By Bruce Berger
During the early Nineties I became aware that a new word was circulating in La Paz, borrowed from the English. The word was privacy and so fresh was the loan that speakers weren’t sure how it went. Was it privacia or privacidad? There had always been the adjective privado, as in propriedad privada for private property and hablar en privado for talking in private. The was even la vida privada for private life. But unlike other Anglicisms for which there was a perfectly good equivalent in Spanish, like troke instead of camion for truck, or raite instead of aventon for ride, the word privacy was borrowed, I felt, because it filled an actual need. The closest equivalent was intimidad, but intimacy didn’t include such aspects as, say, confidentiality. The reason for the conscription, I decided, was that the concept of privacy in all its English-speaking ramifications was only now reaching critical mass in a city like La Paz, capital of Baja California Sur, because so many of its inhabitants had spent time in the privacy-oriented States.
I had experienced no variations in privacy between La Paz and the United States, living solo as I did in a rental apartment and socializing with whom I pleased at home and abroad, and the differences only surfaced during what I would call adventures in medicine. These appeared gradually, for most of the time in La Paz I was in excellent health. I drank tap water without ill effects until local friends prevailed upon me to switch to the purified, and the only time I got sick on the food was at an American-owned restaurant. When I did go to the doctor for a knee problem, a skin rash, the only difference was that instead of making an appointment and waiting with the problem, often I could see the doctor immediately or later the same day. I had, as back-up, an offer from a winemaker who lived two blocks from me and once said, as a neighborly gesture, that if I ever needed quick medical help, he had an in with the military hospital, which was also in the neighborhood and had a reputation for being much better than La Paz’s general hospital, the Salvatierra.
Several years after that offer I woke up with a stinging pain in my left arm, from shoulder to wrist. The skin was red and spiky, and I theorized that on a desert ramble I had collided with some noxious plant. I walked swiftly to the winemaker, who heard my description, saw my arm, and continued the walk to the hospital. He informed the receptionist who he was and who he knew, and after a brief exchange on the intercom the hospital’s head doctor came down the stairs. The doctor apologized that the specialist in such cases was on vacation but he would handle it himself. We followed him to his office on the top floor.
I bared my arm, describing the pain and its probable cause. The doctor held my arm to the light. “The redness is following your arterial system. This has nothing to do with a plant. Did you ever have chicken pox as a child?”
“It can recur in another form during adulthood. You have Varicela zoster.” Mention of chicken pox informed me that I had just heard the Latin for what Americans call shingles. “I’ll write you a prescription for a painkiller, which you can pick up at a pharmacy across the street.” When I pulled out my wallet to pay for the visit, the doctor delivered a crisp “No charge.” After a three-block march back home, I marveled that I had been diagnosed and issued an analgesic within a half-hour, a feat surely impossible in the United States. It hadn’t occurred to me that there was anything unusual in the winemaker, a third party, being present during my consultation with the doctor, since it was he who had brought this miracle about.
But the painkiller didn’t work. In acute distress, I continued normal socializing as a distraction, and it was a relief to unload my tribulation on friends. Our circle of amateur pianists met in the quarters of a veterinarian who lived with her spinet above her clinic. “Let me check the medicine,” said Alejandrina after hearing my story. She pulled out a dictionary-sized tome, paged it, peered into miniscule print, then announced, “He prescribed the wrong medicine. I’ll write you a prescription for the right one.” She fetched a small pad, scribbled, then handed me the slip. Above her writing was printed, “Clinica Veterinaria Cuatro Molinos”.
“When I show it to the pharmacist,” I asked, “should I bark?”
The next morning I took the prescription to the main pharmacy on the plaza, fully expecting to be asked whether it was my dog or cat who had the shingles, but the pharmacist filled it without comment and it worked. The episode occurred shortly before my return north, so I drove home as best I could, turned the case over to my home doctor and billed my American insurance.
It was a full decade before my next encounter with La Paz medicine, this time in the winemaker’s role of impresario. For years my friend Lico, who lived in the Sierra La Giganta, had suffered breathing difficulties because of a deviated septum, a minor problem on his ranch that turned acute on necessary visits to the agricultural town of Constitucion, two hundred kilometers north of La Paz, which was bulldozing its streets ever farther into the desert. As they waited for pavement, the streets blew dust through town – dust that might be implicated in Lico’s endless flus and colds, none of which I ever caught. Because he needed to return to Constitucion often for supplies, and family members needed a place to stay when they required medical attention, he kept a small house there. For years the town’s doctors had pressed upon him the need for a septum operation, but along with dreading the knife, Lico distrusted the quality of medicine in Constitucion. More recently, meanwhile, in an effort to trim his swelling paunch, he had relatives hold his knees flat to the ground while he performed sit-ups, stressing his lumbar so as to throw out his back and trigger sciatica. He found no reliable help for that either in Constitucion, and these agonies needed relief before we could realize our plans to explore and camp in obscure corners of the surrounding mountains. I told him I would canvas friends in La Paz and line up the appropriate specialists.
When I inquired about deviated septum specialists, I learned that the best ear, nose and throat doctor was a man I already knew socially, an eccentric with a keen interest in contemporary classical music. A chiropractor had been recommended to me by an environmentalist whose back he had relieved when no one else could, an experience that resonated with me because the right chiropractor had untied a knot of my own that had defied all other practitioners, from orthopedists to therapists to other chiropractors. I swung by his clinic, to be greeted by a sandwich board that listed services, proceeding through adjustment, massage and reflexology to aromatherapy. This latter fell into a category I called assholistic medicine but I continued through the door, to be greeted by a woman who described herself as the doctor’s professional partner. The doctor was always in, she said, though he wasn’t at the moment, and one could make an appointment on the day one wanted it. I had done my homework for Lico’s visit, which didn’t occur until a month later, when he was over his latest flu.
He arrived on a Sunday night, we had garrulous beers in my apartment, and
Lico wondered if the chiropractor would attack his malt-swollen stomach. When I suggested, in rancher mode, that his best move was a late-term abortion, he texted the option to his overweight La Paz nephew. The next morning I drove Lico to his appointments, beginning with the chiropractor.
The doctor was out but the woman made an appointment for later in the afternoon, then snapped, “So what’s your problem besides bad posture?” Lico explained it and the woman offered him free reflexology. I explained that reflexology was massage that relaxed the foot muscles, releasing tension and radiating stability upward. As Lico pulled off his high-heeled, pointed ochre boots with a grid of bumps on the surface, the woman glared, then snapped, “What is that, snake?”
“Ostrich,” replied Lico.
“Poor ostriches,” she sighed. “There aren’t many left.”
“There’s a whole ranch of them outside Constitucion” he shot back.
For the rest of the visit, whenever Lico wrestled his boots on or off we riffed on the exchange. “Poor chipmunks,” I would sigh. “Poor whales. Poor rats. There aren’t many left.”
On to the septum specialist. It was a pleasure to see friend Maurilio again after a several-year absence, and after our warm greetings I tried to find the waiting room, but there was only a person-wide standing space by the front door. I retreated there, prepared for a long stand, when Maurilio peered at me, baffled, and boomed, “Come in and sit down!” Mozart played in the background and I had a ringside view as Maurilio shone a laserlike flashlight up Lico’s nose. We discussed the possibility that Lico’s incessant colds and flus might be unvented allergies, and he pronounced that Lico didn’t need an operation for what could be handled with drugstore nasal sprays. Lico looked immensely relieved as Maurilio handed him a spray. As Lico skimmed a list of what not to eat or drink to make sure beer hadn’t made the cut, the doctor turned to me and asked, “Do you know Gorecky’s Third Symphony?”
“I do indeed,” I replied. “The definitive recording was conducted by David Zinman, director of the Aspen Music Festival in my hometown. It won a Grammy for best classical recording of the year.”
“I don’t remember who conducted my CD,” said Maurilio.
“It will be Zinman,” I assured him.
“Do you know the music of Arvo Part?” he asked, naming a contemporary Estonian composer.
“I’ve heard a bit but know more from reading about him.”
“You need to listen, not read,” instructed Maurilio.
Lico looked at us with the same blankness I register when he and his friends discuss horse racing in Constitucion.
A bite to eat, then on the the chiropractor.
At last the doctor was in, loud and loquacious, and he too invited me to accompany the patient. Lico mentioned the sciatica, the inability to climb or descend. The doctor ordered Lico to strip to his shorts, and said, “I’ll make my own investigation.” As he did so, he pattered on about country food versus city food, friends on ranches, his favorite towns. Having been to numerous chiropractors, always with preliminary anxiety, I found the manipulations reassuringly standard, if roughly done. I knew that Lico didn’t like to be seen in public without his boots, but empowered to intrude, I asked whether Lico’s high heels, elevating his bottom, didn’t create an aggravating curve in his lumbar. Heels tightened the Achilles tendon, shortened the calf muscles…. The chiropractor replied that the boots didn’t help, but Lico was used to them. He then asked me to steady Lico’s shoulder while he performed a leg maneuver, first one side, then the other. I marveled at my hands-on role in the day’s medicine, since I had been to countless chiropractors and none had required a helper, let alone let alone an untrained onlooker. Lico would need three sessions, with a day of rest between them, which meant we were to return Wednesday and Friday. Meanwhile, something had to be done about Lico’s paunch, because all that weight in front was throwing his back out.
“I’ve tried exercise and dieting,” said Lico, “but it doesn’t seem to work.”
“That’s because your intestines are blocked. You need a purgative before the diet. I’m going to give you something for that. It’s rather like a nut. You cut it in half and eat half. You will have mild diarrhea and perhaps experience nausea, but it won’t be severe. Before you take it, you should drink some suero.” The word meant serum, but was commonly used for a syrupy energy drink.
“That’s all?” asked Lico. I listened closely to the repeat instructions, since I would have to field whatever consequences.
“Yes, just cut it in half and eat half.” He disappeared, then returned with what looked like a large mahogany button. Lico dressed, slipped it into his breast pocket, and we agreed to meet the same time Wednesday.
As we drove home, I marveled to Lico that I, the mere driver, was a participant in the consultation. Lico was surprised at my surprise. “The doctor always includes whoever you’re with.”
“What if there are details you don’t want the person you’re with to know about? What,” I pressed, “if you injured yourself with a stupid fall when you were drunk? What if you had a sexually transmitted disease? What if you didn’t want your problem to become gossip?”
Bruce Berger is the author of eleven books, including the The Telling Distance, winner of the Western States Book Award and the Colorado Book Award, and Almost An Island, an account of thirty years experience in Baja, California. His works has appeared in The New York Times, The Yale Review, Orion, Outside and many others. For three years he was a contributing editor at American Way Magazine.