Vital Signs: Q&A With a UVA Health Interpreter

February 28, 2022 By Christine Phelan Kueter, Christine Phelan Kueter,

Liz Cook, one of UVA Health’s interpreters, is American Sign Language-certified and a familiar face to clinicians, administrators, patients and their families. At UVA since 1998, she has interpreted at births, deaths, classes, town halls and everything in between.

She sat down with UVA Today recently to discuss her life and work.

Q. Talk a little about your background.

A. I grew up in Brooklyn, New York, and am a “CODA” – that’s “child of deaf adults.” Everyone’s in awe when I tell them this: my mom and dad are Deaf, my two sisters are Deaf, all of my aunts are Deaf, and now that my sisters have both married, I have a hard-of-hearing niece and a Deaf niece and nephew. I’m the oddball, the only hearing child in my family. It’s genetic, obviously, though my father wasn’t born deaf. He had spinal meningitis. I’m bilingual and bicultural, and my first language is American Sign Language.

My daughter is the only hearing female in my family besides me. That’s important because, before I became a “YaYa” [grandmother], I sat her down to prepare her. I said, “If this skipped me, and skipped you …” If she had had a girl, she might have been born deaf. When we found out it was a boy, we said, “Oh! He will be hearing.” And he is.

Related Story

Q. What was your childhood like?

A. I didn’t speak until I was 6, because my whole family signed. Back then, they didn’t have kindergarten, so I began first grade at age 6. As a child, I didn’t understand what hearing people were saying because I didn’t have English as my base language. I wrote in ASL – I’d sign a written sentence and say, “me go store, me finish,” that kind of thing. I look back and think now, “How did I survive?”

I always struggled with English. It was difficult, and my parents couldn’t help me because it wasn’t their first language. I always excelled in math, though. My dad taught me what we called “mental math,” and I never got less than an A. But English and reading were always a challenge.

A story I sometimes share is that my mom was mugged when I was in fifth grade. We’d been walking down the street and the guy hit her in the head with a trash can lid and took her purse. A neighbor saw, and the cops came and put us in the car, and we drove around and found the guy. When we went to court, they’d gotten my mother someone who knew a few signs, but my mother couldn’t understand her. Before the [Americans with Disabilities Act] law, they had signers, but not interpreters. So the cop said to me, “Can you do it?” I didn’t know about the big words, but I sat in his lap up front and he whispered what the judge was saying in my ear and I interpreted it all for my mother. Ultimately, the guy went to jail for a year.

At 12, after my grandfather died, I went with my father and interpreted all the funeral arrangements. When we’d go to the movies, we’d sit in the back under the exit light so my family could see me interpreting the whole movie.

Another time, when I was in eighth grade, my parents wanted a loan, [so] I went with them to the bank and signed everything the banker said to them. I told the banker at the end, “I promise you my parents will pay you back. They’re the hardest workers I’ve ever known.” They got the loan.

But I never felt special. I did what my family needed me to do. Now, looking back, I know I grew up fast.

Headshot of Cook

A child of deaf adults, or a “CODA,” Cook went into health care interpreting, in part, because she saw her parents’ frustrations when dealing with difficult situations. (Photo by Sanjay Suchak, University Communications)

Q. Why did you go into health care?

A. I think because I saw the frustrations my parents had and vowed that they’d have everything they needed to understand the whole message of what was going on. I live in both worlds. I was not my family’s ambassador because I was, in fact, one of them. When we walked down the street, or went to events, people looked at us and said, “Look at those Deaf parents and their three Deaf children.” I never wanted to be different. Like any culture, Deaf people love their own. I was very fortunate to be a CODA because I was accepted. But I stood beside them, never in front of them.

Q. Has COVID changed your work?

A. I think it’s the same, really. We’re making sure everybody gets the access they need to make sure they know what’s happening inside of UVA, and outside in the world. I’m still working with patients. The only thing I’ve noticed is that COVID hit the hard-of-hearing population very hard [because of their reliance on lip reading]. …  When we put masks on, they lost their world. Just because you’re deaf doesn’t mean you’re fluent in lip reading or that you know ASL. We’re blessed to have clear masks now, which has really helped.

Q. How did you come to work as an interpreter in the first place?

A. I didn’t choose this work. I really believe it was planned. When I moved to Virginia from New York in ’79, I worked for the Virginia School for the Deaf and Blind [in Staunton] as a dorm parent, working second shift, 4 p.m. to 2 a.m. It wasn’t a great fit, but it was a job I was comfortable in, because I knew the work well. It was my heritage and my culture.

At some point, they told me they needed interpreters, a job I figured, at first, was volunteer. I said, “But I need a job that pays.” They said that they did pay interpreters, and I was like, “Gosh, really?” It really was the 1990 Americans with Disabilities Act that really started that.

I called my parents and told them I was going to be an interpreter. They knew it was my language, but didn’t think I’d make a career out of it.

But first, I really had to understand the system because being a CODA is completely different than being an interpreter. You can’t sign to patients and clients like you’re signing to your parents.

Q. What’s the difference?

A. When I’d sign to my parents, I only conveyed what’s important. When you’re interpreting the whole world, it’s every piece: intent, message, how it’s conveyed. If the lawyer is being harsh, in court, if a judge is yelling, I can’t just stand there and sign what he or she says, I have to convey everything. You also have to interpret the implied, the nuance. Hearing people hear this sort of thing all the time, but in the Deaf language, that is something you as an interpreter have to figure out and convey.

We never add words. We interpret the intent of the message. It’s not finger spelling of English words – ASL is its own thing. Also, we are not liaisons, we are not advocates. We convey the message from the deaf person to the hearing person.

You can see it in the way I dress. In court, I wear a suit. When I’m in the hospital, I wear scrubs. When you see me at leadership town halls, with [Chief Executive Officer] Wendy [Horton] and Dr. [Bobby] Chhabra, I dress in business attire. I’m not me when I’m in that role, I’m them. It really is a fully immersive role. The doctors, by now, are so trained that they know they’ll be looking at the patient, knowing that the deaf patient isn’t giving them eye contact because they’re looking at me.

But I’m not really Liz when I’m walking down the hallway … The doctors don’t look at me as an artist. They say, “Thank God you’re here.” I’m just the messenger.

Q. Are you famous around UVA Health?

A. Oh, not really – everyone just looks at me as an interpreter. They’ll say, “Oh, I saw you today, Liz.” It’s nothing new. I’ve interpreted in every single clinic in this hospital. I go everywhere. I do all ages, too.

Q. What do you do in your off time?

A. I love to bake. I’m Italian, so I make lasagna, meatballs, cheesecake, sauce. Pasta is my passion. I am famous for my peanut butter pie.

Q. What signs do you wish everyone knew?

A. I think everyone should know the ASL alphabet. “Thank you,” “hello,” “please.” I’ll tell you, the Deaf population loves it when the nurse or medical assistant introduces themselves by finger-spelling their name. They will really connect more because you’ve finger-spelled it. The deaf patients will say to me, “They know a little bit of sign! Isn’t that wonderful?” It makes them feel like they’re included.

Q. Do you have some favorite settings that you interpret?

A. I’ve attended 32 births – that’s probably the most rewarding. I interpret to deaf mothers about breathing, counting to 10, and I’ve attended two C-sections. I’m also there if there is bad news about sharing that a patient hasn’t lived. I’ve never broken down at work, though. I might go home and do it but, when I’m the interpreter, I really feel like I’m that person – I become them.

Media Contact

Christine Phelan Kueter

School of Nursing