The hospital in Veracruz

This is where I began working on my first day in Mexico, the Emergency Department of the Hospital Regional de Alta Especialidad de Veracruz:

There's always a crowd of people outside waiting to be seen, accompanying patients, or waiting for relatives who have already been admitted. Throughout the night people sleep outside on the curbs. Sometimes soldiers are posted at the door and in the hallways for reasons that are not quite clear; young men in helmets and boots with rifles at the ready. This is also where the ambulances pull up to deliver patients.

Inside is a triage area, a trauma bay, and the main ward:

This photo is pretty classic. It was taken around 6:00 am, when these residents had already been on duty for almost 24 hours and with another full work day to go before the end of their shift.

On the desk are typewriters for patient charting. In the absence of a computerized charting system, all patient notes are typed on vintage manual typewriters. Immediately following rounds, the ward is filled with the clatter of progress notes being typed on half a dozen typewriters. Despite my limited Spanish skills I was able to help with a little of the more mundane typing, but I needed a refresher course in ribbon management.

In the center a resident holds a film up to the ceiling lights to examine it. There's a light box in the trauma bay, but not one at the resident workstation. Thoroughly examining a film using an overhead light fixture requires a certain art. In the background is a patient on a ventilator, and to the right another ventilator is standing by. It's not unusual for there to be three or four patients on ventilators here at a time.