As a healthcare interpreter, you are a communication tool, but more importantly, you are a bridge over a cultural barrier. Yes, we must repeat exactly what the provider says, and we must strive to convey the message—not so much the words but the meaning. To do this well, interpreters must be aware of cultural differences and advocate when something culturally interferes with understanding the message's meaning. Failing to do so can drastically change the outcome of a patient's treatment. We can say that it is the interpreter's job to make sure that everyone is understood linguistically and culturally and to help in one of the most important aspects of human relations: communication.

The following is an actual interaction that occurred between a provider, a patient in the Smoking Cessation Counseling Program, and me (a trained interpreter).

Interpreter: "Good morning. I am going to be your Spanish interpreter today."

Provider: "How is the chemotherapy going? Are you feeling better today? And please tell me, are you feeling less anxious now?"

As the patient uttered his first words, I realized this would be a challenging encounter. The cancer in his throat had also affected his vocal cords. In a matter of seconds, I thought how difficult it would be to lose your voice suddenly. I could not understand his speech, but I had to try. I wanted to help him, and I wanted him to feel hope.

Interpreter: In a gentle tone of voice: "Sir, would you please repeat that?" Then I added, "Wait a minute, Provider," and raised my hand to practice transparency and indicate that I was speaking as the interpreter. "The interpreter must ask for repetition."

Provider to Patient: "Let us try to modulate. Try to speak slowly."

At this point, the patient started to cry.

Provider and interpreter: "It is okay, Sir, take your time. We are here for you."

Provider to interpreter: "We struggled when using VRI (Video Remote Interpreters) for him in the past, so I requested a face-to-face interpreter for today."

Provider: "I see you have missed appointments in the last six months. I was just wondering, is everything okay?"

Patient: "It is because I have no car!" He cried and yelled.

Interpreter: Shushing. "Sir, let's do this: You talk, I'll repeat what you say, and you can please nod if I'm correct, okay?"

Interpreter: "Provider, I am asking for repetition. The interpreter needs to clarify."

The patient responded with whimpering, gestures of pain and frustration, long pauses of silence, and putting his hands to his face to cover his crying.

The provider gave him some time. She tried to redirect his emotions: "Sir, have you called the 1–800 number we gave you? Have you received all your supplies to help you quit smoking yet? How is that going for you?"

The patient, now expressing anger on his face, says, "I called many times. Translator, tell her! Many times, I called, but they do not speak Spanish! They keep hanging up on me." He begins to cry again.

Provider to Interpreter: "Interpreter, I am confused. We give the same number to all our patients [End Page E12] in the After Visit Summary and it works just fine! Could you repeat that? Did he say he called, and they hung up the phone on him? Could you please clarify?"

Patient raising his voice: "I did! Translator, please tell her I did! They do not speak Spanish!"

The patient continued to cover his mouth with his hand while he spoke and cried, which made it difficult to understand his voice and the movement of his lips, which, in this difficult case were a helpful aid—making it easier for the interpreter to comprehend the patient's words.

Provider: "Let me double-check the 1–800 number so you can order your supplies."

The patient's frustration grew. "Here! This is the number! Are we done? I am in pain; I want to go home now."

Provider: "One moment, please, I'll call for you." The provider dialed 1–800-QUIT-NOW.

Provider: "Well, they say for Spanish press 2. I cannot...