Though ordinary on the outside, this trailer is not used for ordinary purposes.
Inside are a small waiting room, two examination rooms and a humble office filled with patient files, a desk and two chairs. This trailer is the home to the Backstretch Health Clinic (BHC), a free clinic for backstretch workers run by Saratoga Hospital with a rotation of five doctors who come in Monday through Friday during the height of racing season.
Last year, the clinic saw a total of 750 patients and have a goal of treating 800 this season. Though it has only been open for six weeks, the health clinic has already seen 380 patients and with doctors seeing patients until October, they are well on their way to meeting the goal.
Doctors at the BHC act as primary physicians for the workers, becoming familiar with them and their illnesses, giving patients routine checkups, running blood work and lab tests and treating any acute illnesses or injuries. The doctors create a friendly, inviting atmosphere to patients, joking with them and hugging them as they come in for their appointments.
“We do whatever we need to do for them,” said Dr. Alex Cardiel, medical director of the clinic. “We function as their primary doctors and try to manage chronic problems, anything that comes up acutely, keep them up to date with their medicines and give out immunizations on Mondays.”
On extreme days, Cardiel has seen up to 27 patients in the four hours the clinic is open, though he said on an average day about 14 to 15 patients are seen. Each patient is different—some visits are short, while some can be much longer when trying to explain test results or understanding the patient’s symptoms better.
Much of the backstretch workers are from South America, a majority being from Mexico, Cardiel said. Though most of the doctors at the clinic are bilingual, sometimes symptoms can still be lost in translation as certain illnesses or diseases are explained differently in different cultures.
For instance, when patients come in complaining that their head hurts, they will use the Spanish word “cerebro” for cerebrum. Doctors have to interpret that symptom into what it really means: the patient either has severe headache or neck strains from stress, Cardiel said. He also added that many workers come from villages where the only doctor is a medicine man—the closest thing to that in America is a chiropractor.
The range of illnesses the clinic treats varies, and Cardiel said patients often come in much sicker than they realize.
“Some of them don’t know how sick they are and they’re walking time bombs,” Cardiel said. “There are a lot of people who come in with diabetes and hypertension that are unmanaged, which in the short run can be disastrous—for example, if your diabetes is not controlled, you can even go blind.”
Doctors at the BHC have saved lives many times, in many ways; they’ve picked up on cancers that patients were unaware they had, diagnosed workers with diseases such as lupus and liver problems, and every now and then even conduct operations such as appendectomies at Saratoga Hospital.
Noting how hardworking backstretch employees are, Cardiel said their dedication to their jobs can actually hurt their health when they refuse to take off work for their illnesses.
“Many of them need this money very badly and a lot of workers send remittances to their families in their home countries,” Cardiel explained. “They depend on this work to support their families, so it’s very important to them to keep working. One patient has problems with his liver, and he just won’t stop working because he has to earn this money for his family.”
Though workers don’t always follow doctors’ orders to rest, Cardiel said they are all very appreciative and thankful for the work the clinic does for them.
“You do the most you can with the least that you have,” Cardiel said. “It’s not always easy, and we often depend on our colleagues for help, but we try to do as much as we can.”
The clinic is offering its annual free health fair at the backstretch August 6 to help workers learn more about preventative health care. To learn more about the BHC or Backstretch Employee Service Team, visit www.bestbackstretch.com.