People who don’t interpret may think we say what the speaker says “word for word” but it is more complex than that. We sometimes have to go quite far and completely toss out a phrase used in order to come to render the intended meaning. Interpreting is especially challenging during physical exams via video. It is rare that the camera would be so far back that I can see the patient and doctor in full body mode. Usually, I am looking at the patient’s face (supposedly to read their facial cues, which is very limited with mask on). For physical exams, I am often turned to the wall. So I miss most of the cues I would have in person. But we muddle through.

I had a neurology appointment with a stroke victim who was a new patient and needed a full exam, via video. Often, instead of using whatever exacts words the doctor is saying, like “lift your toes to your nose and don’t let me push them down” I will use alternate phrasing to avoid the long gaps as the patient tries to figure out what was said. There can be lots of gesturing and demonstrating by the doctor as well, in which case I can say, “like that” and the patient usually just copies the doctor’s positioning. For “push, pull, don’t let me move you, I’m going to try to push your arm down but you try to hold it up” and so many other quickly stated phrases (most usually without any pause for the patient to hear, let alone process, much less follow the instructions as the doctor launches straight into the movements and tries to hold down the leg that the patient hasn’t even started to try and lift) I will just say “resist” to indicate push/pull/lift/move/stay in resistance to the doctor’s pressure.

Unlike in the case of technical medical explanations, where it is hard to tell whether a polite patient has understood, in these physical performance exams, we can tell if the patient understood enough to do as asked. If we can see them, that is. The same goes for trying to guess what the doctor may be demonstrating off camera. I cannot just say, “like that” if I cannot see whether the doctor demonstrating. In this appointment, the doctor was having the patient walk off-camera (and the doctor was off-camera) and then he said “okay, now tightrope”. My mind reeled into words or phrases for tightrope in the target language: A loose rope. A narrow line. Equilibriism. I didn’t think any of these would work, so I started to say “walk heel to toe” and as I spoke I heard the doctor say “good” so I presume he was also demonstrating how to walk heel to toe as he said “tightrope”.

Realizing he and I were talking at the same time, the doctor peered down at the video camera and said he was sorry for jumping ahead of me, and I almost said “whatever’s clever” but I didn’t want to have to render that back into the target language, so I just said “it’s fine” in both languages. Which it was, because the doctor was able to garner all the information he needed without me tossing the patient a tightrope.