Growing up as the son of Vietnamese immigrants, translating was second nature to me. It started small — helping my parents at the grocery store, helping them order things at restaurants or ask for directions. My mom loved hearing my “good English,” as she called it, proud of how quickly I had picked up a language she struggled with. It became an unspoken rule that I was their voice outside our four walls.

There were awkward moments, sure. I remember translating for my mom at a parent-teacher conference when my teacher suggested I needed help with reading. My mom’s face, both confused and embarrassed, waited on me to bridge the gap. When she saw my hesitation, she knew immediately what was up. “What have you done?” she asked sternly, furrowing her eyebrows. Obediently, I translated, knowing I had no other choice.

When my parents finally went to the doctor after years of focusing on me and my health and development, interpreting during their visits felt natural. Their limited English wasn’t enough to navigate through all the medical jargon — but frankly, at 7 or 8, neither was mine. Still, I think it brought them comfort and confidence to have their Good English Speaker at their side, and on their side. Over time and as I went through pre-med and med school, I became fluent not just in English but in the language of medicine — both through my parents’ aging bodies and my pursuit of a medical degree. My parents, like most immigrant parents, took pride in that success as if they had earned the degree themselves. And in a way, they had. My mom always said it was her dragging me to her doctor’s visits as a kid that sparked my interest in medicine. "You’re going to be a doctor one day," she’d say, as if she’d made the decision for me.

I was home visiting from medical school the day my father died. It was a massive stroke — I knew almost immediately. I still remember his silence—the way he looked at me, unable to speak or respond as I sat by his side, translating to doctors his symptoms and his likely preferences on his behalf, and more importantly, telling him everything that was happening. I had no idea if he could understand me. I still don’t know if he understood a single word. That was the day I realized that even if I was fluent in English and Vietnamese and medicine, I could not protect my parents from disease or death. When life was leaving my father, all I could do was witness it.

As I grew in my career, my relationship with my mom shifted. I was moving beyond the world she had built for me. She had settled into a small Vietnamese community, and her English had improved. She didn’t need me in the same way anymore, and I didn’t need her to translate life as much, either. But then, one day, she fell. She called me the next day because her stomach was swollen and she couldn’t understand why. I scolded her for waiting, but stopped when I heard the fear in her voice. Despite her shaking tone, she insisted it was nothing. I told her to go to the emergency department. A few hours later, I got another call — the doctors in the ED weren’t explaining it clearly. Everyone seemed worried, but no one was telling her what was going on.

That was when I knew I had to step in.

She had gotten a CT scan and some blood tests, and they wanted to admit her for workup. I knew this was a bad sign. I sat with her, watching her sleep and chatting about nothing for hours, days while they ran the tests. I constantly refreshed her online patient portal, waiting for the test results to pop up. Let me see the CT report! I wanted to demand of the team. A piece of me knew what it all meant — knew the protocols in my own hospital that might result in a situation like this. But I could not admit it to myself until I had no other option.

I heard the young doctor before he opened the curtain into my mother’s side of the room. His hesitant footsteps and deep, preparatory breath gave away the gravity of what he was about to say. Per my mother’s request, he ran everything by me first. My certainty of the severity of the news heightened when he asked me to come with him to a separate room. My mother dozed in her bed while he told me the pathology results: ovarian cancer. It had spread all across her abdomen — it was hard to find a place the cancer was not. She had months, maybe.

I should have been thankful he told me first, so I could process it before facing my mother. But what I felt was anger. Anger at him for putting me in this position, and anger at the diagnosis itself. Maybe even angry at my mother, who wanted it this way. She had put me in this impossible situation of telling the one who gave you life of their impending death. Had she thought that this could be a possibility? Would she want it this way — for me to be her reaper — if she knew this was the news that was coming? I was her son, her advocate, not the person who should break this kind of news.

But, of course, as it always had been, it was me who told her. She looked at me, her face calm in a way I couldn’t understand. “Oh, dear,” she said, tears welling in her eyes as she cupped my face in her hands. “Are you all right? You look so worried.” She cared more about how I would handle it than her own impending death. It was such a characteristic response I almost That was my mother, always more concerned with protecting me than herself.

She died a few months later. Through it all, I was the one who translated every lab result, every prognosis, every whispered conversation between doctors when they thought she couldn’t hear. She never trusted anyone else with her care—not after my father’s death, and certainly not after her own diagnosis. It was our way of managing the unknown together, like we always had.

Looking back, that experience changed me as a doctor. I’m hyperaware of how crucial it is for patients to have a translator when they need one. No one should ever be forced into the position I was in — torn between being a family member and the bearer of devastating news. Whenever I’m in clinic, I make sure a translator is there, even if the family insists they can handle it themselves. But more than that, I always talk to the family about how much they want to know, how they want to hear difficult truths. I never assume it’s my decision alone — or one that should be placed on their family translator.

And while I ensure that a translator is present, I make sure the patient's strongest advocate—so often their child—is there too, holding their hand. And although I try to lift the burden of translating language, it is always incredibly clear that they continue to translate for their parents — not the language, but the love.