How do you say denouement in Spanish? Shoot, I don’t even know how to say it in English! I think it means winding things up and bringing an end to the story. That’s what I want to do here. Our month in Guadalajara, most of it in the large IMSS hospital Centro Medico de Occidente is over, and we want to get on with life and living. But I know there are many who are interested in, not only the health of my husband and the outcome of his triple by-pass, but also the IMSS facility itself, and the type and quality of care.
So for the record, Larry is doing very well He’s feeling good enough that I’ve left him in the care of Marta and her sister Lulu, and taken some time off to get my friend Janet installed in the house she’s rented for the summer in San Miguel de Allende. She took it on my recommendation and through a contact I provided, trusting I’d be coming along to provide translation and introductions. She arrived in Guayabitos while Larry and I were still in Guadalajara, and waited patiently till we returned and he recovered enough that I could leave. She loves it here. Whew! I’ll be bouncing back and forth between here and the coast for a while this summer. Larry will just be bouncing back. He’s on the road to full recovery.
Previous blog posts I’ve made these past six weeks (starting here) were done while we were in the middle of what turned out to be a long process. Read them if you’re interested. Friends and family already have.
So I’m writing this blog entry three weeks after the operation and two weeks after leaving Guadalajara. The drama has died down, and I’m ready to share some information and photos — and then move on!
I’ve uploaded some photos of our experience, mainly to give ex-pats in Mexico some idea of what to expect for their IMSS premium. IMSS, incidentally, stands for Instituto Mexicano de Seguro Social. It is the national health insurance that almost every Mexican carries, whether or not they can afford private health insurance in addition. Most surgeons in Mexico work for IMSS, even though many maintain a private practice, as well. For instance, the same surgeon that operated on Larry’s back a year ago (and who we paid directly out of our pocket) does the exact same surgery for IMSS patients. There is no deductible, no co-payment when IMSS pays. Larry and I had just enrolled in IMSS last year, and were not eligible to have his back done, as there is a waiting period of one year after your first enrollment. He didn’t feel he could wait that long. But now the yearly premium we each pay is about $320 U.S. dollars. That’s the very highest bracket because we are both over sixty years old.
Good health care is considered a right, not a privilege, in Mexico. The plaque at the main entrance to the hospital notes that it was built in 1977 under the presidency of Lopez Portillo, “para garantizar el derecho de salud a toda la gente Mexicana,” – to guarantee the right of health to all the Mexican people. Mexicans take pride in this facility, which covers I don’t know how many acres. It’s like a small university with at least seven large buildings and a number of smaller ones, including the blood bank. There are wide swaths of park like spaces, and promenades pathways. Take a look at the photo gallery below. One of my favorite shots is the large bronze statue that serves as the centerpiece for the campus and the motif for the IMSS insignia. It is a large eagle, its wings spread protectively over a mother nursing a child. No fragile feminine form is this, but a large boned indigenous woman, over-sized feet firmly planted on the ground. On so many levels this work of art symbolized for me the ethos of Mexico and her people. I had to pause and look at it each time I walked by.
From what I gather, the IMSS Centro Medico de Occidente is world-renowned for its heart surgeons. There was a wide variety of patients on the sixth and seventh floors of the Torre de Especialidades, from the former Orange County day laborer Juan Jose who I mentioned in a previous post, to distinctly upper middle class families from all over northern and western Mexico. Monterrey, as big as it is, does not have a similar facility. The only other comparable heart unit is in Mexico, D.F. While beds in the hospital rooms were reminiscent of scenes from The English Patient, equipment in the Intensive Care Unit was brand new, and whenever Larry had to go in for some test or exam, the machines used were the very latest. The hospital staff were well-groomed and their uniforms were immaculate. There was always a large contingent of nurses around, and they were quick to respond when anyone called for help. Most did not speak English.
There are no private rooms in IMSS hospitals. Larry shared his room with two other beds. He was happy to have been put in the bed by the window for the time that led up to the surgery. When he returned from the intensive care area, we had a slot by the corridor, which wasn’t half bad. In fact, it had a little more privacy. There are sliding curtains that can be pulled around the bed of each patient.
A family member or friend is supposed to be present or nearby for each patient in order to help with personal business like taking showers and feeding meals. Bed pans and patitos are provided, and there’s a room where you dump them, rinse them and leave them to be professionally washed. (I don’t know the technical English word for patito. It’s the blue duck shaped pitcher thingy that guys pee in.) There are large bathrooms, one for men and one for women complete with shower facilities. They are not fancy, and it’s a good idea to bring your own toilet paper. It’s provided, but keeping the dispensers filled is not often a priority with the staff. Also bring your own towel, soap and other toiletries. What I saw was a good sense of community, where people cleaned up after themselves and respected the modesty of others.
There is no internet and no television in the rooms. I’m grateful for the lack of TV, as most Mexicans are very generous with their love of music or entertainment and tend to turn the volume way up so everyone can hear. I don’t have a smart phone in Mexico, as just a minimal little Motorola unit has served me well. I am rethinking that situation. I ended up taking a cab to the Telcel Client Service Center and signing up for a 3G USB plugin device, which will only cost me 399 pesos a month for the next year and a half. I filled out a long application which asked all sorts of questions, including the color of our house. I am not lying. After signing my name twenty-four times, I walked out with a tiny little plastic dohicky that gives me the world anywhere in Mexico. Sigh. I was desperate.
The food in the hospital ranged from pretty fair to really horrid. We could certainly tell that most of the kitchen crew was on vacation during Semana Santa and the week after Easter. One memorable meal was a cold hotcake with a half of a steamed chayote. But other times there was braised fish or chicken, and Larry said the one hamburger he got up there was really good. (Maybe that was just hamburger deprivation talking.) The security people at the entrance to the large Torre de Especialidades where Larry had his room, turn back people who are obviously bringing in alimentos from outside, but I found that in my big purse I could carry up yogurt and fruit, tortas, (sandwiches made on bolillos), and even the occasional tamale or taco. There was no problem bringing in Styrofoam cups of coffee from the nearby OXXO or Seven-11. There is also a twenty-four hour café, El Caffetino, in the basement that is pretty good. Familiares (family members caring for patients) are provided meals from the same cart that serves the patients, if they desire to partake. I usually didn’t.
Here is a checklist of the things we found most helpful to have:
Your own pillow – There’s nothing like this comfort. Wish I had mine right now.
A foam mattress pad – the hospital bed mattresses are covered in heavy plastic. Sanitary, but very sweat-producing.
A small folding aluminum chair — A side chair is provided for each bed, but if there’s more than one familiar present, the extra chair is welcome. It’s also a good footrest and place to put other stuff.
An electric power bar with multiple outlets — There is one outlet over each bed, and if you have multiple cell phones, a computer, or a small electric fan, you’re going to need access to more juice.
A small portable fan — Mexicans like rooms to be warmer and stiller than most North Americans are used to. Lulu and Marta spent almost 500 pesos for our little one — worth every penny.
A yoga mat or cardboard and extra bedding for whomever stays overnight with the patient. You’ll be sleeping on the floor, amigo.
Towels, washcloth, soap and personal toiletries. Toilet paper.
A large bag to store your stuff in, so you can lift it up and out of the way of the cleaning crew that comes in twice daily to sweep and swab down the floors. They also clean and disinfect those portable tables on wheels that fit over the bed. Nothing gets stacked up or messy.
Reading material or entertainment.
I was fortunate to have the company and support of Marta, our friend Lulu’s sister. Lulu has worked for IMSS in Tepic for twenty-seven years. Most of her family has worked there, so Marta wasn’t afraid to put on Lulu’s IMSS jacket and blend in with the personnel. She got a lot accomplished for us. She also took the night shift and let me go back to a small hotel room each evening, where I put my feet up, caught up on Facebook, and watched a tiny little flat screen television while eating chicken quesadillas from a place across the street. This wasn’t the first hotel I stayed in. After two very sub par tries, I settled on the Hotel Durango, which sits right at the foot of the entry ramp for the hospital Urgencias entrance and the ICU waiting room. The hotel was noisy, but it was close and it was very clean. It was 100 pesos a night per person. I think I spent more on buying cell phone time than I spent on hotel rooms. I got one for Marta so she could have a place to runaway to during the day. There was also an elevator (which didn’t run on Sunday) and a restaurant that served a substantial mid day meal for 60 pesos.
Thinking about the weeks I spent there, I can’t think of any bad memories. All that remains is the good — the caring families who were generous with their help and support, the efficient staff. Gosh even the “queen of programming” who I referred to in rather unflattering terms in one of my posts, ended up knocking herself out to get Larry down for the final X-ray that we needed in order to leave the hospital. And it turns out she speaks excellent English! All we needed was a little patience with each other.
Like I say, the aim of this blog post is to provide information. People have said, “Well, you’ve got the subject matter for your next book.” I really don’t want to “go there” for a long, long time, if ever. It’s not that our experience was horrible, as some have thought. On the contrary, we learned a lot, were deeply moved and touched by much of what we witnessed and went through. We are also extremely grateful to Mexico and its people for providing this system and allowing us to join.