Carrie Gillon: Hi and welcome to the Vocal Fries podcast, a podcast about linguistic discrimination!
Megan Figueroa: I’m Megan Figueroa.
Carrie Gillon: I’m Carrie Gillon.
Megan Figueroa: Here we are.
Carrie Gillon: We had to re-record this for the first time ever – knock on wood [knocks].
Megan Figueroa: Luckily, it’s just an intro and not a whole episode because we wouldn’t have been able to do it if it were a whole episode with a guest. That would be cruel to ask the guest to do.
Carrie Gillon: I mean, I would ask, just in case, but oh my goodness.
Megan Figueroa: How bad we would feel!
Carrie Gillon: But anyway, let’s hope this one sticks.
Megan Figueroa: Yeah. It’s gonna be surreal talking about something that we just talked about recently to each other again.
Carrie Gillon: We just found out about it yesterday, so at least it wasn’t 30 minutes ago. Somehow that feels less bad.
Megan Figueroa: It’s true.
Carrie Gillon: Anyway, speaking of, we were talking about Seth Meyers and Philly.
Megan Figueroa: I feel like people in Philly, from what I’ve learned, even since we released our Philly episode with Betsy Sneller, that people in Philly love to talk about Philly. So, hopefully, everyone is very happy to hear more about Philly.
Carrie Gillon: Except not so much the bad stuff that Seth Meyers had to say.
Megan Figueroa: Yes. Unfortunately, he attacked the Philly accent.
Carrie Gillon: Yes. And in a non-fun way – like, not even interest – I dunno. At first, it was some lexical items – which, fine, sometimes it’s fun to talk about lexical items – but then, of course, the accent and then basically hoping that Philadelphians would all die so that their accent would die, which is uncomfortable.
[Excerpt of Seth Meyers from Late Night with Seth Meyers] [00:02:15]
Hey, Philly accents, I hate to whizz on your hoagie, but you’re something we could all do without. You’re the grossest regional dialect. You make Boston sound like the Queen’s English and “Why do yous talk like dat?” Are you mad you can’t get good bagels in Philly because of the “wough-der,” or is your tongue burnt from licking the scrapple pan? I’ll be honest, I hope Mare of Easttown never catches this murderer, so we can off a few more of you people. Philly accents, time to get up out of this “jawn” because “yous burnt.”
Megan Figueroa: It’s from a section where it’s like “Ya burnt,” and he just goes through things and basically cancels them. I hate using that word now because it’s been ruined.
Carrie Gillon: It’s been skunked, yeah.
Megan Figueroa: “Skunked.” Oh, is that the technical term? [Laughs]
Carrie Gillon: That is the, I guess, technical term, yes.
Megan Figueroa: You know, goes through things like – I dunno. It’s supposed to be silly. Sure, yes, absolutely. Comedy is supposed to be silly – often. But the problem with this – and I think about it in terms of how – I watch Seth Meyers, and he seems to have a fake beef with Philly that has extended over years. So, that context, perhaps, helps explain it. But the thing about all of this making fun of accents or saying that this accent’s bad or whatever is that, often, people see it out of context, or often people don’t have the background knowledge to know that that kind of stuff is actually quite harmful. We see people get fired or discriminated against in other ways because of their accent. That’s the context that’s missing.
Carrie Gillon: He seems to think it’s acceptable to mock a regional accent. I don’t know why. I mean, I guess just because everybody thinks it’s acceptable. But it is more problematic the more difficult it is for someone to live their life and get jobs – be treated with respect. Sure, a white person from Philadelphia is not gonna suffer as many consequences as a Black person from literally anywhere in the United States, but there is still harm being done to Philadelphians who use this particular variety of English that he is mocking.
Megan Figueroa: Absolutely. When linguists or other people who know this – people from Philadelphia or whatever point this out – in this case – because it could be a Southern dialect or an Appalachian dialect – whoever is the person that points this out to someone, it always seems like they’re trying to be a killjoy, but it’s very real. This is a very real issue that people have the right to bring up.
Carrie Gillon: It lays the ground for worse behavior. Now, maybe in this case, knowing that he always mocks Philadelphia, maybe it comes across differently. For me, the real thing is – because I don’t watch him. I’ve never really watched him. I don’t really know why. I just didn’t. The fact that he mocks murdering them – that’s where I’m really upset. Mocking their accent – you can do it in a way that’s not as scary at least. This one is just, to me, terrifying. I dunno. I know it’s nowhere near actually murdering people, but it just feels like you’re down the road of feeling like that’s an acceptable response.
Megan Figueroa: In the clip, he uses a bunch of lexical items that have been stereotypically associated with the Philly accent – like “bagel” pronunciation and “jawn” and other things. For some reason, people lately have been latching onto the word “murder” as a Philly – you mentioned that people in Philly don’t actually say it differently – do they – than you or me?
Carrie Gillon: “Murder”? I think they say “murder” pretty much the same way most people in North America say “murder.” The reason why he brought it up, I think, was because of the TV show Mare of Easttown but also the SNL sketch making fun of it called “Murder Durder.”
Megan Figueroa: Right.
Carrie Gillon: Which is, apparently, not the way that Philadelphians actually say – or anyone in Pennsylvania pronounces “daughter.” I think it’s more like “dough-ter.” But, again, I’m not a phonetician.
Megan Figueroa: Right. Kind of like it would rhyme with “wough-der.” How they say “water.” Right?
Carrie Gillon: Probably. That’s a good guess anyway – “wough-ter,” “dough-ter.” Yeah, that’s probably right. [Laughs] Feel free to correct us if we’re wrong.
Megan Figueroa: Oh, yeah, please.
Carrie Gillon: So, it felt weird to use the murder thing, even though I understand the connection. I can draw the line through the dots getting to murder as a thing to talk about. But it just, I dunno, makes my skin crawl when comedians are joking about murder – in this way, anyway. I dunno. There’s probably a way to joke about murder that would not make my skin crawl, but this one did.
Megan Figueroa: The jokes fell flat.
Carrie Gillon: Also, his affect was really flat. It was weird. Is that how he always is?
Megan Figueroa: Well, I feel like it has been lately because of COVID and just being tired of it all because not having a studio audience and stuff. I feel like he’s been –
Carrie Gillon: All right. Okay. I won’t mock him for that because I understand that feeling all too well.
Megan Figueroa: No, no, I’m not trying to defend him. More just to say, “Here’s the context of it.” But yeah.
Carrie Gillon: I think if he had just stopped short of the murder thing, I don’t think I would’ve really cared that much. It’s not great to make fun of someone’s accent, but eh. We all do it, and comedians do it a lot. As long as you’re not being really wretched about it, I’ll just ignore it. But this was just – [laughs] – it crossed a line for me.
Megan Figueroa: It would be helpful if everyone listened to our show so that they knew when comedians did these things, they could pause and say, “Oh, I know what you’re doing. Every dialect and variety is equal,” and then move on.
Carrie Gillon: Every variety and dialect is equal. Once everyone believes that, then I think it’ll be easier to mock other people’s dialects because it won’t matter as much.
Megan Figueroa: Exactly.
Carrie Gillon: Comedians, you should try to make sure that we all are on the same page so that you get to make your silly jokes.
Megan Figueroa: There should just be an asterisk on the screen, and at the bottom it says, “All varieties are made equal.”
Carrie Gillon: Even that would help a little. Footnotes on TV.
Megan Figueroa: Was that a really academic thing to say – to suggest to have footnotes?
Carrie Gillon: I feel like on TV they do use things like that, but it does feel kind of academic, yeah.
Megan Figueroa: Taking away the fun from everything – that’s what we do. No, that’s why you need to be careful and responsible consumers of media. That’s what we all should try to do.
Carrie Gillon: Oh, my goodness, yes. Anyway, today’s episode is pretty fun. You get to hear some interesting sounds because our guest is in Mexico. It was really fun – roosters and chickens and other birds.
Megan Figueroa: A taste of Mexican life in some parts of Mexico.
Carrie Gillon: Hammering, construction noise, and then, on your end, there was some dogs at one point. There was no way for me to cut it out. It’s like, eh, people will be fine with it.
Megan Figueroa: They’re just saying hi. Oh, and a quick note that our guest, Elena Costello, is now Dr. Elena.
Carrie Gillon: Congratulations.
Megan Figueroa: Yes, congratulations. We have a backlog of shows that we want you all to hear, but this is what happens. Some things change in the meantime.
Carrie Gillon: A lot of things change in the meantime. Canada’s no longer so far behind the United States in vaccination rates. Fully vaccinated, yes, we are super far behind. But now single vaccinations, I think we’re on par with the United States. I feel a little less stressed about that. I took all that stuff out. It just didn’t feel relevant anymore.
Megan Figueroa: Right. It felt like you were whining about something because that thing wasn’t there anymore. It’s like, “Why are you talking about this?” Yeah, I get it.
Carrie Gillon: Anyway, enjoy!
Megan Figueroa: We’re really excited to say that today we have Elena Costello Tzintzun who is a PhD candidate at the Ohio State University in the Department of Spanish and Portuguese where she studies language and identity. Her areas of expertise include heritage language learners as part of Latinx cultural studies, the role of interpreters in healthcare, accessibility to healthcare based on cultures, discourses, and practices of health with a focus on race and equity inclusion. She has worked as a medical interpreter and she teaches heritage language speakers how to be medical interpreters. She managed a Spanish language primary care practice in the United States, Clinica Latina, for 15 years, and she also started the Scholars of Color in Linguistics, which is amazing. Oh, and you’re gonna defend your dissertation in, like, a second – in three weeks – right?
Elena Costello: I’m defending very soon.
Megan Figueroa: That’s really exciting. Congratulations.
Elena Costello: Thank you.
Megan Figueroa: Before we get into healthcare interpretation, COVID, the vaccine rollout, and all that, you’re celebrating something really fun. You teach heritage languages speakers how to be medical interpreters in Mexico, right, mostly?
Elena Costello: I do both. I’m teaching right now medical interpretation to bilingual Latino high school students through the University. When I was in high school, I enrolled in the university – I’m the first woman in my family to finish high school and the first person to go to college. The way that I did that was I took classes in Spanish because I already spoke Spanish at the university. It was my way to sneak in while still in high school.
Then I started working as an advisor in the university and I realized this was a way that I could get Latino kids in who usually wouldn’t be allowed in because you can break all the rules that are required to get in if you excel or have an exceptional ability in some area. I argued that heritage language learners have an exceptional skill in Spanish and that what we could do is do a two-year program to train them to be medical interpreters. They take different courses in different departments like communications, geography, Spanish, and Portuguese. They get background on culture and ideals behind healthcare but also the language part of it. After two years, they take the national certification test, and they are nationally certified interpreters.
I’m teaching that right now at Ohio State online because of COVID. In Mexico City I’ve also been training repatriated people, so people that were deported or chose to come back. And I use the term “chose” very loosely. Maybe their mom got sent back, so the whole family came back, so you didn’t really choose but you kind of did. I’ve been training them in medical interpretation and helped – we launched a cooperative on February 1st.
Megan Figueroa: Yeah! Can you just tell us a little bit about the cooperative that just launched?
Elena Costello: It’s run all by repatriated people, so people who grew up in the United States. I think the shortest amount of time for anyone in the group was eight years that they spent in the US but always as children or adolescents. Most of them spent – they’re, like, 23, and they spent 22 years in the US. There’s a lot of that. People think it’s pretty easy to find work in Mexico, and it’s actually really hard. Or they’ll think, “Oh, you’re just bilingual.” But one of the great things that I’ve found is there’s no national medical interpreting agency in Mexico, so they’ve launched the first.
Megan Figueroa: That’s so cool. That’s really, really cool. You keep in contact with them and you’re still part of the cooperative or do you consult with them?
Elena Costello: Yes.
Megan Figueroa: Awesome.
Elena Costello: I keep trying to tell them that I’m the consultant because I’m trying to stay as hands-off and let them run it. But I’ve done all the trainings with them, so I talk to them daily about it.
Megan Figueroa: That’s amazing. Well, congratulations to you and to them. That’s fantastic.
Elena Costello: Thank you.
Megan Figueroa: Okay. Let’s get into it. What is the role of interpreters in healthcare?
Elena Costello: It’s both language and culture. It’s to get the meaning of the message across and not just the literal translation. For example, sometimes – there’s actually a phenonimon – I can’t ever say that word, “phenomena” – in medical healthcare where people will be like, “We’ll just get through it without an interpreter,” or they speak English well enough, but that then lacks the cultural component, right.
For example, I was working in a hospital – I was the interpreter in the hospital. They could’ve called me at any point. They hadn’t. They called me and they’re like, “Mom’s really upset. We were doing fine, and we were just getting by, can you come up and help?” So, what happened was she’d brought in her child who had a strep throat. They diagnosed the child, and then they gave the child a freeze pop – one of those push ice things.
Megan Figueroa: Like an Otter Pop, right?
Elena Costello: Yeah. Mom got really upset and said, “You should know better.” She started screaming at the nurse and kicked everyone out of the room. They said everything was fine until we gave her child a popsicle. I was like, “Yes. Because in Mexican culture, we believe cold things will cause you to get sick and will cause a throat infection. You just diagnosed their child with a throat infection and then gave them that.” That’s part of the interpreter’s job, too, is how do I explain this in a way that fits both cultures and that everyone understands. It’s also required. It’s required by the Civil Rights Act of 1964. It’s required by the American Disabilities Act. And it’s also required by the Affordable Care Act.
Megan Figueroa: Oh, it is?
Elena Costello: Yes.
Megan Figueroa: Okay. I didn’t realize it was part of the Affordable Care Act.
Elena Costello: I love the Affordable Care Act in terms of its interpretation. It’s my favorite. Because they say it directly, unlike the Civil Rights Act of 1964. The Civil Rights Act of 1964 Section VI – I get all excited about that section – says that –
Megan Figueroa: What a nerd! [Laughter]
Elena Costello: I love it. They’re like, “You can’t discriminate against a person based on national origin,” and that got interpreted to include language. The Affordable Care Act says, “You can’t discriminate based on language, and you have to provide an interpreter at no cost.” They’re much more direct about it. The Civil Rights Act got interpreted legally, and the Affordable Care Act just came out and said it.
Megan Figueroa: I mean, there’re so many loopholes that people can through without the direct statement, right. I’m sure that happened for decades.
Elena Costello: It happens. It still happens. You also – I’d see this with sign language – you would try to explain to people, “No, you’re required to provide an interpreter,” and they said, “No, that’s just for Spanish.” And I’m like, how did we – what? [Groans of disbelief] Right? So, you see that. There’s a lot of misunderstanding.
Megan Figueroa: Is that why it’s part of the Disabilities Act as well?
Elena Costello: Yes. The American Disabilities Act is the one that covers sign language but not spoken language, but generally you’ll see all three come together because it’s – I mean, also people that use sign language may also speak another language. We get that too where the child is using sign language, the parents are speaking in Spanish – you need two interpreters.
Carrie Gillon: Oh, wow! That must be really tricky.
Elena Costello: Yes, yes. Those are fun. I like those. One of my favorites –
Megan Figueroa: Oh, I was gonna say, “Have you been part of that before?”
Elena Costello: Yes. My favorite, though, is two spoken words because then you get to see all kinds of cultural things – I mean, you have cultural things with sign language, too, but how – so the one I’ve gotten to interpret the most, the largest community we have that I was dealing with, was Thai and Spanish. Usually, one person – like, Dad was Thai-speaking and Mom was Spanish-speaking. You would also see the argument, “Well, why do they need two interpreters?” Because I was at a children’s hospital, and they’re like, “They got along enough to make a baby, right?” And I was like, “You don’t need language to make a baby.” [Groans of disbelief]
Carrie Gillon: People are so gross.
Megan Figueroa: Wait. These are doctors saying this?
Elena Costello: Yeah.
Carrie Gillon: Why are you surprised, Megan? You’re always surprised when professionals are assholes.
Megan Figueroa: I don’t – Carrie. I just – I just expect better people. You always have to come and tell me that I shouldn’t. But, you know, I know that it happens. I just – ugh.
Elena Costello: I think, Megan, if you really wanna see the bias, it’s when they call to request the interpreter. I don’t know how many times I’ve gotten requests for “African,” and I’m like, “That’s a really big place.” I’ve had requests for that. There was one where I was like, “Okay, Africa’s a really big place. There’s lots of countries and lots of languages,” and I explained that to time, and I said, “Can you go back and ask again?”, and they said, “Ethiopian.”
I was like, “Okay, we’re getting better.” I was like, “I’m gonna give you the top three languages spoken there. I want you to say these to the patient, and then if you see any kind of reaction, that’s what we’ll do.” Which they did do. I went down there and met with the patient, and then I got accused of speaking Amharic. And I was like, “I promise to god I do no speak Amharic.” I just don’t know anyone who doesn’t know the name of their own language. No matter how little you speak of the other language, you usually know the name of your country or the name of your language.
Or you get that, like – which Jonathan, uh – why am I forgetting Jonathan – Jonathan Rodri – no. Nelson Flores. Jonathan Rosa! I was gonna do that thing where everyone mixes them up. Jonathan Rosa. [Laughter] Jonathan Rosa with the looking like a language – like, I got a request. I’m gonna make up the name. It was something like, “Maria Josephina de Jesus Contreras Rodriguez.” They were like, “We need a Somali interpreter.” And I was like, “Okay, that could happen.” Because maybe, you know, the Somali family took in this kid – I dunno. It happens.
Carrie Gillon: It’s possible.
Elena Costello: It’s possible.
Carrie Gillon: Unlikely.
Elena Costello: Yes. I request the Somali interpreter. They go visit with the family. And I ask the family if they want a Somali interpreter in English because I don’t know how to say that in Somali. They look at me, and I say to them in Spanish, “Did you request a Somali interpreter?” They start to laugh. We start speaking in Spanish. They were from the Dominican Republic. They were black. [Groans]
Carrie Gillon: But of all the countries, why Somalia?
Megan Figueroa: Right.
Elena Costello: That was the larger population in that community of what was the second requested language. Usually, people will just default to what they know, and they’re like, “Black – must be Somali.” [Carrie groans]
Megan Figueroa: Yes. All of this is happening, right? In the medical setting, there’s all this assumptions and misinterpretations and that means that people – their rights are being violated, right, if they’re not getting what they need.
Elena Costello: Yes. I was asked by a facility recently – because I was consulting for a hospital – they asked me if I thought a patient had been discriminated against. They had filed a complaint that they had been linguistically discriminated against and, therefore, by national origin. I said, “I honestly think it would be very hard for any patient who speaks another language to not be discriminated against at all.”
We can start from the moment they arrive. Was the consent form given to them in a language they understood? Were they literate in that language? Because that’s also something else. Did someone explain it to them. And then the whole way through. The other thing is you get a lot of people who also think – with Spanish in the US. We have a lot more Spanish in the US. That’s the one we see the most. You have people who also think they know Spanish – [Pause] – and can be very well-intentioned but are not trained, qualified interpreters. It can put the patient at risk. It puts their care at risk.
Megan Figueroa: Absolutely. I’m thinking I’ve seen this in Spanish Departments where they have a class like “Medical Spanish” and, I mean, some people might actually think that’s enough – someone who’s studying to be a doctor or whatever.
Elena Costello: I would like to beg all Spanish departments in US to please stop sending their students to volunteer at free clinics to interpret for Spanish.
Carrie Gillon: Ooo, yeah.
Megan Figueroa: Just because they’re not trained properly.
Elena Costello: They’re not trained properly, and even if you’ve taken three years of college Spanish, that doesn’t mean that you understand the cultural nuances of language and definitely not at a medical care level. This is the reason why I train heritage language speakers to be interpreters is because, for a long time, we also just used people – we’re like, “Well, you have a college degree in Spanish, so you can be an interpreter,” or “You married someone who speaks Spanish, you can be interpreter.”
Megan Figueroa: Ha! I was gonna say, my mom married someone who speaks Spanish. She cannot be an interpreter.
Elena Costello: Right. But the rules are changing. For ASL, which is awesome, there’s all kinds of standards in place. For spoken language, there’s no national system or state – there’s some states. Oregon and Washington are the only states – well, and California kind of – that have requirements for interpreters. You can say they’re required by law to be “trained,” but what does that mean? Or that they’re required to be “professional,” but what does that mean?
Carrie Gillon: They don’t spell that part out?
Elena Costello: Correct. And it’s not. There’re companies – for profit companies – that will test you in your language abilities and your medical interpretation abilities, but it’s not standardized. So, yeah, I think discrimination can be happening for sure in medical settings.
Carrie Gillon: Well, I mean, it happens anyway on so many different levels. I would be surprised if it didn’t happen along language lines. How about race and culture alongside with language? How do they interact with healthcare accessibility?
Elena Costello: Oh. [Laughter] I mean, I can’t separate any of – when people – this is something I hate about applied linguists is that sometimes they’ll be like, “Sometimes you just got to look at the language and not the people,” and it’s like, “That’s not how language works – or people.” For example, I remember one of our patients who required interpreters got in a fender bender in the parking lot. They didn’t have a driver’s license because they couldn’t get one because they were undocumented. But their child had an appointment with oncology and had treatments for their cancer, and so that took priority.
And people were like, “Well, why didn’t they take the bus to get here?” And I’m like, “Well, their immune system’s already down. I’m glad mom drove them in.” It became this discussion – what was appropriate, who was at fault, should the parent have been doing that. But this is all while the child’s trying to get care. Then you have citizenship status. You have cultural beliefs of what’s appropriate. Medical beliefs of what’s appropriate. It all interacts.
Megan Figueroa: This is affecting healthcare accessibility, which is life threatening.
Elena Costello: It 100% is. There’s also fear of speaking up. That’s a cultural thing, too. I don’t know how many times I’ve heard patients say, “If I complain, they’ll treat my child worse,” or they’ll treat me worse or – that’s understandable. You don’t wanna upset the person your care is in the hands of. How do you know how to advocate in a culture that isn’t yours? Who are you supposed to turn to?
Even interpreters, right. Did the interpreters work for the hospital? Are you just gonna ask – and the role of the interpreter – so we do have a code of ethics and stuff. There’s no standard exam for it, but the code of ethics say that, as interpreters, we’re not supposed to advocate for the patient.
Carrie Gillon: Oh.
Megan Figueroa: Oh.
Elena Costello: Right. Unless it’s something where I’m like, “No, you’re about to kill this person.” You don’t advocate for them. ASL interpreters have a different – they’re allowed to advocate. They’re also considered advocates. But spoken interpreters are not.
Carrie Gillon: Why? What’s the difference there? What’s the motivation?
Elena Costello: That interpreters are just a tool, so they don’t give any opinion for either – for the provider or the patient. You can occasionally act as a clarifier and say, “Let me clarify this.” I probably do that more than most people. An example – I had a mom come in with her baby. This was the fifth time in three days she had brought her baby to some kind of medical facility and they had only been discharged for a couple days from the hospital. It was a newborn. It was still the first week of this child’s life.
The doctor said, “You’re here for the bellybutton,” looks at the bellybutton, says bellybutton’s fine, and mom starts to cry and says, “Everyone says the bellybutton is fine.” And I asked the doctor, “Can I have a moment.” I knew mom was from Mexico. I said, “Are you afraid that your baby’s not gonna love you because of the bellybutton?” And she said, “Yes.” And I said, “Because it’s sticking out?” And she was like, “Yes.” [Rooster crows in background] I was like, “Okay.”
No one had asked mom, and this would’ve been helpful, “Why are you upset?” They just kept telling her, “No, the bellybutton’s fine.” In some Mexican cultures you – my mom would always tell me, “You can tell that I love you because your bellybutton goes so far in.” This is common in some cultures in Mexico. The mom was very isolated, didn’t have any other moms around from her culture. And the umbilical cord falls off after a week or so, so it hadn’t fallen off yet. On its own, it’ll fall off. It was sticking out. [Laughs] And mom’s like, “My child’s umbilical cord is sticking” – like, it’s very normal, but no one had asked, “Why are you worried?” I think that would’ve helped. She had an interpreter for all of her appointments. But that was the other thing. All of the interpreters were from a Spanish-speaking country and culture that she was not from.
Megan Figueroa: Not just in this situation, but I feel like it should be the case where, in medical settings, you ask, “What are you worried about?” It just seems like a good question.
Elena Costello: It is a really good question. Some people are trained to ask that. Some people aren’t. Providers think they’re doing the right thing, right. They told mom, “Just clean it off with a bit of alcohol. It’ll be fine. That’s how you maintain it.”
Megan Figueroa: Because they didn’t see any threat or any possible threat to the child.
Elena Costello: Right.
Megan Figueroa: Because they’re working from their cultural context.
Elena Costello: Yeah. Or if you think about numbers, too. I don’t know if you know this. In Mexican Spanish, “every other day,” we say, “Cada tercer día” – every third day. We say, “every week,” “cada ocho días” – “eight days.” And “every two weeks,” “cada quince días” – “every fifteen days.” If you told someone to take the medicine every other day or take this once a week, you have to make sure that at there’s cultural understanding.
Megan Figueroa: I mean, I’m not a medical doctor, but it seems so important to relay all this information properly. I just never thought about it – not even for myself, really – because I don’t – I mean, I’m in an English-speaking country and English is the language I speak and have never had to really think about whether or not I’m getting the information correctly from the doctor.
Elena Costello: Some of the tests we do have to, for interpreters, focus on – which I hate – on grammar, which is not relevant in interpreting – [Laughs] – in speaking, in some ways. It’s not that we don’t have syntax, but we don’t think about, “Okay, don’t end that sentence with a preposition” kind of thing, right. Those kind of rules – not helpful.
What they’ll frequently do is hire people that have professional training in learning Spanish but don’t know the culture. That’s the part that I love with heritage language speakers is I didn’t know my Spanish was valid until I started to study linguistics. I was like, “Oh, wait. The way I speak is perfectly fine? My Spanish isn’t bad?” And it was like, “No.”
Now I’m like, “My Spanish is better than all my classmates,” because I grew up with it. It just is part of me. That was the training with the people in Mexico City is that the first part of the course was like an ethnic studies class. Your language is valid. Your experiences are valid. You actually make a better interpreter because you know these cultural things. The system is not set up for that.
Carrie Gillon: No, not at all. I mean, it’s not set up to even really interact with the patients on a human level. Yes, there are some doctors and some nurses who really do a good job, but I would say they’re very much the exception because it’s just in and out, in and out, in and out.
Elena Costello: Or when you talk about there are good doctors but when they say, “Your kid’s a little chubby” – if I interpret that, “Está gordito.” Culturally, that’s gonna be like, “Sweet! We’re good to go!”
Megan Figueroa: Absolutely! Yeah. I know. [Laughter] [Dogs barking in background] Yes, this reminds me of how my cousin Gordo – I did not – because I grew up around Spanish but wasn’t taught it, so I thought his real name was “Gordo.”
Elena Costello: Aw.
Megan Figueroa: I had no idea what it meant for a very long time. But it’s a term of endearment.
Elena Costello: Yeah.
Carrie Gillon: It used to be the case even in Anglo culture that you’d be really worried if the baby was too small, right. So, having a chubby child was actually a good thing until relatively recently.
Elena Costello: Oh, my goodness. I was interpreting for some very Indigenous Mexicans. I’m 5’4”. I don’t know how tall dad was, but I could definitely see the top of his head. He was taller than mom. I’m gonna say they were 4’8” and 4’10” maybe. I don’t know. Mom was very, very pregnant. Her due data was coming up, and it was this last ultrasound. They were concerned about the size of the baby. They were saying, “Well, everything seems to have developed fine. The baby’s just below the standard,” right, the size.
I keep thinking, “You’re comparing the standard that you use on – fetal length is not appropriate for this context,” right. But I can’t say that. My job is just to speak. I keep wanting to say like, “Can someone look at the height of the parents.” If everything looks healthy and is developed and it’s just smaller, that makes sense since dad’s 4’10” and mom’s 4’8”, I think. Another one where – the growth chart. From what I was explained by a physician, the growth chart we use for pediatrics is based on 100 white children in Colorado.
Carrie Gillon: [Laughs] 100? [Laughs]
Elena Costello: And I was like, “That seems problematic.” Maybe you have a growth development issue, but do you? That’s something I don’t interpret.
Megan Figueroa: That must be so frustrating.
Elena Costello: Yes. Oh, you’ll love this, too! “Development,” right. You interpret development questions. One of the development questions in pediatrics around age three or four is “Is your child adding on Ss to pluralize?”
Carrie Gillon: [Laughs]
Megan Figueroa: What? What? What?
Elena Costello: All right. Even if I interpret that correctly – if I’m a Mandarin Chinese interpreter, they don’t add Ss on to pluralize. The child is not gonna – so Mom, Dad, or whatever caregiver’s gonna say, “No,” and they didn’t hit the milestone.
Carrie Gillon: That is wildly inappropriate. I mean, even in French, where the S comes from originally, they don’t pronounce it anymore, so not even – only English. What is this?
Megan Figueroa: Right.
Elena Costello: Right.
Carrie Gillon: Ugh!
Elena Costello: But if you only speak English, and you’re a provider, and you’re like, “I have to go through these questions and make sure your kid’s fine. I have an interpreter here, I’m doing all the things I’m supposed to do,” right. We study language. We’re like, “No!”
Megan Figueroa: I’m just thinking it seems so inappropriate that these language questions are being forced upon medical doctors to interpret as developmentally appropriate. I really don’t like that.
Carrie Gillon: They are the wrong people to be asking those questions.
Megan Figueroa: They really are.
Carrie Gillon: We don’t need them to be experts at everything anyway. Don’t ask the language questions, at least not at that level. Maybe it’s worrying if they’re not speaking at all.
Megan Figueroa: With all of this, let’s talk COVID-19 and healthcare accessibility. How do you think that the United States has handled information dissemination about COVID in languages other than English?
Elena Costello: I haven’t seen any.
Megan Figueroa: [Laughs] Okay, it’s non-existent?
Elena Costello: It exists. I’m sure it exists. Just because I haven’t seen it doesn’t mean it doesn’t, but all that I’ve seen has been published by other places. One of the assignments I just gave my students was to find that – my heritage language students. Everything that they gave me was from other countries in Spanish even though these are students who live in the Midwest in the US. I don’t think it’s getting out there. It’s not.
This is again what that intersection – like you asked, Carrie – about race. We know, for example, the COVID-19 inoculation locations are in white areas. How much information is getting – let’s say you even got to the site and you spoke Spanish, I’m not sure you’re gonna understand when to come back or any of the things they’re gonna give you. No, we’re doing a terrible job.
Carrie Gillon: Well, the United States was already doing a terrible job in English. It was such a disaster. Many of my friends who were lucky to get vaccinated early couldn’t figure out when they were supposed to get their second shot. They’ve worked it out since, but if it was a disaster in English, I can only imagine how much worse it is in any other language.
Elena Costello: The online stuff, too, right, even to sign up. Then we have the digital divide – who has access to that, who knows how to navigate that. It becomes the younger generation. You got to get your kids or your grandkids to help you. Even then if you don’t have access to it. There’s someone sitting in the suburbs with their iPad, their laptop, and their phone hitting refresh, and they get it.
Megan Figueroa: I mean, that’s what I did. I was having a quick refresh to see new appointments coming up. I knew how to do that for myself, and I got signed up. But if you can’t do that or if your child is trying to do that for you, I mean, what a clusterfuck.
Carrie Gillon: It is a total clusterfuck.
Elena Costello: It’s a total cluster.
Megan Figueroa: Are there any interpreters on site at these vaccine –
Carrie Gillon: I doubt it.
Elena Costello: I have not seen any and I have not heard of that from friends. I’m sure there’s got to be, but not that I know – [Carrie indicates skepticism]. When I say that there’s got to be, I mean that there might be one. But I mean, in the whole United States, is there a site that has an interpreter? Probably. That’s what I mean there’s got to be one.
Carrie Gillon: Okay. Yeah. That’s true.
Elena Costello: Do I think the sites all have them? Oh, hell no. I mean, they can’t even get interpreters in their emergency rooms. They’re not gonna do it out in a COVID site. It was just crazy to me because – you need it for all languages – but Spanish, we have so many Spanish speakers. Why is this so difficult for us to catch on?
Megan Figueroa: Is there any shortage of interpreters that speak Spanish? Or is it just we’re not reaching out to them?
Elena Costello: No, interpreters totally exist. I think people don’t wanna pay for them. When I started interpreting – because you’re required to, right. You’re federally required to. It’s seen as a cost expense. Sometimes it’s easier to pay fines than it is to do the right thing. I’m thinking of our friend Juan Luna who took his grandparents to get vaccinated. There weren’t interpreters for them, and they were in Long Beach/LA area.
Megan Figueroa: Which there should be interpreters, right?
Elena Costello: Right. You would think. Or providers that spoke Spanish. You get in this line, and the person giving you your shot speaks Spanish to tell you to wait 15 minutes or whatever. Yeah. I dunno.
Megan Figueroa: The people that are giving shots aren’t all nurses in all of this. There’s a lot of volunteers.
Elena Costello: Yeah.
Carrie Gillon: I think they’re actually mostly volunteers because they can’t really afford to have all the nurses out.
Elena Costello: We also have phone and video interpretation, which is widely used in the US, which is great, I think, for languages that are less requested. Spanish is gonna be more requested, but maybe there’s not a lot of people from Ghana in your communities, so not a lot of Twi. You’re gonna see this once every 10 years or something. Then you use phone or video. Those are also available. They could have phone interpretation at those sites. Corporations like phone and video because they think it’s less expensive.
Megan Figueroa: I was gonna ask. Is it?
Elena Costello: I think they’ve been hoodwinked a lot of them. For one of the hospitals that I just went in and did consulting for, they were certain that phone and video was less expensive. It’s more expensive than actually hiring a staff interpreter – that was with benefits and everything. The great thing about a staff interpreter is that they know the staff. They start to learn the culture of the place and they learn what you’re actually trying to ask when a medical provider asks something. They know how to get around the facility instead of trying to find a place where the phone and video –
That’s the other thing. The phone and video are usually connected to the internet. So, if your internet’s shaky or it’s being interrupted by other machines, which happens a lot in hospitals, the connection is really bad. And we don’t have really good rules about that either. The leaders in ASL have made room for spoken language. With ASL, the screen has to be so big – a certain size – and if it gets interrupted by so many seconds or whatever, it’s hard to understand, you immediately have to provide an in-person interpreter.
Megan Figueroa: This is because of d/Deaf advocates working to get this kind of stuff?
Elena Costello: Yes, it’s totally from advocates. It’s the same thing. I think that’s what happened with spoken language is that ASL advocated a lot, and then you get space for spoken language. Again, I think race plays into this. This is where I’d like to see research if anybody wants to do research on this. I think the advocacy to create spaces for white people and other people can move in a little bit into that space. Did we talk about this before, Megan? I thought we talked – I dunno. I think it’s white ASL speakers that made – not that other people aren’t fighting and speaking loudly. I just think white people are listened to more.
Megan Figueroa: I wanna actually talk really quick about actual patients who have COVID and healthcare accessibility. What’s happening to them in the hospitals or in the doctor’s rooms? What’s happening to them?
Elena Costello: Very similar, in some ways, to English-speaking patients where they’re isolated from family. You don’t get to communicate with anyone. Communication’s even harder. Even if you have a liaison that calls into the hospital and speaks, getting through is much harder when you also have family members who don’t speak the language and are trying to figure out how to get information about their family member.
Also, there’s these consults when they know it’s gonna be end of life. Those consults are really hard because they’re still being done by phone and video, and then there’s an interpreter. The interpreter may be present with the patient or with the physician or the team, but the family isn’t necessarily there. Or maybe the interpreter will go with the family, and they’ll phone and video into the patient because they’re trying to keep people separated. There’s a lot of misunderstanding of why that’s going on even for English-speaking patients or family members. They want to see their family. Because you already probably don’t trust the system, and now they’re not letting you see the person, your belief of what’s actually going on, I think, diminishes.
Megan Figueroa: So, you’re not trusting the situation.
Elena Costello: Right. You’re telling me my parent is dying, but I don’t know any of this system or what’s going on, and you won’t let me see them. I don’t know if this is really true.
Megan Figueroa: Do you think this is leading people to not seek help – medical help?
Elena Costello: No, I think other things get them to not seek medical health like health insurance, or “Will someone speak the language?”, “Will I get deported?”, “I don’t wanna put my family through this.”
Megan Figueroa: I mean, the COVID death rate is probably much higher – people are dying at home.
Elena Costello: Yes. And there’s a misconception. I think people think that medical providers are very altruistic, and knowing, and understanding. I don’t know how many times I’ve heard medical providers say, “Well, if they just didn’t party so much,” or “It’s because they all live in close” – it’s not that we’re – racism is the reason we’re more likely to get COVID. It’s not because we are – that’s the missing piece.
So, yes, you’ll have a disproportionate amount of Latino patients – as the system likes to say, “Hispanic” patients – on the floor. There’s not an understanding by the medical providers of why those patients are there. Or they don’t wear masks. I think what we’ve actually found is that Latinos are more likely to wear masks. Or they’ll be like, “Well, they’re out working in the field.” I’m like, “You’re not familiar with fieldwork, are you?” Because they think that’s what’s getting them exposed. I mean, it kind of is if they’re being around people, but it’s not – there’s racism here. I wanna scream that all the time. There’s a misunderstanding of why it’s disproportionately us.
Megan Figueroa: I mean, it’s usually the answer in situations. What’s happening here? Racism.
Elena Costello: One of the administrators pushed back on me because I said that. I was like, “This is racism.” And she’s like, “I’d like to push back on that.” And I was like, “Okay. Systemic racism.” [Laughter]
Carrie Gillon: Is that better?
Megan Figueroa: Sorry. Yeah.
Elena Costello: It happens. This is, again, where ASL is great is the ADA – the American Disabilities Act – they’ve required that – so people that have been tubed, they can’t talk. They’re supposed to have signs they can point at. It needs to be big, and it’ll be like a “yes” and a “no,” which is in English. They’re supposed to provide those in these languages of the patients, and they don’t.
Also, if patients come in – I saw this with a Tagalog-speaking patient. They thought they were Spanish speaking for the longest time. But because the patient wasn’t responding because they couldn’t, they were being spoken to in a language they didn’t speak even though they were using interpreters. The same thing happens with Indigenous communities. Maybe they’ll speak Mixteco or Zapoteco or something, and it’s seen as – I saw this in an article that said there isn’t language outreach in Spanish, and they’re like, “A dialect of Spanish.”
Carrie Gillon: Oh! Oh, oh, oh, oh. That bugs me so much. I can’t even.
Elena Costello: Yeah. And I was like, “No! It’s totally different languages.” Even in interpreting services in hospitals, they’ll think that – like, I did a training. The interpreters thought that Zapoteco was a variation of Spanish. These are all certified interpreters. It was a state that requires certification. I tried to explain to the interpreters, I was like, “No, they’re very different languages.” There may be some contact. Which that was one of the arguments. They’re like, “No, they’re the same because I’ve heard them say, ‘pastilla,’ when they’re speaking.”
Carrie Gillon: Oh my god.
Elena Costello: “Pastilla” means “pill,” right, listeners. In languages that come in contact, we pick up words from each other. That does not mean that the person now speaks Spanish because they pulled a word from Spanish. If I say, “C’est la vie,” I don’t now speak French. [Laughter]
Carrie Gillon: Well, I mean, we’d all be French speakers because how many words have we borrowed from French.
Elena Costello: Exactly. The interpreters had to learn that. That was part of our training. If your interpreters don’t know it, I don’t know how the rest of the medical staff is gonna understand that there’s lots of languages and lots of cultures within languages. There was one I enjoyed, too, in an emergency room where they hadn’t utilized me. I went and asked why. The doctor said, “Oh, she’s white.” And I was like, “I’m sorry?” The patient was white from Argentina and was vacationing in the US and had ended up in the emergency room. They did not speak English, but the provider just felt, “Well, they’re white, so therefore they understand English.”
Carrie Gillon: Amazing. That is like – I don’t even know what to do with that. That’s a myth I have not yet encountered.
Megan Figueroa: I’m not surprised. Carrie, look, I’m not surprised. Look at me! [Laughter]
Elena Costello: No! Megan, you’re losing your Megan-ness.
Megan Figueroa: One more wrap up question. In an ideal world, how would this rollout of vaccines or the information dissemination about COVID and vaccines look like?
Elena Costello: You’d have people way smarter than me that are actually connected with the community doing it. Your federally qualified health centers – your low income and free clinics – asking them and their people, “How do we get this information out?” Because they’re actually connected, and they’re everywhere. Getting the information to them. Then I would have things – so “translation” is written word, right, and “interpretation” is spoken word – is if we could have everything translated into the Top 10 languages if they have – and here’s the other thing – if they have a written language. That would be great. Then getting the information out the way we do with other social media stuff but in the languages we need to get them out in.
Megan Figueroa: It seems so simple, and yet it’s not happening.
Carrie Gillon: First of all, the whole thing was a disaster. But yeah, it costs money, although not tons if you’re only doing 10 languages and all you’re doing is this packaged information that’s not extensive. But it still costs money, and someone has to make a bunch of calls, and yeah.
Megan Figueroa: Calls – ugh! All the calls, yeah.
Elena Costello: I mean, even with the languages, Huston has a huge Vietnamese population. Maybe that’s where I want to send the Vietnamese papers and not to Duluth. I don’t know. Watch Duluth have a huge Vietnamese population and someone message me. I’m sorry. [Laughter]
Carrie Gillon: I don’t know.
Elena Costello: I don’t know. I said that. I’m sorry. I’m sure there’re people out there but probably not as big as Huston’s. Or a Somali community is probably not as big in Huston as it is in Minneapolis. If you can just get it out in the languages of the communities that would be great. And a sign-up system that wasn’t online. If you could just go into one of those qualified centers and tell them and they’ll sign you up that would be great.
Megan Figueroa: Well, thank you for doing the work that you’re doing. I mean, it’s such important work. We really appreciate you talking to us about this. I think it’s just so important that people realize that if you think it’s been a clusterfuck for you, and it’s your language that speak, or whatever –
Carrie Gillon: It’s only worse.
Megan Figueroa: It’s worse. Awareness is key – or the first step, at least. Thank you for talking to us today about medical interpretation and COVID. It was so great to have you.
Elena Costello: Thank you. Can I do one little shoutout because I should’ve said it earlier because I really want them to get business is the interpreting co-op, run by all repatriated people, deported people, is called “Dreamers Interpretation.”
Carrie Gillon: Oh, nice. I like that.
Megan Figueroa: Beautiful.
Elena Costello: Thank you so much.
Carrie Gillon: Yeah. Thank you.
Megan Figueroa: Awesome. Thank you. We leave our listeners with one final message.
Carrie Gillon: Don’t be an asshole.
Megan Figueroa: Don’t be an asshole.
Elena Costello: Aw, that’s my favorite! [Laughter]
Carrie Gillon: We have three people to thank this month. We’d like to thank Daniel Kilby.
Megan Figueroa: Yay!
Carrie Gillon: Who actually has been a supporter for a while, but he upped his monthly donation, so he gets a shoutout.
Megan Figueroa: Thank you.
Carrie Gillon: Robin Gentry.
Megan Figueroa: Yay!
Carrie Gillon: And Karilogue Adventures in English.
Megan Figueroa: Oh, fun! Thank you so much. We appreciate it so much.
Carrie Gillon: Yeah, we really do. For those who want to join us at http://www.patreon.com/vocalfriespod, you can get a huge backlog of bonus episodes. At the $3.00 and $5.00 levels, you get a sticker.
Megan Figueroa: Yay!
Carrie Gillon: So, thank you.
Megan Figueroa: Thank you.
Carrie Gillon: The Vocal Fries podcast is produced by me, Carrie Gillon, for Halftone Audio. Theme music by Nick Granum. You can find us on Tumblr, Twitter, Facebook, and Instagram @VocalFriesPod. You can email us at email@example.com and our website is vocalfriespod.com.