Interpreter’s Quick Action Leads to Prompt Stroke Diagnosis

By on 04/19/2018

Jihee Kim has been a medical interpreter working for Einstein Healthcare Network for more than 10 years, and she is one of a dozen in-house interpreters serving the Network. It’s part of her job to know medical terminology and conditions. She would be the first to say that she is no diagnostician, but when you work with patients all the time—in Kim’s case, Korean patients—you see a lot.

One day, she found herself sitting alongside a patient who had an appointment with a neurologist at MossRehab, Einstein’s renowned therapy branch.

“I went there to interpret for her for the doctor visit,” says Kim. “Right away I saw that she was very disoriented, and when I started talking to her she had slurred speech. Because I had interpreted for her on many occasions previously, I knew she was not her normal self.” Kim recognized the patient’s symptoms as a possible stroke. No one else had noticed.

The patient was due for an MRI after a later appointment with the neurologist. Kim talked to the supervisor working at the neurologist’s front desk, who recommended that the patient go for the MRI first.

Kim talked to a radiology technician, who agreed that the patient’s condition might be an emergency and agreed to see her right away.

Imaging suggested that the patient was indeed having a stroke, and she was transported by ambulance to the emergency department at Einstein Medical Center Philadelphia. There, a doctor confirmed the diagnosis.

A Gratifying Outcome

“Her husband was very nervous,” Kim recalls, “and he had his daughter on the phone, and the daughter wanted to know what was going on. Calmly, we explained to her about her mom’s medical problem. The daughter agreed with the doctor that she needed to be evaluated for neurosurgery. And my job ended there.”

In the end, the patient underwent a successful surgery. Kim finds the outcome gratifying.

“Because I work in the rehab hospital, I see many stroke patients,” Kim says. “That’s the worst thing I worry about for my patients, having a stroke or a brain hemorrhage or some kind of medical emergency where they need to be treated right away. And that’s kind of what I did. I intervened to try to get her the scan she needed immediately so she could be diagnosed quickly, and then I went with her to the emergency room.”

A few weeks later, the patient was scheduled for a follow-up appointment with Einstein neurosurgeon Patrick B. Cooper, MD. Kim arrived to help interpret for the doctor. The patient was recovering nicely. “We were very happy to see each other,” Kim recalls. “She looked great.”

The outcome could have been far different without an interpreter, says Kim, who was born in Seoul, South Korea, and came to the United States as a 14-year-old in 1985. If she had waited and stayed just for the appointment with the neurologist, the patient might have then gone on to get an MRI and from there proceeded to the emergency department without an interpreter. “And,” she says, “there would have been some barriers as far as getting her the quick medical attention that she needed. I was glad that I was able to do that.”

Explaining Cultural Differences

Interpreting, Kim explains, often involves more than just language. Frequently, cultural differences also can present barriers to care.

One example: a woman patient who arrived for an orthopedic appointment for knee and ankle pain who had circular burn marks all over her knee and ankle. The doctor didn’t know what to make of it—but Kim did. The burn marks were the result of self-treatment using a form of Eastern medicine.

“It’s a form of cauterization,” Kim says. “They dry a mugwort plant, and grind it, and put it in a little paper-like covering. They put it on top of the skin, and they burn it. It’s supposed to increase the blood flow in the area, which promotes faster healing.” Unfortunately, the patient fell asleep during one of those cauterizations and suffered a third-degree burn. She needed to get the burn treated before she could be treated for her knee and ankle pain. The burn was so serious, Kim later learned, that the patient might have lost her leg. “She said to me, ‘You saved my leg,’ and I thought it was amazing that I was able to do that. Things like that happen every once in a while.” Explaining cultural differences, she says, is one of the most fulfilling parts of her job.

Kim has come a long way from her arrival in the U.S. At first, her English skills were poor. “I had a tough time going through high school,” she says, “and I remember watching TV a lot, trying to learn how people talk.” Fortunately, Kim was able to improve her English skills and studied hard to get into college. “So, you know, I managed. I’m so glad my parents brought me here.”

Glad to Be an Interpreter

She’s also glad to be working as an interpreter today, making life easier for native Koreans with poor or non-existent English language skills.

Kim is gratified to work at Einstein, she says, because everyone who cares for patients works with the interpreter as a member of the team. “I work with great providers,” she says, “and they make my job easier.”

“I truly love my job,” Kim says. “Many patients show how grateful they are for the services we provide, and sometimes I hear back from patients after we are finished with a case to thank me or let me know how they are doing, and that really makes my job wonderful. And I think that one of the greatest things is that I am part of a team that is focused on saving lives.”

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