Good enough is NOT GOOD ENOUGH until the Deaf patient says it is!
Good enough is NOT GOOD ENOUGH until the Deaf patient says it is!
ASLized courtesy of Delawaredeaf.org
Last night there was a town hall meeting at the Deaf Center discussing the failure or refusal of hospitals to give primary consideration to the request of the patient who is Deaf when they ask for a Live In-Person Interpreter and are told they have to use VRI or get nothing at all. I was in the audience and suggested a script for making such a request.
Several people who are Deaf in the town hall asked, “why should we have to go through all that? Shouldn’t they just respect our request?”
Yes, of course they should. But if they did or would there would be no need for this town hall meeting. Hospitals are businesses and as such will not change just because the Deaf community asks. They will only change if they are forced to.
This script will help build a factual basis for future lawsuits which is the only thing hospitals will respond to.
(If you are in too much pain or stress whomever is with you can follow this script for you)
I require a live in-person ASL Interpreter for effective communication.
Let’s use VRI until we can get an interpreter here for you.
VRI is not effective for me because (pick the one that fits):
I am in pain/stress/destress and I can’t follow the three dimensional language of ASL on a two dimensional screen;
I’m not ordering a pizza, I’m trying to get medical care;
The screen is too small;
The picture keeps freezing;
Your staff does not know how to hook it up;
The VRI Interpreters can’t see or hear what is going on off screen and so I miss half the message;
My eye-sight is not good enough to see ASL on a VRI screen; or,
Your reason here.
Please make a note of the reason that VRI is not effective for me in my medical records so that we don’t have to have this discussion every time I come to the hospital.
But it’s after 5/it’s the weekend and there are no live Interpreters available.
That is not true. Interpreter referral agencies are open 24 hours a day 7 days a week. Please make a note of that in my medical record so I don’t have to explain this every time I come to the hospital.
VRI is the same as a live interpreter.
It is not. VRI and Live In-Person Interpreters are listed as separate accommodations under federal law. The Affordable Care Act in Section 1557 says that Section 504 of the Rehabilitation Act requires you to give primary consideration to the specific accommodation I request and I request a Live In-Person Interpreter. Please make a note of that in my medical file so I will not have to have this conversation every time I come the hospital.
Well, it could take a long time for the interpreter to get here so let try VRI until then.
I will use VRI until the Live In-Person Interpreter gets here if AND ONLY IF you provide me with the following information:
1. The name of the hospital staff person who requested the interpreter on my behalf;
2. The exact time that staff person called to request the interpreter for me;
3. The name of the agency the hospital staff person called to request an interpreter for me;
4. The name of the specific person the hospital staff person spoke to at that agency to request an interpreter for me; and,
5. The time the agency estimates the interpreter will arrive at this hospital.
Provide that to me in writing and make a note of it in my medical file and I will use VRI until the interpreter arrives.
Why do you need to know all of that?
Because I need to know who has ownership of my request.
We are not allowed to give you that information.
Yes you are. None of it is protected by law. If you refuse to give me the information I request please provide me with the specific law that forbids it and also make a note in my medical record that I requested it and you refused to provide it.
We don’t put things like that in medical records.
You put all kinds of things in medical records and this is my medical record and you will put whatever I tell you to put in it.
There is not an interpreter available.
I will now call the interpreter referral agency that you told me the hospital called and verify the time you called and that there is no interpreter available. If there is in fact no interpreter available I will require you to call a different referral agency. Make a note of my request in my medical records.
We can’t call another agency, we only contract with this one.
Who this hospital does and does not contract with is not my problem. I am the patient and have a right to effective communication and if the hospital cannot provide it with the agency it uses it needs to contract with a different agency. Make a note of that in my medical records.
Do that each and every time.
If they refuse to document it then as soon as possible make a request by email to the hospital’s Office of Customer Service or Risk Management Officer that you made the request I explained above and that your nurse/doctor refused to document it in your record. Use the names of the specific people you spoke to as often as possible.
One last point, and I can’t stress this enough. Never say “I prefer a Live In Person interpreter” or “I don’t want VRI” or “I don’t like VRI.” That says to the hearing people that is just a choice you are making. The magic words are, “I need” or “I require a Live In Person Interpreter for effective communication (that comes right from the law).
A couple of weeks ago Shelby Hintze, a television producer and the daughter of my cousin, asked me to review the script of a segment she was planning for a local Sunday talk show discussing the ADA’s 29th anniversary.
See if you can spot the part that I helped write, Grin.
(The prepared video transcript. I am working on a transcript for the live portion.)
Voice of Shelby Hintze
“According to the 2010 Census—nearly 20 percent of the U.S. population has some sort of disability. That’s one in five people in this country. As the Baby Boomer generation ages—that number is expected to grow a lot.
Despite the sheer numbers, the unemployment rate for disabled Americans is nearly twice the rate of their able-bodied peers. But historically, that’s an improvement. 29 years ago—our country took a big step in the civil rights of disabled Americans when President George H. W. Bush signed the Americans with Disabilities Act—also known as the ADA.
Activists argued that people with disabilities were not as disabled by their bodies as they were by their environment. They had a right to access all the services of their able-bodied peers. King Jordan, the first deaf president of Gallaudet University, said, “We’re not asking for any favors. … We’re simply asking the same rights and equality any other American has.” In what is described as the biggest catalyst to the bill’s signing 60 activists left their wheelchairs and dragged themselves up the 83 steps to the U-S Capitol, in what’s called The Capitol Crawl. The bill was signed four months later. Since 2000, 181 countries have signed disability civil rights laws inspired by the ADA.
When we think of the ADA, we often think of improving access for wheelchair users. But it’s more than that. It offers protections for the deaf community, people who are blind, people with chronic illnesses.
One of the biggest misconceptions about the ADA is how it is enforced. The law is mostly complaint based. For example, while new buildings are required to have things like ramps, accessible restrooms, and Braille on signs—there is no one who checks these regulations and must be solved through mediation or court.
For example–Under Title III of the ADA, Deaf people are promised “effective communication” but that really isn’t defined by the law. So if a Deaf person goes to a doctor for example, the doctor gets to decide what “effective communication” means. In this case, it could mean the doctor decides writing notes back and forth is enough–instead of using a certified sign language interpreter, which the Deaf patient may want. The Deaf person cannot do anything legally unless they can prove the communication was ineffective. That can be very hard to prove. If they do win the case, the Deaf person is then only entitled to another appointment with that same doctor, this time with an interpreter. Title III does not allow someone monetary damages beyond legal fees.
Just recently—a Utah family made national headlines after they were denied service at an Ogden restaurant because one of the children used a service animal. That was illegal. But outside of court, there is no way to actually make people follow the law.
The ADA did a lot to change the world for disabled people. But for many activists, it is just the beginning.“
“We don’t have a budget for Interpreters,” is not a defense.
The proper response is, “well nothing is in the budget until you put it there. This oversight will make finding the money for Interpreters difficult, but you’ll figure it out.
On the bright side, now you will know how much to budget for Interpreters in the future so you’ll never have to worry about it again.”
I’m sitting in the Charles DeGaulle Airport in Paris on my way to Malta for a week (look it up. Grin).
Being on a trip like this always gets me thinking about all I learn just being in “not America.”
How we got to Malta is a little bit of a story in and of itself, but, in a rare moment of self-editing I will not tell it here, because if I do I will never get to the reason I sat down to type this out with my thumbs in the first place.
Suffice it to say it had a lot to do with never having met anyone who had been to Malta. As my Note will hopefully emphasize, that is reason enough to go almost anywhere.
Now, the Note I sat down to write.
Years ago I hired a former student to be a Lecturer in my program.
I was thrilled she accepted the position (I firmly believe the strength of a program can be measured by how many former students you would love to bring back to teach).
She was an amazingly gifted student (and has gone on to become one of the finest Interpreters, and in all honesty, one of the finest people I have ever had the pleasure to know).
As a student she had one quirk that caught me off guard. One day in class she told me that she would never work in VRS interpreting.
I agree! because my ADHD CANNOT abide a cubicle.
That was not her reason.
She did not want to work in a VRS setting because “ASL from East of the Mississippi scared her.” It scared her BAD.
I couldn’t let that lie now could I.
Quite literally I picked up my cellphone and called Anne Leahy in Washington D.C. I said, “Anne I’m sending you someone you need to teach how to walk on hot coals, she has all the skills but she doesn’t know how tough her feet are” (not the last time I’ve sent Anne someone with skills o’ plenty and let her take care of the confidence part).
Anne brought out the best in her and sent me back an amazingly well rounded interpreter.
She certified before she graduated and charged out into the world to get some real experience.
A few years later I got approval to hire a Lecturer for my program.
When my former student applied I was thrilled! She was as amazing a teacher as she was at everything else.
The next summer I was invited to CIT in Puerto Rico and I asked my former student, now colleague, if she would like to go as well.
She was nervous.
“I’ve never been out of the country,” she said.
“And you still won’t,” I replied, “Puerto Rico is part of the United States. They use the dollar and have Walmart’s and stuff. You don’t even need a passport” (which is good because she didn’t have one).
She felt better. Somewhat. I mean when you think about it Puerto Rico is waaaay east of the Mississippi.
So. Off we went.
When we landed I dropped her off at her hotel and checked into mine then I picked her up and we made plans for the first day of the conference in the lobby of my hotel. When we finished I suggested we get something to eat.
Now, I have a friend who was born and raised in Puerto Rico and I asked her what is “not to be missed” as far as local food.
“Mofongo,” she said.
So we walked over to the concierge and asked if there was a place near the hotel where we could get Mofongo.
“Yes!” she said, “there is a great place within walking distance.”
At that moment felt a hand in the middle of my chest and my former student, now university colleague, pushed me backwards, leaned into the the concierge and asked, “have you ever actually eaten Mofongo? I mean, what’s it like?”
The concierge looked at her kindly and said, “that is kind of like me asking if you’ve ever eaten a turkey dinner. Yes, it’s the national dish.”
I reached forward and gently took a hold of her ponytail and pulled her backward as her ear passed my mouth I whispered, “we need to talk.”
I got the address for the restaurant from the concierge and we started walking toward it.
“Where to begin?” I thought. I cleared my throat and said, “my father once told me if you haven’t had a parasite at least once in your life you have not eaten enough interesting things.”
She stopped and looked at me just as you are imagining she looked at me and said, “ok that’s crazy.”
“Maybe,” I replied, “but here is what is going to happen tonight. You have a per diem for meals from the university. We are going to this restaurant and ordering Mofongo and you are going to try it. If you legit don’t like it I will spend my own money to buy you a Subway sandwich. Deal?”
“Deal,” she sighed. And off we went.
For anyone who doesn’t know Mofongo, it is mashed plantains fried crispy and smothered in stewed meat. It. Is. Fantastic.
She loved it. She ordered it everywhere we went for the rest of our time in Puerto Rico.
While we were sitting at that very nice cafe in San Juan, eating delicious food, I asked her a question that had been elbowing its way to the front of my mind ever since I first asked her if she wanted to go to CIT.
“You don’t have a passport?”
“No,” she replied, “never needed one.”
“You should get one.”
“Why?” she asked, “I’m not planning on going anywhere.”
“You need a passport,” I explained, “for the same reason that I think golf would be a much more interesting game if they just added a penalty box. They don’t have to change the rules at all-just add a penalty box. The fact it is there will inspire its use.”
She looked at me puzzled. It was not the first time and has not been the last.
“Think,” I explained, “you’re not planning on going anywhere and maybe it’s because you don’t have a passport, but, if you had a passport you would be inspired to use it!”
“I don’t know…” but she was thinking about it.
“Look at you right now. You’re stretching your experiences. You are in your twenties, you have a job that gives you some disposable income, you will never be this mobile, this free in your life.” I made eye-contact. “Get a passport.”
And she did.
Since that meal of Mofongo in Puerto Rico she has been all over the world. She has been to Russia, Thailand, and more countries in Europe and South America than I could possibly remember. She is no longer a Lecturer at my program, she has gone on to do phenomenal work in every area to which she sets her hand. And she has used her passport (I actually called her to see if she could cover some classes for me for during this trip and she was in Lisbon).
The point is she will tell you that each one of these trips has made her a better interpreter. Each has added to her knowledge base. Each one has expanded her cultural awareness and expanded her mind to the diversity of ideas. She has a better understanding that I do of what makes it easier and harder to navigate in a culture that is not your own using a language that is not your own.
She was already awesome and these experiences made her better.
It’s Awesome Gain.
So, here I am now I’m sitting in a cafe called Xemxija on the island of Malta. I took my own advice.
Why Malta? Do you know anyone who has been to Malta. Now you do.
What do you know about Malta?
Well now you know about this^^. This is the oldest know human manipulated edifice on earth. It is literally the first stone they know of on the planet that someone, or more likely, some group of people said, “we should pick this stone up from here and place it, in a very specific way, right there.”
It’s the pillar of the Skorba Temple. It’s older than Stonehenge and predates the pyramids by thousands of years.
This is the only painting Caravaggio ever signed. It’s here on Malta (there are actually two other Caravaggio paintings on Malta).
From what I can see the ADA has not made its way to Malta, but I’ll ask these folks about it tonight.
In Thornton Wilder’s famous play ‘Our Town’ Mrs. Gibbs pines for the experience of going to – ”a country where they don’t talk in English and don’t even want to”
Every interpreter should pine for that same experience. It will make you a better interpreter and a more well rounded person.
Get a passport.No matter your age or place in life-get a passport and let it inspire you.
p.s. Before I published this I sent it to the interpreter it is about. She asked me to quote her:
“Meeting Dale Boam changed the trajectory of my life. He was the first person to see the light inside me and demand that I stop playing small. I never knew that life outside of the comfort zone would be so worth it.”