Thursday, November 7, 2024

Loose Ends: Mexico City 2018: Emergency Health

In winter 2018, I spent a month in Mexico City. My accommodations, originally a Friends (Quaker) guesthouse, gave its third floor over to some refugees from the second caravan coming north from Central America. 

One of the asylum-seekers became ill, and I wrote this:

So when you are vomiting blood and have no money, what do you do? 

In the case of one of my housemates, you go to a pharmacy for a consult - in some pharmacies free and in others, for a nominal fee (but even this is inaccessible if you have no money, so one of your housemates pays the consulting fee for you - about 35 pesos). 

The pharmacist takes your vitals (blood pressure, pulse, temperature, and throat check), but no blood, stool, or urine tests. 

The pharmacist takes a history from you, considers the possibilities, rules some out, and recommends an endoscopy. Which, of course, is outside your financial reach. 

The pharmacist suggests there is an irritation in your esophagus or at another milepost along the gastrointestinal boulevard, and to eat fruits and vegetables, and avoid spicy foods. If still producing blood in two days, do what you can to get that endoscopy. 

What could be the cause? 

The violent blows to your torso, delivered 10 days ago by fellow caravanners from a different country than  yours, who maybe took umbrage at your membership in the caravan's LGBTQI group? Or the cocaine you ingested yesterday evening, even though you've never had such a reaction before? Or stress? Or malnutrition? Or an ulcer? Or a pulmonary issue? Deadly? Or a passing health incident, self-repairing? 

Does an affliction care if you are kind and amiable, that you sometimes engage in risky behaviors, are poor, have left all that is familiar to you, and your access to food, shelter, and employment is insecure? No, it does not; it is impersonal. 

Maybe there's a biological tipping-point algorithm at play: stress+malnutrition+uncertainty+a beating+cocaine+compromised immune system from the cold virus that's been visiting the house = a crocodile crack on a corporeal byway = vomiting blood. 

A truism: Time will tell.   


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