THE SCREAM was like nothing Eddie Welsh had ever heard.
It was early one day in 2007 and Welsh, a nursing student, had just begun his shift at the university hospital where he was training on the high-risk obstetrics unit.
He'd heard screams of pain and grief before, commonplace in a medical setting. They had their own sound.
But this wild bellow - equal parts panic, terror and bewilderment - was out of the ordinary. It ricocheted down the hallway from the room of a very young, pregnant patient who was deaf.
"I rush in there, and she's surrounded by doctors," Welsh recalls. "They were trying to tell her there was an emergency with her baby. They had to get her to the OR right away for a C-section or the baby would die."
But the staff didn't know sign language. She couldn't read lips. There was no time to explain things in writing or wait for an interpreter. They had only minutes to save the baby's life.
"She didn't know what was happening. She couldn't even give consent. I will never forget the look in her eyes. I've never seen anybody so scared in my life."
The staff rushed her to the OR and delivered her healthy child. The mom was glad, later, that the doctors did what they had to do.
But Welsh couldn't forget the emotional trauma she'd endured.
"It bothered me so much," says Welsh, 47 (who prefers not to name the medical center where the incident occurred; he is currently a nurse at Aria Health Frankford Hospital). "How can it be that we have the technology to send people to the moon, but we can't communicate with someone having a baby in an emergency? It really got to me."
So he hit the Internet and learned that medical communication services for deaf and hard-of-hearing patients are shockingly inadequate in this country.
According to a statement from the National Association of the Deaf, health-care access is "routinely inaccessible" to deaf people due to communication and linguistic barriers.
That's the word they used - "routinely" - for 15 percent (about 37.5 million) of Americans aged 18 or older who report some trouble hearing.
"Most providers do not provide adequate communication access to ASL or any other sign language through qualified interpreters," the association says.
Complicating things is that not every deaf person has the same hearing level, communication style and/or language.
Some use ASL; some don't. Some can read lips, but their accuracy can be hampered by everything from the speaker's accent or facial hair to his or her use of confusing medical terms.
Even using the written word can be unreliable. ASL is not based on written or spoken English, so its syntax and grammatical structure are different from English. In fact, the association notes, "English is often a second language for many deaf people."
In medical situations, miscommunications can lead to missed diagnoses and treatment errors.
Ideally, hospitals would have staff ASL interpreters who are also trained in medical terminology. But that's rare, especially in smaller hospitals. The use of on-call interpreters is unreliable; patients can wait hours for one to arrive. While the Internet can allow patients and interpreters to communicate visually in real-time via smart tablets or phones, the services are costly and glitchy.
But even if they weren't, says Welsh, many patients feel marginalized by them.
"Deaf patients are like any other patients," he says. "They want one-on-one communication with someone in the flesh. It's demeaning to interact with a machine, especially in the middle of an emergency. There's no humanity."
There is now, thanks to Welsh and his wife, Laura Paynter Welsh, 32, who've found a way to help medical staff and deaf patients communicate in emergencies while both await the arrival of a real, live interpreter.
Their solution: Flash cards, basically, tailored to specific medical scenarios, collected by a key-ring or collected into a single, laminated booklet. The 4-inch-by-11-inch cards are grouped into categories like "anatomy," "signs & symptoms," "treatment," and the like. Each card shows common words and phrases depicted by images of their sign-language equivalents. In creating the cards, Eddie determined which medical or clinical terms were to be depicted; Laura, a professional illustrator, drew the images.
They now produce the cards through their company, called D.E.A.F.ecc. The acronym stands for "Deaf Emergency Access Form - Emergency Card Cards."
The benefit of such a simple tool is so obvious, it's hard to believe it didn't exist before the Welshes turned it into a thing. But their exhaustive patent search found nothing like it.
There are basic ASL-translation books, yes, but they contain every word and sign under the sun, making the dictionaries too cumbersome to use in a hurry.
"I couldn't believe this had never been done before," says Welsh.
The cards are not meant to replace a live interpreter, says Sharon Manning, vice president of marketing for the company, D.E.A.F.ecc, which has just three employees, including the Welshes.
"They're a stop-gap measure only," says Manning. "They help the staff begin assessment and treatment while everyone's waiting for an interpreter to arrive."
So why aren't these cards everywhere - like hospitals, ambulances, police cars, mental-health clinics, dental offices, addiction-treatment centers and the like?
If the Welshes have their way, they will be. But, like any entrepreneurs with a great idea, they are at a crossroads about to how to get them into the right hands.
Should they team with an investor? Partner with a medical publisher with mass-production capabilities and distribution channels? And how would they maintain quality control and hands-on involvement in what has been a labor of love for both of them?
"We've learned by the seat of our pants so far," says Eddie. "It's time to get the word out."
One hospital is already a big supporter: Erie County Medical Center, in Buffalo, N.Y.
Through a professional connection, Eddie met Sharon Hanson, executive director of nonprofit Deaf Access Services, a New York advocacy group. She was blown away by the booklets the Welshes had created.
"It was like manna from heaven!" she says. "A wonderful new way to get medical services to our clients. Until then, they'd always been asked to write what brought them to the hospital."
Hanson shared the booklets with Sandra Lauer, Erie County Medical Center's director of continuum of care. Within months, Erie's staff was trained in their use. The hospital even produced a commercial to advertise the communication breakthrough.
The response has been overwhelming, says Eddie.
In April, he and Laura were recognized as "Business Parters of the Year" by New York's Deaf Access Services. But that has been the tip of the iceberg.
"We're getting letters and emails from everyone" - EMS services, prison systems, deaf people and their families - "asking how to get the cards," he says.
Not everyone is a believer, though. Just read the skeptical comments beneath a video about the Welshes created by iDeafNews, an online news service .
"This is just another damn 'Band-Aid' for the ER, docs, staff, etc.," wrote Shirley Hortie Platt. "Forget it. Call a live interpreter - without delay or excuses."
Eddie Welsh gets it.
"Deaf people have been shunned for years," he says. "People have ignored them. I understand why they're fed up."
He'll keep at it, though. When he looks back on his life, he thinks the call to help came in the aftermath of the worst time of his life.
Born and raised in and around Frankford, he was an only child raised in an extended, chaotic family plagued by addiction and violence. When he was 13, his mother was killed by his father, an abuser with untreated mental illness.
"After that, I was on my own," says Eddie.
Homeless, he rode the El at night, slept on friends' sofas or in public parks until a friend's mother finally took him in, providing stability. He got a job at 16 working in a hospital dietary department -"I knew I had to earn money; no one was looking out for me," he says - and developed a fascination with the medical field.
Through it all, never missed a day of school.
"I knew it was the only way out," says Eddie. "I knew what was on the streets."
After a circuitous route through the working world, he studied nursing. Got his LPN, then his RN and fell in love with helping people in need.
"I believe I'm called to this," he says. "I feel like my upbringing prepared me to help people. I know what compassion and kindness mean. My life today is a blessing. I shouldn't have survived my childhood, so I really believe I'm here for a reason."
He wants to be of assistance. And he hopes that D.E.A.F.ecc will let him do it.
I hear you, I tell him.
I hope others will, too.