A Broken System.

I’ve written about dealing with inadequate hospital accommodations. Most anyone in the Deaf world knows that last-minute interpreting requests are tricky, at best, to accommodate, especially with specialized medical appointments.

I happen to know Christopher Rawlings from my UW-Milwaukee days. He has three children whom he adores. Recently, his oldest daughter went in for surgery; and later on suffered life-threatening complications that required a stay in the ICU. She’s doing better now. However: someone at the hospital seriously dropped the ball on this one, because at no point– save for a one-hour block after the crisis had died down– did the hospital secure a professional, in-person sign language interpreter for Chris, despite all his efforts to arrange one.

Here’s the story in his own words, after which I will proceed to dissect where the hospital fucked up– and yes, this situation warrants the f-bomb on what is normally a fairly family-friendly blog, because his kid almost died. Watch on and try not to rage, because this happens far too often in the d/hh world, and we really, seriously need workable solutions for hospitals, interpreting agencies, and deaf clients here.

 

Now, the promised reaming.

  1. This wasn’t an emergency or a walk-in. The hospital had time to prepare. Chris requested an interpreter well in advance– an in-person interpreter, specifically not a Video Remote Interpreter (VRI).
  2. He followed up three times– three!– to ensure that his request would be met. No dice.
  3. Instead of a live interpreter, the hospital consistently provided a VRI machine that took time to set up, biting into valuable communication access for Chris while the rest of the room exchanged vital information about his daughter’s state and care; and regularly shut down without warning. 
    1. Now, VRIs can work, sometimes and in some situations. However, in this case, it wasn’t even close to enough for high-risk procedures nor highly-charged emergencies, much less one that involved multiple speakers. Chris covers a bit of the difference at 10:30 -“I couldn’t care less about nurses checking in for this or that — the VRI system is enough. But anything that involves my daughter’s doctors and her prognosis? I NEED a live, in-person, ASL interpreter!”
    2. VRIs run on high-speed Internet access, so having a good connection is vital– and often lacking, as happened hereWhen Chris brought this up at 11:05, their solution was to provide two VRI units.
  4. The hospital had time, during what turned out to be a 9-hour wait for his daughter’s initial surgery to finish, to contact several state agencies for an interpreter.
  5. The staff tried to recruit his wife, ex-wife (mother to the daughter), and his 14-year-old daughter– the patient— as interpreters. OK, it’s bad enough that they tried to ask the mother, then the wife, to interpret. Emotional investment, lack of impartiality, lack of expertise, etc., etc.– but the daughter?! A minor?! Who was also the patient?!
  6. When they did send an interpreter, they sent a Spanish one– twice.

    Spanish.For a deaf man who uses American Sign Language. And whose family members all use spoken English.

There is more, but you get the idea. Someone dropped the ball, enormously, and kept dropping it throughout. This wasn’t an understaffed rural hospital; Children’s Hospital of Wisconsin is located in Milwaukee with decent-to-excellent national rankings in several fields. These people should know better. While Chris’s experience is one of the more egregious examples I’ve seen to date, stories like his are depressingly common in the d/hh world. Now, I don’t like to jump on the outrage train without looking into solutions. Chris is right; the system is broken and it needs to be fixed. But how?

I don’t have answers yet. I do have some specific questions to start off with. First, what can hospitals and interpreting agencies do in advance to prepare for and address situations like this, especially last-minute or emergency requests? Can a partnership be set up with local agencies where interpreters agree to be “on call” (much like nurses)? Can agencies or advocacy centers reach out to the relevant authority at hospitals to educate them? How feasible is it for a hospital to have a staff interpreter on retainer? How do they manage it with other language interpreters (e.g., Spanish)? Which hospitals do it right, and how do they pull it off?

If you know me, you know I’m spamming all the relevant friends I have for answers on this. And hopefully soon enough I’ll have a new post with answers beyond “He should sue!” (I think he should.) and “They’re breaking the law!” (They are.) What Chris went through was the aftermath of someone’s else’s fuck-up. What can local agencies, hospitals, and deaf clients do beforehand to ensure that they don’t run into more fuck-ups?

Cued Speech and Sign Language: Spoken Language Accommodation

Disclaimer: This is not meant to be a value comparison between ASL and Cued Speech. I’m sharing my personal experience with both in different areas, and it depends on several factors.

For spoken language accommodation, my personal preference is Cued Speech, hands down. Not ASL, not Signed English, not CASE, not LOVE.

Since leaving college, I’ve usually used sign language interpreters because that is what is available here in TX, but it really is not my preferred method. Captioning is fine for lecture-based presentations, but a bit slow for discussion-type forums.

It’s my opinion that signed language cannot accurately represent all of the nuances of spoken language on the hands alone. Or if it can be done, it’ll be difficult and cumbersome. That’s why Dr. Cornett designed Cued Speech the way he did: half of the information on the lips, half on the hands, and all based in phonemes, not meaning.

With Signed English, if you already know English and/or have enough hearing or enough context, or you happen to be a superb lipreader/prolific reader… basically, if you have extra support, you can fill in the gaps. Somewhat.

I have had some less-than-ideal experiences with interpreters because my native language is English, and the other person voicing in English, but we have to communicate through a sign language medium, and it’s quite challenging to be precise… especially when the interpreter is used to interpretation rather than transliteration. It’s worse when the interpreter does not have any background information, especially in specialized fields like medicine or engineering. Often (but not always), she can relay that information to me– even if I have to mentally translate it back into English– but if I try to feed it back through her, it falls apart.

Knowing the context is, I think, more essential for sign language interpretation because you are working with vocabulary and semantics. Context does help cued language transliterators too, but I think there is less demand for it, because CLT is word-for-word (well, really, cue-for-sound) and not concept-to-concept. With a CLT, I usually feel like I have a much solider grasp of the other person’s message than I do with a sign language interpreter; there is far less reliance on her understanding of the subject matter or the context.

Cued Speech and Sign Language: Availability of Services

Disclaimer: This is not meant to be a value comparison between ASL and Cued Speech. I’m sharing my personal experience with both in different areas, and it depends on several factors.

American Sign Language beats Cued Speech in terms of availability, especially for socialization and finding real-time accommodations. Most everyone knows of sign language or some variant of it (Signed English, LOVE, CASE, etc.). Although a lot of cuers, particularly those affiliated with the NCSA, are trying to expand resources so it’s more available, Cued Speech is still very much in the minority.

Hence, you can find sign language interpreters in just about every sizable city. Cued Speech… it depends on the area. That said, Daily Cues is working on this nifty Cue Connector that will show you a geographical concentration of cuers all around the world so you can see what the availability is in various areas.

For sure, I know that Chicago, Minnesota, central Colorado, the East Coast, and maybe California and Seattle, have a sizable population of cuers and cueing service providers. Austin, TX, also has a small cue community.

I am the only cuer in DFW that I know of, and was the only known cuer in Milwaukee– maybe the entire state, since I first learned it in 1994 or thereabouts. That isn’t an unusual scenario for cuers, incidentally: being the only one in the school, or even the entire state, that uses Cued Speech– although it’s getting better as we develop more cue communities around the nation.