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When Only Family Is Available to Interpret. When caring for patients and families who do not speak English, medical interpreters are necessary. Sometimes, our patients' families speak languages or dialects for which no in-person or video or phone interpreter can be found. If a family member is bilingual, the members of the medical team must make a difficult choice. Is it better to use a family member as translator or to not be able to communicate at all? In this article, we present the case of a critically ill patient with complicated pathophysiology whose family speaks a rare Guatemalan dialect for which no medical interpreters can be identified.