For a couple of weeks we've been planning this tooth-pulling/ear-washing/giving-lectures-on-healthful-living trip north into the hot Chiapas lowlands. Pastor Bercián, who operates the hospital's dental office, several nurses and myself have been scheduled to go. Don David, an employee at Yerba Buena, has volunteered to take us there in his four-wheel-drive. The first three or four hours will be on fairly decent roads, but the last thirty kilometers will be so rough that probably we'll have to walk. For days the excitement about going into such isolated territory has been growing in the nurses and me.
However, on Saturday night before the Sunday morning departure, the whole projected trip seems to collapse before our eyes. Don David now says that it's been raining too much and he doesn't want to take us. When the Pastor then asks Nela for permission to use the blue truck, Nela refuses, saying that the truck isn't properly licensed for driving outside the state of Chiapas. This remark stuns us all, for we all know that the truck is fully licensed and travels outside Chiapas frequently. Don Alfonso, Yerba Buena's chauffeur, is the most surprised, for he frequently drives the truck outside of Chiapas. For some reason Nela doesn't want us to go on the tour, but she won't give her reason. I'm disappointed to see this kind of lack of communication and cooperation at Yerba Buena. Saturday night, we all go to bed a little discouraged.
Early Sunday morning I visit the Pastor's house and suggest that he and I make the trip alone, and if the clinic won't pay the expenses, I'll pay them myself. The Pastor says he'll think about the idea, and talk to Nela again. A few minutes later he comes to my room and tells me to get my backpack ready for making the trip. Within fifteen minutes we're flagging down a bus heading north. In my backpack is all the medical equipment and medicine. No nurses come with us. Apparently the Pastor instead of asking if we could go simply informed Nela of our plans.
Though our destination, Nuevo Limar, is in Chiapas, to get there by bus we must first go north for about three and a half hours to Villahermosa, in the state of Tabasco, and then east for about an hour to Macuspana. At the station in Macuspana as we're walking toward the ticket counter I spot the bus to Salto de Agua, the next stop-over during our journey, pulling out of the parking lot. Salto de Agua is the closest town to Nuevo Limar with bus service, and only one bus a day goes there. Five seconds later and we'd have missed this bus, and had to stay overnight in Macuspana. Our luck in making this connection is remarkable. By the way, the Pastor now insists that we go "halvers" on this trip's expenses. This a wonderful gesture, for he is even poorer than I.
At dusk our bus pulls into Salto de Agua, in the steamy lowlands of northern Chiapas only about thirty miles northeast of the famous ruins of Palenque, where Pastor Asunción Velázques and his family are expecting us. Pastor Velázques is in charge of all the Adventist temples in this area. He plans to accompany us to Nuevo Limar tomorrow morning.
There's a road between Salto de Agua and Nuevo Limar, he says, but it's so bad that in places it's almost impassable. On a rather undependable basis one truck a day carries passengers to Nuevo Limar, but many times it must stop to fill mud holes with rocks or tree limbs. Moreover, one-way passage costs l5,000 pesos (about $6.50 U. S.) per person. Pastor Velázques intends to go by truck and he supposes that we shall, too. However, Pastor Bercián and I simply don't have the money for truck-fare. Besides, people are expecting us and we should not depend on an undependable truck. We'll walk the thirty or so kilometers alone...
Half an hour before sunrise, Pastor Bercián and I hike out of Salto de Agua. We cannot take our eyes off the brilliant, scintillating stars. The pre-dawn air, moist but warm, is suffused with the odors of coffee-flower blossoms, corn tortillas being warmed over wood fires ignited with kerosine, and brewing coffee.
By l0:00 AM the temperature has risen into the 80's and sometimes the road is nothing but interconnected mud-holes. Wild plants and animals here are completely different from those found in Yerba Buena's cool, piny woods. Here parrots, oropendolas and brown jays punctuate the morning's air with raucous calls and from the shadows deep inside thickets comes the mysterious whistle of the tinamou. Bird-of-paradise plants with gorgeously red and yellow blossoms grow as weeds along the trail. Like thirty-foot- high, leafless redbud trees, cocuite trees stand absolutely filled with pink blossoms, and every couple of minutes we step across streaming lines of large, black leaf-cutter ants (All ants traveling in one direction carrying nothing, but all those heading the other carry above their backs green scraps of leaf, about the size and shape of a fingernail. They'll carry these cut-out bits of tree-leaves into underground chambers and eventually feed on the fungus that grows on the leaves.) About thirty feet up a tree a single, foot-tall blossom of Aristolochia or Dutchman's pipe vine dangles from a limb. The Pastor leaps quickly to one side when in the roadside weeds he spots a deadly coral snake. Later when we see a seven-foot long mata ratón (in English, "rat-killer"), with its alternating bands of yellow and black, cold chills run up my spine, though I know it to be harmless. By noon it becomes too hot and I've grown too exhausted to pay much attention to flora and fauna. Carrying the weight of my backpack stuffed with heavy tooth-extracting equipment, my shoulder muscles burn, and sweat drips off my elbows. It's a very humid 92°.
At l:30 PM we arrive in Nuevo Limar. Looking at us from inside their huts, people view us with profound uncertainty. Mostly they look at me. Children and young women flee us and no one speaks unless we speak first, and their greeting is coldly mechanical and full of mistrust. Here people speak neither Spanish nor the Tzotzil we usually hear around Yerba Buena. They speak Chol, which is another member of the Maya family of languages.
At the hut of the Adventist deacon expecting us, no one is at home. For twenty minutes we stand resting in the hut's shade wondering what to do. Eventually a child peeps around the hut's corner. The Pastor asks the child to go look for the deacon. In another twenty minutes the man arrives carrying a machete, his sweat-stained clothes covered with ants that have dropped onto him from the bushes as he passed by. He's been working in his coffee plantation.
"We sure are thirsty," the Pastor says after greetings are exchanged.
"Síííííí... " the deacon smiles.
"I'll bet that those coconuts are just full of cool water," the Pastor hints.
"Síííííí... " the deacon admits, still smiling sheepishly.
Once the Pastor understands that the deacon is unaccustomed to visitors of our kind and that he is absolutely at a loss as to how to handle us, there is nothing left to do but to smile and give an order:
"Go get us four coconuts and prepare them for us to drink," the Pastor gently says. The deacon seems relieved to be told what to do, and now he serves us with the greatest of respect.
We are conducted to the town's Adventist temple, situated atop a tall hill at the edge of town. It's about forty feet long, twenty feet wide and built atop a concrete floor. Beneath the tin roof the rafters are hung with pastel red, green, yellow and blue strips of crepe paper. One long wall is constructed of massive wooden boards and the other is of arm-thick, debarked tree-trunks. On each wall hang two small platforms for holding kerosine lanterns. Wooden boards laid atop poles serve as seats for the congregation. Seeing this, I muse to myself that the temple's builders must have been overly optimistic to have expected that someday in this town of about 3000 hut-dwelling Chol Indians such a spacious building might be filled with Adventist worshipers.
As soon as we arrive we move the table serving as a podium outside the temple, and place our dental instruments on it. As we arrange things, a young man climbs high into a tree next to the church, drops a rope, and pulls up a large speaker. As he points the speaker in one direction and then another, a second man inside the church, using a battery-operated amplifier, announces to Nuevo Limar, in the Chol language, that we have arrived.
We work until dusk, pulling about twenty-five teeth from fifteen people. Pastor Bercián does the cutting and tugging while I take names, keep instruments sterilized, keep the syringes filled with xylocane, and hold heads during the most difficult extractions. Both of us work hard, continually surrounded by dozens of close-pressing, curious onlookers.
I'm astonished as I take the people's names. In Mexico a person's middle name is the same as the family name of the individual's father. The person's last name is the family name of the mother. If a man bears the name of José Sánchez Fernández, he should be referred to as Señor Sánchez, not Señor Fernández. These people's names suggest that a great deal of intermarrying among the members of a few families has taken place. Here are the two last names of each of the fifteen patients we receive on our first afternoon of work:
Seeing many young girls carrying babies on their backs, the Pastor asks at what age Chol women marry. Usually between eleven and fourteen, is the reply; the men marry between fourteen and sixteen.
Here is how we pull teeth: The Indians tell us which tooth or teeth they want extracted. About half speak enough Spanish for us to understand, but always someone is around to interpret. Xylocane with epinefrina is injected into the gums about one quarter of an inch below the gum/tooth line, on both the inner and outer side of the roots. If two adjoining teeth are to be pulled, the shots are given between the roots. Because xylocane is such precious stuff, the Pastor tries to avoid using more than half an ampule on any one patient. Usually when the shot is given a conspicuous white bubble or blister forms beneath the gum's epidermis, just above the needle's point. The first such blisters I saw, I felt sure they would burst, but they never did. However, sometimes as the shot is being administered the xylocane does spurt from holes in the gums, which usually have been formed by abscesses.
Crowns of most teeth are so decayed that simply grasping the teeth with instruments and twisting and pulling them out -- the basic procedure -- is impossible. The rotten tooth would break if that were tried, and then the more painful process of gouging out fragments one piece at a time would become necessary. Thus usually the Pastor begins his extraction with an instrument looking like an ice-pick. He gouges it between the teeth, trying to loosen the one to be removed and to expose enough of its base to get a good hold on it with his pincers. If the tooth is up front (canine, incisor or premolar) and thus bears only one root, then the main extraction movement is circular -- the tooth is twisted out. If the tooth is a back one, a molar, with more than one root, it must be wriggled back and forth along an imaginary line originating in the mouth's center. Once it's loose, it's simply pulled out.
Once the tooth and all fragments are removed, sterile cotton is soaked with merthiolate and packed tightly into the cavity -- all the way to the nerve-rich bottom. Wherever two or more teeth in a row have been removed, or wherever it's judged that serious bleeding might continue after the patient leaves, the Pastor places a wad of cotton over the wound and tells the patient to hold it there for about an hour.
And that's it. The open, bloody socket remaining after the tooth is pulled is not sewed up, so presumably a significant number of those holes will accumulate food and become infected. I only guess that somebody along the line has decided that this is the "compromise treatment" for those people who otherwise would receive no treatment at all, and probably will not pay anything for the the services provided to them. (We tell patients that we'll gladly accept any money they have to offer, but that if they are unable to pay, they need not pay anything. During our stay at Nuevo Limar, no money is taken in.)
Working next to the temple is not unpleasant. Big trees provide wonderful shade and always a fresh breeze blows around us. However, so many spectators crowd around us as we work that not much breeze gets to the patient and Pastor Bercián. Since I'm over a head taller than everyone else, however, I enjoy the breeze. Again and again we plead for people to stand back and give us room, but after we move them back, within less than a minute they're back, gazing curiously -- or doubtfully if they are scheduled for extractions -- into the bloody maw before them. Everyone cracks jokes and gives a hand translating Chol. When a leaf falls into a patient's bloody mouth, everyone laughs hysterically, including the patient. Though these people must understand the realities of life, death, poverty, pain and desperation far better than the average gringo, to me something about them seems adolescent or even child-like. It's simply impossible to get upset with them as they disobey our requests that they stand back.
I'm told that I'm the first gringo ever to visit Nuevo Limar, though some years ago a tall one like me came to a village not far away, to live for several months. His name was Adán, they say (probably Adam), and he insisted on working with the men in their fields, and riding horses with them on hunting trips. He learned which plants are good for what, and he became able to speak Chol very well. Once Adán's story is told, one man who seems a bit more cosmopolitan than the others approaches me and with a knowing smile says, "Adán was an anthropologist, you know... " It's amusing thinking that now Adán the anthropologist has himself become part of these people's oral history. Maybe in a few years they'll also be passing along stories to their children about the tall gringo who one day came pulling teeth.
Yesterday afternoon Pastor Velázquez was supposed to arrive from Salto de Agua, but he did not. Apparently the undependable truck chose not to run that day.
In the evening Pastor Bercián offers a church sermon. I am astounded when over a hundred worshipers appear, quite filling the temple, the men mostly sitting on one side and the women and young children sitting on the other. Many come carrying both a Bible and a flashlight, for Nuevo Limar is not served with electricity. The Pastor lectures for about an hour on washing hands before eating, keeping pigs, dogs, chickens and turkeys out of the hut, and such. Moreover, to back up the points he makes, somehow he's able to find verses in the Bible. Each time he mentions a verse (the temple's regular preacher stands beside him translating every word into Chol) those with Bibles and flashlights tuck the flashlight between a shoulder and their cheek and in the Bible held before them search out the verse mentioned, just to see for themselves.
As on each morning during our stay, a little after dawn the Pastor and I descend to the thatched-roofed hut of the family that during our stay has provided us with meals. The hut's walls are made of poles tied together with vines and fibrous tree bark and the floor is dirt. No chimney exists for the perpetually burning fire, so smoke simply filters through the thatch, leaving it and its supporting poles with the appearance of having been painted black and then covered with several layers of varnish. This morning, as usual, we're provided with freshly made ten-inch-wide tortillas (much larger than the average Mexican kind), bowls of black beans, and piping hot chayote (an egg-shaped, greenish, semi-prickly squash growing more or less wild in people's corn fields; it's one of the most important elements of Indian meals all through tropical Mexico). I eat everything with gusto. But early in the meal Pastor Bercián discovers a champion-sized cockroach floating in his beans, after which he cannot rekindle his appetite. So as to not embarrass our host, he flicks the soggy insect onto the ground beneath the table. As if waiting for such an eventuality a large red hen with a featherless neck happens to be standing exactly there. Instantly she snatches up the prize and runs outside.
As we are leaving Nuevo Limar, hoping to reach Yerba Buena late in the afternoon, we are stopped by a stranger saying that the night before Pastor Velázquez arrived in the town of Limar Viejo about an hour and a half away, and that we are expected there to pull more teeth. Immediately we abandon our plans and turn toward our friend.
Limar Viejo is even more isolated than Nuevo Limar, but demographically it's very similar -- 3000 Chol-speakers. Here the temple is only about thirty feet long and fifteen feet wide. As soon as we arrive we set up beneath an acacia tree behind the temple and a deacon announces our presence on the battery-operated community loudspeaker.
Quickly it becomes apparent that in this town for some reason we were not expected. Most adults now are too busy to visit us -- the men in their coffee plantations and the women in their huts. We wait for two hours and no one comes. Then it's siesta time, so we take a meal with a deacon and return beneath the acacia to wait. Around four in the afternoon the first patients arrive. By night, we pull about twenty teeth. In Nuevo Limar, once the people had found out who we were, they were very open and friendly with us but here people are much more reserved. Moreover, in Nuevo Limar the Indians seemed to consider our service to be a friendly gesture being offered by "Adventists brothers," so they did not pay. Here, nearly everyone pays, even if it's only a few pesos, amounting to less than a U. S. cent.
In the evening another meeting is held; but this time only about fifteen worshipers show up. Once again the Pastor preaches mostly about "clean living," backing up his assertions with quotations from Scripture. When at the sermon's end he asks if anyone has any questions, a man in his fifties raises his hand and says,
"All these things you talk about -- washing our hands, keeping our animals out of our homes, the eating of plants instead of so much pork -- these ideas are very different from what we are used to. I'm not sure I understand much of what you say. Please, can't you stay a little longer to show us what you mean?"
A pained look comes into the Pastor's face as he explains that tomorrow we absolutely must return to Yerba Buena. It's too bad the nurses had been unable to come with us as planned, for part of their job on such tours always is to give talks on healthy living.
In the night the half-full moon lies straight above us. While the worshipers sing psalms I step outside to walk around and soak up the night's feelings. Carrying a microcasette recorder in my pocket, I record what I see and feel. Here are the very words I speak into the recorder as I stand in the middle of the moonlit dirt street before the church:
"People singing inside the temple, no musical instruments, the songs simple and repetitive... Katydids calling from shadowy bushes... Visible in the moonlight, pale woodsmoke filtering through cracks in the pole walls of the hut next door... Lightning bugs flashing in a banana grove next door... Silhouettes of palm trees on the horizon... Horses standing tied outside the church.... In moonlight, the cumulus clouds above us are like dark blue bunches of cotton surrounded by black sky and twinkling stars.... Up and down the street, inside every hut, a candle or kerosine lantern is burning, an orange glow visible through the chinks between wall-poles... "
At 3:l5 AM we awaken and begin packing. By 3:50 Pastor Bercián and I, guided by a flashlight, are hiking down the dirt road toward Salto de Agua, picking our way past immense mud holes, hoping to arrive in Salto de Agua in time to catch the 11:00 AM train to Pichucalco, for the bus to Macuspana will leave before we can get there. We need to return to Yerba Buena tonight because the Pastor has dental appointments scheduled for tomorrow morning. Some of the more wise-looking individuals we speak to insist that here trains come and go according to no discernable schedule. One just has to sit and wait for them, sometimes for a day or more. Though my past experience with Mexican trains causes me to suspect that this is the truth, we feel compelled to at least hope for an "11:00 o'clock miracle." So now with the moon already set and the stars twinkling almost violently, and the sweet odor of coffee-blossoms hanging heavily in the moist air, we struggle northward.
We enter Salto de Agua at about l0:50 AM. I'm limping badly because of a severe blister on a big toe. My back muscles are on fire and seldom in my life have I been so thirsty. For a long time the Pastor and I sit on the train station's cool concrete benches and I do believe that if the train had arrived at eleven o'clock we wouldn't have been able to climb onto it.
If it's to be believed that the eleven o'clock arrival represents an event in a real timetable someplace (certainly not posted in the station), then our train arrives thirteen hours late. It comes at midnight. During the afternoon and early eveing I'm able to get a little sleep, but the Pastor cannot.
From midnight to about 2:30 AM we ride through muggy, foggy lowlands, standing most of the way because all the seats are taken. The front half of the car into which we are herded reeks of urine and the floor is slippery with it. Each time the train starts or stops, long, straight tears of urine stream from one end of the car to the other. The surly conductor tells me to go stand beside the bathroom because my towering above him as he sits doing nothing bothers him. I refuse because of the odor and he curses me profanely. I want to slap him but fortunately the magnanimous influence of the Pastor saves me.
The train station at Pichucalco lies three miles from town. At 3:00 AM a van comes to pick up passengers wishing to be carried there. Though the Pastor and I are first in line, we are not aggressive enough to prevent the others from pushing us aside and cramming the van so full that we cannot enter. So, we walk. I can hardly believe that a single blistered foot can hurt so much.
We limp into the bus station at 4:l5. The first bus heading up the slopes leaves at 7:00 AM. I get a little sleep, but the Pastor cannot.
We arrive at Yerba Buena at l0:00 AM. I head for my bungalow to take a nap (sleeping right through lunch). The Pastor goes home for a bath, so that he may be clean when he returns to take care of the patients waiting in his office.
What a tough, wonderful little guy this Pastor Bercián is.