"I feel we don't really understand each other": Interpreting medication instructions for a Turkish-speaking diabetes patient

Abstract

This paper is based on a videotaped diabetes consultation involving a German-speaking physician, a Turkish-speaking diabetes patient and a Turkish-German interpreter who has been working in medical settings for a number of years. In the course of the consultation, the physician focuses several times on the importance of the patient carefully maintaining a balance of food intake and insulin supply in order to control his diabetes. The discourse-based analysis indicates the cognitive task load of the interpreter in this encounter when confronted with medication instructions. The data indicate that the interaction could have been more efficient if the interpreter had acquired the necessary knowledge about diabetes prior to the consultation or if she had recognised the elements structuring the discourse. In fact, the interpreter cannot establish a successful communication pertaining to the blood glucose-insulin mechanism between the doctor and the patient. The patient himself seems to have more in-depth knowledge about diabetes as a result of his personal experience than the interpreter has. In this paper, we therefore argue that interpreters need a sound understanding of the specific medical situation (top-down process) in order to interpret interactions adequately in a complex case such as diabetes. If interpreters lack sufficient medical knowledge in one of their varied assignments, they could use their textual competence and their capacity for formal, logical reasoning to infer connections between propositions (bottom-up process). Thus, interpreters’ cognitive-linguistic competence could to some extent compensate for their lack of domain-specific understanding. Nevertheless, the data shows that interpreters need specialized training not only in analysis of linguistic discourse but also in domain-specific knowledge and terminology.