Thursday, October 20, 2011

A night at the General Hospital

At around 7:30 p.m came the call, just as Stew and I were ready to have dinner. Félix, our gardener/handiman/watchman, wanted to redeem my offer to take his wife, who is eight months pregnant, to the hospital if an emergency came up. She'd been having pains since that morning and had not been able to reach the doctor at a nearby health clinic.

Not the most articulate guy even when he's calm, Félix now sounded like he was speaking in Morse code.

Félix lives in Sosnavar, which he calls un pueblito, "a little town," five minutes from our house. It has only about a thousand residents, most of them straddling the line between poverty and misery.

At night Sosnavar becomes a true terra incognita to outsiders when they discover there isn't a single inch of paved street or sidewalk, much less street signs, and only a half-dozen street lights. Ruts weave around rocks and trees and lead you to an open space which must have been set aside for a town square that never materialized.

Towering over Sosnavar, quite incongruously considering the surrounding penury, is the white dome of the Catholic church, with a cross at the very top that is lit up at night. We can see the dome from our kitchen window.

So intent was I in avoiding trees or rocks on the way to his house that I missed Félix, his wife Ysela and two-year-old Alondra standing in a dark corner waiting for me, and I had to drive back.

Not wanting to retrace my way through Sosnavar's Martian landscape, back to the main road, I just gave Félix the keys, asked Ysela to sit in front, and Alondra to come on the back seat with me. This was the start of a three-hour, first-hand glimpse of Mexico's public health system and the serpentine logic and traditions that guide reproductive decisions by poor Mexican families.

San Miguel's General Hospital was built by the state government about three years ago. It is impressive. I had been there twice before, once to get Stew an X-ray of his foot and on another occasion emergency care for a gringa who lived in our condo complex and had taken a bad mix of prescription drugs. The attention was prompt and professional, with shiny, fresh-out-of-the-box medical machinery  standing at the ready, including a CAT-scanner. No problemas except the staff was unable or not in the mood to even mumble a single word of English.

By now, signs of wear-and-tear, and general weariness, already permeate the waiting area of the combination outpatient clinic-emergency room where people wait, and wait, to be seen by a doctor. It has the glum ambiance of a bus station with no definite arrival or departure times.

There was no waiting for Félix' wife. Pregnant women feeling pains and other people with ominous symptoms are escorted immediately into the emergency room through a pair of glass doors guarded by a couple of short but imposing female guards in uniform with nightsticks dangling from their belts.

Félix, Alondrita and I now just had to wait for one of the guards to announce Ysela would either be admitted to the hospital or for her to walk out on her own and go home.

Alondrita readily killed time with some giggly playing and running with a boy her age whose parents, along with dozens other people in the courtyard in front of the hospital, also waited for word from one of the guards.

Chit-chatting with Félix for hours can be challenging. He's not one to have an opinion about the Republican presidential primary or climate change. I once tried to explain the Irish potato famine and he just looked at me politely but blankly.

He's a very bright guy; it's just that he and I look at the kaleidoscope of daily living from different ends. Of necessity his perspective is one of day-to-day survival.

So he told me about Ysela's first and rather complicated pregnancy. It turns out she has epilepsy and high blood pressure and Alondra had to be delivered by emergency Caesarean section at a government hospital in Irapuato, a mid-size city about two hours from San Miguel. Ysela was hospitalized for eight days during which Félix sat and slept on the benches in the emergency room.  


This time around Félix and Ysela, aware of the potential medical complications, frequently visit either a small clinic in Corralejo, a Sosnavar-size town a couple of miles away, a doctor in San Miguel, or in this case the general hospital. 


Félix clearly worries about his wife, enough to ask his boss for a ride to the hospital at 7:30 on a Monday night, but he seldom has shown any emotion to me. At age 25, he seems to have the impassiveness, stoicism--or resignation--of someone twice his age. 


The only time I've seen Félix choke up was when Stew found Chupitos, his favorite dog, dead on a field across from our land. They had to load the mangled carcass on a wheelbarrow, cover it with a black garbage bag, and wait for a backhoe to come and dig a grave. Félix was visibly shaken. 


After a couple of nervous pauses, Félix talked about the size of Mexican families, and who-had-how-many-kids. Take the case of Lucía, a Sosnavar woman with 74 grandchildren. That's 7-4, or seventy-four. He calmly explained that Lucía, one of his father's sisters-in-law, had, hmm, 12 or 13 children, so given the laws of addition and multiplication, 74 was not a number that difficult to fathom.

Last weekend too, some woman in Félix' vast cobweb of a family had buried a seven-month fetus, her second still-birth in as many years. The woman already had six daughters and a boy, but she and her husband insist on having another boy. Both of the dead babies were boys, Félix pointed out, suggesting I don't know exactly what. That she continue to get pregnant until a baby boy survives?

On the next breath, Félix mentions that none of his brothers has a job at the moment, despite several children to support.

I fight the impulse to ask questions, much less preach, as I listen to these Sosnavar family tales. How can someone living on the edge, if not chest-deep, in poverty end up with 74 grandchildren? Why doesn't the couple with seven children, and two consecutive still-births, just quit? And by the way, after Ysela has this one baby, shouldn't she quit too, given her potential complications arising from her history of blood pressure and epilepsy? I'm not a doctor, but hers could be considered high-risk pregnancies.

But out of respect for Félix' privacy I don't ask. He's one of the most thoughtful and decent guys I've ever run across, capable of making his own decisions. Besides, as a childless gay man I feel singularly ill-qualified to pass judgment on questions of who-should-have-how-many-children-when, specially in a foreign land with its own cultural mores and customs.

Beginning in the 1970s Mexico has had an aggressive birth-control campaign that has drastically reduced the national birth rate to a level comparable to that of the U.S. But those macro statistics haven't necessarily filtered down to the level of pueblitos like Sosnavar. Indeed, Félix noted that birth control information, pills and condoms are readily available at the small clinic in neighboring Corralejo, but some people don't want to deal with any of it.

For one thing, given the paucity of pensions among the poor, having a sizable brood is one way of ensuring someone takes care of you when you get old.

The night air cooled rapidly and I moved into the waiting room.

On the way in I noticed a rickety man in his 60s with a mangy beard, hunched over on the floor holding his head between his knees. I recognized him as Don José--I never got his last name--whom we had hired to plant the first dozen trees on our property before construction began. I remembered he had a slick line of bullshit and a major drinking problem and that one day he just disappeared. Most of the trees he planted died as their roots strangled themselves because Don José had not dug holes large enough.

I didn't last very long in the waiting room when I realized it was a cauldron of germs with wheezing and sneezing all around me, and noticed a man sitting next to me holding a colostomy bag.

Finally Ysela came out through the glass doors, still holding her belly but now with a faint smile on her face. She handed Félix the prescription and he ran next door to the pharmacy to fill it, also at no cost to him.

The diagnosis was cystitis, an inflammation of the bladder usually caused by a bacterial infection. The prescriptions were for an antibiotic, an anti-spasm medication of some sort, and generic Advil. The day after she was feeling much better.

As we headed back to the truck, Félix pointed out that Don José had moved, or someone had moved him, and was now lying just outside the waiting room, covered with a blanket and sound asleep.

We all climbed in the truck. Tired from a long night of playing, Alondrita huddled close to me on the back seat and immediately fell asleep, and we headed back to Sosnavar.  




2 comments:

  1. Nice culture post.
    You hit some button issues that are common here in Ohio. Having children when it is not wise is not just a poverty thing. I have a good friend who is a doctor, he and his wife had a child that was not right after they had had two normal children. Instead of calling it a day, these two had two more that were not right. The last one is so bad, he has to be kept in a cage or he will hurt himself or someone else.
    Hang on to Felix, he sounds like a keeper.

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  2. I felt a little queasy dealing with this subject of family size etc. I can't think of anything more personal, particularly since culture has so much to do with it. I agree that Felix is definitely a keeper; hell of a nice guy.

    al lanier

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