The Undocumented Americans Read online

  The pharmacy sells homeopathic ointments and creams. They also sell cleaning supplies, Central American folk dresses, pants sets in tiny sizes for children, and off-brand makeup. There are glass-enclosed shelves under lock and key, prudishly guarding condoms, yeast-infection treatments, and pregnancy tests. Julieta approaches a young woman who assists the doctor and who has “trained” at the pharmacy for many years. Julieta asks me for a symptom to relay to the young woman, and I describe a toothache, which I had in earnest the day before. I describe swollen gums where my wisdom teeth had been extracted, which the Internet tells me is a phantom pain. I ask Julieta if one might be able to purchase pain medication, and she asks for hospital-grade Tylenol. The young woman gives Julieta five pills in a small white envelope. We walk outside and stand on the street corner where we met, squinting in the sun and shielding our faces from the dust. She tells me that if I had walked into the pharmacy on my own, they would not have given me anything because of my accent. “Do you mean an Ecuadorian accent?” I ask leadingly. (My Spanish is telenovela Spanish: fluent, formal, regionally vague.) “Well, just your accent, they would have known not to trust you because of your accent,” she says.

  I ask Julieta if she ever resorts to alternative medicine in the absence of access to doctors, and she dismisses folk medicine as something that Cubans and Haitians do. “They have ridiculous beliefs with respect to medicine, and you’re not going to leave them without them doing a prayer on you,” she says. Instead, she describes another form of alternative medicine. “I have migraines and I have a Cuban neighbor who loves me. She was born here, and she’s insured. She goes to her doctor and pretends she has migraines, she says that the light bothers her, that she throws up, and he gives her medication. She shares. A lot of people count on other people. My sister is a citizen and she gives her blood pressure medicine to a woman who is undocumented.”

  Julieta swears by hospital-grade Tylenol because she, too, sometimes gets intense pain in her molar. She goes to a Honduran man who was a dentist in his home country but cannot legally practice in the United States; instead he goes to private homes to fill cavities. “He does a very good job,” she says. I have only a couple of dozen memories of my early childhood, and one is of my father writhing on the floor with tooth pain. My mother and I just stood back and watched, sometimes bending over to pat his arm, until the pain stopped—it took about a day. Either he would die from the pain or the pain would stop, and that time it stopped.

  All my life, I have accompanied my parents to the doctor. I am their interpreter and advocate. They have gone to the emergency room only once, being pretty good about preventive healthcare and making regular appointments at the local community health center that sees low-income people on a sliding scale. For years, the chief doctor there was an Indian man who didn’t speak great English and didn’t speak great Spanish but who spoke with patients of all nationalities and languages without an interpreter anyway. He didn’t like me and I didn’t like him. When my mom was in her forties she found a lump in her breast, and he explained to me why ordering mammograms for women in their forties was a waste of resources, especially when the patient was uninsured and insurance couldn’t pay for it, if you looked at the number of lives that early detection of breast cancer saved. I don’t think doctors are supposed to worry about the bottom line, I tell him. Didn’t you take an oath? I am maybe eighteen. Aren’t you smart, he says. That’s her! She goes to Harvard, my mom says. That’s right, motherfucker. I go to school in Boston. Well, not Boston. Cambridge. Just a little school in Cambridge. One day I’ll make so much money that I’ll pay for my mom’s mammograms in cash, in crisp one-dollar bills, like a muhfucking kingpin. I’ll buy this clinic and turn it into a museum for myself, in honor of me. I can hang up your children’s diplomas for a special exhibition on children of doctors who go to state school, you cheap-ass motherfucker. I will ruin you.

  “She has history of breast cancer in her family” is what I actually said.

  A lie.

  “I’d appreciate it if you ordered one.”

  * * *

  —

  I have had the good fortune, mere dumb luck, to always have had access to decent healthcare—New York City provides low-cost insurance to minors in low-income families, and then I went on to universities that provide insurance to their students—and I view it with the awe and gratitude that only someone who has seen healthcare rationed could appreciate. When I was a child and I was sick, I went to the doctor. When my parents got sick, I saw them breathe in the vapor from a boiling pot of chamomile to moisten their inflamed bronchi, not the most effective way of treating bronchitis. But you just said your parents had access to the local community clinic, you say? Sure, for preventive healthcare. Blood pressure, weight management, the common cold. My mother has low hemoglobin levels. You can’t get care for that on a sliding scale. In a New York Times article from 2015 titled “Wary of Mainstream Medicine, Immigrants Seek Remedies from Home,” the author writes wide-eyed about the use of medicinal herbs among immigrants in New York who buy them at folk shops called botanicas.

  But I don’t find this reliance on folk medicine charmingly idiosyncratic. Celebrating the treatment of illness with herbs purchased at the same place where love potions are sold is curious to me, especially through the gaze of an outsider. Many people I know, educated, well-off people, love alternative medicine. Whether the effect is real or placebo is not the pressing issue here, so much as the matter of choice and access. Those with resources might drink alternative tea treatments but will ultimately have the choice to have their cancer treated with chemotherapy and not herbs, an option undocumented immigrants do not have.

  But if you’re going to try to treat an illness with herbs or prayer, you’re probably going to have to frequent a botanica. Botanicas are named for the herbs sold inside shops that also stock oils, soaps, sprays, washes, statues, rosaries, amulets, books, and animal skulls. They’re everywhere in immigrant neighborhoods. I wasn’t allowed to go inside them as a kid because they were associated with dark magic. That’s because for most of my childhood we were Catholic, and then Jehovah’s Witness, while the belief systems that support the botanicas are vodou and Santería, two misunderstood religions that date back centuries. Santería and vodou were born when the Spaniards and French forced conquered peoples to convert to Catholicism but the people found a way to continue practicing their religions by combining them with Catholic iconography and rituals.

  It is difficult to know how many botanicas there are in the United States because they are commonly registered as religious or herbal stores (or pet shops, because they sell small animals) and are thus not subject to the regulations that would apply to therapeutic establishments—including the need to register with the government, but that doesn’t stop some Latinx people from using them for medical treatment.

  In Miami, a woman named Esme—whom I met through Julieta—tells me she sometimes uses botanica herbs to treat illnesses, and I ask her to show me around some local botanicas. Esme is forty-nine years old and has lived in the United States for fourteen years. She has a dusting of freckles on her nose, with skin and hair the color of dull copper. Esme finds everything funny and her laughter is contagious. We meet at an overly air-conditioned Starbucks, where she orders a hot chocolate. “I’m a defender of alternative medicines,” she says. But she erupts into laughter every time she mentions the herbs she used to treat a recent bout of pneumonia because she couldn’t see a doctor. “I don’t know what cured me, but I got better.”

  Her husband, Johnny, picks us up in his car. Unless you live in cities where immigrants can legally drive or in cities with excellent systems of public transportation, to be undocumented means you drive without a license in order to simply go about your day, which means always running the risk of being pulled over, charged, and deported. I am a little afraid when I get in the car because we could be stopped for literally anyth
ing, but I relax when I learn her husband is a permanent resident. We drive to the Great One Corporation, a large storefront with a garish seascape mural covering two walls. A mermaid that looks like Cher advertises that they are also florists. They do sell a lot of ceramics, but the only pets I can see are the small canaries in cages for sale along the entire length of a wall. “Oh, here’s some linden blossom,” Esme says as she points to a splintery yellow flower. “It’s for nerves but it never works for me.” There are baskets containing uva ursi, which looks a bit like holly, and yerba Buena. A tall porcelain figure of a black orisha named Obatala, the chief orisha and creator of human bodies, stands on a glass shelf. He is black, with a long, flowing gray beard, and wears a white turban and cloak. Underneath Obatala is a stash of brazilwood, said to cure diabetes, anemia, high blood pressure, and UTIs, and to be generally helpful in purifying blood. Nearby are piles of screwdrivers and hammers. Botanica Olocum is also a hardware store.

  I approach two women behind the counter and ask them what they’d recommend for depression. They are both middle-aged. One of them has bleached hair. They look at each other and have an exchange under their breaths, then point to a stand containing books and pamphlets. I buy a small illustrated book printed on pulpy newsprint called Cure Yourself of Alcoholism Through Natural Medicine. It is part of a series inspired by the works of Dr. Edward Bach, the British doctor and homeopath whose eponymous flower remedies are foundational to homeopathic practice. (I remember a small glass vial of brand-name Bach white chestnut that I was gifted a couple of years ago by my in-laws. “Take two drops when thoughts and worries go round and round in your head,” the bottle said. It was 27 percent alcohol, and after seeing a fat opossum cross the street one summer night when I was sitting on the porch I drank half the bottle. It was like taking a shot of tequila. I felt better.)

  After Esme is done pointing out the useful herbs, we head back to the car. She and her husband hand me a gift: a small waxed-paper envelope containing a dream catcher and five energy stones. “These stones are not Santería,” her husband explains to me. “This is what yogis do. The earth is vibrating and the stones have a different kind of vibration so they absorb different energies. The pharmaceutical company Bayer sent people to the Amazon to find indigenous cures for things and that’s where they got their formulas. Of course, the problem with medicine now is that it doesn’t cure illness. The doctor prescribes pills that won’t cure you, just keep you a slave to other pills. They want patients to keep being patients. Medicine wants you to be a client.” Her husband goes on and on and on as we drive to our next destination, and Esme doesn’t say anything, just laughs softly, which she does as easily as she breathes. A little bit like Marilyn Monroe: a dark, girlish, worldly laugh. We arrive at a small pharmacy next to a fried-chicken joint. Another clandestine operation. Esme’s husband approaches a man behind the counter and says that I am a friend. I ask for medications that I am either on or have at some point been on so the feds can’t accuse me of looking for drugs later. First, I ask for Latuda, an antipsychotic. “Nope,” he says. “That’s an expensive one.” Okay. Risperdal. “What dosage?” It’s been a while, so it’s all muscle memory here. Three milligrams? He brings out a bottle of brand-name Risperdal, which has $3 written on it in marker. Maybe I can go back on Seroquel, I tell him.

  “What dosage?”

  Six hundred milligrams. He goes to the back for a few minutes and comes back with a white bottle of brand-name Seroquel with $5.50 written on it in marker. I thank him for showing me my options and promise to come back later.

  Seroquel and Risperdal are powerful antipsychotics. They’re tough drugs. Mean. The side effects can include akathisia (a feeling of bodily restlessness), sedation, and increased levels of the luteotropic hormone prolactin, a pregnancy hormone that causes mammals to produce milk, even if they’re not pregnant, even if they’re not female. In the long term, this can cause osteoporosis. There can be periods of nausea so bad you’ll be prescribed antinausea meds used for patients on chemotherapy. They can be lifesaving drugs, but require careful monitoring and any changes should be incremental. I’m scared at the thought of people taking these meds without supervision. Both carry black-box warnings, the strictest possible FDA warning that can appear on a drug’s packaging. There’s a potential increase in suicidal thinking in youth, and elderly patients with dementia have exhibited higher rates of mortality, usually due to cardiac arrest or infection. The people who would resort to purchasing antipsychotics without a prescription at a pharmacy like this are not necessarily people who do not trust doctors due to cultural reasons. It’s a different kind of people who would find themselves at a place like this—people who feel lucky to have found a shot at a miracle, even if the miracle risks deeper trouble than they can imagine.

  Later that night, I take a cab to a lush, remote neighborhood outside Miami to attend a ceremony to initiate new priests and priestesses into vodou. I was invited by a local Haitian priestess named Roseline, a friend of a friend of someone I cold-called. I am generally unfriendly toward institutionalized religion, but vodou is a religion that was born out of anticolonial resistance—slaves in Haiti developed a spirit religion based on African, Native American, and Catholic beliefs, a true syncretism. Though French colonizers openly opposed it, slaves kept nurturing the belief system, creating a space where they could be free and where they could communicate with god through spirit intermediaries—so I have an open mind. At least, until I remember the caged canaries in the botanicas from earlier that day and become anxious about the possibility of witnessing an animal sacrifice. I suggest to Roseline that I am cowardly about “animal things.” I say this delicately because I don’t want to seem dismissive of their ritual, but I am also having a hard time shaking my Western sensibilities. She obliges me by not responding. I regret asking about the animals.

  During my first visit to Miami, there were rumors that the current administration will be rescinding TPS (temporary protected status) for Haitians, the program that allowed victims of the 2010 earthquake in Haiti to stay in the United States temporarily with a protected status, meaning they could live and work legally. The wait period before TPS expires is a crazy-making purgatory. I came to Miami just as many Haitians were contemplating what it might feel like to become undocumented and deportable overnight. People were scared. And scared people are vulnerable.

  I arrive at the ceremony, which is held in a private home. I am so embarrassed about the animal question that I immediately try to compensate. I hug everybody. There are folding chairs fitted with white sheets and guests are wearing all-white everything. I’m wearing a black dress like a fool. I stand to the side and admire the artwork on the walls. There is a painting showing a group of topless women dancing near a large pig as a man approaches it with a sword. Someone dressed in all white hands me a Corona and asks me to put my notebook away. I approach a young man who seems about my age. He’s leaning, and I like boys who lean. Jacob is tall and really cute and very warm and is actually so, so young. I learn that he is a priest already, that the spirit chose him when he was young, and in fact everybody at the ceremony either is, or is about to become, a houngan (priest) or mambo (priestess). “When people hear about vodou, they hear about negative stuff,” he says, “but there are different branches. There is healing, there are treatments, there is protection. There is also bad stuff, but I focus on the good.” He tells me about a friend who couldn’t walk but after a vodou treatment is up and working. That sounds good to me, so I ask about cancer. “I was told there is a cure” is all he says. He knows a lot about herbs, so I ask where they’re grown. “We grow them ourselves,” he says. “Down here, in Florida, you can find plants on the side of the road. I also go to an old lady in Little Haiti to get herbs. She’s a friend.” He gives me specifics, which other people I speak to are reluctant to do—papaya leaf to keep your insides young, cerasee to clean out your system (“for example if you’re on probation an
d can’t be on drugs, this keeps the drugs out of the system”), sapo tea for diabetes, and vervain for low iron levels.

  He walks me over to a dapper older man named Henri, who raves about vodou’s medical efficacy. “They’re the best antibiotics I know,” Henri says. “There are herbs that can cure AIDS, high blood pressure, diabetes, swelling, blood clots, skin cancer—they just clean out your system,” he says. He tells me I can find them at a botanica in Hialeah and he has friends who can grow them for free. “There is a leaf in the Amazon that cures cancer,” he says. “Only Africans and Haitians know the cures.” I ask how a cure for cancer could possibly be kept only among a small group of people. He doesn’t know.

  During the ceremony, a man dressed as a warrior holding a machete comes up to me and spits a liquid at me, which he says will bring success to everything I do. I overhear two people saying they don’t trust me because I’m showing them too many pictures of my dog. There is a lot of alcohol at the ceremony—they bring out a strong blue drink, and I am told to drink it, and I do. I bond with some young mambos and houngans at the ceremony. I take down phone numbers. I’m fully aware of my surroundings, and I interview people about their experiences with vodou, but when my parents call me, they tell me my speech is slurred. I don’t remember calling a taxi back to the hotel, but that’s how I got home. In my room, I put on pajamas, take off my makeup, and go through my elaborate skin-care routine. It’s weird. If I was drunk, I wouldn’t even have brushed my teeth. When I wake up the next day, I am not hungover. But I do feel odd, kind of floating.