Twelve Patients: Life and Death at Bellevue Hospital (22 page)

“My
pecado
, sin, was to marry a man who suffered from ‘
mamitis
’—a mama’s boy. The first offer. He never left me alone for a moment. What I thought was love was really hatred. He was jealous of everything I did and gradually restricted my movements from the house, my visits with friends and even neighbors. Over a couple of years I went to work and returned home, to cook and clean for him and satisfy him sexually. At his whim, like whistling for a dog. That was it. My life contracted.” She made a sphere with her hands the size of a basketball and then crushed them down to a clenched fist.

“I often woke being beaten on the face and head. My alarm clock, a brutal drunk
cabrón
. He fractured my arm and I spent three weeks in the hospital having it pinned and getting rehab therapy. You know,
it was the best thing he gave me. I finally had time to think. I planned my escape from his attacks and his infantile attachment to his mother, who lived next door. Most important, it gave me time to examine my life and the imbecility of marrying the first man who asked me. A poor stupid naive girl from the Highlands. We were a dime a dozen, many sold themselves for a few quetzales to buy food.” The recounting was matter-of-fact. It happened, these are the facts.

“I walked to the hospital where I worked from the bus stop every day and passed a deep
barranca
, ravine, that ran through the city. Barranca Guayama. There were frequently bodies at the bottom of the
barranca
, thrown there the night before from passing cars. Tossed out like garbage. Many of the bodies were
descuartizado
, quartered, with heads missing and signs carved into their chests or foreheads. You learned to walk by quickly, trying not to look, covered with a shawl. You didn’t talk about it. It was normal.” She took a breath and looked at her sister, who was listening intently and nodding in agreement. “I took my boss’s kids to the Cloisters last weekend. I work as a nanny. Imagine you found bodies cut up and stuffed just off the walkways under leaves and brush. A foot sticking out. New ones every day.

“At the General Hospital in Guatemala City the rate of alcoholism and violence, beatings and rapes increased every month, as predictable as the sun coming up. The police did nothing. You avoided the police at all costs. They dragged around Las Zonas, the neighborhoods, on high-powered motorcycles, covered in black Kevlar, with machine guns over their shoulders. They swaggered and demanded. The violence once limited to gangs over turf, drugs, and petty theft had changed. It penetrated everyday life. From buying milk at the store to walking your dog. Random assaults and beatings, kidnappings, murders, gang rapes or young women sold into sexual slavery where they had to live and adapt. And homes themselves, I mean inside your own house, your own apartment was no longer safe. It was contagious and spread. The temperature rose and kept rising.”

“When did you decide to leave?” I asked when she paused to take a bite.

“It was unbearable to watch it and it was unbearable to be a part of
it any longer. I planned my escape with a coyote to the United States. I would leave my two nearly grown children with a relative to finish school and then send for them. My only other move was to kill my husband, but then he would be with me forever, as a nightmare. That’s how contaminated my thoughts had become. My only way to preserve my humanity was to leave.” Clara was calm, and her voice did not change its inflection. It was the humiliation that stung her so deeply. More painful than his fist.

Clara took a minute to drink her soda. We were all quiet together. Soraya broke the silence. “Clara, tell the doctor my story. I have no
animo
, no spirit, to talk now.” Her sister gave an almost imperceptible nod.

“My sister had no education except the most minimum grade school level available in Salamá. Barely reading and writing. Good for bearing children and cleaning a house. She met an older man at a community dance in San Juan who courted her for six months with flowers and cheap sweets. She agreed to marry him, a virgin in body and in mind. The violence in our home area was terrible. Rabinal had been a massacre zone. Soraya was too young to know what was happening and had never left the town. Our parents never breathed a word. I think they had seen too much in their lives of suffering. It was all about survival. Nothing else.

“My sister’s marriage was not a happy one, but it ended more tragically. They had a son, Tomás. Her husband ignored her and left her on her own for months at a time. One time he didn’t come back. He ‘disappeared.’ In fact the town was disappearing. All of the towns were emptying out. Ghost towns with elderly men and women left tending small plots of cornfields on steep hillsides. There was emigration to Mexico and to the United States. There was something new on the streets. Narco violence. Young men on
motocicletas
, motorcycles, or small pickup trucks carrying heavy weapons high on drugs controlled the neighborhoods and violated women randomly and regularly.” Clara knew that her sister’s story was more than a personal story. It told of the destruction of a society. “One day,” Clara continued, “her husband’s right hand was left outside her doorstep.”

She knew she and Tomás, then six, had to leave. She saved and borrowed three thousand dollars from family and friends to join a group of sixteen men and women leaving from the Mexican border town Tapachula to Brownsville, Texas. “The journey would take two months and be very hard and dangerous. My sister had no idea.” Things can always get worse. Beware of false sentimentality, my mother warned me. Many years in the medical profession had taught me firsthand.

Guatemala was both the Beauty and the Beast. I was familiar with the areas Clara was talking about. I thought back on the trips that Diana and I have taken there, once on a crazy journey to Tikal in the Petén via the Usumacinta River in a dugout canoe at the height of the civil war. A young Mexican man rowed the canoe. What were we thinking? Another more recently to see an ancient performance of pre-Conquest origins in Rabinal that Diana was writing about. It was a magnificently gorgeous country. But also a ravaged one on so many levels.

The terror had started with the fall of newly elected President Arbenz in the 1950s in a CIA-backed coup blessed by President Eisenhower in a Cold War frisson, requested by the United Fruit Company. The destabilization established a pattern for Latin America and made it the “Empire’s Workshop”—felicitously named by the Latin American historian Greg Grandin. What followed were repeated changes in government, coups, countercoups, and the increasingly heavy hand of the CIA. Advanced military training in Vietnam-style counterinsurgency warfare has been provided for generations of military leaders in Latin America by the U.S. military at the School of the Americas in the Panama Canal Zone and later in Georgia.

By the early 1980s, Ríos Montt, a fervently evangelical general formerly out of favor, exiled to Franco Spain briefly and trained in the School of the Americas, became president of Guatemala. The uprisings that occurred sporadically around the country, the strikes by schoolteachers and workers, were seen as the work of communism, which in the U.S. lexicon meant unlimited logistical, military, and financial support. Ríos Montt understood the Yankee mentality well, along with the trip wire that opened their pocketbooks and trumped any
minimalist congressional oversight. Ronald Reagan called him a great friend of the United States while he devised a scorched-earth program, Victoria 82. He lifted his tactics from the playbooks of the failed war in Vietnam, the village pacification programs. He amplified the role of Los Kaibiles, the counterterrorism black-ops group that was headquartered in the Petén, in northern Guatemala in the Yucatán, in special camps along the Usumacinta River. We happened to have been their guests at their training camp for five hours on that ill-conceived trip as they cross-examined our Mexican rower. These young recruits were carefully chosen and carefully brainwashed to be unsentimental killers.

Victoria 82 was a campaign to eliminate villages in the Highlands, in Rabinal, in Salamá and its surrounding areas. The idea was to “drain the sea”—to exterminate men of recruitment age for the insurgents and terrify the remaining population into submission. The fish in the sea were the Mayans and Ladinos or mixed-race Guatemalans living in their towns. Terror became a critical strategy, one might argue the essential one. As Mayan groups turned against each other, and Ladinos turned against Mayans, the links of trust, kinship, mutual assistance were dissolved in the blood of forced murder, picking apart the jealousies and animosities that are latent in all communities. The leaders were deliberately marked for execution or exile.

Father Ricardo Alemán, a Catholic priest who lived for nearly thirty years in the Verapaz districts and knew the Molino sisters and their families intimately, had come to see Soraya. Clara had emailed him from her boss’s apartment when her sister had become ill, apologizing for not going to speak with him directly. He visited often, and was always animated when he joined the conversation. He had witnessed the Red Handkerchiefs. Young men, wearing red scarves around their necks, would come into the center of Rabinal and shoot young men at point-blank range. They would shoot any women coming to their aid and anyone else who looked or acted suspicious. They left one man alive to pile the corpses on a truck and drive it to Salamá. The driver would stop short of the forensics building, get out, and stand by the back of the truck, where he would be shot, stacked with the rest of the
corpses, and driven into the stockade. The head of the red
pañuelos
, handkerchiefs, who rode on a motorcycle outside Rabinal, was himself shot to death by the son of one of his victims. He asked not to be tortured, as he had tortured so many by his own hands. They put a bullet in his brain and threw his body down a
barranco
.

Clara and Soraya recounted many stories of their lives in and around Rabinal and Salamá and the isolated village of San José. They were remarkable survivors, lovely human beings, with integrity and deep humanitarian values. What category of naturalization and immigration could the Immigration Customs and Enforcement arm of the U.S. government put them in?

Soraya’s personal story continued to evolve over a series of more frequent hospitalizations. The fluid built up more rapidly in her legs, her abdomen, and her lungs as her cardiac function dropped another percentage point. Her weakness progressed with less tolerance for walking and doing any household activities. Our social services arranged a van to take her to her office visits. She was months behind in rent, but the neighborly and kind landlord was not going to put her out on the street. We had a little time to pull together some additional community resources. The clock was ticking, however, and we could all hear it. Soraya would make it to cardiology clinic on a Wednesday afternoon. I would get an email that she was in the CCU later that day.

As I sat on the edge of her bed or pulled up a chair close by her side, she and I would talk, her voice barely a whisper. Sometimes Clara was there, and occasionally Father Alemán would come to chat and say some prayers in his white short-sleeved guayabera no matter the temperature outside. Soraya sighed. Her life’s good days had been measured on one hand. She suffered and then she suffered some more.

One day Clara told me about her sister’s trip from Tapachula to Brownsville. We came up on the elevator together, and I asked her to join me for a few minutes. I was drawn to her directness and clarity. She was always completely present and focused. She was never sentimental and did not burn with pity or anger. I borrowed the head nurse’s office. Leslie was wise and emotionally connected. She knew the issues were more complex than what showed up on a monitor and
was comfortable looking after the medical issues and being on call for anything else that was needed. She cleared off some space for us to sit. “Here, guys, it’s all yours. Let me know if you need anything. The coffee is fresh, help yourself.” She pointed to a Mr. Coffee machine and quietly closed the door, taping a “Do Not Disturb” sign to the outside.

“Clara, I am not only concerned about your sister Soraya. You have your own medical problems.” It was clear she was getting chemotherapy. How she could help her sister and keep functioning was a real question, at least for me.

“Doctor, I will be truthful with you. I have learned not to complain in my life. It doesn’t pay and doesn’t make anything better. It is what it is.” She settled into the chair and, as always, was direct and forthcoming.

“I had some spotting six months ago, and delayed because of my sister and her health issues and my own denial. Being in the business like you, I thought it might be fibroids or something similar. Finally, the lady I work for took her kids on a trip and I made an appointment to be seen here.”

“And?”

“The doctor found a mass in my uterus. The ultrasound and CT scans confirmed a cancer. A couple of weeks later I was in the operating room for a hysterectomy and lymph node dissection. Everything was removed.”

“Clara, I don’t understand how you managed to look after yourself and your sister. Who looked after you?” I was incapacitated beyond comprehension by my own cancer treatments.

“After I recovered from the surgery, the oncologist put me on a chemotherapy regimen every month for six months. I am just about finished. I won’t tell you it has not been hard. I focus on my sister, which keeps my own fears and private demons at a distance. I also don’t have a choice.” She was very emotional at this point. I hadn’t seen her go there in the dozen visits we shared together. “I honestly don’t care about myself at this point. It isn’t about me and perhaps not about Soraya, either. We may follow each other into the ground. She has two children. One by her husband from Salamá. The other child,
Laura, is from a common-law husband she had a relationship with when she arrived in New York City alone and without a cent.” The children were a big concern of ours also. We didn’t know what would happen to them if Soraya died. The archipelago of relationships in her life was fragile, in and out, very poor, floating from job to job and state to state, wherever something could be found.