Emergency Medicine Resident Physician

Reprinted with gracious permission from Caduceus, the newsletter of the ATA Medical Division
By Anonymous
(Submitted by Tricia Perry)

What is your job title? What educational background is needed for this position?

I am an Emergency Medicine Resident Physician. Training required: 4 years of undergraduate coursework with all medical prerequisites. 4 years of medical school. I’m in my last year of Emergency Medicine residency which can last 3 or 4 years depending on the type of program. Don’t forget the many high-stakes tests along the way, such as your medical boards or specialty boards.

Where do you work?
I work at a large inner-city county-style safety net hospital in the Northeast.

What does a typical day for you entail? What’s the hardest part of your job?

There’s no typical day in emergency medicine, but shifts do tend to have themes… somehow we see more abdominal pain on one day, more headaches on another. When it’s a beautiful spring day, it’s trauma season. The best part of the day is really helping someone feel better or being able to reassure them they do not have a life-threatening condition at this time. The hardest part of the daily job is addressing unrealistic expectations. People tend to want solid answers or immediate solutions, and we can’t always offer them. I can rule out life-threatening conditions, which is what the emergency department is designed for, but that doesn’t necessarily tell you exactly why you’re having pain. It can be frustrating both for patients and providers. The hardest part of the job overall is when there is a death, especially of a young person. No one expects young people to die from a trauma or a medical illness. It’s a lot to handle sometimes.

Please talk about the types of interactions you have with other medical professionals.

I interact with all kinds of medical professionals. From attending within my specialty or a consulting service, to nurses and techs all over the hospital. We are fortunate to get to know people from most departments in the hospital.
Do you know more than one language, and if so, do you ever use these language skills at work?

I do speak another European Romance language, but have never had a chance to use it in my job.

In what way, if any, do you come across translation and/or interpretation in your work?

Many of my patients are from the Caribbean, so Spanish and Haitian Creole are both used at my hospital. We do not often have on-site medical interpreters or translators, so the Cyracom translator phones are our go-to for appropriate communication. The real trouble arises with older folks who are hard of hearing or severely demented; the phone just isn’t loud enough or can’t be understood. Times like this are when we reluctantly get family, nursing, or techs involved in “unofficial” translation and interpretation. And of course, in a truly life-threatening emergency where a patient may die within seconds to minutes, I will use any available speaker (usually a tech or nurse) without hesitation.

What do you wish medical interpreters and medical translators understood better?

Please don’t have a detailed conversation with the patient and only translate one or two words. If I have not been clear, please help me ask the question in a better way. Also, I wish we had more of you on-site!

Does your institution have a structured system in place for when interpreters and/or translators are needed?

I have been most impressed with our deaf and hard-of-hearing patients, whereby a video translator/interpreter for American Sign Language is enacted through triage so that the video system arrives with the patient into the emergency department.

What do you wish would change about the way you and/or your institution interact with translators and interpreters? What good practices do you see already in play?

Sometimes no interpreters are available. Using interpreters over the phone is a very frustrating and awkward experience.
Feel free to add any other comments or to describe a specific experience involving an interpreter or translator.
My funniest experience was with a deaf patient from an English-speaking small Caribbean island, whose primary language was a local variant of American Sign Language. I studied sign for a year a long time ago, but I cannot conduct a proper medical visit alone so I use the video interpreter. The woman that popped up on the screen spoke and somehow signed with a southern drawl, and the patient signed with very “slangy” signs. The ensuing conversation where we all struggled get on the same page had us all laughing by the end. Fortunately, that patient did well.