In the early morning my friend Agustín Arisqueta, from Bordontita, rode into Chilar to ask me to go with him down the trail to where his cousin, Nacho Torres, was slowly and painfully making his way in our direction. He had been unable to urinate since the morning of the day previous, and with his bladder now distended, the pain was excruciating. Agustín had insisted he come to Chilar to seek my help, and as Nacho found it impossible to travel on horseback, he made his way, step by painful step, on foot.

Riding double, we set off at a trot, and in twenty minutes came up to Nacho, propped against a stone, gripping his abdomen and groaning. By his side were several persons including his wife, his sister, and a very dark skinned little boy, who was sobbing.

I gave Nacho a sedative and when it began to take effect we started the slow, painful journey back to Chilar. As we proceeded, moving like snails, I kept asking myself what I would do. I had neglected to bring with me so much as a catheter! *

The dark-skinned boy continued to tremble and sob, and his fear for Nacho was to me like an omen of death. The day before this boy had come—as he has each day with his languid, laughing eyes and eager smile—to watch me prescribe my many coloured pills, and follow me as I made my way through the village. Now he was weeping with terror. I asked him if Nacho was his father.

“No, señor,” he replied.

“Es mi tío”… and then adding softly, “Es como si fuera mi padre… Los dos me criaron juntos.”

Arriving at last in Chilar, I set about searching for something I could use as a sonda (catheter), but… nothing.

As Nacho said he had previously experienced occasional pain urinating, I suspected his condition was due to infection, possibly gonococcal. But it was now too late to wait for the effect of antibiotics. On the off chance his condition might be due to muscle spasm or intestinal pressure (he was also unable to defecate), I gave him a muscle relaxant and suppository evacuant. With this his bowels moved, but still could not urinate.

The only answer was catheterization. But how? I sent a man off at full gallop for San Ignacio to fetch a catheter, but was sure that if he traveled even by day and night he could not make it back in time.

My eye fell on a very slender-stalked asparagus-like plant called aliento del niño growing in a flower-pot hanging in the portál. I asked if I could cut a frond of it, and then proceeded to strip and smooth the stalk with a knife. It was slender, firm, yet moderately pliable. I rounded the tip as carefully as I could and coated the tip with a corticosteroid antibiotic (ophthalmic) ointment, as I had no better lubricant. I feared using such a crude instrument and doubted if it would work, but I knew that if Nacho’s bladder burst it would be the end. I remembered only too well my first trip to México 14 years before, when, in the small town of has Las Varas, Nayarít, I had helped Dr. Ricardo Sánchez try to catheterize a gonorrheal patient. The patient’s bloating and pain had been the same a Nacho’s. I can still hear his groans and the oft-whispered “¡Poquito, médico!” when the doctor asked him if he felt the urine coming. But the block proved too obstinate, the catheter too flimsy, and the urine did not come. The next day the patient died.

I tried to insert the makeshift tool in Nacho’s penis, but the tip of the shoot was not smooth enough to enter easily and I feared damaging the delicate epithelium. Quickly, I dispatched a child to purchase a vela in the small shop of Basilio Bueno, and when he returned I lit the candle and carefully capped the tip of the shoot with wax. I tested it to be sure the wax was firm and re-coated the stalk with the ointment. Men, women, and children—all family and relatives—crowded around in suspense. This time the shoot entered smoothly and easily, though Nacho bellowed with pain. When I withdrew the shoot the urine, drop by drop and then in a small trickle, began to exit. It blocked again, and I had to repeat the process several times. But by nightfall the bladder was no longer distended, and with good fortune the immediate danger had passed. I placed Nacho on combined Mandelic Acid and antibiotic therapy and hoped that he would be better by morning.

The next morning Diego Gallardo arrived from Caballo de Arriba to transport me there with his mules, but Nacho was still in critical condition with extreme abdominal pain requiring heavy sedation; I decided to remain in Chilar until he improved.

It was a battle for me to get those caring for Nacho to give him his medicine according to directions, and I finally had to give him each medication myself. My own treatment was accompanied by a variety of native cures which I was not sure whether to prevent or allow. Nacho was given lavados (enemas) of cooking oil. Hot orange leaves were placed on his abdomen. Ezequiél, the wandering minstrel and mimic, appeared with strong-smelling weeds to be sniffed, and when these failed he resorted to God: In front of Nacho’s catre he stood solemnly, his stout arms folded over his extensive stomach like Rodin’s statue of Balzac, chanting an incantation in the name of Christ and the Virgin Mary. (To raise Ezequiél’s mock fury, Agustín referred to this supplication as brujería, [witchcraft].)

By the morning of the third day (this morning) I again climbed the steep hill to see how Nacho was faring, and discovered that he was at last greatly improved, He felt weak but had little pain, no fever, and the dull, blurred look in his eyes was replaced by its former shine.

At last I could leave for Caballo; but when I talked with Diego an hour before, I learned that one of the mules has strayed into the hills. It will probably take him half the day to find it; and as Caballo is some eight hours (35 km.) from here, we shall probably wait until tomorrow. This gives me a chance to sneak away to the shade of a guayabo by the arroyo, to write and watch the birds coming to drink. At this moment two palomitas, inca doves, have landed, whistling at the waters edge, and are delicately taking up beaksful of water.