Sirens blare as Finney County EMS truck 94 bounces over the bumps of Mary Street in the heart of Garden City.
When EMS workers Crystal Justice and Tasha Oglesby arrive on scene to the multigenerational Latino home, Justice grabs the “go bag,” and the two head inside.
It’s the second call of the morning. Neither is surprised when they learn the patient sitting on the loveseat in a living room, an 84-year-old gentleman, speaks little English.
Calls like this are routine for Finney County EMS. Out of 3,284 calls in 2015, Skylar Swords, director of Public Health and Safety for Finney County, estimates about 25 percent of those calls were with non-English speaking patients. That’s the way it is in a city where the school district cites 39 languages are spoken.
Swords said most of the time there’s someone with the patient, like a family or friend, who can interpret. Finney County EMS also has two paramedics on staff fluent in Spanish. Bilingual personnel from the fire department and police department sometimes lend a hand, but when all else fails, EMS workers resort to a thorough patient exam.
On this particular call, the patient’s daughter-in-law steps in to interpret. The patient is experiencing pain in the right side of his abdomen, which could have been inferred through some basic gestures and rudimentary Spanish if necessary. However, the patient also suffers from Parkinson’s disease and diabetes. This morning, his blood sugar levels are twice as high as normal. Without the patient’s daughter-in-law present, Oglesby and Justice might not have figured this out.
Swords said that although it would be costly, the department is also looking into Rosetta Stone or a similar program so all of his employees can learn at least basic Spanish. Ultimately though, the bottom line is getting the patient to the hospital if they decide they want to go.
Oglesby grips one of the handlebars lining the interior ceiling of truck 94. The patient has agreed to go to St. Catherine Hospital. His daughter-in-law follows not far behind.
“Dolor?” Oglesby says, asking about his side.
He mumbles a few words.
“He says ‘take it easy,’” Oglesby yells to the front cab. “You can yell at her. I do it all the time,” she says jokingly.
As the ambulance pulls up to St. Catherine, Justice parks and the two jump out, wheeling the man into the Emergency Department.
Oglesby and Justice brief the hospital team on the patient’s condition while moving him from the stretcher to a stationary bed. The patient sits quietly without objection. He has no other option when surrounded by conversation he doesn’t fully understand, but that’s about to change.
“Prefiere inglés o español? (Do you prefer English or Spanish?)” Dr. Michael Miller says.
Miller is just one of several bilingual hospital employees. St. Catherine also has two full time on-site interpreters, several blue phones (interpreting phones), and the latest addition to their interpreting armory, Martti, My Accessible Real-Time Trusted Interpreter.
Language Access Network, the company behind Martti, is currently in more than 500 hospitals across the country, but St. Catherine is the only hospital in Kansas using the service.
St. Catherine started using the service in mid-2015. Currently, the hospital has four of the devices, which can best be described as Skype meets the pay-per-minute cell phone plan. The sleek, flat screen TV style devices are portable and extremely easy to use.
When the situation deems it necessary, a hospital employee simply dials the service, tells the on-screen operator which of the more than 210 languages is needed, and within minutes a real-time interpreter appears on the screen.
“The benefit of the Martti is you see the person’s face,” said Dr. Matthew Byrnes, St. Catherine’s chief medical officer.
Byrnes is a surgeon and a critical care doctor. He said he’s had many complicated conversations through an interpreter, often asking if the patient wants to opt for surgery in cases where the patient might have a deadly cancer, for example.
“I’ve not had a single person that I can remember in my career who has opted against surgery, so, in other words, opted for the option that would be fatal, through a translator, so that would lead me to believe that we’re effectively communicating,” Byrnes said.
Although interpreting phones get the job done and video interpreting has improved exponentially through the years, Albert Kyaw, a translator and interpreter for the Garden City school district, thinks there should be more medical training for interpreters.
“It’s important for them to have someone who can help them,” Kyaw said. “Sometimes providers, when they try to have interpreters on the phone or so-called blue phones, sometimes they don’t work perfect.”
Kyaw came from Burma to the United States in 2007, and received his medical training from a Jewish vocational program called Bridging the Gap. Kyaw, who has been in Garden City since 2009, speaks Burmese and Karen, a minority dialect of Burma.
He remembers once about three years ago visiting a family in the community at the request of one of the schools. When he arrived, he overheard the family on speakerphone talking with a medical provider and an interpreter. The mother in the family was trying to tell the medical provider that she had been having seizures, Kyaw said, but the interpreter couldn’t find the right word and instead said she’d been dizzy and had headaches.
“That’s why especially when we come to a situation where we helped the patients with the appointments or at the hospital, it’s important that the interpreters should know the proper medical terms,” Kyaw said. “Unless the interpreters know the proper medical terms, we can put patients in the situation where he or she could be in danger.”
Shortage of interpreters
John Birky, a family physician at Wellspring Family Health Care and member of the LiveWell-Finney County Health Coalition, said the organization recognizes that Garden City needs more medically certified interpreters. The challenge is finding those who are qualified, money to train them and the right mix of organizations to fund the interpreters’ on-going salaries once they are certified.
Birky, who has only been interacting with the coalition for the past year, hopes that he and his clinic, along with several other physicians, can help the organization with the challenges tied to training more interpreters.
While many health care professionals gravitate toward other more popular areas of the country, Birky, who grew up near Newton, said the diversity of Garden City aligned perfectly with his interests and his training. He studied an extra year during medical school as part of an international medicine fellowship in Zimbabwe.
Birky says cultural differences are part of what drives him when it comes to helping address the needs of immigrants and refugees. For example, he’s inspired by how hard many of the refugees and immigrants work only to send half of their wages back to their families who still live in their home countries.
“I think that knowing that gives me more compassion for these folks and desire to want to serve them and keep them as healthy as possible, so they can continue to love their families the way that they want to,” Birky said.
Communication in many forms
Of the 21 full-time employees at the Finney County EMS building, only two speak fluent Spanish. Because of this skill, supervisors in the department try to keep them on separate shifts so the EMS has at least one speaker on two of its three rotations.
Abel Nieto, one of the two Spanish speaking paramedics, said even when he’s on a call where the patient is non-English, non-Spanish speaking, he’s not nervous.
“We just try to do our best,” Nieto said. “It’s kind of nerve-wracking because you can lose a lot in translation, but I’d say on most calls, we rely a lot on our assessment of what we see.”
But just because the other workers don’t speak fluent Spanish doesn’t mean it’s from lack of trying.
EMS employees shared a story about a car accident outside the Tyson plant, when one paramedic asked a patient, “tienes trabajo”, which means do you have a job, when she meant to ask do you have pain. The patient just looked back at the Tyson plant confused.
Although health care workers and patients always will wish language barriers didn’t exist, trust, familiarity, kindness and a willingness to help always will be at the heart of each encounter.
Riley Mortensen is a University of Kansas senior journalism student from Bonner Springs.