The Case of Willie Ramirez in the 1980s
Let’s imagine a medical encounter with a Spanish-speaking patient, a doctor, and a family member acting as an interpreter.
The doctor asks the patient why they think they may have gotten sick, and the patient says he thinks he’s ”intoxicado”, which is the Spanish word for ”food poisoned”.
As the family member has not received any medical interpretation training, and intoxicado sounds really similar to intoxicated, the family member says ‘’he’s intoxicated’’, which you may know means to be drunk or under the influence of drugs.
Would you say that the family member’s translation was accurate? No, because the meaning was changed upon interpretation. What’s more, this inaccurate translation may cause misunderstandings that lead to misdiagnosis and, therefore, inadequate treatment, all because of a simple word. This actually happened in the 1980s with a patient called Willie Ramirez.
When we’re interpreting, we need to be accurate, not only to allow people to communicate clearly but also, to avoid any harm to the patient. But what exactly is accuracy?
What is accuracy?
As a simple concept, accuracy means that the interpreter says exactly what the person is saying when rendering the message from one language to another.
Accuracy is key to ensuring effective communication, as we saw in the previous example. Accuracy is also a hard skill that’s very specific to interpreters, as well as an ethical principle interpreters abide by.
The accuracy principle is present in many, if not all, interpreter codes of ethics and standards of practice, including those from the 3 major interpreting associations in the U.S.
As a simple concept, accuracy means that the interpreter says exactly what the person is saying when rendering the message from one language to another.
Accuracy is key to ensuring effective communication, as we saw in the previous example. Accuracy is also a hard skill that’s very specific to interpreters, as well as an ethical principle interpreters abide by.
The accuracy principle is present in many, if not all, interpreter codes of ethics and standards of practice, including those from the 3 major interpreting associations in the U.S.
| IMIA | NCIHC | CHIA |
| Interpreters will select the language and mode of interpretation that most accurately conveys the content and spirit of the messages of their clients. | The interpreter strives to render the message accurately, conveying the content and spirit of the original message, taking into consideration its cultural context. | Interpreters transmit the content, spirit and cultural context of the original message into the target language, making it possible for patient and provider to communicate effectively |
You may have noticed in these definitions that accuracy not only involves conveying the content of the message, but also other aspects of the message, such as the ‘’cultural context’’ and ‘’spirit of the message’’.
To illustrate this idea, take, for example, the word ‘’bus’’ in English.
If you were to translate this term into Spanish, you’ll find a variety of terms depending on where you look at.
In Mexico, a person would probably say ‘’camión’’ or ‘’micro’’. If you go down to the Caribbean, you’ll hear ‘’guagua’’. Travel to South America, and you’ll hear ‘’colectivo’’ in Argentina, or ‘’micro’’ in Chile.
Are all of these translations accurate? Yes, they are! Because they match the meaning of the word ‘’bus’’ in English.
However, if you say ‘’guagua’’ to a Chilean, they probably wouldn’t think you’re saying the ‘’bus’’ but ‘’baby’’ since that’s what ‘’guagua’’ means in Chile.
Tone of voice
Let’s look at the tone of voice for a moment. If a person says ‘’You want to go THERE?’’ and ‘’You WANT to go there’’, we would assume the meaning of the message to be different, wouldn’t we?
In the first case ‘’You want to go THERE’’ is as if the person was surprised or judgmentall about you wanting to go there because it’s a place they consider you shouldn’t want to go to. In the second case, ‘’You WANT to go there’’, the person is reassuring you that this is a place that you must visit or you shouldn’t miss!
As you can see, we have the exact same phrase whose meaning can be changed by altering the tone! To be an accurate interpreter, you also need to keep in mind that your tone should match the communicative intention of the speaker.
Let me know in the comment section, how do you say ‘’straw’’ or ‘’pop corn’’ in your language and where this word is used! It will be very interesting to see all the variations!
Are interpreters parrots? 🦜
A common misconception people seem to have is that interpreting is ‘’repeating in your own words’’, ‘’what you understood’’, or ‘’the most important things’’ the speaker said, but this is far from the truth!
Interpreters should possess the skill to repeat in the other language everything that the person says without omitting, adding, distorting, embellishing, or changing the message in any way, shape, or form.
As you can see, faithfulness to the original message is paramount. This may sound like a pretty strict standard, but here’s the reason why.
Firs, I want you to think about the telephone game you probably played when you were a kid. Remember how one person at the beginning of the line would say something that would end up being completely distorted by the time the last person heard the message? While this may have been fun as kids, this communication breakdown is unacceptable in medical encounters. Especially when discussing critical life issues, we can’t take that risk!
The truth is that when we listen to a message, we pass it through our own ‘’mental filters’’ or ‘’lens’’. We inevitably attach our own opinions, thoughts, and emotions to the message. If we were to say what we think the person said or meant, then we would imbue the message with a lot of extra things that the speaker may have not originally meant and sometimes, even cause unduly misunderstandings! That’s why interpreters render the message exactly as it was given.
Below you can find some examples of the 4 most common interpreting errors you would want to avoid to preserve accuracy:
Omissions
This is when you leave something out. For example, if a doctor says ”you’ll take your Losartan medication twice a day” and the interpreter says ”you’ll take your medication twice a day”, the interpreter omitted the name of the medication: Losartan. Although this may seem as a simple, harmless mistake, it may create significant confusion if the patient is taking multiple medications. The last thing we would want is for the patient to take the incorrect does of their medication, that’s why adhering to the original message is critical.
Additions
Additions occur when the person interpreting adds something to the message that wasn’t originally said. For example, if a patient says: ”I don’t know, I called this number 315 222 7676” and the interpreter says ”I don’t know, I called this cellphone number 315 222 7676”, the interpreter is specifying the type of phone. Maybe it was a landline phone and not a cellphone, so the interpreter cannot add or specify something that was not said.
Distortion
Changing the meaning of the message either by addition, omissions, sentence order, grammar, or any other interpreting error. For example, if a doctor says ”We’ll make a small incision in your groin” and the interpreter says ”We’ll make a small incision below your groin”, the interpreter has changed the meaning by substituting ”in” for ”below” which are essentially two different messages.
Embellishment
Embellishing consists of altering the message to make it sound better. For example, imagine that you’re interpreting for a very rude doctor who is asking questions in a stern manner. He says with a noticeably frustrated tone of voice, ” don’t need to hear the full story, just answer yes or no”, and the interpreter says very politely, ”Please, I don’t need to hear the full story, a yes or no will suffice, thank you”. The interpreter embellished the message by adding words like ”please” and ”thank you” that were not originally said. The interpreter doesn’t need to be as rude as doctor, but they do need to be faithful to the spirit of the original message.
What about curse words, insults, and foul language?
Sometimes an interpreter may think ”I want to help, be polite, and make people feel comfortable” and while all of those intentions are very good, if you misrepresent someone’s words the patient or the provider will have a different idea of the other person’s personality. For example, if you make a doctor look more polite than they really are in your renditions, a patient may think ”this doctor is very nice!” And imagine they schedule another appointment, but this time around with an interpreter who is completely faithful to the message and renders rude remarks, then the patient will be surprised because the doctor is not who they thought they were. This is one of the reasons why embellishments don’t quite work for transparent communication, as we’re not being fully honest with a person’s message. Additionally, the use of curse words can represent a person’s emotional state, which can be a very important sign or symptom in mental health encounters. Or maybe using foul language was the best way a person found to express their frustration. Omitting offensive words would be -in a way- limiting their expression. Hence, we should interpret everything that a person says and yes, that includes curse words, insults, and foul language!
How to become a more accurate interpreter?
The road to accuracy, from the standpoint of interpreting skills, may not be particularly easy. Interpreters are challenged with the task of remembering very long utterances and many details, all the while thinking in two languages, which can be mentally taxing and demand a lot of memory capacity. But, just like any skill, with patience and practice, you can go from zero to hero!
It’s a great idea to learn good memory retention strategies which is precisely what I’m going to teach in my upcoming webinar: Memory Retention Techniques for Consecutive Interpretation this Saturday, February 25th. In this webinar, you’ll discover proven memory techniques that will lay the foundation for accurate consecutive interpretation. There will be interpreting practice exercises and guided feedback that will help you grow your skills in the right direction! If you cannot join live, the webinar will be also recorded and made available here on our website for Pro, +Memory Club, and Master+Memory Club members. If you’re not a member or a Standard member, you can purchase the course here.