Dying in Another Language

During one overnight in the intensive care unit, I took care of 2 patients: one was Polish speaking, who I will call Peter, and the other was Spanish speaking, who I will call Teresa.

For Teresa, the night started off with pain and ended with her unexpected passing. Her nurse could tell she was in pain, but could not understand where the pain was. Interpreter services were unfortunately difficult to access on this particular night. I happened to be on that night, thus was called over to help communicate with her. Teresa ended up dying unexpectedly 12 hours later. The death of patient is difficult every time, but I was struck by the start of the night. It started with Teresa being unable to voice her pains. I wondered how many LEP patients die without a voice.

For Peter, language barriers made the diagnosis of delirium difficult. I was called over to the bedside because Peter was becoming agitated and raising his blood pressure to dangerous levels. Unfortunately, neither the nurse nor I spoke Polish and interpreters were difficult to get a hold of. With his increasing agitation, I looked to technology for help, bringing out Google Translate. It was not a success since Peter had difficulty forming coherent phrases to translate. Peter eventually calmed down on his own and his blood pressure came down to our relief. I wondered what role language plays for a patient who is agitated.

Clearly communication and interpretation are important in all areas of health, and in acute settings they become critical. One night with 2 patients that will continue to guide my work in improving access for LEP patients.