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Published on April 04, 2022

Medical Interpreters Play Vital RoleMedical Interpreters Play Vital Role

“When you work as a medical interpreter, you’re not the patient’s voice; you are interpreting their voice,” says Cecilia Phelan-Stiles, senior manager of Interpreter Services at Cape Cod Healthcare. “You’re not giving an opinion; you are simply interpreting every word and the meaning of what they said.”

The CCHC Medical Interpreter program provides 24/7 services via telephone, video or in person at both hospitals, urgent care centers and Medical Affiliates of Cape Cod. Phelan-Stiles credits CCHC senior leadership for investing in and supporting the medical interpreter program. Because of demand, a new Hyannis Urgent Care position was recently added. “Communication is the number-one key in medical care,” says Phelan-Stiles, “and there can be serious mistakes when something is lost in translation.”

To become a medical interpreter, one must fulfill several requirements: Earn a certificate at an accredited institution, such as Cape Cod Community College, which includes completing Medical Interpreting I and II, Survey of Anatomy and Physiology and Medical Terminology classes; fulfill 150 hours of practicum at Falmouth Hospital or Cape Cod Hospital; and complete an entrance exam. 

To get a sense of what life is like on the job, we recently sat down with four CCCH interpreters who work either the day shift or night shift at Falmouth Hospital, Cape Cod Hospital and Hyannis Urgent Care Center. “My team is phenomenal,” says Phelan-Stiles, who started her career as a medical interpreter and still jumps in when needed. “They put their heart and soul into what they do every day.”

Manuela Xelo Full-time Spanish interpreter at Cape Cod HospitalManuela Xelo

Full-time Spanish interpreter at Cape Cod Hospital
Years in profession: 15 years at Cape Cod Healthcare
Originally from Mexico

My career path: I was born in Mexico and when I was 17 years old, I moved to New York City. I was fascinated to be among so many cultures and languages. At the time, I was just absorbing everything. When I got married, we moved to the Cape and one of my friends mentioned to me they were looking for interpreters at Cape Cod Hospital. I was very curious and started researching this profession. I had gone to school in Mexico and New York City and I was able to read, write and speak both languages. I thought it would be a very interesting career to pursue.

In the beginning: I was a shy person (I still am) and then I realized I was just a voice. If they ignore me completely, I am doing my job. I overcame my shyness by helping people to connect and to communicate.

A day in the life: I cover the emergency room from 7 a.m. to 7 p.m. Mondays and Tuesdays and then work two or three nights, and sometimes weekends. I could help anywhere from 10 to 40 patients, which includes telephone and video conference calls with patients at the urgent care centers, Cape Cod Hospital Rehabilitation Center and the Cuda Women’s Health Center. We can get calls from anywhere, not just the hospitals.

The most rewarding: Working with parents and children. I enjoy helping parents understand what’s going on with their children when they are desperate and upset at the same time. The parents don’t understand the language. It’s really difficult for the young patient to deal with anxiety and desperation and not be able to express what’s going on. I feel like I am making a difference.

Finding the right rhythm: In the mental illness setting, we speak one moment behind the person who is talking because you can’t tell this type of patient to pause. With mentally ill patients, it’s more challenging. You have to express and project the mood of the patient so the provider can catch what’s going on mentally. In the ER, we can let the person finish a couple of sentences before we step in. It’s like a harmonious song we “sing” together among myself, the patient and provider. One person comes in, then the other voice follows.

A vital voice: I always think of ourselves as radio actors and actresses performing in shows. Growing up, that is what I listened to. You really get the sense and meaning through the voice.

Viviane De Souza MinihanViviane De Souza Minihan

Senior Medical Interpreter at Falmouth Hospital (Portuguese)
Years in profession: 5 years at Cape Cod Healthcare
Originally from Brazil

What drew me to this profession: When I came to this country 18 years ago, I needed an interpreter for my doctor visits. I was afraid of going to the doctor because I didn’t know if they would understand me. I felt I could be one of those that could help others by learning from my own experience. 

Memorable moment: One of my patients had cancer and went to the ER, and they did not have a primary care doctor or insurance. We were able to manage insurance, find a PCP and schedule tests. The patient came back to me after radiation therapy and she said, “I would be nothing without you. I am very grateful for you to exist in my life.” We feel that, too.

Hardest part of the job: It’s very difficult to see a patient leave with sad news. As an interpreter, we are close to the patient and we know everything. We have to maintain our composure and not get involved in their life. When I leave here at the end of the day, it’s hard to forget. I have to detach from the sadness when I have to give a patient bad news.

Repeat after me: Everything the provider says, I repeat, and what the patient says, I say. I am their word.

Advice for her new interpreter, Pricila Ray: Maintain your smile, even though you have a mask. Work with your heart, put love in everything you say and do. Eye contact is so important and be positive. Clarify if you have any doubt. Don’t guess what anyone says.

Ariana Jacobs -time Portuguese interpreter, Hyannis Urgent Care CenterAriana Jacobs

Full-time Portuguese interpreter, Hyannis Urgent Care Center
Years in profession: 17 years at Cape Cod Healthcare
Originally from Lower Cape

The inspiration for my career: My dad brought up the idea. He saw an ad in the paper for a medical interpreter class at Cape Cod Community College. He said, “You speak Portuguese. You should look into this.” I took the course and I really enjoyed it. 

The language: Even though I knew Portuguese, I realized how much I had to learn when I started taking classes and working in the field. When you work as an interpreter for the hospital and community visits, you have to say exactly how the doctor says it. It can’t be slang or a cutesy way of saying things. The words have to be specific. 

In the early days: I started at the VNA. They didn’t have the program set up at the hospitals yet. We did a lot of in-home visits with the visiting nurses, and it was interesting because you got to see a whole gamut of patients, from new babies and post-surgeries to cancer patients. 

The challenges: There are a lot of circumstances that are very emotional. You have to be a strong person and not break down. You have to make sure you are present, that you are getting all of the facts and interpreting in a calm way. it’s a lot of information. You may walk into trauma and you have a bunch of people talking you all at once—doctors, nurses, registration.

Advice for someone new to the profession: There might be a lot of information thrown at you at once and you can’t be afraid to tell the doctor, “Can you slow down a little bit or repeat what you just said?” Make sure you get the right information 100 percent. You have to be able to multitask and love the job and love what you do.

Best part of the job: When you meet a patient for the first time, you see the relief that comes over their faces with the look of “someone who speaks my language.” They touch your arm and say, “Thank you, I’m so glad you’re here.” There is nothing better.

Catarina Hegner Full-time Portuguese interpreter at Cape Cod Hospital, night shiftCatarina Hegner

Full-time Portuguese interpreter at Cape Cod Hospital, night shift
Years in profession: 2 years with Cape Cod Healthcare
Originally from Portugal

My first day: I started my position right when COVID hit on March 16, 2020. I was a fresh, new interpreter. It was challenging because everything I had learned in school didn’t apply because we had to do everything over the phone. We were not allowed in the hospital for a couple of months. It was difficult communicating over the phone with the patient because most of them had trouble breathing and they couldn’t talk. The staff's gown, mask and movements made a lot of noise, so sometimes it was hard to hear them. But then we eventually got iPads, so we could see and communicate with the patient. We all adapted and learned from COVID. It helped me as an interpreter and helped me adapt to any situation.

On the night shift: Most of my patients are in the ER. You never know what is going to happen at night. I could have zero patients one night or as many as 14. The job is not predictable and I like the fact that every day is different. It could be a simple belly ache or it could be a big car accident. After a certain time, I don’t get paged for the patients that are admitted on the floors because they are sleeping, but I still get ER patients all night. I work from 7 p.m. to 2 a.m., but then I’m on call until 7 a.m.

Capturing the right tone: If somebody is annoyed or in extreme pain, you have to be able to convey that to the doctor. When you see sign language on TV, you see how expressive they are because they have to give meaning to the words. One word can have many meanings depending on the tone you use. You can show concern from the doctor and it depends how you say it. It can be perceived as if he’s not concerned, depending on the tone and expression.

Memorable moments: The ones that stick with you are the labor and delivery. You remember the babies, and it’s a very good feeling when you see them grow up. We are there during deliveries and they will remember you forever. It’s a very personal experience with the patient.

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