11/30/2011 Translation Experience

On Monday November 28, 2011, I volunteered at the San Jose Clinic with the dermatology staff as a translator. I saw surgical procedures involved in benign mole and syringoma removal with a derma-knife, chemical peels to treat hyper-pigmentation, and the use of an epilation needle for syringoma treatment. In most of these cases, the patients needed a translator to better interpret what they want to say or to better understand a doctor's explanation.

Compared to volunteer experiences with endocrinology and neurology, dermatology usually sees patients who do not have very severe, critical conditions. However, I learned from the dermatologist the importance of the work they do at the San Jose clinic. One part is to teach the residents in dermatology how to do procedures such as chemical peels for acne and hyper pigmentation and epilation needles for syringomas. The doctor also taught me that the preservation of facial anatomy is also very important in people because the face is very important in social presentation, and having a disfigurement on the face, no matter how benign, affects the person's self-worth and possibly how people see the person. Since people that come to the clinic make an income that is at least 2.5 times below the poverty line, it is very unlikely that they would be able to afford the treatments anywhere else. The clinic provides the opportunity for these patients to get treatments that are usually out of their reach and for new dermatologists to receive training in dermatological procedures, practice in learning Spanish, and an opportunity to help the community.

I have really enjoyed my volunteer experience at the San Jose Clinic. Even thought this post concludes my volunteer requirements and further volunteering will probably not affect my application to medical school, I will be volunteering at the clinic at least once a week until I start medical school. I have learned that there is a real need for translators and Spanish speaking medical staff, especially in places were the poverty level is high and with few affordable options for treatment. I am very happy to have had the opportunity to work at this clinic and I have seen the impact of my work there from both patients and staff. I will look forward to another nine months of volunteering there.


Signing off,

Eduardo Mulanovich

11/21/2011 Translation Experience

On November 21, 2011, I volunteered at the San Jose Clinic with an endocrinologist. The major problems we saw were diabetic patients who were non-compliant with treatments and life style changes. These patients were reluctant to be on exercise programs and sometimes did not take the medication prescribed to them. The patients complained of the worse pains they were feeling - including exacerbated symptoms of numbness in the extremities suggesting diabetic neuropathy - but it was difficult to feel sympathy for them when they did not keep up with the medications that they received free of charge nor make the effort to change diets and increase daily exercise that they were instructed to do with the help of a dietician. It is understandable that it is difficult to make such changes when poverty may not allow the time nor resources, but the patients did not seem to budge from their normal routines. This experience was important to see that not all patients are complaint with treatments, and that there may be problems with communication of the severity of the disease or the importance of the treatment and life style changes. It would be interesting to investigate this further, maybe even find a way to research the effectiveness of doctor-patient communication.

11/18/2011 Translation Experience

On Friday November 18, 2011, I was a volunteer translator for the neurology team at San Jacinto Clinic. The team consisted of five doctors. There were only two patients that needed a translator: one that had daily, painful migraines and another that had an uncontrollable spasm around their eye. The eye spasm condition was particularly interesting because the doctors had to look for solutions that did not involve using Botox which would run the patient a bill of at least $800 per year to paralyze the muscles causing her discomfort. It goes to show that even though these problems are not generally seen as important, they are problems that would really affect people in poverty, reducing quality of life.

Fifth Translation Experience

On Friday, November 12, 2011, I volunteered at the San Jose Clinic as an interpreted for a physician assistant in Adult Medicine, Lewis Wu. Compared to other translation experiences, Mr. Wu had very little Spanish experience and relied heavily on me to translate everything to the three patients we saw. All three patients had high cholesterol, triglyceride, or very low density cholesterol counts - which are indicators of possible heart attack or stroke. Most patients were given medications to lower these factors, but also referred to a dietician to help make a diet and exercise plan to aid in lower these levels. It was interesting to see the perspective of a physician assistant in general adult medicine since they are playing an ever increasing important role in primary care. The patients themselves had complained of stresses such as paying for their children's college, bills, lack of work in the current economy, and other factors of life in poverty. This gave me a better glimpse of why most patients have exacerbated conditions prior to making an appointment at San Jose Clinic since most are too busy with other factors in their lives that they must make health a second priority to family or work. The lack of good food options or choices and/or time to exercise seems to be a key factor for those with high cholesterol and diabetes at the clinic.

Fourth Translation Experience

On Monday November 7, 2011, I volunteered as a translator for Dr. Earthman, an endocrinologist. We saw patients who were either pre-diabetic or diabetic. Diabetes, as Dr. Earthman says from years of experience treating mostly Hispanic and/or poverty stricken patients, is a major problem in the poor Hispanic population. Every patient we saw had one thing in common: they either had or were in the process of becoming diabetic and they needed to lose weight to counter the effects of diabetes. I felt my translation of his message to the patients of the importance of weight loss gave a better impact than when he attempted to assert the importance of weight loss. It was interesting to see that all patients could have lesser symptoms with simple weight loss as opposed to medication, but that this is a challenge since they would need to not only have a better diet, but also find time in their very busy schedules - that they must have in order to support their family, as many patients have claimed - to exercise.

Third Translation Experience

I had my third translation experience on Monday, October 24, 2011. I was with a new doctor, a gastroenterologist who practiced internal medicine in the clinic, since the doctor I normally assisted was sick. There were very few patients this particular day as I only saw two. This doctor, although born and raised British and living in Houston for 50 years, spoke Spanish very well without having taken classes. All I helped in was to translate what a male patient had to say about his general complaints of general weight loss with ballooning of the stomach. Overall it was an interesting experience to be with another doctor and see his perspective on the health crises of the United States, which he puts particular blame on readily available unhealthy foods.

Week 4: Second Translation Experience

On Monday, October 10, 2011, I volunteered as a translator with dermatologists at the San Jose Clinic. Most of the doctors at the clinic knew a little bit of Spanish or just enough to be able to ask basic questions. I was there mostly translate when they were stuck on terms, when they needed me to give a long explanation on how to specifically treat their ailments, or to translate long or complicated answers or questions from the patient. Every single patient I saw was Hispanic and about half of them were proficient enough in English to not need assistance in translation. In most cases, the younger patients would know English probably because they are educated in American schools and may be of a at least second generation of immigrants. It is interesting to see the different cases of dermatological diseases, but I find the sociology very integrating as well.