16.2756, Review: Translation/Sociolinguistics: Angelelli (2004)

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LINGUIST List: Vol-16-2756. Sun Sep 25 2005. ISSN: 1068 - 4875.

Subject: 16.2756, Review: Translation/Sociolinguistics: Angelelli (2004)

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What follows is a review or discussion note contributed to our 
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1)
Date: 22-Sep-2005
From: Simon Bacchini < s.c.bacchini at qmul.ac.uk >
Subject: Medical Interpreting and Cross-cultural Communication 

	
-------------------------Message 1 ---------------------------------- 
Date: Sun, 25 Sep 2005 16:54:21
From: Simon Bacchini < s.c.bacchini at qmul.ac.uk >
Subject: Medical Interpreting and Cross-cultural Communication 
 

AUTHOR: Angelelli, Claudia V.
TITLE: Medical Interpreting and Cross-cultural Communication
PUBLISHER: Cambridge University Press
YEAR: 2004
Announced at http://linguistlist.org/issues/16/16-168.html 

Simon C. Bacchini, Department of Linguistics, Queen Mary, University 
of London, PhD research student in linguistics.

Claudia V. Angelelli's book is a study of medical interpreting in a 
Northern California hospital. To carry out her research, the author 
adopted an ethnographic approach and for a period of almost two 
years she shadowed a team of interpreters who work for the hospital, 
California Hope (not the real name). All interpreting was done from 
English into Spanish and vice-versa.

Angelelli's stated aim was to problematize the role of the medical 
interpreter. In particular, she wanted to challenge the idea that the 
interpreter -- in particular the medical interpreter - can be invisible, a 
simple carrier of meaning from language A to B. in addition, the other 
myth to be dispelled is the one that places the interpreter and the 
practice of interpreting in a social vacuum.

For Angelelli, the interpreter's invisibility is 'a myth' and the fact that it 
is presented as both a fact and an ideal is a cause for concern. The 
concern, Angelelli argues, is both theoretical and at the level of 
practice. In Angelelli's opinion, for the field of interpreting to advance, 
one needs an underlying theory; but 'a theory based on a myth [that 
of the interpreter's invisibility] is not a substantial theory' (p. 3). 

The other concern is at the level of practice. It is 'about the ways in 
which the belief system of invisibility impacts on the lives of those who 
rely on interpreters for their daily communicative needs [...] as well as 
the interpreters themselves and the healthcare providers' (p.3).

It is these concerns that prompted the author to question the role and 
the very existence of the invisible interpreter and to explore, on the 
other hand, his or her visibility. Angelelli's ethnographic immersion in 
the world of interpreted interactions at California Hope (CH) resulted 
in several hours of recorded material, both of face to face as well as 
over the phone 'interpretative communicative events' (ICEs) between 
patients and health-care practitioners (HCPs). Through a careful 
analysis of these interactions, many of which appear in the book, 
Angelelli shows how interpreters become visible by showing agency. 

The author contributes to making interpreters visible by including a 
chapter in which synthesis of interviews with the interpreters she 
shadowed and recorded is given, as well as of an interview with the 
manager of the interpreting department at CH. Interestingly, during 
these interviews many interpreters described their role using 
metaphors, which Angelelli discusses in her final chapter where she 
also gives us her conclusions and illustrates the theoretical and 
practical implications of her findings.

'Medical Interpreting and Cross-cultural Communication' is an 
ambitious work. As the author herself states, it is aimed at a variety of 
readers, 'researchers, policy makers, interpreter-educators, 
practitioners, students of interpreting, healthcare professionals, and 
communication specialists' (p. 5).

With such a varied readership in mind, the risk is always that of 
disappointing one or more of the intended target audiences by, for 
example, concentrating on theoretical aspect while neglecting more 
practical points, or vice versa. Another possible risk, in this kind of 
work, is that of falling into the trap of an easy prescriptivism by giving 
lists of dos and don'ts. And so forth. Angelelli, a professional linguist 
with vast experience in both academic research and translation and 
interpreting, mostly avoids this pitfall.

The book is well planned. From the outset, she states her aims and 
concerns, as well as the gaps in the current literature that the book is 
intended to fill. Angelelli recognises that researchers have begun to 
address the notion of the interpreter's neutrality and invisibility. Her 
goal was to expand on previous research by studying a large number 
of interactions over an extended period of time. Hence the choice of 
an ethnographic approach.

As noted, one of the author's main aim was to question the 
interpreter's invisibility. Participation in a large number of ICEs led her 
to propose a new model of medical interpreting, one where the 
interpreter is all but invisible, a mere facilitator. Angelelli argues that 
the visibility of interpreters manifests itself when they do one or more 
of the following (p. 11): 
1) introduce or position the self as a party to the ICE, thus becoming 
co-participants and co-constructors; 
2) set communication rules (for example, turn-taking) and control of 
the traffic of information; 
3) paraphrase or explain terms or concepts; 
4) slide the message up and down the register scale; 
5) filter information; 
6) align with one of the parties; 
7) replace one of the parties to the ICE. 

When an interpreter does one or more of the above, 'agency' 
manifests itself. In chapter 6, Angelelli shows interpreters doing just 
that, in various degrees. 'Agency' here, is located in discourse moves, 
rather than in specific lexicogrammatical choices. The more an 
interpreter controls the traffic flow (instead of following it), the more he 
or she shows agency. Another way identified by the Angelelli as a 
means of showing agency is by showing awareness of differences in 
register.

The manifestation of much of this type of agency depends -- as the 
author acknowledges -- on the institutional setting in which the ICE 
takes place. Courtroom interpreting, for example, poses many more 
restrictions on the kind of discursive actions an interpreter can take, 
thus imposing -- in a way -- a role of conveyor of the linguistic 
message. 

In addition, Angelelli alerts us to the fact that interpreting does not 
take place in a social vacuum. All the parties involved in the ICE have 
socio-economic and cultural backgrounds, and thy take place within 
institutions (the hospital, for example) that operate with a certain set of 
norm, most of which are assumed to be shared knowledge.

And here the author shows how interpreting in a medical setting 
involves a lot of cross-cultural brokerage and that there is much more 
than language that needs translating in an ICE. Parties in an ICE in a 
medical setting often come to the interaction with different 
expectations and different sets of socio-cultural norms. What 
constitutes appropriate behaviour in a doctor, for example (degree of 
formality vs. informality, directness, etc.) can vary considerably across 
cultures. The interpreter is thus responsible for the success (and, 
potentially, the failure) of the interaction by operating simultaneously 
on various levels of translation: the linguistic, the cultural, and the 
personal.

It is in this arena that interpreters display their abilities, demonstrate 
their visibility, and exercise their agency. As noted, in Ch. 6 the author 
provides many examples of this. They clearly show various degrees of 
visibility and agency on the part of the interpreters. In some cases, 
interpreters even take the lead in the encounter. They begin a line of 
questioning of their own initiative and even reprimand patients when 
they are not complying with the health practitioner's instructions.

Crucially, Angelelli shows examples of what motivates an interpreter's 
display of agency. This could be the perception of a possible 
misunderstanding, often caused by the perceived imbalance between 
the educational level of the patient and that of the health care 
practitioner.

In those cases where the author shows that the display of agency is 
caused by the interpreter's wish to tone down a statement by the HCP 
or by the patient, it could have been helpful to have referred to 
notions of politeness and face (Brown and Levinson 1987) as a way 
of explaining some of the discursive move by the interpreters. This, in 
my opinion, would have added explanatory power to Angelelli's 
argument. The medical encounter provides fertile ground for the 
generation of face-threatening acts (with potentially devastating 
effects). It could have been interesting to have looked at the 
possible 'face-saving by proxy' that might occur in this kind of 
interactions.

As mentioned, the author conducted interviews with all the interpreters 
she shadowed asking them clarifications about particular occurrences 
and also about the perception of their own role. The former was a 
very useful tool for clarifying the reasons behind some of the 
interpreters' choices. In linguistic investigations, it is quite easy for the 
linguist to read too much in the talk of the informants. This particular 
aspect of her ethnographic approach allowed the author to avoid that 
pitfall, simultaneously adding scholarly rigour and giving interpreters a 
voice or more visibility, one is tempted to say. Particularly interesting is 
the part where interpreters use metaphors to describe their own role. 
And so we have the interpreter as bridge-builder, diamond 
connoisseur, and miner. Perhaps here, some reference to Lakoff and 
Johnson (1980) would have not gone amiss. This might have helped 
clarify what the participants' own, possibly sub-conscious theories of 
translation might be. In this respect, it would have been interesting to 
conduct interviews with at least some of the patients and some HCPs 
to shed light on their ideas of the interpreter's role in the medical 
encounter. This, however, would have certainly added another burden 
on Angelelli's already heavy task of data collection and analysis, and 
perhaps is more suited for a multi-authored work.

Overall, this is a very useful and readable work. In it, the author sheds 
light on the complexities of cross-cultural medical interpreting, and 
shows convincingly that -- at least in this kind of interpreting -- the 
notion of an invisible interpreter is no more than a myth, and a 
potentially dangerous one at that. This is applied linguistics with 
the 'applied' part very much in the author's mind and it will certainly 
prove useful to the categories in the intended readership mentioned 
above.

Importantly, Angelelli's clearly explained methodology makes it 
possible for other researchers to replicate the study (perhaps on a 
smaller scale), thus exploring the issues further, addressing other 
questions or the same ones while taking into consideration other 
theoretical orientations (an investigation the interpersonal 
metafunction from the point of view of Systemic Functional Linguistics 
would be one of my preferences).

REFERENCES

Brown, P. and Levinson, S. (1987). Politeness. Cambridge: Cambridge 
University Press.

Lakoff, G. and Johnson, M. (1980). Metaphors We Live by. Chicago: 
University of Chicago Press. 

ABOUT THE REVIEWER

After a Mater's in General Linguistics and Comparative Philology at 
the University of Oxford, I began a PhD in Linguistics at Queen Mary, 
University of London. The aim of my project is to investigate the 
linguistic expression of physical pain. I am looking at issues such as 
the grammatical encoding of pain, the expression of evaluation, 
subjectivity, affect and agency. The analysis is carried out on an 
original corpus of interviews with Italian women suffering from 
autoimmune diseases, such as Lupus and Rheumatoid Arthritis. The 
theoretical framework of my work is functional (drawing in particular on 
Halliday's Systemic Functional Grammar) with insights from 
sciolinguistics and discourse analysis. My other interests are 
sociolinguistics, Italian linguistics, discourse analyisis, and language 
variation.





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