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Employing the theoretical foundations of conversation analysis, this dissertation examines the actions of patients with limited English ability who depend on family members to mediate their medical interaction. Analysis shows how patients seek immediate contact with their interlocutors despite limited English competencies. Using a variety of semiotic resources, non-English speaking patients are found to override the brokering process and construct their patienthood independently. The study discusses communicative competence, conversational commitment, asymmetries of participation, and decision-making in brokered medical encounters. It demonstrates the complexity of participation and decision-making in triadic interactions in the medial setting, in which roles of participation intersect and overlap in non-conventional ways. The dissertation's findings lay significant claims on novice communicative competence, brokered medical discourse, and doctor-non-English-speaking patient relationship. It also suggests future research direction and provides recommendation to improve interaction in cross-linguistic medical encounters.