122 NC Med J May/June 2003, Volume 64 Number 3
Introduction
I
CAME TO LIVE HERE about ten months ago with
my husband, Jesús. I really didn’t want to come, but a
wife must follow her husband everywhere he goes. We are
from the state of Michoacán, in Mexico. His brother, Jacinto,
called many times telling us there was a lot of work here. It
was hard work, but it was worth the pay. We barely had
anything back home, so we came hoping to find a better life
here. The three of us live in a trailer in the outskirts of town.
It’s a very small town, similar to our town back home. But
life is very different here. I don’t know many people, and I
don’t speak English. I can understand a little bit, but I really
can’t speak anything. I’m nineteen, and I only went to school
until the sixth grade. My husband and his brother work all
day, and I stay at home cleaning the house and cooking for
them. I don’t go anywhere until they come home because I
can’t drive, and we need Jacinto’s old car if we want to go
anywhere. We know a few Mexican families from church,
but we don’t see them during the week since they live on the
other side of town. I was hoping to find a job, but our baby
is due to arrive in three months. Jesús felt it would be best
for me to stay home. However, since Jesús had his accident,
I don’t know what we are going to do to support the family.
The Accident
It happened a couple of weeks ago. I was in the kitchen
cooking tamales when I heard someone banging on the trailer
door. It was Jacinto. Jesús had been hurt. His hand got caught
in a machine while he was working in the fields. I could
hear his screams of pain coming from the car as I got closer
to the trailer door. Their boss was not in town that day, so
we were left on our own to figure out what to do. We knew
we had to take him to a hospital, but we weren’t sure where
it was. We decided to find the priest from our church. He
was from South America, and he had helped a lot of the
new people who spoke Spanish. I was riding in the back of
the car with Jesús. He was in so much pain. He had tears
coming down his face, and he said to me, “It hurts too much.
I can’t stand it!” His hand was wrapped with a dirty tee-
shirt, covered with bright red blood. When we got to the
church the priest wasn’t there, but we found Carlos, the
church’s grounds-keeper. He told us how to get to the hos-
pital, and he said he would let Father Juan know what hap-
pened. After circling around for twenty minutes, we found
the hospital.
At first we didn’t know where to go. All of the signs
were written in English. We found the door that read “Emer-
As evidenced by the Latino Health Task Force Report, Latinos living in North Carolina face numerous challenges
when seeking healthcare services. Those of us who have had the privilege to serve Latinos in clinics and hospitals have
been witnesses to the drama that unfolds every day for these families. Navigating through our healthcare system can be a
very taxing process for Latino immigrants. In order to fully understand these difficulties, sometimes it’s best to let the
people tell their story. It is with this thought in mind that we bring you this commentary piece. María and Jesús live in
North Carolina. María tells her story to a nurse who speaks Spanish. Although these characters are entirely fictional, the
events described here—and many others like them—have taken place all across the state and the country. Any similari-
ties to actual people living or deceased is purely coincidental.
The author is Hispanic Patient Educator for the Brenner Children’s Hospital and Health Services in Winston-Salem. Address
correspondence to her there at 10th Floor Administrative Suites, BCH, Medical Center Boulevard, Winston-Salem, NC 27157. Email:
Eva M. Gómez, RN, BSN
Maria Tells Her Story
COMMENTARY
123 NC Med J May/June 2003, Volume 64 Number 3
gency.” Of course, it means “emergencia.” Jacinto almost had
to carry Jesús inside. We walked up to a desk where a lady
with white hair and glasses was reading. Jesús was still moan-
ing with pain. She said something in English, but we could
not understand her words. We all looked at each other,
puzzled. She repeated the same words but much louder this
time. She said, “Do you speak English?” Fortunately, Jacinto
knew a few words. But Jacinto didn’t understand all of her
questions, so he kept saying, “His hand. His hand is hurt. Is
hurt! We need doctor.” The lady called for someone. A very
pretty young woman came out. She said in very broken Span-
ish, “Come, come inside. You see the doctor.” They placed
Jesús on a stretcher and they whisked him to a room. I was
very scared for my husband, and I began to cry. He was still
screaming with pain, and the shirt around his hand was now
filled with blood. I wanted to go with him, but the lady with
the glasses would not let me get past her. “¡Pero es mi esposo,
él me necesita! (But he is my husband, and he needs me!)” I
begged her, but the pretty lady came back and told me in
Spanish to wait for a minute.
While I was in the waiting room, I could hear Jesús
shouting. We waited for an eternity until they finally let
Jacinto and me come back to see him. The doctor had re-
moved the dirty shirt, and Jesús’ hand was on a table with a
bright light shining on it. It was covered with blood and I
couldn’t see it very well. The doctor was trying to ask us
questions in English, but Jacinto could only say a few words
back to him. He kept talking in English. We stared at his
face intently, hoping to find some meaning in what he was
saying. After many unsuccessful attempts to communicate
with us, the doctor took a deep breath and began to talk to
the nurse. Although we could not understand his words, we
could see his face was red, and his voice was stern. We could
sense his frustration; we were frustrated, too! He turned away
and left the room without saying another word to us. I felt
very bad, as if we were a problem. Finally the nurse injected
something into Jesús. She said, “Medicina para dolor (pain
medication).”
After they left, we all looked at each other in silence. I
still had tears coming down my face. I had never seen so
much blood. Jesús was worried. He said, “How are we go-
ing to pay for this? We don’t have dinero (money) or
aseguranza (insurance).” He knows his patrón (boss) would
not pay for anything that the workers did to themselves at
work. But just in our darkest moment, we saw the light.
Father Juan walked through the door of the room with the
doctor.
The doctor explained to us that Jesús had a very serious
injury to his hand. He needed to have surgery, but he had to
go to another hospital. They couldn’t help him here. I won-
dered why they couldn’t do anything for him here. Was it
because they knew we didn’t have money or insurance? Was
it because we didn’t speak English? Were they sending us
off to a worse place? But I didn’t want to say anything to
contradict the doctor; I had to trust that he knew what was
best for Jesús. I found out much later that we were moved
because they didn’t have a doctor that had the skills to fix
his hand. It took a long time to sign all kinds of papers with
the help of Father Juan. The nurses loaded Jesús in an am-
bulance and sent him to Big City hospital. We couldn’t ride
with him, so we had to go in Jacinto’s car in order to get
there. Jacinto was nervous. He had heard of Big City, but he
had never been to the hospital there. With directions from
Father Juan we started toward the hospital. It was ninety
miles away from our town. After first getting lost in Big
City, we finally got to the hospital three and a half hours
later.
The Hospital
The hospital in Big City was the biggest place I have ever
seen. Again, all of the signs were in English, and we had no
clue where to begin looking in such a big place. Fortunately,
we ran into a Peruvian man who worked in housekeeping.
He helped us find out where Jesús was and told us how to
get to him. I spent the night with Jesús while doctors came
in and out of the room with interpreters. Many doctors didn’t
look at us when they spoke; they kept talking to the inter-
preter. I felt as if we were not part of the conversation. One
of the doctors who came was laughing as he spoke to the
interpreter, but I didn’t understand why. We weren’t laugh-
ing. Jesús was very sick.
It was almost two in the morning when I began to feel
faint. I had not eaten anything for twelve hours. To be hon-
est, I was starving; but we hadn’t brought any money. Even
if we had money, I wouldn’t have known where to go, or
how to ask for directions if I got lost in this big place. Jesús
was asleep and Jacinto had gone back home. When the nurse
came in, she looked at me closely. She said something in
English. I shook my head; I didn’t want to be a bother to
her. But then, I thought about my baby. If I starved, he would
starve, too. So I gathered all of my courage, placed my hand
on my belly, and said, “Tengo hambre (I’m hungry).” The
nurse gave me a puzzled look and said, “Uno momento.”
Half an hour later an interpreter came, and they were able
to get me something to eat. Three hours later, they took
Jesús to surgery. The doctors were able to fix his hand, but
they told us he wouldn’t be able to use it like he did before.
Several days later, we prepared to take him home.
A doctor came to see us on the day we were going home.
He didn’t have an interpreter with him. He walked in with a
big smile and said, “¡A la casa hoy! ¡Muy bueno!” He started
to say something in English, but he gestured for us to wait.
He said, “Interpreter.” We had a lot of questions. What about
his hand? What was going to happen now? Would we be
able to leave the hospital? In our country you can’t leave the
hospital until you pay your bill. The doctor acted as if he
was in a hurry, so I kept quiet. When he came back with the
interpreter he told us that Jesús could have the stitches taken
out by his doctor at home. I wondered how we would do
that, since we didn’t know any doctors back home. Again,
124 NC Med J May/June 2003, Volume 64 Number 3
we kept quiet listening to the doctor. It would be rude to
interrupt him. He gave us the prescriptions, and told us how
Jesús should take them. He told us to call if Jesús had more
pain, or his wound got infected. But how would we call him?
We can’t speak English. I was so overwhelmed with all that
was going on, I forgot the instructions the doctor gave us for
the medications.
After the Hospital
When we got back home, Jacinto had to go by three phar-
macies in order to find the medicines. They cost $115, all of
one week’s savings. And what was our surprise when we saw
the bottles? The instructions were in English! We had to
find Father Juan so he could explain the instructions and
write them down on a piece of paper for us. I was exhausted;
this had all been very difficult for me.
The days passed, and the bills started coming; we didn’t
know what to do. The bills were thousands of dollars, more
than what Jesús would make in a year. Three days before
Jesús needed to have his stitches taken off, his hand began
to look redder and puss was oozing from the wound. We
tried calling the phone number the doctor gave us, but we
got a recorded message in English that we couldn’t under-
stand. We tried going to see a doctor in town, but the first
time we went he couldn’t see us because we didn’t bring an
interpreter. The second time we got our 16-year-old friend
from church to come with us. But this time they told us we
would have to pay in order for Jesús to see the doctor. $75
dollars! We only had $40, so we didn’t have a choice. We
turned around and went home. Jesús had not worked in many
days; we were barely making ends meet with what little
money Jacinto earned from his job. Just when we thought
we had no way out, our Lady of Guadalupe gave us the
answer. Carlos, the church’s grounds-keeper, found out there
was a free clinic for people who have no money. We got an
appointment the next day. We traveled two hours in Jacinto’s
car and found the free clinic. That’s how we got here.
The doctor here is very nice. Although he is American,
he speaks Spanish. Immediately he gave us so much
confianza (trust). He looked at us when he spoke, he treated
us with respeto (respect), and he listened to all our questions.
He made us feel welcome, like we mattered to him. He was
going to call the doctor in Big City Hospital to let him know
about the infection. He also gave Jesús more medicine for
the infection, but we didn’t have to pay for it. Thank good-
ness, because we don’t have much money left.
We still don’t know what will happen in the future. Solo
Dios sabe… (Only God knows). We will have to wait and
see if Jesús will be allowed back to work. Jacinto will keep
supporting us. Perhaps I can find a job until we have the
baby. But we will keep going. We’ll do the best we can. I
hope we can stay here in the United States. Our baby can
have a better life here than he will ever have back home in
Mexico.
Original Research: A Call for Papers
Herbert G. Garrison, MD, MPH
Scientific Editor, North Carolina Medical Journal
North Carolina is blessed with some of the finest medical research institutions in the world. The work of the medical
scientists that labor in our research facilities becomes complete (in many ways) and public when it is published in peer-
reviewed journals.
While medical researchers in North Carolina have many journals to which they can submit their manuscripts, we want
them to consider keeping their work here at home. To be more specific, we invite the authors of our state to submit their
papers to the North Carolina Medical Journal.
The Journal seeks papers that convey the results of original research. We are especially interested in publishing research
papers that have relevance to the health of the people of our state.
An editor reviews all papers received and those of sufficient quality are peer-reviewed. As with any journal of merit, only
papers of high quality will be published. Papers printed in the Journal are indexed in the National Library of Medicine’s
MEDLINE public database.
The North Carolina Medical Journal is published six times a year. It is distributed free of charge to the members of the
North Carolina Medical Society, the North Carolina Hospital Association, the North Carolina College of Internal Medicine,
the North Carolina Academy of Physician Assistants, and the Medical Review of North Carolina. The Journal is available by
subscription to others.
For guidance on manuscript preparation, authors should consult the “Author Guidelines,” which can be found at
www.ncmedicaljournal.com.
