Our ongoing health care saga and the Affordable Care Act

One of the unintentional running themes in my blog has ended up being health care.

Upon our return to the USA, our primary concern was what we would do about health care. Costs in the USA are out of control, and the cost for health insurance was outrageous. How does one put a dollar value on quality of life?

When John needed an emergency appendectomy, our decision was sorely tested.

In the end, we made the decision that having the opportunities for robotics and advanced math/science studies that we have in Boise made it worth dedicating 19% of our monthly income to health insurance. We also knew that even with the health insurance, medical costs would be too much for us to afford.

We crossed our fingers and toes, hoping beyond hope that we would not need medical care until we could get back to Mexico or some other country with affordable treatment options.

Now, the situation here in America has changed. In some ways, it’s a change for the better. In other ways, it’s a change for worse. It is, nevertheless, a change. For my readers from other countries who perhaps don’t understand it all, here is my account of how the Affordable Care Act (Obamacare) has affected us.

What does the Affordable Care Act do?

ACAThe health care situation in the United States of America was broken before. Seriously broken. The ACA attempted to fix some of the worst parts of our system.

1)      Children are now allowed to stay on their parents’ plan until they are 26. Previously, kids would have been kicked off prior to that, leaving many with no health insurance at all.

2)      Anybody with a pre-existing condition would be routinely denied coverage. Health insurance companies only wanted to cover healthy people who didn’t need care. If you were one of many millions with some sort of medical issue, insurance could (and did) boot you out. Now, the ACA has prevented that from happening.

3)      There is now no lifetime max, meaning that you can continue to have insurance even if you have a condition that costs a lot. It used to be commonplace that people with serious illnesses would get treatment up to their max, then have no choice but to drop out of the treatment and die.

4)      “Health insurance” has now been defined. Whereas before, you could pick up a plan that basically covered nothing, now there are set guidelines for what a health insurance plan must cover.

5)      The maximum out-of-pocket expenses per year for a family is now $12,700. Previously, it wasn’t unheard of at all that people were paying $50,000 or more, depending on what happened with your family that year. One serious accident or illness could easily have led to a family losing their house and entire life savings.

6)      Preventative care is now provided free of charge with every insurance plan. Too often, people didn’t get routine care due to the expense, which actually meant it was more expensive when the condition reached more advanced stages.

7)      Health insurance companies are now required to spend a certain percentage of premiums on health care. That seems pretty obvious, but for years the companies have charged higher and higher rates, and pocketed the profit. Now, their profit level is stipulated by law. If they overcharge, they must issue refunds.

8)      There are now subsidies available for people with low incomes in order to help them pay for the insurance premiums.

 

How the ACA affects us

So what does this mean for us? It means that we will be getting a much better plan for a much cheaper price. Although we do qualify for a small subsidy, even without it, better plans were priced about the same as our old plan.

For the first time since we arrived in the USA and decided to be self-employed, we will be able to go to a doctor without budgeting for it for months. Now, we won’t have to fly to another country if we need surgery done. And we’ll have the confidence of knowing that if we do need treatment, we won’t lose our entire life savings to pay for it. That’s huge.

How the ACA affects others

Unfortunately, some people are seeing their rates increase. I’m hearing from some people that their premiums are as much as doubling. I’ve heard from others that they have no choice but to go without health insurance now.

It seems to me that what we’ve done is manage to insure the poor, while at the same time, un-insure some of the middle class. We’ve traded one group for another. Which group has the greater number of people? I don’t know. I hope that when all the dust is settled, we will have more people covered with health insurance than we had before.

But what about health care costs?

What the ACA didn’t do is regulate health care costs at all. Although I suspect the reforms will affect costs somewhat, we still need to take some pretty serious measures to bring costs down. Yes, people are now insured, and that’s a good thing, but the costs are still entirely too high.

Why no public option? What about universal single-payer health care?

My theory on this is that the American people simply were not ready to move to a universal system. They were too tied to the idea of private health insurance companies and going from where we were to universal coverage was a leap way too big. I’ve had a few people try to explain why they were against it, but so far I’ve never heard a logical argument against.

The propaganda is deep here in the USA these days. Opponents of the ACA talk about death panels and government mandates of certain procedures. They claim Obamacare is killing jobs and that socialized medicine equals communism. Mostly what they say is flat-out false, yet there are many who believe it.

I was discussing the idea of living your dream with some friends the other day. For every single American in the group, our major concern was getting sick and not having enough money to pay for treatment. Even with health insurance, we’re concerned about the financial side of health care and that affects what we’re willing to do in terms of living our lives the way we want. We Americans all had back-up plans to go live in another country if the worst happened.

For my Canadian and British friends, however, they had the comfort of knowing that if something major happened, all they had to do was get back home and they would be taken care of. They didn’t have to worry about saving many thousands of dollars for a medical emergency. They didn’t have to think of a back-up plan of living in some other country if they get really ill.

To me, that speaks pretty dramatically about our health care problems in America.

The Affordable Care Act has attempted to fix some of the problems, but we still have a long way to go.

 

books by Nancy Sathre-Vogel

Are concerns of medical care holding you back from traveling? Think again!

on crutchesAre rumors of horrible medical care abroad holding you back from heading out as a family and roadschooling your children?  Take heart – most of those rumors are unfounded. A while ago I read 5 Myths About Health Care Around the World by T. R. Reid and started thinking about our experiences with health care in the four corners of the globe – including the United States of America.

In Ethiopia, my husband’s heart went into arrhythmia and he was admitted into ICU at the local hospital.  Within minutes of arriving at the hospital, he had a team of doctors on his case and received the best care possible in the country.  As it turned out, the Ethiopian doctors knew exactly what needed to be done, but they were not prepared to equip my husband with a pacemaker should it be required – so they arranged to have him evacuated to Israel.

In Israel, top-notch doctors treated him with the most current, innovative methods and did a massive barrage of tests to ascertain exactly what was going on.  In the end, they managed to get his heart converted and he went home to Ethiopia a healthy man once again.

In Taiwan, my hip suddenly began to hurt.  The very next day I had an appointment with a hip specialist who sent me for an MRI – in two hours!  After dealing with the US system of waiting weeks to get an MRI approved and scheduled, I was pleasantly surprised.

In Mexico, doctors took care of my son’s badly sprained wrist and I got to see a knee specialist about my bum knee.

In Panama and Colombia,  my son had ingrown toenails surgically removed.

Yes, I’ve dealt with the medical system in the USA and it is slow and cumbersome compared to the health care you will get at a much lower cost in most other countries.  Doctors around the globe are highly trained and professional, good facilities can be found in nearly every country, and health care is generally much more affordable than in the USA.

If you are thinking of globetrotting around the world, medical issues should certainly not stop you!

books by Nancy Sathre-Vogel

What is Freedom?

Freedom

America. The 4th of July. Hot dogs. Apple pie. Rugged individualism and hardy cowboys.

Freedom

That’s why our forefathers came to America, isn’t it? Freedom to live life the way they chose? To be free from tyranny? To live the American Dream? To be free?

As I traveled around our country this past month, I talked with a lot of Americans from all walks of life. Let’s just say, it was an education.

What struck me most about my conversations with people was the prevalent idea that we stand alone. Many people seemed to think we are an island unto ourselves – both as a country and as individuals.

“We need to take care of America!” they cry. “Let the rest of the world take care of themselves!”

“I am not my brother’s keeper! I live my life the way I want and you live your life the way you want! Nobody should mandate that I do anything I don’t want to do.”

But I can’t help but think they are missing the point. Whether we like it or not, we’re all in this together. The United States of America is part of a greater world. We are one nation among many. Our actions have grave impact on the rest of the world.

As individuals, our actions/inactions have an impact as well. You want to live your life one way, but your very choice impacts the way I live my life. We are an interconnected world, with many of the connections so invisible we can’t see them with the naked eye. That doesn’t make them any less real.

1776Bear with me for a minute as we travel back in time to the year 1776. Our country had just gained freedom. We were no longer under the rule of Britain, but were free to do as we pleased. No rules. No regulations. No government. Just a whole lot of free men running around… well, freely.

Fast forward twelve years and people realized that, perhaps, they weren’t so free. This running around freely with no agreed-upon rules wasn’t working. Things weren’t quite so dreamy with no structure, no obligations, no rules. And so, our country elected our first president, George Washington. Government was formed.

I am fairly certain there were some Americans who didn’t agree with George. They didn’t like his views on taxation or commerce or national security. There were those who felt he was taking our country in the wrong direction.

george washingtonAnd yet I’m also fairly certain that they recognized that George Washington had been fairly elected by the people, for the people, and of the people. He had been elected for the express purpose of designing rules and regulations that all Americans would abide by. He wasn’t perfect and his ideals were his own – he was human, after all. He saw the world through glasses tinted by his experience and he acted accordingly.

I would be willing to bet that George compromised and the others compromised and, while what came out of that process wasn’t perfect for both sides, it was something they could live with. They understood that no two people will ever see eye-to-eye on everything and we need to compromise. That’s something we should all have learned in kindergarten.

Unfortunately, my conversations with many Americans of late have indicated that there is a sizable percentage of people in my county who don’t understand the whole “give a little, take a little” way of life. They don’t seem to understand that things work better when we’re all on the same page. A rising tide lifts all ships. If I do better, then you do better. What was it the 3 Musketeers said? All for one, one for all?

I’m seeing more and more people with the attitude that they stand alone, yet we’re all in this together, whether we like it or not.

No man is an island,
Entire of itself.
Each is a piece of the continent,
A part of the main.

If we truly believed we should all be completely free to live life the way we choose, then we shouldn’t have any police or jails or government of any kind. Every man for himself. Live the way you want to, cross your fingers and hope for the best. Our founding fathers knew that didn’t work. They knew that didn’t lead to true freedom. They knew there was strength in numbers and in working together. Why have we, as Americans, lost that knowledge?

“I shouldn’t have to pay for your broken bones!” I’m hearing from people opposed to President Obama’s new healthcare plan. “I work hard for my money and I shouldn’t have to give up one red dime so your child can get his broken arm set.”

I have to wonder what George Washington would have thought about that.

We want our taxes a la carte. We want to pick and choose which taxes we’ll pay.

Taxes a la carte

No matter what the president/congress/supreme court rule, SOMEBODY’S right to do SOMETHING will be curtailed. Right? We give a little, we take a little. In the end, it all works out. Maybe some get a little more and others get a little less, but it works out just fine. We’re free when we work together.

The very fact that we live in a society means we have certain obligations within that society. If I choose not to accept and abide by them, then I can choose to move to a remote island somewhere and cut myself off from society and truly live the “every man for himself” idiom. I choose not to do that, therefore I accept that I will have to compromise in a way that makes society as a whole function the best it can.

“That’s all fine and dandy,” some would say. “As long as the rules are rules that I agree with. That are correct.” And my response is, “Correct according to whom? To you? To me?”

Whether we like it or not, if there are to be certain rules and regulations in order to make society function, they MUST be decided upon by somebody. When individual people protest and argue that they are “losing their rights” I don’t get it. I mean – WE (the American people) elected our governmental officials specifically so they can make those laws and set the standards by which we will all live. Then, when they do that, we get upset because we don’t like the decisions they made. We can’t have our cake and eat it too.

I am baffled by the outrage over Obama’s healthcare law. I realize it’s not perfect. Heck – I think Obama realizes it’s not perfect! But it’s a step. It’s a teeny-tiny step toward taking care of ALL Americans, not only those lucky enough to be wealthy. There is still a lot of work to be done. There are thousands, if not millions, of steps left before we get there but you know what they say: The longest journey starts with a single step.

If we, as Americans, are going to be truly free – free to pursue our passions and follow our dreams – then we’ll need to know we can get an appendectomy when we’re doubled over in pain. We need to know that a simple medical procedure won’t break the bank and put us in the poorhouse for the rest of our lives. We need to be able to focus on where we want to go and what we want to do, not on who’s going to pay the hospital bill when we wake up one morning and find our kidneys have shut down.

With great freedom comes great responsibility.

working together as societyYes, we have personal responsibility. We have an obligation to ourselves and to society to take care of ourselves. I’m a firm believer in whole grains, organic veggies, homeopathy and essential oils. But all the granola in the world ain’t gonna help when little Johnnie slips on the monkey bars and ends up with a bone sticking out where it shouldn’t.

We have an obligation to be part of society and take care of others. It’s not just some loosy goosy thing we can do if we want. As human beings living within a society, we need to step up to the plate and do our part to take care of all. By supporting others and being a member of our community, we lift us all up. We make us all free.

No man is an island unto himself. We’re in this together. Let’s rise together and take care of one another. Only then can we be truly free.

 *********

A bunch of other blogger friends are also writing about freedom today – go check them out!

Let Freedom Ring
Are we free?
The Freedom to Choose
Freedom and straying off the beaten path
Living a Free and Meaningful Life
Freedom to Roam
Do you know what Freedom is?
Free Falling

books by Nancy Sathre-Vogel

…and they say the USA has the best medical system in the world?

My husband’s sick. It’s Sunday evening and clinics are closed and we should probably head out to the ER, but we’re still at home because we’re living in the United States of America and we don’t have health insurance.

We’re having to make decisions based on knowledge we don’t have. Can we afford to wait? Will he make it through the night? Is it worth the many thousands of dollars it would cost for the ER if it turns out to be just the common flu?

This is not the way things should be in one of the wealthiest nations on our planet.

When we were in Nicaragua John slipped and fell and hurt his thumb. We visited the local hospital where he had x-rays and visited with a doctor. We were out of the hospital within thirty minutes and didn’t have to pay a dime.

In Panama my son needed to have his toenail removed in order to dig out a very serious ingrown toenail. The bill came to $15. He had the same procedure done in Colombia by a top-of-the-line specialist for $50.

Over the years we’ve sought medical care in Ethiopia, Tanzania, Egypt, Taiwan, Malaysia, Vietnam, Thailand and others. I was hospitalized for a week in Argentina for pneumonia. As we gallivanted around the world, health care was the last thing on our mind. We knew we would find doctors wherever we went.

And yet now that we are back in our own country, health care is a massive struggle.

Choices are always hard to make, but when it’s a choice that you really don’t think you should have to make it’s even harder.

We are loving living in the USA. It’s a great place with a lot going for it:

  • We’ve got a great little house that’s very comfortable.
  • Our sons are involved in robotics and Boy Scouts, which they love.
  • The boys are taking a few classes through a world-class program through the public schools that we couldn’t find any other place. Our school system has been very supportive of our homeschooling and allowed us to pick and choose classes to make a tailor-made program for our sons.
  • Everything we need is here. We have running water and a flush toilet and a stove to cook on.

Overall, this is the best place in the world for our sons right now. We can’t imagine any other place that would be able to provide them the opportunities they have here.

But that all comes at a cost:

  • We’re paying a lot each month for a high-deductible catastrophic health insurance policy that will only kick in the event of some major accident or illness.
  • Each time we need to see a doctor, we have to consider the seriousness of it and decide if it’s worth the $300 or more to go. And yet we are not qualified to make those decisions.

What I really don’t understand is why we’re having to make these choices. Why should we in the United States of America have to make choices on whether we can afford to visit the doctor?

If our country can afford to destroy the entire country of Iraq, why can’t we afford to take care of our own citizens?

I’ve heard all the arguments for our private insurance system but honestly, none of them make sense. If other, much poorer, countries can provide health care for their citizens, why can’t the USA?

I do take comfort in the fact that we can leave the country. If, at any point, we feel we can’t handle this stress any longer we’ll pack up and leave for another country. But still – why should I need to do that?

books by Nancy Sathre-Vogel

Health insurance options (or lack thereof)

Seeing as how this topic is bound to come up again in this blog – and maybe end up becoming a major theme (although I hope not) – I figured I’d start it now… We’re looking for health insurance. In the USA. And it’s not looking great.

Before we left for our adventures we were covered through the school district. Since I worked as a teacher I was able to cover the whole family for a very reasonable amount. It was decent coverage. Life was good.

Once we left the USA, we converted to a high-deductible policy through IMG that was designed for expats and long-term travelers. We’ve never had reason to file a claim so I have no idea if they are any good or not (have heard good reports from other travelers), but knowing that we have a policy has given me tremendous peace of mind over the years. (I’ve written about health insurance here)

Now we’re back in the USA and hoping to stay here. IMG stipulates that we be out of the country for at least six months each year in order to continue coverage, so we had hoped to find something else. So far, my (admittedly very  basic) search has led me nowhere.

Seeing as how we are covered until January 1, 2012 I haven’t spent a lot of time on this issue yet, but I have to say I’m stunned. Truly blown away. Yes – I’ve read loads of articles about how unaffordable health insurance is in the USA, but I didn’t “get it” – until now.

Right now we are living on the income generated by rental properties we own and the small amount this website is generating. Our needs are basic and we live frugally. We’re currently living on about half of what I used to make as a teacher – but I’m not complaining. At this point in time, we prefer the freedom of this life to the constraints of a classroom.

A quick check of health insurance policies floored me – if we were to switch to another policy, we would be paying every penny we have coming in for insurance. EVERY PENNY! JUST FOR HEALTH INSURANCE! That would leave nothing to buy food, nothing to pay electricity, not a single red cent for clothes or bike parts or – God forbid – to see a doctor. Every dollar we bring in would go for paying the health insurance.

Seeing as how we aren’t bringing in a lot, I wondered if maybe we would qualify for low-income health insurance. Holy Mother of God!! We would have to be living on less than $382 for a family of four to qualify! That’s just downright insane. NOBODY can live for less than $382/month for four people in the USA! You just can’t do it.

At this point we don’t know what we will do come January. Our hope is that we’ll find some sort of affordable policy out there. Maybe one of us will try and find a job with benefits just so we can get health insurance. Maybe we’ll leave the country and hit the road again.

I don’t know, but it makes me very, very angry that we may have to leave the United States of America – our own country – because we can’t afford health insurance here. I can’t believe that is a very real possibility in our lives.

Maybe we’ll go back to Nicaragua where they have great, free medical care. But dang – I had hoped to live happily ever after in the US of A.

*****

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books by Nancy Sathre-Vogel

Life lessons from a health emergency on the road

a.m.  I am soooo glad I decided to come into the hospital last night rather than wait until today.  Even in the midst of chaos in the emergency room, I slept so much better than I would have in the tent.  The drugs they’ve given me are a godsend.

I’m still in the emergency room – there are no regular beds available right now.  But at least I’ve got drugs – antibiotics and expectorant going in through an IV and my lungs are being opened with the nebulizer.  I can actually breathe finally.

At this point, I still don’t know how long I’ll have to stay in the hospital.  They are saying I’ll be transferred to a regular room as soon as one opens.  And then once I get out of here, I don’t know how long my recovery will take.

John and the boys should be on their way in now.  No doubt they’ll take plenty of time as the valley is so incredibly gorgeous – red sandstone Dr. Seussian stone formations similar to southern Utah.  I hope they take plenty of pics.

Davy is truly amazing.  Just the other day he was standing next to John and I realized he is now officially taller than his father.  When I could no longer ride yesterday, we decided to see if Davy could possibly take my bike.  It’s way heavier than his so we really weren’t sure. But the kid hopped on and took off with no problem whatsoever.  We didn’t even have to lower the seat.

Daryl, of course, is incredible too – but we already knew he could handle Davy’s bike.  As much as he prefers to ride on the tandem, he never complains when – for one reason or another – he needs to take Davy’s bike.  It’s not easy for him, but he steps up to the plate and does it.

I think that is one of the big lessons from our journey – sometimes you just gotta do it.  There are times when we’re faced with some unexpected situation and we just have to jump in and do what it takes to get the task done.  It can’t be planned in advance – we never, ever thought Davy would have to take my bike.  We had planned all along for Daryl to take Davy’s, but didn’t think Davy would be big enough or strong enough to take mine.  If I couldn’t ride it, we figured, we would put it in a bus or pickup.  And yet here, there simply were no pickups so that wasn’t an option.  Davy and Daryl stepped up to the plate and did what needed to be done.  And I couldn’t possibly be prouder of them.

Kilometers today:  35
Kilometers to date:  22992


Camping in Quebrada de los Conchos
Camping in Quebrada de los Conchos

Quebrada de los Conchos

Quebrada de los Conchos

Quebrada de los Conchos

Quebrada de los Conchos

Quebrada de los Conchos

Quebrada de los Conchos

Quebrada de los Conchos

Quebrada de los Conchos

Quebrada de los Conchos

Quebrada de los Conchos

Reunited

Nancy in hospital

books by Nancy Sathre-Vogel

Acceptable Level of Risk

I was chatting on Facebook the other day with a fellow traveler, Jeanne Dee.  She made a comment that left me speechless, horrified, and quaking in my boots.  Her daughter has not been immunized.  Against anything. Ever.

“People get sick because their immune system is weak,” she told me.  “My daughter is very healthy.”

Now here’s the thing:  I think not immunizing your child is way too high a risk to take.  She thinks biking around the world is dangerous.  Who’s right?  We both are.

“You see the world through lenses tinted by your experience,” someone once said.  And it’s that experience that guides us in making decisions about what’s dangerous and what’s not.

Jeanne has seen more people harmed by vaccines than by the diseases.  I’ve seen way too many people crippled by polio.  Her experience leads her to make the decision not to immunize – it’s too high of a risk.  My experience led me to get vaccinations for my sons as soon as I could – not doing so was simply an unacceptable level of risk.

“I am so scared for you,” Jeanne tells me frequently.  “What you are doing is so dangerous!”  Her experience tells her biking is full of danger.  Her brother was killed by a car while taking a break from biking and standing on the side of the road taking off his shirt.  Jeanne hit a trash can while biking one night and seriously broke her arm which led to major surgery and nerve damage.

And yet my experience tells me biking is fine, and biking around the world is no more dangerous than biking back home.  I’ve cycled thousands of miles; John many thousands of miles more. As a family we’ve pedaled nearly 24,000 miles.  In all that time, we’ve had four accidents.

  • In 1993 I headed out for an early morning training ride in Alexandria, Egypt (where we lived at the time), hit an oil spill, and fell.  I broke my hand.
  • In 2005 John and the boys were cycling the bike path along the Boise River when Davy took a slow motion tumble and ended up with the handlebars in his belly and an injured pancreas.
  • In 2007 I was riding home from work one afternoon when a car inched out of its parking spot and hit me.  I ended up with nasty road rash on my arm and leg.
  • In 2008 John and Daryl were riding home from a bike store in Albuquerque, NM (where John lived for 9 years) when a driver turned and ran into them.  John ended up with two sprained wrists.

Our experience tells us that most accidents happen near home and the accident rate is very low – in other words, it’s an acceptable level of risk (4 out of many thousands of miles for our family).  I’ll happily jump on my bike and pedal from one end of the earth to the other, but take an unvaccinated child out traveling?  Uh uh.  No way.  Not in a month of Sundays.

We all have those ideas – some things simply appear more dangerous to us than to others.  I shudder to think about kids riding motorbikes, yet many of my students regularly suited up and hit the tracks in races.  Jumping over barriers on horses terrifies me.  And don’t even get me started on car racing.  And yet there are many parents out there who, based on their many and varied experiences with those activities, deem them fine.  Who am I to judge?

What lenses are you seeing the world through?  What things will you allow your children to do that other parents won’t?  What activities have an unacceptable level of risk to you?

Edited to add:  I wrote this post a few days ago and now need to add one more accident to the list – Davy hit a rock in the road yesterday and tumbled down, yanking out his fingernail in the process.  That makes our family accident rate 5 out of hundreds of thousands of miles.  Still an acceptable rate for us.

books by Nancy Sathre-Vogel

What We Do When We Are Sick

I’ve had a number of people ask me lately what we do when we are sick on the trip. That’s a hard question to answer.  There were many times on our year-long journey around the USA and Mexico when we faced illness or injury, and there is no doubt we will face it many more times on our adventure from Alaska to Argentina.

What we do when we are sick or injured depends on many factors.  There were times when we got on our bikes and rode anyway – read here or here.

There were times when we decided to hang around and wait it out.  When my knee went out in Mazatlan we delayed our departure for nearly a week as we waited to see if it would heal itself, and then we rode low mileage for a while to make sure it would hold.

We crossed the border back into the USA with a cast on Davy’s arm.
davygettingcast.jpg

 

Although none of our sicknesses were “Mexico-related” it seemed like there were more incidents when we needed to seek medical advice while there than in the USA (we actually never needed a doctor in the US).  I just wrote this up yesterday about trying to find a doctor in Mexico – it always seemed to lead to adventure somehow.

Finding a doctor in Mexico was always an adventure.  It was one of those things that added a bit of the unknown to our lives.  In the USA, finding a doctor was a fairly simple affair, and  I’m sure finding a doctor in Mexico is simple too – for Mexicans.  For an American with a sick kid, however, it was quite an event.  In retrospect, it was quite amusing.  But as I walked the streets of Los Mochis with Daryl whimpering in pain beside me, it wasn’t much fun.

Daryl had been complaining of an ear ache on the train back to the coast, but he didn’t appear too sick.  The next day, as we hung around a motel readying our bikes for the onward journey, Daryl slept.  But when he woke up the following morning with both ears screaming in pain and with a high fever, I figured it was time to find the local doc.

With Daryl in tow, I asked a man outside our hotel where I could find a doctor.

“Just down the street there – across from the candy shop.”

That sounded simple enough.  Daryl and I set off to find the candy shop, but couldn’t find anything remotely resembling anything like that.  We found a video game shop, and an auto parts shop.  We found a beauty parlor and a shoe shop.  But no candy shop.

I approached a woman walking on the road.  “Excuse me, ma’am,” I said.  “Can you tell me where I can find a doctor?”

She looked at Daryl with tears streaming down his face.  “Just go right around this corner and down a block.  You’ll find a clinic right there on the corner.”

A few minutes later we walked into the clinic – into mayhem.  In one corner a man gave a talk about dental hygiene to one group of people, in another corner a group of people tried to figure out what to do with three huge sacks of potatoes.  Scores of people milled around the waiting room, quietly talking.

I approached a person wearing a white uniform.  “Can you tell me what I need to do here?  My child needs to see a doctor.”  She looked at me with a puzzled look and directed us to sit down on the bench.

Somehow, we had managed to walk right into craziness – once again.  This time we had managed to find a social services clinic, and no one had any idea what to do with us.  The clinic was for poor people who needed the welfare of the state, not for American travelers.  I could see them scurrying around, trying to figure out how to handle us, as Daryl lay there with his head on my lap, moaning and groaning in pain.  After a few minutes a nurse came up and stuck a thermometer under Daryl’s arm, then dragged him off to the scale.

We eventually got in to see the doctor, and he prescribed some pain killers and antibiotics for Daryl ear infection.  They never did figure out how to deal with us on the paperwork side of things, and I suspect they simply didn’t even record our visit, but Daryl was pretty happy about the medicine the doctor gave him.

books by Nancy Sathre-Vogel