Paving the road to nowhere, one word at a time.

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Location: Tijuana, Baja California, Mexico

American born, living in Mexico since 1992.

Tuesday, January 19, 2010

The Last Sunny Day For A While

I can’t remember the last time I actually ventured out the front door before Saturday. I would watch the sun cast shadows across the cobblestone through the front window, briefly, before the pain would begin again. Then I would have to find a chair. Sitting is better than standing and lying down is better than is any other option. I can’t stay in bed all day and the couch is out of the question because the television is intolerable. Sitting is the compromise, then. Writing and reading articles on the internet are preferred activities to distract me from the dull throbbing pain in my right leg.

It started well over a month ago with a couple of day’s worth of chest pain, high up and not seemingly related to the heart or the thorax. I figured I was smoking a bit too much, and I cut back on the non-filtered delicados I have come to enjoy here in Baja. After two days, the chest pain subsided only to be immediately replaced by a right leg that felt as though I had so completely overextended it as to cause me to reach for a cane once used for another injury more than a decade earlier. This is what happens.

Three weeks after that, I told Rocio to make an appointment with the doctor, that something was wrong.

Rocio is the warrior I once was, crossing the border before sunrise every day to report to work and then coming back home in the dark. I did that for fifteen years. Like many employers in the United States of America so close to the border with Mexico, the health insurance offers the employee a choice of coverage in Mexico. Rocio took this option because she is more comfortable with the doctors here. I am bound by that option now whether I like it or not.

* * * *

My first experience with a doctor in Mexico was actually with an obstetrician. Six months into what has now become a permanent sojourn into Baja, my daughter was born in a small clinic in Las Brisas, not more than a few miles from here. In about a month, that daughter will be seventeen years old. It seems ridiculous how much time has passed since that afternoon. It doesn’t seem so long ago.

The tiny clinic, not unlike other tiny clinics in Baja, had a small reception area with a few old chairs and it also served as a waiting area. The receptionist also worked as a nurse in case the clinic became too crowded for one nurse to handle. It wasn’t clean, it wasn’t dirty; it was merely adequate, right down to the lighting. It was a simpler and much more rustic version of any doctor’s office in the United States of America.

Once we chose the clinic, I recall paying half of the six hundred dollars that the entire procedure would cost. This would include monthly visits, but not tests and the ultrasound. We didn’t want to have my daughter born in Mexico merely because it was inexpensive, but it worked out wonderfully well that way. We wanted to have Anna born in Mexico because she is Mexican, so that she would feel rooted in the culture we chose to bring her up in. One day, green card in hand, she may have a decision to make concerning where she wants to live – and she can make that decision freely while keeping in mind the flavor of freedom she has grown accustomed to here in Mexico.

My experiences in childbirth from my first marriage were different; both children were delivered by Caesarian section. I lied about having attended the class for the first one, and sat next to my ex-wife who was awake during the procedure. I delightfully remember her guts laying exposed beside her torso, a memory that serves me well when any of dozens of awful recollections from that marriage might creep up from time to time. The second Caesarian section was filled with technical and personnel problems from the beginning – the assisting doctor was a half-hour late, they lost suction right after the second incision, and so on. Afterward, both doctors commended me for maintaining my composure and keeping my ex-wife calm. My only thought was this: What else was I there for?

In that clinic in Baja, as I gowned and scrubbed up next to the doctor, I remember wondering how many deliveries he ever made by Caesarian section.

A half-hour prior to that evening in February of 1993 I was in a supermarket near the clinic and it was raining harder than I have ever seen. Water was coming through the light fixtures, as if the roof served no purpose at all. Back in the clinic, as I finished scrubbing, I could still hear the water pounding the roof and I worried as much about getting my wife and my new daughter home as I did about anything else. We entered the birthing room and the nurse took sight of me and blushed. I didn’t speak much Spanish but I did understand the doctor telling her that it was common and often expected that Americans be with their wives during the birth. The nurse would have none of it, she left while Rocio crushed my hand during transition, and only re-entered after Anna was born, quickly taking my daughter into another room to clean her up and take her vitals.

The rain never let up, and a few hours later with a healthy baby and a healthy wife, I was ready to get them out of there and take them home, up the hill and away from the flooding. The doctor would not even remotely entertain the notion, that it was customary for the mother and infant to remain at the clinic for twenty-four hours. We argued. One point that came up? I still owed the clinic one hundred dollars, which I was not scheduled to pay for two weeks. We argued some more. Finally, a younger doctor just beginning his shift intervened on my behalf, and we avoided the worse flooding in Tijuana in over fifty years, safe and up the hill, watching the catastrophe unfold over the next few days on the local news television programming.

* * * *

My second experience with a doctor in Mexico was more benign - it was a simple matter of having a common cold. I was in the doghouse of the owner where I worked for reasons that now escape me, and when I called in, my boss recommended I get a note from a doctor or there would be hell to pay. That office was also rudimentary, featuring a ceramic tile floor and sparse furnishings on the second story of a small cinderblock building next to a restaurant and a hardware store. The doctor barely examined me, and fifteen dollars later I had a prescription for antibiotics and a note in Spanish excusing me from work until I felt better.

It was recommended that I fill my prescription right downstairs, because apparently the doctor also owned the pharmacy underneath his practice.

I took that note to work the next day and nothing was said. While Rocio and Anna visit the doctor here in Baja regularly, the last time I had been to a doctor in Mexico was perhaps fifteen years ago. I didn’t look forward to last Saturday. I was sure that I would find the same dusty plastic plants, old, worn, and dirty chairs left over from some newly remodeled business office from twenty years ago, and diplomas hanging on the wall touting achievements from places I’d never heard of.

* * * *

I showered and dressed not thinking twice about my dirty old tennis shoes and dusty cap, grabbed my cane, and Anna accompanied me because she knew where the doctor’s office was. We left early at Anna’s urging because apparently there would be many forms to fill out. With Anna handling the money, we took a route cab to Zona Rio and then a metered taxi to an office right across the street from Tijuana’s General Hospital. The office was immaculate. The chairs – and there were plenty of chairs – were practically new. The entire office, including the large contoured counter, was as modern as was anything, anywhere. Anna presented them with my insurance card (I didn’t even know I had an insurance card), and I signed a small digital screen. There was no paperwork to fill out.

Rocio came directly from work and met Anna and me as we waited briefly and then a nurse called me into a room and took my vitals. My blood pressure? "Good, very good," she said, rattling off numbers that made no sense to me. I returned to my seat in the lobby and Rocio asked me my weight. I couldn’t tell her, since it was taken in kilograms and I paid no attention. I was then instructed to wait in exam room three, and took Rocio with me in case I needed a finer translation than I was capable of relating.

The hallways were spotless, and the small exam rooms were immaculate and fully stocked. In a minute, the doctor arrived and I explained what was wrong. There was ten minutes of questions, and he listened attentively. We chatted briefly about things unrelated. He noticed my black cap, which sported the fleur-de-lis embroidered in gold with silver and black trim.

"Saints?" the doctor inquired.

"They’re playing right now," I said in Spanish.

He then recounted a recent trip to New Orleans, a trip that he very much enjoyed. That doctor put me more at ease about everything than any doctor I’ve ever visited, save for one specialist I had when I shattered my heel bone over a decade ago, a young Stanford graduate that I credit very much for my ability to still walk normally. At least, before this latest thing, whatever it was. I was made to de-pants and wear a silly paper gown, and the doctor immediately came back in and examined my leg, comparing the injured one to the non-injured one.

"The good news is that there is no obvious signs of a stroke," the doctor said. I was relieved.

He ordered a lot of tests, including a Doppler ultrasound, whatever that is. "These tests will find any blockage in your circulatory system, if such blockage exists," he said. "Go Monday. No drinking or smoking forty-eight hours prior to the testing."

Rocio cringed. She knows me all too well.

* * * *

We sat at the bus stop outside of the doctor’s office and I lit a cigarette. It was two-thirty, which was the exact time of my appointment. I was finished with that doctor and I knew the next one would be a specialist of some sort. At some point. I had no designs on getting those tests done on Monday. Rocio knew it. I exhaled smoke onto a beam of sunlight reflecting off of the windows of the hospital across the street. Eventually, we piled onto the bus to downtown Tijuana.

"I haven’t had a drink in over a month," I told Rocio. "I’m going downtown and watch the Saints game and the game after that. I’m going to have a few beers and talk to the friends I haven’t seen in several weeks. Then I’m going to get some tacos de chile rellenos and bring them home. This is the last sunny day for a while, and I’m going to enjoy it."

Rocio slipped me twenty dollars.

By the time I managed to navigate Centro de Tijuana on a cane, avoiding the cracks and holes in the old sidewalks, I walked into the Perico tired but happy. Scott and Jody were both there and the Saints were in full control of their game. The world was right again, at least for that afternoon and into that evening. The beer tasted friendly and helpful, like good medicine. The pain in my leg didn’t matter for a while.

The Doppler ultrasound will still be there, even on a rainy day such as this.


Anonymous Anonymous said...


4:25 PM, January 20, 2010  
Blogger The Real Tijuana said...

"Sitting is better than standing and lying down is better than is any other option."

Refried Gringo reminds us all of the advice Louis XIV offered on how to be a king: "Never stand when you can sit, never sit when you can lie, never fast when you can eat."

Could it be that don Refrito is telling us that anyone can be a king here in Tijuana?

4:01 PM, January 21, 2010  

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