George Gonzalez grew up in Cuba speaking only Spanish. But he had a career ambition that required him to learn English.
“I have a cousin who is an interpreter,” he said. “He came to Cuba several times, and he would explain his job. And I was like: ‘Wow, so that means you are the conduit of communication between the doctor and the patient.’ And I said, ‘Cousin, that sounds amazing. I would like to do that when I get to the U.S."
But first, he needed to learn English. And then he needed to learn medical lexicon.
When he got to the U.S. in 2012, he started work at another hospital in Winston-Salem as a housekeeper. It was one way into his chosen field.
He also started working at the YMCA. Gonzalez had been a swim coach for the national team in Cuba, and he began coaching and lifeguarding at the Y and learning English there, too. “My (English) instructor taught me a lot,” he said. “He told me I needed to learn not only the language, but the culture, as well. He told me when your English gets better, I will give you the green light to start taking the test for interpreters.”
Gonzalez enrolled at Forsyth Tech Community College and joined Novant Health Forsyth Medical Center as an interpreter in 2016.
The job has become even more than he imagined as a teenager in Cuba. In 2019, Novant Health expanded the responsibilities of the 19 Spanish-Cultural Ambassadors/ medical interpreters (12 in Winston-Salem/Salisbury and 7* in Charlotte) and gave them a new job title, too – cultural ambassadors. They do more than interpret; they’re patient advocates.
Supported by a three-year, $195,000 grant from the Duke Endowment, the cultural ambassador program helps ensure Spanish-speaking patients understand their condition and the treatment approach being recommended.
That’s essential work, considering the size of the Hispanic population in the U.S. The number of Hispanics living here surpassed 60 million in 2019, according to the U.S. Census Bureau. Nearly 9 percent of the American population speaks – and comprehends – English “less than very well.” That’s more than 20 million people.
To help that fast-growing population, Novant Health also publishes Noticias de salud para Latinos, a Spanish-language health resource similar to Healthy Headlines but tailored to the needs of that community. Patients can also find Novant Health doctors who speak Spanish by clicking here.
Becky Swaringen Allman, cultural ambassador supervisor for both Novant Health Forsyth and Rowan Medical Centers and her team are working toward learning about other cultures such as Arabic, Vietnamese, Urdu, Afrikaans and more. Gonzalez is studying Mandarin so he can ultimately communicate with Spanish- and Chinese-speaking patients. “In addition to the Spanish-speaking cultural ambassadors, Novant Health offers video and/or telephonic interpretation for more than 200 languages and dialects through companies we contract with,” Allman said.
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Understanding what’s not being said
“Being a cultural ambassador lets you go way beyond being an interpreter,” Gonzalez explained. “We do more than listen to what a patient is saying. We have to focus on the facial expression of the patient. A patient may be telling us she understands, but in her face, I can see she is confused. I have to say [makes timeout gesture], ‘Excuse me, doctor. Sorry; she is saying yes. But I think she's not understanding. Can you use different words, or draw a diagram on the board?’”
Ambassadors go the extra mile to ensure patients understand – and are understood. It requires more than being bilingual. “If you don’t have compassion, you won’t fit in,” Allman said.
Gonzalez and the other cultural ambassadors don’t know from one day to the next what part of the hospital they’ll be working in. They go where they’re needed and may be in several different wings – from radiation oncology to the ER – throughout their shift. Each discipline, each department has its own vocabulary, and cultural ambassadors need to know all of it.
Labor of love
Gonzalez, one of two men on the team, is sometimes dispatched to labor and delivery.
A new mother – who’s also new to America – may not know about the benefits breast milk has for her baby. She may also need to be coached on how to do it.
“Many Hispanic ladies – from what I have noticed – when they deliver, they may not know anything about colostrum.” (That’s the first secretion from the mammary glands after giving birth.)
Sometimes the woman delivering a baby is entirely alone in the hospital – and maybe even be alone in this country. The father may not be part of her life anymore. “We step in and say, ‘I’ll be your sister today. I’m here for you.’” Allman said. “We’ll ask what we can do. Maybe it’s holding their hand through labor. Maybe it’s grabbing a camera and snapping the first photo of mom and baby skin-on-skin. We are there to do whatever they need.”
Across the hospital, he’s there to help. “I don’t know what I would do without George and the other interpreters,” said patient Modesta Issac Delgado, 68. “For us Spanish speaking Latinos, having someone that can interpret for us is the best thing that can happen to us. George is great at lifting my spirits.”
The joys and sorrows
Cultural ambassadors are present for births, but they may also be present for end-of-life care, too. “Delivering tough news – that's the most difficult part of this job,” Gonzalez said. “And we have so many dear patients that we love. We have to be ready, not just with the right vocabulary, but to engage emotionally.”
“Our team has to know so much more than a patient’s language,” Allman said. “We need to understand their culture and, at times, we need to understand their cultural beliefs around death.”
They encounter many patients who don’t have insurance or a primary care physician. “We have to know many resources here in the community,” Gonzalez said. “We have to ask patients if they are aware of these resources and then link them when necessary. If they don’t already have a primary care provider, we can help them find a Spanish-speaking one. When they say, ‘I'm going to that doctor,’ that's a great relief for us.”
The ambassadors look out for needs that go beyond a patient’s physical health. “We make referrals to free clinics, food pantries, shelters, clothing ministries,” Allman said. “We have a vast community network that can address a variety of needs.”
“Our team is here to take care of, really, anything a patient might need,” she continued. “It might be as simple as getting a phone charger – or it might be a religious object – but if the staff can’t understand what a patient is asking for, they can’t help.” That’s why ambassadors round on patients every day during all three shifts. They stop by the room of every Spanish-speaking patient to ask how they’re feeling and what they need.
It’s emotional work. But the team is always there for one another. “We are like a family here,” Gonzalez said. “Every single day, we nurture each other.”
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- Face-To-Face Interpreter
- Video Remote Interpreter (ROLL & ZOOM)
- Over-The-Phone Interpreter (Telephonic)
- Written Translations
Pedro E. Mendez
Corporate director of language & cultural services/Email: [email protected]
Maria C. Mesiemore
Interpreter education coordinator/ Email: [email protected]
Supervisor language & cultural services operations/Email: [email protected]
Specialist, language & cultural services operations/Email: [email protected]