in medicine. From cardiology to orthopedics or dermatology, I can understand every other specialty’s basic language. It’s like being able to order off the menu at any restaurant in the ethnic tongue. I certainly can’t communicate in the homeland like a native, but I probably won’t starve. Understanding the landscape and language of most of the house of medicine is crucial to being an effective medical translator.
We use these same skills with ED patients all the time. When explaining the concept of ovarian torsion to a young woman on the way to the OR, or calming the fears of a wife who thought she was about to become a widow, we have to communicate in a language our ED patients and their families easily understand, leaving the medical jargon for our progress notes and consultants conversations.
But the other part of being a medical translator is completely social and personal. And as a mother, daughter and wife, it falls right in with the other roles I assume in my own life. As Anne-Marie Slaughter and her husband Andy discuss in their respective Atlantic articles, women are frequently the lead parents and primary care providers in their families. And, in my experience, women will look to other women for support and answers when faced with medically challenging situations. And as women ourselves, regardless of our medical degrees, we are members of the cohort who, often by default, manage the medical ailments and issues within our own families.
Last December my father in law became ill. We knew he wasn’t going to make it. He was in pain and his prognosis was poor. It was clear to me (and him) that palliative care was the right path, but his sons (my husband and his brother) had so many questions. “What tests are they going to do?” “Are we giving up on him?” “Should we bring him home?” By translating the prognosis and care into a language they easily understood, both sons felt empowered to follow through on the wishes my father in law had clearly expressed.
The questions I answer are not always related to life and death. Often the questions and circumstances are more benign. My cell phone blows up with texts after a nurse’s office calls from school or a friend falls and breaks a leg. Once the rash is treated or the bone is set, there are questions about next steps. “Who do I follow up with?” “How long should I want to see them?”
The truth is that being a medical translator is a privilege I cherish. I love that I can help my friends and family feel grounded during their most vulnerable moments, and that if needed I can advocate for them in a language they don’t understand. I love that I can help them make their own decisions at a time when they might let others make decisions for them. And most importantly (and probably selfishly) I love that it validates all the parts of who I am. I am a wife, I am a mother, I am teacher, I am a friend and I am a doctor. And in order to be the best medical translator I can be, I need to continue to be ALL those things.
Epilogue: Steve’s surgery went incredibly well. He was discharged from the hospital in record time. He is back to spending days with his wife and face-timing with his granddaughters.
*Names have been changed.