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thelinguist.uberflip.com DECEMBER 2015/JANUARY 2016 The Linguist 27 OPINION & COMMENT The panel was 80% in favour of interventions for clarity during clinical consultations, but there was one dissenting voice. There were some strongly worded objections to cultural briefing, with a panel member describing it as "deeply suspect, an open invitation to a set of behaviours that are not suitable for an interpreter". The concern was that this can turn into stereotyping or even prejudice. Truth and the lifeworld Lifeworld and truth are sometimes in conflict. Conflict in one's lifeworld can pose a serious threat to 'face'. Immediately after a heated argument, for example, the participants begin to repair their places within society's expected norms. Each will rub out the sharp bits, clean up the language and delete some of the unwelcome truths delivered. 'Face' must be preserved. Clinicians need to pursue a hypothesis for diagnosis or a treatment plan. They need to 'hear the voice' of the patient directly, at the time, in the clinic, not half an hour or two days later through a third party. One reason is that we often respond differently to the same question, e.g. "did you enjoy your holiday?", from one day to the next, as we are all acting in our own lifeworlds all the time. The work of Heritage and others shows that no interpreter is qualified to assume epistemic authority within an interpreted communicative event, except when they intervene to establish clarity of mutual understanding on the basis of their direct knowledge of the two languages and cultures. The participants are the only people with primary rights to their own understandings and meanings. Erving Goffman, in his comprehensive and encyclopaedic inquiries into social interactions, understood that personhood must not be usurped. "The regulation and sanctioning of such rights is no trivial matter, but is rather a part of the internal 'housekeeping' that is a condition of personhood and even sanity." 3 Glossing the message In psychiatric assessment, intricacy and detail are major features of diagnosis but are often glossed over by the abstracted nature of the note-taking style. Both the clinician and the interpreter take notes using minimal numbers of words or symbols. This time-saving device is ephemeral, so it is vital that the message is written in words on the clinical record as soon as possible. The full information spoken by the client/interpreter cannot be captured again. Even when the interpreter is maintaining an impartial role, it seems that the particularities of a patient's speech may get lost in the doctor's clinical notes. Use of the 'intervention for clarity' protocol is important in order to avoid potentially serious misunderstandings. If, for example, the word tío (Sp; 'uncle') crops up frequently in a patient's narrative description, this word may enter the patient's record. Without an intervention to reveal, for instance, that the tío is just 'some bloke in the park', safeguarding issues may be missed. The distinction between formal speech and jargon must be made, in this case, to avoid confusion between real family relationships and slang describing a stranger. If this is not done immediately the problem will become a damaging myth that is recorded as fact in the written notes. Interpreters in such situations must always convey, in both languages, that they are intervening to clarify something. Mental healthcare settings Interpreted communicative events, most particularly in mental healthcare, are all about the words. A near fit must be found for the concept and contextual references in the language of the clinic. The diagnosis hangs on the words. Public service interpreters need, more than in any other domain, to employ 'close interpreting' in order to leave clinical assessment to the doctor. Doctors have no choice but to rely on the competence of interpreters. That is not our fault; interpreters must be the gatekeepers to every turn-at-talk. My research data shows that there is still confusion between the terms translation and interpreting. There is one unifying factor though, which applies to both: "The better written a unit of the text, the more closely it too should be translated, whatever its degree of importance […] If the details and nuances are clearly expressed, they should be translated closely, even though they could just as well be paraphrased. There seems no good reason not to reproduce the truth, even when the truth is not particularly important." 4 Neither does there seem to be a good reason for interpreters not to "reproduce the truth", meaning to interpret closely, even when the content of the spoken message seems not to be particularly important. But who is to say what is important and to whom? Notes 1 Heritage, J and Raymond, G (2005) 'The Terms of Agreement: Indexing epistemic authority and subordination in talk-in-interaction'. In Social Psychology Quarterly, 68/1, 15-38 2 El Ansari, W et al (2009) 'The Role of Advocacy and Interpretation Services in the Delivery of Quality Healthcare to Diverse Minority Communities in London, United Kingdom'. In Health and Social Care in the Community, 17/6, John Wiley & Sons, 636-646 3 Goffman, E (1983) quoted in op.cit. Heritage 4 Newmark, P (1991) Paragraphs on Translation, Multilingual Matters Dr Jan Cambridge FCIL has 30 years' experience as a public service interpreter. TL