Writing Resources from Fifteen Minutes of Fiction

You don't think I'm crazy, do you?

Language gets so much harder when it's altered by psychological problems.

Psych is such an interesting field, but I'd rather keep it at arms length if at all possible. I've brushed up against a handful of cases during my time here at the hospital - we have a Psych Emergency center, and you never quite know what's coming in. Every time I get ready to walk into one of the tiny rooms, I take a second to readjust my brain. As an interpreter, I constantly search for meaning, using context, body language, whatever can help me get the proper meaning transferred. But Psych changes all of that. Body language doesn't have to match words, words don't even have to match language structures. But it all has to get through.

The implications of proper interpreting are huge. I step into a world where every precious word counts, where every inference, second meaning, and cultural sideline must be ushered safely across the language barrier. It doesn't have to make sense to me - that's the job of the psychiatrist sitting next to me, and I am so glad of it. But I do have to catch the undercurrents - the tones behind the word choices, the difference between choosing one word and the next, the silent cries for help in the way the words are put together. I have to say what the patient says so the provider hears not only the words, but the meanings, and the possible meanings, all without tainting any of it by my impressions. I have to enable the psychiatrist to do what he does best, across a language barrier. It's an awesome responsibility.

Strangely enough, I'm never scared in Psych Emergency - I'm not sure if that's good or bad. I remember standing in the hallway with the doctor, trying to usher a patient back in his room. He kept squinting up the ceiling, and twitching as if he'd had hot water sprinkled on his face - 'He won't stop...he keeps spitting at me," the patient said, pointing up to the empty ceiling. Another patient, thin, bony, defensive, wouldn't even speak to me, because she was indigenous Mexican and I had a cara blanca. A white face, and of course we the white faces stole all their land, all of it, theirs, all of it, stolen, and that was unforgivable. Her mind crawled into a shell harder than her body and refused to come out. Then there was the schizophrenic-off-his-meds who came in with two self-inflicted abdominal stabs from a butter knife. He wanted to know where the doctors kept all the patient brains. Nothing we could say would change his mind.

Most cases aren't so spectacular though - they're simply depression (if depression can ever be called simple) or patients who've never really been 'off' enough to seek psychiatric help until suddenly something triggers them into isolating themselves and ignoring the world. I remember one lady in particular. I sat very still as we talked, focusing on her words, letting the psychiatrist try to engage her attention without seeming rude myself. Tu crees que soy loca? Do you think I'm crazy? she kept asking. Her poor brain was crammed full of so many bad things that she couldn't let go of. Anger, loneliness, fear of being thought insane, pride - yo nunca pido disculpas de nadie, she said - I never apologize to anyone. Guilt over an accident of an epileptic brother who fell off a horse at age 4 and was never the same. It was my fault, it was, it was! A veces mi abuela me viene - sometimes my grandmother comes to me - soy loca? Am I crazy? Thoughts of dying, thoughts of ending, too many thoughts.

We try to leave hope behind us in our patients, giving them something to look for and live for. We connect them to resources, give them medication if that will help, send them to counselling, and even keep some admitted to our psych unit. Sometimes just having someone to talk to is all they need, a kind of bad-bloodletting, getting it off your chest. Everything about it is so very different from clinical medicine - I almost feel myself undergo a mental change when I step through the door.

What an interesting job I have.

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