Intended for healthcare professionals

Career Focus

Biomedical translation

BMJ 1998; 316 doi: (Published 03 January 1998) Cite this as: BMJ 1998;316:S2a-7124
  1. Iain Bamforth, General practitioner and writer
  1. 37, Rue Wimpheling, 67000, Strasbourg, France.

    Iain Bamforth finds meanings and monies in the European medical babel

    When I go through what I euphemistically call my archives, I find mounds of dog-eared A4, heat-sensitive fax paper and computer disks on subjects such as fermentation techniques for monoclonal antibodies, nitric oxide (Molecule of the Year in ‘92), sterile loopostomy bridges, French marketing chat on why pills that dissolve on the tongue are better than pills that fizz in water, use of the Markov model in cost benefit analysis, and heaps of curricula vitae.

    That is a very small sample of some of the subjects I've translated recently from my own source languages, German and French, into English, the target language of about 85% of all biomedical translations. The titles provide some idea of the many environments and disciplines that impinge on medicine and the biosciences - marketing, regulatory affairs, science journalism, production management - words that stare back in their strangeness. The human subject is often lost in this jungle of competing outlooks and deadlines: but the titles tell us why translation can be a source of income, or even a profession, for it carries the dominant culture of our time - technology.

    Biomedical translation is a specialised area of translation, distinguishing itself from general translation by its reliance on terminology: one estimate is that specialist terms account for 5-10% of a technical translation.1 Out of necessity, since I often have to work in areas which skirt my basic field of competence, I keep and continually update glossaries of French and German words I encounter only rarely. In my experience the various Euroglot dictionaries on offer are not much use, being full of dodgy “equivalents” - it might be physiopathologie in French but it has to be “pathophysiology” in English. I don't know why either.

    Translators must be alive to the richness and nuance within both their target and source languages. As George Orwell put it: “above the level of a railway guide, no text is ever quite free from aesthetic considerations” A rapid flick through my own files brings to light such curios as: amyÑlÑ (pithed), lÑsion achromatique (non-staining gap), blutig bestimmen (measure by invasive method), HaltungsanormalitÑten (lack of motor coordination). Some of these terms are ordinary words co-opted to other denotative ends, others concept-terms or phrases which require formulaic repackaging. Chez la femme en pÑriode d'activitÑ gÑnitale ends up on a pack leaflet as the less fearsome “in women of child-bearing age”, which isn't quite the same thing, but is more revealing in the context (teratogenic effects of a drug on the foetus). Translators should never be afraid to omit empty phrases when translating, or prune the archaicisms or rhetorical flourishes which are sometimes used to dress up the functional or declaritive.

    Many phrases in French are redundant and can be rendered with simple English prepositions like “about” (de l'ordre de); true to its clerkish soul German has convoluted adjectival constructions, which go on for ages by the simple trick of turning a participle into an adjective (see Mark Twain's essay The Awful German Language).

    A dualist approach is often adopted when thinking about translation.2 Poetry translation approaches untranslatability; scientific translation hunts for the right Lego piece. Poetry posits silence as the only thing mankind really holds in common; science overrides philosophical niceties, since the results seem to work. For technical translators, the act of translation is an exercise in impersonality and secular reality (i.e. a job for money) - rendering connotations, “transcoding” professional or technical terms, and improving the semantic clarity of the text. Translators are often more interested in getting the job done than in following the original, although in my experience it is impossible to work without first understanding both the source language text and the context. This might appear axiomatic, but I have often been asked to salvage translations where it has been clear that the original translator did not understand both. Part of the translator's ethics of competence is knowing when not to translate.

    Practical points

    Most biomedical translators have a basic degree in the life sciences rather than medicine. English speaking translators living abroad may find that pharmaceutical companies are eager to employ them for in house sessional work.

    Most doctors who double as translators work freelance, maintaining a close network of reliable agencies and clients. It is important for all concerned to define a field of competence. It is also important for translators to know their own work rate as deadlines are becoming increasingly inflexible.

    Good word processing skills and a fax/modem are essential. A freelance secretary who can type technical language is a godsend, should the translator wish to offset the cost of employing a secretary by increasing throughput, but not always easy to find. Earnings are wholly subject to the market, and the situation has become noticeably more competitive in Europe over the past few years. Agency rates for French/German to English vary from £40-60/1000 words, although it can increase for urgent or very specialised work, or for external translators working directly for a company or international body.

    Rarer languages command a higher premium, but commissions are less common (except for Japanese). All translators acquire their own personal library of internet addresses, reference material and archives.

    It is always good policy to receive annotated or corrected versions of one's work. Data confidentiality should always be

    Since history suggests languages tend to drift slowly apart like tectonic plates, it's worth remembering that linguistic convergence is also a powerful force. English and French have been converging for the last century or so, and German is remarkably hospitable to all kinds of specialist jargon from English: AIDS slides off the French tongue as the adjective sidaÑque (from the French form of the acronym Sida: syndrome d'immuno-dÑficience acquise) but German simply phagocytoses the English acronym. The French for “evidence based medicine” entered the language in 1994 as mÑdecine factuelle, which makes you wonder what was being practised beforehand. In other words, a problem for the Euroglot translator is that Europe's languages are cognitively too close. That may be one reason why Esperanto survives as the only artificial language with a mass following. It is not entirely irrelevant that Zamenhof, its Polish founder, was an ophthalmologist. On original publication in 1887 of his language project, Lingvo Internacia, he used the pseudonym Doktoro Esperanto (one who hopes): it was this catchy pseudonym which took over as name for the language.3 The linguist Whorf has called this cognitive proximity of the Romance and Germanic languages Standard Average European, and it is the ghost behind the very idea of translation in Europe: that it comes down to a process of lexical swapping, with a few minor syntactic modifications. Meaning is something which can be uncoupled and reassembled over and over again in a new linguistic form - les dÑcoupes du mÑme rÑel.2

    Which raises the issue of machine translation, the automated process of translating from one natural language to another. In the episode of the grand academy at Lagado in Gulliver's Travels Jonathan Swift was able to satirise the notion of a machine that could handle language. Three centuries later, after Orwell and less confident about language, we still rely on Turing's test as the best way to “out” a machine: by getting it to answer a human question. When I tested a machine translation program it came up with the term “forward bedroom of the eye” for the French chambre antÑriÑure. I know of companies which use it to produce roughly usable versions of texts from Japanese or other distant languages, but for little else.

    Other factors impinge on the translator's autonomy. The power of transnational bodies like the EU has an increasing effect on permissible terminology. Al-though the term “product licence” used to be a perfectly acceptable term for what a medicine required before its marketing, Eurospeak dictates use of the unwieldy “marketing authorisation” (by derivation, one presumes, from the French authorisation de mise sur la marchÑ); a drug is a medicinal product. Nothing, to an English-speaker, is quite so presumptuous as the official publication of the French state, les JournÑes Officielles, which prints sanctioned versions of new scientific terms; it is interesting to consult these publications with ten or twenty years' dust on them, and note which words have had staying power. EndoprothÑse might be the sanctioned term for a ‘stent' in French, but you'll be lucky to find it outside this essay. In fact, English is a handy language for objects to come to voice in. Its furniture is more mobile than that of other European languages, and it is almost desexed. English prefers simple or co-ordinate to complex sentences, and doesn't frown on, indeed may actively favour, terms like boil-off, shelf life, breakpoint, fit, doped, spiked where more conventional latinisms are also available. It's worth pointing out, as Lakoff and Johnson do,4 that no natural language is exempt from buried intentionality: even in technical translations, you can find yourself running up against (a sporting phrasal verb itself) the weird prominence of cricket and golf as imagistic sources for metaphoric terms in English.

    But to be fair (and the idea of “fairplay” has hitched its way into all the European languages) I would point out that French and German have their own qualities. French neologises effortlessly - morbimortalitÑ, cathodique, and the homophonic cÑdÑrom are three recent examples - and German is adept at making sense with prepositions: take the basic root term Blick and add aus, ein or Ñber, or other substantives such as Licht or Augen, and five subtly related new words come into being.

    While translating keeps a translator, by proxy, on the cutting edge of what's new, there are times when I feel like the American poet John Ashbery in his poem The Instruction Manual,5 a poem in which a man translating a very boring technical file looks up to find his imagination running off to South America. I suppose doctors who end up in applied linguistics do a valuable job, since the practical application and extension of the sciences into Technology and Big Business require self effacing types prepared to don the translator's traditional mantle of invisibility. There's the rub: when translators do their jobs properly, nobody notices.

    Medicine itself can never get away from symbolic language, or abandon its lay orientation, and it is perhaps as well that doctors are instinctively more attuned to the curse of babble than to knowing just where Broca's area is. Should you have another language and the time to apply it, being a medical translator will make you even more acutely aware of how opaque the medium is. On the other hand, many doctors are unwittingly translator/interpreters anyway. Next time you have a quiet moment read someone's medical history: it's nothing other than a target language rendition of what for a patient may well have been a barely recountable source language script of threateningly inchoate bodily sensations.


    Recommended reading

    • Steiner G. After Babel. Oxford: Oxford UP, 1992.

      Although it raises more questions than anyone will ever be able to answer, this is the bible of translation, a passionately argued and erudite book about translation as a metaphor for understanding. The endpapers of the second edition carry a useful list of mainly literary publications and journals.

    • Ostarhild E. Careers using languages. London: Kogan Page, 1996.A best-selling guide to the variety of careers on offer to anyone with language skills, including a section on specialist careers

    • Newmark P. A textbook of translation. Hemel Hempstead: Prentice Hall, 1988. Intended as a textbook for students at the Centre for Translation Studies, this is engaging and iconoclastic practical guide to applied linguistics; it contains many useful tips on how to translate challenging texts, neologisms, metaphors, and how to trace ‘unfindable' words. According to Newmark the BMJ “has a ‘marked' house style, including rather pronounced use of passives, restrained double-noun compounds, frequent use of suffixed or non-suffixed deverbals collocated with equative verbs or all-purpose verbs…”

    • Lakoff G., Johnson M. Metaphors we live by. Chicago: Chicago UP, 1980. A study of metaphor as a constitutive cognitive phenomenon, or how body movement and function give intentionality to abstract ideas.

    • Samuelsson-Brown G. A Practical Guide for Translators. London: Multilingual Matters 1993. A comprehensive guide on all aspects of work and time organisation for the intending freelance or staff translator.

    • Samuelsson-Brown G. A Practical Guide for Translators. London: Multilingual Matters 1993. A comprehensive guide on all aspects of work and time organisation for the intending freelance or staff translator

      Gladstone's heroic English-French Dictionary of Medical and Paramedical Sciences (Edisem, QuÑbec, 1990) essentially represents his life's work.

    Some useful addresses

    • The Institute of Linguists, Saxon House, 48 Southwark Street, London SE1 1UN. Tel 0171 940 3100 Fax 0171 940 3101. Website The Institute offers a highly regarded Diploma in Translation (DipTrans) in 40 different language combinations leading to membership, maintains a specialist register for commerce and serves as a forum for all types of linguists. Its bi-monthly journal is called The Linguist.

    • Centre for Translation Studies, Dept. of Linguistic and International Studies, University of Surrey, Guildford, Surrey GU2 1XH.

    • European Medical Association, place de Jamblinne de Meux 12, 1040 Brussels. The EMA runs a course in medical translation and maintains a database of medical translators.

    • ComitÑ d'Ñtudes des termes mÑdicaux franÑais, 8, rue RoquÑpine, 75008 Paris.

    • Eurodicautom automatic internet wordfinder: Some companies specializing in biomedical translation

    • Always consult SL/TL Yellow Pages under ‘Translation Agencies'.

    • In the UK, RWS Translations, Gerrards Cross, Bucks SL9 8BQ. Tel. (01753) 887241.

    • In Germany, mpÑ (medizinische-pharmazeutische Ñbersetzungen GmbH), RÑlanderweg 11, 89075 Ulm. Tel. (07 31) 9 54 95-50

    • In France, Kraus Biomedical, 70 rue Jean-JaurÑs, 92800 Puteaux. Tel. 01 47 68 12 75. RFS Consultancy, 9 citÑ du Petit Thouars, 75003 Paris. Tel. 01 42 74 11

    • Communications directors of pharmaceutical companies, transnational bodies (W.H.O., Council of Europe, European Patent Office, UNESCO, etc.) especially if you have non-European langauges (Mandarin, Japanese, Arabic), although most large firms will have in-house translators, checkers and editors. French, though relatively unimportant in population terms, is still an official language in many institutions.


    • A list of useful addresses and further reading accompanies the web version of this article.


    View Abstract