Potentially, one of the best steps that the Mexican Government has taken toward bettering conditions for its citizens in remote regions has been the establishment of rural health centers, or Centros de Salud, staffed by a doctor and several nurses and dedicated especially toward providing medical services to the poorer villagers. Each municipio has at least one such Centro de Salud. The doctor is supplied with both salary and free medicine so that families who cannot afford to pay will not be deprived of sound medical treatment. The Centro is also responsible for a program of inoculation against the more dangerous immedicable diseases—polio, tetanus, whooping cough, diphtheria, and smallpox—in every village within its territory.

Fifteen years ago, the Centro de Salud in San Ignacio got off to an excellent start under the dedicated direction of Dr. Raúl Vega, who—technically speaking—is not a “doctor” at all. A native of San Ignacio, Dr. Vega studied in the medical schools of Guadalajara and Mexico City. Unable to complete his degree for lack of funds, in 1932 he set up a practice in his home-town. He had achieved a notable reputation by the time the Health Department installed him as head of the Centro de Salud. Dr. Vega carefully supervised the construction of the new Centro, and to this day the physical plant remains excellent. It is in the shape of an “L” with two large wards, each with six beds, and has a consultation room, minor surgery, kitchen, dispensary, laundry, and store room. Upstairs are living quarters for the doctor and nurses. The building has glass windows, running water, a flush toilet, a shower, and is attractive.

Seven years ago, the Health Department, in an attempt to raise its standards, made an effort to place a full-fledged M.D. in each Centro de Salud. So it was that Dr. José Félix López, M.D. from Mexico City, was placed as head of the Centro in San Ignacio. Raúl Vega was retained on the staff, but soon found coexistence with Dr. Félix untenable, and resigned.

I can appreciate why Raúl Vega resigned: Dr. Félix doesn’t care about anyone’s health or welfare but his own. Apart from that, he is an agreeable and genial man, clean, orderly, and handsome. He is easy to get along with, provided you don’t mind being slapped on the back constantly and asked how many girls you’ve screwed in this village and that, whether such and such a señorita doesn’t need an injection—with hot beef, that is, ha ha—etc., ad infinitum. I get a little exasperated when I come hurrying to the good doctor about a sixteen year-old girl who has been severely hemorrhaging, and before he replies whether he will give her blood transfusions or not, he winks naughtily and asks, “What does she look like? Is she good for…?” and knocks his fists together, swinging his hips. Or, likewise, after I have explained to him how many children, like Pipi, have been stricken with polio in the barrancas, I grow irritated when he responds, “If you bring some of your students with you, sure I’ll go vaccinating with you up into the mountains. But you’ve got to bring Gringas. Just Gringos won’t do. Gringas! Understand!”

When the occasion demands, Dr. Félix has a very convincing spiel. In fact, his expressed concern for the villagers can be truly moving. After Dr. Price, the pediatrician from Palo Alto, California, had been guided through the Centro de Salud, he was puzzled. “Dr. Félix talks like a very dedicated man,” he said, “but I wonder! If he can afford his new Chevrolet convertible and that luxurious radio-phonograph console, why doesn’t the Centro have a single microscope? And, with all the villagers we’ve seen in such dire medical need, why is the hospital so empty?”

The hospital is always empty, or nearly so, because Dr. Félix prefers it that way. I have known him to dismiss patients still in critical condition even when no other hospital bed was occupied. Dr. Félix makes a point of keeping his hospital immaculately clean, and this, of course, is more difficult when there are patients. The villagers, for their part, have little confidence in the Centro. The sick would rather go to Raúl Vega or La Apolonia, or sell their chickens and pigs and go to Mazatlán for treatment. Even from San Ignacio, patients come to me in Ajoya, although I try to discourage it. They have learned, through experience, that the Centro attends in a most cursory manner those patients who have little money. They have found that Dr. Félix too often prescribes or applies medicines, at the patients’ expense, and that often those medicines do little good. The villagers say of the doctor, “¡No sirve!” (He’s no good.) Many even speak of him with contempt, charging that he has converted the hospital into a whorehouse, that his nurses are his mistresses and that his gardener is his pimp. If what the people say is correct, two of the doctor’s nurses already “salieron embarazadas” (came out pregnant) and the doctor narrowly escaped being assaulted by the father of one of the nurses as a result.

Part of Dr. Félix’s responsibility is to see that the children throughout the municipio are vaccinated. A large portion of the villages and ranchos of the Municipio de San Ignacio are accessible only by burro trails, yet Dr. Félix has never once set foot beyond the road’s end in Ajoya. In the second Report from the Sierra Madre I mentioned how delighted I was that Dr. Félix had at last condescended to make a vaccinating tour with me to the upper villages of the barrancas. I told of my hurried 70-mile circuit through the barrancas to advise the villagers that we were coming to vaccinate. Yet in the third Report, I made no mention of how the vaccinating had gone: It hadn’t!

The day Dr. Félix and I had scheduled to leave from Ajoya, and Dimas Lomas was ready with his mules, I waited and waited, but Dr. Félix never showed up. At last I phoned San Ignacio and contacted the head nurse, who told me that the doctor said he couldn’t make the trip. I asked to speak with the doctor, but the nurse said he was busy. I found that hard to believe! I asked her why the doctor couldn’t make it, and she said she thought it was because he had trouble getting ice for the vaccines. I told her to tell Dr. Félix that if he couldn’t get ice, I could, and that I would expect him in the morning. She told me to hold the line. A few minutes later she came back and said that she had been mistaken; it had not been the ice but the vaccines that the doctor had been unable to get. I thanked her, and asked that the doctor call me as soon as he was no longer busy.

The doctor never called. Next morning I borrowed Caytano’s mare and rode the 17 miles into San Ignacio. Dr. Félix was not at the Centro.

“Where is he?” I asked the head nurse.

“He left to vaccinate in Coyotitán,” she replied. He should be back for lunch.”

“How can he be vaccinating if he couldn’t get the vaccines?” Feliz asked.

“The head nurse blushed. “You’ll have to talk with the doctor,” she said.

Shortly after noon, Dr. Félix pulled up to the hospital in his spiffy, light blue convertible. I was there to meet him. He looked surprised. “How did you get here?” he exclaimed.

“On horseback,” I replied. “And you?”

The doctor fell into his usual banter. “How are all the girls in Ajoya?” he asked, smiling broadly.

“I understand you’ve been vaccinating in Coyotitán?” I began.

“You know, you really ought to make something of Ramona,” the doctor continued. “She’ll do it. The other day when she came in for her blood test she told me she liked you…”

“I’d like to speak to you about our vaccinating trip…”

“What’s the matter? Isn’t Ramona pretty enough…?”

“I have the mules all ready and waiting if …”

“Ah, David, what a friend!” The doctor clapped me on the shoulder. “I’ll admit she looks like a toad, but she smells nice. Heh heh! And she’s got a lot of meat on her. The other day she was sitting in that chair with her legs apart. Umm! Have you noticed her thighs?”

“Yes,” I said. “Now, ice I can get. The vaccines you have. The program we have all drawn up. Seven villages have been notified that we are coming. The mules and Dimas are ready. When do we leave?”

Dr. Félix was suddenly serious. “Now I’ve been giving a lot of thought to this,” he said, “and I’ve decided it’s all too uncertain. I don’t like to take part in something unless I’m sure it’s going to turn out right. Would you care for a cigarette?”

“No thanks,” I said. “Why shouldn’t it turn out right?” (I could think of a lot of reasons.)

“Well, in the first place…” and he followed with a song and dance about not being sure how long the ice would last or how the “primitive” people would accept being vaccinated. Etcetera. It became increasingly clear that he was both too lazy and too chicken to go.

At last he said, “I’ll tell you what, David. Why don’t you go ahead and give the first round of vaccinations, and if everything goes well, I’ll go with you on the second trip.”

“All right,” I said, controlling my anger. “I’ll do it. Where are the vaccines?” Dr. Félix gave them to me in a large iced thermos, and I left.

As I rode swiftly back to Ajoya over the winding dirt track, the fresh air and quiet calmed my spirit. It was not until that night when I was lying awake in bed planning the trip, that it dawned on me that I should have gotten a letter from the doctor authorizing me to vaccinate. This was imperative, especially considering that I was a foreigner, and not long had passed since people in Verano had rumored that persons taking my medicines would die in two years’ time. The villagers tend, at best, to be skeptical about vaccination. When they are sick, they may clamor for an injection, but when they are well—and the vaccines can only be given to children who appear well—it’s another story. For example, this spring in Ajoya an army doctor came to vaccinate, and only 15 or 20 percent of the parents brought their children. The soldiers managed to capture a few more. Then, three weeks later, when the youngest son of David Salcido died of encephalitis resulting from mumps, the villagers angrily threw the blame on the vaccination.

In like manner, about six years ago, when Mencho Pereda, the kind-hearted medicine man from Jocuixtita, decided to vaccinate the village children, a couple of the first children had mild side effects from the vaccine. The villagers, who up to that point had trusted Mencho and come to him confidently for treatment, protested angrily. One man threatened to kill him if he vaccinated any more children, so he didn’t. Not a child had been vaccinated in Jocuixtita since! All this considered, I had good reason for wishing Dr. Félix to accompany me, or at least to give me written authorization.

I telephoned San Ignacio again, and asked the head nurse to ask the doctor to write the authorization.

“He says he can’t,” she said when she returned:

“Why not?”

“He says he hasn’t got the authority.”

“But he’s already given me the vaccines and the complete okay!” I protested. “All I want is for him to write me a note that he’s done so.”

“Just a minute,” said the nurse, and a few minutes later she returned and said, “He can’t.”

The following day I made another trip to San Ignacio. My conversation with the doctor followed roughly the same pattern as the day before, Ramona not excluded. He ended up by clapping me on the back and saying, “I’m sorry, David, old friend. It’s a touchy question. I’m sure you understand…”

I understood, all right! The doctor wanted me to do his job for him, but preferred to stick out my neck instead of his own. “The hell with it all!” I said to myself, and left.

It was not until some two weeks later, as I was passing through San Ignacio on my way back to the United States, that I saw the good doctor again. Dr. Félix was very friendly, and asked me to make specific inquiries for him in California, where he plans to visit.

“Tell you what,” I said. “I’ll get the information that you want, if you get the written authorization that I want. Okay?”

Dr. Félix clapped me on the back. “Ah, David! What a guy! It won’t be easy, but I’ll try.”

A few days later I received a telegram in Palo Alto, which read:


“Whoopee!” I cried. Yet on my return to San Ignacio a week later, I found I still had to haggle to get the letter. But after two weeks I cornered Dr. Félix, having followed him all over town until almost midnight, and he wearily sat down at his typewriter and wrote (in Spanish):

To whom it may concern:
David. Werner, the bearer of this, we authorize to give necessary vaccinations where necessary. We beg you to assist him in whatever way he finds necessary.

J. Félix Lopez

“Hadn’t you better date it?” I suggested. And he did.

“Hadn’t you better stamp it?” I suggested. And he did. Upside down. It was not until I had left that I noticed that the stamp merely said, “AÑO DE LA AMISTAD” (YEAR OF FRIENDSHIP).

At last I had authorization—such as it was—and could commence with the inoculation of the village children. But now that the personal obstacles had been overcome, the natural obstacles commenced. The rainy season began with a crash, and I resigned myself to waiting until the end of “las aguas.”