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— Nurse Gladys was a prim young woman in her mid-30s with a slightly officious air. Unlike the other nurses, she did not readily volunteer what medicine she was administering -- something I always asked when someone was about to inject something into my veins. "Medicine ordered by your doctor," she said condescendingly, tapping my hand two or three times as if admonishing a child. (When I mentioned this to Dr. Zúñiga during one of his visits, he added this note to his standing orders: "Allow patient to ask questions. Allow patient to express himself.") Gladys had an hourglass figure and was quite a looker, if you could get past her austere understanding of the nurse-patient relationship. She seemed more like the kind of nurse you might encounter in an American hospital -- strictly business, little time for chitchat. Either that, or she just didn't like this difficult gringo patient, full of questions, presuming to know as much about medicine as she did. When I complained of feeling as if I were in jail, she told me, a dash of contempt flavoring her voice: "You may feel like you are in a cage, but this cage you are in is a golden one -- still a cage, but golden. And soon you will be out of it."

All of the nurses seemed surprised that I spoke Spanish fluently, and they were curious as to why a gringo would choose to live in Tijuana. They attended to many gringos, most in Tijuana for weight-reducing surgery, which costs about a third as much as it would in the U.S. Very few spoke Spanish, and those who did spoke it poorly. Tijuana bariatric surgeons offer attractive packages to Americans: patients are greeted at Lindbergh Field by an English-speaking escort who drives them to a five-star hotel in Tijuana, where they spend their first and last days -- with three days in the hospital sandwiched in between -- all for $9000-$12,000. I had learned the language by osmosis over 16 years spent in relative contentment as an expatriate in Tijuana. During that time, I had lived in virtually every area of the city -- from $12-a-night hotels, where you had to sign for your toilet paper at check-in and return it to the desk before checking out, to high-density Mexican public housing in the crime-ridden dusty hills on the eastern outskirts of town, and now, in a pleasant, safe, middle-class neighborhood. Like many emigrants to the city, my living situation had improved as my economic situation improved. In the lean, early years, there were days I struggled to come up with enough money to feed myself. Like my Mexican counterparts, I came to rely primarily on panaderías -- the fresh bakeries that dot the city. Two freshly baked bolillos -- small loaves of French bread with origins in the brief French occupation of Mexico -- cost less than a dollar. And, unlike in the U.S., sandwich meats did not come prepackaged. Customers can order as little or as much ham or bologna as they desire, purchase one hot dog or eight, two strips of bacon or a quarter kilo. The system made it easy to eat on an austere budget, though the diet was not always a healthy one.

As a result of the time I had spent in Tijuana, my speech was littered with expressions picked up on the street, with turns of phrase not taught in language schools, some bordering on the vulgar. I am by no means a perfect speaker of Spanish; I still screw up verb tenses and personal pronouns and trip over trilled r's or multiple vowel sounds. Still, the nurses seemed charmed by my command of the language and said it made their job easier. It enabled them to quiz me: Why had I moved to Tijuana? Had I married a Mexican woman? Did I want to? Where was my family? What kind of work did I do? With good reason, many people who live in Tijuana harbor dark suspicions about gringos in their midst -- not so much so in places like Rosarito Beach, where an estimated 15,000 Americans live in pricey beachfront condominiums -- but in the everyday neighborhoods of the city.

I know from firsthand experience that many of my compatriots in Tijuana come to the city with bad motives: pedophiles taking advantage of the huge income differential to buy sexual favors from minors; SSI pensioners "disabled" by alcoholism, who pass their days and nights in cheap bars drinking beer at less than a buck a bottle; lawbreakers on the lam from justice; and con men of all varieties. I, too, had come to look upon other gringos with suspicion and disdain. I had spoken to many of them and been shocked by the assumption that all gringos shared their perversities. "I've already had three boys, and I've only been downtown for five hours," one dirty-old-man type had bragged. Others introduced youngsters 40 years their junior as a "girlfriend" or "boyfriend." Still others solicited "investments" for diamond mines in South Africa, promising returns in the millions, or asked me to smuggle bullets or guns into Mexico, a federal crime in a country where possession of a weapon is prohibited. The local news was full of reports of gringos arrested in pedophile sex rings, peddling child pornography, operating from their homes Internet sex sites offering "paid escorts," or nabbed with huge supplies of Valium or other illicit drugs. I still remembered a photo in El Mexicano, one of the city's four daily newspapers, of two drunken old gringos sitting handcuffed on the porch of a house in Playas with two huge marijuana plants growing openly in pots in the background. A neighbor had called police. And consider this September 8 posting on craigslist Tijuana: "Important note to owners/managers. Always check references thoroughly, especially when renting to Americans. Why are they in Tijuana if they are not of retirement age? Why would a 'professional person' cross the border to work? Check their car registrations, their driver's licenses, their visa status. Beware especially when people tell you how wonderful they are. Talk to at least one of their former neighbors. Helpful reminder from someone who knows the pitfalls of not checking ruthlessly."

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pampal Sept. 22, 2008 @ 11:49 p.m.

I also am an American living in Mexico and loving it. Agree with the author about the medical care. Since I have no med insurance I receive all my care here and agree that the standard of care is as good as, and even surpasses the care I have received in the US. The doctors here do spend so much more time with me and seem to be more thorough and LISTEN. I have had nothing but great experiences with both dentists and MDs. A nagging bladder infection was cleared up after years of suffering under the care of an Hermosillo urologist. A son in law found relief with a simple cream subscribed by a dermatologist for his bad case of phoriasis (sp?), and this after considerable expensive care in the US. The Cima Hospital in Hermosillo is one of the best and comparable to any US hospital, but at a cost of 25% to 50% of what a US hospital charges. Our friends are shocked that my husband and I get our medical needs taken care of in Mexico!

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