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Hello, this is Elizabeth Ralston, I am a consultant working in the accessibility and public health space, and I am a white woman with silver hair, sitting on a couch with a beige wall behind me and a green plant in the corner and wearing a blue shirt with geometric patterns on it. And I'm here today to talk with Patty Liang about the challenges that deaf people face during this pandemic, especially with mask wearing.

Hello there, my name is Patty Liang. This is my sign name. I'm an Asian woman with brunette hair, shoulder length, I'm wearing a blue button up shirt. And I have a teal background and glasses

Welcome, Patty I'm so glad to be talking with you today. So my question to you is, what have been your challenges as a person who signs, when you are out and about in public?

Sure, I think we need to recognize that everybody is going through the pandemic and it's a difficult time. People are struggling. And we need to show, patience, understanding and compassion. As a deaf person. I use vision to navigate. You know, see people's facial expressions and what not to know - if they're friendly or, you know, something else that day, when we're wearing masks we're hiding about half of our face so a lot of that visual information is lost. And it's exhausting, physically exhausting, to try and navigate people in public. When you can't really interact fully. When we can't really communicate we can't really see what they want, etc.

And of course, I enjoy getting out and doing things in the community, going to the store the park, etc. But it feels like I have to be more careful. It's not, there's like an increased level of stress to navigate public settings. And I know that we're all navigating that, but thinking about - did people wash their hands? Did I wash my hands? Staying healthy to survive, basically.

How about you, Elizabeth?

No, I agree with you I think is very challenging, because you don't know what to expect when you go out and you meet someone who has a mask, and you need something from that person. And you have to explain, over and over again, what your communication needs are. And for me, as a reader. I function very similarly to you and I rely on facial cues as well. Well, I read lips, but seeing the whole face really makes a big difference. Like you said, if someone is friendly or if someone is going to be helpful, or if they are going to be impatient - you kind of get a real quick sense of what a person is right when you first interact with them. So when I go to the grocery store it’s particularly challenging. You know, because the cashier is always talking to me. And so I have to be creative. And that's one thing I've learned is to be very creative thinking on my feet. Yes, it’s tiring.

But at the same time, I find that if I listen more my hearing, it's actually getting better, in some ways, because I have cochlear implants. And this is really good for my listening skills and I never anticipated that would happen. So that's been sort of a plus for me. And I also use a lot of technology. When I interact with people, for example I use automated speech recognition on my phone. And that seems to work really well. What are some strategies that you use when you try to communicate with people.

Sure. For me, if I'm around other people. Let's say, I go to a restaurant or a grocery store, I have my phone on hand. And I have specific apps that I use. Big note is one of them. Another one that I use is Cardzilla. And some people have speech or like you said speech recognition. They have Siri or speech recognition software or they could text back and forth. I know before I go into the store, I prepare myself with a list of what I need to get for communication purposes, I might have this like go to list. I'm deaf. Can we use a pen and paper? Can we text back and forth using our phones? And if there is glass like a window, we could communicate through. You know, we can't really interact, the way that we did before COVID. So I end up having to show them my screen and whatnot.

And it's important that I need to be up front with my needs in that interaction and that they understand why that's important. I'm not going to hear them. So they're wearing a mask, I'm not even being able to identify that they're talking necessarily, so facial expressions are going to be obscured as well. Paper and pen on hand if my phone isn’t working in that scenario. I keep a paper and pen in my car, in my backpack, just have it ready to go if I need it as a tool. And I'm a strong self advocate for what my needs are. What I need to communicate with other people. Elizabeth, do you have other examples that you'd like to share?

Yeah, I was talking to a friend of mine, about strategies, and she was saying if you plan well in advance, do some advance planning so that you can anticipate any challenges or obstacles that you might run into. And another person was saying that the pick up, drive thru, and pick up groceries or any other items is really a great way to have to avoid to go into the store and interact with people. And all you have to do is just put a piece of paper up, or use your Big note and your phone and write your name and they'll go and get your stuff. So that's been working really well, and I never have to ask anyone to take their mask down. Have you had to do that? Have you asked anyone to take their mask down when you are trying to communicate? Has that ever happened?

I have not. I understand people's concern about health and safety and health and safety for all. Masks are just a temporary thing, we're not going to be doing this forever. And who knows what the future looks like but it's temporary, we're all going to survive this. That's the goal. We all want to be able to survive this. Hospitals are overwhelmed, too many patients, people are getting sick daily. So I want to consider my safety as well as their safety. So I utilize text, you know paper and pen to communicate. And let me think, is there anything else you'd like to add to that list?

Yeah, there’s one more thing. Only if I'm outside. If I see somebody I know, like a neighbor or something and they want to talk to me but they have a mask. Then they remove the mask and as long as we are social distancing, and I can use my laser focus eyesight, which is not so good these days. But that really helps in terms of explaining to people, please stay at least six feet or more away, and that we can communicate outside, but not inside.

So let's talk about the healthcare setting. Have you had experiences, I'm thinking, have you had experiences in the healthcare setting when you've had to talk to doctors or anybody to try and get the healthcare that you needed? And if not you personally, what stories have you heard of other people who may have experienced challenges going into the healthcare system?

Sure. I think it's important to have a game plan in advance before you go into a healthcare setting, talk with friends and family about your communication plan.

And if something were to happen, have a contact plan for who to contact if you go into the hospital with COVID-19 following those safety protocols. You won't have a lot of people interactions. People won't be interacting, they’ll be masked. They might be wearing other safety equipment. So you have to be a really strong self advocate. Know your rights in the medical setting. And also have something ready in print that says your name, that you’re Deaf, DeafBlind, Hard of Hearing, your preferred communication mode. And your emergency contact information. Because they may not have something available in the hospital so you need to bring that information with you, have that resource ready. And bring an emergency bag with you, something to read, your phone charger, laptop charger. Anything you feel you might need but you won't be able to leave and pick up. If there are apps that you have been intending to load to your phone, go ahead and do that and test them out before you go to the hospital and have a paper and pen, you know, that low tech option.

Staff will be overwhelmed with patients and knowing that going in, you know, it's an emergency situation. And there's isolation too that you need to consider. So be prepared, have that information ready as you go in the door, and your health is important. And you may have to advocate for VRI- virtual interpreter. If they have that option to provide you. Oftentimes we don't know before we go in, but we can prepare, we can call ahead and ask questions, research before you go into that healthcare setting, know what the local supports are for COVID-19 protocols, practice them.

Elizabeth?

You are really prepared, those are great examples. I wanted to include a couple others. I think that requesting clear mask is very, very important. And I feel strongly that all doctor’s offices, hospital settings need to have clear masks. Because for those of us who rely on facial cues, so important. And this is something that I'm going to continue to advocate for. Another tool that a friend was telling me about was using dry erase boards. You know, the small ones that you can just carry with you and you can use those to write and hold up to someone, so it’s easier maybe then pen and paper. Pen and paper are great. But these are tactics that will help someone if they have to stand far away, and communicate with you. So I thought that was an interesting solution. And also, I think, first, it's easy to get frustrated with someone who doesn't really understand your needs. And I've been practicing, taking deep breaths and just kind of grounding myself in. Okay, this is temporary. They’re overworked, everyone's scared. They don't understand sometimes, and kind of give people the benefit of the doubt. I know that's easier said than done. But the more we prepare and the more we self-advocate and explain to people what our needs are calmly and carefully. And also, bring an advocate with you, if you can, like a family member who has hearing, a family member who is sighted or a friend, or someone in your path that could help advocate for you is another solution. Anything else about healthcare settings and also not just about healthcare settings but also businesses that if you want to get some coffee. Or if you want to order some food. Are there any other strategies you can think of?

Sure. So I'd like to emphasize, let's see, I've had the number here. Let's go to share one second. Oh okay, the National Center for Health Statistics - NCHS. They estimate that 28 million Americans - about 10% of the population - have different degrees of hearing loss, some degree of hearing loss, it's a range, and about 2 million are identified as deaf. So it doesn't matter if they sign, lip read, whatever, deaf. And to consider that. So many people out in the world on their journeys, some sign, some read lips, some do not. We need to prepare for all of those people. Some people are just not going to hear well, if you're talking. It is okay to be flexible and try and navigate that the best you can. I think the number one thing is each time you go in as a patient, what's your communication mode? What do you want to do as far as communication, what do you need there? And then things from there can work themselves out but if you don't set up that communication mode, it's tricky and you'll have further complications.

Speaking about eating out at restaurants and so forth get, getting pickup. Take out. I am so happy that we have the internet and being able to make that pivot, you know, different restaurants have provided that pivot, providing food service in this day and age, being able to order online. We are so lucky to be able to do that. Order takeout, we can order it delivered, whatever it is, Google Maps, you can see when your food has arrived. More and more drivers and businesses are happy to text, which is not something they did before. So we're able to communicate that way. I've had friends try and hang up on me or hang up on me when I call through the video relay service so having text options is pretty great. And I don't really order coffee. I'm a tea drinker these days, but there is an app that I use for that when I order tea. If I'm in the line, you know and it's a long line. A lot of restaurants follow Washington State protocols. Maybe they're closed, but you can stand and order food or order food online and then go pick it up and leave. So it's good for business that we have all those options.

I'm actually a tea drinker too. It's been a long time since I met anyone who was only a tea drinker. So, yay. Um, yes, I think the bottom line is that there are so many different communication needs. And if you think outside of the hearing loss disability, there are so many invisible disabilities that have their own way of communicating and their own way of dealing with them. So, having the strength and the fortitude to communicate with people what your needs are, is very important.

I also want to say that. Another thing to remember is to if you have any hearing device like a hearing aid or cochlear implant, to bring batteries with you wherever you go. I know, this is easier said than done, but I'm constantly forgetting my batteries. Just before we started this interview my battery was going dead. So I had to run upstairs and get a battery, so always have them on you, really important.

Patty, this was an amazing conversation, and I feel like we have so much in common, and yet we have different ways of handling communication strategies. But can you imagine what life would have been like 20, 30 years ago, before the internet and the pandemic hit? Where would we be? So I feel like we are really lucky in some ways to be living in such an advanced time of technology so make sure that you take advantage of whatever technology is out there, because it really is helpful. So thank you so much for your time and energy and we're happy to get the word out about how we can all stay safe and sane during this time. Thank you.

Sure thing. Thank you, Elizabeth, for the opportunity to share my story. Bye now, mask up please!