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Gather around, translators and language service industrialists and MT folks and AI language pioneers, and I will tell you a strange but true story that may give you ideas that will earn you a ton of money, or save lives, or both.

There’s a kind of preamble, set in Italy. It took place in January 2023, and the cast consists of my partner Kristi and her two sons, all of whom were visiting Italy for the first time. Even though they had been racing up through the levels of DuoLingo Italian, when push came to shove, as it will, their language skills deserted them, as they often do.

They visited Venice before catching the high-speed train down to Rome, agog for history, architecture, pasta, and free-range cats, but that night her elder son said he was feeling ill.

She took him to the hospital. This is Rome, remember, a capital city in Europe, the continent of professional languages. The first two people she met, in a kind of anti-COVID pre-admission pop-up tent, pulled out their phones and were able to do exactly what your trade promises, my friends: They dialed up the target language of English, spoke Italian into their phones, and an almost instant translation came up on the screen.

What the translation said, more or less, was: “Go to a pharmacy and get a COVID test before we will let you in.” The pharmacist had no such app, but after some sign language and some anti-American abuse, they tested negative and went back to the hospital for further attention.

Her son was admitted, but in a suspiciously short time he came back out.

“What did they say?” she asked.

“I don’t know,” he said. “I don’t speak Italian, they didn’t speak any English.”

They had no app. She took him back to the AirBnB, and he was so ill that afterwards, he couldn’t remember being in Rome at all.

Note to digital creatives: Develop hospital apps. Now.

Second note to digital creatives: Don’t ever assume they will be enough. Yes, I realize that’s a rather opaque statement. Please read on.

The story now comes right up to date, to late September 2023, and the scene shifts to the small fortified city-port of Kotor in Montenegro. Kristi and I are there on the vacation from — well, certainly not heaven. On our approach, our plane is blasted sideways and downwards by windshear. The pilot tries a different runway, and again we get savagely shoved off final approach, and he pulls up hard, right into a thunderstorm, where we are struck by a bolt of lightning…
…which may have been a contributory cause to what happened two days later, when I woke up at 2 a.m. with an attack of atrial fibrillation, a cardiac arrhythmia that sends the heart stuttering and racing up to 200 irregular beats per minute.
Weak and dizzy, I could barely walk. The ambulance service Kristi phone turned us down, saying, “We can’t help you.”

Eventually three young Montenegrin guys carried me to a taxi, and I ended up at the town’s public hospital for another perspective on the role of language in medical interventions.

The hospital’s facilities were, shall we say, basic. It had a CT scan machine and could do X-rays and blood analysis, but the women’s bathroom didn’t have toilet paper, and the men’s didn’t have a toilet seat. As if to demonstrate its up-to-dateness, a TV in the reception area played constant videos from the heyday of MTV, which made the place seem even more dated: pre-collapse of the music industry, pre-collapse of television.

Most people in Kotor speak what you might call English for Tourists, and the hospital staff were no exceptions. “You are his woman?” the doctor asked Kristi.

Kristi’s translation app just wasn’t doing the job: too long a delay, too much ambiguity, too many technical medical terms — a formulation for frustration. I was sent back to the AirBnB with my heart still in chaos, and before 8 a.m. we were back at the hospital. Just when things looked desperate, we were joined by Laska.

Laska was one of the front-desk staff in the Foreign Patient arrival office. She was anything but an app, anything but an artificial intelligence — she was intelligence incarnate. She was what the Pentagon calls HUMINT — human intelligence.
Short, slim, dark, alert, she told me she had learned her English in school, and by God, I hope her teachers were proud of her. She was not just a translator; she was the medical interface, the doer, and explainer. When I had questions, she nodded seriously, understanding my confusion. “I will ask the doctor,” she said, and went at once to ask the doctor, who was in another room with another patient.

Short, slim, dark, alert, she told me she had learned her English in school, and by God, I hope her teachers were proud of her. She was not just a translator; she was the medical interface, the doer, and explainer. When I had questions, she nodded seriously, understanding my confusion. “I will ask the doctor,” she said, and went at once to ask the doctor, who was in another room with another patient.

She came in to ask how I was feeling. She called taxis. She wrote out in Montenegrin the name of the pharmacy for the cab driver, she wrote out in English the names of the medications I needed. When the ratchet slowly failed and the head of the bed gradually descended to the horizontal, she searched the place for a spare pillow to put under my neck. When everything was busy and uncertain, she stood with her hands in the back pockets of her jeans and the room turned around her.

She knew technical medical terms such as “prescription,” “sinuses,” and “therapy,” but above all, she listened — and anyone whose heart is beating erratically at 200 BPM knows the supreme value of an intelligent listener.

Later I realized how badly a medical bot would have done in her place, because the input from the incoming patients was an AI nightmare: incomplete sentences between sobs, slang, suppressed sarcasm from snippy Brits, suppressed fear from an Australian who needed a transfusion of a blood type not to be found any closer than Croatia.

This was not the time and place for the glittery end of AI, the, “Oh my god, I just said ‘Buddhist warrior’ and it drew me the Dalai Lama with a sword on an elephant in front of the Himalayas.” This was the time and place for humility, for making sure everyone was heard, everyone felt understood, no matter their point of origin or mental and physical condition. It was the proof that language, successfully exchanged, is more about empathy than it is about vocabulary and syntax.

That day the hospital staff stabilized my heart, and for the next week I went back for an hour every day for IV antibiotics (they had discovered pneumonia hiding, like a clinical Easter egg, in my chest) and general observation.

During that time, it became clear, my technical friends, that digital help is still clearly needed in the medical realm. I needed to refill one of my own ongoing medications, one that even my own local English-speaking pharmacist can’t pronounce: pramipexole. By then I was alert enough to come up with a hack. I went into Wikipedia, looked up the medication, copied and pasted the paragraph into Google Translate, converted it into Serbian (the closest approximation to Montenegrin), took a screenshot, went to the pharmacy, showed them the screenshot, and I was out of there within three minutes.

Over the week I met four of Laska’s colleagues; collectively, I thought of them as The Ambassadors. They were all cheerful young women who spoke English (and, I assume, other non-Slavic languages) capably, but they all carried out an apparently infinite number of other duties on behalf of the hospital staff and the patients.

When I met the youngest of the Ambassadors for the first time, she asked me if I knew Harry Styles personally. The others egged her out from behind the counter, and she revealed she was wearing Harry Styles crocs.

Translators and localizers and AI folks, we will never outgrow the need for the Ambassadors, for the people who understand situations and what people need, who know that language is vital but care is more vital. So please keep working on the language training programs.

Make sure they include “prescription” and “therapy.”

Make sure they include, “I will find out for you.”

Make sure they include, “Everything will be okay,” and the instruction, “As you say this, look into the patient’s eyes and lay your hand on their shoulder,” something no app will ever do.

Tim Brookes’ latest book, Writing Beyond Writing, is now available at endangeredalphabets.com