Sunday, January 18, 2015

January 14, 2015 Wednesday

You can buy Amantenango pottery from
the local market, but your choices
are better in Amantenango.
Bela, Ricci, Manuela (Bela’s cocinera) and I had planned a trip to Amantenango de Valle to shop and buy handmade and painted pottery but with Ricci’s tummy problem it was a no go. This worked out as I could spend time with Don Sergio before our departing on Thursday.

Handmade and hand painted pottery from Amantenango.

He was glad to see me at the museo as he thought I was going to Amantenango. We quickly fell into our routine as we waited for the taxi. I told him the progress of our two crucial patients as we prepared our bags.

Our driver, Juanito, was running late so DS and I sat in silence until he started telling me of Elsa’s situation of dividing things amongst her sisters. He hopes it does not become too complicated.  Then he started telling me of his visit with his father and how his father wanted to leave him part of the house in Mexico City. DS said he did not want part of the house and since his step-brother had been taking care of the father the house should go to him.  There were other family issues and heartbreak but it sounded like a good visit.  Then with pause he said he wanted to spend more time with Elsa and take her on a trip to Tuxtla for one night - this was music to my ears as I told him that was a fantastic idea.

It was in November 2008 when I met Don Sergio and the person I am most grateful to for sending me to him is Nadia Guilliard. She started the La CasaEn El Árbol Language School and speaks 5 or more languages herself. Over the last 7 years we have seen each other infrequently, but today I had the pleasure of visiting with her again.  It turns out Christiane, Tuesday night’s tour guide, is good friends with Nadia and invited her to join us for tea in the afternoon. It was a short but wonderful visit at Tierra Adentro en Real de Guadalupe andador.
Nadia, right, is expecting her first child in May.
During the evening clinic DS was in his natural stride; quietly doing his wound care as he’s done it for 40+ years.  The crew was there except Cesar; since starting medical school he can only come in occasionally; and Ricci still battling the runs, but she came in later. It was nice having DS back.

Fellow PA, and dear friend, Ricci Silberman and I spend our last night, for this
trip visiting with Alfonso, Edith and Iker while DS gives a tour.

Shortly after patients left we sat on the benches looking forward to chatting with him but three English-speaking tourists had come in and were hoping DS would give a tour.  Whenever English speakers come it’s my opportunity to tell them of DS’s humanitarian work that he does not mention himself.  He gave a nice tour and I followed up with checking if they had questions. Everyone always has questions, as they are amazed with him. The words ‘surreal, amazing, Mother Teresa, Saint’ comes up a lot with many questions about the healthcare system, injuries, funding, and help.

Don Sergio and I hugged and said our good-byes for now. He knows I will be back this summer.

That evening Ricci and I had a dinner party for the crew: pizza, salad and Iker brought the Spanish wine.  It was quite and simple and we all visited. Bela joined us and chatted with everyone.  There were 7 of us and we could not finish the two bottles of wine Iker brought – wimps.

Posted by Patricia Ferrer.

Saturday, January 17, 2015

More Supplies Arrive

January 13, 2015 Tuesday

A well constructed home-made child seat for the bike.
 I love the innovation of necessity, this is probably
someone's main transportation.

My cousin Roy happened to be visiting at this time and he always brings an extra suitcase of medical supplies from NGO MedShare  for Don Sergio.  Always one for adventure he had stayed one night in San Cristóbal and was off to Palenque. He texted saying he left the suitcase at his hotel.  What he brought will last 2 – 4 weeks.

Roy brought a suitcase of medical supplies, then off to Palenque
with Mexica Tours. He will return in a few days.

I picked up the suitcase prior to arriving at the museo for morning rounds and Iker was waiting but our taxi driver had not arrived. Again the struggle of finding our two patients' homes was crazy but we found our way to the burn patient’s home where Alfonso, who lived in the area, met us.

They both did the cleaning, debridement and bandage change very efficiently. Fortunately the patient did not have as much pain. Our second patient with both foot ulcers still complained of dizziness but the ulcers were healing well (to our surprise).

We returned to the museo and Alfonso and I took the opportunity to clean and organize this so called ‘clinic’. Don Sergio stopped by and told us la suegra was buried and now the family is getting together. He was on his way to buy 4 kilos of tortillas. He said all was emotional but well and would return the following day for morning rounds.

The evening clinic was busy but there were 4 of us to do the work. Ricci was excused as she had now caught the ‘diarrhea bug’ and was not doing well. ¡Oye, los estomagos las gringas!

Christiane, (in purple sweater) from France, gave a tour to two visitors
 on Tuesday night while Don Sergio was with his family.

Friday, January 16, 2015

A Loved One Passes

January 12, 2015

Ricci during our morning walk at Riñcon Hotel garden.

Before meeting Don Sergio for Monday morning rounds, Ricci and I went out early for a walk then returned to Bela’s for breakfast. As we were preparing to head to el museo I received an email from a friend I have not heard from in 4 years.

Betsy McNair, with MyMexicoTours who I met in 2011 at a fundraiser for Don Sergio in San Miguel de Allende contacted me. She said she was in San Cris and is bringing a tour group and had stopped by Don Sergio's house Sunday evening to arrange a museo tour. Don Sergio, and his wife Elsa, told Betsy that Elsa's mother had died an hour prior and told Betsy he was hoping I would continue to take care of the patients while he took care of the necessities of the situation.  Elsa had been her elderly (and frail) mother's caretaker for more than five years. Don Sergio and Elsa raised their family of 7 children in his suegra’s (mother-in-law) house where they still live not far from the museo.

We arrived at the museo and saw DS had left a note explaining what happened and he couldn't come with us.  Ricci and I were on our own again, but we had a different driver who did not know exactly where to go. The streets of the San Cristóbal burbs are not well marked, but we found our way to the most crucial patients we had been caring for.

Our first patient was the 45 y/o man with severe anemia, liver disease, diabetes and almost blind (most likely diabetic retinopathy) with the grossly ulcerated feet.  Daily we ask him how he feels and usually he says 'más o menos'. Today he said, 'whenever I sit up I get really dizzy'.  Oye!  This is no surprise, he is so anemic, not hungry, and for lack of a better word he looks like Skelator (cachectic is the medical term). His feet are now retaining water without gravity assistance and they are becoming infected no matter how well we clean and treat the ulcers. As we did our job we explained to him why he is dizzy and asked if he can go to the hospital or see a doctor, but he does not want to go and at this point I'm not sure what they can do for him anyway.

Our second patient was the 26 year-old with the severely burned leg. When we arrived it was a surreal scene.  As were knocking on the door a truck with 6 men in the back said he was not at his house but down the street visiting someone, then said '¡mire!' (look), he was heading toward us. Don Sergio had bought muletas (crutches) for him last week and he was already mobile and about. Not with the fastest stride but making progress.


His emotional happiness was soon taken away by the excruciating pain from the bandage change. The wound is improving and there was no putrid smell. Yesterday we had debrided most of the nonviable skin and clinically it looked good (relatively speaking). However, only part of his leg, the pre-tibia region, has a third degree burn (usually painless due to the depth of the burn) and the rest of the leg has deep second degree burns which is the most painful. At burn centers patients are medicated prior to bandage changes, sometimes put completely under general anesthesia.  Not here: we are hesitant to give him tylenol or paracetamol due to not knowing his liver status after 11 years of heavy drinking, so we give ibuprofen. He had so much pain, that no matter how much we pause to let the pain pass he was writhing.  Twice he fainted but quickly came to. He allowed us to continue until done.  We told him to rest, sleep, take the ibuprofen every 6 hours and we will return the following day.

Ten-minutes later an internal shaking took place in my body for about a minute, a few tears, and then I was over it. This is how it was for medics prior to anesthesia and this is how it is now here in Chiapas. This had to be done in order for the wound to have the best chance and to reduce pockets of retained bacteria that may cause infection. Ricci took the following day off from this case; it was just too much to bear. Experiences like this is what Don Sergio has dealt with for many years.

The evening clinic was busy with patients and to my relief Edith and Cesar arrived.  After telling them Don Sergio’s suegra se murío and he would not be coming they both jumped in. Our patient load was quite heavy and Cesar took complete control directing the patient flow. He was telling me which patients to see, telling Ricci and Edith what to do as he took the most challenging cases. Cesar, el general, is a natural born leader: clear-headed, able to see what needs to be done in different areas and execute a plan of efficiency.  I loved it, a 20 year-old medical student was bossing me around.

Christiane, a French woman living in San Cristóbal half the year and who has been an avid supporter of Don Sergio for 26 years came in  asked if there was something she could do. We had had 4 visitors earlier wanting tour but I had asked them to return later in the week. So, Christiane agreed to be the museo tour guide on Tuesday night. She speaks French and Spanish so the museo doors would be open for visitors.

Alfonso has a quiet demeanor, is a hard worker,
and can focus like a laser beam.
During clinic Alfonso came and calmly got to work. Ricci keep everyone supplied with what they needed. After things settled down Cesar told Alfonso to get flowers, Edith for cups, he was going to get coffee and sent Ricci and I for bread.  He told us to meet him back at the museo at 8pm said he will find Iker and we will go see Don Sergio juntos (together).

At 8 pm Iker and Edith were waiting at the museo doorsteps in the dark. We chatted and watched sporatic fire works until Alfonso and Cesar arrived. I lead the way along the narrow sidewalk to Don Sergio home. His son answered the door and from the back of the central patio of this ancient colonial home comes Don Sergio, in a stride I have never seen before: a fast and efficient pace. He welcomed us into the large bare foyer and as we half-circled around him he hugged us all and recounted what happened.

On Sunday he returned from seeing his father in DF (Mexico City) around 3pm and all was well in the house. His suegra sat with the family, chatted with him, ate and was in a good mood. She then went to lie down and a few minutes later she yelled 'ayudame, ayudame' (help me, help me). They came to her and saw something was wrong and she became limp and slumped over. Don Sergio tried to revive her with mouth-to-mouth and chest compressions but she was gone. Sergio snapped his fingers as if this was as fast as it happened and said, 'gracias adios, ella no sufre' (thanks to God she did not suffer). He believes she had brain hemorrhage or stroke.

We remained entranced with this story then he told us of his visit with his father in DF who remains lucid and mentally alert although he cannot walk or feel anything from the waist down. Then he burst into tears that he had the opportunity to spend some time with him. There were no dry eyes in this group.  He hugged us one by one as we left the items we'd brought and told him not to worry about anything with the clinic and patients. He said he’d return to work on Wednesday.

The six of us walked in silence toward the Zócolo at which point we split into our separate ways. Ricci took the next day off and Alfonso and Iker agreed to come with me to see our crucial two patients. 

Friends of Don Sergio coming together at this time remind me of It's a Wonderful Life. George Bailey who had always treated people fair and kind had his own ‘time of need’ in which his friends showed up.  My timing for this trip was perfect. Although busy, intense and with a touch of diarrhea and nausea for three days, with all the help, the wound and burn care did not miss a beat.

Betsy McNair stopped by Bela's for comida.
We have not seen each other for
4 years. She knows all of Mexico
and advocates supporting Don Sergio`s work.