Twelve Patients: Life and Death at Bellevue Hospital (16 page)

The parents were trying to come up with some money to pay the hospital; only the completely indigent paid nothing. The Mexican team had assumed control, and it was clear they were going to work with the family to ensure his pain control and complete care at home. The phone calls and negotiations were in process; he would be moved later that day. Diana took Liliana aside and slipped her a hundred dollars. Again, Liliana accepted this as a matter of course. They needed help and would not turn it down. We then went back to say good-bye to Octavio. I took his hand in mine and promised to come back and
visit in a month. His eyes filled with tears, but he agreed to believe that we would see each other again.

After our good-byes to Octavio and Kat, we took the other family members across the street for lunch. Patients’ families were sitting on the side of the entrance eating tortillas off paper napkins while licking their fingers. Cars kicked up dust clouds in the desert air. We were deep into the dry season. There was a long row of bright-colored plastic tarps providing shade for a dozen taco food stands in a row on the other side. Elena’s, Erika’s, Rosa’s, Eugenia’s. We strolled across and walked the gauntlet until we found one with the right atmosphere of TV on low volume, red plastic tables and chairs, blue corn tortillas and quesadillas on the large circular
comal
heated with a gas burner, a gigantic
cazuela
filled with crispy pig skin and red broth, and—most important—a smiling
anfitriona
or hostess to greet us.

We sprawled out over a few tables and put in our orders. We were surrounded by women except for Octavio’s father, Brigido. We made small talk until the orders came.

Octavio’s sister Barbara started the conversation. She had been in Arizona with her husband and had been picked up by ICE (Immigration and Customs Enforcement) and immediately put into detention. “
¿Tiene una hija?
Do you have a daughter?” they had asked. “If you want to see her you have to leave and not come back to the States for five years. If you come before five years are up we will put you in prison for two full years.” They threatened and bullied her. They were Latinos themselves, Chicanos from Texas, Latinos who had grown up in the States and had their U.S. citizenship. She had left without seeing her husband, who drifted to New York City to stay under the radar of the immigration services and the deteriorating vigilantism of the Southwest. The Sheriff Arpaios who were making a name for themselves in Phoenix were all known through the informal networks where information was transmitted rapidly via cell phones and word of mouth. He wasn’t necessarily the worst, she said, only “he liked the publicity and the power.”

Octavio’s mother, Elena, told us that she had made an attempt to visit her son when he was in the hospital. She had been granted
papers from the Mexican consulate in Mexico City and told to cross at Laredo, Texas. After a forty-eight-hour bus ride, she arrived at the border. The U.S. ICE officials called the New York hospital, which denied that Octavio was a patient in the facility. They put Elena in handcuffs until the Mexican consulate was contacted in New York City and was able to verify Octavio’s existence and his medical status as an inpatient. They released her but refused her entry. She was too distraught to try again through official channels. The pain and humiliation of the experience left her anguished and defeated. She took the next bus back to Morelos. The family wrote a letter to the Mexican president asking for assistance. They never heard back.

Octavio’s cousin Jessica had jet-black hair and was on and off her cell phone throughout the meal, getting up a few times to talk privately, her back to us. She was in her early thirties and looked much younger. Her husband and kids were in Waco, Texas. She had worked in the States for thirteen years maintaining a household with her husband and four children, all of them U.S. citizens. While commuting to her job at Wendy’s in the standard checkout counter uniform and apron, she was picked up by the police on a stop-and-frisk protocol. She was immediately taken to an ICE intake center since she had no identification, then transferred to a remote detention center. Her location changed four times in eight months. Middle-of-the-night rousings, the gathering-up of belongings, and being bused to new locations with no stated reason was the routine for the hundreds of detainees in orange jumpsuits who lived in an expanding parallel universe to the U.S. prison system. They gave her a blanket and a prison uniform and food in the morning. At the end of her eight months in detention, ICE officials eventually released her at the U.S.-Mexican border. The guards, she said, called her a “bitch” and told her to stay the “fuck” out of their land.

“Why do they hate us so much?” she asked me.

She made it back to her family in Cuautla, where she continues to participate in the daily life of her husband and children via phone calls many times a day. A virtual mother to a virtual family. The children, preschoolers to adolescents, the wife and husband are in suspended
animation, waiting for some kind of reunion, for the possibility of a life together that may not happen. With each year that passes the ties that bind are frayed.

Sitting around the table, Diana and I acknowledged the widespread community of pain. We also knew it is the deliberate policy of the U.S. immigration service to raise the bar for economic immigrants. The reduced risk-reward ratio will supposedly change the decision-making behaviors of young men and women who risk their lives to get into the States. The costs and risks are considerable: the costs of a coyote, the risks not only of ICE but also of criminals engaged in the increasingly lucrative business of extorting and kidnapping immigrants heading north from Central America and Mexico.

Brigido had another order of
tacos de carne
, cheese, and mushrooms on blue corn tortillas with an orange-flavored drink. He mopped up the salsa with extra tortillas, sprinkled on some salt, and dropped chopped onion and cilantro onto his last mouthful. He looked chronically tired. He wore the same clothes from the day before, a brown-checked shirt and brown pants. He was skinny and had short gray-flecked hair. I asked him if he had ever spent time in the United States. “I never wanted to immigrate,” he said. “Too many stories of prison time from my friends and their children. Plus, the heat in Texas is worse than Cuautla. Who would want to suffer like that for nothing? The drugs and alcohol have ruined more lives than the
remesas
have helped.”

He then started to talk about the upsurge in the narcotics trade in Morelos. “It isn’t like Michoacan here with
La Familia
[the narco cartel in Michoacan state] in charge, extorting and kidnapping. The cartels don’t control the entire state. The drugs get shipped through Cuernavaca up north or flown through the airport in the city center. I am more worried about unemployment and the young people, though. What will they do to support themselves? How will they live? I couldn’t even support Octavio, my own son in my own business. It dried up in front of my eyes after twenty-plus years. The corruption is everywhere in government and could spread to the men who cannot support their families, who cannot afford a house or an apartment, a girlfriend. If
you cannot afford to get married to have a family, you are creating a different kind of desperation.” Brigido was animated and angry as he talked. I had not seen him this lively before—just quietly helpful in the background of the entourage of women he assisted in his steady way. I would not see Brigido again as this Brigido. He couldn’t protect his family and could barely keep tortillas on the table. His shame was shrouded in rage that he contained in order to be of service to others and his work.

“I used to have my own car repair business,” Brigido said matter-of-factly. “With the economy sputtering down a dozen more businesses opened on sidewalks, parking lots, and empty spaces everywhere. Prices dropped for repairs and I had to lay off my three employees whom I had worked with for many years. I was embarrassed. They had wives and families. I knew all of them like family. The price of parts doubled in the last two years. Electricity and gas go up 20 percent a year minimum year after year. The
gasolinazo
or Pemex price increases on gasoline every three months forced me to sell my car, a much-used Chevrolet. I cut out everything that was not totally essential and charged only what my customers could afford. At this point, I depend more on credit and bartering. I didn’t have a cash business left. I now do everything myself and bring in Raul, my brother, for the occasional big job, an engine or transmission. I have to keep everything locked up all the time or my tools will get stolen. No one can afford tools. I also repair everything and anything, from refrigerators to air conditioners.

“But I am just one man, and there are many more in the neighborhood. I hate the narcos, but I can see where things are going. Where the pressure is. Without jobs or a future, what are you going to do? Just how do you survive? Maybe if I was a young guy like my son I would go to the States and take the risk. It is kind of like a prison staying here if you are a young man like Octavio. So what is the difference, really? I see my grandchildren and don’t see what they will do, where they will live. Who will they marry and how will they bring up children? We can barely bring them up. I sleep on the couch to allow my children the dignity of privacy. They lost their spouses a long time ago to immigration. The U.S. news reviles us, makes fun of us, makes us
into thieves and criminals. Who are the criminals exactly? If Mexico is a criminal state or at risk of becoming one, why sell us advanced military assault weapons at border depots? Why launder the narco money in the biggest U.S. banks? Why purchase billions of dollars’ worth of drugs?” Brigido was almost done but had not quite run his course. This was the Mexican street speaking loud and clear. “We are a relatively poor country, but not an impoverished country. We are a deep country with a profound wisdom. The United States is risking its own heart and soul by hating us, hating others.” Brigido sipped his soft drink and looked at all of us and then turned toward a distant spot and lost himself into infinity.

I looked at Brigido with some surprise. He had been so taciturn and private. I knew he felt a great pain for his son. His wife was the emotional member of the family who looked after the grandchildren and kept an eye on the house. He tried to bring in some pesos and keep the lights on. He had a very realistic sense of the Mexican government, U.S. policy, what it meant, and where it was headed. Was this a look into the future for the United States, its own future foretold?

We paid the bill and all piled into our small VW for a short drive to the Salcedo house through the center of town and over the dried bed of the Cuautla River. Middle-class gated communities fell away as we slalomed our way into a working-class neighborhood where the work had evaporated. We pulled into a nondescript barrio of rectangular cement houses and cement sidewalks. There was barely a tree in sight. A few ancient dust-covered cars parked on the street. Brigido opened the door and welcomed us into his home. Octavio’s two young children were playing on the floor; both had baby bottles filled with milk in their mouths, lying on their backs in front of a large color television screen. They squirmed and moved by pushing their legs against the ground, sliding across the floor. They were too old for baby bottles. This was a case of elderly grandparents taking the path of least resistance under enormously stressful circumstances, caring for another generation they were not mentally or emotionally prepared to manage.

There were no alternatives. The family was tapped out in every
direction. Both children had obvious severe developmental delays in language and skills from benign neglect. They were never abused; they had food and decent clothes, and a loving household. The energy required to read to them, talk with them, and participate in meaningful activities for their age did not exist. The time, effort, and money required if they were to socialize with their peers, or take part in activities that might engage them both mentally and physically, were unavailable. The barrio had changed in recent years. It was not safe for kids to play in the streets and hang out without supervision. Every family was locked into its concrete bunker of a home. The family showed us pictures of Octavio as a young man and the marriage portraits of his parents thirty-five years earlier, a handsome couple. The Virgin of Guadalupe looked over the room from her altar surrounded by candles over the door.

As we drove away, retracing our steps through central Cuautla and back toward the giant Walmart leading us to Tepoztlán, we couldn’t help but think about the Salcedo family. We were leaving a community shaken by seismic economic forces way beyond its borders. Mothers and fathers, brothers and sisters trying to make some sense of a world that had changed so much over the last few decades and was putting more and more pressure on them to keep a step ahead of a game they could barely make sense of. It was like a gravitational field from a black hole that pulled away at industries and livelihoods, added great wealth to a small class, and created a huge demand for illegal drugs. This new parallel economy was as big as the traditional one but spawned a level of violence and civil unrest that even defied the state “ownership” of lethal violence. We were bringing a young man home to be with his family during his final weeks. Yet we had become witnesses to the intimate violence that was part of economic immigration as it tore through communities and families.

The flight back was unremarkable, leaving at one p.m. and landing at Liberty Airport in Newark, New Jersey, that evening. Diana and I hardly spoke on the flight. Once we landed, we took a cab to our apartment, checked in with our family, ran through the pile of mail, ordered
some takeout, and crawled into bed. We both knew the next morning would bring on the routines, emails, and phone calls that would begin to erase the physical and emotional drama we had been a part of.

Over the next few weeks, everyone who had cared for Octavio asked about him and Liliana. Octavio had made it home and was under the medical care of a daily visiting nurse and a physician several days a week. His pain was well controlled with a combination of narcotics and medications for anxiety in liquid form titrated to his changing needs. He played with his kids, talked with his family and friends as his strength allowed. According to his sister via a poor phone connection to my New York line, he was enjoying his mother’s tortillas, hot to the touch, with coarse salt and green mangoes the day before he died.