Aphasia results in numerous communicative barriers for patients and conversational partners, which are heightened in a cross-cultural context. In an interaction in which multiple communication barriers exist, participants must successfully negotiate mutual understanding and manage layers of breakdown. This paper explores the notion of cultural brokerage in an interpreter-mediated clinical interaction in the context of aphasia. It presents a methodology which appears to be a successful way of examining the complex interactional dynamics of a cross-cultural and cross-linguistic medical interaction. It also presents some suggestions for training health professionals who work with interpreters as well as ways in which we can maximize an understanding of the patient’s lifeworld.