Trailer Park Nirvana image created by Stefany Kleeschulte.

Sunday, February 26, 2012

Spanish Word of the Day: Ginecologia

An indistinct dark-colored van pulls up outside the gynecologist’s office. A tall man gets out and walks to the back doors and helps a woman step down. Actually, she’s more a girl than a woman. So tiny and thin, beautiful, with thick hair pulled back in a pony tail. They come into the office and she takes the chair next to mine. She turns slightly so I can’t see her face but I do see that she has a wadded up tissue in her hands and I hear her sniffling.

The man stands at the door and gives the receptionist the girl’s history which I don’t understand but I’m thinking I guess they don’t have HIPPA regulations (patient privacy) here in Mexico.

I’m with a friend who is pregnant. She is nearing the end of her term and is at the gyn’s for an ultrasound to check on the baby’s status. Hours earlier we had made a mad rush to the hospital in Calle Doce – about thirty miles from Kino – because she wasn’t feeling well. Her husband had to work so it was just the two of us. Oh Lord, I sure didn’t want to have to deliver a baby but I threw blankets and pillows in the back of the van just in case.

While my friend is in the examination room another dark-colored van pulls up and this time a man helps a woman out who can barely stand upright she is in so much pain. This time I catch words like blood and bathroom and the woman is holding her stomach. I wonder if she hasn’t had a miscarriage. I don’t know who I feel worse for – the women who have to share their personal information with a man (a stranger) or the man who has to hear it. Somewhere in the rapid-fire Spanish I hear “campo.” Were these women working in the fields when they took ill?

There’s a dilemma – two women who need immediate attention. The receptionist, who is typical of the professional women here – perfectly groomed, pedicured and coiffed – goes back to talk to the doctor. I hear every word of their conversation and it’s obvious that the driver and the women waiting can hear it too. There’s that privacy thing again. The receptionist comes out and it’s been decided to keep the woman in the more obvious pain and send the girl with the man on to the hospital Hermosillo, another thirty miles away.

The girl sitting next to me has silently cried throughout her entire wait. She seems so sad and scared. I want to put my arms around her and hold her but I’m afraid of scaring her or breaking some kind of Mexican code of behavior. The other women ignore her. They offer no sympathy. I watch the girl walk to the van. On the faux-leather chair the decorative studs on the pockets of her jeans leave perfectly marked indentations.

Meanwhile the other woman – who is 42 years old but looks younger, which is unusual for the women here – is standing, bent over holding her belly, in obvious pain. When she first arrived she attempted to sit down but I watched her reach down between her legs and quickly pull her hand away. I think she’s afraid of bleeding on the furniture. She is probably grateful she has on loose-fitting black nylon drawstring pants.

The receptionist and I watch television. No novela, no game show, but a more sedate news-type show which is more appropriate for a doctor’s office.

My friend comes out and we wait for the ultrasound photos. She pays for her visit – 300 pesos – less than $30. We have to go back to the hospital to get the results of her lab work but neither of us have eaten so we stop at Pollo Feliz for a mediocre lunch but at least there’s a bathroom which is so tiny my pregnant friend can barely fit between the wall and the toilet. The floor is covered in a mixture of pee and water. I have to be careful to hold onto the cuffs of my pants as I sit.

During lunch I ask her about the women at the gyn’s office.

It seems they both had the same problem, whatever that was, and when the receptionist went to the doctor to ask him what she should do, he blew up at her. How was he to know when he hadn’t seen them yet? My friend said the receptionist cried at being yelled at. But somehow he made the decision to send the girl to the hospital in Hermosillo and keep the older woman.

“Did they work in the fields? I thought I heard the driver say campo.”

“Yes, I think so,” she says.

“Will your husband be with you when you deliver?” I ask.

“No. Men are not allowed because it is one big open room where the mothers are lined up. We can bring another woman with us.”

She and her brothers had been born at home and we both agree that would be the ideal option if only there was a midwife in our town. "But the woman who helped my mother give birth, she had no tools. What did she use?” I tell her about the time in my life when I assisted at home births."All she needed was some clean towels, sheets and a pot of boiling water to sterilize the scissors to cut the cord.”

We return to the hospital to get the lab results. All’s well with my friend’s baby. Her worries had caused her blood pressure to spike. She’s been hearing too many nightmarish stories about that hospital and all the babies who have died there.

When we get back to our town we joke that we should find a newborn baby to borrow so she can walk into her house and surprise the hell out of her family. Finding a newborn baby would be easy but it probably wouldn’t have been a nice thing to do.

We’re both wiped out. It’s been a long eight-hour day – her scheduled office visit was an hour late, there was difficulty finding a blood pressure cuff that worked, then the visit to the gynecologist’s office. With all our stops this hugely pregnant woman had to climb in and out of my humongous van.

Of course the first thing I do when I get home is pour a gin and tonic. Then I give people in the park - gringos and workers - an update on our friend’s status. She’s fine, bebe’s fine and thankfully there was no roadside delivery.

At first, while waiting with my friend to be seen by the doctor at the hospital, I thought what a horror the Mexican medical system was, especially the long wait in a room filled with sick people, mostly children hacking and coughing. (There are many asthmatic children here because of dust from the fields, not to mention other ills caused by the fertilizers and chemicals used.) Then the trip to the gyn’s office for the ultrasound, then back to the hospital for the lab results. But, really, this isn’t any different than ERs in big U.S. cities where people go for routine medical care because they don’t have insurance. At least the medical treatment my friend received that day at the hospital was free. Even her meds were free as long as she got them at the hospital pharmacy – as long as the pharmacy had them in stock. And $30 for a visit to a gyn’s office for an ultrasound? How much would that cost in the U.S.? I heard last night that if a woman is required to have an ultrasound before an abortion, that’s an additional $200.

The other benefit here is the paid maternity leave although there are some caveats: a woman does not start receiving “disability” pay until her 33rd week of pregnancy and she must work up until that time. Should she have a problem with her pregnancy and not be able to work, she loses the maternity benefit. Her paid time off is three months, I think. But this is only for people whose employers pay into the system. At least that’s how I understood it.

I have no medical insurance. But as long as I have cash or room on my credit card, I can be seen at one of the private hospitals in Hermosillo which are more like hotels than medical facilities. Needless-to-say, a hospital stay here is much cheaper than in the U.S. And if you are old enough for Medicare and have the supplemental insurance, the hospital bills them directly and, depending on the insurance company, pays 80% to the whole shebang.

Even though I stayed up late (I had to watch Portlandia), I had a difficult time falling asleep so I took half a Xanax a friend had given me. I kept thinking about that young woman. She seemed so fragile and sad and alone. None of the other women paid her any notice. I guess that’s what you do when there is a lack of privacy; you learn to shut out the pain that is around you.

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