Summer In Mexico With the Otomi
In the summer of 1968, I went to Mexico as part of a medical field trip among the Otomi Indians
Recently, I got an email from my son David, “Didn’t you spend a summer in Mexico? I remember seeing a picture of you with a moustache in some desert like climate. What was that like?”
That question came in a most timely and coincidental fashion. The day before, (I kid you not), I started going through one of the 8 or 9 boxes I have stored in my little office in our apartment. These boxes lay untouched since we moved from Teaneck over 10 years ago. For the first time in New York, I looked at a dozen or so pictures that I saved from my trip to Mexico. They brought back memories. And then, the very next day, I get this question directly referencing them.
Given the fact that I have just now found and looked at these pictures, I have decided to answer David’s question in a photo journalistic style. Let me start with the basics. In the summer of 1966, between my second and third year of medical school in Dallas, I went to Mexico on a medical field trip, to live and work among the Otomi. These were “Indios”, who still make up a significant segment of the Mexican population, a much greater percentage than the native Americans in our own country. The Otomi live in extreme poverty in the Mezquital Valley, a high desert plateau, about 100 miles north of Mexico City. They are one of many peoples in Mexico, who despite the arrival of the Spanish Conquistadores after Columbus, continued to maintain their language and culture. They were always dirt poor; their land was dry and arid; they had no resources.
The trip was sponsored by a group of Rotarians from Dallas and Mexico City, who knew one another through business connections. (Rotary International, started in 1905, is a world-wide charitable organization of business and professional people.) The Rotarians gave each of us a monthly stipend of $300. One of the Rotary members owned a commercial trucking business and donated a used van for us to use over the summer. It was a kind of van that a laundry might use for deliveries. It had front and rear bench seating, a stick shift positioned on the floor, and a cargo space behind. It was slow and ungainly, not built for highway use in the US, much less Mexico. It rattled on the road and we, lacking seatbelts, rattled around in its bare unpadded interior. We managed to hit up all the pharmaceutical reps we could find for drug samples. We collected enough boxes of sample drugs of all types to completely fill the cargo space. Thus provisioned with our medicines and armed with a PDR (physicians desk reference) and a ‘Merck Manual’ of diagnostics and therapeutics, we set off for Mexico.
There were four of us who went down to Mexico. Two were my classmates, Henry Caldwell and Dale Howard. The three of us had completed two years of med school. We each had 10 meager weeks of clinical experience, consisting only of a single course entitled “Introduction to Physical Diagnosis”. Otherwise, our medical knowledge did not go beyond the Krebs cycle, the intricate physiology of the kidney and various assorted images from our pathology textbooks. The fourth member of our group was Chuck, the younger brother of Henry Caldwell. Chuck was still in high school, but he came along because he was said to be fluent in Spanish, which none of us spoke. On the way down, we picked him up in Austin, where the Caldwells lived. We stayed with them overnight. Both Caldwell parents were professors at the University of Texas. I could tell they were urbane, sophisticated, well-traveled, and moneyed — everything, in fact, that I was not. Leaving Austin behind, our little group prepared to go south and bring health care to the poor people of the Mezquital.
What drew me to sign on to this expedition? For me, the answer was easy. There was a trifecta of good reasons: (1) I was always ripe for adventure, (2) the adventure paid $300 a month and I wouldn’t have to go hunting for a summer job, and, (3) there was an opportunity to do good, which was not preeminent among my motivations, but still did deserve a place.
We went to Mexico knowing that an American nurse (an LPN) had retired there 20 years earlier (thereabouts), moving to the Mezquital Valley. She settled in a village called Panales, about 5 miles outside of Ixmiquilpan. The town of Ixmiquilpan, on the Pan American highway, was the center of the Otomi community. This nurse, whose name I no longer remember, was called ‘Chabalita’ by the Otomi. She had moved there to help them. She made it her life’s work to raise up the Otomi and bring them succor and comfort. All this information had been made available to us by Cowan Collins, a med student a year or two ahead of us. He had travelled extensively in Mexico and South America, and had met Chabalita and spent time with the Otomi.
Our first task was to check in with Chabalita in Panales. We found Panales about a quarter mile off the highway, reachable only by a dirt road. There were no paved roads anywhere about. There was no running water in the village and no sewage system. There was no electricity, with the exception of a single line, recently installed, running into the tiny school, and only powering a string of lights.
Panales itself consisted of a few raw unpainted cinder-block houses, maybe 20 or 30. We had no trouble finding Chabalita’s house. She lived in a simple cement house, composed of cinder-blocks set out ranch-like with a patio and porch. The walls of her house had been coated with a smooth stucco and painted a light blue. In Panales, her house was a palace.
Chabalita was an elderly woman who had a commanding and pompous air about her. She showed us her piano and the loom she had set up in the living room to help teach the women weaving skills. Native crafts, particularly textiles, were the principal source of income. They were prized by tourists and collectors. She pointed to a prominent peak on the horizon and said the Otomi had renamed the mountain after her, and when she died, she would be buried there. She was always accompanied by a young woman, whom Chabalita treated as her disciple or acolyte. This woman spoke no English and always smiled inscrutably. I could not determine if Chabalita’s rendition of their relationship was actually the case. That first day in Panales, as far as I remember, was the extent of the time we spent with Chabalita.
Our task now was to settle in, and set up our “clinic” in Panales. Chabalita had made all the arrangements. We had a house to stay in, a house to go for meals, and a cinder-box shack where we would see patients 2 or 3 days a week. We moved into one room of a 2 room cinder-block house, owned by the village head, or mayor, who also was the village’s school teacher. There were no facilities whatsoever, not even an outhouse or latrine. In back, outside on a ledge, was a jug of water and a bowl for washing. The other room was occupied by the mayor’s cousin, Manuel, and a small kid who was his helper. Manuel’s legs were twisted into a pretzel shape. Either they had been horribly mangled as a small child or were the result of a birth paralysis leaving his legs shrunken with contractures. He lived his entire life on what we would call today a skate board. At night, moving about with a flashlight, you might come upon Manuel, sleeping upright on his board, and mistake him for a pile of rags. He would lift his head and smile. He was always smiling, always seemed serene.
It seemed as if Panales was small and insignificant, just a collection of dusty raw cinder-block houses in the middle of nowhere. But that view was misleading. There was a ’suburban’ Panales, if I can use that term, extending a half mile or so in all directions. If you walked out of the village, initially all you saw was a desolate region consisting of stunted trees and cactus. But walk 10 or 20 yards through scrub landscape and suddenly shacks would appear, seemingly thrown together with scraps of wood; or you would come across compound-like dwellings, each surrounded by a lean-to fence of dried cactus, enclosing a few goats. The entire area was spread-out like a vast primitive village, like something you might see in darkest Africa.
I think you might well ask, what was a “clinic” day like? Were we the heroes of our dreams, bringing the benefits of modern medicine to these simple benighted primitive peoples? Our clinic days were 2 or 3 times a week and never strenuous. About a dozen “patients” would drift in throughout the day, coming from the village and the surrounding areas. As “work”, it was not arduous. I fear that David’s grandmother, his Bobbe, might well be asking if she were reading this, what did we, little pishers, accomplish? I would have to answer, sometimes a little less, sometimes a little more, than nothing. The best I could do is say overall we did no damage. It’s not that we were particularly cautious. We were ready to do maximum damage, as much as we could! We simply never knew what in hell we were doing, and we lacked the means to even attempt to find out!
These people only spoke the Otomi language. We had assigned to us a volunteer, who was said to be able to translate Otomi to Spanish; then our translator, (my classmate’s younger brother), would supposedly translate the Spanish into English. Anything we said would have to go back along the same route. It was very clear that both interfaces, Otomi <-> Spanish and Spanish <-> English were so faulty as to be useless. No verbal communication was possible in any direction. If we could see something, like a boil or skin infection, then we could lance it or give out our sample packs of penicillin. However, those easy presentations were quite uncommon, even rare. Besides pointing somewhere on the body and pantomiming something, we had no idea what our patients were complaining of. I was already thinking in a psychiatric fashion, and I found the pantomimes so bizarre that I assumed most complaints were psychiatric in nature. (That may have been true.)
We had been informed in Dallas, that our “patients” would require a concrete token of medical care, in order to feel the visit had been worth their time. Therefore most patients, after we listened to their chest with our stethoscopes, and duly palpated, pushed and probed on their abdomens, (finding nothing), received before they walked out the door, a 1 cc injection of sterile normal saline — in a word, an IM placebo.
We had a liaison with a young English speaking doctor doing his government required post-training service in the dispensary at Ixmiquilpan. He had agreed to be our consultant if we needed help. One night we put in our van a woman who had “rales”, wet respiratory sounds in her chest. He examined her and said she had tuberculosis and needed to go to the TB hospital in Mexico City. While we were there, a family brought in a young woman in obvious severe pain. We watched him do his examination. He carefully undid the cloth tightly wrapped around her belly. Underneath were layers of wet leaves. He explained this was the native treatment for all stomach disorders. When he gently touched her belly (and allowed us to likewise examine her), even we, the pishers, could tell she was suffering from peritonitis with an acute surgical abdomen. The family was told she would need to go into the hospital for surgery. But first, they would have to go to the pharmacy and get 2 bottles of intravenous fluid, costing 5 dollars each. They would have to bring these, along with her, to be admitted. The family said they did not have the money and left. I don’t remember the outcome. I would like to think that both women received treatment, but I’m not confident.
Only now, as I look back on my Mexico experiences, (forced to do so by David’s question), do I realized that our trip to Mexico was, in reality, two trips to two Mexico’s, in one. That statement may not make much sense, but to a significant degree, I submit that the trip itself had a schizophrenic aspect that likewise made little sense. Let me explain what I mean.
I hope I have given you some awareness of what life was like in Panales, living among the Otomi. I was living not among the poor, but among the poorest of Mexican society. Remember, we had been sponsored by the Rotarians. In Mexico, the Rotarians came from the richest elite, an extremely thin slice of society. We would live in Panales 5 days a week, bunking in the house with Manuel and his little helper, among the poorest one percent. On Friday afternoon, we would pack up the van and travel 2 hours down to Mexico City where we would sometimes stay with the people involved in sponsoring us, among the richest one percent.
They were eager to make us happy. There was a young single man our age, Jorge, a very nice guy, perhaps a low level lawyer or business executive in one of the Mexican Rotarian’s companies, who was assigned to be our guide. We saw him on a number of those weekend visits. He would pick us up in a nice car, in suit and tie, and personally guide us through the usual tourist sites in Mexico City. He saw to it that all doors opened to us, and that we received first class treatment. He would drive us to the archaeological sites outside the capital or take us to small towns to experience a Mexico tourists rarely see. On one occasion, he took us to a typical small town Mexican cantina, analogous to a pub crawl in England. We learned the technique of tequila shots: carefully positioning a quantity of salt on the webbing between your left thumb and index finger, then throwing down the tequila, licking off the salt and biting down on a wedge of lime before your esophagus knew what hit it. I was a quick learner. We had a fabulous time, singing and dancing with all the people around the bar. That is, until I felt dizzy, went outside in the rain and lay down on the sidewalk. The last thing I remember was the feel of the rain drops pelting my face. Vaguely I sensed some hands under my arm pits dragging me away… Then all went black. I came around in the back seat of Jorge’s car, on the highway heading back to Mexico City. I was told they found me in the police station, talking and carrying on. Although the police conveniently relieved me of any pesos I had on me, it could have been much worse. It was the first and last black-out I ever had.
That was the pattern of our Mexican trip, weekdays in Panales and weekends in Mexico City, either staying in an inexpensive but adequate hotel or put up with some Mexican Rotarian. A few episodes stand out. Once we were invited with a family to join them in their house in Acapulco for 4 or 5 days. We pulled up in our van to their residence in Mexico City. I cannot remember anything other than my thought at the time, “Mansion”. We spent the night with them in elegant surroundings and the next day, the family got into their gleaming spacious SUV-type vehicle. We followed them down to Acapulco in our rickety van. We stayed with them in their home near the beach: my thought at the time, “Palacio”. We had a fabulous time for 5 days and then returned to our “house” in Panales.
During another weekend, a different family feted us in their spacious, well-appointed home in suburban Mexico City. We had a wonderful dinner with them. They were unbelievably charming and hospitable. They spoke of their experiences in the States. The wife turned to the husband and said, “I didn’t like New York City. I didn’t like those people… what were they called… were they Irish or Jewish?”
Growing up in Texas, I had never been to New York, so I had no first hand information. However, I thought it rather unlikely that she was associating New York with an overabundance of unpleasant strangely-garbed Irish people. Henry and Dale knew I was Jewish; it had never been an issue. I was relieved when the topic seemed to pass. However, a few minutes later, she asked us (mind you, not with hostility or suspicion, only mild curiosity), what were our religions? I heard my companions say, “Methodist”, then “Presbyterian”. It was my turn. Could I really deny my heritage? Was I going to be so cowardly? On the other hand, they were so nice, why should I spoil what had been a lovely evening. Some ganglion in my primitive hindbrain nonetheless quickly calculated the odds of any discussion about prejudice or antisemitism in these circumstances turning out happily — particularly when the person at the other end of the discussion isn’t sure whether the people she dislikes go by the name of “Irish” or “Jewish”? What felt to me like an interminable span of time probably only took a second or two. I answered, “Protestant”. I was relieved when the discussion moved on and no one asked me to be more specific.
Before leaving Mexico, we took an extra two weeks to travel all over. We put thousands of miles on that van. We ended up finally at the far end of the Yucatan, spending 2 or 3 days on Isla Mujeres, at that time only reachable by ferry. The island was still relatively undiscovered. (Now the island has an airport and Trip Advisor lists 14 posh resorts.) I remember perfect white sands, sleeping in hammocks on hostel porches, and cheap outdoor restaurants serving good food, among them, their specialty, turtle steak. It was unbelievably tasty and tender. (Now turtles are endangered. Who knew, back then. You chastise me and say I should have known. I say, how? That’s an argument that always ends with me feeling very sympathetic toward all those historical figures, now being toppled from their pedestals, because they lacked, or failed to develop, the proper future extra-sensory perception.)
Looking back on the entire trip, I can confidently say it was worthwhile. I really learned about Mexico, its culture, its history and accomplishments and I admired them. I learned what life was like among the most impoverished people in North America. I got a sense of what little impact we had. I returned home to Dallas feeling we really made no appreciable difference. Maybe I have carried forth that cynicism in my life, I don’t know. I can only say for certain that I learned a lot about Mexico and maybe even a little about myself. It was a worthwhile enriching summer.
EPILOGUE
After writing all this, I went on Google Maps to see if Panales even showed up. To my shock and delight, I found that it did. The dirt road was paved, even divided with a center strip. Street view images were available and I was able to digitally drive the streets and download two images that I could juxtapose with two that I took 54 years ago.
I hope these improvements have made a difference in the life of the Otomi. I hope Chabalita is watching from her mountain top tomb and feels pleased.