today my senior resident called in a translator to tell this patient (a Latino man with an enormous hernia that we couldn't do anything about and an open wound at the site) that he needed to be discharged that day.
the senior, who was fed up with the large degree of social work involved in the patient's care (his entire family had left for el salvador, it was unclear whether he even had the keys to the house, he couldn't take care of himself, his story kept changing), demanded that the translator translate that "this hospital is not a hotel, you can't just stay here any time you want."
the translator--a latina woman with her hair pulled back tight in a dignified bun and her eyes large and sympathetic--said to him in a quiet but curt voice "do you really think it is necessary to tell him that?"
the senior cut her off and told her a resolute yes. she translated his words in a quiet voice that conveyed how much she resented having to tell the patient. the patient's face became more and more dejected as the translator told him this. he coughed and winced in pain from the hernia. he and the translator looked at eachother in a way that can only be described as one of complete helplessness--him helpless to convince anyone that he is a dignified man who does not lack a home, but is simply ill and in a bad situation, and her helpless to shrug off the yoke that makes these words come out of her mouth without actually meaning them. it was pretty hard to watch and to be one of the ones in the white coat--as though i myself had already taken a side without even speaking a word.
