The Doc Project

'I've done a good job when they forget I'm there': The medical worker who strives to be invisible

"We're there to make sure that two people who don't share the same language understand each other."

Medical interpreter Maria Anna Calamia describes how she manages to stay present while disappearing

(Ben Shannon/CBC)

Maria Anna Calamia (PhD) delivers heartbreaking, life-changing news every day — all with zero eye contact and a straight face. 

As a medical interpreter, it's her job is to facilitate communication between a patient and a health care provider who don't speak the same language, all while being the most unobtrusive presence possible.

"I try not to make eye contact with either of them so that they can build a relationship and make eye contact with each other," she explained. 

I always strive to be invisible.- Maria Anna Calamia  (PhD)

So, while it is Calamia's job to bridge the gap between doctor and patient, she also has to do everything in her power to fade into the background.

"I always strive to be invisible," Calamia said. "I know that I've done a good job when they forget I'm there."

And there's no room for error: an interpreter must deliver everything exactly as they hear it, including profanities, stumbles, tonal changes, and even slurred speech. This is because the medical staff need to be aware of everything their patient is experiencing. 

"If you don't interpret everything as faithfully as possible then the care provider may not know that a chair may be flung at them or that the patients are really unhappy about the way they've been treated," Calamia said.

"You can put yourself and the patient at risk."

Vicarious trauma

Medical interpreters are an integral part of some people's most vulnerable moments. From a patient learning they are cancer-free to another hearing they only have a few weeks to live, Calamia is there — and sometimes finds it difficult not to absorb some of what she's hearing. 

"Vicarious trauma is something that really does affect interpreters … We have a really high burnout rate," she said.

When you're in a session and your emotion comes through, that for me was unforgivable.- Maria Anna Calamia (PhD)

Calamia remembers the first time she experienced this type of trauma. It happened when a patient she'd be working with for a year suddenly and unexpectedly ended up in intensive care, and she had to interpret while the patient discussed end-of-life care with the doctor. She maintained composure during the appointment, but not after.

"I was walking and before I got to the end of the hallway I just started to cry uncontrollably. I didn't think that would happen. And so that still sits with me today even though that took place nine years ago," she said. "It just hit me. I think this is what happens to us as interpreters when something unexpected happens."

"I felt like I'd failed"

Crying after you leave is one thing, Calamia says. Breaking down in the presence of a patient is another. 

"When you're in a session and your emotion comes through, that for me was unforgivable."

It happened while Calamia was interpreting between a patient and her mother. The patient was having a final conversation with her mother before being taken off life support.

I know that I've done a good job when they forget I'm there.- Maria Anna Calamia (PhD)

"Things are fine, and then I look over and the nurse stands next to the mother and the nurse starts to cry. And as soon as I saw the nurse cry that's when I also started to cry," she said. "I felt like I'd failed in my job."

This is why multiple interpreters are often sent when interpretation is needed for an extended period of time; the emotional and mental toll is heavy, and it builds up fast. 

Turkey's President Recep Tayyip Erdogan listens to an interpreter as US President Donald Trump speaks during the 72nd United Nations General Assembly. The UN assigns interpreters for 20-30 minutes at a time. (Brendan Smialowski /Getty Images)

"This is why interpreters have very high burnout rate. At the UN, interpreters change every 22 minutes. Twenty-two minutes is really the ideal time to continue interpreting before you get burned out and before your brain sort of goes mushy," Calamia said. 

Staying sane

In between those 20-30 minute stints, Calamia says it's important that interpreters find ways to prepare themselves for what's next. Basically, it's about learning to expect — and be ready for — the unexpected. 

"It's all about prevention. We have to be proactive. It's not about being reactive. If you are being reactive you're going to get burned out really quickly. For me it's about keeping my sanity," she explained. 

Breakdowns. Frustration. Lingering trauma. But for Calamia, the hard parts of the job are worth it.

"When you walk out and you think this person has made a decision about their healthcare based on information they received from their care provider," she said, "That's very rewarding for me." 

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This documentary was produced by Veronica Simmonds and Acey Rowe.