Nicolas Barnett, Nicholas Chare and Dominic Williams consider how issues of language and translation intersect with questions of power and identity in witness reports by healthcare professionals.
The Clinical Witness
The multilingual research strand of The Polyphony calls for approaches that challenge the “dominant understanding of English as the lingua franca of the medical humanities” and expand awareness to work being carried out “beyond the anglosphere.” In this piece, we will discuss how our work on the recently published volume, The Clinical Witness (2025) has carried out some of the sort of work Multilingual MedHums calls for, highlighting how simply expanding into Francophone scholarship and healthcare practice increases the ways in which the Global South can be represented. At the same time, we will also consider the important issues of translation and linguistic power.
The Clinical Witness investigates how healthcare professionals testify to moments of conflict and catastrophe, taking inspiration from the fact that conflict and catastrophe medicine places less importance on how a situation has come about, and more on how medical aid workers should respond to an emergency. Our premise was that the kind of witnessing that doctors and other healthcare professionals carry out could also be compared across a range of situations without assuming that each set of circumstances was alike. As we show in the volume, that does not mean that healthcare professionals never think about issues of why events occur and who is responsible for them. But, as often the first witness reports from the sites of these events, their testimonies frequently need to convey both the facts of what happened, and their overwhelming nature.
The languages of medicine
In this context, medical language, commonly conceived of as precise and yet also alienating (Charon 2006, 6; Helman 2007, 104), and medical training that emphasises objective description even in the face of injustice or indifference, can both enable and constrain. Healthcare professionals’ testimony can fight against the limits of medical language as often as it works within them. In the context of the COVID-19 pandemic, for example, a poem published by the physician Rafael Campo (2020) in Harvard Magazine eschews technical medical terminology in favour of pared figurative language that provides striking auditory imagery the better to capture the powerlessness felt by medical personnel when met with patients suffering respiratory distress and acute cardiovascular complications linked to coronavirus. In the same year the poem was drafted, a letter by the cardiac physician Stefan Möhlenkamp and the professor of cardiology Holger Thiele (2020) was published in the medical journal Herz. The letter makes a series of recommendations regarding the use of ventilatory support to counter hypoxic vasoconstriction in COVID-19 patients in ICU. Both these texts involve authors who are healthcare professionals and both texts can be understood to bear witness (in a broad sense of the term) to the pandemic as it was experienced in hospitals.
We would read neither text as superior in its ability to attest, but would argue that the choice of language (governed by the aims of the authors and their intended audience) in each is simultaneously enabling and limiting. Through his use of poetry as an idiom and his rejection of a specialized vocabulary, Campo is able to evoke emotions and sensations connected to a painful sense of failure to meet patient needs. His text, however, is not an “easy” read, requiring intellectual and emotional engagement. Möhlenkamp’s and Thiele’s presentation of technical information is dense with medical vocabulary that ably presents facts and information linked to viral infection and its treatment but is, by its nature, unfeeling, even as it is inspired by the need to prevent the same loss of life that motivates Campo’s despondent verses. Both texts translate experiences of the initial phase of the COVID pandemic but to different ends. They are nonetheless united in a dedication to healing, with Möhlenkamp and Thiele offering practical advice to enhance survival rates for those in intensive care and Campo providing a crucial space where other healthcare professionals living with emotional exhaustion can find their own frustration and sadness mirrored and thus, perhaps, find a measure of solace in knowing their pain is shared. The two examples give an idea into how we believe language operates in both empowering and restrictive ways within specific testimonies.
Sometimes Anglophone clinical language also frames medicine in terms of conflict (e.g. Fuks 2010) or catastrophe, with a disease “battled against” or an infection triggering a “cytokine storm.” In our volume, we also engage with the implications of specific choices of literary form (rather than combative or imperialist language) and individual-centred approaches to testimony. In the Introduction we compare accounts by the surgeons Hans Husum (a contributor to our book) and David Nott of the humanitarian work they have undertaken, addressing ethical issues raised by their narrative choices.
Witnessing beyond the Anglosphere
Issues of language and style, therefore, are central to the witnessing that healthcare professionals carry out. Linguistic and social power vary within different registers and varieties of one language and between one language and another. In editing this volume, we wanted to acknowledge this fact as far as we were able. This also allowed us to represent a wider range of approaches and perspectives.
One editor of our volume speaks French as a mother tongue, so we took advantage of that linguistic competence to contact and work with Francophone researchers. This allowed us to include several contributions translated from French to English. Nathalie Heinich is a major French sociologist whose work (e.g. Heinich 2011) is underrepresented in English. Anne-Yvonne Guillou is a leading French scholar of Cambodia (Guillou 2009, 2025). These scholars are from intellectual traditions that address issues of professional identity and humanitarian work in different ways from those in the Anglophone literature.
We were also able to draw on the work of healthcare professionals in Francophone countries in the Global South. Jeanty Fils Exalus reported on his work in health communications in Haiti, and Oléa Balayulu Makila on his experiences as a psychologist in the Democratic Republic of Congo (DRC). French, the language of the coloniser, is by no means the only written language in DRC or Haiti. It is, however, the language in which most doctors in these countries write, and have great facility in doing so, even if it is not necessarily the language in which they converse with their patients. Their experiences are important ones that we wished to include in the volume.
International humanitarian responses to the Haitian earthquake of 2011 had severe limitations, exemplified most abjectly in the cholera outbreak caused by UN troops (Schuller 2012; Brant 2014). It is important, then, to attend to Haitian voices and perspectives. Not doing so replicates the harm caused by actions of outside medical and humanitarian agencies. Similarly, Balayulu Makila offers a valuable internal account of how the DRC healthcare system and government has found successful ways of responding to epidemics. Including their originally French-language testimony gives more room for voices from the Global South to be heard.
We were aware, nonetheless, of the limitations of what experiences could be articulated and of the issue of linguistic imperialism that has been foregrounded by authors such as the Kenyan novelist Ngũgĩ wa Thiong’o (1986). The decision to bear witness in hegemonic languages such as English or French can come at considerable cost due to the restrictive terms of reference it imposes. Equally, the need or choice to attest in a person’s Indigenous language presents difficulties for them at the level of reception if translation is then required.
Translation and trauma
In the Introduction to the volume, we discuss the testimony of Cambodian healthcare workers who escaped the Khmer Rouge regime at the International Cambodia Hearing, held in Oslo in April 1978. Although the text we used was in English (ICH 1978), it was clear from the translation (especially of medical terms) that the doctor, Nal Oum, testified in French. The nurse, Cheng Vibol, seems to have testified in Khmer: the text fails to transcribe many names, and a member of the tribunal attributes one misunderstanding to a problem with translation. Cheng’s testimony was less extensive than Nal’s; his status, and the intertwined issue of the language he was using and concomitant need for a translator (and translation time), probably played a part in this difference.
Attending to language in this encounter allows us to see several things. Firstly, professional status and level of education is bound up with language used: French for a doctor, Khmer for a nurse. Secondly, languages have material qualities (sounds, time taken to articulate them), but how those sounds are perceived, and what time is allotted for them, is the result (and sign) of power relations, including colonial domination. Sounds become less easy to recognise, time is occupied by the process of translation and clarification. Together, these mean that testimony in non-hegemonic languages – even from generally trusted sources such as healthcare workers – is not guaranteed a straightforward or sympathetic reception.
Issues of translation play out in multiple ways in testimony, and in scholarship on testimony (as Davies (2018), among others, has shown). In our work writing and editing this volume, we explored a number of these aspects. In his chapter on Miklós Nyiszli, the Hungarian Jewish doctor who was deported to Auschwitz in 1944 and forced to carry out autopsies for Josef Mengele, Dominic Williams shows that an engagement with issues of translation is important to understand overlooked dimensions of this relatively well-known work (Nyiszli 2012). Translators, seeking to bring Nyiszli’s writing into French and English, carried their own assumptions about what it means for a doctor to write, thinking either that his language was too clinical, and therefore sometimes needed to be humanised, or that it was too emotional and raw and needed to be tidied up.
For example, the text is written in the present tense in Hungarian and in the French translation. Although this use of the “historic present” is probably more common and accepted in both languages than in English, it gives the text a more immediate feel, heightening the sense of Nyiszli discovering and responding in the moment to the horrors of his immediate environment. The English translation uses past verb forms, adding to the emotional distance that many readers perceive in Nyiszli’s use of medical language. The contradiction between emotion and clinical description exists within Nyiszli’s text, but also across the translations and the different forms that it has taken. Tracing this is an important way to understand not only how healthcare professionals conceive of themselves, but also how they are perceived, and how that perception shapes the form of their testimony as we receive it. Translation therefore offers an instantiation of a more general point: testimony is produced, but also transmitted and received. In the case of healthcare professionals, how it is transmitted and received is not only the product of trust in scientific objectivity or social status. It can also be marked by negative ideas of clinicians as less emotional, and therefore less warm and human. Healthcare workers attesting to conflict and catastrophe therefore need to take these negative as well as positive expectations into account.
Translation in a broader sense, related to concepts such as “trauma,” is also important to the volume. In the Introduction, we discuss the recognition by psychiatrists such as Patrick Bracken (2002) and Derek Summerfield (who has contributed a chapter to the volume) that there is a danger in globalising Western psychiatric categories such as “trauma” and treating them as universally applicable. The hegemonic definition of trauma inspired by the Diagnostic and Statistical Manual of Mental Disorders (DSM, one of the most widely used textbooks to classify and treat mental health conditions), and the language that accompanies it, does not translate to all cultural contexts. We develop this idea to consider whether dominant ideas of “witnessing” are also not applicable in all cultures.
About the authors
Nicolas Barnett is a critical care physician based at the Royal Free Hospital in London. He has over 20 years of experience working in the National Health Service.
Nicholas Chare teaches critical and cultural theory at the Université de Montréal.
Dominic Williams is assistant professor in history at Northumbria University.
References
Barnett, Nicolas, Nicholas Chare, and Dominic Williams. 2025. The Clinical Witness: Conflict, Catastrophe and Medical Testimony. Routledge.
Bracken, Patrick. 2002. Trauma: Culture, Meaning and Philosophy. Whurr.
Brant, Daniel. 2014. “Traumatic Encounters: Negotiating Humanitarian Testimony in Post-earthquake Haiti.” Journal of Haitian Studies 20 (2): 40–63.
Campo, Rafael. 2020. “A Poem by Rafal Campo.” Harvard Magazine, April 17, 2020. https://www.harvardmagazine.com/2020/04/a-poem-by-rafael-campo.
Chare, Nicholas, and Dominic Williams. 2019. The Auschwitz Sonderkommando: Testimonies, Histories, Representations. Palgrave Macmillan.
Charon, Rita. 2006. Narrative Medicine: Honoring the Stories of Illness. Oxford University Press.
Davies, Peter. 2018. Witness between Languages: The Translation of Holocaust Testimonies in Context. Camden House.
Fuks, Abraham. 2010. “The Military Metaphors of Modern Medicine.” In The Meaning Management Challenge: Making Sense of Health, Illness and Disease, edited by Zhenyi Li and Thomas Lawrence Long, 55–68. Brill.
Guillou, Anne Yvonne. 2009. Cambodge: Soigner dans les fracas de l’histoire. Les Indes savantes.
Guillou, Anne Yvonne. 2025. Puissance des lieux, présence des morts: Sur les traces du génocide khmer rouge au Cambodge. Société d’ethnologie.
Heinich, Nathalie. 2011. Sortir des camps, sortir du silence: de l’indicible à l’imprescriptible. Les Impressions nouvelles.
Helman, Cecil G. 2007. Culture, Health and Illness. 5th ed. Hodder Arnold.
[ICH] International Cambodia Hearing, Oslo 21–23 April 1978: Preliminary, Unofficial Transcript. Oslo, September 1978. https://d.dccam.org/Archives/Documents/pdf/The_International_Cambodia_Hearing_Oslo_21-23_April_1978.pdf.
Möhlenkamp, Stefan, and Holger Thiele. 2020. “Ventilation of COVID-19 Patients in Intensive Care Units.” Herz 45: 329–31.
Ngũgĩ wa Thiong’o. 1986. Decolonising the Mind: The Politics of Language in African Literature. James Currey.
Nyiszli, Miklós. [1946] 2012. Auschwitz: A Doctor’s Eyewitness Report. Translated by Tibère Kremer and Richard Seaver. Penguin.
Schuller, Mark. 2012. Killing with Kindness: Haiti, International Aid, and NGOs. Rutgers University Press.
