Main content

Healthy communication

As a teenager, Michelle McCullough used to accompany her father to doctors’ visits to bridge the communication gap between him and the people responsible for providing him with critical care.

As the daughter of a Deaf parent, she was called in to interpret in a number of circumstances. Today, she works as a medical interpreter for The Ohio State University Wexner Medical Center, helping patients navigate their health care journeys.

There are many misconceptions people are not aware of about Deaf culture. (For example, did you know some people in the Deaf community prefer to capitalize the word “deaf”?)

McCullough explains these and more.

Misconception: Deaf, hard of hearing, hearing impaired — it’s all the same.

Truth: “Hard of hearing” is a phrase often used to describe people with hearing loss. The phrase “hearing impaired” is also used in a similar way.   

But the word “deaf” can actually have two meanings. The word “deaf” with a lower case “d” can mean that a person is affected by the audiological condition hearing loss and may prefer to identify with Hearing culture/community. But “Deaf” with a capital “D” signifies that a person has hearing loss and prefers to identify with the culture and community of other Deaf people and communicates primarily with American Sign Language. Calling a Deaf person “hearing impaired” can be offensive, McCullough cautioned. It’s a term that tends to focus on what Hearing culture may feel “needs to be fixed.”

The National Association of the Deaf (NAD) uses the term “deaf and hard of hearing,” but also emphasizes that people have the right to be what they want to be called.

Misconception: The doctor or provider doesn't actually need to have an interpreter to have a conversation with a Deaf patient. Writing things down is adequate. 

Truth: A person with a strong ASL background may find that a written conversation is unsatisfactory.

English does not translate directly into ASL because it has a different grammatical structure, and ASL is not a written language — it is a visual language. ASL, like any spoken language, also contains significant nuance. The context in which a particular sign is used can convey a great deal of information. One sign can have multiple meanings.

Attempting to write it down may leave out some of the valuable context that a provider needs to have to truly understand the patient’s questions, concerns or reactions, McCullough explained.

The patient also will lose out on the nuance of the provider’s side of the conversation if they rely only on the written word. Think about all the nuance that is conveyed in a person’s tone of voice. That nuance is lost when only the words are put down on paper. The context can get lost, and the meaning can get muddled.

McCullough, like other ASL interpreters, takes great care to make sure to preserve the nuance on both sides of the conversation.

Of course, ultimately, it should be up to the patient as to whether he or she prefers to engage an ASL interpreter to help facilitate communication with health care providers.

“The best thing to do is to ask a person’s preferred mode of communication,” McCullough said.

Misconception: Interpreters also serve as helpers or advocates when interpreting for a Deaf person.  

Truth: ASL interpreters facilitate communication between Deaf and Hearing. Deaf people don’t need others to think for them or champion their cause. Interpreters also provide cultural mediation where appropriate.

“I’m a patient advocate in cases of abuse or imminent danger” said McCullough, who has been a medical interpreter for eight years. “Advocating or acting as a ‘helper’ is not my role. That is taking power away from a Deaf person.”

Misconception: A Deaf person who is a good lip reader doesn't need an interpreter.

Truth: Many Deaf people and people with hearing loss can read lips quite well. But lip reading can be tricky even under the best of circumstances, and a medical situation involves the use of medical jargon and other words with which non-medical people may not be familiar. So even a person with good lip-reading skills can miss important information.

“It can be difficult to navigate for both the Deaf patient/provider and the Hearing patient/provider if an interpreter is not present,” McCullough said.

Misconception: A family member can serve as a medical interpreter for a Deaf person with no issue.

Truth: McCullough does not recommend that family members act as interpreters. A conversation between a person and his or her doctor must be interpreted with neutrality and full access to the conversation on both sides.

Family may not be able to maintain neutrality, may be “medical knowledge challenged” and may not interpret content fully and accurately. Patient-provider confidentiality may become an issue as well.