Cough!

Once a year I spend a week in Antigua, Guatemala, where I interpret for a group that does free surgeries for people for whom even the almost-free national health care system is too expensive.  I spend a lot of time in the recovery room. It’s a challenge–you’re interpreting for people who are half-asleep, and often wearing an oxygen mask–and I do like a challenge. (This use of do explained in the English notes below.)  Sometimes the challenges are unexpected ones, though.

One day last year a recovery room nurse asked me to tell a little boy to cough. That’s not unusual in a recovery room–sometimes post-operative secretions in your lungs cause a minor drop in the amount of oxygen that you’re getting, and a cough or two will clear them right up.

Tosa, I said. The kid looked at me uncomprehendingly.  Hmmm, I thought to myself–does the kid not speak Spanish?  That’s not uncommon in Guatemala, where 70% of the population is indigenous and over 20 Mayan languages are spoken.

The father looked at me and smiled. Tosá, he said. The kid coughed. So: no cough when I said tosa, but tosá elicited the desired response.

The father was using a verbal form that’s used in Guatemala and a few other places in Central and South America. Indeed, it’s probably the most distinctive thing about Guatemalan Spanish. However, although I know a few local regional nouns and usually get a happy laugh when I use them, I had never learnt this particular verbal form–Americans would rarely have an occasion to use or to hear it, as it’s used only in the context of particular social relationships, and it wouldn’t be at all typical for a foreigner to have one of those.

My “voseo” lesson at Maximo Nivel, a Spanish language school in Antigua, Guatemala. Picture source: me.

The verbal form in question is called voseo. It’s used in very close relationships–between friends of long duration is the typical one.  In Guatemala, the tu form of verbs is used in many situations in which the usted form would be used anywhere else in the Spanish-speaking world–for example, waiters in restaurants and the ubiquitous vendedores ambulantes (people who stroll constantly through the tourist areas selling stuff, primarily Mayan women of a variety of ethnicities from the surrounding pueblos) will typically address you with the formal terms señor or señora (sir or ma’am)–and then use the tu form of verbs with you, which even on my fifth time in-country sounds weird.

So, you’re wondering: how does one form this mysterious conjugation?  For starters, let’s go over the present indicative.  It’s almost entirely regular, and very easy to relate to the three classes of Spanish verbs.

Spanish verbs end with either -ar, -er, or -ir, with the -ar verbs mostly being homologous with the French -er verbs.  (Sorry–I havent even thought about the others!)  To form the voseo present indicative of almost all verbs, you keep the vowel of the infinitive, add the -s that you would expect in the tu form of the verb, and put the stress on the final syllable.  So:

  • escribir – escribís
  • decir – decís
  • venir – venís
  • tener – tenés
  • comer – comés
  • volver – volvés
  • tomar – tomás
  • buscar – buscás
  • caminar – caminás

Of course, just because Ive learnt the voseo forms doesnt mean that I have anyone with whom to use them–as I said, there are only some relationships in which its OK.  I did use them with the dog at my host familys apartment.  I listened carefully, and they use the formal usted form with him,  but he didnt seem to mind my voseo–although I was sneaking him treats, so who knows…

Enjoying these posts from Guatemala?  Why not make a small donation to Surgicorps International, the group with which I come here?  You wouldn t believe how much aspirin we can hand out for the cost of a large meal at McDonalds–click here to donate.  Us volunteers pay our own way–all of your donations go to covering the cost of surgical supplies, housing for patients’ families while their loved one is in the hospital, medications, and the like.  Scroll down for the English notes, per usual.


English notes

I do like…  This use of do emphasizes something.  As far as I can tell, the primary use, although not the only one, is to emphasize something that is contrary to expectations.  For example, in this Dashiell Hammett quote

I do like a man that tells you right out he’s looking out for himself. Don’t we all? I don’t trust a man that says he’s not. And the man that’s telling the truth when he says he’s not I distrust most of all, because he’s an ass and ass that’s going contrary to the laws of nature.

…you wouldnt expect anyone to like a person who is looking out for himself (a very Trumpian behavior, particularly if youre only looking out for yourself)–hence the do.  How I used it in the post:

It’s a challenge–you’re interpreting for people who are half-asleep, and often wearing an oxygen mask–and I do like a challenge.   Liking a challenge is presumably at least somewhat contrary to expectations–hence, the do.  

In-country: being or taking place in a country that is the focus of activity (such as military operations or scientific research) by the government or citizens of another country (Merriam-Webster)

 

Um, about that time you almost died…

This is a second attempt at something that I accidentally posted the other day before it was done–sorry!  My laptop died on arrival to Guatemala, and I’m limping along on my cell phone.

Picture source: http://statpsych.blogspot.com/

In science, you often worry about something called the observer effect. This refers to situations in which by observing a behavior, you change it.  It’s a real problem for linguists: tell people that you’re a linguist and you’re there to study how they speak, and you can bet that they’re going to speak differently than they would have otherwise.

One way for a linguist to deal with the observer effect is to get people speaking about something that’s so emotionally engaging that they’ll stop thinking about how they’re speaking. One linguist who worked with teenagers in gangs would ask them to tell him about a really great fight they were in. With people who are not teenaged gang members, you might ask them to tell you about a time that they almost got killed, or the last car wreck that they had seen. You get the picture.

I thought about how linguists handle the observer effect today when my Spanish tutor asked me if I’ve ever seen anyone die.  Once a year I spend a week in Guatemala, where I interpret for a group of surgeons, anesthesiologists, therapists, and nurses who do surgery gratis for people for whom the almost-free national health system is too expensive.  A couple months ago I had a glass of wine with a Mexican friend in Paris. She’s been there for 25 years, and normally we bounce back and forth between French and Spanish as the holes in our vocabularies dictate, et tout s’arrange. This time, though… I tried to switch to Spanish, and it was as if my tongue were frozen–nothing would come out of my mouth. I tried again–bobkes.   (Bobkes explained in the English notes at the end of the post.) I listen to the news in Spanish every day and don’t have any trouble understanding it, but I had to face it: I couldn’t speak Spanish anymore.

No problem, I figured: the town that we go to in Guatemala is jam-packed with schools offering intensive Spanish courses, so I’ll sign up for one. A couple days should loosen up my Spanish-speaking muscles, and all will be well.

Indeed, after a couple of days of 6-hour-a-day private lessons, Spanish is back.  What that means: yesterday my teacher made me explain Zipf’s Law in Spanish, then the principle of compositionality and what the implications of light verbs are for said principle. Today I had to relate–off the top of my head–the history of the migrations of the population of the United States and how they relate to the distribution of anti-Hispanic prejudice, followed by a discussion of regional, generational, social class, and social-contextual variability in language, with examples. (Damn good thing I went to William and Mary.)

So: my professor’s avoid-the-observer-effect technique worked well.  Need a good Spanish school?  Try Maximo Nivel in Antigua, Guatemala.  Want to do something nice for someone who is more than a little necesitado  (needy, in need)?  $20 bucks will pay for more than the entire amount of Motrin (the only painkiller that we can send people home with) that we’ll hand out all week.  Click here to donate, and for today only you’ll also get to see a photo of my adorable fellow interpreter Amelia and a super-cute baby.

Conflict of interest statement: I don’t have one.  Maximo Nivel doesn’t pay me–I payed them for a week of their time, and it was totally worth it.


English notes

bobkes: this word is mostly used on the East Coast, where it means something like nothing, but is stronger than that–perhaps a big fat nothing.  This latter is a very emphatic way of saying nothing.  There are lots of ways to spell it–bopkes, bubkes, bupkes…

Your hands and how you feed your children

On an atypical day, the biggest hardship that one has to overcome is explosive diarrhea and projectile vomiting due to forgetfulness about not rinsing your toothbrush in the tap water.

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That curly thing (it’s called a “pigtail”) is a catheter sitting in the left ventricle of the heart. Frame D is what it looks like when a healthy heart contracts–if you’ve had damage from a heart attack, you’ll see it here as a section of the chamber that doesn’t contract. Picture source: https://goo.gl/MaS89j

One week a year I get on a plane with a bunch of surgeons, nurses, anesthesiologists, and therapists and head to Guatemala, where everyone else spends the week providing free surgery for people for whom the almost-free health care provided by the government medical system is still too expensive, and I spend the week interpreting.  Don’t get totally lost in Doctors Without Borders fantasies–we stay in a lovely hotel, the surgeries happen in a four-OR operating suite, and on a typical day the biggest hardship that one has to overcome is finding someone to relieve you so that you can get to the cafeteria before the hand-made Guatemalan tortillas (yes, they’re different from the ones that you’re used to) are gone.  (On an atypical day, the biggest hardship that one has to overcome is explosive diarrhea and projectile vomiting due to forgetfulness about not rinsing your toothbrush in the tap water–but, as I said, that’s atypical.)

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The left ventricle needs to get filled with dye far more quickly than your hand could inject it, so you need a special pump to slam it in quickly. Picture source: https://goo.gl/1S41Am

When new interpreters join us for the first time, the thing that they’re most worried about is the medical vocabulary.  However, that’s actually the least of your problems–medical vocabulary is more or less finite, and you can buy a book about it, memorize it, and modulo local dialect differences (every cardiac catheterization lab that I ever worked in had a different name for the special pump that you use to shoot a bolus of radiopaque dye into the left ventricle), you’ll be just fine.  (Modulo is explained in the English notes at the end of the post.)

The real problem is everything but the medical vocabulary.  Think about this: a patient presents themself to the surgeon.  They’re missing two fingers, and one is just hanging there, useless.  The surgeon’s first question: what happened?  The answer could be anything.  

  • I was getting out of my car and three guys attacked me with a machete.
  • I fell into the cooking fire.
  • I was sitting in a truck and the carburetor exploded.

I didn’t make any of these up, and the cooking fire thing happens tragically often–mostly with children.

I mostly work with a hand surgeon.  The basic principle of hand surgery is this: make the person be able to function again at whatever they do.  You often have to make choices about trade-offs–a surgery that would let you open your hand again after it’s been scarred into a fist by burns might leave you with a weak grip, and that’s going to be a problem for a farmhand; a surgery that would give you back your full grip strength might make it tough for you to do things that require fine motor control, which is not OK if you’re a seamstress.  Consequently, one of the questions that the hand surgeon always asks is: what do you do for a living?  …and that could be pretty much anything.  

So, yeah: it’s not the technical vocabulary that keeps you on your toes in medical interpreting–it’s the entire remainder of the language, and if you’re a regular reader of this blog, you know that the statistical properties of human languages are such that if you’re not a native speaker, you will come across vocabulary items that you don’t know Every. Single. Day. Of. Your. Life.


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The shirts are called huipiles. In the Guatemalan highlands, you will see women wearing them every single day. Weaving one takes about a year. Picture source: https://goo.gl/SpjLW3

For today’s vocabulary, here are some words for professions that require quite a bit of use of your hands.  Note that almost any profession requires some use of your hands–I’m picking just a few here, focussing on ones that you wouldn’t be surprised to come across in low-income people in Central America.  If you have almost no education, and you’re doing any of these for a living, and you lose the use of a hand, your options for feeding your children become quite limited.  Hand surgery is about removing those limitations.  Want to support this kind of work?  Twenty bucks from you would literally pay for more than all of the pain medication that we’ll hand out in one week’s time.  You can donate here.

English Spanish French
farmhand granjero  ouvrier agricole
farmer  agricultor  fermier, agriculteur
gardener jardinero jardinier
seamstress modista  couturière
tailor  sastre  tailleur
waiter/waitress  mesero, camarero  serveur
weaver tejedor/a tisseur, tisserand
 carpenter carpintero  charpentier
 construction worker el albañil  ouvrier du bâtiment

English notes

modulo This is originally a term from mathematics.  In casual use, it means something like with the exception of, or besides.  I should point out that this word is characteristic of the speech of geeks, and only geeks–but, amongst my people (geeks), it’s quite common.

This example should be incomprehensible to any normal human, but I find it adorable due to exactly that incomprehensibility–“init” refers to a common part of a program, and the writer is saying that she’s left the “init” part out of what she’s showing you:

How it was used in the post: Medical vocabulary is more or less finite, and you can buy a book about it, memorize it, and modulo local dialect differences, you’ll be just fine. 

themselfHere we get into the controversial topic of pronouns in the Pacific Northwest, the part of the United States where I grew up.  Many native speakers of American English would balk at this pronoun, as well as theirself, which we also use in the Pacific Northwest.  Another vagary of our local use of pronouns is that when you have a subject that consists of two conjoined pronouns, they have to be in the dative: Me and him are going to the store, do you want some Redman?  Here’s a nice article on the themself form from the Merriam-Webster web site, which points out that themselves (which every other native speaker thinks us Pacific Northwest natives should be using) didn’t show up in English until the 1400s, with themself being the only possibility up to that point.

How it got used in the post: Think about this: a patient presents themself to the surgeon.  They’re missing two fingers, and one is just hanging there, useless.  


French notes

There are two French words that could translate the English word “carpenter:” charpentier, and menuisier.  Looking them both up on Google Images, it seems to be the case that a charpentier is a carpenter in the sense of someone who builds buildings, while a menuisier is a carpenter in the sense of a woodworker.  Native speakers, do you have thoughts about this?

Hits for charpentier from Google Images:

Hits for menuisier from Google Images:

…and, yes, this is how linguists try to figure things out.  We’re actually less excited about dictionaries than you might think…

Juventud, divino tesoro

…con el cabello gris, me acerco a los rosales del jardín…

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Darío lived in Paris for 4 months–who knew? 4, rue Herschel, 75006. Picture source: DanielaBPSept.

For National Poetry Month, here’s some Rubén Darío.  I first came across this poem sitting in a night class at Old Dominion University, purveyor of fine educational experiences to a wide range of traditional and non-traditional students, including a hell of a lot of sailors.  The first stanza was carved into the top of the desk at which I was sitting (the desk I was sitting at, more commonly):

Juventud, divino tesoro,
¡ya te vas para no volver!
Cuando quiero llorar, no lloro…
y a veces lloro sin querer…

Youth, divine treasure, // you’re gone, never to return! // When I want to cry, I can’t… // and sometimes I cry without wanting to….

I thought it was the saddest thing I’d ever read, and in isolation, it most certainly, certainly is.

In isolation.  And, oddly: even more so at 25 or so than at 55.

Eventually, I tracked down the rest of the poem–much harder back in those pre-Google days–and made it to the end.

Mas a pesar del tiempo
terco, mi sed de amor no tiene fin;
con el cabello gris, me acerco a los
rosales del jardín…

But despite pig-headed // time, my thirst for love is endless; // gray-haired, I approach the rose-bushes in the garden…

(Don’t feel bad–I had to look up terco, too.)

As the grandson of a man who started a new family in the United States in his 60s (¡muy fuerte!, say my Mexican buddies when I tell them the story–I’ll spare you the accompanying gesture of admiration), I think I get the metaphor.  You go, pépère.  You go, Rubén.  Do I ever cry without wanting to?  Rarely–I am certainly an American male of my generation–but, yeah: it happens.  Nonetheless: I’m headed out to the back porch for a cigarette next to the lilacs, and the plum tree, and the flowering chestnut…

JUVENTUD DIVINO TESORO DE RUBEN DARIO

Juventud, divino tesoro,
¡ya te vas para no volver!
Cuando quiero llorar, no lloro…
y a veces lloro sin querer…

Plural ha sido la celeste
historia de mi corazón.
Era una dulce niña,
en este mundo de duelo y de aflicción.

Miraba como el alba pura;
sonreía como una flor.
Era su cabellera obscura

hecha de noche y de dolor.
Yo era tímido como un niño.

Ella, naturalmente, fue,
para mi amor hecho de armiño,

Herodías y Salomé…
Juventud, divino tesoro,
¡ya te vas para no volver!
Cuando quiero llorar, no lloro…
y a veces lloro sin querer…

Y más consoladora y más
halagadora y expresiva,
la otra fue más sensitiva
cual no pensé encontrar jamás.
Pues a su continua ternura
una pasión violenta unía.
En un peplo de gasa pura
una bacante se envolvía…

En sus brazos tomó mi ensueño
y lo arrulló como a un bebé…
Y te mató, triste y pequeño,
falto de luz, falto de fe…

Juventud, divino tesoro,
¡te fuiste para no volver!
Cuando quiero llorar, no lloro…
y a veces lloro sin querer…

Otra juzgó que era mi boca
el estuche de su pasión;
y que me roería, loca,

con sus dientes el corazón.

Poniendo en un amor de exceso

la mira de su voluntad,
mientras eran abrazo y beso
síntesis de la eternidad;

y de nuestra carne ligera
imaginar siempre un Edén,
sin pensar que la Primavera
y la carne acaban también…

Juventud, divino tesoro,
¡ya te vas para no volver!
Cuando quiero llorar, no lloro…
y a veces lloro sin querer.

¡Y las demás! En tantos
climas, en tantas tierras siempre son,
si no pretextos de mis rimas
fantasmas de mi corazón.

En vano busqué a la princesa

que estaba triste de esperar.
La vida es dura. Amarga y pesa.
¡Ya no hay princesa que cantar!

Mas a pesar del tiempo
terco, mi sed de amor no tiene fin;
con el cabello gris, me acerco a los
rosales del jardín…

Juventud, divino tesoro,
¡ya te vas para no volver!
Cuando quiero llorar, no lloro…
y a veces lloro sin querer…
¡Mas es mía el Alba de oro!

I can’t tortilla: denominal verbs and hand surgery

When we talk about hand surgery being all about function: it’s about the function of the hand, sure. But: it’s also about the function of the person. 

I’m in Guatemala at the moment. I come here once a year with a group called Surgicorps. We’re volunteer surgeons, anesthesiologists, nurses, technicians, therapists, and interpreters (that’s me) who provide surgical services to people who are so poor that for them, even the almost-free Guatemalan health care system is too expensive. There are a lot of groups like us, actually–you can find them all over the world. What makes Surgicorps special is the set of surgical specialties that we bring with us. One of those is hand surgery. Hand surgery is a very specialized occupation—in the course of learning his trade, our hand surgeon did fellowships in both plastic surgery and orthopedics. A fellowship is about five years, and that’s on top of four years of college, four years of medical school, and a three-year residency—so, these guys are hard to come by.

Every medical and surgical specialty has its central concept, its central concern. In hand surgery, that’s function. When our hand surgeon told me about this, he was talking about the function of the hand–the goal is to take something that isn’t working, and make it able to do things again. Hand surgery is about function in a larger sense, too, though. The thing is: in a country like Guatemala, most people work either in agriculture or in manufacturing, and opportunities for education are few. (In 2010, 31% of the female population was illiterate.)  In that kind of economy, for most people it’s the case that either you work with your hands, or you don’t feed your children.  Functioning here means doing manual labor, which for men is likely to be farming and for women is likely to include weaving and doing housework.  You’ve got a hand that doesn’t function?  Then you don’t function.

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Guatemalan handmade tortillas from the hospital cafeteria. Picture source: me.

For women here, part of functioning is making tortillas.  Guatemalans might not get much in the way of nutrition, but getting enough calories per se is usually not a problem: when there’s no drought, corn is plentiful and cheap.  If a Guatemalan is poor enough, he might be living on tortillas and salt–but, he’s living, not dying.  Not from hunger, at any rate.  (The top five causes of death in Guatemala: respiratory/pulmonary diseases (influenza and pneumonia), violence, coronary artery disease, diabetes, and stroke.)

 

 

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A contracture.  I’m showing you one called a Dupuytren’s contracture because after a week of looking at poorly healed burns, skin grafts gone bad, and the like, I just can’t take any more. Call me a wimp, but it’s difficult. Picture source: https://www.thebmc.co.uk/dupuytrens-contracture-research-survey

You make tortillas with your hands.  They’re actually made somewhat differently here in Guatemala, as compared to elsewhere: not so much with the palms, as patted out with the fingers.  So, when women show up on screening day with a contracture in one of their hands from a burn, or a cut, or whatever horrid thing has happened to them and won’t let them open their hand all the way, and our hand surgeon asks them what the matter is, they say: No puedo tortillar–I can’t make tortillas–while making a characteristic slapping-your-fingers-together-while-turning-your-hands-over motion.

Here’s a short video that shows you how a Guatemalan woman makes tortillas.  Like 70% of the country, she’s Mayan.  There are a bunch of things to notice in the clip:

  • When the video starts, the language that you’re hearing is one of the 20-22 different Mayan languages spoken in Guatemala.  (There are some more spoken in Mexico.)
  • The women are wearing the traditional clothing of their village.  Mayan women most definitely do still wear the traditional clothing, every single day.  Choosing not to wear it makes a huge statement about your personal identity and affiliation, and the waiting rooms of the hospital where we do our thing are jammed with people in this kind of clothing.  I’ll point out that every village has its pattern of dress, apron, and huipil (the shirt that the ladies are wearing), and leave it at that.
  • The lady is cooking over an open fire.  Super-common here, and I haven’t yet been here without a few people showing up on screening day to show us their burn-scar-contracted hands.
  • The American speaking crappy Spanish.  One of the main industries of the town that we’re in is intensive Spanish lessons.
  • The lady’s hands are wide open, and fingers are flat–with a contraction like the one that you see above, she couldn’t do it.
  • At about 1:05, the verb tortillar. 

Tortillar is an interesting little verb (at least if you’re the kind of person who gets excited about verbs).  As far as I can tell, it doesn’t exist anywhere else.  Here’s where I looked:

  • WordReference.com, which has an amazingly complete on-line dictionary.  No luck.
  • The Bantam New College Spanish and English Dictionary, which is by no means huge, but has excellent coverage of Central American Spanish.  (If you’re an American, and therefore don’t know where Guatemala is: it’s in Central America.)  Also no luck.
  • Google, through which I found a number of blog posts written by people who ran across the word while travelling this part of the world, but no evidence that the word exists anywhere else.
  • (I did find a French dictionary of the natural sciences from 1845 that lists the word as the common name of some species of Orme with a tall trunk and small leaves.  I have no clue what an Orme is.)

What the verb tortillar means: to make tortillas.  It’s a nice example of a verb that comes from a noun–what’s called in linguistics a denominal verb.  We have lots of these in English–“bare” or “zero-derived” ones like to tango, to cash, to water; ones made with prefixes, like to defrost and to encage; and ones made with suffixes, like to victimize, to vaccinate, and to classify.  (Language geeks: yes, I am leaving out back-formation.  No hate mail, please.)

One of the interesting things about the process of making nouns of out verbs is that there is some systematicity to it–there are particular types of relationships that tend to exist between the original noun and the derived verb.  You might remember a post in which we talked about the particular kinds of relationships that exist between the nouns in compound nouns, like kitchen knife (knife that is used in a kitchen), bread knife (knife that is used to cut butter), and pocket knife (knife that is carried in a pocket).  In that post we talked about how the set of relationships between those nouns is limited, and about how trying to explain that set of relationships is a good example of the issue of falsifiability in scientific theories–if you can posit any old relationship on the basis of any particular compound noun that you happen to run across, then you have a theory that cannot, even in theory, ever be shown to be wrong (“falsified”).  That’s a theory that can’t actually be tested, and a theory that can’t be tested is a crappy theory.

How about verbs?  Carolyn Gottfurcht wrote a fascinating doctoral dissertation on the subject of denominal verbs and the kinds of relationships that can exist between the original noun and the derived verb.  (All of the English verb examples in this post are from her dissertation.) She looked at 8,900 English verbs and found that in that language, one of the most common relationships is what is called the resultative

The resultative relationship is especially relevant to us today, because that’s what the Guatemalan verb tortillar is based on.  The resultative relationship holds between a noun and a verb that is derived from that noun when doing the verb brings the noun into being.  For example:

  • to granulate: to cause something to exist as granules
  • to enslave: to cause someone to be a slave
  • to mummify: to cause someone to be a mummy
  • to summarize: to cause a summary to exist
  • to cripple: to cause someone to be a cripple

This is the kind of verb that tortillar is: to tortillar is to cause tortillas to exist.

Here’s the thing about causing tortillas to exist: if you’re a functioning Mayan woman, that’s one of the things that you do.  That’s not the only thing that you do–but, if you can’t do it, you can’t take care of your family.  So, when we talk about hand surgery being all about function: it’s about the function of the hand, sure.  But: it’s also about the function of the person

Like the rest of us Surgicorps volunteers, our hand surgeon donates his services, buys his own plane ticket, pays for his food and lodging, and contributes a week of hard-earned vacation.  The costs of the surgeries themselves–instruments, medications, dressing materials, anesthetic agents, pain medications, etc.–are covered by Surgicorps.  Surgicorps lives or dies on the basis of donations from nice folks like you.  Want to make a donation?  Click here.  $250 will pay for all of the costs of surgery for one patient.  $100 will pay for four surgical packs.  $25 will pay for a nice lunch for you–or one surgical pack for us.  $10 will pay for all of the Tylenol that we’ll send our patients home with all week–and, yes, we send our patients home with nothing stronger than Tylenol, in the vast majority of cases–or, it’ll buy you a latte and a scone.  I have nothing against lattes and scones–I’m a big fan of both–but, when you think about it from that perspective, how can you not click on this link and make a donation?

No French stuff today–back to the language of Molière on Monday.  Now, donate some money!  I’ll stop hitting you up for donations next week.

 

The next splint is here: metonymy and hand surgery in the Guatemalan highlands

The most important part of a surgical mission: it’s not actually the surgeons. Plus, here’s how you can be a hamburger in the corner.

Yesterday I was interpreting for our hand therapist. She was putting bilateral (this and other obscure English words discussed below) splints on a young man. (Some patient details changed to protect privacy.) “The next splint is here,” she said. Great, I thought, looking around—where? I’ll grab it for her. I didn’t see a splint, though. “Where is it?”, I asked her, somewhat puzzled. She watched me look around. “No—there’s someone else coming in to get a splint, and he’s here.” Ahah—metonymy. More on this later, but first, let’s talk about those splints—and that hand therapist.

I’m in Guatemala at the moment, with a group called Surgicorps. We’re a team of all-volunteer surgeons, anesthesiologists, nurses, technicians, therapists, and assorted non-medical personnel, such as myself—I’m an interpreter. There are lots of groups like ours that come here to Guatemala—there’s an enormous need for surgical care, and not a lot of options for getting it for the very poor population that we serve.

What makes us special: among other things, it’s the fact that we have a hand surgeon. Hand surgery is a very specialized occupation—in the course of learning his trade, our hand surgeon did fellowships in both plastic surgery and orthopedics. A fellowship is about five years, and that’s on top of four years of college, four years of medical school, and a three-year residency—so, these guys are hard to come by.

As specialized and as in short supply as the hand surgeons of the world are, there’s another profession that’s even harder to find an expert in: hand therapists. Hand therapy is a subfield of occupational therapy, which is the art and science of teaching people how to function normally after things like strokes, heart attacks, and amputations. The other day, one of the physicians said to me: The first time I went on one of these missions, I heard that we had a hand therapist with us, and I thought: why the hell do we need one of those? What could she possibly do on a surgical trip? Then I saw her working, and I realized: she’s more important than the physicians.

Almost every kind of hand surgery requires some kind of splinting afterwards, and it’s to the extent that the splinting is or isn’t successful that the surgery is or isn’t successful. For example: an operation that our hand surgeon does here quite frequently is repairing something called syndactyly. Syndactyly is a condition in which fingers don’t separate from each other during development in the womb. It’s ruinous here in Guatemala, where most people’s educational opportunities are nil, and the only option for earning a living for most people is manual labor.

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Syndactyly. Picture source; http://thehurds.weebly.com/aidens-syndactyly-surgeries.html

Our hand surgeon can undo the syndactyly. Typically what happens in syndactyly is that the genes that should cause the tissue between the fingers in the fetal hand to reabsorb don’t work right, and what the surgeon does is to cut that tissue away, and then graft some skin between the fingers. (I’m simplifying the description of the surgery!) Once that surgery is done, though, those fingers have to be kept apart for several months. Otherwise, the fingers will re-fuse. How you keep that from happening: a hand therapist builds you a special kind of splint. These have to be made to order after the surgery, as they have to fit the individual child very well, and they have to fit that child when he has bandages on his fingers after the surgery. (That’s why you can’t do it before the surgery.)

Splint-1
A custom-made splint. Imagine trying to mold that on a toddler who is scared, nauseous, doesn’t speak the same language as you, and thrashing around while screaming for mama at the top of his lungs. Picture source: https://plasticandhandsurgery.com.au/hand-surgery/hand-therapy/

The surgery to repair syndactyly is usually done when a child is small. So, here’s what it’s like to fit one of those custom-made splints after surgery: you’ve got a little kid. The kid is coming out from under anesthesia and is disoriented, nauseous, surrounded by funny-looking people speaking a language that he can’t understand—and he’s scared shitless. So, you’re trying to build a very precisely-sized splint for a kid whose hand you need to fit it to—while he cries, and screams, and tries to pull his arm away from you, and tries to make a little fist while you’re trying to get things between his fingers. Add to the mix the fact that the splint is made from a kind of epoxy that is rigid when cool, and flexible when heated. You heat it up, then take it over to the kid and try to mold it to the right size while he cries, and screams, and tries to pull his arm away from you, and tries to make a little fist while you’re trying to fit it between his fingers. The resin cools down while you’re trying to do your thing, and then it won’t bend any more? Tough shit—go back to your heat source, heat it up again, and then try again.

So: the surgery doesn’t work without a good hand therapist. Being a hand therapist is a difficult job to do, and it’s hard to find places to learn to do it, and in addition to having considerable technical skills in order to make the splints correctly, you need to be able to do it under very adverse conditions, and to keep your cool while you’re doing it. Indeed, it’s the hand therapist that is the key to our mission.  We can replace a surgeon, or an anesthesiologist, or a nurse—or an interpreter—but a good hand therapist is hard to come by.

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Kids with cerebral palsy. Picture source: torc2.com.

So, back to the young man and “the next splint:” he has cerebral palsy. This means that he has essentially no control over his muscles whatsoever. They twitch, and cramp, and they make his hands clench into useless fists that can’t be opened. He can’t speak.  He can’t nod his head “yes,” or shake it “no.”  Our hand therapist was making splints for the young man that would keep his hands open for half of the day. If they can stay open, he will be able to grasp things. This is a smart teenager who can’t hold so much as a pencil—having hands that function even a little bit would be life-changing for him. Can the hand surgeon make this happen? No—it’s only the hand therapist who can give him that new capacity, one that you and I probably never even think about.

So, “the next splint is here:” this is an example of a phenomenon called metonymy. Metonymy is the process of referring to something by one of its attributes. For example:

  • The hamburger in the corner is a slob and needs more napkins. Meaning: the person who is eating a hamburger and is in the corner is a slob, etc.
  • Would you ask if the right front flat in bay two is also supposed to get an oil change? Meaning: there’s a car that has a right front flat in bay two, and I need to know if it’s also supposed to get an oil change.

This is a different phenomenon from metaphor, in which we refer to something as something else entirely—love is a river, life is a journey, for example—as opposed to referring to it by some attribute that it has—the hamburger that the sloppy customer has, or the flat tire that the car has, or whatever. Metonymy is a super-common phenomenon in language that lets us take advantage of context in the course of communication—and not just linguistic context, but what you could think of as “world” context, and from a theoretical point of view, that’s pretty interesting, for the following reason.  Most linguistic theories are entirely about language and its structure (I’m simplifying here—if you’re a sociolinguist, please don’t send me hate mail), and if you need to incorporate the world into your theory about how language works, that’s quite a challenge. Being context-dependent, it also requires that both the speaker and the hearer know what that context is—I didn’t know that the therapist had another patient scheduled, so I totally misunderstood her statement, thinking that she was referring to an actual splint, not to a person who was going to receive a splint.

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Hand contracture in cerebral palsy. Picture source: http://www.cerebralpalsy.org/inspiration/artists/anne-abbott

Back to the kid again: he went home happy, him and his mother hopeful that next year his hands will be more functional. We’re talking about a kid who is super-happy to be spending his days in a wheelchair, because it means that he’s not spending his days in bed. (How’s your day going, dear reader?)  If he gets some improvement over the course of this year, then when we come back with a hand therapist again next year, he can improve even more with another splint. Someday he might be able to hold a pencil and use writing to get all of the stuff that’s in his head out of it, like I do—he sure as hell isn’t ever going to be able to speak.

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Courtney Retzer Vargo, PhD, checking a splint.

Here’s the thing: if there’s no Surgicorps, then there’s no hand therapist, and there’s no hope for functional hands for that kid—a teenager with a fully functional mind and not a lot of physical abilities.  (OK: no physical abilities.)  One of our hand therapists is Courtney Retzer Vargo.  Courtney has a PhD in occupational therapy, two kids, a hot husband, and a busy job in the United States.  But, every so often she burns up a week of her hard-earned vacation time and flies to Guatemala or Zambia to volunteer a week of her time doing exactly this.  Like all of us in Surgicorps, she buys her own plane ticket, pays for her own food and lodging–contributes a week of hard-earned vacation time. Surgicorps pays for all of the costs of the patients’ treatments, and Surgicorps lives or dies on the basis of donations from nice people like you. Click on this link, and making a donation will take you less than 5 minutes. $250 will pay all surgical costs for one patient, or the expenses for transportation and lodging for a patient and their parent during the period of the surgery. (See this post for what that trip is like, and why they need us to put them up.) $100 will pay for four surgical packs. $10 will pay for all of the Tylenol that we’ll send our patients home with this week—and, yes, our patients go home with nothing stronger than that. Do it—if you don’t feel better about life immediately, I’ll give you your money back—and you know where I live!

English notes:

  • Bilateral: on both sides. Bilateral symmetry is one of the most common features of multi-celled animals. How it was used in the post: She was putting bilateral splints on a young man.
  • To be hard to come by: to be difficult to obtain. During a famine, there actually is usually food, but it’s very expensive and hard to come by. How it was used in the post: Indeed, it’s the hand therapist that is the key to our mission—we can replace a surgeon, or an anesthesiologist, or a nurse—or an interpreter—but a good hand therapist is hard to come by.
  • Physician: a somewhat technical or formal term for doctor, and specifically, a medical doctor. Non-health-care people don’t use it very often, but health care professionals use it frequently—especially doctors. 🙂  How it was used in the post: The other day, one of the physicians said to me: The first time I went on one of these missions, I heard that we had a hand therapist with us, and I thought: why the hell do we need one of those?  What could she possibly do on a surgical trip?  Then I saw her working, and I realized: she’s more important than the doctors.

Spanish notes:

  • Férula or tablilla: a splint. I’ve noticed over the course of the past four years that some people know one word, some people know the other, and many, many of them don’t know either. In that case, I ask the therapist if I can tell the patient that a férula is a piece of hard plastic that will keep their fingers apart/fist from closing/wrist from moving/whatever.

French notes:

  • une attelle: a splint. I think there’s also a word une éclisse, but I haven’t been able to verify that one.

 

 

Life isn’t cheap here, but sometimes things go to sh…: consecutive and simultaneous interpretation

Writing from Guatemala in the 1980s, Jonathan Maslow said that it is not true, as is often said, that life is cheap in Central America, but it is true that life is briefer there, and so takes place faster. I thought about this yesterday when a conversation went completely to shit. (I was talking about this with one of the anesthesiologists today. “It went completely to pieces,” I said. “Kevin, you can say it went to shit,” she said. This and other obscure English expressions discussed at the end of the post.)

There are two basic kinds of interpretation, known as consecutive interpretation and simultaneous interpretation. In consecutive interpretation, the person for whom you are interpreting says something, and when they stop, you repeat it.   In simultaneous interpretation, the person for whom you are interpreting speaks without any pause other than their normal ones, and you repeat what they said immediately, essentially phrase by phrase.

Each form of interpretation has its advantages and disadvantages. I’ll summarize them:

  Consecutive interpretation Simultaneous interpretation
Plusses ·      Much easier with some language pairs

·      Easier for bilinguals to listen to

·      Obligatory in “double interpretation” situations (see below)

·      Greater accuracy

·      Required in legal situations, where both languages are recorded

·      Faster—as little as half the time of consecutive

·      Better provider/patient contact

·      Obligatory in certain situations: multilingual (more than two languages), speeches, conferences, and live media

Minusses ·      Slower (see below for how you can make it less slow) ·      Sometimes harder for bilinguals

·      More difficult—special training required

·      Interpreter can’t clarify without interrupting

·      In many situations, requires two interpreters

A number of these are relevant to interpreting for Surgicorps, the group with which I’ve come to Guatemala. Here are some specifics:

  • “Double interpretation” refers to a situation where the interpreter and the person who speaks the “target language” don’t share a language. This happens on occasion here, and the solution is “double interpretation:” the health care provider speaks in English, the interpreter speaks in Spanish to a second person who speaks Spanish and one of the many indigenous languages, and then that person speaks to the patient in the language that they share—then it goes back in the other direction. This kind of situation has to be handled with consecutive interpretation. (I had a double interpretation situation on screening day. The gentleman who was doing the Spanish <-> indigenous language interpretation had no teeth, and it was a challenge to understand him, even for me.)
  • How you can help with the relative slowness of consecutive interpretation if you’re a health care provider: use shorter sentences. If you use long sentences, professional interpreters will often write down notes while you speak. The shorter your sentences, the less need there is for note-taking on the part of the interpreter.

How this all became relevant yesterday: I was interpreting between one of the Surgicorps people and one of the Guatemalan staff. The Surgicorps person was anticipating the end of the local nurse’s sentences while I was still repeating them, and responding in English. So, now I’m speaking a sentence that I’m having to remember in Spanish so that I can interpret it in the Spanish -> English direction, while someone is speaking to me in English. This is the kind of context in which you need two interpreters because you’re basically doing simultaneous interpretation instead of consecutive interpretation: this is the kind of situation where everything immediately goes to shit.

…and that’s when I thought about Maslow on Central America: life is briefer there, and so takes place faster. No problem: the other thing about Central America is that people here know how to make things work in suboptimal conditions. Ask everyone to stop, tell them that you’re having trouble and why, and people will do their best to accommodate—the Americans, as well as the Guatemalans. As is almost always the case: communicate what you need, because the only way to guarantee that you won’t get it is to not tell people what it is.

How about helping our work in Guatemala?  Surgicorps provides free surgical care to people who cannot afford it.  We pay for all of our patients’ costs through the generous donations of the kind of person who would read a blog like this.  Click here to donate–I’m the funny-looking bald guy. 

English notes here—French and Spanish vocabulary below:

  • Life is cheap: a delightfully ambiguous expression. The most common interpretation: it’s a way of saying that life is not valued. That’s not to say that people don’t value their own lives, but more that the society doesn’t, in general, value people’s lives. That’s the sense in which it is used in the Maslow quote: it is not true, as is often said, that life is cheap in Central America, but it is true that life is briefer there, and so takes place faster. The other possible interpretation is the more obvious, but the much less common one: it is inexpensive to live. For example: life is cheap in Benin—I think a nice apartment is maybe $50 a month. From the context, it will probably be clear which is which; in case of doubt, the default interpretation is the “life is not valued” one.
  • to go to pieces or to go to shit: for a situation to suddenly start going very badly, for things to stop working. To go to pieces is acceptable in pretty much any social context, but to go to shit is very casual and mildly obscene, and you should only use it with peers with whom you are very comfortable. Now: if you’re talking about a person, then to go to pieces (but not to go to shit) has a different meaning. It means something like to stop functioning, perhaps to start crying if you’re talking about an incident; or, if you’re talking about a chronic situation, not to cry, but to stop functioning normally in life. An example of the isolated incident version: I dropped her cell phone and the screen broke, and she completely went to pieces—locked herself in the bathroom and cried for maybe 15 minutes. The chronic one: After his wife died, he completely went to pieces—stopped showering, then stopped showing up for work, got fired, and ended up living with his daughter.

French notes:

  • merder: to go to shit, to get complicated.

Spanish notes:

  • embolismo: this word does not mean what it looks like—a false cognate. In Spanish it is basically a situation that has gone to shit. The word for “embolism” is embolia, e.g. una embolia cerebral, a cerebral embolism (a kind of stroke).  (The other kind of stroke is a derrame.)