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They call me . . . “Gramps”

Back in the States briefly to do some grand-parenty things, which brings a heavy dose of perspective. Bottom Line Up Front, as we used to say: all the things you endure as parents, when time and patience are limited, become luxuries to enjoy as grandparents.

I watched grandson Henry at basketball practice the other: ten six-year olds with one coach, trying to learn the fundamentals. That coach must have the patience of Job. It brings to mind the old joke about monkeys and a football (Google it; I can’t repeat it here).

Henry (#5, gold) looking all basketball player-y

We didn’t have such “youth sports” back in the day: sports started mostly around 5th grade, when the boys acquired sufficient motor skills–but not enough self-discipline–to play. I grew up in Indiana, where basketball is and remains king. You played basketball, or got beat up and called words which aren’t socially acceptable . . . today.

I recall practice being good preparation for the Military Academy: endless exhausting drills with much screaming and questioning of one’s manhood (remember, we were ten year olds). After enough berating, we could enjoy a little scrimmage, although there still was the terror of the coach blowing his whistle and yelling “freeze,” which induced a Pavlovian mixture of fight-or-flee. We had to stop exactly where we were, so the coach could point out some crime against humanity one–or occasionally all–of us had committed. Then it was back to the joy of the game.

Henry and his friends had no such experience: it was all joy. They travelled with abandon, shot when they should have passed (and vice versa), and sometimes wandered off into private flights of fancy. One young lad took a break from the action literally, heading to an empty space on the court to do a little break-dancing.

I recall taking my daughters to basketball practice so many years ago: a change in type and kind, since girls were left out back in my day. I knew they didn’t need the drill school I experienced, but what exactly were they doing? Team sports are an important part of growing up, but how much pressure to exert on skills versus fun? I over emphasized the former, but they had plenty of the latter. They couldn’t possibly imagine how much of an evolution that was!

Organized sports, especially Indiana basketball, was all seriousness growing up. We remembered the scores, the good and bad plays, the missed shots. In my case, especially the missed shots. I had what you would call substandard athletic skills. Okay, I had none. To borrow the Rudy quote, even in college I was ‘five feet nuthin’, one hundred and nuthin’, with barely a speck of athletic ability.’

I became adept at using my skinny lil’ bod to block out, because there was no other way I would ever get a rebound. I learned that if you ran fast enough, you would get a fast break leading to an uncontested lay-up, which I shot successfully around 50% of the time. Which was an improvement from any other shot I attempted, including free throws.

Basketball games were a mix of anticipation, adrenaline and pure fear at how I might screw things up this time, but still in some ways I enjoyed them. And it was a sport I was able to really enjoy when I finally grew into an adult body sometime in my twenties.

Was that high pressure approach wrong? Is today’s Let it Be better? I dunno. If you survive missing a tying free throw with a second on the clock in a crowded auditorium, life’s other strained circumstances are a little less apocalyptic. Still, screaming has never been an appropriate form of leadership (drill sergeants excepted), so why would it be for kids?

Ch-Ch-Ch-Ch-Changes

Most expats at lakeside quickly adopt the refrain that life here is wonderful. Soon after, they start to lament all the newcomers and changes ruining paradise. I’m a little guilty, too, though I resist falling into the trap mightily.

You knew this was coming . . . RIP, Ziggy Stardust.

I am less of a “close the door behind you, and please, everyone go away” expat and more of a “change is inevitable” one. One hopes for the best and prepares for the worst, as they say.

What’s new in the few years we’ve been expats? Plenty, just in a physical sense. Due to the growing demand of (relatively) wealthy expats with need of medical services, we now have:

A new hospital, and
a new cardiac clnic, rising behind the old facade of a car wash (in yellow)
a senior living facility, under construction. Think they’re marketing to gringos?

Restaurants come and go (as in either move or close) all the time. Old timers blamed the boom and bust cycle of the off-season, when part-time expats flock home. We full-timers enjoyed the quiet time and the ability to drop in for dinner without a reservation, but it was hard on the business owners. Seems like there is no off-season any more, just “way crowded” and “less crowded” periods. Which should have helped the restaurants, but now land owners have started hiking rents by as much as 50% a year! So a restaurant which was marginally profitable a year ago might be priced right out of its location.

Retail locations continue to grow along the carretera (main street). Sometimes we have a case of in-fill, where a small lot blossoms into a retail complex, but otherwise the development grows like a vine alongside the road between Ajijic and its nearest neighbor, San Juan Cosalá.

Once an empty corner in town, soon to be a shopping center
Mixed use shops and apartments (where are the apartment windows?) next to Walmart
West of town, this farm field is about to become a materials yard.

There is a constant need for more and different housing, both for the torrent of expats discovering lakeside and the Tapatios who want nice weekend retreats.

This was an empty field when we bought our home. Now its a muy moderno subdivision.

Anecdotally, I’ve heard prices have gone up so much that the rental market is beyond the reach of locals, and many long-time residents have given up resisting the prospective fortune they own by selling and moving out. It is the challenge of living where so many other people want to live, even if in doing so, they change the character of what they sought. It’s the Heisenberg Uncertainty Principle of living in paradise.

As Don Henley sang long ago, “you call some place paradise, kiss it goodbye.”

The development is for the good. In the past, our hospital (really more of a clinic) immediately sent emergency cases via ambulance to Guadalajara, but now they can be treated here. Eventually, the demand for housing will result in a demand for better services (like roads, trash collection, etc) although the lag will be considerable.

Even in the two and a half years we’ve been here, the physical scene has changed considerably, although I think the essential character of the place remains the same. The local pastor told me Ajijic is unique, in that there are three different villages: the locals whose families have always lived here, the Tapatios who vacation here on weekends and holidays, and the expats, both temporal and permanente. The mix remains about the same, and the three “thirds” still get along.

Paradise is a state of mind, after all. Oh, and the first rule of Paradise is (wait for it) like Fight Club: never talk about Paradise!

The friendliest place

One thing that strikes tourists and expats alike is just how friendly the Mexican people are. That friendliness stretches from the mundane to the extreme. People greet each other throughout the day, with a “buen dia/tarde/noche” as appropriate. This may be becoming a rarity in the largest cities, where urban dwellers adopt the instinctive distrust of strangers the world over, but in small and mid-size towns, you talk to strangers. This is superficial, it’s true, but it evinces a culture’s approach to others.

Absolutely nothing to do with friendliness, but we had globos overhead yesterday!

Many visitors of all types have stories of a car breaking down somewhere in Mexico and the resulting group effort to fix the flat or find the part, which involves lives disrupted, friends marshaled, cousins called in, food shared, and eventual success with the absolute refusal to accept any payment for services rendered, time spent, or disruption caused.

Just a few weeks ago, we were looking for a specific grocery store in a giant plaza in Guadalajara, following the well-placed signs in the parking lot, which led us to the bottom of a parking garage and . . . no grocery store. But we did see the ubiquitous “car -washers,” Mexican men with rags and buckets that cheerfully offer to wash your vehicle while you’re shopping. We flagged them down and asked for directions, which they rattled off far faster than we could comprehend. We thanked them, then started to drive off, when we realized the man giving us directions had begun to sprint up the garage ramp, where he stopped and waved us on. We followed as he deftly dodged between lanes and pointed us around corners until we were in sight of the grocery, then he doubled back before we could even give him a final “gracias!”

Friendliness does have its downside. Despite that last paragraph, one generally does not ask locals for directions. Why? Because they are too friendly to say they don’t know where something is, so they give you directions to something like what you want, or to somewhere where other people are. In a similar vein, most Mexicans hate to say “no” as it feels impolite, so they often mean “no” but say “yes.” So you may ask if they can make something, they tell you yes, but then never get around to completing the deal, because they don’t really make such a thing. On the flip side, if you’re in a restaurant here, and happen to order something they’re out of, or that’s not on the menu, your waiter might still say yes. If you watch carefully, you will see someone from the cook staff sneaking out to the store down the street to buy the ingredients!

Most often, the friendliness of the Mexican people is abundant. Expat friends of ours tell us that they visit our local club, which sometimes hosts huge weddings for Tapatios (from Guadalajara). Many times our friends get invited to join in the fiesta. Not wedding crashing, mind you, just hanging out nearby, and of course, you must fiesta!

Mexico’s legendary friendliness is not just based on anecdotal evidence, although there is plenty of that. Internations, a global expat community, conducts an annual survey among expats, and Mexico perennially ranks first for the ease of making friends with locals and friendliness in general. And by friendliness, I don’t mean that false–almost obsequious–friendliness one encounters at an all-inclusive resort. There, employees are coached to bend over backwards for any request, and to do so with a smile. Out in real Mexico, the friendliness is more akin to treating others as you would like to be treated, and welcoming a visitor like family. It is not as if there isn’t the occasional rude waiter or smiling con artist, but that such people stand out most for not being common.

You say hello, and I say goodbye

College football is back, which has fans everywhere saying hello to another season. So why am I saying goodbye?

If you watch any football game this year, you might notice something different about the uniforms: college teams have a patch celebrating 150 years of college football, while the NFL sports patches memorializing 100 years of the professional sport.

That’s not a typo: the amateur game preceded the pro one. In fact, college football was the second most popular sport in America in the 1920s (behind the national pastime, baseball, and just barely above boxing). Pro football at the time was a novelty, a sport with young men who should be working full time but instead continued to play football while holding down odd jobs. Pro football didn’t become the popular juggernaut it is today until well into the 1960s: the first four Super Bowls weren’t even officially called that!

The college game’s popularity transcended its elite beginnings as a sport mainly played by the well-known Eastern universities. How? Partly because even if the vast majority of people did not go to college, every family was proud of some relative who did, and adopted a university as a result. Additionally, colleges presented the sport as a manly ideal, where otherwise regular students demonstrated their masculine qualities on the “field of strife.” This was appealing because it presented the students as selfless teammates contrasted with the mercenary professional players. Finally, the sport prospered on regional and ethnic rivalries, so anybody could join in by taking sides and rooting for the (good) local squad and against the (evil) hated rival.

To maintain the distinction between the professional and amateur versions of the game (and to protect the latter’s popularity) the colleges developed rules for eligibility. The players had to be students, but could not have tuition paid by the school: the very idea of an athletic scholarship was forbidden as a contradiction in terms. Rather, schools were allowed to arrange work-study and other reimbursement programs to pay for the athlete’s tuition. However, players caught moonlighting for local professional/semi-professional teams could be disqualified, as it muddied the distinction between the sports.

Predictably, this approach led to elaborate cheating scandals: everything from make-work “jobs” at the university to state schools putting the entire team on the state payroll for essentially no work. This led the colleges to flip the paradigm, prohibiting any outside payment, but permitting the concept of athletic scholarships and promoting the notion of student-athletes. Once on scholarship, “student-athletes” quickly learned how to avoid taking classes, which led to more rules on minimum GPAs, semester loads, and graduation criteria.

There was always some level of rules-avoidance (nay, cheating), but the system held together in the main. College football remained a very unique and distinct sports phenomenon. But then a ton of money got involved. Where did the money come from? Ticket sales (80,000 fans x $200 tickets x 7 home games = $56 million a year), television rights, and merchandising. Once upon a time, the colleges regulated how many games were televised and how often teams were on “national” television, with an eye to preventing an unfair advantage in publicity. With the advent of 24 hour programming, ESPN and other networks made offers the schools couldn’t refuse, sending hundreds of millions of dollars to the institutions and making virtually every game available to fans on television.

Where did all the money go? College football became big business. Very big business. How big? The highest paid state employee in 31 states is the head football coach at one of the state universities (in eight more it’s the basketball coach!). Athletic departments expanded staff, facilities and amenities in a continuing competition to have the best. Currently, the reigning NCAA Champion Clemson Tigers have the best football-only facility (cost: $55 million dollars), which includes multiple pools, a nap room, mini-golf, and video games for the players.

Overall football scholarships actually declined from 105 (1973) down to 85 today due to the necessities of Title IX compliance, but rosters remained around 125 players: enough players to fill out 6 complete squads. The players went from seasonal performers to a year-round regimen: summer school to keep eligible along with unofficial summer work-outs (sometimes supervised by coaches), specialty clinics and expert training, then Fall camps, the regular season, finally post-season bowls and play-offs, then Spring football and more class work before starting the cycle again.

The players got tuition, and eventually a stipend, and some freebies, but no pay; they were instead given the opportunity for a quality education. But just the opportunity. Given the demanding athletic schedule I outlined, serious academics were a luxury. Some schools shepherded student athletes into “gut” programs which kept them eligible but didn’t result in an education or a useful degree. Every school could trot out a star player who was also an Eagle Scout with a 4.0 GPA in Electrical Engineering: with 125 football players, you’re likely to have at least one. Meanwhile, many other players were only graduating in name, and others proved to be illiterate despite their degrees!

Meanwhile, the universities were reaping huge payouts . . . sort of. While some of the math (like the ticket example above) is pretty simple, there is no universal standard for reporting revenues and costs. Schools build ever-larger stadiums and keep the costs off the athletic department books or add in classrooms as a cover. Private schools can remain mostly mum. Even state schools can do things like reporting every athlete as “costing” a full scholarship at full tuition (sometimes out of state) when in fact, they “cost” nothing. Other schools move most of the athletic department into a privately-held association, avoiding both financial scrutiny and skirting the transparency requirements of any state “sunshine laws.” Large, successful programs make a lot of money, while smaller and less successful ones play along and hope for a windfall season.

Nicolae Ceausecu Memorial Stadium in South Bend . . . see the classrooms? Lotsa classrooms!

The players have taken the NCAA and the universities to court for the right to make money off the merchandise bearing their name and likeness or to just be compensated as employees. The results are mixed, but the cases and appeals are heading in the direction of allowing pay and benefits. The NCAA has preemptively increased direct stipends and allowable benefits in an attempt to avoid the inevitable. But the path forward is clear: since the academic institutions have treated college football (oh, and basketball, too) as a business, eventually the courts will insist student-athletes get their share.

So what? Back in the day, players walked off the field and got “golden handshakes” when wealthy alumni shook hands and palmed a fifty or a hundred over to star players. But the advent of a full pay-for-play era will tear up the existing system. It is a change in type, not in extent.

First off, some schools have ruled out paying players. My Notre Dame, Northwestern, Stanford, Duke, Wake Forest, Vanderbilt, the Service Academies, Boston College and the “Big 10″conference so hold, so they say they will not compete in an association (the NCAA) which does. In the era of paying players, small schools who don’t make much money may want to pay, but will probably have to drop out of the arms race (remember, their costs just went up). But this won’t stop the biggest schools and football factories: they will revel in the newfound freedom to emphasize the sports. What they don’t understand is the amateur nature of college football–even if it is a charade at times–is essential to its log term success.

The current useful fiction retains the patina of “student-athlete” from the past, so there are rules (even if fudged). Once the student athletes are employee-athletes, the university can’t make arbitrary rules about school attendance a condition of their football (work) performance. As one athlete already noted,

For the pay-as-you-go teams, they won’t immediately drop all pretense of student-athletes. They will probably start with limits on how much athletes get paid. But the amounts of money involved are large, and therefor largely corrupting. And if it’s a business, business rules (e.g., labor rights, antitrust laws) apply. Eventually, they must allow for the possibility of non-student athletes, but perhaps limit the numbers. Schools will avoid some limits by having teams associated with the university (The Gators associated with the University of Florida?). How will they limit how much a school can offer a high school recruit? How about an overall salary cap? Players will be free agents, changing teams/schools for better pay or more playing time: you can see the beginnings of that in today’s transfer portal.

College football will still be popular, and it will still make money. It will avoid the fake-student scandals of the past, although it will doubtlessly invoke new ones (look at college basketball, which skips the pretense of student athletes but must deal with many other problematic behaviors). Instead, college football will be what some already charge it is: simply a minor league for the NFL, only one with some odd attachment to places called “institutions of higher learning.” That will be a loss for the fans, the students, and the sport.

Life’s been good to me, so far

As Joe Walsh crooned in the same song, “I can’t complain, but sometimes I still do . . . “

Friends have admonished me for the negativity of my recent posts; I plead guilty. I was–after all–an intelligence analyst for almost forty years, and when I spoke publicly about it, I almost always used this joke: “An intelligence analyst is the type of person who—when he smells flowers–looks for a casket.”

But life IS good, even if “sometimes I still do (complain, that is).” What’s so good about it?

The weather has returned to its normal spectacular. The climate is so good here we get spoiled, and a few hot/sunny or cloudy/rainy days become a national tragedy. It’s cool (60s) in the morning, gets sunny and warm (80s) in the afternoon, then cools quickly in the early evening. Passing storms appear and disappear in the late afternoon-through evening-to early morning. Mostly they present spectacular lightning displays over the lake.

We have a special word for this: it’s called Thursday.

I seem to have won my war with leaf cutter ants. For those unfamiliar, leaf cutters are the plant world’s version of the creature from the Alien-series of movies: a relentless killing machine that turns beautiful tropical foliage into a bunch of naked sticks-n-stems overnight. They had so denuded my jasmine plant thrice before I caught on. Like Ripley, I nuked them from orbit (“it’s the only way to be sure“) using a product called Trompa which they take back home to the evil queen and die, already!

Like Aliens, they’ll be back, but for now I can smell the jasmin!

If you put your nose up to the screen, you’ll smell it, I swear!

College football season begins this weekend, and all teams not named the Miami Hurricanes are still undefeated. Canes fans can take solace in the fact that they assaulted the band director of the Florida Gators: keep it classy, UM! Anyway, certain defeat lurks somewhere in the distance, but for a brief moment all fans can dream bigger dreams. I don’t know how many more college football seasons there will be (topic for a future post), so enjoy it while you can.

We’ve started to explore more of Guadalajara. Any town with five “a’s” in eleven letters deserves to be investigated. Many expats avoid it: too big (mas que cinco millones), too many cars, too Mexican (what?!?). We have been attending Mass up there, and then checking out new restaurants, shopping, etc., and it has been a very positive experience. We hit City Market last Sunday, which is sort of a Whole Foods on steroids. We sat at the lunch counter and ordered tapas and coffee. Since the coffee was served from the cafe, our waiter went over there to get it and bring it to us, along with some complementary chocolate croissants. Then we went grocery shopping on a full stomach–highly recommended over the alternative.

Judy & I are in great health: eating better and exercising more than ever before. We still eat out almost every day, and there are always new restaurants to try, even in our little town. We hit two more news ones (a creperie and a Tex-Mex one) recently. Judy got me to adopt walking laps in the pool. I always resisted this as something only ‘rehabbers’ and people “exercising without sweating” did. One more thing to be wrong about. It is very solid exercise and you leave feeling refreshed; who knew? We’ve even kept up “playing” tennis, which is to say we spend sixty-to-ninety minutes each Friday trying to volley the ball over the net. No score, no rules, just racket-and-ball-and-go! Good fun, better exercise (since we never know where the ball will go). Judy now has tennis outfits, so she looks marvelous, too! I got tennis shoes. I had tennis shoes my entire adolescence and never played tennis. Now these two parts of the my story have aligned.

Our Spanish language lessons continue, and while some topics are very frustrating (how about the seven different verbs they use to convey the verb “to become”?), we can now hold a conversation with locals, as long as they verbally downshift to second gear. We had a young waiter in Guad last week who spoke supersonic español: I think he was trolling us! Yet it is nice to be capable of basic interaction, even with our limited vocabulary and gringo accents.

We got hit with something called DAC, which is the Spanish-language acronym for overuse of electricity, resulting in a triple rate charge. I guess it was the air conditioner use back in May/June; while it irritated me to no end (I have solar panels!), the triple charge resulted in a monthly bill of (wait for it) about $75 USD. I doubt I ever had an electric bill that low in the States. So even the bad news has a silver lining.

So, yes, I can’t complain, but sometimes I still do . . . just with a sly grin.

“What, me worry?”

Statistics are funny things. Done correctly, they have an unarguable standing, yet a clever person can use them to prove damn near anything. As Disraeli said, there are “lies, damn lies, and statistics.”

If I asked you to complete the sentence “the greatest threat to human life today is ________”, what would you say?

Based on the headlines, some might say gun violence. After all, there seems to be another mass shooting every thirteen days (a true statistic, depending on definitions) in the US. Despite the news coverage and the pathos of each of these attacks, the number of victims is still small (102 fatalities so far this year, another true statistic). Gun enthusiasts will remind all that the vast majority of guns are never used for a violent act (true), yet gun control proponents will counter that the most common use of a gun in your home (in the United States) is to kill yourself, a close friend, or family member, not a robber (also true).

Parents are buying bulletproof backpacks for fear of school shootings. These same parents blithely give their teenagers cars and smart phones, despite the fact that these two objects combine to kill ten teenagers every day (due to distracted driving).

Concerned for gun violence: quite valid. Worry? Maybe about the underlying causes.

People with a longer timeline might say climate change is the biggest threat. The violent weather and social disruption envisioned under most climate change scenarios is certainly a vivid threat, but sudden climate change remains a thing only in (bad) Hollywood movies. The imminent threat claim mouthed by politicians–you know, that we have only ten or twelve years left on the planet–has been rejected by the UN Intergovernmental Panel on Climate Change (IPCC).

What their report states is we have no time, since climate change is already here. If you live in New York or LA, you’re already experiencing the +2 degree centigrade average temperature increase that is the benchmark for climate disaster. But the IPCC states that dramatic efforts to reduce carbon emissions could (by 2030, hence the ten-to-twelve years stat) save us from even worse effects, when the rest of the world catches up to +2. No one knows exactly how bad things will get, or when or where the worst effects will hit. Threatening indeed, but the imminence is a call to action, not despair.

What I have in mind is a threat already lurking, with the possibility of sudden emergence. So let me give you something new to worry about (right, because that’s what we need, another existential threat!). I say new, but that is only true if you’re younger than ninety-one years old (That’s a hint).

Prior to 1928, the most common cause of death worldwide was . . . infectious disease. The most common cause of death among children, the most common cause of death among soldiers, the most common cause of death among any group of human beings. The average life expectancy in the industrialized world in the 1920’s was approaching forty-nine years. It had inched up due to cleaner water and public sanitation, but was still low by modern standards.

1928 was the year Alexander Fleming discovered penicillin, the first antibiotic medical treatment. The antibiotic qualities of some substances had been known for hundreds of years, but Fleming’s discovery was a mass-producible treatment which went widespread among the Allied armies in Wold War II and then everywhere else after the war. Prior to modern antibiotics, a cut or abrasion gave you a distinct possibility of dying. Gathering in large groups with poor sanitation risked the same. Your grandparents or great grandparents thought of hospitals as places where injured people went to get fixed up, but often got sick and died there. This wasn’t superstition: it was lived experience.

If you’re ninety-one or younger, you have lived entirely in the antibiotic era, which was different in type from previous human history. Life expectancy in the developed world shot up after 1928, gaining upwards of 30+ years in the next six decades! Antibiotics (and a better understanding of the bacteria they fight) was a major cause of this improvement. Proof lies in the fact that infectious disease remains the scourge of developing countries where antibiotics are unavailable.

The bad news is that evolution still holds, and bacteria, having countless numbers with which to experiment, are winning. Antibiotic resistant bacteria are popping up with increasing frequency, all around the world. Most of our antibiotics were developed in or before the 1970’s, the so-called “golden age of antibiotics.” But we misused them, using them to treat viral diseases (they don’t work against viruses), to fatten up farm animals, to mass spray and protect crops, in inadequate dosages or after they were expired, washing them down the drain where (other species and) bacteria were exposed. And survived. And evolved. And grew stronger.

There are new antibiotics in development, but of only a few new types. We have learned that bacteria are most vulnerable when hit with several different classes of antibiotic approaches at the same time: this complicates their natural selection, and buys us more time. So the new antibiotics are just a delaying action, and we don’t know how long before some truly deadly, easily transmitted disease beats the current set of “last-ditch” antibiotics.

What is a post-antibiotic world like? For a recent example, read about life during the Great Flu Pandemic of 1918. Granted, that was a virus, not a bacteria, but still it shows how an unchecked disease completely shuts down a modern society, and how social norms dissolve in the process. And that was just a 10-20% mortality rate. For a slightly more troubling scenario, read about the Black Death in Europe in the 14th century, where mortality exceeded 50% and the surviving remnant society was totally changed.

Unfortunately, there is not much an average person can do about the bacterial threat. Don’t ask for antibiotics when you probably have a virus, don’t use them when expired (or flush them down the drain), oppose policies of mass use for livestock or agriculture. Pretty small potatoes, what? That is what makes it such a threat, and why I choose to highlight it: individuals can’t do much about, it is massively deadly, and we have come to rely on antibiotics almost unconsciously.

Now that I have unburdened myself of this worry, I think I’ll take a good siesta. Sweet dreams!

Medical costs, up-close & personal

Continuing a theme, here is a real-time update on the quality and cost of medical care for expats in Mexico.

During Judy’s recent annual physical, she realized it was time for that occasional right-of-passage for those of us of a certain age: a colonoscopy. She has had one before, back in the States, and it was as unpleasant as the procedure can be, or at least as the prep can be.

For those unfamiliar (lucky you), the prep involves 24 hours of only clear liquids the day before, ending in several hours of large volumes of water and a choice of prescription laxatives, designed to…ahem…clear the intestines so the doctors can get a clear view. The procedure itself is done under a mild sedation so oftentimes, you don’t remember it at all.

First, Judy and I visited the doctor we were referred to by our regular physician. Note I said”we,” as the doctors here have encouraged us to attend visits as a couple. It seemed odd at first, but we welcome it, as two people can compare notes on what was said. The doctor was very friendly, completely fluent in English, and made sure he had a good patient history during the visit. He talked over some options for location (here at a new hospital in San Antonio Tlayacapan, or up in Guadalajara), gave us a cost sheet (and reminded us NOT to pay more, as this was the cost he negotiated with the hospitals), and explained the schedule and prep. Total cost for this visit: $800 MXP, a little over $40 USD.

The cost of the prep materials at the local farmácia: $487 MXP, or $25 USD. At least the powder had no flavor, but drinking 4 liters in four hours is no fun . . . and the aftermath is torrential!

The hospital–in our small community– is brand-new and squeaky-clean. The day of the procedure, we arrived at 9:30 for our 10:00 appointment. The front office staff–excellent English–processed Judy’s paperwork and gave me the wifi password for the waiting room. Judy left for prep at 9:50 and came back out at 11:10. No issues, no complications, todo bueno. We were on our way to breakfast at 11:30. One interesting difference: in Mexico, you keep your own medical records, so Judy left with a portfolio including photos and other results from her colonoscopy.

She reported that her specialist, doctor Daniel Briseño Garcia, visited with her during prep to answer any questions and see how she was doing. She recalls the anesthesiologist was very familiar with her medical history and had a great sense of humor (all in English). She also remembers some of the support staff speaking Spanish, but that was as she drifted off.

Cost for the doctor and anesthesiologist: $ 6500 MXP, about $350 USD.

Cost for the hospital: $ 4800 MXP, or about $ 260 USD.

Total cost ran under $700 USD. Since our insurance covers us anywhere in the world (most do NOT), our cost will be zero. It’s been awhile since I had one in the States, so I googled costs and it varies between $1,000-3,000 USD, although most forms of insurance cover it there too as an important preventive procedure.

Like anywhere, you get what you pay for (we could have found a cheaper alternative), and you go with the doctors you trust. Overall, a very positive experience.

Win. Win. Win.

I saw an article in the New York Times yesterday that was interesting for several reasons. You can read it here. For those unwilling to click through, or who have used up their “five free articles” for the month, here’s the gist of the story. An American woman needing a knee replacement went to Cancun for the procedure, and the entire trip and all medical costs were less expensive than just the procedure stateside.

As far as that goes, it’s just another medical tourism story. But there are a few twists. First, the surgeon was a US doctor who was also flown down to Cancun just for this surgery. He was accompanied by a Mexican doctor and staff, including a bilingual nurse who helped translate the doctor’s instructions. Why did the doctor do it, on his day off? He was paid triple the US Medicare rate for his work, including expenses.

Second, the woman and her husband are middle class folks from Mississippi, and her care came under her husband’s coverage through his employer, Ashley Furniture of Wisconsin. So this isn’t some ridiculously rich patient, nor a gold-plated health plan. Yet the health insurance provider paid all the expenses for the patient and her husband to stay at a resort attached to the hospital for the day before the surgery and ten days after. Oh, and she got a $5,000 bonus for agreeing to participate in the program. How? The total cost for everything was less than 40% that of doing the same procedure in the States. So Ashley furniture has saved millions in the last three years by offering this option to its employees.

Third, the care team consciously exceeded the health and care standards of US hospitals, using extra sterilization equipment and accelerating the physical therapy regimen. Why? the entire program is managed by a US firm called North American Specialty Hospital or NASH, who makes all the arrangements for the travel (even passports), connects the doctors and patients, and even provides malpractice insurance for the American doctor in case of complications. NASH insists on exceeding US standards to mitigate patient concerns; it’s the same reason they arrange for a US doctor. NASH is a for-profit business that gets a flat rate from the insurers for its work.

Last, why a private, upscale Mexican hospital? The cost per night is only $300 USD, and the care staff was excellent. As the patient related in closing, she would gladly come back and pay, as she was treated “like family.”

What we have here is a wining situation. Average couple gets high quality medical care: win. Company saves millions of dollars on said care: win. Upstart firm makes money ingeniously by putting consumers and providers together in an innovative way: win. Mexico gets credit for the quality of its care: win. Even the American doctor made out well.

Granted, this is not the solution to America’s health care challenges, if only because some people won’t accept it just because it is different. But it does show how there are ways out of the health care mess which don’t destroy the system as it exists. We need more innovative thought–and less sloganeering–on health care.

Dogz in the Dellz

We’re attending my annual college reunion (the BrewDogs), hosted this year in the Wisconsin Dells. Our trip got off to a sputtering start courtesy of AeroMexico airlines and an unannounced, last minute flight change.

We had reserved a non-stop flight from Guadalajara to Chicago O’ Hare, a four hour trip arriving just after midnight. We were going to clear customs & immigration and stay at the airport Hilton, which is adjacent to the terminal. Three days before the flight, I checked our seat assignments and noticed most of the plane was empty. Judy asked me “they wouldn’t cancel the flight, would they?” “No,” I opined, “they probably have connections to make, and this flight does not show a history of being cancelled.” Just by chance (or the intervention of the Holy Spirit), Judy checked the next day, and informed me we now had a morning flight, twelve hours earlier!

No e-mail, no notice of change on the Delta App (their partner). A Delta rep on the phone tried to tell me they sent both of us e-mails on June 30th (neither of us received such an e-mail), and oh-by-the-way, why did the App still show the original flight on July 29th? What can you do?

We were able to make the necessary changes to take the earlier flight, and make lemonade out of the lemons by staying the day at the airport Hilton, enjoying the gym and the pool and turning a hectic travel day into something more pacific.

Panoramic view of ORD from the top floor of the Hilton

While we enjoyed ourselves, the costs were shocking. Now I know we’re talking airport prices, but $77 USD for a shrimp Caesar salad, a bolognese pasta bowl, and two glasses of house wine? Not to mention service with an attitude. The waiter approached, stood facing away from our table, and asked “what can I get you?” We weren’t sure he was even talking to us!

But that’s travel now, especially in overcrowded US airports. The better portion was spending time with old friends (a term I mean literally these days) in the picturesque Wisconsin Dells, catching up on life and just enjoying each other’s company. Yes, there was too much bacon and too much custard (a Wisconsin specialty), too much wine and too much beer, too much loud music and too much raucous laughter. How else would a gathering of BrewDogs be?

Catching up means hearing of bad news as well as good. There were stories of friends and family passing, illnesses discovered and jobs lost, all the things that inevitably confront us as the years and decades pile up. And the stories were related in the frank manner only possible among good friends, who have shared hardship in the past, and can quickly revert to a level of intimacy only reserved for those you trust absolutely.

As the tally of empty beer bottles mounted, conversation veered to the deep end of the pool, and more than one time we confronted the same question: “what the h#&*! is going on out there?” Liberal & conservative, politically active and un-involved, all agreed that there is something fundamentally wrong in the country. We didn’t come to any brilliant conclusions; there simply wasn’t enough to beer to reach that level of performance!

Yet we noted that while the world we grew up in was fundamentally flawed in many ways, it was collectively far superior to today’s environment. Furthermore, those past failings hadn’t been resolved or even traded for new ones: many were still in place, adding to our woes.

Was it the inevitable finale of the age of Aquarius, since doing you own thing usually ends in destructive individualism? Was it unfettered commercialism, turning citizens into consumers and changing all human relationships into a contractual zero-sum game? Did we get too tired and cynical to believe in self-sacrifice and the common good? Or were we led on by politicians, manipulated into warring camps more interested in power and might than in duty and right.

We have to face it: America has always been a violent, individualistic place. But once upon a time, other peoples looked on that as something a touch quaint, a little odd, perhaps even useful. We seem to have passed from character to caricature. Maybe I’m just ruminating in a virtually empty O’Hare airport at midnight, waiting for a flight home. But my college friends come from all over the country, from backgrounds as different as can be. We all seem to be ruminating alone at midnight.

A Tale Told Three Ways

Is there any more contentious issue in America today than immigration? One side talks of “murderers, drug-dealers, and rapists” while the other talks of “concentrations camps” and “kids in cages.” Even in an age of gross overstatement, it’s a bit much. Regardless of where you fall on the spectrum, could we agree that we need less heat and more light on the issue? Good journalism could really play a role here. Here’s a story in three different points of view. See if you spot the better journalism.

Version 1: Francisco’s story

Francisco was out for a drive with his buddies. He was a rising high school senior in south Texas, and he and some friends were trying out for a local soccer team, so they were going on a little road trip. When they rolled up to the immigration checkpoint, they weren’t concerned. After all, they had driven through without any problem many times before, and such checkpoints are a fact-of-life in south Texas. Francisco thought nothing of it, as he was an American citizen, born and raised in there. But some of his family was undocumented, and one of them–his brother–was in the car, too.

The Border Patrol officer seemed a little too concerned about this carload of Hispanic teenagers, but Francisco knew he didn’t have to answer his questions, and they had nothing to hide, so probably the officers would inspect from outside the vehicle and soon they would be on their way.

Unfortunately, the right to remain silent doesn’t always include the ability to do so. The officer kept questioning his brother, and instead of ignoring him, his brother admitted to not being a citizen, and soon the entire group was on the way to a CBP processing station.

Now Francisco was a little concerned. He always carried his Texas state ID, a US Social Security card, and his Texas birth certificate, so he felt certain things would work out. But the CBP officers were suspicious, as he was travelling with an admitted undocumented person (his brother), so they were questioning the validity of his credentials!

After being processed and fingerprinted, all-hell broke loose. The CBP officers called him in and asked him why he was lying. When he tried to explain that he was a American, they cut him short and asked “why did you apply for an American visa as a Mexican national?” He had no idea what they were talking about, but next he found himself in a crowded cell with hundreds of recently apprehended people seeking asylum.

The CBP personnel were completely swamped by the numbers, and Francisco quickly realized he had no way to gain their attention to explain his situation, or call his parents. Two days later, his brother was voluntarily deported back to Mexico, where they had family. Francisco refused to go, insisting he was an American, and he was only going home.

The days ran into weeks as the government tried to confirm his papers, contact his family, and come to some definitive conclusion about his status. After three weeks, Francisco was transferred to an ICE facility, and was able to call his mother, when he learned the family had retained an attorney and was working to get him released. A week later, as removal proceedings against him continued, ICE finally released him to his mother and his family’s attorney. Francisco was just what he had always said: an average American kid. But now he was also an innocent victim of a cruel government bureaucracy.

Version 2: Duty Log, South Texas Region, 27 June-23 July 2019 (excerpts)

27 June. Border Patrol delivered four Hispanic youth for processing, after collecting them at a checkpoint. Officer stated some had Texas and/or US identification, but one admitted to not being a US citizen and had no documentation. As result, officer was suspicious of all the identification provided, and brought the individuals to station for processing. The group was assigned daily processing numbers 78-81.

29 June. Update: Marlon ________, previously admitted to being in the country illegally, and agreed to voluntary deportation back to Mexico. His brother Francisco _________ refused to participate in the removal proceeding.

06 July. Update: Suspect national Francisco _________ had previously provided a Social Security card and other Texas State ID which checked out as valid. However, his fingerprints came back as identical with a Mexican national (same name, DOB) who applied for a US visitor visa. When confronted, suspect denied any knowledge of application, without further explanation. Attempting to resolve contradiction by contacting family.

13 July. Update: Station was contacted by an attorney representing the family of Francisco _______. Attorney indicated Francisco’s mother, Sanjuanna ________ , could confirm his status as an American citizen. ICE officers asked why this woman’s name was different than the name of the mother on Francisco’s birth certificate; attorney indicated the mother had given a different name on that document, as she is undocumented (no further information). Woman further clarified that she had applied for the visa for her son because she could not get him a US passport due to the discrepancy on his birth certificate (no further information).

23 July. Update: After further clarification provided by his attorney, suspect Francisco _________ was released to his family.

Version 3: The story you didn’t find.

The sad tale of a American teenager named Francisco dramatically demonstrates the pitfalls of how the United States controls its southern border. Francisco, born in Dallas and raised in south Texas, was caught in an inland immigration checkpoint. These checkpoints, which have been challenged in court but remain legal, are an odd fact of life up to one hundred miles from the border.

Customs and Border Protection, or CBP, has the authority to stop vehicles and check for the presence of undocumented persons. US courts have held that drivers and passengers so stopped do not have to answer any questions, and can only be taken into custody for probable cause, but their vehicles may be visually searched from the outside. It is the closest America comes to the uncomfortable notion of “papers, please.”

People like Francisco are used to this, and he carried several forms of ID that day, including a Texas birth certificate. But his brother did not: his brother was undocumented, born in Mexico, and in the United States illegally. This caused the CBP officers to question the legitimacy of all the people in the car, leading to their apprehension.

Francisco’s brother agreed to a voluntary deportation back to his extended family in Mexico, but Francisco rightly refused: he was an America after all, and that was that. His IDs quickly checked out, which should have been the end of the story, but instead was the beginning of the ordeal.

When CBP ran his fingerprints, they matched a person of the same name, age and date of birth, who was born in Mexico and applied for a US visitor visa. Francisco denied knowing anything about it, but the match was undeniable: he was either a Mexican with fraudulent US identification, or an American with a bogus visitor visa. Either way, someone had some explaining to do.

Weeks passed as CBP pressured Francisco to come clean, while his family learned of his plight and retained an attorney. Their initial efforts came to naught: when they contacted ICE, his mother’s name did not match the name on his Texas birth certificate, which only raised more suspicion. His mother, also undocumented, admitted she had given a different name at the hospital when he was born. She later explained that because of this discrepancy, Francisco could not get a US passport, so she applied for the fraudulent US visitor visa for him, indicating he was Mexican, so he could travel back and forth to Mexico and visit family.

Another week of continuing communication between the government, his family, and their attorney led the government officials to release Francisco after almost a month in custody.

What separates these stories? Point of view. All three are factually true. The first takes a sympathetic view of the poor lad, who after all deserves the sympathy. Imagine being caught in such a situation! It’s a story echoing a lot of opinion writing on the border, long on emotion, but lacking the facts which are essential.

The second is strictly business. It shows what happens when resources are strained and laws flagrantly ignored: the business of law enforcement becomes problematic. Note how about a week transpires between each new disclosure. Are ICE and CBP officials supposed to ignore such a fantastic story as it dribbles out? Yet this version lacks any empathy.

The third tries to steer a middle road, letting the reader feel the pain of the innocent but also recognizing the ridiculous nature of the facts as they gradually appeared to the responsible officials. That would be journalism, at least as I learned it editing my high school newspaper.

If you want to know why I wrote all this, read how the Washington Post covered this story, here: WaPo link

Be careful, the online version has changed subtly over time, and even I only captured the third or fourth version of it. The original story serves one major purpose: to inflame readers about the immigration issue. There is no mention of how routine such checkpoints are (author’s note: I have been stopped at them every time I transit Texas). The allegation that border officials were suspicious comes out in paragraph five, but the basis for that suspicion is left to paragraph ten. The length of his detention is in the headline and lead paragraph; the explanation show up in paragraphs eleven-to-thirteen.

Next time your blood pressure spikes while reading a purportedly responsible new source, recall this exercise and ask: what are they trying to make me feel? What are the other possible explanations? Where is the other side of the story?

There is so much wrong about our immigration policies and border controls right now. It is a shame journalists are going the easy route and fanning the flames rather than shedding some light.