Spanish at the dairy

The cows they are many, the workers are few

Spanish is spoken by all of the crew

I just love a caper

With records on paper

The time in the morning just flew.


Synopsis: I’m a Family Practitioner from Sioux City, Iowa. In 2010 I danced back from the brink of burnout, and honoring a 1 year non-compete clause, traveled and worked in out-of-the-way places in Alaska, Nebraska, Iowa, and New Zealand. After three years working with a Community Health Center, I went back to adventures in temporary positions until they have an Electronic Medical Record (EMR) system I can get along with. A winter in Nome, Alaska, assignments in rural Iowa, a summer with a bike tour in Michigan, and Urgent Care in suburban Pennsylvania stretched into the fall. Since last winter I’ve worked in Alaska and western Nebraska, and taken time to deal with my wife’s (benign) brain tumor. After a moose hunt in Canada, I am back on the job in western Iowa. Any identifiable patient information has been included with permission.

Yesterday morning my first email asked me if I would mind going to do dairy workplace physicals. I would get two nurses, records would be on paper, and business would be conducted in Spanish. I asked how much I’d have to pay; the clinic manager laughed.

I saw a win-win-win situation.

This morning I checked Googlemaps and put the address into my GPS. I didn’t think anything amiss until she had me turn right at the edge of town.  Which didn’t quite look like what the map had shown.  I followed the electronically feminine voice until she told me I’d arrived at my destination.

I looked around at a plum thicket, some pasture land, and a grain bin. Definitely not a workplace.

The first person I passed, a trapper throwing a muskrat into his truck, shook his head, and gave me some convoluted directions. As I made the first indicated turn, I hailed another driver approaching.  He got out of his pick up when I asked directions.  He shook his head, too, and then he laughed, and asked me if I’d used a GPS.  I had to admit I had.  Such electronics, he said, don’t work on country roads, and he’d seen plenty of others, including semi drivers delivering goods, make the same mistake.  From his economy of delivery, I could tell the directions he gave had been given dozens of times before.

Three miles later, I got onto pavement, then back onto a dirt road, and arrived at the dairy.

The two nurses preceded me. Halfway through set up, we discovered we didn’t have disposable paper to cover the conference table to turn it into an exam table and we had to phone for a roll.  But I ran through the questions with the first patient, and started the exam.

The learning curve lasted 3 patients, then we fell into a rhythm.

Eighty percent of the physical abnormalities occurred in the head and neck, several serious enough to require follow-up. Not surprisingly, like most American patient populations, I dispensed a lot of advice on binge drinking, tobacco cessation, and dietary restraint.  But every dairy worker gets an enormous amount of exercise, and I didn’t tell anyone to get more.

About half the people came from Guatemala, half from Mexico. We had a good time talking about Mexican cooking.

I learned that the dairy milks more than 3,000 cows twice daily and that the milk gets hauled less than two hours.

When I asked what work they’d done before coming to Iowa, I got surprises. At least two (who gave me permission to write this) finished veterinary school in Mexico.  I didn’t understand what they told me about licensing (after all, I’m 20 months into trying to get a Canada license and I couldn’t explain what I’d learned in less than an hour), but I found out that the three most common diseases they see are pneumonia, mastitis, and laminitis, a problem with the hooves.  Others had university degrees in other areas of expertise, and all wanted to learn English.

I recommended Rosetta Stone.

We finished 15 complete physicals by noon. I lunched at the restaurant the workers recommended.

I make better enchiladas.



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