CHAPTER 8

The Doctor

Cities where the flu spreads like a plague.

Not the plague of olden times.

Not some virus wiping out humanity in all its forms.

Just the flu. That kills the elderly, small children, the undernourished, and the poor.

Still these two years later, his wife refuses to speak in English. Even though she’s long spoken it better than him.

“Please,” he says to her.

She shakes her head. Lying on her small bed. She won’t eat today. He knows already that she won’t. But he tries again.

“Please,” he says.

“No,” she says. She picks up her book. Reads again by the sunlight that illuminates the white canvas around them.

Someone knocks on the flimsy door frame to their tent. He goes from this room, where they live, to the next room. A room created simply by two sheets of canvas hung from the ceiling. But they call it a room.

The woman knocking has a prescription that needs updating. Medicine for her heart condition. The doctor renews the prescription he wrote for her.

The doctor is allowed to prescribe drugs still. And so he does. He’s allowed to treat patients still. Even perform certain operations. And so he does those things too.

The authorities here, they welcome anyone who relieves them of a service they are required to supply.

And the doctor needs the money. To pay for a tent he and his wife can live in without other people. To purchase better food than the rations distributed twice a week from the back of a truck. To buy protection for himself and, especially, his wife.

Why wouldn’t he want to buy these things?

He’s been a doctor for more than ten years. Before coming here, they had a home with a courtyard. A bedroom that overlooked the bay.

The doctor cannot distribute the drugs. The security firm handles that. But they will honor his prescriptions.

And, of course, the doctor is paid in cash.

There are almost one hundred thousand people living in this camp. Just across the border. Built alongside the wall.

Building the camp here was a mistake. There are tunnels underneath the wall that come out in tents in the heart of the camp. It is not just the easy access between both countries that’s a problem. It’s the economics of the matter. People in the camp have many financial needs. Helping others cross the border is an easy source of money.

The people who come through a tunnel into a camp like this, they are mostly transporting drugs. The people who want freedom, who want to escape into the cities and farms to the north to start a life here, to work and live and marry, all of them now use boats, not land. Once the wall was finished, it blocked the easy overland entrances that had existed for so many decades.

That’s when the migrants shifted to boats.

The number of migrants didn’t change. All that changed was the number who died in crossing.

Sometimes refugees are able to buy their way out of the camp through these same tunnels. But the cost is now beyond the means of all but a very few.

He finishes writing prescriptions. Finishes with his patients. He’s checked a man’s sprained arm. He’s checked a child’s pink eye. He’s checked a woman’s belly.

Yes, he tells her, you are pregnant.

She begins to cry. He’s not sure if they are tears of sadness. She hides her eyes, and so he isn’t sure. But if she’s sad, unbearably so, then she will be back. He does not need to tell her that he can take care of that issue too.

She leaves. He steps outside for a moment.

They have no children, the doctor and his wife. They could never conceive. Even with the help of drugs and doctors. There was no diagnosis. They tried every option. All failed.

They are forty now. They tried for fifteen years.

He wonders, of course, if he’d have been able to have children with a different woman.

For him, it’s a merely clinical question.

His wife, he thinks, she wonders this too. But for her, he is sure, it’s a different question. One unspoken. Never discussed.

He simply sees it in her eyes.

Hospitals have set up tents in their huge parking lots. Treating children and the elderly, all of whom have the flu. Some die. Most do not. Billions of dollars are spent treating the illness. Doctors turn to the TV cameras, begging everyone, next year, to please get vaccinated.

“This could be so much less severe,” one doctor says, “if everyone listening simply got one shot.”

He and his wife crossed the border knowing they’d likely end up in a camp like this. First, they walked a hundred miles through the desert to the coast. Then they paid their way onto a small boat. Once a fishing boat, it was loaded now with almost fifty people. This was the safest boat they could afford. It was intercepted within a few days of being out in the Gulf. After much processing, days of questions, they were taken to this camp.

The doctor and his wife knew this could happen. But the violence at home had gotten to where they could no longer stay. Friends of theirs disappeared. Police demanded larger bribes for even less protection. Homes near theirs were firebombed in the night.

Drug violence. All of it. Violence institutionalized. Violence fueled unintentionally by the desperate flood of workers fleeing the thousands of failing farms and villages throughout the countryside.

They had known a camp like this was likely. But it was a theory then, a thing they’d read about, heard about, seen in videos and read about in the papers.

There are five of these camps. Spread evenly across the border. The biggest of them are on the coasts, camps that hold the migrants who can’t escape the coast guard or the navy, or who can’t escape the weather or the fragility of their small boats, or who can’t escape the callus ineptitude of their sea captains or overland guides. The camps on the coasts hold many hundreds of thousands of migrants.

In that sense, the doctor and his wife are fortunate. This camp is smaller, less chaotic.

He’s not sure why they were brought to this one.

Luck.

“Have you gone to the administrators today?” she asks. In Spanish, of course.

“Not yet,” he says in English.

She turns back to what she’s reading. He sits near her. Reading a newspaper.

In theory, the camps are only holding pens. Where the administrators tend to the migrants as they wait to be processed before release. Background checks. Medical screening. Citizenship tests. An assessment of one’s reasons for seeking asylum.

What do you want? What will you do? Will you make something or only take?

In reality, far fewer are released than gain entry to the camps. The politics, the economy, the fear engendered by stories of crime and violence. All combine to keep the doctor and his wife and the hundred thousand people around them detained here indefinitely.

He takes a sip of wine. Offers his wife a glass. She declines. Lunch was chicken and rice with fresh tomatoes grown in the camp. The girl who cooks for them worked for years in one of the luxury hotels on the Gulf’s coast, back before the hotels began to close.

Beaches steadily washed away. Hillside resorts that no amount of rocks or concrete barriers could keep from collapsing into the ocean. Heat that fewer and fewer travelers chose to bear.

Some days, he knows, he’s come to find a comfort in how he lives here. In his position, his authority over his patients. His relationship with the authorities.

He never mentions this to his wife. She’d kill him, probably. If she even knew such a thought had crossed his mind. She’d slit his throat in the middle of the night.

Not an idle thought.

She’s the daughter of a drug lord. He ruled the southern provinces. Until he, like all of them are eventually, was taken away in the night. Stripped. Tortured. Slowly killed. By another drug lord, one who wished very much to replace him.

One who would later be taken away in the night himself.

That the daughter, his wife, was only thrown out to live in the street is hard to believe. Just fourteen. Most like her, the fallen families of drug lords deposed, are raped, and tortured, and eventually also killed.

She was allowed to leave. For years she lived abroad, she told him. On her own. He met her when she was twenty-five.

He looks at her on her small bed. Eyes closed. Dark hair across her pillow. A beautiful woman. Pretending to sleep.

But she is only thinking. Waiting. Wanting to leave this horrific place.

“And you know,” she says, on television, a doctor, calm but her exasperation shows at the edges of every sentence, “you need to know, nothing will kill more people this year than obesity, inactivity, and the simple, stupid choices people make.”

In the night, he wakes as she gets into bed with him. Whispering in Spanish, touching him, she has him ready before he’s even really awake, atop him, moving gently. She whispers still, between her short breaths. He’s half asleep, half awake, she kisses his neck and then his chest, pushing harder. But almost silent. She comes soon, probably she’d been touching herself in her bed before this started. Her breasts just barely brush against his chest as she rocks forward, back again, whispering to him, and he comes now too.

She’ll sleep the rest of the night with him.

He loves her. The way she touches him. The way she smells.

He hates so much the many ways in which he’s failed.

In the morning, he sees patients in the front room of their tent. They’re lined up to see him. He has a nurse who works with him. She was a scrub nurse working on transplants at one of the university hospitals. She is much overqualified for the job. The colds people have. The pains and vague discomfort.

Most of the illnesses here are a function of the sadness people feel. The worry that they won’t ever get out of this camp. The depression that this is all their journey will possibly achieve.

This is his worry too. So few visas are now issued. So many more people cross the border, most caught and sent directly to these camps. Fear of the refugees grows steadily. Anger toward them. Resentment and distrust, and for many people it is simple hatred.

His cousin made it out of his camp. Legally. He lives far west now, in a city there. He tells the doctor about the hatred. He’s an architect working as a cab driver and weekend busboy. Unable to get any other job despite the visa and work permit he was granted many years ago. “They don’t like us,” the doctor’s cousin says when they speak by phone. “They see us all in the same light. We’ve come here to take, they think. Take money. Take jobs. Offer nothing. Give nothing. I tell people I designed office buildings. Hospitals. A library. A museum. They look at me and laugh.”

Some part of the doctor wonders if they’re not better off here. In this camp.

He knows this is wrong. He shuts down the thought. He thinks again that were his wife to hear him say such a thing, were she to know he’d ever thought this, she would be uncontained.

He checks patients’ eyes. He listens to their lungs. He listens to their heartbeats. He looks over each of them for signs of any of the truly terrible diseases that could sweep across this camp. Cholera or dysentery. Measles. Some sort of flu.

He’s paid in cash. There’s a price list. Some people can’t afford it. He takes what they can offer.

Most everyone offers something.

With the money they give him, he can buy extra supplies. Medicines beyond the allotment that the authorities who run this place give to him and the other doctors.

Coldhearted, often violent, the men and women of the security firm officially in charge of this camp spend most of their time patrolling the high fence bordering this camp. They monitor the occupants with binoculars, with drones that buzz overhead around the clock. Periodically, they’ll drive through the camp in a long train of black SUVs.

If security enters this place on foot, it is only in force, a group of forty of them in their dark uniforms, heavy helmets. They come in to arrest some former member of the drug trade or a gang.

However, some of the security guards enter the camps late at night. Headed to the brothels. They’re given deep discounts. The best girls. New ones. Fresh.

The doctor treats the prostitutes. For ailments professional and otherwise. He treats them in his office sometimes. But he also goes to them during the day, where they live. Some doctors won’t. But he will. Like the children who come to him without parents or family, the prostitutes he treats without charging them anything at all.

“There’s so little I can do,” she says, on the television. “I’m a doctor to bodies. Not minds. And what most people have, what they are experiencing as pain, is a symptom of choices and illnesses that originate in their minds. Real illnesses, not imagined. But not ones I can ever possibly solve.”

The security firm assures that the refugees are contained in the camp. But the camp itself was long ago taken over by the members of a gang. Extensions of the cartel, the various gangs almost immediately sent members to run the camps across the border.

In many ways, though, the camps are more peaceful than the cities people fled. In the cities south of here, the gangs are at war over territory, shipping routes, shrinking cropland, limited water, labor to process the crops and drugs. But across the border, each camp is dominated by just one gang. By agreement, the gangs have split these places among themselves. Thus, there are no turf wars. No disputes that go unsettled.

There’s a hierarchy to the gang’s control over the camp. Representatives from each area of the camp sit on a council that brings issues to the leadership. The council determines the fair distribution of water, food, and medicine and is especially concerned with the safety of families, women, and children. The gang tolerates no petty crime, no theft or fighting. Gambling is controlled and limited to specific tents in the camp. Alcohol and drugs are available, but open abuse is not allowed. The gang’s tax rates are quite reasonable, less than what most people paid to the corrupt governments they left behind.

Some in the camps consider the gangs to be, at worst, benign. Still others view the gangs as the saviors of all these unwanted refugees.

The doctor might think so too. Were it not for the women they keep in the very busy brothels.

And the drugs and guns they transport across the border through the tunnels.

And the young girls they traffic north, every week, through those same passageways.

The doctor treats these girls as they are moved through the camp. Before they are transported north. Human packages, often sold by their parents or deceived into this choice with promises of jobs, visas, the freedom and safety of places to the north. Promises of relief from the hopelessness, the misery, the endless sorrow in which they lived back home.

The doctor goes twice a week to the tents that hold these girls. The food for the girls is better. The tents clean and stocked with fresh clothes and bedding. The gangs make available any and all medicines the doctor might need. He checks the girls for disease. He gives them full batteries of tests, completes their vaccinations. He administers birth control, simple implants in their arms. That is required for them all.

Some girls he sterilizes. A choice the gang lets the girls make on their own.

The doctor sometimes feels he is only prepping these girls to be more efficiently abused. To assure the survival of these high-priced investments as they head north for a life of rape and torture. He’s a veterinarian to prized cattle, maximizing their health before they’re sent to a long and conscious slaughter.

He pauses for a moment. Closes his eyes. After a minute, he pats the dark-haired girl on her slim shoulder. She smiles some. He smiles back.

As he leaves the tent, the gang member at the door offers him money. As always, the doctor says no thank you.

He walks back toward his tent. It is nearly a mile from one end of the camp to the other. It is hot today. And still. Probably more than one hundred and twenty degrees. In the two years he’s been in this camp, he’s treated hundreds, maybe a thousand, of the girls who are trafficked north. He declines the gang’s money. But the gang does treat him well. He has access to more medicine. He is given better food. His wife is safe. He is too.

A bargain he made without wanting to be part of it.

A thousand girls. Made healthier than they’ve ever been. Made infertile for a time. Or for their whole lives. Made ready for the work they’ll do.

Made ready by him.

They are shuttled through tunnels that head north, under the camp fence, emptying in fields near highways far from here. Met by buses that continue their transport.

For some of them, he’s sure, his is the last kind face they’ll ever know.

“Honestly?” she repeats, looking down for a moment. Pondering the question. “Well,” she says, looking up now, “honestly, I often leave my office feeling hopeless. That’s how I feel. That’s my answer to your question. Hopeless. I go to the clinic. I see patients. I prescribe drugs when that is best. But more and more often, I prescribe exercise, a change of lifestyle. ‘Get outside,’ I’ll write neatly on my small and stupid notepad. ‘Take a walk with family and friends.’ Then later, after I’ve left these patients to dress and leave, I’ll return to the room they occupied. And I’ll see that the prescriptions I have written are simply crumpled up and left behind.”