Interview

1. What drew you to become a medical interpreter, especially at a free clinic setting?

I was working as an interpreter at UMass and helping coordinate medical interpreter services when I learned about St. Anne’s free clinic. We knew many of the people coming to the clinic were underserved, uninsured, and did not speak English. 

A group of students began going to the clinic on Tuesday evenings, and I went with them to help address language barriers for patients while also helping students build their language skills. That goes back to around 1990.

At that time, the Brazilian Portuguese community in Worcester was growing, and many people were working very hard but did not have insurance or time to go to the doctor during the day. The evening clinic gave them a place to receive care.

2. How is interpreting in a free clinic different from working in a hospital or private practice?

In a free clinic, many patients are hardworking people who cannot afford insurance, medication, or specialty appointments. It can become a vicious cycle: the patient is sick, but they may not be able to pay for medication or access specialists like dermatology or pain clinics.

That can be frustrating for patients, interpreters, medical students, and providers. When someone has an acute illness or needs surgery, the team has to work hard to connect them with services outside the clinic.

The medical staff does an incredible job trying to reduce barriers. For example, they compare prescription prices between pharmacies and help patients find coupons so medications are more affordable.

3. What unique challenges do patients at free clinics face when it comes to communication?

For many new patients, the first challenge is simply arriving at the clinic and not knowing whether anyone will understand them. You can see the relief on their faces when they are greeted and asked what language they speak.

The clinic also has translated registration forms in the languages most commonly spoken by patients, including Spanish, Portuguese, and Haitian Creole. That helps patients feel more comfortable from the beginning.

Another challenge is fear. Some patients have limited insurance but are afraid to use it because they do not understand what the implications might be for them as immigrants. They may ask whether their visit will be reported to the government. We have to reassure them that the free clinic is free of charge and not connected to government paperwork.

4. Can you share a moment that really stayed with you — something that reminded you why this work matters?

One of the most meaningful parts of this work is helping immigrant children access healthcare and education. Many families come to the clinic with vaccine records from their home countries, and the medical students help enter those records into the Massachusetts immunization system so children can start school right away.

That is very gratifying because it helps newly arrived children begin on the right path in the United States.

Another moment that stayed with me was a Brazilian patient who came to the dermatology clinic because his wife encouraged him to get a spot on his skin checked. He was not very interested in being seen, but he came — and it turned out to be skin cancer. Many immigrants work outdoors, such as in landscaping, so identifying something like that early can make a major difference.

5. What’s a common misconception people have about interpreters?

The biggest misconception is that anyone who is bilingual can be an interpreter. That is not true.

There is also a difference between translators and interpreters. Translators work with written documents. Interpreters communicate spoken information, including the meaning and context of a conversation.

Medical interpreters need to understand not only the language, but also the culture. Culture is embedded in language. A Portuguese speaker from one region of Brazil may speak differently from someone from another region, and someone from the city may communicate differently from someone from the countryside. Interpreters have to communicate clearly and precisely while helping providers understand cultural context.

6. Beyond language, how do you help bridge cultural gaps between patients and providers?

Interpreters help open communication between patients and providers so providers can ask better questions and understand the patient’s background. Culture affects how patients describe symptoms, what they believe about illness, and how they experience care.

For example, I once interpreted for a patient from Brazil who had Lyme disease. The provider asked where he was from and what kind of work he did. He explained that he had worked on a farm in the countryside, where he may have been exposed to ticks. Without an interpreter, that important social and occupational history might not have come out clearly.

I also teach medical students about Latino and Brazilian cultures. Understanding where a patient comes from, when they arrived, and what their life has been like helps providers give better care.

7. What does a typical day look like for you at the free clinic?

It is a very busy evening. We start by greeting patients, helping them register, giving them forms, and assessing their language needs. From there, we keep going until the last patient has been taken care of.

Sometimes I interpret in both Spanish and Portuguese, depending on how many volunteers are available. If I am the only Portuguese interpreter that evening, I may focus on Portuguese-speaking patients.

It is busy, but very rewarding. The medical students and the whole team work hard to make patients feel welcome and cared for. Patients often leave with gratitude, smiles, and blessings for the team.

8. What skills does someone need to do this job well that people might not expect?

Medical interpreters need formal training. Being bilingual is not enough. Interpreters need to understand ethics, confidentiality, HIPAA regulations, professionalism, and the proper role of the interpreter.

A key skill is interpreting everything accurately without summarizing. Every detail, even subtle parts of a conversation, may be important for the provider.

Interpreters also need to understand advocacy in the right way. For example, if a patient says they have not eaten all week because they do not have money for food, I should not try to solve that alone. I need to involve the case manager and work with the team so the patient gets appropriate support.

9. What do you wish more people understood about your work?

I wish people understood that interpreters do not simply do the work and go home. Some cases stay with you.

Interpreters hear difficult stories, including trauma related to immigration, violence, poverty, and hardship. That can create vicarious trauma. This work is meaningful, but it is not easy.

For me, this is a vocation. I think many interpreters who have done this work for years feel the same way.

10. What keeps you coming back to this work?

The satisfaction of serving the community keeps me coming back.

When I came to this country, I was relearning English and trying to understand my own path as an immigrant. Volunteering opened my eyes. I began helping people in the community, especially when the Latino community in Worcester was much smaller.

Communication is such an important part of society. People often criticize immigrants without knowing their lives, their struggles, or why they came to this country. Everyone has a story, including me.

11. One word to describe the experience: Satisfaction