Medical interpreting and cross-cultural communication. By Claudia V. Angelelli. Cambridge: Cambridge University Press, 2004. Pp. xiii, 153. ISBN 9780521066778. $36.99.

Reviewed by Colette van Kerckvoorde, Simon’s Rock College

Given the increase in the number of recent immigrants, many hospitals in the United States are faced with new challenges, since patients and their caregivers often do not share the same language. While smaller communities usually rely on relatives or friends to help out, it is clear that such ad hoc solutions are not optimal. In larger hospitals, medical interpreters are employed, and the need for such professionals is rapidly growing. In this book, Angelelli focuses on the role of the medical interpreter and examines whether the prescribed rules and codes for these professionals are realistic.

Medical interpreters are typically part of a private interaction between two people in hierarchically different positions. During such an encounter the caregiver must try to understand the symptoms and attempt to facilitate the patient’s expression of thoughts, feelings, and expectations. The official role of the medical interpreter is one of neutrality and invisibility: the interpreter supposedly does nothing beyond decoding and encoding parts of the conversation. While such an expectation of the interpreter may be quite appropriate and feasible in a court setting or in a business interaction, it does not make much sense to expect the same in the field of medical interpreting, A claims. Over a period of two years, A followed, observed, and worked with a team of medical interpreters in a California hospital in order to determine what role the interpreter plays in an interpreted communicative event (ICE). Her study included both face-to-face interactions and conversations over the speakerphone.

Her findings clearly challenge the notion that invisibility and neutrality are attainable. In fact, the interpreter is much more than a mere language-switching operator. A describes medical interpreting as a communicative act in which interpreters frequently create and own text, and thus are not invisible. She examines what triggers the interpreters’ participation in the interaction between patient and the caregiver and concludes that there is a visibility continuum: minor visibility usually happens during the highly ritualized openings and the closings of an ICE, where interpreters may modify or direct the conversation so that it conforms to the norm of the patient’s culture. Various levels of visibility may occur during the actual medical exchange: interpreters exercise agency to achieve the communicative goals of both parties involved, they may expand the renditions of the patient and/or the caregiver by producing texts that they own, and they frequently include some cultural brokering. They also orchestrate moves and coordinate information-based relations between the speakers.

This book does not require any linguistic background and is written primarily with health-care professionals, communication specialists, and students of interpreting in mind. It offers a good glimpse into the daily life of medical interpreters and stresses that medical ICEs occur within institutions that are permeable to the mandates of society, that each party brings his or her own social factors to the encounter, and that the interpreter must consider these social factors while processing information between languages and cultures.