Paola Guerrero Leigh speaks three languages – Spanish, English and “Medical-ese.”
“Medical interpreters need to understand two languages equally well, and they need to understand medical terminology, which is its own language,” said Carolina Perez-Tobon, Novant Health’s Language and Cultural Services operations specialist. She oversees the
COVID-19 testing site interpreters and ensures they’re all where they need to be on any given day.
The need changes often. During the COVID-19 pandemic, interpreters have been required at pop-up testing centers – which are, for safety’s sake, outdoors.
“My department makes sure that any patient who needs an interpreter can get one, no matter what language they speak,” Perez-Tobon continued. “We offer telephonic and video remote interpreters, but the in-person interpreters are really needed now at our COVID testing centers.”
Since the pandemic started, face-to-face interpreters for Novant Health have seen more than 10,000 Spanish-speaking patients at COVID testing sites. It’s part of the organization’s mission to care for everyone in the community it serves
‘The voice of the patient’
Guerrero Leigh describes her role as that of a bridge between patient and provider. “I always keep in mind,” she said, “I am the voice of the patient. But I do more than interpret words. I need to know their implications. While I’m listening, I’m also watching to see what a patient’s body language says.”
At drive-up COVID test sites, a health care provider greets the car and its driver. If an interpreter is needed, then Guerrero Leigh, wearing goggles and a mask – and sometimes a face shield – approaches the car.
“We have the option of wearing a face shield,” she said. “I have worn one at times. But on days when it’s above 90 degrees, it got too hot. The asphalt is hot, and patients keep their cars running, which makes it even hotter.”
Given the conditions they work in, there’s one trait medical interpreters should have, Perez-Tobon said. And that’s resilience.
And compassion. “I smile with my eyes since I am wearing a mask,” Guerrero Leigh said. “I introduce myself and tell them I am an interpreter. The first thing I tell them after my name is that everything that is said between them and the nurse or doctor will be kept confidential.”
She explains that test results may take a few days to come in and that they need to stay home until the results are in. She also has to be sure they understand that a positive result means they must quarantine for 14 days. (“We always ask if they feel safe quarantining at home,” she said.)
Patients are almost always anxious, Guerrero Leigh said. She tries to put them at ease. She tells them the test will be over quickly, and she projects an aura of calm. “If patients see you are confident, they feel relief,” she said.
Patients with negative test results get a letter in the mail. Patients who test positive get a phone call. Guerrero Leigh calls the COVID-positive patients she met and helps them schedule follow-up appointments. Interpreters are needed at every contact point along the way – not just at testing sites.
She spoke Spanish in her native Ecuador and learned to speak “doctor” when she was in college. She trained as a marine biologist, so she already had the right vocabulary for the job. (She also taught science in the Charlotte-Mecklenburg Schools system before becoming a medical interpreter.) Still, doctors and nurses still occasionally use terms unfamiliar to her. “I will always ask for clarification if I don’t understand,” she said.
Each disease has its own lexicon. When Guerrero Leigh interprets for cancer patients, she must speak the language of oncology. With COVID-19, she’s had to learn the vocabulary of infectious diseases.
As the voice of the patient, Guerrero Leigh uses the patient’s exact words when communicating with a provider. She doesn’t say, “The patient just said …” She says, “I,” as if she herself were the patient. If she has her own question, she’ll speak about herself in the third person: “The interpreter needs clarification.”
It’s not just patients who are glad Guerrero Leigh is there. Providers appreciate her service, too. "Good communication between the patient and the provider saves resources and time,” she said. “And that matters in terms of health.”
“There should be a bond between patient and provider,” she continued. “I never, ever, ever stand in the middle of them. The conversation is between them. I am just a voice.”