Oct 22, 2015 ยท 21 minutes

There’s an old guy I have coffee with sometimes, at the Starbucks near my house in Las Vegas.

We’ll call him Barry; it’s not his name, but then again, neither are the two or three names I’ve heard other people call him, all of which he cheerfully answers to.

Barry used to run numbers for the Irish mob back East, until he got busted and did a long prison stretch. He wrote a book about it and made some money off a movie option or two, enough to supplement his Social Security. His DNA may or may not hail from the Emerald Isle, but as far as I can tell, his real ethnicity is pure 100% 20th Century Mook. He wears Cuban shirts, white linen pants, weave-top leather hush puppies, and tinted glasses. He’s nominally retired, but based on the vague, half-coded conversations I’ve overheard him having on his phone, and some of the people he’s brought to Starbucks from time to time, I’m pretty sure he’s still involved in some shady gambling shit, even in his golden years.

Like most of the career criminals I’ve ever met, Barry is as conservative as a Mississippi alderman. He attends Mass faithfully (where he prays for my heathen atheist soul, as he constantly reminds me), believes Barack Obama to be some sort of Sunni socialist, thinks George W. Bush was the finest president we’ve ever had, etc. etc. He’s casually racist and homophobic in the kind of way that was last acceptable in polite society circa 1958 or so, and he spends a lot of time flirting with college girls, who let him buy them coffee and giggle at his old-fashioned notions of gallantry and his idea that they find a nice Catholic boy, settle down and start popping out babies.

When I told him I was going down to Ciudad Juarez to get my teeth fixed, he shook his head. “I been there,” he said. “It’s a shithole. Why the hell would you wanna go there?”

“I can’t afford to get it done here,” I said. “Of course, if we had universal health care, like a civilized goddamn country—“

“Oh, get the fuck outta here with that,” he said, waving his hand at me. “You’re a socialist, just like Obama. The Commies had a name for people like you, you know that? You wanna know what it was? They called people like you useful idiots.”

“Oh, for Christ’s sake—“

“Never mind. Don’t get me started. So how does this whole thing work? How’d you find ‘em?”

“Google,” I said. “Google and Yelp. I looked up websites for Mexican dental clinics, looked up customer ratings where I could.” Barry gave me a puzzled nod. As far as he is concerned, the Internet is a mechanism that exists solely for delivering sports scores and the front page of the New York Times.

“How do you pay ‘em? They take credit cards?”

“A lot of the clinics whose websites I looked at said they do cash only,” I said. “But I’m a little nervous about carrying a couple of grand in cash around in Juarez, you understand.”

“I’ll tell you what you do,” Barry said. He lit a Winston. “Back in the old days, I used to have to carry a lot of cash and paper around, back and forth — you know, I’d be going back and forth to different bookies. The cops would always stop me, ‘cause they knew me, right? I had this beautiful Pontiac, brand new, and they’d tear it all to shit trying to get something on me — the bastards! I’d be standing there by the side of the road, they’d be tearing open the goddamn dashboard, ripping up my upholstery, the works. But they never found nothin’, and I’ll tell you why: I kept it all in a roll, tucked up between my dick and my balls. Even if they frisk you, they ain’t gonna, y’know, search too hard there. Unless you got, like, a fag cop or something.”

“How did you keep it from falling out?” I asked. “I mean, I’d be afraid it’d come loose and go tumbling down my pants leg.”

“Well, you wear, y’know, like, tight underwear. Tightie whities.” he said.

That’s the other reason I hang out with Barry: he’s full of useful information.

“Look, if I was you, I wouldn’t go down there,” he said. “But you’ll be okay. I’m gonna pray for you. Just don’t try to buy dope or pick up a hooker. And don’t drink the water.”

* * * *

There are around fifty million Americans who have no medical insurance, and I’m one of them.

If you’re a citizen of any of the other nations considered part of the developed world, you may not fully understand the ramifications of this. In your country, everyone has access to basic free medical care, no matter what. When you go to the doctor for a checkup, or to the hospital in a medical emergency, you are not presented with a bill at the end of your visit.

This is not true in America. We have no nationalized health care program. We have something called Medicare that provides financial assistance for medical treatment, but that’s primarily for people over 65 years of age or who are disabled by their illnesses to the point that they cannot work. We have another program called Medicaid, also to provide financial assistance, but there’s a laundry list of requirements to be eligible for it, beginning with but not ending with poverty. In other words, if you are not indigent or close to it, you are probably not eligible for Medicaid.

Instead, Americans get their medical coverage through private for-profit insurance companies. You can buy your own insurance coverage, but it’s expensive; the average monthly cost (or “premium”) for individual health coverage in 2011 was $183 per month; for families it was $414 per month. Keep in mind, by the way, that this is merely your monthly fee to keep your insurance coverage. In addition, you have what is known as a “deductible”, which is the portion of any incurred medical bills that you are expected to pay.

For example, if you have a $500 deductible, it means that if you get hit by a car and run up $10,000 in bills, your insurance company will cover $9,500 of that, but you’ll have to pay $500 out of pocket. For preventative and routine treatment, there’s something called a “co-pay”, which means a fixed amount you pay every time you go to get a checkup from your physician, say. It’s actually more complicated than this: some insurance programs pay a percentage of medical costs, not a fixed amount, for example.

So in reality, an odd circumstance has evolved: most Americans who have insurance get it through their employers, who purchase group coverage at a discount. While five states (California, Hawaii, New Jersey, New York, Rhode Island) and one US territory (Puerto Rico) require employers to purchase disability insurance for employees, which pays the employee’s wages if the employee is unable to work due to non-work related injury or disability, generally employers in America are not required to provide health insurance to their employees. Even those that do often only provide it after a certain period (usually three to six months) and only to full-time employees; rarely are part-time employees covered, and contractors and freelancers almost never are. When you terminate your employment, your insurance is also terminated, though in many cases you can keep your coverage—at your own expense— thanks to a 1985 law called the Consolidated Omnibus Budget Reconciliation Act, or COBRA.

This system has evolved from the apparent notion that your employer has an interest in keeping you relatively healthy and not dead. Your chances of getting insurance benefits with any given job, and the coverage amounts and deductible costs, are directly tied to how difficult and expensive it would be to replace you if, for example, you happened to fall dead of a stroke or a heart attack on the way to the office. 

The CEO of a Fortune 500 company receives health care that would make most royal families snarl with envy, and probably pays less for deductibles than he does for macchiatos on the daily commute. A nineteen year old kid flipping burgers at the local gristle emporium might get two free checkups a year, if their franchise overlords are feeling especially progressive that quarter.

The practical result of this is that most Americans who have insurance benefits from their employer live in mortal terror of getting fired and losing their coverage. This often results in a weird sort of free-market indentured servitude, where employers know that they can shove any amount of horrible shit down their employees’ throats and get away with it, so long as they keep paying their premiums. It’s the main reason that a lot of Americans — my dad, for example — work at jobs they absolutely despise; not because it keeps a roof above their heads, but because it keeps the wolves of disease, death and disability away from the door.

All of this, of course, only applies to people who work for companies that actually insure them as part of their benefits package. For the other fifty million Americans, like me — who are unemployed or self-employed or who’ve slipped through the cracks of Medicare and Medicaid, or whose employers can’t or won’t provide them with insurance — medical care is a cash-and-carry affair, a higher stakes version of going to the mechanic when your car breaks down. If you go to a doctor in America and don’t have insurance, they’ll often run a credit check on you. If your credit rating is low enough, they’ll demand cash up front. If you’re in relatively good standing, they’ll work out a payment program with you. If you can’t work one out, they won’t treat you, period.

Emergency rooms cannot, by law, not treat you, but they will only admit you for, well, emergencies, and they’ll bill you accordingly. Hobble into an emergency room on a broken leg, without insurance, and you can expect to hobble back out with a basic cast, a prescription for cheap painkillers, and a bill between twenty-five hundred and fifty thousand dollars, depending on how badly you’ve fucked yourself up.

Get cancer or diabetes, or suffer a serious injury that requires long-term treatment in America, without insurance, and you’re fucked. If you can’t work at all, you might be eligible for disability, but you’ll receive a pittance and live in constant fear of having it revoked. And if some bureaucrat looks at your application and decides you can still work some sort of job — even if it’s difficult or nigh-impossible or utterly outside your skillset or career path — you are, as the man said, proper fucked. You’ll end up sitting on a stool right inside the front door at Wal-Mart, greeting sullen hillbillies for the maximum number of hours you can be employed each week without qualifying for the big corporate health benefits package, and spending your federally mandated fifteen minute break periods trying to figure out how you’re going to pay for your physical therapy on a paycheck that, if you’re lucky, is slightly above minimum wage... or if it’s just easier, in the long run, to head over to the sporting goods section, shove a Remington 12-gauge in your mouth, and spray your pain-ridden neurons all over the morbidly obese pig-woman with the tank top that says ONLY GOD CAN JUDGE ME and a gallon bucket of generic vodka in the basket of her whining and smoking electric mobility scooter.

As John Cougar Mellencamp once said: Ain’t that America, something to see?

* * * *

The Border

My hotel is called the Camino Real, and it’s celebrating its centennial this year. It’s nicer and more expensive than I was aiming for, a venerable seventeen story affair that rises above downtown El Paso like a dignified old dowager aunt in a whip-tight corset.

I had planned to find some sort of shitty cheap motel on the border and stand out on the balcony all night in my wifebeater, smoking cigarettes and staring out into Mexico like some postmodern version of Robert Mitchum in Night Of The Iguana. But those don’t seem to exist; all the cheap motels in El Paso are in other parts of town, miles away. And let’s be honest: in a couple of days I’m going to get some major replumbing done on my mouth, and I’d rather not recuperate in some fucking ramshackle Motor Oasis where I have to worry about the downscale junkie in the next room smashing down my door because he can smell my pain pills through the wall.

Not that I’d worry much. For one thing, I’ve got my trusty Gerber Chameleon II serrated pocket knife, the blade of which pivots around an integrated ring in the handle you slip your finger through like the trigger guard of a pistol; it won’t slip in your hand no matter how slippery things get, and it’s damn near impossible to take it away from you. These are signature virtues in a knife. I never leave home without it, ever since the night I came across a dying woman in a car accident out on Boulder Highway in Las Vegas and she choked to death because I didn’t have anything to cut her seat belt away from her larynx. That was rough.

I’ve also got another new toy, slipped into a tight Cordura sheath and shoved into the bottom of the gaudy blue embroidered suitcase I bought in Turkey last time I was there. It’s a footlong matte black pigsticker that looks like the unholy spawn of a bushman’s machete and John Rambo’s trusty Ka-Bar survival knife. Razor-sharp on one side and serrated viciously on the other, it looks as if it’s been designed solely for the purposes of hacking some son of a bitch’s head off, and it makes me giggle every time I look at it.

I’m carrying this demon’s plaything because after talking to a few cops and DEA people and other writers, I’ve become increasingly paranoid about this whole trip. Mexico in general (and Juarez in particular) is one of the most dangerous places on Earth to be a journalist. Reporters Without Borders lists Mexico as #149 on their list of the 180 worse places to be press; just last week a high-profile anti-corruption blogger disappeared in Mexico City, ahead of their upcoming elections.

The local drug cartels aren’t known for their subtelty. If they get wind that I’m a writer, they’re not likely to find out if I’m doing some hard-nosed investigative reporting on their business or just a big goofy Anglo dipshit trying to get his goddamn teeth fixed and write about medical tourism. They’ll just take me in some alley and empty a clip into my face and ask questions later, which is to say never.

Hence the pigsticker. Unfortunately, as I’ve discovered, I can’t carry it into Juarez itself: owning a gun or even a pocket knife is illegal in Mexico. If I get stopped by la policia — who, I’m told, love to randomly stop tourists and shake them down for bribes — and they find a knife on me, a discreet $20 isn’t going to get me out of it. I’m going to jail. And in a city where the police are notoriously corrupt and on the payroll of the cartels, I’m likely to end up in that back alley with my brains sprayed on the wall anyway.

So I’ve mainly got it to make myself feel a bit better, and just in case some maniac cocaine cowboy decides to take a trip up north in the middle of the night and turn my hotel room into an outtake from The Shining. It’s unlikely in the extreme that this will happen, because despite the Sam Peckinpaugh levels of wholesale violence right across the border, El Paso is the safest city in America. (And more about that later.)

But what the hell. One of the best things about being an American is that you can trot down to Wal-Mart and buy a knife big enough to skin a Hessian soldier for less than the price of a decent meal, on the off chance that a Mexican cartel assassin tried to murder you.

The advice I got about visiting Juarez from the cops and the DEA guys and the writers and even WikiTravel was: simply don’t. Don’t go to Juarez, and if you’re going to go, don’t go without an escort, and for God’s sake, don’t be there when the sun goes down. I started to get visions of some kind of Pandemonium on Earth, maybe an entire city that’s like the Titty Twister bar in From Dusk ’Til Dawn. Maybe Juarez is just full of fucking vampires.

After I check into the hotel and take a shower, I decide to go walk around downtown El Paso and find some food. Downtown is mostly late 19th and early 20th century midrise buildings, a lot like downtown Seattle... but it’s a ghost town now, even at six thirty on a Saturday night. Most of the ground-level storefronts are empty, their display windows dusty without even a token FOR RENT sign in them, and the few that seem to still be occupied are dark and shuttered, except for a few 24-hour bail bonds joints, where Mexican girls in ratty office-casual skirts sit on the stoop and smoke and wait for someone to need their services. There are almost no cars in the street, no people on the sidewalks save for a couple of homeless guys. It’s shadowy and silent and frankly creepy.

I head south down Stanton, and the midrises give way to single story houses, stucco rather than brick, huge, faded murals of Jesus and the Virgin Mary covering their walls. I begin to understand something. On a map, the border between Mexico and the United States is a thick black line. Politically, the border is infinitely thin: according to governments, to policy and treaties, there is no fuzziness between the two countries. You’re either in Mexico or you’re in Texas.

The reality, of course, is more complex than that. When you walk south of the Canam Highway in El Paso, you begin to notice that all the signs are in Spanish instead of English; that all the people you pass, sitting on the stoops of their tiny houses and drinking cerveza and chatting are speaking Spanish instead of English; that the loud music drifting through the hot Texas night air from a few blocks away is Mexicancumbia, and when you follow it to its source you find an eight-piece band in matching red shirts and black vests standing on a portable stage parked in the middle of a side street, playing to the dumpy middle-aged Mexican women with dyed blonde hair beneath their Stetson cowboy hats and denim mini-skirts and Justin boots, who dance sinuously on the pavement as their children run between them giggling and laughing, their tongues dyed improbable shades of crimson and aubergine from the shaved ice cones they’ve bought from vendors who sit, bored, inside of unlit makeshift plywood booths. You realize you’re the only Anglo you’ve seen in an hour, maybe the only one for a couple of miles in any direction.

And maybe you’ll understand that the border doesn’t really exist at all, except in the minds of politicians. This part of Texas never stopped being Mexico, really, even when the norteamericanos came and put in the Whataburgers and the Wells Fargos and started bitching about los illegals coming over and stealing jobs from white folks — as if the white folks didn’t steal the land from the Spanish in the first place, who in turn stole it from the Aztecs, who stole it from the tribes that wandered this rough, hot land before a single conquistador ever set booted foot on American shores.

El Paso isn’t American or Mexican. It’s Tejano, and probably will be until the Sun expands and burns away the dirt and the cacti it’s been slowly baking for a billion years.

Tejanos aren’t like the Hispanics in Las Vegas or Southern California, who tend to be first- or second-generation immigrants, with all the pride and resentment that status carries with it anywhere. In a Hispanic neighborhood like this in LA or Vegas, I’d expect to see scary dudes with shaved heads and elaborate tattoos on every square inch of exposed skin. I’d expect to see a tricked-out low-rider go by every couple of minutes blasting hip-hop or reggaeton, girls in skin-tight outfits with their eyebrows carefully plucked and drawn back on in giant arches that leave them looking perpetually surprised, lurching down the sidewalk in ludicrously high heels, screaming brassily back at the assholes who drive by them and yell obscenities. I’d expect to see street people, in other words, signaling don’t fuck with us in a pantomime that needs no translation.

I see none of that here. Just people, hanging out with their neighbors because they’re too old or too young or too poor to go to a nightclub or a bar. This is a safe place, for them and for me.

I watch the cumbia band for a while. They’re pretty good. But I get bored, so I keep walking, past a big lot full of rusting furnace boilers surrounded by razor wire, until I find a taco truck parked next to a convenience store. The kid taking orders seems a bit nonplussed at a big-ass gringo wandering up out of the dark, but he’s kind enough to ignore my crude imbecile Spanish and repeats my order of uno tacos asada, por favor back to me in English. I take my tacos to a makeshift picnic bench made from scaffolding and two-by-fours and sit next to the women who gossip as their kids and grandkids run around in their Super Mario Brothers t-shirts and wolf them down. They’re pretty goddamn good, especially with the salsa verde the kid gave me wrapped in a little plastic sack.

Taco achievement unlocked, I keep moving, still restless and curious, still southward, until the residential road I’m on dead-ends into a six-lane thoroughfare with a wide median called Cesar Chavez. On the other side are train tracks... and beyond them, the Rio Grande, and Mexico. About a mile down the road, a massive bridge lit up like a Christmas tree arcs up and over the train tracks and the river, down into Juarez.

I look at it. I look north, over the rooftops, to where I can just see the top of the Camino Real hotel. I wonder if I’m making a huge mistake. It’s not like the desk clerk’s gonna notice if I don’t come back.

I bend down as if I’m tying my shoe, surreptitiously slip the Gerber out of my hip pocket into my Doc Marten work boot, and slide the cuff of my jean back down. You can’t see it at all. I pat my ankle. Even a vigilant Mexican policeman, I think, wouldn’t catch it there.

So I head for the bridge. Fuck it. Why not?

Part Two: "Even the little kids... one might have a knife"


This story was originally written for NSFWCORP, now part of Pando. To read the full story right now, get the ebook version on Kindle or iBooks.