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The Translator as a BiCultural Being

Putting a human face on your language services provider

Translators tend to be at home in more than one culture—be it by birth, circumstance, or the conscious choice of immersing themselves in different cultures. But what sets them apart is that, while assimilating to the culture they live in, they also cultivate their membership to other cultural circles. This gives them a unique perspective, not unlike the vantage point of the artist, who needs to step outside his or her paradigm to get a clearer grasp of what shapes its realities.

 

 

The little differences

You might recall the opening dialogue of Quentin Tarantino’s “Pulp Fiction”, when John Travolta’s character shares some surprising discoveries of his stay in Europe—like the re-naming of a burger staple necessitated by the metric system or the unusual way of eating French fries (with mayonnaise). What appears to be completely ordinary to someone who has grown up in a certain culture can be quite astonishing to anyone not accustomed to it. The life of a translator is full of such epiphanies, because no matter how well you know your working languages and cultures, you continue to discover things that would escape you if you did not see them in association with what they are outside of their habitual setting.

 

Going the distance

By association alone, as a matter of fact, can one small word that may not even be any different in two languages result in an entirely different meaning. After Germany’s liberation from Nazi rule and to clearly distinguish the Allies’ sectors from the Soviet sector, newly or re-founded institutions in Berlin were labeled as “free”: the radio station Sender Freies Berlin for instance, and, as it is still known today, the “Freie Universität Berlin”. 65 years later, it would never occur to Americans that a “Free University” in Europe has anything to do with the “Free world”—free of Nazis, free from communism—instead, they are very likely to mistake it for meaning “free of charge”. Historical and geographical distance creates a new context that can easily be misread, but serves as the road the translator travels when carrying messages across and discovering worlds in between.

 

Inside out

Immersion is everything, or so we are told, when learning another language and adapting to another culture. And while it is only by way of immersion that we delve deep enough to understand a culture’s treasures and truths, the translator’s work is accomplished by being there and somewhere else at the same time, which tends to characterize how he defines himself otherwise as well. The “other” is never far, because you are trained to keep it present and your identity resides within this continuous duality: You are forever creating the subtitles to your own film. Ironically, this heightened self-consciousness enlightens yet another conceptual and even psychological difference between the English and German languages: While someone who is conscious of his or her self is understood as having (self-) confidence in German (Selbstbewusstsein), self-conscious doubles as insecure in English.

 

 

Serving two masters

With the consciousness of complexities, however, comes the mandate of clarity. As Confucius puts it: “If language is not correct, then what is said is not what is meant; if what is said is not what is meant, then what must be done remains undone; if this remains undone, morals and art will deteriorate; if justice goes astray, the people will stand about in helpless confusion. Hence there must be no arbitrariness in what is said. This matters above everything.” The need to be loyal to what is said is trumped only by the necessity to be clear when rendering it in a different language. Striving to do justice to source and target is the daily bread of the translator, and the answer is different every single time. Decisions are called for consistently, and the knowledge that two things can never be the same runs deep.

 

A band apart

In a world and time where you are defined by what you do rather than by who you are, we easily become what we do. Over the course of a career, the cultural and linguistic as well as social and intellectual sensitivities required to successfully translate from one language into another will thus rather deepen than disappear, making the translator all the more aware of his status caught in perpetuity between the lines. Living in two worlds is living rich, but it also means living apart. Yet, as in art, expression is the key. Continuing to discover, to learn, and to communicate creates a well of knowledge for everybody—or in Ella Fitzgerald’s words: The only thing better than singing is more singing.

Nanette Gobel

Global Clinical Trials: Using the Translator as a Recruitment Tool

Translators are notoriously not provided with an understanding of the purpose of a project. This is not intentional. It is the product of many people seeing translation as a non-strategic entity, just a required piece of the global puzzle. Changing this thinking can improve your patient recruitment and retention figures.

It’s a fact: patient recruitment can make or break a clinical drug trial. Most pharmaceutical industry studies indicate as many as 80 to 90 percent of clinical trials fail to complete on time and at least 72 percent of trials go over by at least one month. With the average daily cost of running an average phase III trial costing around $35,000 per day, time is indeed money. The usual culprit in creating trials that run over is a lack of consistent enrollment at the trial site.

Keeping this in mind, many companies spend hundreds of thousands of dollars to hire a firm that will develop a recruitment strategy and identify potential populations for the study. Rarely, however, does anyone stop to consider how the recruitment strategy needs to be adjusted in order to adapt to the cultural influences on participation.

In the United States, for example, sponsors run radio ads encouraging people with a specific ailment who satisfy certain criteria to call a number to inquire about participating in a clinical study. Then trial sites are added in South Korea. The documents and radio ads are translated and they look great However, no one stopped to contemplate that Koreans consider radio ads to be an untrustworthy source for information on resources concerning their health and only trust a doctor from which to get this information. Changing the language is not enough. A translator specializing in clinical trials knows this.

Translators understand the sponsor needs to enroll quickly, get good consents, have ready access to their data and be able to retain the participants for the life of the study.

They also understand that culture drives willingness or lack of willingness to consent. Not language. A woman will not consent because she feels that participation is a decision she cannot make without her husband’s approval. No straight translation will work to ease this cultural issue. But subtle changes can be made, within the translation process that addresses these issues. Adapting recruitment and retention material can be easily done – and can have a great impact cross-culturally.

Translation agencies need to be provided with a mandate that allows for excellence. This excellence, appropriate for patient recruitment and retention, comes from less rigidity and more focus on content and purpose. Translators need to be involved in the planning and implementation of the strategy for a trial. They will, ultimately, be responsible for communicating across languages and, hopefully, across cultures.

A culturally applicable retention program is the key to successful and consistent patient enrollment. Translators are an underutilized resource that can help mold recruitment tactics that work.

Sherry Dineen

Pharma Companies Can Weather the Storm

As hurricane Sandy meets a turning gulf stream and a nor’easter winter storm to unleash havoc on the Mid-Atlantic region, so too is the pharmaceutical industry entering an era of the perfect storm.  Recent trends and events have set the industry up for major shifts and changes.

The current blustery economic recession created, not a drop in pressure, but a drop in industry growth.  In prior years, a billion dollar industry expanding its growth at about 10% per year did not need to worry about small niche markets or tiny fifty-million dollar areas of market growth.  With pharmaceutical companies fighting for market share and growth, times have dramatically changed.

Concurrently sweeping across the country is a jet stream of demographic change.  The 2010 census results reported for the first time the US had more minority or mixed-race newborns than non-Hispanic whites.  Surely, this tipping point will effect the US population for decades to come.

Additionally, the winter storm (with its chilly reception by some) of the Patient Affordable Care Act of 2010 increases the number of insured in the US to 33 million in 2014, forty-three percent of which will be from multicultural population segments.

Unlike the path of destruction Sandy is currently cutting across the Eastern Seaboard, this perfect storm creates a tremendous opportunity for pharmaceutical companies.  A whole new influx of consumers will suddenly be up for grabs and getting their attention will be necessary for a company’s survival.  Roughly 14 million non-English speaking patients will require information on navigating new terrain created by the Affordable Care Act.  

Multicultural marketing budgets, often considered optional and usually the first budget cut in recessions, will be a necessary lifeline as multicultural consumers’ loyalty will go to those who made the effort to reach them.  Educating multicultural populations on how to use the whirlwind of state specific online Health Benefits Exchanges for buying insurance under the Act will give companies the lead in market share and help them weather the new environment in which the pharmaceutical industry now operates.

 

Sherry Dineen

Next Please

Patient/provider relations via medical interpreter

While meant to facilitate communication in hospitals and doctor’s offices, the fact that a third party is involved in very personal matters can often lead to awkwardness and even misunderstandings. Healthcare providers are well advised to educate themselves and their patients so both can reap the full benefits of having a professional interpreter assist during appointments and procedures.

 

The elephant in the room

As with the proverbial elephant, it is helpful to start by acknowledging the presence and clarifying the role of the interpreter at the very beginning of each meeting. Everybody will be more at ease if introductions are made and it is established what kind of interpreting services are required. For patients with little to no knowledge of English, the interpreter will translate consecutively what is said. This means that he/she speaks after the respective source-language speaker has finished, rendering the message in the target language.

 

Turning invisible

In this process, the consecutive interpreter will actually take him/herself out of the conversation as much as possible by translating in the first person. While such a linguistic device is not a cloak of complete invisibility, it does make the dealings between healthcare provider and patient as direct as possible. The interpreter relies on memory, so the segments need to be short enough to memorize. If the answer to a physician’s question is more complex—for instance if asking about a patient’s medical history—or the doctor or nurse is explaining a diagnosis or procedure, it works best if the speaker pauses after every other sentence to allow for translation.

 

Keeping it familiar

The interpreter can also serve as a comfort factor, especially if the patient is visiting from another country or seeking treatment abroad. The anxiety often associated with a doctor visit tends to be heightened in unfamiliar territory. In such a situation, the presence of someone who speaks your native language and knows the local customs and conventions will have a calming influence. Cultural differences and barriers can be more easily addressed and overcome, with the interpreter acting as intermediary. Even if the patient speaks basic or conversational English, having an “ally” who shares his or her native background will create a feeling of safety.

 

One-way might be the way

A patient in this kind of scenario may opt for having the interpreter translate only what the healthcare provider says and express him/herself in English. The interpreter will then stand by and assist if anything is unclear. This also works the other way around: Some patients may feel confident that they understand what is said but are insecure about their own language skills. However, if the care provider prefers that everything be translated, the linguist will proceed with the consecutive interpretation. The same applies if the patient requests that the interpreter only be present during the consultation and not during the exam or procedure. While the physician will in most cases grant the patient’s request to make him or her as comfortable as possible, it is ultimately the physician’s choice since the services of the interpreter are usually a requirement on the part of the hospital or practice to ensure effective communication.

 

Party of four

That’s one of the reasons why some patients are actually surprised and—in most cases—relieved to find an interpreter when arriving at their appointment. Since they are not notified in advance, some bring a friend or caregiver to help with the translation. Pursuant to hospital guidelines, however, family members or friends of the patient should not act as interpreters, since the risk of mistranslation is too great. Errors can have serious consequences on diagnosis and treatment—and the healthcare provider must be able to rely on the language skills of the interpreting individual, which is only possible if the service is provided by a certified professional. But the cooperation between interpreter and caregiver can be valuable, since the person accompanying the patient is usually familiar with his or her medical history, allergies and prior doctor’s visits leading up to the appointment. The situation may sometimes be complicated by the fact that more than two languages are involved or the patient’s difficulty to focus on the interpreter, especially if the patient is elderly or a young child. Different scenarios may require different solutions. The interpreter will be glad to offer his or her professional opinion and always defer to what the healthcare provider deems best.

 

Red tape

A patient’s Odyssey at a clinic or practice often continues beyond the end of his visit or procedure. The assistance of an interpreter may be needed even more urgently when the patient is dealing with office matters such as payment, scheduling, and insurance. Especially the latter can be quite complex and involve foreign language documents that need ad hoc translation. Medical interpreters are trained accordingly and will stay with the patient at the hospital or practice until all bureaucratic issues are solved as well.

 

Jack of all trades, master of none?

In the daily life of a healthcare interpreter, he or she may spent one morning assisting in an MRI procedure, then move on to an OB/GYN appointment and finish the day interpreting in a neurological consultation. The terminological challenge is tremendous. Patient and medical staff must be aware that they cannot expect the interpreter to know every term in the book. Based on their experience and training, interpreters will have certain fields of expertise but are required to serve across the board, including questions of insurance and billing as mentioned above. All professional interpreters in the healthcare industry, however, are trained in general medical terminology, ethics as well cultural traditions and idiosyncrasies. They continue their education on an ongoing basis by attending classes and seminars and master the art of interpreting, which requires a high level of skill and concentration.

 

So when everyone is on the same page and knows what to expect, an office visit aided by a professional interpreter will be just what the doctor ordered.