Thursday, November 7, 2013

A pain in the pompis in any language

About the only downside of our marriage in Massachusetts was that Stew and I both got sick with what felt and sounded like serious respiratory infections. We gulped syrups and other cold remedies to no avail and were ready to try anything, including a stop at a pharmacy in the North Mexico City bus station—the last leg of our long trip home—that advertised the services of a doctor.

There was no doctor but a couple of smiling young women in white smocks asked a few questions and handed us bottles of antibiotics and in a small room behind the counter, told us to drop trou' for a shot of penicillin in each of our butts.

"¿En las nalgas?" I asked, using the Cuban word for "butt".

"Sí, pero en Mexico se dice 'pompis', " the nurse/clerk said helpfully, thus introducing me to the Mexican word for "butt" or "ass."

Bing, bang, and three-hundred or so pesos later for each treatment we were on our way. At least the storefront pharmacy had a dressing room-like cubbyhole in which to perform these interventions discreetly, away from the eyes of fellow bus travelers.

"I don't ever recall getting penicillin shots at a bus station," Stew said, though we both recalled getting them for any cold, or practically any ailment, when we were kids.

And so began our latest encounter with Mexican medical care, which for the most part has not been too reassuring. Stew has suffered through a botched carpal tunnel syndrome operation that left him in pain and with three numb fingers, in addition to a bungled diagnosis for a detached retina that sent us on a trip to Chicago for emergency eye surgery. Most recently a local orthopedic doctor told Stew he most likely needed a knee operation for a torn meniscus. A second opinion at a hospital in Texas showed there was nothing wrong with his knee except the onset of arthritis. Uh-oh.

As is usually the case in colonies of past-a-certain-age folks, sometimes referred to as geezers, talk of ailments and doctors to cure them consumes an inordinate amount of breath among expats in San Miguel. Social gatherings sometimes sound like a parking lot full of 50s Chevys, honking and sputtering about dimming headlights, leaky radiators or creaky ball joints.

In addition to symptomalogies and cures, in Mexico we also debate, sometimes heatedly, whether medical care here is worse, equal or perhaps even superior to that in the U.S.

Take our only local hospital the condition of which was until recently, appalling. After a visit to the emergency room a couple of years ago, U.S. Consul Ed Clancy told me he wouldn't take his cat there, never mind his wife or himself. Though I tend to agree with the honorable consul many gringos here swore it was a fine medical institution.

Fortunately a bigger hospital in nearby Queretaro recently took over the local facility and invested quite a bit in such novelties as a CAT scan and a recent-vintage X-ray machine, plus paint, new ceiling tiles and functioning light bulbs. Reportedly a good portion of the former medical and nursing staff also were placed in the dumpster. Things are looking up, along with the prices which although considerably higher than before are still much lower than in the U.S.

The day after we returned to San Miguel and my condition worsened, we went to an old-time clinic downtown called Our Lady of Health run by a trio of a father and his two sons, all of them doctors. The young ones were on vacation so I checked in with the paterfamilias.

He was a man I'd guess in his seventies, whose gentle countenance was beyond avuncular. His ancient consulting room, dimly lit and decorated with parchment-like diplomas and commendations, some faded by age and humidity, made you feel as if you'd entered a small museum.

He told me to sit on an examining bed that looked menacing until I realized there was no way my feet could fit in the two prominent stirrups. He whipped out an old-fashioned glass thermometer from a glass jar containing alcohol—no newfangled disposable or digital thermometers for this fellow—shook it vigorously to jostle the mercury, and stuck it under my tongue.

While we waited for the thermometer I glanced around the room and settled on a venerable ultrasound machine with a tiny screen, its keyboard covered with a piece of yellowed plastic sheeting and so old it couldn't possibly tell the difference between twins and kidney stones.

The doctor asked all sorts of questions and along the way talked about the difference between a horse cough (a "muermo" in Spanish) and "tos perruna," or canine hacking. I don't remember which one described my cough. The consultation came down to another prescription for antibiotics and another shot of penicillin right in the old pompis with instructions to return the next day for a second dose.

He wasn't in the following day, but the receptionist helpfully grabbed a syringe, loaded it with penicillin and told me to go in the back room and drop trou' yet again.

Bing, bang, fifty pesos for the second shot or approximately four-and-a-half dollars. By this time Stew had decided he was feeling much better, thank you, and no more shots in the pompis for him.

Just about that time we saw a PBS' "Frontline" documentary about the overuse of antibiotics and the consequent appearance of "super bugs" that don't respond to any known treatments. An excellent but unsettling show, my gut and pompis at the time being filled with penicillin, amoxicillin and what-have-you.

Take one and call me for another one. 
Indeed, several years ago the Mexican government passed a law requiring a doctor's prescription for all antibiotics to prevent overuse though the two young women at the bus station pharmacy obviously were exempt.

A couple of days later it was off to the newly refurbished hospital to check with a pulmonary specialist, an earnest and seemingly overworked man in his forties. He was nothing if not thorough and went on to prescribe two X-rays, a CAT scan of my chest plus a bronchoscopy, one of those hose-through-the-nose procedures I don't recommend to anyone.

Along with that came hundreds of dollars worth of prescriptions, for Cipro and other antibiotics, inhalers, antifungal and antiacid pills to settle my stomach, adding up to what felt more like medical carpet-bombing than targeted treatment. For his consultations and all the tests, the bill came to over two-thousand dollars.

In case you're wondering, I've fully recovered physically if not mentally. When I asked the doctor for a diagnosis he gave me good and bad news. There's nothing wrong with my lungs, no tumors, lesions or any other ominous signs.

The bad news is that for all the testing and drug-taking, the doctor couldn't figure out what was wrong with me.


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