December 2, 2005

Child Medical Translators – At Grandpa’s Bedside, Trying to Find Words for ‘Defeat’

By Eugenia Chien

My grandfather always doted on me because I was his eldest grandchild. He’d call me his “shing gan,” literally his “heart and liver,” organs he could not live without. It was his liver that gave him the most trouble.

It has been 10 years since my grandfather died from liver cancer. Memories of him, especially during the end stage of his disease, are still difficult for me. This month, California lawmakers are considering banning children under 15 from being medical translators in non-emergency situations. The proposed bill has forced me to revisit my own experience as an ad hoc medical translator.

Although I was 17 at the time, the experience was so painful that I cannot imagine asking a young child to go through the same thing.

My grandfather battled liver cancer for most of my life. No one in my family treated his disease as a terminal illness. He was determined to fight it any way he could.

After three of their four children moved to the United States from Taiwan, my grandparents moved to Torrance, Calif., to be near them. When grandpa’s health started declining, my family went to see a new liver cancer specialist in Los Angeles to get a second opinion.

On the way to the doctor’s office, my parents had asked me to translate for my grandfather. “Your English is the best,” they told me. “Just tell grandpa what the doctor says.”

The doctor took out a stack of medical reports and slides. From what he was saying, grandpa’s cancer seemed serious. But nothing prepared me for what I had to tell my grandfather next.

“You can have chemotherapy, or you can choose not to have it,” I stammered.

“Well, what would I do if I didn’t do chemotherapy?” my grandfather asked me incredulously.

My grandfather was a mechanical engineer before he retired. Like many engineers, he was an eternally optimistic problem-solver. At 17, I had watched him try so many different treatments to fight his disease. All my life I believed he would win his struggle against cancer. How could I tell him now that his best option was to wait and die?

I knew I was there to translate exactly what the doctor said, but I didn’t want to hear it. I was getting confused. I wanted to take care of my grandfather, to tell him what the doctor could do, not what he couldn’t.

“I don’t know, Grandpa, I think the doctor means you could go home if you don’t want to have chemo,” I said.

For the first time, I saw a look of defeat in my grandfather’s eyes.

A few weeks later, we received an urgent phone call from my aunt. By the time we arrived in Torrance, grandpa was in a coma.

After my grandfather died, we never spoke about that day in the doctor’s office. I tried to push it out of my memory. I felt anger and resentment at my parents and relatives for pushing that responsibility on me. I was just a kid.

As I became an adult, the resentment slowly faded. I knew that although my family was well-educated, they were also first-generation immigrants who could never be confident about their English abilities. They wanted to make sure they had someone they could trust to translate the doctor’s words. And someone from the family, instead of a stranger, surely would have seemed the best choice.

When my family asked me to translate, I never thought to refuse. But 10 years later, I am still haunted by what I had to do that day. Was the doctor saying that my grandfather had a choice, or was he saying that my grandfather was too weak to have chemotherapy? Did I give grandpa the correct message? Did my attempt to soften the blow of the doctor’s words actually hurt my grandfather more?

California lawmakers want to ban children from being medical translators. Opponents of the bill say that if children are kept from doing what I did that day in the doctor’s office, thousands of immigrants may not receive the medical information they need. But medical translation goes beyond naming body parts and symptoms. Sometimes, you have to tell your family the kind of information that even trained medical professionals dread to tell.

I wanted to help take care of my family that day. Like any child, I wanted to please them. But my desire to please also meant that I only wanted to bring them good news, not bad. That could be a dangerous characteristic in a medical translator. Not only is a child unfamiliar with medical terms, a child’s motives can be clouded by desire, a sense of obligation and all the other human emotions that prevent children from being clear and accurate translators.

It’s a shame that our hospitals do not provide for immigrant families. But asking children to make up for what hospitals fail to do is equally irresponsible.

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