Lost in Translation

As I was channel-surfing in a restful state shortly after last Christmas, I happened upon a Monty Python marathon. Such instances of good fortune are why I label myself an optimist.

I freakin’ love Monty Python. The British comedy troupe skewered ’70s society with iconoclastic parodies as clever as they were absurd. If being a Python had been a career choice, I never would have finished engineering school.

It would be difficult for any Python fan (Pythonite? Pythian?) to pick a favorite sketch, but I don’t think any were funnier than the Hungarian phrase book bit: A Hungarian tourist walks into a London smoke shop wanting to buy cigarettes. After consulting his flawed Hungarian-English guide, he tells the tobacconist, “I will not buy this record, it is scratched.” When the clerk looks perplexed, the tourist scans his booklet again, then adds, “My hovercraft is full of eels.” The scene degenerates into a fistfight when the Hungarian inadvertently antagonizes a police officer with “You have beautiful thighs.”

I don’t remember any of my futile attempts at street Spanish leading to violence, but I’ve worked many calls where patients and I have become very frustrated at our inability to communicate. I think some non-English speakers assumed I was being obstinate when all I was trying to do was understand their complaints—not a radical way of beginning care.

One source of help is translation services that promise to connect customers to native speakers of almost any language within seconds of phoned-in requests. Not a bad idea, but when I simulated a call from the field, I found the interpreter on the line wasn’t comfortable with medical terms like seizures or antidepressant. And then there’s the matter of involving a third party in a confidential discussion. Gaining consent would be much easier if there weren’t a language barrier in the first place.

I think the solution might be as close as our smartphones. You do have one, don’t you? Sorry—I don’t mean to sound obnoxious, but being an early adopter of the latest technology is a new experience for me. Now that I’ve signed up for more data per month than I’ve stored, cumulatively, on every PC I’ve ever owned, I’ve been looking for apps that enhance my productivity instead of my pastimes.

One is called Translate. It works just the way you’d expect: Type a word or phrase in one language, see or hear a translation in another. I decided to test that app with a slightly idiomatic English phrase before progressing to something medical; I entered I want to see how well this whole translation thing works and requested Spanish, the second-most-popular language in the world (per About.com) and second-most-common language spoken around here. Here’s what Translate gave me: Quiero ver lo bien que funciona todo esto de la traducción.

It works, I thought. Then I remembered I don’t speak Spanish well enough to know that, so I put the exact Spanish phrase back into the translator and asked for English. I got I want to see how well this works in translation. Close, but not the same intent I’d expressed idiomatically. I wasn’t surprised Translate didn’t digitize verbal subtleties accurately; that would have been a lot to expect of a device that still can’t process body language.

Next I wondered if I could rely on Translate to interpret basic medical questions—the kind we ask patients during every assessment. I chose a common question—What does the pain feel like?—and requested translations into the world’s most popular languages (other than English). Here’s what I got when I converted those foreign phrases back into English:

Chinese (Mandarin): Feeling of pain is what?

Spanish: What is pain?

Arabic: Why the pain feel like?

Hindi: What kind of pain do you think?

Portuguese: What does the pain feel like?

Bengali: What is pain?

Russian: What does the pain feel like?

Japanese: What pain I would feel?        

German: What does the pain feel like?

Four (Chinese, Spanish, Bengali and Arabic) were more philosophical than clinical, the Hindi translation sounded adversarial, and Japanese was just plain weird. Only the Portuguese, Russian and German translations were precise.

The Translate app is impressive; it’s compact, free, easy to use and not terribly inaccurate. I see it inspiring a new prehospital caveat, though: Treat the patient, not the cell phone.

Time to put aside Spider Solitaire and stuff a few stockings. As we say in Hungarian, Boldog Karácsonyt!

Mike Rubin, BS, NREMT-P, is a paramedic in Nashville, TN, and a member of EMS World’s editorial advisory board. Contact him at mgr22@prodigy.net.