393: VRI... Sign Language! Access!

This Friday night in NYC my darling Zlotte will be leading a really important discussion at Morton St.:

Important DIRC meeting Friday, January 19th! Your support is needed!

Are you now or have you ever been a patient at Beth Israel Hospital? Did you know that Beth Israel is planning to fire their sign language interpreters and switch to Video Remote Interpreting (VRI) for all their Deaf patients?

How do you feel about using a VRI service during your medical appointments? Are you comfortable working with a TV screen when your doctor asks you how you're feeling? Will you trust the VRI interpreter to understand your sign language and your medical history? Do you want to work with a TV screen when you're getting serious information and instructions about your health?

When Jane Fernandes was hand-picked to be President of Gallaudet University her ASL skills came under discussion repeatedly. Hearing people didn't really understand what the problem with Jane was, and because it was a Deaf university, they pointed to what was different - her use of sign language and her Deafness. It was easier to accept what they already knew to be different as the problem, rather than seeking a true understanding of the issues. It was easier to find a reason to dismiss the concerns of the protest.

VRI (Video Remote Interpreting) uses videoconferencing equipment to present an interpreter on a TV screen. The interpreter is in a different city. When I went to a hospital in Brooklyn one day with a friend and found that they had been using VRI with him, I was curious. I had never seen it before. Another friend is doing a dissertation on the issues surrounding VRI, and I was excited to get my hands dirty, so to speak. My experience was abominable. The hospital staff took an hour to find the equipment, and another hour because "the guy who knows how to hook it up isn't here." The friend understood nothing on the screen, and I wound up having to "deaf interpret" everything. The friend was really frustrated. Why?

1. He didn't understand a three-dimensional language in two dimensions.
2. The technology was good, but this portable VRI technology was still not Sorensen - most VRI doesn't seem to be as high quality as what Deaf people use.
3. They were talking about VERY personal things. Because he'd never met the interpreter before, my friend had no comfort level. Because the interpreter was on TV, he had no way to develop that comfort level.
4. The terp itself sucked. He had no experience with the hospital staff or with this particular person and no connection to the person's history. In the past I've requested the same interpreter for my medical appointments because it makes things a lot easier when you don't have to take a half hour to teach the terp names for things. That's if the terp ASKS - they may just brave it out and fingerspell stuff, and because you (as a Deaf person) are LOOKING AT THE TV SCREEN you don't have an opportunity to try to lipread the doctor and suss out if the terp is correct.
5. The terp didn't understand the patient. He was apparently from Minnesota, and didn't understand the NYC dialect of ASL. (There's correlations to this in spoken language - interpreters do not always understand spoken variation.)
6. Erfo wants me to add that the Doctor was standing BEHIND the patient at this point and prattling on, then left the room. With no visual or audio connection to the patient, they had no reason to bring out their bedside manners.
   

"But he has sign language!" cried the hospital staff, three hours after we started, when the client's 15-minute appointment was completed. "That's access! You can't complain!" But we did complain, and legally: it's the hospital's responsibility to match the needs of the patient, not focus so hard on finding ways to save money that they reduce the quality of their own service. When I was a youngster in the NYC public school system, the school was frustrated with the cost, and to save money once gave me an interpreter - who sat down in my French class and began speaking Italian.

I imagine that's how many hearing people felt about the Gallaudet protest. And like the Gallaudet protest, the underlying problems are very similar. But like the advertisement for the meeting on Friday states, do you feel comfortable telling a TV screen about your health? The most effective health care for Deaf people comes about when Deaf people's self-expressed boundaries, in terms of communication, are established and respected. VRI was initially created as a means of providing access to people in remote areas where there are few or no terps - not to become standard in big cities where hospitals have STAFF who are interpreters. It's expensive, in terms of money but especially time (there were four hospital staff standing around for an hour trying to hook up the television - certainly their time cost more than the interpreter!)

God. One day you KNOW some nurse is going to show up saying "Sorry, we couldn't find the terp, the television, or anything else, but... we did find this!" And when she pulls the signing puppet bear from behind her back and we complain, they'll say, hey, it's sign language: it's access... (Yeah, and they speak English on subway car announcements. Sure.)

Let me close on a personal note. The other week in Florida I was walking with my father on the side of the road. I asked if we could switch sides; he was puzzled and frustrated, but agreed. I noticed his frustration and asked if he understood why I wanted to move - he said yes, because we were now walking on the left side of the road, into oncoming traffic! I explained that as a Deaf person I could see traffic in front of me, but not hear it behind me, so I'd rather walk on this side so I could protect myself. His eyes cleared and he understood. (Then we got into an argument about why I had to be so bloody independent. But that's another story.)