By Danielle Allen
The barrier
“Do you know what language she speaks?” I pull out my phone with my non-sticky glove to search “Language Line Services” in my contacts.
My partner asks, “ma’am, what language do you speak?”
The young woman stares wide-eyed and terrified at my partner.
“Do you speak Karen?” he asks.
“Karenni, not Karen.” she whispers, barely loud enough to be heard over the idling ambulance engine.
“Did she say Karenni? Is that a dialect of Karen?” I ask.
My partner shrugs. I put the language line on speaker and wait for the operator. I doubt the operator is even going to have a Karenni speaker, much less know what language it is.
The patient
My patient looked to be 7 or 8 months pregnant. Her neighbor, a nine-year-old girl, called 911 for her because she said she was having sharp pains in her tummy. When I asked her in what part of her tummy, the kid just gestured all over her stomach. The neighbor spoke just enough English to be able to talk to the 911 call taker and myself.
The language line
The language line operator finally picks up and asks for my department account number.
“My what?”
“Yes, hello. Ma’am. It’s the 9-digit code associated with your department’s account.”
I look out the window and see we’re pulling into the ER bay.
“You know what, never mind. We’re already here. Thank you.” I press end call, completely miss my bunker pants pocket, drop my phone into the puddle of green emesis that didn’t make it into my patient’s emesis bag.
The hand-off
“Name?” My partner points to the pregnant woman as we help the patient out of the ambulance.
The woman murmurs again, it sounds like a jumble of consonants. “Hleh?” “Htet?” “Hmet?” I really can't say, I scrub the goo off of my phone and enter my closest guess into the iPad.
The hand-off to the hospital staff goes just as awkwardly.
“This is Htet? She’s approximately 24 years old and maybe 7-8 months pregnant. The nine-year-old neighbor girl called because she was having pains in her stomach and vomiting. I believe this is her second child.”
“Wait, the neighbor or this lady?” The doctor interrupts.
“This lady.” I point to Htet.
“And what language does she speak?” The nurse asks and he rolls in the interpreter stand.
“Karenni.” I reply
“Do you mean Karen?” The nurse rebuts.
“No, I asked, and she insisted it was Karenni. It’s apparently a dialect found in a different region of Burma.” The hospital staff stares at me. “I looked it up en route.” They all nod.
“Well, okay, let’s do some labs then get her up to OB. Does she have anyone else coming?”
“I think she called her husband, but he’s still at work.” I reply.
The nurse is leaning over into the interpreter iPad stand. “No, I said Karenni. Not Karen.”
“Sorry. Hello, sir? The interpreter does not speak Karenni. Only Karen. The approximate wait time is 45 minutes. Will you hold?”
“Dr. Brauer, there’s no Karenni, only Karen, so…” The doc shrugs as she’s taking another call from what sounds like CT. “I guess we’ll wait for the husband…”
The reassurance
As I'm turning to leave, I wave at Htet. “The hospital staff is very nice and will take care of you. I hope you feel better.” I point to the hospital staff and do this weird bow with my hands clasped towards her.
Between my mask, her mask, the language barrier, and the lack of Karenni interpreters, I’m sure she wishes she would’ve just stayed at home, but if there really was something wrong, the hospital is the best choice— although it doesn’t feel like it.
“Just use the language line” They say… If only it were that easy.