9 October 2012
20 minute read
agk’s Library of Low Resource Medicine
Some street medic friends and I were invited to contribute our commentary to the latest edition of Hesperian’s Where There Is No Doctor. The book leads a double life. Ostensibly for “village health workers” in developing countries, it has developed a cachet among homesteaders in the first world, who look to it as a way of avoiding going to doctors by providing their own health care for their families. More recently it has become popular for survivalists looking forward to a day when all the doctors have perished in whatever brand-name catastrophe they wish upon those who do not share their various hobbies and obsessions.
In order to provide good context for our editing work, we had to determine who our actual target reader was and what their needs would be; towards that end we decided that a good approach would be writing fiction about who might be using WTND in thirty years. (Grace had suggested that our intended end users of the book should not be the customers today but the folks who picked up used or free copies down the road.) This is my contribution to that effort, entitled “The Kid You Want.” Enjoy! – Anne.
It started as a normal day. I was just kicking around with McQuarie because my aunt was freaking out about mom, and we figured we’d go look at shoes downtown. It wasn’t like we had anything planned. I was mostly texting this girl from Fort Bliss and McQuarie was like totally addicted to this new game where you move your phone around and it projects these zombies into your googles, so we both had our phones out when the alert came that some people had taken over the old clinic and were giving out free HIV tests where they wouldn’t report you if you were positive.
Let me make it really clear, I don’t have any problem with people with HIV, but y’know, my mom and all, back then it was different. So we figured we’d have a bit of fun and went down to where all these people were, like lined up around the corner already, and these big muscley guys with googles on were walking back and forth in identical t-shirts looking nervous. The doctors and nurses and all from the clinic were sitting on the corner together in their funny bedsheet clothes that doctors wear – yeah, I know they’re called “scrubs” but I didn’t know that then, y’know? We called them bedsheets cause they had Betty Boop and Angry Birds and shit. Anyway, all the doctors and nurses were looking pissed off and smoking cigarettes. The muscley guy standing by them had a gun on his belt, but he wasn’t touching it or shouting or anything.
McQuarie was chewing this big wad of gum, as usual, and what he did was, he went up to the side of the line and blew this huge bubble so everyone would notice him. Then he popped it and spit his gum at all the people in line. I picked up a drink cup off the ground and threw it. “Faggots!” we yelled, even though some of them were women, “Plague fuckers! Dirty atheist shit-lickers!”
We did this every time there was a clinic takeover. It was, like, normal. Usually we would yell a few times until somebody got upset and then we’d run like hell. It was just a way of letting off steam. This time, though, the muscley guys were too fast and grabbed us by the collars and threw us on the ground so hard I hit my mouth and started bleeding. The muscley guy holding me was kneeling, sort of, but in this way where you knew he could jump up and run you down before you even finished thinking about getting away. He had a shaved head.
“The fuck’s your problem, man?” he asked. I spit blood at him. A drop stuck to his googles. He didn’t flinch.
“You got some sort of problem here, you can go sit with the doctors, ese.”
“You fuckers kilt his moms” said McQuarie. Now the guy did flinch a bit; I think I know why. See, McQuarie has this real light skin, and he keeps his hair short so it doesn’t look Spanish, and lots of people think he’s a white guy, but only until he opens his mouth. When he talks, it comes out in the worst, like, MadTV.com barrio accent. One time up in another neighborhood a bunch of Latin guys jumped him cause they thought he was making fun, but that’s just the way he talks. So the guy probably thought his buddy had some ignorant white boy, and then realized he didn’t.
McQuarie kept talking: “Lansing’s moms, man, she’s got AIDS and she’s gonna die cause you fuckers didn’t register and wear rubbers and shit. They oughta put your ass in jail. She can’t even get the cocktail.”
The muscley guy cocked his head. I thought it made him look gay, and then I realized he probably was gay cause it was always gay guys trying to get you to take the HIV test. I tried to get away but his hands were like rocks. He looked at me over his googles.
“That true, kid?”
“Yeah.” I spat back, “like you care. Faggot.”
“Your mom’s got AIDS and can’t get the therapy?”
I didn’t say anything. See, they passed this law, where if you found out your kid was taking drugs, had no papers, or was in a gang, or a was terrorist or a traitor or something, you had to kick them out of the house and family right away. My big brother was in the Zetas, and when they caught him, one of the teachers at the school said mom had said something about it, so that meant she’d known and now we couldn’t get the medical card, or a food card, or a heating bill card, or have guns or anything. It was like, oh, your brother fucked up and got caught, see ya, wouldn’t wanna be ya, bam bam. Then they elected some other guy president and he said he wouldn’t enforce that law anymore, but there was like a lawsuit or something and the never got around to fixing shit for all the people who already got screwed. But I wasn’t telling some uppity faggot with googles on that.
Then the muscle guy said something weird. You couldn’t tell, but I thought his eyes changed expression at me. He goes: “hey, kid, how sick is she?”
I didn’t say anything.
“I mean, like, is she sick? Or does she just have the virus. Like, is she coughing or tired a lot?”
That caught me, somehow, because for a moment it was like he was seeing my mom, skinny and barfing and coughing and lying on her back in the yellow bed in the living room, with my aunts running around putting cold water on her forehead. I don’t know why I thought that, but it made me mist up. Okay, it made me cry, but just a little. The muscley guy shook his head at me.
“Hey, man. You promise if I let you up for a minute you ain’t gonna run up and hassle these folks getting tested?” I must’ve nodded my head.
He let go of my arms. It was like they went from being these pavement decorations I had somehow been lying next to, to being my arms again, just like that. I wanted to ask the guy where he worked out, but I didn’t want to because it was probably like a gay gym or something. I got up and walked with him to this ancient Transit around the corner by the doctors and nurses. They glared at me as we went by.
The muscley guy ducked into the van for a minute. Looking back now, I think the whole thing about me, that made me me and not just the dumbass kid I thought I was, was that I didn’t take that minute and run the fuck away and catch up with McQuarie later. I mean, I had a date with that girl, I had shit to do downtown, and it wasn’t like when mom died anyone was going to blame me. I mean, she had AIDS, right? Nobody’s like “oh, that lady had AIDS, but Lansing ran away from some faggot with a book and she died of that pneumonia thing he was supposed to fix for her.” Right? Or maybe I was just chickenshit that he’d run me down and catch me again. He was a big dude. Maybe the best shit always happens when somebody, somewhere, is just too slow to do the smart thing and get out before it hits the fan.
Anyway, I stood where I stood and the guy comes back with a copy of Donde No Hay Doctor. I told him I can’t read Spanish (which is kind of a lie) and he asks if I can read at all and I say yeah (which is also kind of a lie, or was then) and he comes back with Where There Is No Doctor which is the same thing. He says to take the book and see if I can’t help my mom from it. I think he’s crazy, because who the hell keeps paper books in their van, especially in two languages? But I say thanks and go back to where McQuarie is getting up and trying to be all tough in the other muscley guy’s face and we run off and try to sell the book at a pawn shop, but they won’t take it because nobody buys paper books any more.
The next thing I did wasn’t real cool, looking back. I mean kinda it was and kinda it wasn’t. I didn’t really know what the book was – I looked through the pictures and it was all these skinny people, like they have AIDS or cancer or they’re models on TV on diets or something, and they’re all sick. So I figured cause the title was Where There Is No Doctor that it was all about how you get sick if you don’t go to the doctor, and end up skinny and dying of AIDS which, hello, was something I knew. And I figured that the muscley guy at the clinic was giving me this book because he thought I was just being a chotch and wasn’t taking my mom to the doctor because I was stupid. I figured he figured that once I saw the book, I’d realize that mom needed a doctor and that would be the end of it.
And y’know, he wouldn’t have been the first asshole to do that. I mean, like, on every website anymore there’s all these ads about how you’ve really got sick nuts, or a sick heart, or sick blood vessels, or everything else sick, and unless you buy the shit they’re selling, which is usually just a book about how to eat like a monkey or something, you’re gonna die of sick. It isn’t like I don’t know that. I watch my mom die, and all her sisters had to do their sugar all the time and they just got sicker, and like half the kids in my school were so sick they needed medication all the time, and the other half were taking medication anyway and it was making them sick. I mean, sick and dying is just something everybody seems to have to live with, except the white people on TV. Even Magic Johnson, who used to play basketball, is sick and dying, and he’s the worst of them all when it comes to trying to make you feel bad about not going to doctors. So on top of all that, here’s this book called Where There Is No Doctor as if the reason you get sick is that you’re just some dumbass who doesn’t understand about life.
I mean, that isn’t the point of the book, I know now, but maybe it should’ve been. I tried to help a lot of people, but man, don’t tell me they wouldn’t have been helped a lot more if there was a doctor there too. The difference, though, is that what the book really thinks is that there should be a doctor but it’s the doctor’s fault for not showing up, not your fault for not going and getting one. It isn’t your fault for being sick and not having a doctor, unless you smoke or something. That’s what I like to tell people. But that’s now and we’re still talking about before.
McQuarie ended up going to prison for a year for some dumb shit, which had nothing to do with the muscley guys or HIV or me or anything, and that girl ended up moving to North Dakota cause her dad had student loans. That summer I ended up being so bored, that I tried reading the book, and sure enough, it was a book for people who don’t have doctors and are sick anyway. As soon as I figured out what it was, I went and looked up HIV, and there were all these entries on diseases that get you if you have AIDS. There were two that sounded like they were talking about my mom, and one of them was called something something complex. I was still real dumb then, and I figured that since my mom’s sickness was pretty complex, and I couldn’t even pronounce the name of the other problem, that must be it. I looked to see what drugs to use and they said you could use the same drugs as you do for TB. My cousin died of TB, the kind you can’t take drugs for, but he had a bunch of drugs anyways, and so I got them from my aunt and gave them to my mom and it was like she started getting better immediately.
The book said you had to take the medicines for six months, and Ernesto’s meds ran out after a few weeks, so I went down to La Ciudad and got some over the border. I didn’t do that a lot, at least not before, because the only things I knew to buy were the kind you go to jail for, and I didn’t want to be a dealer like my brother, but still – you grow up in El Chuco, you know these things.
Time went by and my mom kept seeming a little better at a time, and my aunts were real happy and happy with me. Then one day one of them got some kind of boil on her foot, and I figured she could soak it in saltwater like the book said, and everybody got even more happy with me when the boil went away. I stopped going to school and started spending time trying to sew up chickens with needle and thread, and then with stitches from the Farmacias, and then my aunts would bring in the kids from the neighborhood when one of them would wreck a moped or burn their hand or something. Except for the drugs for mom I didn’t give out too much medicine because the book says its dangerous to do that, and anyway, I didn’t want to get caught.
One day I tried to get some HIV medicine, like Magic Johnson gets, for my mom, but it cost too much except at one place where the guys say they sell fakes. I didn’t buy them.
The last piece of the story was when I met Mac. Mac is not McQuarie, understand, but he does have a different name he said I shouldn’t write here. Mac was the dad of one of my cousin’s girlfriends. He was this real hairy white guy, probably about fifty, and his skin was grey. I don’t know why he says I can’t say his name when there’s not a whole lot of old guys with grey skin out there. Anyway, he comes to my house one day and asks for me and my aunt thinks he’s so weird looking he can’t possibly be a cop. Which is funny, because a cop is exactly what he used to be. Anyway, he says he’s heard I can get medicines for sick people who – this is his phrase – “want to keep their heads down” like it’s a war and you can only get antibiotics by jumping in front of a bullet. He starts talking about Where There Is No Doctor and quoting all the best parts from memory, and I figure he’s probably okay and try to work a deal. He gives me this list of like seventy medications, some of which I’ve never heard of, and tells me if I can have them back here when he comes back in a week, he’ll hire me regular.
Well, I do and he does, first as a mule – though I don’t have to swallow any balloons or anything – and then when he sees I don’t just get medicines, I use them, as an apprentice. Mac showed me how you can do what I was already doing and make money – most of his “patients” were guys like him – old white guys who liked guns and didn’t work and lived in shitty dirty white-people houses by themselves. A lot of them were involved in this political thing he didn’t like to talk about around me, but I figured out it was about skinny dirty white guys taking over the government with handguns, and didn’t think much about it after that. Some of them had girlfriends, and some of the girlfriends had these little dirty white kids who were big assholes to Latins, but Mac made them shut up and respect me when we came to take care of their ear infections or when they couldn’t shit or whatever. Once, Mac stood and watched while this white girl had a baby right there on the bed in a hotel room. They all paid him cash and he gave some of it to me to get medicines from El Ciudad and some of it I got to keep.
Mac taught me a bunch of stuff I never would have learned from that book. For one thing, he made me by a reader and put lots of real medical books on it, the kind doctors learn from. He made me read them, and keep them ready on my own googles, which I hadn’t had before. For another thing, he told me there were things that doctors didn’t know or didn’t want to know, like how colloidal silver could kill any infection. I don’t know if I believe that, but it definitely can make any person look a funny color for the rest of their life. He showed me how to grow penicillin on an orange, even though he said penicillin didn’t work anymore, and he showed me how to get pure alcohol from leftover beer using a pressure cooker with a pipe and bunch of pot scrubbers. He said some day he wanted to raise silk worms so he could make his own sutures, which is what doctors call stitches.
Eventually McQuarie got out from Sanchez, and he got pissed that I was spending all my time hanging around with this crazy white guy while my mom was dying. My aunts started getting at me too, and to be honest, most of Mac’s political buddies were pretty dicey on having a Spanish kid sew up their drunken knife wounds. They started calling me “Lansingo” the way white people think you make Spanish words, or else “Tonto,” and one time I stuck a needle right into a guy’s arm and walked out cause he was so disrespectful. Mac probably meant well and all, but it wasn’t just him out there and sometimes I think he wished I’d go back to only running drugs over the border, just to keep things simple. Anyway, I started hanging around my mom’s house again, taking care of all my cousins and neighbors and shit, until my mom died from something that my textbooks say was probably a heart attack. I didn’t even know she was “at risk” for dying like that, what with AIDS and all, but the priest at the funeral, who always sent the altar boys to me when they got sick, said that it was probably the best way she could have gone.
Finally, one day my cousin, who had been dating Mac’s daughter LeAnn, says that he heard through the grapevine that Mac got arrested, and I better keep low in case he turns me in. So I didn’t do anything for a while, like six months or so, and I hear Mac got a fine and a PO and still nobody’s come to find me, and I start thinking real hard about what I want to do. I got kind of good with the medical thing, but I couldn’t keep my mom from dying. My aunt tried to buy the house, but now it looks like we’re gonna hafta move out next month, and she’s going to go live with her ex and the neighborhood is going to get turned into a stadium.
So I’ve decided, why limit myself to Where There Is No Doctor? Why not be the doctor who never showed up for my mom? I may not have a lot of school, but I’ve seen people’s hands get blown off and kept them from getting infected; I’ve seen people shit blood and live; I’ve seen a girl get bit by a mad dog and cut her own leg off to keep out the rage. This is why I am applying to you today, to join the Johns Hopkins School of Medicine Class of 2043.
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