To a U.S. editor, the words" Glorious Hunchback" in the middle of a medical report leap off the page as few other word combinations have the power to do.  I believe that a hunchback could possibly be considered glorious in India, (such is the level of a U.S. MT's understanding of life in India), but what could this possibly have to do with a medical report?  I read on.  "The patient was attacked by a glorious hunchback while unloading her groceries."  This could be a plausible statement.  The word hunchback, I can only assume, may be used more in India than the word which sounds very much like it; hatchback. This was; however, a report generated in the U.S. and "hunchback" does not impart the same level of medical language professionalism as "kyphosis". Still, we all know that some doctors have been known to lapse into shall we say colloquialisms from time to time.  I listened closely to the dictation and read along with the report.  "Gloria was unloading her groceries from her hatchback when the hatch fell on her".  Even though there are hatchback cars in India, they aren't called that, so the term hatchback was a foreign one to the Indian MT.
 
I call this kind of blank filling "fitting a square peg in a round hole."  It's making something fit that doesn't exactly, but sort of fits syllabically.  Let's take this example.  The patient was injured while fixing the pump on his waterhole.  Why on earth would a patient fix a pump on a waterhole?  What is a waterhole?  If it's where drinking water comes from, that is a well.  If it is a puddle resulting from a rainstorm, then it's a...well it's a puddle.  In this case the patient had in fact been fixing a pump. The water pump on his motorhome.  Listen to the sounds:  wa-ter-hole... mo-tor-home - it fits syllabically.  It was the only thing that sounded remotely like anything in the transcriptionist's realm of experience that would work, so waterhole was chosen.  There are now more than a few MT's wondering, "What is a motorhome' and is it the same thing as a mobile home?"

Another example of this type of interpolation error would be:  "The patient's mother said he suffered a seizure while shopping and chasing pennies."  This has the possibility of actually having happened, but still, chasing pennies is an odd phrase.  It could be a game played by unruly kids in stores, but pennies don't generally move of their own accord.  They lie still and wait for someone, generally a youngster who is more in tune with ground level, to simply pick them up.  Closer inspection reveals that, "The patient's mother said he suffered a seizure while shopping at J. C. Penneys."  An Indian MT is no more likely to be familiar with the name of J.C. Penneys, (a department store) than a U.S. MT would be familiar with "Nilgiris".  Although our reference material available on the Web makes it easier to look things like this up, you'd still have to know it was a store first.
 
How do we pass on a lifetime of experiences to our Indian partners?  Through experience and feedback, obviously.  Through exposure.  It is no less odd for me to read in an Indian English language newspaper that "Dacoits abscond with reliquary worth Rs 1 crore".  There are maybe three words I truly understand in this sentence, but it is in English.  Not American English, to be sure, but still English.  What's a Dacoit?  (a bandit) What on earth are Rs 1 crore?  (10 million rupees).  This understanding of different forms of English, or the lack thereof, goes both ways.  Every Indian knows what these words mean, but I had to learn them by asking.