Tag Archives: health

Blue-Gown Daydreams

4 Jun

There’s nothing like being naked under a half-open blue robe, laid out in a hallway with a bunch of helpless sick and injured folks, to make you feel like the exact opposite of WonderWoman. I kept pondering to myself, “Julia, you’re not sick or injured. Why would you choose to come here?”

Then I forcefully pushed those pesky rational thoughts out of my little head and daydreamed about glorious sex without the risk of making more babies. Oh yeah, that’s why I’m here. Goals and dreams. Keep your eyes on the prize.

Plus I was there on principle. I mean, the insurance company takes money out of every paycheck, so I have every right to this. Just as compellingly, it would have cost more than a month’s pay to get the surgery done privately. When I asked a private doctor whom I trust if I was crazy for going to IMSS, my insurance company, for this surgery, he assured me that I wasn’t. IMSS is the Mexican Institute of Social Security, and it provides health insurance to a large portion of folks who have formal jobs. In many ways, it is much better than in the US because many more people are covered, and aside from whatever monthly cut they take out, there are no other, extra costs. It gave me 12 weeks paid maternity leave, which is 12 weeks more than what I got in the states. The main downside is that it is a giant institution that sees you and treats you as just another number in the system. It is slower than molasses in January, stressful, dehumanizing, often inadequate or just plain wrong.

But still, a free surgery is a free surgery. “The same doctors who work in IMSS also work in the private sector,” my doctor reminded me. “It’s perfectly safe. The only thing that might be bad is how big of a scar they leave you. It’s kind of the luck of the draw, depending on the doctor. He might leave you a tiny scar or he might leave you looking like you had a C-Section.”

“Good thing I wasn’t dreaming of a career in pornography,” I told my husband, because sure enough, the doctor left me a giant scar. It’s longer than my friend’s C-Section scar, as a matter of fact. It kind of looks like a kindergartener who cut their own bangs, except on my pubic region instead of my forehead. Luckily, I’m not concerned about the aesthetic of it. I think scars are just visual reminders of a life lived, a show of how bad ass and interesting someone is. On another level, though, the excessive size of my scar makes me feel expendable and dehumanized. The surgeon couldn’t be bothered to take care with me (or anyone else, I’m sure). My body is so unimportant and inconsequential to him that he cut what must be the maximum possible, for what? Just because he can? To make the surgery part as easy as possible for him?

The gynecologist didn’t even acknowledge me when he came into the room, or at any point before I passed out. I didn’t even realize that I was going to be knocked out for the surgery, since I signed up for local anesthetic. I had to fight to have anything explained to me, and I neglected to realize that I needed that part explained. I just can’t imagine treating people like that, and it makes me sick to my stomach thinking about all the people these doctors and nurses are in charge of who aren’t getting quality and humanized care.

It’s not just this doctor, either; it’s the whole system. I mean, this is the insurance company that thousands (millions, I think) of people are paying into, and the best they can do is beds in the hallway? There are some overcrowded rooms as well, and I suppose I can be grateful that I was the only one in the surgical room while my surgery was happening (as far as I know). But geez.

And heavens forbid you are there without a family member. One poor guy was brought in by his coworkers, who called family members immediately, but no one had arrived yet when a nurse came by with a tray of food for him. “You don’t have family here?” She asked him and everyone else around, incredulously, about 8 times. I wanted to scream at her by the 5th time. She couldn’t figure out what to do with his breakfast. She asked him to sit up, but he couldn’t sit up on his own. Then she tried to get the wheelchair attendant to sit him up, but for some reason they aborted that mission as well. Finally, after being assured yet again that he was all by his lonesome, helpless, vulnerable, defenseless self, she carefully balanced the tray on top of his chest and walked away. He was totally unable to eat anything from the tray at that angle. And it couldn’t have been comfortable. But there you have it. The nurse officially did her job of delivering the breakfast tray to the patient. Eventually the wheelchair attendant took pity on the man and removed the stupid tray from his chest. I closed my eyes some more and continued to daydream about a better universe.

Hopefully you’re also not a child in need of emergency services at my insurance company. A small, tough girl with her chin up walked past me into a room at one point. She must have been about 4 or 5- my daughter’s age. Of course she wasn’t stoked about giving a blood sample or whatever needle-related thing they were doing to her in there. But the nurses had zero tact or style about calming or convincing her. Instead they used various threats and near-impossible deals, none of which helped anybody achieve their goals. They even brought in one of the security guards to scare her into submission. Bless her, it did not pacify her in the slightest. She just cried out more for her mama, who I think was nearby, but who I got the impression wasn’t allowed to be with her or touch her or something? I couldn’t see anything, so it was purely aural clues that painted the painful picture for me. At one point they told her if she was quiet and cooperative that her mommy could come and be with her, but how the hell do you expect her to calm down without her calming person in the first place? It reminded me of the clueless (or purposely mean?) nurse when Lucia had to be hospitalized for an asthma attack; the nurse thought they were going to be able to stick a tube in her arm with me out of the room, leaving her all alone. Yeah, being alone with strangers who seem to want to hurt you is always great for small children. They calm right down and obey. Gosh, even using sarcasm to deal with the situation doesn’t make it less distressing. I know that kids are going to scream and cry over pain and new situations, but it seems like the hospital tactics just escalate the fear and pain for kids. It was pretty disheartening, to say the least. (Also, my dear, dear friends, please don’t threaten your kids that a police officer is going to come and get them for not obeying you. UGH! Have some compassion for these lovely, little human beings, please! Imagine how terrifying that must be!)

Also on this grand adventure, I learned that soap and toilet paper are luxuries far beyond what one deserves in this insurance hospital. Not one bathroom of the three that I visited while there was stocked with soap (or toilet paper). I was sharing my outrage and disgust about it with my mother-in-law, Paulina, who matter-of-factly said you have to bring your own soap to a hospital. However, I remain stubbornly indignant about it because a) Nobody tells you that; b) It’s totally impractical to expect you to carry it around the hospital with you. What are you going to do? Tie it to your gown? it’s not like you have your own bathroom to put your soap in; and c) This is BAD public health policy! It’s supposed to be a hospital, a beacon of health and wellbeing, not a hotbed of reckless germ-spreading!

By the time they wheeled me on my hallway hospital bed back towards surgery, I’d had a nap and managed to psyche myself up despite all the circumstances. Eyes on the prize. No more never-ending months of pregnancy (seriously, both times I’ve been pregnant for more like 10 months- and twice is enough for me!). No more diapers as soon as this little one is all the way potty trained. No more painful/tedious/expensive forms of birth control. No potential need for abortion. (Okay 99-point-something sure.) You got this! Let’s do it!

The anesthesiologist seemed like a nice enough person, except she left my butt completely hanging out while she was putting that bizarre stuff into my back. I get it. They’ve seen it all, blah blah blah. But are you not allowed any shred of modesty, any tiny sense of privacy or autonomy over your body? There was no need for my ass to be uncovered. There was a cover for my use that was just being used inadequately. It was unnecessary and inconsiderate, and I felt too vulnerable to say anything about it. (You don’t want to piss off the anesthesiologist, right?)

The last thing I remember before the surgery, after the doctor came in and ignored me, was the anesthesiologist asking me if my legs felt tingly yet. And then I was down for the count. Nobody told me that I was going to be asleep for the surgery, though. I thought that because I was getting an epidural, it would be like getting a C-section. I wouldn’t feel anything below my waist but I could be awake and aware. (Isn’t that how it happens? Something like that?) Nope. Nothing of the sort. The first time I woke up I felt drunk/high and totally giddy. “This is great!” I think I told the nurses. They asked me if I drank wine. “Sometimes,” I said. They must have taken me for a raging wino because they proceeded to ask me how many cups it took to make me feel like this. “A lot?” They asked. If only they knew what a light weight I am! But my mind was too cloudy to explain. I got it together to ask if the surgery was already over. And I demanded to know how in the world anyone could give birth on this epidural business! Nobody would answer me. I went back under.

At some point I woke up again in the hallway right outside of the surgery area to the gynecologist giving me my instructions for care. I mumbled in response, trying to reaffirm and think of relevant questions. “So everything will be like normal in 7 days?” Yes, he assured me. (Umm, that was not true for me, by the way.) He also promised someone would come around with written instructions before I left. He left the very important paper that would be my paycheck for my week off of work in my hands, and I carefully laid it on my belly and passed back out.

When I woke up again, still in the surgery hallway, I could feel the pain in my abdomen and I did not feel giddy. I asked for some water. The nurse told me it would be just a little longer. He’d already let the hallway nurses know I was ready to return to my spot in the hallway, but they were really busy, he explained. I asked several more times for water and received nothing. Finally he said he would send my family member for some food and drink. I was too wiped out to tell him that I didn’t want any food. I just wanted water. I felt like a camel after months in the desert. Finally they brought me some orange juice and yogurt that they’d sent Conan off to buy. Apparently they didn’t ask him to buy water, which was my lone request and hope for life in that moment. I was feeling very nauseous and I asked if I could have anti-vomiting medicine like they’d given me before surgery. He said no; they’d already given that to me before surgery. I drank a little orange juice and almost immediately threw it up.

Then they let Conan come back, because supposedly I was ready to be sent home. Basically, the anesthesia had worn off and my legs were working fine. That makes you ready for home. The nurse realized I wasn’t really okay. I kept throwing up and could barely walk from the nausea. But he didn’t know what to do, because I understood from Conan that they were short on beds. The nurse checked in with the anesthesiologist and assured us that I was sick from the pain meds and not the epidural. They’d given me morphine or something equivalent. I had forgotten to try to negotiate over pain meds, which never, ever sit well with me. “You can stay here and wait for it to wear off,” the nurse explained, “but we’ll have to put the tube back in your arm and change back into the hospital gown.” (I’d already gotten other clothes on to leave, with Conan’s help, in between vomiting.) He told me technically he couldn’t let me leave without eating something. I knew I wouldn’t be able to eat for a long time. I ate a couple bites of yogurt and threw it up. Mission accomplished. He then said I could wait out the effects of the meds there or somewhere else; “It doesn’t really make a difference.” So of course I opted to get the hell out of there.

We were in Huatulco, about two and a half hours from home. There was no way I was gonna stomach that journey, though, in the state I was in. I am so, so grateful that we had the money to go get a hotel room. I can’t imagine having stayed longer in that hellhole. Already Conan had been sitting out in the waiting room from 7am to 5pm and had picked up some stomach problems from some dodgy street food meanwhile. (We’d had to arrive at 7, although my surgery hadn’t happened till about noon.) I am also eternally grateful that my mother-in-law was staying with my kids and didn’t mind staying an extra night. I couldn’t even hold down water until sometime in the middle of the night; I can’t imagine how I would have survived a bus ride like that.

Although I’m complaining about this very specific problem with IMSS in Mexico, I realize that many of these things aren’t unique to my insurance company or to Mexico. You can get rude doctors and nurses anywhere. Overcrowded hospitals happen. Planned surgeries, folks have told me, are a big, routine, impersonal business most everywhere. It’s also easy for people to treat children and helpless adults as less-than-human in any setting. It doesn’t make it okay, though. And when the whole system is designed to dehumanize us all, and we’re the ones paying for it? It’s time for an insurance uprising, in my humble opinion. And after the health revolution? There will be soap in every bathroom, dammit! Soap, humane treatment, and health justice for all. Amen.

Routine and Obscene: Birthing in Oaxaca Part II

12 Apr

Life is messy, and birth is super messy. No matter how you birth, C-section or vaginal, in a pool while listening to jazz or screaming like a banshee at that dumb-ass doctor, it is full of messy body fluids and messy emotions. There is no sterile birth. The whole messy shebang- pregnancy, birth, and the never-ending afterwards is a wild medley of joy and misery for most people. Your body is totally hijacked by this creature and just about everything in life therefore becomes about this creature, which is maddening some of the time even if you had to work hard to get that creature in there. But here’s the thing: it’s still your body, and everybody, every body, every baby, and every body carrying a baby, deserves respect. Period. You deserve respect. You deserve information and you deserve care. No ifs, ands, or buts.

So this is about to be messy, y’all. This is approximately my 18th attempt to finish and publish a blog post about this topic, but I am over-the-top-determined, fired-up and mad and impassioned all over again. So brace yourselves. I am bringing the mess.

Now, let me be clear. I’m about to get very detailed and slightly rabid over doctors, nurses, education, and health care in the state of Oaxaca, Mexico (especially the coast, since that’s where I live.) But that does not mean that this does not apply to you, too, my darling USA. Do not- I repeat, Do Not- go around patting yourself on the back that you’re doing better than Mexico, or that you don’t need to worry about it because you’re safe up there in the North. Do not fool yourself. Mexico learned a lot of these tactics from the US in the first place. The problem is, Mexico ends up scoring higher on the charts at all the wrong things. Soda consumption? Mexico wins! Type 2 Diabetes? Another goal for Mexico. Cesarean births? Mexico is kicking the US’s butt again!

So there are the fews stats I have: “…(T)he maternal mortality rate in Oaxaca is approximately 62 maternal deaths per 100,000 live births, double the national rate,” according to Child Family Health International. The US has about a third of its births via C-section, when the World Health Organization suggests that a C-section is medically necessary about 10-15% of the time. Around here in Oaxaca, it’s hard to get solid statistics*, but it’s estimated that 50% of births terminate in a Cesarean, and that the rate of C-sections is even higher in private clinics, with some estimates at high as 80%. Such a high C-section rate brings much higher risks and worse birth outcomes for both mother and child. And that’s only part of the story of what’s wrong with birthing in Oaxaca.

References: WHO C-Section Statementmortality ratein Spanish, more information about the state of giving birth in Mexicomore info in Spanish, more info on estimated rates  (I am not very familiar with the publisher of the information in Spanish, so I can’t vouch for how definite it is, but it is just about the only information I can find.)

Now, I studied sociology and everything in me is against relying on anecdotal evidence as fact, but in the absence of well-researched statistics, I think anecdotal evidence is worth a mention. This is a big part of what has had me crying and wringing my hands and pumping my fists alternately in these nearly 5 years of living down here- the birth stories that I hear. This is what is going to be my long-term mission to join with others in the community to change, if I end up living here forever: humanizing pregnancy and birth.

It’s ugly in the public sector and it’s ugly in the private sector, but your treatment is drastically worse the poorer you are. In the news there are loads of stories about women who were forced to give birth in the parking lot, on the lawn, in the bathroom, in the waiting room, etc., because there wasn’t enough space for them in the hospital/clinic when they came in. The women that this happens to are always indigenous, but luckily there is no racism here (yes, this is sarcasm). I suppose that’s the worst end of the spectrum, although I’m not sure the care that people receive when you’re admitted qualifies as desirable, either. Yes, it is better than giving birth outside with nothing, but is that really what we’re willing to accept?

What always strikes me as the worst acceptable, routine thing, is that women are giving birth alone. Labor and delivery is one of the hardest and most beautiful and wildest and messiest things you can do in life, and that’s cool if you choose to do it alone. Anytime you give birth in the public sector, though, you have to be alone. All by yourself, with just a bunch of other women around who are also in labor, with not enough doctors and nurses or even, sometimes, enough beds. ALONE! With no one to advocate for you, for your health and wellbeing, for the baby’s health and wellbeing. With no one to hold your hand, to rub your back, to get that hair out of your face, to tell you that you’re doing great and it’ll all be over eventually. Alone! For your entire labor and delivery. Already that, in and of itself, is completely and utterly inhumane to me. I can. not. fathom. it. And it pisses me off extra here in Oaxaca because if you go to the hospital for ANY other reason, they force someone to accompany you. If you have to be recovering from something in the hospital for 3 months, you have to have someone there, just about 24 hours a day, because there aren’t enough resources for the hospital to take good care of you. So why the hell would you send people in to give birth totally on their own?! Heartless bastards! I suspect it’s partially because they don’t want anyone there to defend you and help take care of you.
Let me tell you what kinds of things happen there, while you’re there, contracting and alone. You don’t get any water. I know, many places in the US like to do this too, which is equally senseless and unnecessary, but it’s even more cruel here, where it’s 85 degrees and more humid than Hades. One friend told me that they STILL wouldn’t give her water or food for hours after her birth. Finally she begged a doctor for water and he told her it was at her own risk- as if water was going to do her harm after giving birth!

Furthermore, more than one person has told me that nurses berated them for making too much noise. You’re often in a big room with a ton of beds filled with other laboring women, receiving little attention. One woman just told me that during her birth, they decided that she wasn’t progressing fast enough (normal), but there were no gynecologists in at the time. Therefore she had to wait another 12 hours for the gynecologist to come on call, and then they could only give her a C-section because they decided it was too late to try to speed up her labor any other way (which is a pretty common story in the public sector, due to lack of gynecologists).

Then there are all the excuses they give you to have an unnecessary C-section, especially in the private sector. The cord is wrapped around the baby’s neck. The baby is too big. You’re a couple days past forty weeks. Your hips are too small. You already had one C-section. Ad infinitum.

All of this is similar to stuff they might tell you in the US, but the difference here is that there is no such thing as pregnancy and birth education. There are no child birthing classes. There is no education about what to expect while pregnant even. If you have a doctor like the one I had at the insurance company, they don’t even tell you basic information like when to suspect there is a problem. Culturally, there is no questioning authority. So if the doctor says your baby is too big for you to give birth to, you don’t ask how he or she knows that. You either accept it and get the C-section like they want or you reject the system entirely and go to a midwife, which could or could not be a good option. (More about midwives in another post, I promise- it’s too broad a subject to broach). Many people don’t have the option of midwives, or of anything beyond the very limited bit their health insurance provides.

If you do have the money or borrow the money to give birth elsewhere, it ends up being a similar scenario. The private sector thrives on your ignorance and the total lack of available options, on the fact that almost all the doctors are out to screw you over equally. For example, one prominent gynecologist here told me beforehand that if I didn’t want an automatic episiotomy, that I would have to sign a bunch of consent forms beforehand, and that, you know, it was all at my own risk, because that made it very dangerous! It felt to me like they just make stuff up to sell you more services you desperately “need”- and if it turns out you need a C-section, (which you probably will), then even better, because it’s more convenient and way more money for them. (Multiple people have sworn to me that doctor friends have even admitted this is how they operate.)

On top of treating women like animals in labor, often doctors take the opportunity to abuse their power and your reproductive health and rights while you’re there. The straw that broke the camel’s back in forcing me to finally publish this messy, disorganized blog post about this was hearing ANOTHER story of forced birth control. This story came directly from a doctor who had no reason to make it up. We were talking about IUDs, and how sometimes the strings hang down too short, and he was telling me that he just had a case where a woman had been trying to get pregnant with her second child for years, She had had all kinds of testing done and everything, and they couldn’t figure out what was wrong. Finally, it turned out that she had an IUD in place, that had been put there when she had her first child via C-section, without her consent or knowledge. Apparently this is a common thing- giving women an IUD, either without their knowledge at all, or forcibly without their consent. Another second hand story came to me about a woman getting a forced IUD and the doctor telling her, “I don’t want to see you in here pregnant again for the next few years!” Which I can totally imagine, because that is how doctors talk to people here, especially to women.

Of course they do the same thing with sterilizing women. They pressure you into it if they decide you have enough children. Just this weekend I was chatting about this with someone who experienced it. They tried to force her to get a tubal ligation when she gave birth to her fourth child. “How many children do you have? Don’t you think four is enough?” The doctor tried to shame her. This woman is a total heroin, though- she is the same woman my nurse friend told me about who REFUSED to let the doctor put his hand in her uterus to “clean her out” after birth (another routine, unnecessary, and very painful procedure). She was like, “I came to deliver my baby, not to get surgery, thank you.” She said the doctor wouldn’t leave her alone about it until another doctor who is her neighbor came in and defended her right to decide. Your rights mean nothing. She got to decide because a man in power intervened on her behalf.

I could rattle on and on about more abhorrent stories and accounts, more abuse and lack of rights, but here’s the end game for me: We need more education in the community, AND a total shift in the system. Let’s stop reading about another indigenous woman giving birth on the lawn of IMSS and acting like it doesn’t affect us. Let’s stop listening to each others’ horror stories. It does affect us. It means that we are accepting this as the care that we deserve.  Giving birth is messy but it shouldn’t be dehumanizing. Being routine does not make something acceptable.

Decision-Making for Dummies

22 Feb

Is paper/rock/scissors a valid decision-making method? Since I’m trying to make a gigantic, life-altering decision, obviously I would do best two out of three. Or perhaps I need a Tarot card reading. Or I could pose the question to all my Facebook friends, and go by whatever option gets the most votes. I might write each decision on opposite sides of the room, spin around until dizzy, and then point with my eyes still closed. Similarly, I continue to contemplate getting wasted drunk and writing a note to myself about what feels the most right, with all the hidden insight that excessive alcohol might bring out.

And these are just my better ideas.

Seriously, I cannot make this decision. I won’t do it and you can’t make me! I want to shout at the universe, complete with a stern pout and possible foot-stomping or middle-finger-flying. It’s too big a decision, it affects other important people too much, and it’s all on my shoulders, for better or for worse. I’m not gonna! (I’m sticking my tongue out at y’all, now, too, moon and stars and everybody.) The recovering perfectionist in me is pissed because there is no “right” answer. The anxiety monster in me is terrified because there are major negative consequences on both sides, but which negative consequences will be worse- and for whom? If I make this decision and the worst happens, it’ll be all my fault and no one will ever forgive me and I won’t even be able to live with myself- assuming I’m still alive after the worst. Oh, hell, no, y’all, I am not taking responsibility for this. No, siree. I’ll just wait for a definitive sign from the heavens first, thanks.

Except I have to decide. Even if I pick the default option of doing nothing, that’s still a decision that I will then have to live with, with all the positive and negative consequences that entails. And there are consequences for my whole family. Ugh! Part of me, of course, recognizes that I am ridiculously privileged to even have options, despite them not being exactly the options I’d like. Who the hell gets all the options they want in life? Nobody I know, and probably nobody I care to know. So I think about other folks with trickier and much more dire choices- or lack of choices- and I shame myself for bemoaning the fact that I have to / get to make a decision in life. Unfortunately, the shame doesn’t actually change anybody’s situation or help me make a decision. So here we are.

I have a deadline. It’s almost here. I don’t want to say the date out loud, because then it will be more real. But it’s very, very soon. (Shiver and shake!)

Because apparently, life requires some modicum of planning, and institutions like schools and jobs and banks always want to know whether you will be utilizing their services or not in the coming cycle. Those nosy bastards. Then there are the other folks, close friends and family, who also insist that your most major life choices affect them. They’d like to plan accordingly, they say. And yet they refuse to take the decision off of your hands. Selfish, selfish, selfish!

Instead of deciding for me, loved ones give me sage advice. For example, a dear friend encouraged me to listen to my heart. The problems with that are that a) my heart is divided in multiple directions, and b) my heart usually leads me down the most difficult and dangerous path available. That certainly hasn’t been exclusively awful; as a matter of fact, I’m pretty damn pleased about many of the outrageous decisions I’ve made. Once I’ve made a decision, once I’ve survived some of the results, I get very zen about it all, magically. This is forming and growing me as a person, and all that. Even the decisions I made that, in hindsight, were excessively foolhardy and ill-advised, I can shrug my shoulders and toss it into the pile of “makes for a great story fodder.” I am the main character in my life’s novel, right?

(Joyful Girl, by Ani DiFranco, is one of my anthems since adolecense that encourages this philosophy for me: “The bathroom mirror has not budged. The woman who lives there can tell the truth from the stuff they say. She looks me in the eye, says, Do you prefer the easy way? No? Well then, okay, don’t cry.”)

But I feel a distinct lack of zen now that there are small children involved. These little humans are counting on me to not ruin their lives. So the question then becomes, which path will ruin their lives less? (They’re gonna need therapy either way, as my dad would say.) But how can I calculate the least-harm scenario? There are short-term and long-term effects for them, but most of the long-term effects are potential effects. There’s a whole bundle of maybes in all my equations, which is yet another reason why I’m not a great mathematician nor decision-maker.

So if the short term effects for them are fairly negative, and then the hopefully excellent long term effects go all awry, then I will have made the wrong decision, right? Alternately, if the short term effects are mostly positive, and the long-term effects don’t have much room for astounding but might not be abysmal, either, does that mean that’s the right choice? Either way, super-duper disasterous things can happen! And where do my needs and desires, and my life partner’s needs and desires, all fit into this? What about the If Mama Ain’t Happy Ain’t Nobody Happy effect? How much and in what way does that count in this? Where is my text book? Where is my tutor? It’s like you just learned to do division and then they throw some complicated thing into mix, something like, I don’t know, exponential numbers. And the teacher doesn’t explain worth a damn in the first place; they’re just throwing random numbers crap at you, so how can anyone expect you to ever solve this problem?!

My perceptive and astute therapist mother reminded me to “use wise mind” as my guide. Wise mind, theoretically, is that brilliant and perhaps fictional combo of emotional mind and rational mind.

Here’s a little visual about “wise mind” for all you visual learners out there. I acquired this image from this site.

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Does wise mind exist in me? Hmmmph! Sure, I guess it’s in there somewhere, since I can do both rational or emotional exceptionally well. But blending them? Quieting my anxiety and ceasing to analyze long enough to listen to the deeper part of my being? Ha. When? Between my full-time paying job and my full-time mother job and my full-time housekeeper/cook job, I’m pretty booked. Ain’t no space left in my calendar for an appointment with wise mind.

Maybe that’s an excuse, though. I mean, really I know what path I want to walk. I already know, because I know exactly who I am and what I want to do with myself in this one little life. I know what my values are. I know what I have to contribute to a community. I know what decision I think will put me in a position to live more in line with those values and let me contribute to the universe best. I already know.

But as soon as I say that, my raging, roaring bear named Anxiety rears up on its haunches and yells, “What if you’re wrong, though? How do you know that you’ll be able to live your purpose in life on this path? Maybe you can find your purpose on this other path just as well. You just need to look harder.”  Then I get new information that kicks rational mind back in to gear, like a know-it-all-doctor from the 50s calmly blowing smoke in my face, telling me I need this treatment for my hysteria. “Look at these facts,” that jerk says.  “This is a bad time. All of the evidence points to disaster.”

Back and forth I go, several times a day. Every day I debate and deliberate, tying my stomach in viscious knots, winding myself up like wind-up doll, and waiting to see what decision I’ll have made when the coil stretches. Every day I dream of somebody coming to take this weight off my shoulders, of someone telling me the decisively “right” thing to do. Except I’d probably STILL find some reason to keep arguing about it. “But read this study first!” I imagine I’d say.

I suspect that either way, it’s gonna be ugly and it’s gonna be lovely. No matter which path I take, I’m doing somebody wrong. All concerned parties are going to have some negative consequences. No matter which path I take, there will be some negatives and some positives and ultimately I cannot predict what they will be or how wonderfully joyous or horrendously grave life might be in the future. Which is probably a truth about the Whole of Life every single day, we’re just not usually as hyper-conscious of it as I am right now with this blasted decision.

Meanwhile, the deadline looms. Weigh in on your decision-making advice, before it’s too late and I decide to just flip a coin!! Seriously, folks, I don’t ask for advice every day; now is your chance to give me your best decision-making guide.

 

A Gratitude Interlude

8 Nov

Lately I’ve pretty much been one giant ball of stress, chaos, and anxiety, so…. We interrupt your regularly scheduled programming to bring you this important announcement:

These things only happen to the living. (like my Nonna always said)

I write at least three things to be grateful for every morning as I drink my coffee. It’s a good way to start my day, and over time it’s augmented the fabulousness in my life tenfold. But sometimes the morning gratitudes are just not enough. I need a bit more focus on the gratitude. A bit less wallowing in my problems, pulling my hair out trying to find solutions that don’t exist. So here goes.

First off, our car is permanently dead-to-us (RIP Poderoso), despite all our valiant efforts. So I’m incredibly, madly grateful to the parents with functioning cars who are schlepping Lucia to school and back with their kids. (Thank you, thank you, thank you; it is the difference between our kid going to school or not.) I’m grateful that public transportation exists to get Lucia to the car pool pick-up spot so she can get a ride. I’m grateful that Lucia gets to go to a school that she is thrilled about every day of the week, and that it’s a school that’s also totally in-line with our parenting values (more on that to come). Even though sometimes I feel bad about needing help, I know that we would do the same for someone else, and that makes me feel better about it.

I’m grateful that Conan has a paying job outside of the house! It means more work and more stress for both of us, but the economic stress is already greatly lessoned. “Conan,” I said, “we’re halfway through my pay period and I haven’t had a panic attack about money! This is serious progress!!”

I’m insanely, intensely grateful that we’ve turned in the first step of our paperwork for immigration. That people threw a benefit karaoke potluck for us, and more folks keep donating, keep sending us their wishes and energy and hope and love. Can’t even tell you how awesome it is.

I’m majorly grateful that Arturo is lending us his truck for Conan to get to work and back. I’m grateful that there were no accidents in the week that Conan spent driving it with nearly non-existant brakes until we had enough money for repairs. I’m grateful that the bald tires are holding out so far (keep your fingers crossed for us- it’s next on the list).

I’m grateful for the obligatory quality time I have with Khalil every day that we go to pick up Lucia from the carpool drop-off spot. I used to spend a good portion of my lunch break getting lunch ready, but now Khalil and I go for a walk to catch a bus or a colectivo (shared taxi) and we have a big adventure to pick up the big sister. The whole ride there, he shouts about every big vehicle that he sees, which is approximately every three seconds. “Yes, dump truck,” I agree. “Yes, another big semi.” He barely says words- except more, his first and most important word- but he make a vroom vroom noise, and a buuuuhhhh deep rumbling in his throat noise that means ‘big.’ This child is determined to communicate. We continue our fun if Lucia’s not at the spot yet, playing with sticks or leaves, or throwing rocks or reading a book. It’s truly a pleasant time that I used to not have on a daily basis.

I’m grateful that at least the three of us still get to eat lunch together, and that I have a crock pot! It has rescued me in a big big way. Otherwise we might be eating tuna sandwiches every other day.

I’m grateful that we’re not totally destitute. I’m grateful that we have nutritious food to eat and a safe and sturdy shelter. A man was working on a neighbor’s yard the other day, “cutting the grass” like they do here- by hand, with a machete, slowly wacking away, in the sweltering heat and humidity, for two days, at the tall weeds that had overtaken the landscape. While we talked, he inquired about the casita– the “little house” on our property. “This building?” I asked him, pointing again at our shed. Yep, he meant the shed- the tiny tin shack where Conan slept while the house was being built. He wanted to live there for a while with his family. “Got my perspective back in check,” I told my mom, “when I realized that we are ‘rich’ enough to have a garage that could be someone’s house.”

I’m grateful that we have a home- not just a shelter, but a refuge. It’s an appealing, spacious-enough-for-four, comfortable, comforting place that’s all our own. Even though it’s unfinished and might never be finished, even though we still don’t have doors separating rooms, even though half the time it’s a hurricane-style disaster of toys and clothes strewn about and dishes left undone, it’s ours and I love it.

I’m grateful for this past weekend’s few calm minutes to sit by the back door and look out at the world with my littler firecracker. For smoothies made of strawberries and Oaxacan chocolate, and a surprise afternoon storm.

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Khalil’s favorite spot- looking out the door… Normally he likes to sit in this little chair, but when I sat on the floor with him, he decided to sit on the floor, too.

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Cheers! To chocolate and children.

I’m grateful that thus far my rambunctious, determined, fiercely excited littler one hasn’t injured himself in any dire way yet (I’m pretty sure it’s going to be inevitable with this one). That so far we’ve managed to keep him from ingesting bleachy cleaning water; he only dumped a little bit on top of himself that one time. That the soapy dirty bath water he drinks on the sly sometimes doesn’t seem to do much damage (and let me remind you, tap water here is not drinking water to begin with). That just yesterday he only drank about 1ml of Lucia’s steroid dose that he grabbed off the table in the .2 seconds that I turned my back; glad it was not the whole thing (especially since it was right after he’d had his full dose). That despite several falls (off the bed, against the concrete wall from throwing himself in playful abandon, etc.) he seems to have avoided concussions so far. That he has so many moments of random tenderness and hugging and loving and smiling to make up for wrecking the entire house every 15 minutes of every single day.

I’m grateful that my wild thing older one has such a strong, unstoppable imagination. That she can play by herself and create an entire complex little world for sometimes hours at a time. I love that she’s never seen a whole princess movie and yet she proclaims herself an expert in princesses. I love the rules she makes up about them. “Princesses are always nice, right?” she says. Or she refuses to brush her hair because apparently that’s princess-style. Even though I thought I was anti-princess, I love the conversations we have thanks to this princess obsession. She puts on one of her fancy dresses and says how pretty she is, and we talk about how everyone’s pretty in different ways, for example. She told me the other day, “Mommy, you’re the prettiest, because your hair do like this,” and she fluffed out my hair and made little wispys like it does. “Your hair is the funnest,” she said, and my heart totally melted. Every other day, between bouts of screaming at her brother and throwing tantrums, she says fun and interesting and tender stuff that makes me glad to keep her. More love in my heart than I thought I could stand- thank you, universe, for this.

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Lucia’s make-believe time: always an elaborate affair

 

I’m so grateful that we’ve been able to buy a nebulizer to treat our kids’ asthma. That Khalil doesn’t mind wearing a mask over his face because we read so many books while we do it. That we have such a fabulous pediatrician, who’s very experienced in asthma treatments, and who doesn’t even get pissed at me for calling in the middle of the night in a panic. (Read more about how great she is here.) That both of our kids are now going to be on daily asthma preventative medication (WHAT did people do before all these treatments existed?). We just had a crazy week with the both of them with asthma attacks- even though Lucia already takes preventative medication, and it’s been so stressful and anxiety-inducing. But I’m so grateful that they’re okay, and they’re going to be okay.

I’m grateful that my kids are awesome, healthy eaters. It kind of makes up for them being such crappy sleepers. When Lucia practically begged me to share my broccoli snack the other day, and then Khalil ate a bunch later on, I laughed maniacally to myself, thinking, “Yes, I accept this sure-to-be-temporary victory!”

I’m grateful for about a kajillion other things, but this has been enough to stem the tide of chaos and woe for a bit. I’ll leave it at that and give you time to think about your own “gratitudes.” Thanks, universe, and thanks, friends. I’m happy to be here with you.

Traditional Cures for the Partially Lost Soul

27 Sep

In an English class of mostly Mexican moms in Kentucky, for potluck I once took a beautiful dish of locally-grown heirloom tomatoes, with chunks of mozzarella cheese, and fragrant, fresh basil. Nobody even tried it. “Maybe because the tomatoes don’t look like normal tomatoes?” suggested the other teacher; indeed, the tomatoes were orange and reddish. I was discouraged because I’d been so hyped up to share my flavorful and pretty dish (aesthetics are not my strong suit in the kitchen), and nobody told me why they weren’t eating it.

Now that I live in Mexico, it’s obvious why nobody ate my exotic appetizer. The same reason almost nobody is interested in making pesto, even though you can get a huge bunch of basil for just 5 pesos. The culprit is the basil! Here, basil is like medicine, not food. (Why can’t it be both? I’m still not sure about that one.) People put a big bunch of basil in a vase as if it were flowers for their business to attract more clientele. More importantly, basil is used to curarte de espanto– it’s part of the treatment to cure you when you’ve lost part of your soul.

Sounds dramatic, huh? Erase that part from your mind for a second. Picture a kid in the US who is not gaining weight like they should. What happens? They get a bunch of tests and some pediatric protein shakes, their parents get nutrition counseling and vague threats of involvement by Child Protective Services. Something like that, right?

Down here, in many households the first line of defense would be to take the child to the curandero or curandera (the healer- usually a woman but not always) to get curado de espanto (cured of fright). One of the tias (aunts) was just telling Conan that Lucia is too whiney- and therefore she needs curing. When I first started having troubles with Lucia’s sleeping, when she was a baby, many folks suggested that we take her to get cured. I was convinced she just needed a better sleep routine, but Conan’s womenfolk (his mom and all the aunts) were very concerned that she needed curing. You might need curing if you have a loss of appetite, if your hands and feet are cold, if you have insomnia, if you are tired all the time, if you’re pale, if you have slight fevers, if you have headaches or chest pains, if you just feel run-down, out-of-sorts, not yourself. All of those symptoms could signify that you have espanto (fear/fright) and that you need to go get cured.

Conan used to go get cured from recurring migraines, which were supposedly caused by mal de ojo (the evil eye, yes, siree!). Funnily enough, he didn’t get migraines the whole 10 years that he was in the US. Shortly after we moved to Juquila, though, he started getting one right after walking past his mean neighbor. His aunt- who is not a curandera per se, but who knows tons about herbs and massage and other healing- came over and gave him a quick limpia– a cleanse, let’s call it. And his migraine was gone.

A cleanse is like a quicker, simpler version of getting cured- just something to clean the bad energy off of you. It involves rubbing an egg over you (no, you cannot eat the egg later- it makes the egg bad), brushing you with a big bunch of basil, and using rubbing alcohol or alcohol like mezcal, among other things.

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See? That egg is no good afterwards. Apparently.

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One of the Tías shows Khalil how it’s done.

People here have all kinds of rituals and protections woven into their daily lives, and who am I to say whether it works or not? For example, there are special charm bracelets for babies to protect them from the evil eye. Everyone in the US would surely be freaking out about them as a choking hazard, but here it’s par for the course. People also hold or touch a baby when they see one that they think is cute, because somehow touching the baby prevents you from accidentally giving the kid your bad energy.

Evil eye is not the only thing that causes these ills that require curing. The other main cause is “espanto”- a fright, let’s call it. Any moment of serious fear can cause those symptoms we talked about above, and therefore require this ritual of getting cured. It could be falling off a horse, seeing a snake, a wave knocking you down in the ocean- all kinds of stuff.* I remember that a friend of mine from Mexico was in a car accident once in Kentucky, and he called his cousin to hurry and bring him some bread to eat, so the fright of being in a car accident wouldn’t get into him (and make him lose part of his soul, I suppose- they didn’t tell me that part because they probably saw that I was already thoroughly confused. I bet it’s harder to find a decent curandero in Kentucky than here, too.) A student of mine from Mexico told me once, too, about how a fright like that is what really causes diabetes. It was one of those moments of seriously testing my abilities to show respect for a person’s culture and beliefs while also hoping to provide alternate/conflicting information that could be really important for that person’s whole family. (I’m still not sure how well I scored on that one. It’s a learning process.)

There is where the problem lies for me- and why I didn’t send Lucia to get cured when everyone told me too. I am never going to believe that one episode of shock causes someone to have diabetes. I think that many cases of “unexplained” symptoms might have a clear explanation, like anemia or poor circulation. My concern would always be about using a curandero exclusively and perhaps missing out on something important that needs a different type of cure.

Being open to this type of healing, however, without excluding other possibilities or treatment options, is absolutely fine by me. While Conan and I both revere science and reason, while we feel a bit dubious some of this evil eye business, we also respect and appreciate the power of energy, and the ways that it can be used positively or negatively. It’s not incredible to think that someone’s negative energy can make you feel bad. Conversely, if just suggestion can make someone feel better- just a placebo, for example- it’s not the slightest bit outlandish to think that a person’s benevolent touch and attention wouldn’t make us feel better, too. Both of us can accept that it might not be the egg or the basil exactly, so much as the ritual of it that focuses the person’s attention and energy, the healing touch, and a little bit of the placebo effect.

So after Conan got his big head injury a few weeks ago, he was happy to take off for Juquila, for a full-scale curing. He’d spent the week attempting to recover and rest amidst the chaos that is our household- kid problems, car problems, money problems, etc.- the usual workweek. He was still tired and dizzy with bouts of confusion. He had bags under his eyes from not enough sleep. Added to that was the fact that he’d lost weight lately. (His weight loss was absolutely due to a positive lifestyle change, but all of his aunts were walking around acting like I was forcibly starving him- although that’s another story.) “You look terrible;” his womenfolk told him. “Go and get yourself cured!” Even his mechanic buddy (the very honest but not very knowledgeable one) had told him that he really needed a cleansing, at least, to improve things with our car, too. We decided that a whole weekend without responsibility and caretaking might be enough cure in itself. So off he went to see the curandera in Juquila.

Getting curado de espanto is a much more elaborate ritual than the simple egg/basil/alcohol business that I’ve seen. A cleanse can be done by anybody who knows the ritual, but getting cured has to be done by an official healer. In Conan’s case, it involved crosses made of palm, many candles, and “some awful green drink,” among the other routine cleansing tools. The curandera analyzed the candle wax to determine what caused his fright, and whether or not he’d been cured after the first session.

The curandero also calls your spirit to return to you- which is part of the difference in this curing versus just getting rid of the bad energy of the evil eye. This ritual is to cleanse you and also bring this lost part of your soul back to you. This soul-seeking part totally makes me think of Peter Pan and his lost shadow. I picture Conan there trying to sew it back on himself and a little old lady laughing and shaking her head. The idea of a lost shadow- this lost part of the soul- sparked my thinking about the shadow parts of ourselves. Now I can see more clearly the beautiful and wise symbolism in this kind of ritual.

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Peter Pan trying to capture his shadow, all by his lonesome. Somebody go find that boy a curandera!

It took two curing sessions for the lost part of Conan’s soul to return. He also got a massage and a bath of rose petals. (I admit I was a bit jealous about that part.) The best part, though, according to Conan, was getting all that special attention- from the curandera, from his aunt, with whom he had good, long talks. I mean, imagine! A whole two days devoted to receiving TLC and being taken care of. Granted, you have to do what they tell you and stay under the covers in bed for like a whole day (not sure if I’m capable of that), but I can see how it could be worth it.

Conan conjectures that getting cured probably works so often in part because of the care and attention involved. Imagine being in the turmoil of adolescence and having some “fright” symptoms (aka normal teenage madness). Imagine your mama saying, “Come on- I’m worried about you; let’s go cure you. Stay home from school today, maybe tomorrow, too.” She cooks your favorite foods, she doesn’t ask you to do anything. Your whole family is extra nice to you, or at the minimum doesn’t bother you. You rest and relax for a couple of days, getting massages and special baths. You get the full dose of a placebo effect, too. That surely would cure me from an ailment or two.

I don’t think it’s going to cure diabetes, no. But what if it helped a person in a way that addressed the shadow parts of their spirit that were causing them to overeat and thus contributing to diabetes? I can see how it could be beneficial, even while I can doubt that it would be beneficial enough to be a complete treatment for diabetes. And I have no doubt that it can work for many types of problems. I don’t by any stretch think that all these curanderos are quacks, either. Some of them are herbalists, and I suspect that some probably have lots of other wisdom and healing knowledge to boot.

So did the curandera cure Conan? Her healing did not help our car continue to run. But Conan is certainly much better than he was, even if he’s still too skinny for his aunties’ liking. Can we chalk it up to the curandera’s powers? Who am I to say- it certainly didn’t hurt him, anyway.

Maybe I will get Lucia cured after all. If there’s a possibility my four year old will sleep better and whine less, what have I got to lose?

*I got examples of causes and some other good info from this really insightful page, which is for medical doctors and discusses respecting curanderos. It’s in Spanish.

 

 

No Medicine is the Best Medicine Sometimes

26 Feb

“Oh, she’s the doctor who doesn’t give medication,” our family friend said when she realized who our pediatrician is. It amused me to hear her reputation described as such, but the good news is that it’s true- in all the right ways, anyway! We have a radical, thoughtful, socially-minded doctor for our kids now. This has been revolutionary for our life.

A while back I mentioned in a blog post that my parenting anxiety was more extreme because of not having a doctor that we had trust and confidence in. (You can read about that here: https://exiletomexico.wordpress.com/2015/01/25/just-keep-breathing/  ) But then- ta-dah!- we found our ideal pediatrician, Dr. Anja. And as we recover from another bout of Lucia’s asthma, and bask in a reassuring check-up for Khalil, I thank my lucky stars yet again for her existence in Puerto and for us finding her.

You guys just don’t know how novel it is to have a doctor who has a file on our kids, a doctor who wants to see them for check-ups. I can quit referring to old Facebook posts to check on their previous weight. I can ditch some of my excessive notes from every illness ever- because now their doctor has that info. I can ask questions and get advice on what to expect, what to watch out for, how to keep my kids safe and healthy- information specifically for my child, not generated by parental desperation, academic websites and parenting books! Her information comes from medical school in Germany, residency in New York, experience in a public hospital here in Puerto, plus her own practice here. It is a much, much wider range of experience and education than most doctors around here. (Not to mention her credentials are much, much better than mine; I don’t even have aspirations for being a doctor, guys! I just want to be healthy and informed.)

And that reputation for not giving (useless) medication? Perhaps it’s frustrating for people who believe you always need medicine, but that’s not us. For us, it’s a miracle to find a doctor here in Puerto Escondido that doesn’t want to inject a patient with antibiotics every time they cough. “It’s an infection,” they tell you, as if infection were a synonym for bacterial-problem-requiring-antibiotics. Or else it’s something like, “When they have a fever they do need antibiotics.” Really? So, the flu now requires antibiotics? Mosquito-borne illnesses, too? Give me a break, doctors. Even when they don’t give antibiotics around here, they always give you some kind of medicine to buy. Of course, if you go to one of those doctors that works in a pharmacy (which costs about a tenth of what a non-pharmacy doctor charges), they pretty much have to sell you some kind of medicine. But even when we took Lucia to a different pediatrician, he still prescribed us some symptom-relieving medicine for her virus (which I didn’t give her because he didn’t resolve my questions about it, and because I’m a mean, mean Mommy). But our pediatrician has the same philosophy that I do about medicine: You don’t need medicine that’s not going to help. Revolutionary, right?

Before finding Dr. Anja, we also had the medical establishment* here telling us that my healthy, in-the-normal-weight-range daughter is underweight and malnourished. I think they told us that because Lucia’s tall and thin now, and thus out of the very limited “healthy” range for Body Mass Index here in Mexico. I mean, they were working with limited information, bless their little hearts. They certainly couldn’t check her growth over time, since they didn’t keep files on her. By using those same limited standards, she would have been considered overweight as a baby, and they probably would have advised me to breastfeed her less or some other such insanity. I suppose the plus side of not having well visits for her as a baby here was the lack of opportunity for them to tell me she was too fat.

By the way, I did not resort to violence, thank you, and I didn’t even laugh in their face at the word malnourished applied to my healthy, often voracious eater. Both times I nodded politely and left as quickly as possible, before they could suggest I feed her chips or something to fatten her up. Yes, that is plausible; a doctor told me I needed to eat more sweets because my blood sugar was a bit low during pregnancy. If doctors prescribe candy to pregnant women, then why not chips and donuts to “malnourished” children? Sigh. The saddest thing is that these 2 different doctors didn’t recommend anything at all for Lucia. They told us she’s underweight with no suggestion as to how to remedy the supposed problem (not that I would’ve listened, but that’s beside the point).

But all that is in the past! Now we have our doctor. And did I mention that my kids like going to the doctor now? Lucia’s always excited to go there. “Are we going to my doctor? The one with the toys?” she asks. You guessed it, Dr. Anja has a waiting room with toys and books and puzzles! There are colorful things hanging from her walls. There’s a giant stuffed animal in the exam room that Lucia likes to hold during asthma treatments. Her walls are painted and her space is inviting. As an added bonus, there’s always soap for hand washing available (you can’t say that about every health center, unfortunately). We haven’t been to any other medical place with this kind of kid-friendly (or even just friendly) environment.

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The waiting room- You wish you had this doctor, too, don’t you?

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There are even more toys than what you can see in this picture.

Even if she had an ugly, boring office, though, her awesome manner with the kids would still make up for it. The first time we took Lucia there was the first time she wasn’t scared of a doctor. Our doctor knows how to get kids to take a breath before they understand what taking a breath means. She is friendly and talks to them in a respectful way, but on kid-level. She tries to be as noninvasive as possible while doing her job, not making them sit still for more time than they have to, distracting them with toys while she does some things. Of course, I’m sure it also just helps that she’s not trying to give every kid shots of antibiotics every visit.

Dr. Anja explains things to us, the parents, as well. She wants us to understand and be part of our child’s health and care, instead of assuming that we’re completely ignorant about all things health-related and that we need to be protected from ourselves.

She is also trying to reach out and make her adopted community a better place. She now has a bus she uses to take her important services to smaller towns, places where they might never see a pediatrician otherwise. (read more about it here: https://www.indiegogo.com/projects/pediatric-mobile-clinic-in-mexico#/ ) She is also interested in maternal health and promoting more options and information about pregnancy and birth, which is another desperately needed service down here. (What’s that? You guys can sense the future collaboration happening between us? Here’s hoping!)

Being from the U.S., of course it makes me feel at ease knowing that our doctor is familiar with best practices and protocol on an international scale. It’s nice to be able to talk about health issues in my native tongue, too. But it’s not her being foreign and trilingual, or her having experience abroad, that makes her our ideal pediatrician. There are great doctors around here who are from here; for example, my gynecologist is home-grown on the Oaxacan coast, and he’s brilliant and ideal for me, too (someday I’ll write a gushing post about him). Likewise, you can find plenty of doctors in the U.S. who are just as willing as most doctors here to give you antibiotics for your virus. I’m sure Europe also has its share of doctors who think all patients are idiots because they didn’t go to medical school. So it’s definitely not her being foreign. It’s her attitude, her way of doing things, combined with her knowledge, that make her the perfect pediatrician for us.

So amen again for the peace of mind that comes from having a great doctor available. Now we just need to find a good general practitioner for us grown-ups, so the whole family can get sick whenever we want, without the stress of relying on Google and tea to cure us. Meanwhile, y’all who don’t live in Puerto can hope you find your own Dr. Anja. Good luck!

 

*I’m sure there are plenty of good doctors around here. I’m not saying other docs are all awful, but we’ve had some unpleasant consultas, and I am saying that the other doctors that we’ve visited are not a good fit for us. And, okay, I am talking bad about the many, many doctors everywhere who don’t want you to ask questions. They are bad doctors if they don’t want the patient involved in his/her own care, in my humble opinion. For more examples of the madness, you can read about my fight with my insurance company doctor during my pregnancy here: https://exiletomexico.wordpress.com/2015/02/01/me-versus-the-insurance-company-doctors-a-saga/

Nevermind the Pharmacists

8 Oct

Part One on Health and Safety: Doctors, Medicines, and Vaccines (oh, my!)
People in the U.S. have strong opinions and culture around health and safety. I hesitate to post this, because even while I feel critical about my new adopted country, I also feel protective of it. I know that my critique could be used as more fodder for the kind of people who are already xenophobic, people who are hateful and/or fearful about Mexico, Mexicans, and/or other immigrants to the U.S. Of course, all I want is to share some anecdotes about our adjustment to this country, and probably those xenophobes are not reading my blog anyway. Nonetheless, other well intentioned folks, potentially some people who I love and who care about me, are liable to be just as appalled, just as worried and upset and condemning about this country- which, after all, is the country where my partner was raised, and the country where we are raising our daughter for now. It’s a country where my heart lives now, and one that I’m not leaving anytime soon.
It is hard to share some of the negative or difficult things about my life here. People sometimes feel bad for me, feel pity, feel dismay, want to save me from it somehow, or just can’t fathom it. But I want to share, so that someday, when I go visit my city again, someday, when potentially we move back, someday, when you and I chat on the phone, the bridge between our experiences won’t feel so vast. So I hope that people can read this, and all the other negative, critical, difficult, or just wildly different things that I post, and keep in mind that this is just where I am. Every place has serious flaws, including and especially the U.S. I am not sharing this so that people will worry, or be shocked, or feel sorry for me. Rather, I want to give you an idea of my landscape, so here goes.
Doctors
My first experience with a doctor here was fantastic, since I didn’t have to leave the bed. Conan called his cousin who’s a doctor, explained my symptoms, and the cousin prescribed an antibiotic for me. Brilliant.
However, the same informality makes me nervous in terms of my baby. When we took Lucia for her first check-up, I diligently took all the paperwork from the hospital and the doctor’s office in Louisville. But the doctor didn’t even start a file for her- not a single note was taken, except by me. He also didn’t do all the same routine stuff like they do in the U.S., although maybe not all of that’s necessary? This doctor is a general practitioner, not a pediatrician, so maybe that’s the difference? I’m not sure that check-ups are the norm, so maybe that’s it? I did find out recently that there is one pediatrician (and one gynecologist!) in this town, so we’re discussing the possibility of going to see him/her for Lucia’s four month check-up.
It’s not like we have an appointment for her check-up. That’s because there are no appointments here. You just go to the doctor when you need to see a doctor. You wait if they’re not available. They have longer working hours, although they also might not be there at all, randomly. This is because most people work out of an office attached to their home. It’s nice for everyone concerned, as far as I can tell. The doctor doesn’t have to be twiddling his/her thumbs in the office if there are no patients- they can be in their house doing whatever they need or want to do there, and just slip in when a patient comes. The patient has more access to the doctor since the doctor’s “office hours” are longer, since the doctor doesn’t have to be there the whole time. The patient decides what time and day to go in. And wait times don’t seem to be longer than in the U.S., where you wait despite having an appointment.
Medicine
Antibiotics and other medications don’t come with 3 pages of warnings and information, either. They come with as little information as possible, it seems. The one bit of information mine had on it said do not use while pregnant or lactating. Even though I heard Conan tell the doctor on the phone that I was breastfeeding. Even though Conan says the doctor says that he’s gonna prescribe me a not-so-strong antibiotic since I’m breastfeeding. Even though Conan says the pharmacy person looked in some textbook to make sure it was okay. So why does my package say it’s not okay?
I’m 3 days into it at this point, and almost decide to panic. I’m also in Oaxaca City, not Juquila, so I can’t just go ask the doctor. I decide to skip my dose for the night and go ask a pharmacist in the morning. So when we pass by a pharmacy the next day, I say, “Hold on. I’m just gonna go ask about the medicine real quick.” There’s a guy that looks like a teenager working behind the counter- I avoid him. Then there’s a woman who looks like she’s at least a little more in charge, and not a teenager (no offense teens, but I’m looking for medical advice).
I approach the woman and explain the situation. “Well,” she says in a school-teacher voice, “that’s right. Antibiotics are bad for babies. It damages them.” I just look at her for a minute. “Really? All antibiotics? So pregnant women and breastfeeding women can’t take any antibiotics?” I ask, catching myself before I raise my voice. “Correct. It’s dangerous.” She affirms. I want to channel my Nonna and ask her where the hell she learned that. I want to tell her that I know that’s not true, that there are different classes of antibiotics and they affect fetuses and babies in varying degrees. I want to tell her it would be insane and more dangerous if pregnant and breastfeeding women couldn’t take any antibiotics ever. I want to scream at her that she’s probably doing more damage to women telling them they can’t take antibiotics. Instead I stare at her again for a minute, controlling myself, and give her my best sarcastic “thank you,” and storm out of the pharmacy.
“How can she be a pharmacist?” I ask Conan irately. “She’s not a pharmacist, Julia. She’s just some woman who works in a pharmacy.” He explains. “Then where is the pharmacist?” There isn’t a pharmacist, he tells me. So imagine, it’s like there’s just the Walgreens clerk there doling out your medicine. Not someone who’s studied medicines. Someone who’s maybe graduated from high school. This is the norm. Fabulous.
Antibiotics also don’t come in the quantity that you need, for some reason. They’re prepackaged, so you might have to buy a couple of packages and then have some leftovers. I didn’t realize this until Conan got an antibiotic. He was prescribed to take it for 7 days but there were only enough pills for 5 days. Then when he went back to get some more they were out of it, so he went back to the doctor and got prescribed a different antibiotic to take for another 5 days. Not particularly efficient, to say the least, but surely there’s some reason for it? I guess so the non-pharmacists can’t mess it up? Any other ideas, anyone?
Vaccines
Before we arrived in Mexico, we researched vaccines fairly extensively. Mexico and the U.S. have pretty much the same vaccines, and more or less the same schedule, which made things a little easier. We had decided, however, to delay the Hepatitis B vaccine (routinely given at birth), and had delayed the rotavirus vaccine, and were discussing skipping it altogether. Then we arrived in Mexico, and were told by a doctor that you can’t opt out of or delay any of them. They’re obligatory- and supposedly more necessary than in the U.S., according to some.
Vaccines are also free, which is great, though it means the demand outweighs supply regularly. They are only given at hospitals and health centers, not at doctor’s offices. When we went to the hospital to get the 2 vaccines Lucia hadn’t had yet, they were out. The rotavirus vaccine can only be given within a certain time frame, and time was almost up. Since it’s slightly unpredictable when a new batch of vaccines would get to Juquila, we needed to get it elsewhere. While I wasn’t that worried about her not getting the rotavirus vaccine, I didn’t want them to make her get it outside of the time frame that’s been studied as the same time frame for the vaccine.
Luckily, Conan’s mom knows somebody- a key factor in any country, as we all know. So she called her nurse friend in the next town over and got the okay for us to go to the community health center there. I, of course, have to pee while we’re there. The bathroom looks relatively clean, but I go to wash my hands and there’s no soap.
Now, this is a situation that happens often, and I could do a whole post on the lack of public restrooms and lack of toilet paper and lack of this and that, thanks to my incredibly small bladder helping to over-inform me about these things. But we’re in a community health center! There’s a sign over the sink that explains how to wash your hands effectively and tells you about the importance of hand washing. And there’s no freaking soap. And while I’d already learned to carry hand sanitizer with me everywhere, the idea of all those sick people and no soap is enough to make me ill on the spot. (I will say that the nurse in the health center washed her hands with soap in the sink right in the exam room before giving Lucia the vaccine, for the record. Thank you, hygiene gods.)
To be continued…..