When a translator has to contend with translating medical documents, he or she must translate special collocations, idiomatic expressions, connotation, register, style, structure, terminology and syntax in his/her quest for an accurate translation. For the purposes of this article, I'm going to delve into the particular problems that arise at the word level, as opposed to the levels of grammatical equivalence, textual equivalence and pragmatic equivalence.
Word Level Problems That Arise When Translating
The lexical meaning of a word is its meaning in a language that has evolved through use. There are different types of meaning linked to the lexical origin of a word. These are the types of: propositional meaning, presupposed meaning, expressive meaning and evoked meaning. The propositional meaning is the most basic, clear-cut and straight-forward meaning of the word. The expressive meaning, or connotation, is that which accounts for the shades of meaning on top of the propositional meaning. An example of this is the difference between the words "smell" (definition: giving off an odor) and "reek". The two words have the same propositional meaning but contrasting expressive meanings.
The presupposed meaning stems from collocation. For example, the adjective "sturdy" is more often used to describe animals, plants and inanimate objects rather than human beings. Evoked meaning refers to register or dialect. A register is the language used for a specific interaction or situation, such as an adult talking to a child. Mona Baker, in her book "In Other Words," defines a bad translation at the word level as being caused by mismatches in any of the four kinds of meanings.
Fortunately, medical translations, unlike legal translations, have the propositional meaning generally match between the two languages. This is because disease and the anatomy of the human body are essentially the same the world over. Medical translation does, however, trip up the translator when it comes to evoked meanings that do not match between different languages. At the same time, medical translation often offers mismatched presupposed meanings between languages as a result of collocations.
Different Registers in Medical Translation
What sets medical translation apart from other technical translations in terms of difficulty is its multiple registers. In the field, many body parts and diseases have one name in a more elevated (medical) register and another in a lower (colloquial) register. Examples include "thorax" versus "chest," and "pertussis" versus "whooping cough".
According to Peter Newmark, the author of "A Layman's View of Medical Translation," the reason different medical registers exist is due to historical reasons and because different medical field evolved separately:
"The medical language register in European languages is a jungle of synonyms -- different words being applied to the same condition, depending sometimes on whether the point of view is anatomical, clinical, or pathological, and sometimes on when and where the expression is used. Thus 'brucellosis' has at least 25 (linguistic) synonyms in English alone (6-12 in other European languages)."
Medical translation is considered especially difficult because the translator needs to know how the body works, how a disease evolves, etc. One could argue that a translator working on an electrical engineering text on power transmission systems would also have to grasp how the system works. The difference is that an engineering translator can commonly name a machine part and system in a lower register for all engineering translation texts. An engineering text for the layperson would simply be less detailed.
The existence of two registers in medical translations would not present the translator much difficulty if not for the fact that a certain number of languages have only one word for both registers, while other languages have two or more words. When translating a single medical term from the source language into a target language with two or more options, the text context and register must be considered.
In medical translations, the audience the text is designed for influences the translation. Many attempts have been made to list the different communication types in medical translations. But, more or less, the four categories are professional to professional (doctor to doctor), professional to semi-professional (doctor to medical student or nurse), professional to non-professional (doctor to patient) and non-professional (reporter to reader).
Three registers also exist in medical translations: doctor-to-doctor, doctor-to-patient and patient-to-patient. The latter refers to documents written by laypersons for others also suffering from the same disease. Here are examples of the three main registers that exist for a medical term:
- medical register (e.g.: candidiasis)
- general register (e.g.: yeast infection)
- mixed (e.g: yeast infection (candidiasis) or candidiasis (yeast infection))
The obstacle for the medical translator is to determine which of the three, or more, potential translations correspond to each of the 3-5 communication situations detailed above. The translation that is considered the most accurate will often depend on the field of medicine. For example, in the following sentence on vaccinations found in the New England Journal of Medicine:
"We have launched a vaccination campaign to protect the refugees from diphtheria, measles, mumps, pertussis, rubella, and tetanus."
The sentence mixes medical ("pertussis") and colloquial ("mumps") register terms. However, the meaning of the sentence is understood since it is about vaccinations.
Thrombus is the scientific medical term equivalent of the general register term of blood clot. The below sentence from the New England Journal of Medicine clearly uses the scientific medical term:
"In this patient, the CT finding of a bright linear signal in the region of the right middle cerebral artery suggests the presence of a blood clot, and the subtle early ischemic changes in the territory served by this artery reinforce the diagnosis of evolving infarction."
Dictionaries can only partly address the problem. Newmark recommended: "Never accept a bilingual or multilingual dictionary as an authority. It often contains too many synonyms without their context, obsolete words or 'dictionary' words (that is, those that are found only in dictionaries)."
If a medical translator only works with medical texts that are within a specific field, then register will not be so cumbersome. The source or target language of many medical texts happen to be English as the latter language is the lingua franca of the medical profession. A good medical translator will know how to cope with a variety of registers between the source and target language.
When first working with a medical text, a medical translator must first identify its register and translate this to the target language. This can be hard for the translator when one term exists in either the source or target language and when several terms exist in the second language. Besides register, the translator will have to contend with the basic concerns of any translator, that is, that of syntax, grammar, style, terminology and more. Considered a highly difficult field to translate to and from, all medical translators generally have a professional medical background to help them with the translation.