In addition to breaking down linguistic barriers, medical interpreters are tasked with eliminating cultural ones as well. The misinterpretation of a message can hinder communication between people. Likewise, a cultural misunderstanding between speakers can be detrimental if an interpreter is not familiar with, or is unavailable to explain, cultural norms.

One example that shows the importance of having a culturally-aware interpreter was in a case where an Iraqi woman was complaining of having constant pain in her stomach and “heaviness” in her head. Doctors were later able to determine that the woman needed a visit to a psychiatrist. The woman was strongly against a psychiatric evaluation because, thanks to her interpreter’s explanation, there is a negative stigma associated with mental illness in her culture.

“The Spirit Catches You and You Fall Down” illustrates another example of the importance of using culturally-competent interpreters. In the book, author Anne Fadiman describes how a Hmong refugee family did not provide their epileptic daughter with the proper dosage of medicine prescribed by doctors to combat her seizures. The family was skeptical of modern medicine and, instead, believed that the seizures were due to the daughter catching a malevolent spirit. The family also relied on ad hoc interpreters instead of qualified medical interpreters. This confusion and misunderstanding between the family and medical providers caused the daughter’s condition to worsen.

It goes without saying that medical interpreters are both message and cultural clarifiers. Being a cultural broker is part of the medical interpreter’s role and they are expected to recognize and clarify cultural misunderstandings. Thus, medical interpreters should not only be experts in words that are being said, but they also must be familiar with the unwritten rules that govern the people who are saying those words.