La Clínica: A Doctor's Journey Across Borders

Chapter Thirteen

 THE MEMoRy oF THAT DAy IN THE CLINIC MERgED WITH my memory of the next day, and what I had had to do. It started the next morning as I sat in Rosa’s kitchen waiting for breakfast. Sopa vieja splattered in the cooking grease as I drank a cup of warm milk flavored with powdered coffee. Rosa cooked the leftover tortillas with egg and tomato for my breakfast while she directed her children to help with various tasks. “Tomás, take this to your father for lunch,” she would yell, handing a few rolled-up tortillas with beans to the eager eleven-year-old. And off he would go on muleback, riding miles into the mountains where Ricardo tended cattle. or she would direct the next oldest, Paulo. “Run and get some eggs from the chickens.” She usually fed me long after Ricardo had gone out to the mountain pastures, even though I was up and at the table by seven o’clock in the morning. I looked forward to this time with Rosa, when we could talk about families or recent cases in the clinic or just sip coffee together. But on this morning, Ricardo was still at home, and he sat at the table sipping coffee as I ate. He waited until I had finished before asking me, “David, do you mind visiting my father?” “No, I’d be happy to see him,” I said. I had met Ricardo’s father, Daniel, a few times. I remembered his firm handshake and how he spoke in almost unintelligible, idiomatic Spanish, smiling as if we shared a great joke. Daniel was the patrón of the family, the one who chapter thirteen  • david p. sklar had settled the land and raised the family when Indians still roamed the area. It seemed as if half the village was related to him by blood or through baptism. “It’s his hand,” Ricardo said. There were five of Daniel’s adult children around him when I walked in the door of his house, and they all looked up at me. Daniel had drool hanging from his lip, which his oldest daughter wiped with a red cloth. “What happened?” I asked. “He woke up this way,” Ricardo said. “He cannot talk. He cannot move his right arm.” I grasped the right hand hoping for his energetic handshake, and it fell away limp. His words became a sound. “Mmmmmm,” he said as his children strained to understand. “Mmmmmm,” he said again. I decided to examine him and sent Ricardo to the clinic to get my stethoscope and a blood pressure cuff. “Can he have water or tea? We have a native herb tea,” said one of the daughters. I looked at the gray liquid in the cup and smelled the minty, pungent fumes. “yes, if he can swallow,” I said, noting the steady dripping of saliva from his lip. He drank the tea eagerly but coughed as he swallowed. “This tea can cure sadness,” said another daughter. “Is he sad?” I asked. “yes,” she said. “He misses his wife, our mother. She died last year. He wants to be with her; that’s why this happened.” “I don’t know,” I said. “But I think we better give him intravenous fluid instead of letting him drink. I don’t think he’s swallowing too well. I can put a needle in his vein, and then we just have to watch the bottle and change it when it’s empty.” Daniel coughed again, spitting up the tea that had pooled in his mouth—as if to emphasize what I had said. When Ricardo returned, I had the family help me undress Daniel. Even at seventy, Daniel’s muscles felt taut, like woven rope fibers. With his strong left arm, he strained to help us remove his shirt. I listened to his lungs with my stethoscope on his back. “Respire,” I said, and he took a breath. Even if he could not talk, he seemed to understand me. The sound in his lungs should have been like air rushing through a straw, but instead it sounded like slurping  la clínica • the last few drops of milk from the bottom of a cup—that bubbly, harsh sound of fluid mixed with air in the straw. Then I listened to his heart. “Fuerte,” I said. “It is strong.” “He has always had a strong heart...