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Doing Something Different- Adventures of an Itinerant Speech-Pathologist
by Jacquie Frerichs
Reprinted with permission from MASHA News, January/February 2001

Jacquie Frerichs

Adventures as a Itinerant Speech-Pathologist

Jacquie Frerichs spent a number of years working as an itinerant Speech Pathologist in southwestern Minnesota In this demanding role, she routinely drove 2,000 miles a month, visiting clients in small towns across her region. She reminisces about her experiences and her continuing excitement about her work.

About 13 years ago I went back to school to study communication disorders. After 20 years as a piano teacher and church organist, I was interested in doing something different. Although the three years of commuting from Worthington to Mankato were long, going back to school was invigorating. A new chapter in my life gradually emerged.

Where the rubber meets the road

Jackson County, Minnesota

Following graduation in 1993, I began my adventures as an itinerant speech pathologist for Habilitative Services, Inc. a locally-owned company based in Windom, MN. We had contracts with hospitals, nursing homes, group homes, developmental achievement centers, and home health agencies in many small towns dotting the prairie.

I learned so much those first few years. Topics which I understood theoretically now arrived at the rubber meets the road stage. Selecting vocabulary for and programming a Touch Talker? And worse yet, completing the paperwork for prior authorization for a trial period and then a purchase? Doing video swallow studies? I was just lucky if I didn't get lost driving from one little unknown village to the next. In fact, I did get turned around while taking a shortcut from one Western Minnesota town to another. I realized it only when I passed a sign reading, "Welcome to Minnesota." Yes, my territory was very close to South Dakota.

During those first years, I relied heavily on friends in the field. I was not too proud to make yet another phone call. My memory was challenged with so many different staff and patients seen on a weekly basis. It was interesting to notice how each facility had its own distinctive character. In addition, each had their own system with forms I needed to complete, staff I needed to inform, etc. I became skillful at sensing where the 3-whole punch was kept at various nurses' stations.

Typical morning

Winter in Minnesota

On a typical morning I would load my car with all the files and supplies needed for the day: my map, car phone, lunch, schedule, and winter survival kit from October through April and headout. Most months I drove 2000 miles or more. I monitored the weather forecast religiously. I discovered that driving across the prairie, often with no other cars in sight, was a calm time for thinking about patients or listening to tapes. I think it would be safe to say that I was the only driver between Windom and Jeffers listening to Dr. Arnold Aronson's wonderful tape-Dysathria: Differential Diagnosis. At other times, the driving seemed endless, and I wondered why I was doing "this crazy job".

I stuck with it for the patients

The patients were an important reason why I stuck with it. Many of them I would see in their homes after they had returned from rehabilitation programs in a metropolitan area. They graciously and gratefully, or sometimes skeptically, invited me into their homes, entrusting me with the pain and dismay they felt with their loss of language, speech or swallowing capabilities. Many times their return home startled them and their families with the reality of their disability.

I was touched by their trust and honesty. Sometimes their spouses became co-therapists; reminding, encouraging, thickening those liquids. And, of course, some homes were unpleasant, even painful, to visit. In those instances, I looked forward to the date when it would be reasonable to discontinue therapy.

Some situations were just plain unique. For instance, one summer I had two clients on my caseload who were both living with their wives in the same campground. Invariably, I would get disoriented driving through the maze of campers. Then I would spot a site with a myriad of pinwheels blowing to beat the band in the prairie breeze. One of my clients lived there. He would be standing out by the narrow road, grinning and flagging me down. We did aphasia therapy out at the picnic table. I still remember his wife's low chuckle. What delightful memories!

Switch to the school setting

Jackson County Central High School, Minnesota

Several years ago, I decided to switch to the school setting. I work for Jackson County Central Public Schools now. My caseload includes all ages in four different school, but I never have more than 40 students at one time. Now and then, I long for the autonomy of my other job, the freedom to pull over and pick Queen Anne's Lace at 2 in the afternoon while racing to the next little town. But I am spending much more time doing my work now instead of driving. And I appreciate the stability of working in the schools and not having to worry that my caseload is taking a dangerous dip.

I miss sitting around the dining room table, hearing stories about what it was like being in New Guinea during World War II. But I love the eagerness and freshness of the children who are just realizing that "cat" starts with a /k/ and not a /t/ sound. I still do some work for my previous employer to a limited extent. Since SLPs remain scarce in this part of the state, I have the best of both worlds.

Occasionally some of the teachers I work with wonder aloud how I can cope with taxiing from school to school. Little do they know!

Email Jacquie Frerichs at: frerichs@rconnect.com