The morning after I arrived the rain continued to pour down. The muddy calle in front of the case was barren of both people and pigs. I stared at my huge cargo, mostly medicines, stacked against the back wall of the “portal” (front veranda). I felt a little ridiculous with all those cartons and boxes
piled between the calabazas and corn.

But when the storm slackened the people, remembering me from our Pacific trip the year before, began to arrive for medicines. They came like the rain itself, first a sprinkling and finally a deluge.

The vast majority of the sicknesses here are related to either poor hygiene or malnutrition, usually both; children with head lice (piojos) where dirt and scratching has caused secondary infection and sores (granos); festering ulcerations (llagas) of the skin with gaping cavities up to half an inch deep; boils (nacidos), especially on children; pelagra-like bruising (manchas) of the skin; large, suppurating, spreading unhealing sores (lepra), especially on children; rickets; mouth ulcerations (postemillas); irritating ringworm infections (jiotes), especially on children around the eyes; muscle cramps (calambre); arthritis, rheumatism, sciatica (all called reuma) sometimes beginning in children, and present to some degree in almost everyone from middle-age on; hemorrhaging, especially in women; scaly infections (tiña), probably fungal, of the face or scalp; ulcerating varicosity and tissue degeneration of the lower legs; stomach ulcers and painful hyperacidity (agruras); persistent dizziness (tarantas) and/or ringing (zumbido) of the ears; and an endless variety of aches and pains and organic disorders coupled with anemic conditions and general debility. Breastfeeding infants are typically scrawny, for the mothers of the poorer families have a scarcity of milk in their own breasts, and lack the con qué to purchase fresh or prepared milk. (The infant mortality rate is very high. Rare is the mother of a large family who has not lost one or more children, and on the average, a mother here loses one fourth to one third of her children, frequently more). Dysentery, both bacterial and amoebic, causes much suffering and takes many lives, especially of young children.

The list of ailments I have already encountered goes on and on: eye and ear infections; festering cuts (heridas) and scratches; chronic bronchitis; la gripa; rashes (ronchas); vaginal and urinary infections; etc. Of less frequent occurrence have been the stings (picaduras) of scorpion (alacrán) and centipede (ciénpies). More common are reactions to the bites of bedbugs (chinches), fleas (pulgas) and ticks (garrapatas). Plant poisoning has included a child who chewed on the bola of Jimsonweed, and a severe poison ivy-like reaction to a plant called hierba de truncha. (So called because it is used in poisoning a knife-shaped river fish called the truncha. The leaves of the plant are margined with stiff, sun-dew like bristles, each bearing at its tips tiny droplet of the oily poison.) Other injuries have included dog and rat bites, and cuts of varying severity from machete and hacha. An epidemic of mumps (here called coquetas) has now begun in Ajoya, and promises to be severe, for apparently, it has never struck Ajoya before, and isolation is impossible. Not only do entire families sleep together in a single room, but the children group in threes and fours under a single blanket, because no more blankets are had.

I have been doing my best to treat the people who come to me, but for many ailments I am frequently at a loss. I have had to turn many persons away, saying that I lack both the knowledge and equipment to make a proper analysis. For others, it is apparent that the only reasonable treatment is operation. Yesterday, I gave a father fifty pesos to take his small daughter to Mazatlán to have an enormous and rapidly growing shin tumor removed. And I have provided others likewise, but there is a limit to my funds, and none to the need. Frequently I have to make blind guesses as to the seriousness of a condition I have little or no understanding of. It is easy enough to say, “You should see a doctor.” But most of the people can no more afford the journey to Mazatlán than they can to New York. I alone have to make the decision—for there is no one else to do it—as to whether to provide the trip-money to this person or that. Usually, if I am not fairly certain that the need is critical I do not provide the money, for there are more than enough cases where there is little question, even to a layman like myself. At times I am forced to play the role of a blind god, whether I like it or not. My limitations are enormous, but I have got to accept them.

And how fast this supply of medicines—which at first struck me as so huge—is diminishing! Especially those medicines which are in greatest demand.

I can now see that I will have to get many more medicines if I am to have anywhere near enough for a year. Vitamins seem by far the most critical. I am already gently refusing them to all those who do not manifest chronic deficiencies, and am doing much consulting as to diet. (I fear, however, this is of minor import, as most of the more nutritious foods are beyond the means of the vast majority of the people. Nonetheless I am emphasizing the importance of many of the wild fruits, like guayabas, arrayanes, and the peanut-like seeds of pochote, which are now coming into season, and are free for the gathering.

The first two or three days, I must confess were rather hectic. I arranged my medicines according to categories on the floor of the “portal” of the casa where José Vidaca lives with the family of his wife. There is not so much as a table available, and occasionally the family rooster parades across the boxes of medicines, or tips one over as he leaps with a squeak, trying to escape a pursuing child. José Vidaca and a little boy named Goyo have become my assistants, and are a great help during the periods of “rush.”

But “rush” is never quite the right word here. There is a friendly leisure about all activities which I am coming to accept and even enjoy. When meal time comes and I am called, those who are waiting seem to enjoy waiting. (Many of them, it seems, have spent their lifetime waiting.) They chat with each other or we chat together as I eat. There is always a great deal of laughter and kidding.

As for the ailments of the people, rarely are they so severe that the patient cannot joke about them himself. The people have evolved an enormous amount of patience—or better, resignation—about their infirmities. They have learned to lighten them with humor, and are rapidly teaching me to do likewise.

Sometimes, however, the leisurely approach goes too far. One evening as I was writing a boy came, apparently to chat, and we chatted. Shortly someone else came and the boy stood quietly in the background. Then I turned to him again he told me that his little sister, age 7, had just been stung in the back by a scorpion, which had crawled out of the burning firewood onto the floor where she had been lying. As we hastened up the steep hill together, I told the boy that if ever there was another such an emergency to please let me know a little more quickly… We had lost only about five minutes… but at times that can make the difference.