From Xico

Death of a Good Man

On October 16, Chris Brown died in Xalapa of  hepatitis C. He had it for a long time, but nonetheless lived a good and active life.  We were shocked and discovered we were also very sad.  I had never met Chris personally, though I'm sure I saw him at various places.  Nonetheless we considered each other friends, and friends of long standing, communicating by email and via our blogs. From his blog, you can get a real sense of this man with his curiosity and sense of purpose and decency.  It's worth reading to learn about an expat in our area who lived an exemplary ex-pat life. He traveled and worked his land and was a good neighbor and friend to people who needed him.  Children around his terreno became his frequent, rambunctious and devoted helpers. He detailed his mundane labors to turn his plot into his garden and home so well that I looked forward to each new installment as if he were writing serial.

Jim and Chris shared a dentist, a prosthodontist, named Edgard Hernández Guitiérrez, himself a very interesting man.  Yesterday we went to visit him because he is doing work on Jim.  I wasn't sure he would even remember Chris, but he did.  He too was clearly shocked and distressed by the news. Like others whose comments I've read and heard, he remembered Chris as a good and gentle person.   No more will they bump into each other at the same club to listen to music. 

Death seems to swirl about us here, more part of our lives than in the US.  It often seems to me that I can sense in scattered moments whisps and puffs of it. Death feeds our lives and our lives feed death.  It is terribly sad to lose someone.  That death is woven into our lives so clearly here makes the losses both more melancholy and more ordinary.  It seems to me that it is not ghosts which inhabit the world with us but some sort of smokey energy that drifts through the trees and rides the ripples of the rivers and streems and slides along the breezes and it works to churn the dying plants back into earth.  

Sometimes I do get a sense of a presence, an indigena suddenly materializing and just as suddenly gone, or a long-dead Spaniard. Or the woman up the street who died of diabetes or Santiago on our block. This place we live is crowded with life and death. We are all in it together

 

 

 

 

Abraham Verghese, Crusader, and Mexican Medicine

First, a some excerpts from an article about Dr. Verghese, from The New York Times of October 12. It's very definitely worth reading the whole thing.

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"Dr. Verghese (ver-GEESE) is the senior associate chairman for the theory and practice of medicine at Stanford University. He is also the author of two highly acclaimed memoirs, “My Own Country” and “The Tennis Partner,” and a novel, “Cutting for Stone,” which is now a best seller.

"At Stanford, he is on a mission to bring back something he considers a lost art: the physical exam. The old-fashioned touching, looking and listening — the once prized, almost magical skills of the doctor who missed nothing and could swiftly diagnose a peculiar walk, sluggish thyroid or leaky heart valve using just keen eyes, practiced hands and a stethoscope.

"Art and medicine may seem disparate worlds, but Dr. Verghese insists that for him they are one. Doctors and writers are both collectors of stories, and he says his two careers have the same joy and the same prerequisite: “infinite curiosity about other people.” He cannot help secretly diagnosing ailments in strangers, or wondering about the lives his patients lead outside the hospital.

“'People are endlessly mysterious,' he said in an interview in his office at the medical school, where volumes of poetry share the bookshelves with medical texts, family photos and a collection of reflex hammers.

"He is out to save the physical exam because it seems to be wasting away, he says, in an era of CT, ultrasound, M.R.I., countless lab tests and doctor visits that whip by like speed dates. Who has not felt slighted by a stethoscope applied through the shirt, or a millisecond peek into the throat?

"Some doctors would gladly let the exam go, claiming that much of it has been rendered obsolete by technology and that there are better ways to spend their time with patients. Some admit they do the exam almost as a token gesture, only because patients expect it.

"Medical schools in the United States have let the exam slide, Dr. Verghese says, noting that over time he has encountered more and more interns and residents who do not know how to test a patient’s reflexes or palpate a spleen. He likes to joke that a person could show up at the hospital with a finger missing, and doctors would insist on an M.R.I., a CT scan and an orthopedic consult to confirm it.

"Dr. Verghese trained before M.R.I. or CT existed, in Ethiopia and India, where fancy equipment was scarce and good examination skills were a matter of necessity and pride. He still believes a thorough exam can yield vital information and help doctors figure out which tests to order and which to skip — surely a worthwhile goal as the United States struggles to control health care costs, he said.

"A proper exam also earns trust, he said, and serves as a ritual that transforms two strangers into doctor and patient.

"Stanford recruited him in 2007, in large part because of his enthusiasm for teaching the exam. He seized the bully pulpit."

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Yesterday I found myself in my doctor's office here in Xalapa, Veracruz, Mexico.  My regular doctor. We sat and talked for awhile: lots of questions from him, lots of careful listening. He noticed two of my complaints before I even mentioned them: a red blotch on the top of my hand and some trembling.  Then we went to the physical exam.  I remember why human beings, trained and dedicated and compasionate are not machines.Touch, hearing, sight, smell and mind woven together by years of experience, focused on a specific person, following signs down muscles and veins, listening to the woosh and thump of the heart, testing the elasticity of the skin. Checking color and clarity, texture. Noting sadness or fear or listlessness or wistfulness.

Then we talk some more.  He asks more questions, then presents some hypotheses and some conclusions.  He writes out on crisp thick paper his instructions for me, orders for tests he thinks would be helpful, and prescriptions as necessary.  Like a teacher, he presents what he has written, going over the instructions and reasons for them, talking about the prescriptions and the tests he is prescribing.  He answers all my questions, sometimes knowing the answers, sometimes saying we will have to wait and see.

The appointment takes about an hour. He schedules most appointments to be an hour.  After I leave, I am  surprised yet again at the thoroughness of his exams, the care he takes, his skill, and the trust I have in him.

It was much to my surprise to find the kind of care Abraham Verghese advocates for here in Mexico.  And contrary to some opinions in the US, a hands-on physician offers a lot more than simply a bridge to trust beteen doctor and patient.  It offers the doctor knowledge about his patient that is not only a way to avoid expensive tests, but a way to really be able to monitor her patient's condition and build a profound knowledge of the patient over time.

Where we live, there are very few non-Mexicans.  When our family knew we were moving here, they had a lot of concern about the kind of medical care we would receive. My son even advocated that we buy the kind of insurance which would pay for helicopter evacuation in the case of serious medical issues.Though we didn't tell them, at the time, we shared soome of their concerns.

Instead, we found ourselves increasingly inclined to seek medical care here and NOT in the US.

And it is not just because of our personal doctor.  I also go to a gynecologist and an ENT here and my husband sees  a cardiologist and an opthalmologist with whom we are very satisfied, to say the least.  And  I endured an episode with a food toxin last Christmas following a meal in a restaurant (the first time I'd gotten sick in a Mexican restaurant in years, and the last time I have).  I could not stop vomiting and thought I was dying since I could barely breathe between upchucks.  I ended up in the emergency room.  As with all facilities heere, there was nothing fancy: no interior decorating, no carpeting.  But I got what I needed from very attentive medical staff.  Because I was covered by the state health insurance program, I ended up paying the hospital abou $8.00 and about $60.00 for medication.

More impotant than the price is the expertise, the attentiveneness, the warmth of all these medical professionals.Here, nobody appears concerned about not appearing professional if they show themselves to be warm and caring and comfortable using touch.

If Dr. Verghese would like to refresh his faith in physicians, he can come here to our area of Mexico to find some comrades who will support him.  At least some doctors here find the US medical system at the moment to be pretty strange.

 

 

Mexico Economy Rebounds says Business Week -- Whatever you Say.

According to Bloomberg Business Week:

The government says Mexico's economy grew 7.6 percent in the second quarter of 2010 compared to the previous year's quarter, the largest jump since the 2009 global economic crisis plunged the country into recession.

The National Institute for Statistics and Geography reports that the gross domestic product increase was driven mostly by a 7.8 percent growth in the industrial sector.

The institute reports Friday that the rebound also came from a 7.4 percent increase in services and 4.8 percent climb in the agricultural sector.

The country saw a big jump in sales of automotive products to the United States, analysts say.

Mexico had a GDP drop of 6.5 percent in 2009, its largest in decades.

This puts Mexico in the lead in Latin America in terms of foreign investment.  But only for the moment.  International Business News sees see this burst of energy as temporary, partly because Mexico's economy remains so entwined with that of the US, and the US isn't doing so well.

Even more important, the growth was in areas that have little to do with improving the lives of ordinary Mexicans, just as whatever recovery is touted in the US doesn't seem to reach ordinary Americans. Agricultural expansion tends to be industrial agriculture expansion meaning fewer jobs and more food and environmental degradation.  Similarly, an underlying issue for all of Latin America is that it continues to expand extractive industries, or industries that benefit the countries it exports to more than it helps the exporting countries.

In Mexico, inflation continues to be a significant problem for ordinary people, with the government maintaining low interest rates to continue to encourage foreign investment.   For instance, while inflation in August was low, it was expected to start rising, possibly to an annual rate of over  5% for the year, and though supposed to settle into a 4.5% rate, this is really tough for people who already can't make their income go far enough.  Other Latin American countries, including Brazil, which is doing better than Mexico in terms of growth rate, are raising interest rates to control inflation.  Mexico, under Calderón, is sticking to its US Republican business model. 

The whole Washington Consensus macroeconomic model driving growth in Mexico and still in much of Latin America though not as much as in Mexico, is a rickety, unstable model at best.  In a new book, The Dragon in the Room, Kevin P. Gallagher and Roberto Porzenkanski arguethat China's road to globalization, one that emphasizes gradualism and coordinated macro-economic and industrial policies, is far superior to the Washington Consensus route taken by most Latin American nations, particularly Mexico."  Download this PDF for a brief summary of Gallager's arguments.

I wrote some blog posts giving basic explanations of economics sometime ago (on another blog and in another lifetime!). They may help you understand something of the way economics work.  You can check here and  here for starters.

 

 

 

Flows and slices -- Barcelona artist Romero Campos Paints San Juan de Ulua

The rant I wrote before Hurricane Karl sprouted  from my experience at an exhibit at Las Galerías del Agora in Xalapa.   The paintings were made at San Juan de Ulua. I wrote about San Juan de Ulua here, but only briefly.  We've visited San Juan de Ulua more than once.  I had a bunch of photos but they disappeare with a hard disk crash. However, there are plenty available online. Below I give you an aerial view.  The rectangle at the center of the lower half with the elongated corners is San Juan de Ulua proper.  It is situated in the harbor of Veracruz.  Before the Spanish landed, it was an island used for religious purposes. While the Spanish ruled Mexico, it continued as a fort.  After independence, some Spanish resisters remaining in the fort continued to fend off attacks and maintain that Spain had not been defeated.  After Independence, it was used as a prison for political prisoners and as a presidential palace.  Today, it sits largely empty except for a small museum and some offices. Elton John gave a concert there recently. It is being renovated. I hope it isn't too extremely renovated, because the haunted quality woven into its walls and floors and doorways embody five hundred years of  history.  Walking in these buildings, knowing a bit of what happened there, we learn to feel and understand the past a bit, to understand who we are.     

It is this that the artist Alfredo Romero Campos seeks and captures in his exhibit and connects with the personal.  He says:

"It is the investigation through the recovery of these architectural spaces of the places I visited during my stay in Mexico, in which there is the presence of the abandoned, solitude and emptiness.  But at the same time, they are filled with atmospheres left by the passage of time, where the walls cry, breath and even hear the memories of the nostaligic and melancholy past.

"These places which you see are also our laberynthine interior passageways, trapped darknesses in narrow walls, destroyed by the light of hope and our 'I'  immobilized by fear."

The curator of the exhibit, in his introduction which he calls "Infinite Perspective," put it this way:

"...[W]e discover an artist who..speaks to us about intimacy through desolate and silent rooms, who questions the existnce of emptiness, since they speak to us as containers of private histories which implore us to hear them."

I hesitated to put up photos here because the paintings are flattened so on a screen.  They are indeed pretty much two-dimensional although the paint has been applied in  layers, but of course paintings themselves have a depth that photos can't hope to reproduce, and in these paintings the depth is very important.  However, you can learn something from them I hope if you can imagine their subject: an old fortress on an island in a harbor, stone room upon stone room, often dim, connected by archways, through which the light filters, sometimes one color, sometimes another, depending on time and weather.

The paintings have no names, only numbers.  Wandering past them evokes wandering through thearched doorways from room to room in San Ulua.

 

 

 

 

 

Donations from the US

I have heard from my contact in Veracruz that in fact it doesn't seem possible to donate money to DIF from abroad. Therefore, the Mexican Red Cross remains the best alternative I know of.

FOR DONATIONS to the Mexican Red Cross for Veracruz flood relief, you can donate via a US bank to the following Bancomer account.
0404040406 Bancomer branch 683 in the name of Cruz Roja Mexicana IAP
This is a Mexican account so you will also need the interbank key: 012080004040404062

Veracruz Emergency Assistance Update

The Mexican Red Cross -- Cruz Roja Mexicana -- has a nice updated webpage which you can go to to donate directly at: http://www.cruzrojamexicana.org.mx/pagnacional/index.jsp

If you want to donate medicines, please contact one of the following or information on how to do it.  It is complicated.  Neither of these groups has a current project in Veracruz, but they can tell you about shipping drugs across borders.

Partners in Health:  http://www.pih.org/

Doctors without Borders:  http://www.doctorswithoutborders.org

Money remains the most useful donation -- the easiest to send, receive and make use of from foreign countries.  It isn't meant to be ungrateful; it is just that there are all kinds of hurdles involved in shipping and receiving meds and foods.  

My recommendation is Cruz Roja, a money donation.