This heat.

Well, my parents think I’m crazy.” I couldn’t hold back my laughter as I nodded knowingly—I had long-ago resigned myself to the fact that most of my decisions would seem that way to my parents. The fact that they don’t hold me back despite their opinions is a testament to their faith in my ability to learn from my own mistakes. And I’ve always loved them for it.

Just a few nights ago I was talking to one of the pasantes (social service year physicians) as we sat in the CES office, fans blowing up a windstorm around us as they attempted to lift the suffocating heat. Ah, the heat. I hadn’t been prepared for this—or perhaps I thought I was too prepared. I’m an island-girl after all, born in Hawaii and raised halfway between there and Sri Lanka. So, I figured that I should know something about relentlessly hot weather. But I quickly figured out that I had been very wrong and could feel the weight of my miscalculation pouring down my back as I arrived back to Jaltenango after spring break. It looked like I would have to develop my strength over the next few as the infamous heat of these months (it would be far worse in August, I was told) took hold and led me to plan my days according to little else than the feel of the air at any given hour. Here in the mountains, the temperature changes can be even more bizarre as the relentless sweat-inducing heat of the day transforms into a frigid cold during the night. Even though I go to sleep with my face turned towards the open window and my arms outstretched in a desperate attempt to maximize my bodily surface area, I awake with my legs curled beneath me, blanket clutched close, and skin shivering in a plea for additional layers.

But back to my conversation with this pasante—we’ll call him Jay. Jay had come from a school in one of the larger cities of Mexico but had since moved into one of the tiny community clinics operated by CES in the mountains of the Sierra. As a recently graduated medical student, he would fulfill his social service there for the entirety of the coming year.

So why did you choose to serve your service year here, instead of a local hospital in the city, for example?

Jay paused for a minute, but I had asked him in English and so I knew he would respond likewise. He explained that he could easily have spent this required year of social service close to home in a cushy hospital with oodles of air conditioning. But instead he chose this, the literally off-the-beaten-path experience where he would be spending a year working in a rural community clinic and sleeping in a bare room with little more than his cot, a single light bulb, and the natural walls of the mountains surrounding him. To his friends and family, this wasn’t considered an “exotic” choice either—as it might be for an American college student traveling to a foreign country, for example—for he was still here within his home country of Mexico. But he had wanted to see a view of healthcare that was out of his singular frame of reference, he explained, and to experience the medical practice in a way that he could be assured would be different from the bedside manners he had seen and learned from in school. Medical school had been hard, he said—a concourse that had tried his physical strength as much as his mental vigor—but it hadn’t prepared him for the experience of knowing a piece of the lifestyle of his patients in a way that might give him true insight into the origin and nature of the illnesses that afflicted them. As the doctor, he sat squarely on the same plain as his patients, living and knowing their circumstances both through the stories they related of the poor coffee harvest this year and the struggle of putting each of their children through school, and the experience of sharing these mountains with them. For all their vastness, these towering forces of nature had created one of the most close-knit communities he had seen yet. Jay put up a few pictures of his community and described the scenes of the people he knew and the homes that had opened their doors to him as I watched the images flash past on his Macbook’s glowing screen. He admitted that the people there had their challenges—among them a history of domestic violence, entrenched poverty, and the still evident machismo that often dictated wives’ choices based on their husbands’ demands—but despite the heaviness brought by these, they were a people who remained hopeful and receptive to the care that he was there to offer. He had confessed that, at first, he had often been mistaken for a “gringo” (white person/foreigner), but those around him soon realized that he was as Mexican as they and had come to be a part of their community for the coming year.


 The consultation room in one of the CES clinics

And you? Why did you choose to come here to Mexico? he asked.

Ah, the perennial question. I had answered it many times since coming here, but even still I felt that my response had evolved with time. While this experience might be considered “exotic” by some of my friends and family back home, I explained that I really didn’t see it that way. “Exotic” was just a more exciting way of saying “unimaginable,” I figured. Not in a bad way, surely, but it was just that I knew that many of the people I had left behind back home simply couldn’t imagine what I was experiencing here, including my own mom. She still wondered aloud at my decision to leave the comforts of my home and school behind in order to live in this way. For me, I knew that it was partly curiosity, partly ignorance, and wholly a desire to know—and I mean truly know—the experience of patients in a way that I knew no professor was prepared to teach me. Here in the Sierra, I am not part of any “establishment” nor a representative of the white coat-clad doctors that work diligently at saving lives in the hospitals I had known growing up—rather, I am the student, the neophyte, the young girl who can work her way into the fabric of a new life and sew a patch in this quilt for herself.  And so, I persisted and I came. As I take my six-year-old host sister to school in the morning, or walk the dusty streets with my host-mom and carry a covered straw basket full of milpa perched on my waist, I can feel myself being an outsider to the medical practice as much as I am connected to it. It’s this chance to see from that point of view that has most enriched my experience here.

I realized that Jay and I were in a similar boat, equal with the other pasantes who had chosen to spend their social service year delivering care in a way that denied them the typical lifestyle they would have had back home. Our friends and family may wonder at our decisions, but—at least for me—this in turn has motivated me to challenge and then re-confirm my own conviction in the value of being here.


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