Edith Hernandez, 20 weeks pregnant, lay on the bed, her belly slathered with ultrasound jelly. Obstetrician Dr. Doug George was ready to deliver the news.
“Do you want to know if it’s a boy or a girl?” George asked.
But Hernandez turned for help to a third person in the room who stood next to the bed: Elisabet Telecher, a Spanish-language interpreter, who relayed the message in Spanish.
“Si,” Hernandez replied with a smile.
“Because I don’t speak English she translates what the doctor tells me,” Hernandez said in Spanish. “You leave without any doubts because they’re here to tell us what the doctor tells us.”
Jackson Hole is home to many people for whom English is a second language, which can make receiving health care services from English-speaking providers challenging. But under the Civil Rights Act, those with limited English proficiency are entitled to equal access as native speakers to services like medical care. Teton County providers and nonprofits collaborate to achieve that standard, especially for the Spanish-speaking population.
“It’s a matter of engaging Spanish speakers in all levels of being part of our community,” said Sharel Lund, executive director of One22. “And having access to the same things everyone else does. It’s a matter of integration, really, because otherwise people are only able to participate in their community to the same degree of their language skill, which for some people is a fairly limited sphere.”
Offices at St. John’s Medical Center outsource interpretive services to a company called LanguageLine Solutions, which provides remote, virtual interpreters who appear via mounted tablets, Chief Communications Officer Karen Connelly said. The hospital also hires One22 interpreters as needed. One22’s language access program extends beyond the medical field and offers assistance in settings like social services and legal matters.
Another group of five interpreters, La Voz, focuses on services for private practices, such as OB-GYNs, dentists, pediatricians and orthopedists. Director Vida Sanchez said La Voz helps with every aspect of health, from calling to schedule an appointment, to following up with lab results, to attending to the bill and navigating insurance.
“Your one 15 minutes with a provider could have taken five hours to get you there,” she said.
Sanchez said language access services foster broader health care access for immigrants.
“You open the door, and that’s the first step towards patients being able to get services and the guidance and the care they need in order to be as healthy as possible,” Sanchez said.
People who use interpreters’ services aren’t necessarily monolingual, One22 Program Director Carey Stanley said. In fact, many clients have substantial English skills but lack the vocabulary for crystal clarity in a specific setting, like a doctor’s or lawyer’s office, where they may encounter complex medical jargon or “legalese.”
“Someone may be able to talk to the secretary at their school or check into a doctor’s appointment, but then when you take that further and you go into a higher register, or you’re giving instructions on how to care for a wound, or how to care for a sick child afterwards, they may not fully comprehend that,” Stanley said.
Not just anyone who speaks two languages can be an effective interpreter. It’s important for interpreters to be professionally trained and adhere to a code of ethics.
La Voz and One22 interpreters use different programs, but all interpreters go through professional training.
Interpreters are expected to be impartial and communicate exactly what’s said by each party without inserting their own emotions or judgments, in order to “respect the communicative autonomy of both parties,” One22 interpreter Emily Gomez said.
“You are there to be an impartial person and to render the meaning of what’s being conveyed in the other language,” Gomez said. “You are not there to be putting your own bias [or] experience into it.”
At the same time, sometimes interpreters must sometimes take cultural differences into account.
For example, in the doctor’s office at Hernandez’s appointment, George asked his patient if she wanted the baby’s sex written down and sealed in an envelope. In her interpretation Telecher explained in Spanish that some people want the gender to be a surprise.
There are linguistic differences, too: Telecher is from Argentina, but most of her clients in Teton County are from Tlaxcala, Mexico. Words and connotations can sometimes differ. Through her work interpreting she said, she has learned to adjust her vocabulary and more about Mexican culture.
“I have to change my Spanish a little bit to make sure they will understand what the doctor is saying,” she said.
Interpreting can build a relationship. Sanchez said interpreters can provide a sense of familiarity when patients are entering unfamiliar medical territory, as well as “an increased sense of security and guidance, so people feel confident they are taking the best steps possible toward what they need to do to improve their health.”
Because Jackson is a small town, Telecher said she has provided interpretation services at childbirths and then been called to attend the kids’ checkups throughout their childhood. Just as she was there for the gender reveal, it’s likely Telecher will be there when Hernandez delivers her baby girl, and maybe even for appointments after.
“We get to know them for years,” Telecher said. “It’s amazing.”
When the time for the reveal came — una nina! a girl! — and Hernandez broke into happy tears, Telecher broke out of her strictly interpretive role.
“Felicidades!” she offered, smiling and grabbing Hernandez a tissue.