In marked contrast to my current work, I used to attend political asylum hearings as a refugee advocate during several civil wars. I was not interpreting then, but sitting with the refugee and their attorney as support. And I remember things the judge at that time would say. At one hearing, after reviewing a doctor’s statement and attached medical record confirming electric shock to the kidneys administered with two knives to the back, the judge simply stated that “I know you guys all play soccer and I have no way of knowing this isn’t a sports injury.” Political asylum denied for lack of proof. Applicant ordered held in custody.

This trial remains in my mind because of the hours of detailed testimony about torture from a kind-faced man whose mother was wailing softly in the corner with a handkerchief held over her face so as not to disturb the judge. She was allowed to stay in the room after she had testified about how he was taken from their home before dawn, roused from his bed and forced to leave in his underwear, because the soldiers assured her “he won’t need any clothes where he’ll end up!” The mother went on to testify that so many dead bodies were being tossed into their local river during the civil war that the residents didn’t have the heart to eat fish from there any more, “because we fear we may be dining on our beloved missing ones”.

I cannot describe the emotion and the strain of that immigration case in words, except to mention that at the end of the trial after the decision was rendered, the attorney stood up with tears on her face, and sent a shock wave through the courtroom by straight up saying to the judge: “I hope you can sleep tonight!” The judge from his throned chair was able to calmly reply, “Thanks, it has been a long day!” and adjourn the session. One guard led the refugee away in handcuffs, and the other ushered us back into the street, as our trial had run over and the building was closed. Having to stand by the mother while armed men once again took her son away. Saying our goodbyes outside of court, leaving the mother bereft. Knowing a young man who had been tortured in prison was now facing custody again. Imagine the pain. The suffering. The helplessness. Multiplied.

I once worked with a man who while under interrogation in his home country, was presented with a psychiatrist on his torture team. Not a treating physician, but a military staff doctor who would come in and see if he was close to breaking under interrogation, and make sure he wasn’t likely to die before he had said everything they wanted to hear. With post-traumatic stress, you can imagine how hard it was for this counseling patient to accept meeting with a psychiatrist here in the US, who was sadly quite a cold fellow, and limited his “treatment” to pharmaceutical side effect oversight, such as appetite and sleep. There was no reaching out or acknowledgement that “someone in his position” had so irretrievably harmed this patient, even after the refugee tremblingly explained in wrenching detail what the “other psychiatrist” had done. It left an aching void in all subsequent sessions that was never healed over.

These are extreme cases, and I sometimes comfort myself by choosing to believe they are rare, because the alternative is too painful. Let us turn to more everyday disappointments and reasons not to trust. What about interpreters? How many of our language service recipients have had another “interpreter” let them down? How many have had their voices cut off or skewed? How many were not fully and accurately told what the English speakers with power and control were actually saying? How many suffered some degree of harm? Probably most, to one degree or another, over time. From a bilingual border agent to a resident doctor to a teacher’s aide at their children’s school. To a certified interpreter, yes, it can happen. Do interpreters have any obligation to acknowledge the harm, acknowledge the power dynamic, and vow to do better? Do we have any obligation to reach across to them? Are we even allowed to?

In discussing this with various colleagues who work in the medical field, where such a pre-session would be allowed, while some agree, others don’t seem to fathom the problem. Some have shrugged and claimed, “I just say what they say.” Some talk about how they are not responsible for what someone else said or did, so why should they apologize? Most of those cases were not even “real interpreters” so what does it have to do with us? Some feel that even a two-sentence introduction before an interpreting session could seem invasive and center the interpreter, where we are supposed to be “in the background”. They hate pre-sessions and just want to dive in. A few have even told me that they cannot possibly know, nor do they need to, whether someone has had a bad experience in the past with an interpreter. Not their problem. They do a good job!

It may be worth pondering how healing, how helpful it might be, to have a very brief acknowledgement: These can be difficult experiences, but I want to assure you that with me, you will be heard and respected. Or should our work, should our words, should our voice, as it becomes their voice, tell them all they need to know? Should we silently expect them to take that leap of faith, once again, and trust this unknown and imperfect process to keep them safe? I find that with a clearly hesitant or worried patient, it merits a quick statement, even a couple words and a nod, to reassure them that we are here for them. That we will do our work honorably, and serve them faithfully. A quick acknowledgement to let them know that we care. Remembering the many ways in which our patients may be particularly vulnerable, this is a kindness that should not be overlooked.