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(Soundbite of phone ringing)

Ms. NATALY KELLY (Telephone Interpreter): This is Nataly, interpreter number 3940 for Spanish. How may I help you?


Commentator Nataly Kelly - she has more than 10 years of experience working as a telephone interpreter. She is the person that lawyers, insurance agents, or social workers call when they are trying to help someone who doesn't speak English. She's fielded calls from Alaska to Alabama, from Maine to Montana. She says the toughest calls come from the world of healthcare.

Ms. KELLY: A middle-aged Spanish speaking woman has just been wheeled into a Boston emergency room. She hurt her arm in a machinery accident. Her son is with her. I am with her as well. I'm her telephone interpreter.

(Spanish spoken) he says. My mother is in a lot of pain, I interpret. I concentrate on his inflection, his concern for his mother, his sense of urgency. I've memorized thousands of medical terms. Oddly enough, the most challenging phrases are not the ones like...

Tomografia axial computada(ph), CAT scan, or otorrinolaringologo(ph), ear, nose and throat doctor. It's the terms like HMO and co-pay that don't have direct translations.

But telephone interpreters deal with complicated issues that go far beyond terminology. Once, I interpreted for a nurse who was visiting new teen parents. It was a hot summer day. Their home had no air conditioning. The nurse quickly noticed that the couple's baby was red-faced, sweating, and swaddled in multiple layers of blankets. She took his temperature. He had a fever. The nurse asked gently, why did they put so much clothing on the child? The teenage mother offered a quiet explanation.

(Spanish spoken)

Well, that's how baby Jesus was dressed. The nurse hesitated. She asked the parents if they know how to take the baby's temperature. They didn't. The nurse began demonstrating only to be interrupted by the father.

(Spanish spoken)

Excuse me, ma'am, but we don't know how to read.

Not even numbers? said the nurse. The young father replied, no.

(Spanish spoken)

The nurse said nothing for a few moments. Neither did the parents. Finally, I piped in with a suggestion. This is the interpreter. Would it be possible to show them the red line on the thermometer? The nurse immediately said, yes, of course.

In telephone interpreting, the experiences aren't always positive. I've heard comments from healthcare staff that are rude, even offensive. A patient asks, why is the doctor speaking so slowly to me? Does he think I'm stupid? I once even heard a doctor say in all seriousness, next time you come, you speak Ingles, understand?

My job is to faithfully interpret everything. When comments like these are made, I'm grateful that I'm on the phone and can't see the look on the patient's face. I'm also grateful that no one can see the look on mine.

As a telephone interpreter, these patients are also my patients. I'm the voice of both the patient and the doctor or the dispatcher, the receptionist, the benefits coordinator, the social worker, even the billing specialist. So, even when it's time for a call to be disconnected, I know that, as a telephone interpreter, I couldn't be more connected.

SEABROOK: Nataly Kelly's essay originally appeared in the journal Health Affairs. Kelly works with the market research firm Common Sense Advisory.

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