Extremes

I think a lot about the word “tenacity.” What it takes to survive in a world that is sometimes beautiful and sometimes hostile. I’m always amazed at the body’s willingness to continue, to keep going. The heart that keeps pumping, the lungs that keep breathing, the way the will to live can outsmart those other dark voices inside. -- Ada Limón

Thousands of solar panels on the red roofs across Mexico City glittered like diamonds in the sun. I was looking out the window as the plane was descending over the city. The sprawling city nestled between mountains was home to 22 million people. I had never seen a city so large.

We were having a preterm birth meeting in Mexico City that I had helped organize. Three days of presentations and committee meetings to make collaborative progress on one of the biggest problems facing pregnant women and newborns. It was my first time leading a scientific meeting and I was excited and nervous.

Yet, the irony of my research career – dedicated solely to women – stung a little when I thought about how men had been excluded from many breast cancer clinical trials. And, as a result, how little we knew about my husband’s rare disease. More could be done, but the medical interest in the plight of men with breast cancer was low.

Meeting me at the airport was a good friend and scientist, originally from Mexico City. She insisted on picking me up from the airport, and I was grateful. Although I was a seasoned traveler, parts of Mexico City and Mexico were known for high crime related to drug cartels. This was my first time here and I didn’t know what to expect.

“I am sorry about the car,” my friend said after hugging me when I emerged from customs. “My Dad didn’t want me to drive his van. He said that I would wreck it. The car is not so nice – a stick shift – and I am still getting used to it.” I could hear the veiled annoyance through her thick, Mexican accent.

“I don’t think you’re going to wreck it. We’ll be fine. I’ll be co-pilot,” I said with a feeling of driving bravado that surfaced from my high school days. After several car accidents during the years of sleep deprivation in medical school and residency training, a more careful and circumspect driver in me had slowly emerged. But now I was on a driving adventure with a friend in a new country.

I confided in her about my husband’s cancer long ago when I still felt very raw. She listened when I shared his diagnosis, my struggles and fears. Her support was genuine and deep; the kind that comes from someone who could be close family.

“How is your husband doing?” she asked carefully as we were walking to the parking garage. It was something we always talked about when we saw each other. I was open about my heartbreak and grief at his prognosis; she kept her struggles more private. Regardless, we had a bond in having achieved some success in our fields and knowing the grit that it took to get there.

“He’s doing OK. You know, it’s a struggle,” I said keeping it short. There were two students traveling with me, who were trailing behind us. Although they knew about my husband’s cancer, I didn’t want to burden them with too much information about my home life. They needed the emotional distance from me to maintain that student-PhD supervisor relationship. It was better for them this way.

She nodded in understanding, her black mane and black-rimmed glasses moving ever so slightly. She could read me like a book and knew immediately that things were about the same in terms of his health; and I didn’t want to say more right now. Without any more words, I could feel her radiating sympathy and care.

We were approaching the car now, and it was just as advertised. The last time I drove a stick shift was in high school and it brought back memories of football games, parties, and speeding around in our small town. All I needed to go back in time to these days was to see duct tape holding car parts together, hear an unexplained noise from the hood, or see an air freshener hanging from the rearview mirror. When I got into the car, I saw the cross hanging from the rearview mirror. Close enough.

She started the car and made her way out of the parking garage to merge into traffic of one of the most heavily congested cities in the world. Cars flowed in and out of lanes with a seeming mind of their own. Signaling a turn was either optional or discouraged because no one seemed to be doing it. How did the cars know how many lanes there actually were on this street? It seemed like they were making it up as they went along. My friend looked a little stressed and so I thought I would lighten the mood.

“My greatest achievement is that I navigated using only a paper map along dirt roads for about eight hours through Swaziland. We can do this,” I offered confidently as I pulled up the navigation app on my phone.

She shot me a quick look to tell me that sarcasm wasn’t appreciated right now. Then, she leaned forward in the driver’s seat, head turning slightly right and left every few seconds to gauge the intentions of the drivers around her. We weren’t moving all that quickly and I could see from my app that traffic would be thick the whole way to the hotel. It wasn’t long before a car started swerving slowly into our lane.

Like lightning, she raised her left index finger to wag at the driver. “Non, non, non,” she warned in Spanish, but he merged in anyway. She grimaced and tightened her grip on the wheel as we slowed to a stop a few moments later. The light had turned red. None of us were going anywhere.

In front of the stopped cars, two young men started performing an acrobatic routine. Each took a running start from opposite sides of the street, then somersaulted in the air at the same time. They repeated the running flips another two times before walking up to cars with hands outstretched for a tip. I leaned forward in my seat but couldn’t see the condition of their shoes.

If they had landed the flip poorly, they would have cracked their heads open on the street in front of us, which would be game over. And if they did this routine flipping three times with each stoplight, how many times would this scenario be repeated in a single day? It would take only one misstep on these broken streets for their young lives to be cut short.

“Mexico City is a city of extremes,” she stated matter of factly. “We have poverty. But we also have billionaires. We have luxurious restaurants, a vibrant city, but also many poor people. I really hate it when the street performers breathe fire,” she said.

Oh, I thought with sadness. Yes, that would be worse. Watching someone intentionally pour diesel fuel into their mouth and then spray it into an open flame for the entertainment of cars at a stop light was worse. I could feel the burning of their mouths and lips from the chemical exposure. Not to mention how toxic that is for the cells in the mouth and throat.

The contrast between the life of these men performing on the street and my own was stark. What did I have to worry about, really? I was suffering first world problems with a husband, whose cancer was diagnosed, treated, and technically in remission. How many homeless people on the streets of Mexico City or in Seattle had undiagnosed cancers?

I had a home. I had food and clothes. I had two daughters that were happy, busy, and engaged in their lives. Perhaps, I needed to come to Mexico City to see life in its extremes and get my head straight.

“The white building on your right is the Palacio de Bellas Artes, which means the Palace of Fine Arts. It is a beautiful cultural center that hosts arts events and exhibitions. There are amazing murals inside. We should visit if we have time,” she said.

I silently agreed. It looked like the palace was made of white marble and a combination of Art Deco and maybe a few other architectural styles. There were golden domes, decorated arches, and white pillars galore.

In fits and spurts, we were inching closer to the hotel when I began to see tents along the sidewalk. It looked like the homeless tents erected along some streets in downtown Seattle. On my drive to work, I would also see homeless people sleeping in the rain in sleeping bags or wrapped up in blankets. It wasn’t abnormal to see someone walking half-clothed into the middle of the street or laying prostrate on the sidewalk in the middle of the day. Occasionally, I would see a drug deal in plain sight. It was easy to become numb to it and this made me ashamed.

But in Mexico City, the homeless people looked entirely different. There was an energy around the tents; people were milling about, cooking food, talking, and sitting in small groups. Definitely a more organized and purposeful swarm than I was used to seeing in Seattle. Then, I suddenly realized why. It was because they weren’t addicted to fentanyl or heroin.

“Why are they here?” I asked.

“They are trying to escape a bad life in Venezuela or Haiti or Salvador. Many thought they could make it all the way to the U.S., but they got stuck here,” she said.

Oh, I see. They left a life of abject poverty in countries with repressive governments. And probably had a harrowing journey to get here. And now they were stuck in Mexico City and still struggling. Yet, they were taking a chance for a better life. It was probably safe to say that they had left something much worse than a completely unknown future, which fueled my greatest fears for my husband’s health.

Honestly, honestly. What did I have to worry about?