When I tell people that I work in a children’s hospital, their first reaction is often, “Wow, that must be very difficult!” When I reflect and ask them in what way, typically they will mention two things: 1) medical terminology, and 2) how hard it would be to work around sick children.
For a long time, I agreed with them. I find deep value and satisfaction in my work of lifting people’s voices. But when I transitioned from adult to pediatric medicine, one aspect that was hard for me was interpreting more for family members than for patients.
In adult medicine you mainly interpret between a patient and their clinicians. In pediatric medicine, though, you mainly interpret for parents and other family members. Parents care a lot about their children, to put it mildly, and I found that these conversations were harder for me. When you interpret, you’re not just a conduit of words, but also of emotions – it’s one of the ways we uphold our ethic of interpreting accurately. Those emotions can stick with you, so I carried a lot of worry and fear and pain and grief in those days.
Trying to keep a healthy distance
I developed ways of coping with carrying those things. I wrote my cares on snippets of paper that I put in a “worry jar” at home. I focused on exercising and sleeping enough to maintain emotional stability for myself. I also developed a bit of detachment, distancing myself somewhat from feeling my emotions while transmitting those of others.
Recently though, I had an encounter that shifted those burdens for me in a deep way. It was an average day in the hospital. Over time you get to know the areas where you work, the different types of clinicians, and the types of conversations those clinicians tend to have with patients. I’d been having routine encounters. Then our dispatcher sent me to the ICU to see a patient who had been in and out of the hospital for such a long time. Most of the staff in the areas where she tended to stay knew and loved her.
Unkosher as it was, I admitted to myself that I couldn’t understand what about her so charmed the rest of the staff, who talked about her with an affectionate kind of indulgence. She grunted more than she talked. When she did, it was loud and sharp and sudden. She was mostly engrossed in her own world, no matter how many people were trying to get her attention – unless she didn’t like something or was uncomfortable. Then she’d make that known, loudly.
So of course, I was the one who got the call to go interpret for her parents when her condition worsened to the point of fear.
“Y tu, no te vayas”
I knew this encounter would be difficult, because of the turn for the worse this patient had taken since the previous day. When I arrived, the ICU doctor used me to explain to the parents that their daughter needed a minor procedure immediately if she were to survive, but that her heart might not be able to tolerate the stress. She was firm and direct. She talked about other cases she’d seen and expressed both urgency and profound doubt about the procedure’s success. It sounds, as I write it, like the high drama TV shows we watch, but I assure you it was inescapably real.
In these situations, doctors are careful to be truthful. They do their best not to talk in absolutes, because nothing is certain. I am used to that type of discourse, so you can imagine my surprise when, as we walked out of the room, the doctor suddenly expressed, within earshot of me, utter hopelessness that the child would survive the procedure. I replied gingerly, trying to help her process, and internally amazed that she was letting her feelings out like this. It was a clear sign to me of how deeply distressed she felt.
Meanwhile, the team called for the chaplain. Not knowing how long it would take him to arrive, they dismissed me. I was grateful, as the encounter had left me shaken. On my way back to the office, just outside the unit, I saw the chaplain walking up. I could leave, but it would take much longer for the next interpreter to be assigned, so I about-faced and walked with him back to the ICU, updating him on the way. We went in to talk to the family, prayed with them, and the chaplain turned to me and said I could go. His plan was to just sit with the family for a while. At that moment, the mom turned, pointed at me and said, “y tu, no te vayas” – and you, don’t leave. I was floored. Patients don’t often address me like that, don’t often express that they want my voice. So I stayed.
How memory transformed the crisis
We left the room so the medical team could perform the (sterile) procedure and waited in a small family consult room with comfy chairs and a little table. As we sat together, waiting for the medical team to do their work and send us word, the chaplain started asking questions to help the parents process the situation. Gradually, as the parents talked, fear’s roots of deep love for their daughter were exposed. Fear gave way to reminiscence and reflection. They shared cherished memories and showed us pictures, and we spent a good hour waiting, talking, laughing and crying together.
At one point, her mom was talking about all the times the doctors had told her that her daughter would soon die. But she lived. She told us how much she had learned from her daughter: that illness couldn’t crush her daughter’s determined personality; that doctors are wrong sometimes; that there are so many more medical specialties than she’d ever known existed; that she had been amazed to find her neighbors would defend her daughter instead of judging her; that her community’s capacity for love was way more than she would have imagined; that her daughter’s illness and disability would, in fact, bring people together. As we talked, the shadow of death that had frightened us all moved away, replaced by the warmth of love. Worry and fear and sadness made way for laughter, amazement, gratitude and joy.
When the mother said with awe, “Mi hija es un angel, siempre he dicho que es un angel” – “my daughter is an angel, I’ve always said she’s an angel,” I had to repent of my callous heart. Yes, she was loud and unapologetically demanding, but it was a part of her thorough disregard for being sick or different or in the hospital. That is a sharp difference from the anxious, worried or fearful emotions many of our patients display. I saw how she inspired her community of neighbors, friends, family, and healthcare workers to unapologetically run with the life we’re given and acknowledged her beauty. We ended up spending about an hour and a half together, at the end of which the chaplain left to find out how the procedure had gone. Fortunately, that day, she lived.
The Foundation Revealed
On my way home that day I reflected on all the emotions I’d borne witness to, transmitted, and felt, and I realized that every one of them was underpinned by love. The doctor was distressed, in part, out of love for the family. The parents were fearful and tearful because of love for their daughter. The chaplain was patient and compassionate out of love. I stayed out of love for the parents. The parents feared for their daughter because they loved her, but that same love also made it possible for them to shift from fear and grief to gratitude. Their fear was subsumed in love.
Walking out of that encounter, the chaplain told me he’d never been able to build such an easy, poignant connection with a family through an interpreter, that it’s often much harder. Facilitating that connection is the reason that I’m deeply honored to do this work. When I lift up and amplify voices of Spanish speakers, when my skills give them equitable access to healthcare conversations, English speakers and Spanish speakers alike learn that love’s character doesn’t change across cultures. More than that, as I facilitate these conversations, my own heart is challenged to love more perfectly – and so love grows.
Now when people ask me if it’s hard to work in a children’s hospital, I tell them this story. Yes, my colleagues and I walk with families through some of the hardest, most gut-wrenching, heart-twisting things in life. But every day I get to see how fiercely people can love each other in the midst of difficulty, how that is the bedrock of everything. I get to facilitate communication based on love. What more could you really ask for in a job?