Found in Translation

The Seventy-Million-Dollar Word
What happens when there is no one to help with translation? The consequences
can be life threatening at worst, life altering at best. Even when individuals
speak two languages with advanced levels of proficiency, they often fail
competency tests for translation and interpreting. Language conversion,
whether spoken or written, requires special skills that can take many years to
be developed to a professional level.
A poignant example of what can go wrong when a lay bilingual is asked to
interpret instead of a trained professional is the case of Willie Ramirez. Back
in 1980, the eighteen-year-old was admitted into a Florida hospital. The
hospital staff had plenty of people around who spoke Spanish—this was
Florida, after all—so finding someone to communicate was not a problem.

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Finding a professional interpreter, on the other hand, was another matter.
Willie’s family members said they thought he was intoxicado. This word is
an example of what translators often refer to as a “false friend.” That is, it
doesn’t translate the way it appears it might. (A false friend is not the same as a
false cognate. False cognates mean roughly the same thing in two languages
but do not come from the same linguistic root. As an example, the German
Ach, so! and Japanese Aa, soo (
) both mean “I see,” but are unrelated
linguistically.)
The first impression of the word intoxicado is misleading. It does not mean
intoxicated, but unfortunately for Willie, that’s how it was interpreted into
English by the bilingual staff person who had been roped into interpreting. Due
in great part to this misinterpreted word, Willie was diagnosed incorrectly,
leading to the wrong course of treatment and, eventually, to quadriplegia.
What does intoxicado really mean, and how do you say it in English?
Unfortunately, there really isn’t a perfect linguistic equivalent. Intoxicado
refers to a state of poisoning, usually from ingesting something that is toxic to
the system. To provide some in-context examples, intoxicación solar means
“sun poisoning” and intoxicación por alimentos means “food poisoning.”
Which kind of intoxicación was Willie’s family referring to? They suspected
that he had food poisoning because he had eaten an undercooked hamburger.
Without any context, the word intoxicado is not easy to render, even for a
skilled interpreter or translator. After all, it doesn’t sound right in English to
say, “He is poisoned,” even though that’s the literal translation. A professional
interpreter, especially in healthcare settings, is trained to clarify whenever
there is any ambiguity about what the speaker is trying to convey. A
professional would have clarified to find out what type of intoxicación they
were referring to, if it wasn’t already evident from the rest of the conversation.
But the average bilingual? Not a chance. They’re not trained to think about the
nuance of language and how it can affect cross-lingual communication. (As for
the correct way to say intoxicated in Spanish, the word is ebrio.)
Because of the mistake, Ramirez was diagnosed with an intentional drug
overdose. He received a malpractice settlement of $71 million. It was later
discovered that his symptoms were the result not of food poisoning after all,
but of an intracerebral hemorrhage.
1
Because of the amount of the settlement,
the word intoxicado is sometimes referred to in translation circles as the
“seventy-one-million-dollar word.” $71 million is a lot of money. Assuming
an annual salary of $50,000 per year, it’s enough to pay for 1,420 full-time
professional staff interpreters—that’s probably more interpreters than all the
hospitals in the state of Florida have on staff, combined. Unfortunately, history

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keeps repeating itself. In 2010, a surgeon at a California hospital failed to
provide an interpreter to Francisco Torres, a seventy-two-year-old Spanish-
speaking patient with a kidney tumor, and the surgeon removed the wrong
kidney by mistake.
2
It isn’t to say that the same thing couldn’t happen in a
language-concordant situation (in which both people speak English, for
example). It certainly could, but the risk is greater without an interpreter.
In fact, the costs to the entire healthcare system are higher when interpreters
are not used. When language barriers are present, medical errors are more
common. There are countless reported incidents of doctors ordering
unnecessary—and expensive—diagnostic tests instead of simply paying for
interpreting services. When patients cannot understand their instructions, they
can easily overdose by accident or take medications incorrectly. It’s a risky and
high-cost business to forego language services.
3
Patients may say that they understand some English, leading the doctor to
believe it’s fine to write a prescription in a language the patient may not speak
fluently. However, a Spanish speaker who reads the words “take once per day,”
could easily think they are supposed to take the pill eleven times per day. After
all, once means “eleven” in Spanish—like intoxicado, it’s just one of many
false friends that can cause horrific consequences.