Imagine getting sick, being alone and not being able to easily communicate with your doctors.
That’s the reality for many patients in Massachusetts who don’t speak English as their first language. “It is a feeling of panic, of helplessness, anguish,” said Carolyn Santiago of Massachusetts General Hospital.
Santiago’s mother had a stroke 12 years ago. Santiago asked staff at the local community hospital if there were interpreters there to help her mom communicate. There were not. So she stayed by her side for days -- making sure her Spanish-speaking mother’s needs were understood.
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“Put yourself in their shoes,” she said. “Trying to tell someone something that is urgent and not being able to communicate that.”
The experience was so profound, Santiago switched careers to become a medical interpreter herself. She’s now at MGH in the height of the coronavirus pandemic. “If the interpreters are there right from the beginning, it makes everything else so much easier,” she said.
The hospital has 39 interpreters who speak 12 languages. According to MGH, they’re now having more than 600 patient contacts a day, up 40 percent from before the virus. Interpreters were already using phones and iPads to remotely keep up with patient demand, but Santiago misses the human contact during coronavirus -- the eye contact, the touch of a hand. “In person is always better,” she said. “But as soon as I say, ‘Hola, yo soy su interprete’ it’s a recognition of, ‘I’m going to be understood.’”
Dr. Wendy Macias-Konstantopoulos heads MGH’s center for social justice and health equity.
According to the hospital, roughly 40 percent of their inpatient COVID patients are Hispanic -- the majority, about 80 percent, speaking Spanish as their primary language.
“You’re so fearful about your life, about your health, about your family,” Macias-Konstantopoulos said. “Unable to communicate, scared to access healthcare.
Macias Konstantopoulos speaks Spanish and relays the story of a recent patient who broke down realizing she could understand him. “He began to cry and he said, ‘God has sent me to you because I have not been able to tell anyone about my symptoms.’” She says having an interpreter or medical staff that speak their language, know their culture -- helps patients understand complicated medical terms and make informed decisions about potential end of life care.
“Those types of conversations are difficult even in English,” she said. “It’s that compassion, it’s that understanding. I can walk in their shoes, easily.”
MGH does serve a diverse patient base and Massachusetts was slower to track race and ethnicity data for coronavirus so it’s challenging to see a clear picture, but outbreaks in predominantly black, Latino and immigrant communities like in Boston and Chelsea are worrisome to doctors and state officials.
“These are the same cities, towns and neighborhoods that have disparities.” said Macias-Konstantopoulos “There are social disparities, economic disparities and that certainly leads to health disparities. It hits hard.”
Barriers can hit hard too. If patients cannot understand or be understood through the phone or ipad, interpreters will don PPE and go to their bedside without, Santiago says, hesitation.”
“This is what we work in a hospital for,” she said. “To step up when we’re needed.”