Adrian turned toward her. "The platform is designed to reduce the need for them. That's where much of the savings comes from."
"Reduce the need in which situations?"
"Appointments, check-in, consent forms. Routine interactions."
"Those aren't all the same kind of conversation," Marian said. "Asking someone to confirm a mailing address is different from explaining a medical decision."
A few people nodded. Adrian clicked to the next slide. "Naturally, complex cases will be escalated. We have safeguards."
Two days later, she visited South Quay Community Clinic, one of the three pilot sites. The building sat between a laundromat and a grocery store on a block where five languages could be heard before breakfast. Its waiting room was crowded with children, older patients, and workers still wearing uniforms from early shifts.
A receptionist named Nadine Brooks showed Marian how the new tablet worked. "It helps when someone needs directions," she said. "But sometimes it decides it understands a person before they finish talking."
At the counter, an elderly Hungarian woman was trying to explain something to the machine. The tablet translated her statement into English and displayed a green check mark. Nadine frowned.
"It says she doesn't want an interpreter," Nadine whispered. "But she keeps pointing at the interpreter sign."
Marian approached the woman and asked, in Hungarian, whether she would like someone to help her communicate with the clinic. Relief flooded the woman's face. Her name was Ilona Horvath, and she had been asking for a qualified interpreter since her first visit. The machine, she explained, kept presenting a sentence that made it sound as though she had declined assistance.
Marian translated the request for Nadine, who immediately arranged the clinic's existing telephone interpreting service. She did not try to handle the appointment herself. Years of language study had taught her how easily even a capable speaker could miss the precise meaning of an unfamiliar medical term.
"That's happened before," Nadine said after Ilona was seated. "With a few patients. We tell the vendor, and they say the update should fix it."
"Do you record the problem?"
"I write it in the shift notebook. Sometimes the tablet overwrites the old screen before I can show anyone."
At her kitchen table that night, Eleanor was mending the hem of a neighbor's dress. Surgery had restored much of her eyesight, although she still used a magnifying lamp for fine stitches. Marian set down her bag and began describing the clinic, stopping when she heard how angry she sounded.
"You thought this job would be about finding the right words," Eleanor observed.
"It is about words. That's the trouble. One sentence on a screen can make a person feel they no longer have a choice."
Eleanor removed a pin from the fabric. "When I couldn't see, people used to talk to you instead of me. They weren't always being cruel. Some thought they were helping. But I was sitting right there."
"I remember."
"Then don't let anyone confuse convenience with listening."