My introduction to the American healthcare system began at the age of 12 when I had to make all the doctors’ appointments for myself and my parents. My broken English and nervousness did not matter to the desk assistant. The blank stare in my eyes did not give answers to the nurse about my medical history and the shakiness of my voice did not answer the doctor’s demand to translate for my parents. However, the good doctor did suggest that “I should be in school and learn English to help my parents and be a good daughter”. The first thing the American healthcare system taught me was its failure to provide for the underserved.

From an early age, it was decided that I would become a doctor and make my family proud. A girl whose parents never finished high school was going to be a doctor in the United States of America. As a little girl growing up in Pakistan, I could never fully comprehend the meaning of “healthcare” or any other role besides the title of a “doctor,” because my parents were in charge of providing me with “proper” healthcare. My naïve attitude or I should say childhood unable me to learn about the healthcare system. I had never given a second thought to how a language could change the healthcare system and the care it gives to patients. At the age of 11, my family and I moved to the United States of America to fulfill our “American Dream” and achieve better things for my future. Little did I know that my “American Dream” would also consist of hospital visits and a need to understand the healthcare system better than any other child my age.

At the age of 12, many advised me to learn the English language, so I could prosper in a foreign country. Not only for the sake of my education but to also “help out my family.” At the age of 13, it was my responsibility to make doctors’ appointments and make sure that a translator was with them at every visit. At the age of 14, I had to explain to my elderly mother what “menopause” was and how to properly take medicine. From the ages of 14 to 19, It was my responsibility to be aware and be in charge of all the healthcare decisions for my parents because I could speak their native tongue. At the age of 20, I declared Anthropology as my major to focus on the cultural aspect of healthcare provided to different communities and how stereotypes of a community can affect the given healthcare. At the age of 22, in an auditorium filled with students, my health disparities professor spoke the unspeakable truth, “it was not the responsibility of a child to provide services of a translator.”

Now that I am reflecting on my experience, as a child I never gave a second glance to all the little things I had to do to help out my parents. For me it was normal. It was normal for me to ask a desk assistant to go into the room with my parents because I needed to translate. It was normal for me to be in the OB/GYN room with my mom and have “the talk” about my parents’ lives. It was normal for me to feel embarrassed and shameful as I am having these conversations with my parents because I was the only one who could understand. It was normal for me to miss school events and friends’ parties because I had to help my parents. It was all normal for me to act as a provider/parent to my mom and dad.

However, what wasn’t normal is the failure of our healthcare system. It wasn’t normal that the doctor had to speak to a child to know the patients’ medical history. It wasn’t normal that a healthcare provider had to belittle me for speaking broken English when I was 12. It wasn’t normal that proper resources were not being utilized in an FQHC. It wasn’t and shouldn’t be normal for any child to take on the responsibilities of a certified medical interpreter.

The “American Dream” should not be dictated by the burdens of translating for a family or loved one. It is not a responsibility for any child to be in this position, and yet countless children still have the responsibility to be a “good child who is helping out their parents.”

For more information about LEP patients and their understanding of health and how to become a certified medical interpreter, head to read the research article and its findings. 

Published by Mishal Khan

Mishal Khan, M.H.A a Medicare patient group professional and contributing writer with a Master's degree from the University of Miami Herbert Business School. She writes regularly for Patient Orator on matters regarding healthcare advocacy for Medicaid & Medicare patients and other healthcare-related topics.

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