Gudulia treating an infected finger, assisted by Marcela and Pastor Bercián

For Adventists, Sunday is a work day, so today is our busiest day for pulling teeth and other emergencies. Once again I am saved from having to use my book-knowledge about tooth extraction, for Gudulia wants to try her hand at it. To be honest, she's not such a good puller. She tugs and tugs and the patient squirms and groans, but the teeth too often just don't come out. A good half of her attempts end by her asking the Pastor to take over. Apparently she's not strong enough; or maybe she just needs more practice, or confidence (later she becomes quite expert). Marcela washes ears (frequently flushing out objects looking suspiciously like half-disintegrated cockroaches) and helps Gudulia. I wash and sterilize the instruments. Here is an example of the kind of thing that happens all day long:

Up the weedy trail an old woman comes riding on a horse, with two scrawny dogs following. Way down the trail I see her staring hard at us, but when she comes nearer she begins looking into the weeds in front of her horse, never giving us even a hint of a glance. She's about sixty-five. She wears the usual baggy, white blouse trimmed with red embroidery, a longish black skirt and a wide, red belt. Her graying black hair is tied into two long pigtails. She dismounts, leads her horse through knee-high weeds to a spot that looks a little more lush and thus more palatable to a horse, and ties the reins to a waist-high bush.

Then, still without looking at us, and with the hungry-looking dogs following with uncertain looks on their faces, she grimly walks toward a group of about ten Tzotzil-speaking women of her own age. The women greet her familiarly but rather solemnly. Now she stands with her back squarely toward us while asking about our cost (free) and the pain and bleeding (much, by North American standards). Later in the day I recognize her sitting in the tiny, homemade chair with her mouth wide open, explaining through a bilingual friend that she wants six teeth removed, not just the two that the Pastor says he's willing to extract. The Pastor asks the interpreter to explain that extracting more than two teeth might cause excessive hemorrhaging.

Despite the old woman's wish to have six teeth removed, I'm astonished that teeth here seem to be in much better shape than generally they were in Nuevo Limar and Limar Viejo. I wonder whether this area's limestone bedrock might be the reason? Limestone is largely composed of calcium, a major constituent of teeth. In contrast, I don't recall seeing limestone around Nuevo Limar and Limar Viejo.

In the afternoon, down from the forested slopes above us, a pair of board-cutters arrive carrying their 3½-foot long Homelite Super l050 chainsaw. In Tzotzil they explain to Dionisio that the chainsaw has stopped working. Required for producing their only source of income, the tool cost about $775 U.S. Dionisio removes the spark plug, identifies no problem, but then finds that the spark plug won't go back in. He invites me to look at the problem, for here gringos are honored for their knowledge about everything. Threads in the aluminum cylinder-head have been ruined by someone trying to force the spark plug in crookedly. Inside the combustion chamber large flecks of aluminum filings can be seen.

"Didn't papers on proper maintenance come with this chainsaw?" I ask? "Doesn't anyone here know about small engines?"

No. And, no. Dionisio seems to be the only alternative, and he freely admits that he doesn't understand these things much at all.

Today three people have asked for special afternoon consultations in their homes, so at 3:00 PM the four of us walk down to the main part of San Lorenzo. At the first home the man who asked that we come at this hour has not returned from work. We say that we'll return later.

The second house, typical for San Lorenzo, is a 20 x 30 foot wooden building with a tin roof, dirt floor and no chimney. Smoke from the eternally burning wood-fire escapes through open areas between the roof and walls. We are met by a tall, incredibly gaunt, forty-seven-year old man, the father of ten. Never in my life have I seen a face so inflicted with the hollow look of impending death. This man's head is like a skull with articulating jaws and blinking eyes. He says that for six years he's been coughing, and that two months ago he began coughing up blood. He's spent most of his family's money on "inyecciones." (Here injections are seen as kinds of "magic bullets," with not much thought for what is injected; just having an injection is what counts.) But the injections have done no good, so now he hopes to enter the free government hospital in Pichucalco, as soon as he can scrape together money to rent a horse to get him to the road, and bus money for the trip to the hospital.

Though the man talks as if he hasn't the slightest idea of what is wrong with him, surely he realizes that he has TB, and that almost always people in his shoes simply die, as did his sister eight years ago. The Pastor advises him to get a lot of fresh air, to each morning sit in the sunshine, but to wear a hat so that his face doesn't burn. Eat lots of eggs and greens, he says. And lots of garlic and onions, adds Gudulia.

During this talk children peek from beneath beds, gaze through windows and squall from hidden places. The air here is oppressively warm and moist, smelling of mothballs, baby excreta, mud, kerosine and wood-smoke. I can hardly stand being inside. Becoming nauseated, I stagger from the house gasping for breath, and wishing mightily that here all this were not so real, so commonplace, so inevitable...

At the third house the woman who sent for us lies in a room partitioned off by walls of slender poles tied together with fibrous tree bark. A pink, tattered blanket hangs across the doorway. Her room is lighted by the pale orange glow of a single candle. A week ago the woman had a stomach ache so she paid someone to give her an injection. Apparently the needle was dirty, for now she suffers from a large, feverish abscess in her rump's left cheek, where the shot was given. Though we've come prepared to drain the abscess, the woman's husband is not at home and she refuses to let Gudulia work until he's here. So we return to the first house.

Still the man who asked for us has not come home. However, among the fifteen or so people of various affiliations in the household (children, children everywhere, crying, whining, vomiting, playing, running, screaming... ) is a woman of about forty who says that her fifteen-year old boy has had severe stomach cramps for several days. Would we please look at him? He's lying there in the corner... Gudulia diagnoses the trouble as "inflamed intestines" and suggests mudpack therapy. She asks the woman to go dig up some clean mud. At 9:00 PM we'll return and show the mother how to make mudpacks.

At 9:00 PM sharp we return. (Though I no longer keep an eye on my watch, word has gotten around about gringo time, so now it's like a big game, and everyone laughs about it good naturedly.) In a yellow, plastic bucket the mother presents Gudulia with a ball of yellow-brown mud about six inches across. It looks like wet putty. Gudulia adds two inches of water and with her fingers begins mixing the mud and water, sometimes adding more water. Fifteen minutes later the mud is of the consistency of thick, creamy mayonnaise. Onto a clean rag about l8 x l8 inches in size she dips three handfuls of mud, creating a layer of mud about half an inch deep, and nowhere coming closer to the rag's edges than three inches. Then she folds the rag into a neat rectangular package. This is placed on the boy's stomach. Finally the boy and his mudpack are covered with a heavy blanket. Coldness from the hardening mud is supposed to be beneficial, plus the mud itself will "draw out poisons." Among Gudulia's further instructions are these:

• Make such mudpacks four or five times daily until the stomach feels better, and then reduce treatments to two or three daily applications, until the patient is well
• Keep the mudpack on until the mud hardens, unless it causes discomfort
• Don't apply a mudpack until at least two hours after eating

Furthermore, Gudulia suspects that the boy, as well as everyone else in the family (and probably all of San Lorenzo), is heavily infested with intestinal parasites -- worms -- so she advises the following:

• Each day eat five to ten raw pumpkin seeds. (Pumpkins here are completely different from what we have in the U.S.)
• For several days, each day drink the juice of two lemons
• Take several enemas of "tea" brewed from garlic and the commonly available herb called epazote (Chenopodium ambrosioides, sometimes called Mexican tea in U. S. botany books).

By the time we leave, an uncomfortable chill is creeping into the night air. Everyone agrees that it's going to be another cold one. A man who so far has only sat in the shadows saying nothing now approaches the Pastor and asks if the thing that people are saying is true -- that someplace back toward the Guatemalan frontier a volcano has erupted, spewing out vast storms of pure, white ice...