The patient’s daughter opted to speak for her mom, rather than use the interpreter JPS Health Network had provided. Marcella Galdamez waited quietly.
Before long, the medical terminology proved vexing — as it does across languages — and the daughter asked Galdamez to take over instead. She did, and the ease and fluency with which she communicated to both provider and patient shook the family.
“They realized the difference between being bilingual and being an interpreter,” Galdamez told the Report.
An interpreter, someone who translates speech orally, works to impart not only words but meaning from one person to another. Doing so can improve clinical care for the millions of people who don’t speak English fluently in Texas and the U.S.
“(The patient) is in the loop, too,” Galdamez said. “And she’s able to understand, and I feel like that makes them feel more comfortable, too, because they’re included in everything and everything is transparent.”
For Galdamez, one of more than 50 interpreters at JPS Health Network, the role requires both an emptying and acute awareness of self. She becomes, as she describes it, the “voice” of each person in the room and at the same time, an intermediary when understanding breaks down.
After growing up in Los Angeles, Galdamez planned to work in the background, mostly with medical equipment. She studied biomedical engineering at Smith College in Massachusetts, then moved to Fort Worth to live near her sister and niece. An internship at JPS Health Network challenged her plans. She realized, then, that she enjoys working with people more than objects.
“I like working with patients and helping them,” Galdamez, now 28, said. “And I like the energy I get and the fulfillment I feel from interpreting for a person that wasn’t going to understand what the doctor said.”
In Tarrant County, about 1 in 10 people have limited English proficiency, which means they don’t speak English as their primary language and struggle to read, write, speak or understand English.
Galdamez, who has interpreted at JPS Health Network since 2016, speaks Spanish and English. She also translates, the written equivalent of interpretation.
Her colleagues speak Arabic, Vietnamese, Swahili, Pashto, American Sign Language and more than 100 other languages for patients who move through the county hospital. On average, the team provides more than 15,000 patient calls in person, over the phone or by video each month.
“(Interpreters) are just a very, super important aspect of health care,” said Dr. Julia Zepeda, a family medicine physician at JPS Health Network. “We wouldn’t be able to carry out the quality care that we do here at JPS without them.”
She and Galdamez work together almost daily, and she marvels at the interpreter’s compassion. Her presence allows Zepeda to gather not only clinical data but information the patient may not otherwise deem important. In a patient room, comfort enables sharing.
Do you or does someone you know need an interpreter at JPS Health Network?
The Civil Rights Act requires hospitals that receive federal funds to provide language services for free to people who need them.
- A member of your health care team can request an interpreter for you.
- When you make an appointment, you can indicate your need for an interpreter to be at your visit.
The process works like this: When Galdamez meets a patient, she introduces herself and what interpretation looks like.
“‘I’m going to be your voice. I’ll be the doctor’s voice,’” she tells them. “And that way, they know what I’m doing there. I’m not just another doctor or a nurse. I’m just there to be their voice.”
If the patient says, in Spanish, “I have a stomach ache,” Galdamez employs the first person. “I have a stomach ache,” she interprets. She does the same for the provider.
People communicate not only with words but bodies and tones. If a patient cries, Galdamez adopts a somber tone. If the patient curses, Galdamez will do so too — but only enough to communicate the patient’s anger. Her purpose is to echo but not exacerbate any feelings in the room.
Furthermore, more complicated exchanges require cultural and linguistic finesse, and Galdamez chooses her words carefully. In Spain, for example, “tonsil” is “amígdala.” In Mexico, it’s “angina.”
The relevant diction offers only one layer of meaning. The patient may understand the term but not the concept: tonsil, a lymph node at the top of the throat. If need be, she’ll clarify.
“(Marcella) has a good sense of whether or not patients are understanding the language she’s using,” Zepeda said. “And she can backtrack and use more direct language or simpler language that the patient might better understand.”
Sometimes, Galdamez herself doesn’t understand a term: A few years back, her provider mentioned the duodenum, the first part of the small intestine that connects to the stomach. She asked the provider to define and locate the duodenum so Galdamez could do so for the patient.
“I’ve never heard that word before and now I can apply it, I understand it, I can study it,” she said. “It’s a learning process.”
Along the way, Galdamez gathers not only words but relationships. She may interpret for the same patient, over and over again, for years. She’s with them as they enjoy and endure life’s many seasons: the birth of a baby, the securing of insurance, a cancer diagnosis.
“I’ve given good news and bad news. And I feel like each one is equally important,” she said. “They both leave a mark on you.”
When the hard days come, she prays for her patients and afterward, she pursues self-care: unplugging from devices, journaling, praying some more. She hopes, one day soon, to pursue medical school. She’s thinking family medicine, like Zepeda.
“I’d like to be able to speak to my patients the way my doctors do,” Galdamez said, but in a language that they know and understand. That connection point is a balm to the patients she works with now.
“They feel like there’s a voice that understands them,” she said. “I find that very rewarding.”
Alexis Allison is the health reporter at the Fort Worth Report. Her position is supported by a grant from Texas Health Resources. Contact her at alexis.allison@fortworthreport.org or via Twitter. At the Fort Worth Report, news decisions are made independently of our board members and financial supporters. Read more about our editorial independence policy here.
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