With palliative care/hospice patients and their fragile health status, there is a chance that every time you see them might be the last time they ever have a meaningful connection with a fellow human being. Things can change in an instant, people can lose consciousness or clarity. Keeping this in mind, try to make each interaction as pleasant an encounter as you can for the both of you. The following tells of an unpleasant distressing encounter.

I was asked to see an unwell Oncology patient, who was in a lot of pain, and possibly about to die. There was a language barrier in that he did not speak English, thus an interpreter was organised to facilitate communication. That was the idea anyway, what actually happened was different.

The man in bed looked fragile, he had trouble communicating with his family, as he was lapsing in and out of consciousness. The interpreter arrived, a young man, who looked nervous. He stood at the end of the bed and didn’t greet the patient or his family members. The patient was being prepared for a scan and might need to head downstairs at a moment’s notice, so time was of the essence.

The patient did not have hearing impairment but had trouble paying attention as he was dozing off constantly. The interpreter kept his distance at the end of the bed. He seemed to be afraid of catching whatever illness that our patient had, even though the patient’s end-stage cancer was not contagious. The interpreter shouted at the patient, and lacked patience himself. He expressed annoyance when the patient kept falling asleep. The interpreter would raise his voice even louder, and his tone sounded more aggressive with each repetition of his questions.

This communication attempt was heading nowhere, and was the strangest encounter with an interpreter that I had ever witnessed. Luckily an orderly arrived to take the patient downstairs to Radiology. At which point I took the interpreter aside to have a word with him.

Why were you shouting at the patient?

He wasn’t replying and I thought he might be deaf.

He wasn’t deaf, he was very unwell.

Oh.

How would you feel if you were unwell and someone was shouting at you?

Silence.

You seemed uncomfortable in the room, have you dealt with unwell patients before?

Yes, all of the time.

Do you treat other patients like you treated this patient?

What do you mean?

Without compassion or care.

What does that mean?

I’m not happy with your work and I am going to make a complaint, because of the way you treated that man.

Silence.

Goodbye, your services are not needed any more, you’ve done enough.

20 minutes later the patient was brought back to his room, he hadn’t been able to have his scan as he had become unconscious and was unresponsive when he arrived at Radiology.

He never regained consciousness and died later that day.

It felt awful to think that the final interaction that the patient had with a fellow human being was of being shouted at by someone who was employed as a hospital interpreter, but was afraid of patients. An interpreter who might have had language skills but lacked humanity. A robot might’ve shown more compassion and respect.