Amalia Gladhart: Cicatriz – Scab – Costra – Scar

Ruth had been looking to branch out, not teach Spanish forever. So she completed training, passed the interpreter’s exam, signed up for practice hours at the free clinic. Today was her first solo shift. Her instructor had said interpret everything, that was the ethical imperative. But when the surgeon, washing his hands, regaled the nurse with grisly YouTube videos he’d watched (tracheotomy, hip replacement)—what was the point? And if she did interpret, should she use third person or first? Set it up with a stage direction? The doctor (aside). They weren’t even talking about the patient, let alone to him.

The surgeon volunteered one day a month, outpatient procedures. He wore green scrubs, the nurse a yellow top printed with fast food items, burgers and fries. Maybe scrubs were donated? Ruth had assumed staff brought them from home. The nurse had curly red hair tied back with a thin yellow ribbon and a sweet, mellow voice that made Ruth wonder if she was a singer in her off hours.

All that vocabulary, fear of getting it wrong: maybe the blood rushed to her head. The room was crowded, hot; the procedure, routine. A bump near the crown of the balding patient’s head. Most likely benign—we’ll do a biopsy, shave off the surface. You’ll have an open sore for a couple of weeks, be careful to keep it dry.

The man looked doubtful. No shampoo?

Not those first forty-eight hours. After forty-eight hours, wash gently; don’t knock off the scab.

Scab, naturally, was a word Ruth couldn’t summon. She tried to paraphrase, mimed picking at her arm. The patient nodded, ready. Half-bilingual, he had only wanted an interpreter as a back-up.

The surgeon waited for the man’s scalp to numb. Then, before the man was even aware the process was underway, he used a tiny blade to slice off the top of the mole or whatever it was. He slipped it into the jar of formalin the nurse held out, the blue of her glove visible through the clear plastic walls, background to the floating scrap of flesh, a little disk, an unnamed sea creature.

That’s it? the patient laughed. I didn’t even know you’d started.

And then blood was geysering out of his scalp. Ruth’s head hit the edge of the examining table and then the floor and she was out cold. Out like a light and almost as quickly conscious again, awakening to a fluttering rain of sponge wrappers and extra gauze from the instrument tray she’d upended as she fell.

The nurse’s syruped voice met Ruth as she came awake, balm or cough syrup (jarabe, bálsamo). Like a buzz saw, when Ruth registered the words. “Are you kidding me? Don’t they vet these people?”

 “New one on me,” the surgeon agreed, but his smile was kind. And Ruth had to interpret that too, explain the joke and what just happened, even though she didn’t really know. Had she been out long enough for the situation to be resolved? Was the patient still bleeding?

Apparently so. The nurse held a gauze pad to the patient’s scalp. Ruth scrambled to her feet, bewildered.

“No, no, take a seat,” the surgeon said. He helped her to a chair, filled a paper cup with water. “Did you have breakfast?”

Ruth nodded, looked at the patient. Interpretation was a hopeless tangle. She took a sip, touched the cool cup to her forehead. Her skin burned with embarrassment, she must be red as a beet (remolacha, betabel).

“Is there anyone. . . ?” The surgeon nodded toward Ruth. The nurse shrugged. Ruth told the patient the others were asking was she okay, was there a second interpreter. She felt herself speaking at a remove.

Bleeding stanched, the first nurse excused herself to look for the lab nurse. The patient sat patiently. Ruth caught his eye, then looked down at the ground.

As promised, the lab nurse was skilled at simple instructions and soothing nerves, said she used to faint, too. “Tense and relax your feet and hands,” she told Ruth. “Or look away.”

“To do that, you need to know you’re going to faint, right?” Ruth was breaking the cardinal rule, speaking in her own voice on her own behalf.

“At least know the warning signs.”

But there had been no warning. She’d never had a problem with blood. That she knew of. She’d picked up the usual scrapes and dings as a kid. She’d never fainted.

A sideways glance confirmed the wound had been neatly bandaged. The surgeon pulled off his gloves, washed his hands again. I think we’re done here. Any questions?

The patient shook his head before Ruth could speak, patted the air near her shoulder. Mumbled something about his sister being the same. Ruth opened her mouth, then changed her mind. Explanation would prolong the agony.

It would be one thing if it were her own appointment, if she keeled over when the phlebotomist drew blood. And she could live with a stunted career in blood donation, over before it began. But she had taken the guidelines to heart. The interpreter must be a conduit, an almost absent presence, in no way inserting herself between provider and patient beyond the provision of words, and more words, and then the seemingly same words over again, only different. She wasn’t there to provide drama, an occasion for medical concern. Not even an opinion, a side conversation with patient or nurse. Perhaps a carefully framed and offset request (speaking as the interpreter. . .). An expression of unease, if it seemed some misapprehension were underway. Not splat, smack, are you okay, lie down, take a minute, drink some water.

It was the patient who walked her to the door. The outside air was a relief, laced though it was with parched grass and hot asphalt. Ruth drew a deep breath. Lamento mucho—

No, no, no, the man said quickly. The mole, they removed, and you are okay. Cuídese.



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