The dentist is a taciturn son of a bitch who doesn't speak much English and he has a device in his hand that looks, in my peripheral vision, like a steel bar with a sharp screw on one side and a thumb dial on the other. He's going to screw this thing into my ruined back molar like a drywall anchor and rip the tooth out of my skull.
He jabs in another long, sharp needle full of anesthetic. After two and a half hours in the chair -- during which time an oral surgeon has removed my upper wisdom teeth by sawing them into pieces and pulling them out through my gum -- my face is pretty much numb from my cheekbones to my Adam's apple. But I still feel the jab, which worries me.
It worries me a lot more, a second later, when he puts his little drywall anchor to the top of my tooth and begins screwing it in. My head is filled with white-hot agony. I yelp and he pulls back. "What?" he says in English. "Pain?"
"Fuck! Yes, there's pain, Jesus fucking Christ, goddamnit," I snarl.
So he hits me with the needle again and tries the screw: it still hurts as bad as before, and I scream again. But after those two and a half hours, I just want this over with. "Fuck it, man," I mutter through lips that feel like they're constructed of inner-tubes. "Let's do this thing."
Of course, what neither of us knows yet is that the dentist is pushing the needle straight into an infected part of my gum, and the infection is immediately soaking up the anesthetic. He might as well be injecting me with sugar water.
Oblivious, he bores in. And that's when I start screaming for real.
This is how you find yourself in a dentist's chair in Ciudad Juarez, Mexico, inadvertently having a molar pulled without the benefit of anesthetic, crying and howling and kicking the floor while trying hard not to actually move your head.
For starters, you visit a Las Vegas emergency room having suddenly found yourself unable to spit. A pretty young doctor tells you that your wisdom teeth have kicked into some sort of cellular overdrive, running amok through your skull and slowly, inexorably crushing all the rest of your teeth together. The kicker, she says, is that left untreated they are likely to grow through your sinus cavity and into your brain.
None of that would be a problem, of course, if you lived in the vast majority of countries in the developed world which considers universal health care to be a basic human right. But you don't. You live in America and have spent most of your life working low-paying freelance writing and web development gigs. And so, like 50 million of your fellow citizens, you have no medical or dental insurance.
But there's light at the end of the tunnel. You once spent a couple of weeks during the height of the recession sitting in the sumptuous Las Vegas McMansion of a telemarketing impresario, building link-bait websites for him while he watched Fox News on a TV. While taking a smoke break on the patio one day, your sole co-worker told you about how he went down to Mexico and got a king's ransom worth of crowns and bridgework done for pesos on the dollar. You filed this information away in the back of your (aching) head for future reference.
Eventually, the impacted wisdom teeth and the tiny cavities they caused in your other teeth become so painful that you start having teeth pulled by dental school students and emergency dentists. All the while you're obtaining painkillers on the black market just to be able to sleep at night without crying once your prescriptions run out, because it's still cheaper to get Oxycontin from some club kid with an overfilled prescription than it is to go to an actual doctor for a refill. You're extremely careful not to get addicted to them, but all things considered, you'd rather not spend the rest of your nights popping opiates and wandering around your house waiting for them to kick in, like some kind of white-trash Howard Hughes.
Finally you get a real job. As lead developer for a new publishing outfit called The Not Safe For Work Corporation. Your new boss tells you that since you don't have insurance, he'll pay for your dental work, if you promise to a) stop constantly moaning in pain and nodding off from painkillers like a homeless junkie out front of the bus station, and b) get treated in Mexico and write about the experience in the most gruesome of detail.
And so you Google "Mexico dental clinic" and pick a place in Juarez because their website is in English and also doesn't look like the front window of a Tijuana bootleg record shop... despite the fact that Juarez is a battleground between rival narco gangs with a reported murder rate, in 2010, of 3,100 people.
Your wife begs you not to go, your gangster friends offer you advice on hiding your money from gangs and dirty cops ("roll it up in the space between your dick and balls") and even your boss starts to have second thoughts. But your mind is made, and your teeth continue to creep brain-wards. You make an appointment and book a flight to El Paso, Texas.
The fact that I'm still alive to share this story is even more of a surprise to me than it is to you. I have legendarily poor self-preservation skills... which is how I found myself, on my first night in Juarez, wandering around the backstreets after dark, being propositioned by a diminutive, aggressive prostitute with a face like a mean-ass bulldog and a baby in a threadbare stroller, who invited me to have "sexo por dolarés" with her in a narrow, muddy alleyway. (I declined, as much on aesthetic as moral grounds.)
When people in Juarez and El Paso talk about "the violence", you can hear the capitol V: la Violencia. Things have got better recently, for sure -- at least since that high watermark of homicide in 2010. But, to be fair, things couldn't have gotten much worse unless the narcotraficantes set up industrial meat grinders on every street corner and just started tossing random pedestrians into them. But still, since the height of the Violence in 2010, the murder rate has dropped by more than 50 percent.
Yes, Juarez is an incredibly dangerous place but, so long as I didn't take up any of the cabbies who hung around every corner on their half-whispered offers to take me to places with "nice girls, young girls, si?", or try to score coke from a random street dealer, I felt safe enough. At least with my trusty pocket knife hidden in my boot.
Mostly Juarez isn't scary, it's depressing: a poor city that exists in a weird symbiosis with the wealthy nation on the other side of the Rio Grande. The drug trade is almost entirely an export business, but so are the maquiladoras where workers toil long hours in terrible conditions for low pay. A local source explained to me that the multinational corporations discovered that the Juarez maquiladoras couldn't consistently maintain the quality control required for actual manufacturing... so instead, all the MP3 players and iCarly backpacks and other bits of consumer gomi that end up on the shelves of your local megamart are actually manufactured in cyclopean Foxconn-style factory-cities in Chinese and Taiwanese free-trade zones. Then it gets loaded into shipping containers onto big-ass boats that make their way across the Pacific to Juarez, where marginally-skilled workers stick it all together for an average wage of $7.50 a day.
Thanks to the complex and nearly occult intricacies of trade agreements, most of the workers in Juarez can't afford to buy even the crappy stuff they make when it finally arrives in local shops. Perversely, it's cheaper for them to cross the Santa Fe Bridge into El Paso, where dozens of discount stores await them, their window displays filled with paper-thin bedazzled jeans, blunt cutlery sets, and pirated or no-longer-fashionable haute couture, like Aeropostale and Bugle Boy.
When it comes to medical and dental work, however, the situation is entirely reversed. As happy as I was to introduce my (very) modest dental fees into the Mexican economy, it's absolutely goddamn ridiculous that, in 2012, a citizen of the most powerful nation on the world has to jump the border to get the kind of basic medical care that the United Nations defined as an absolute baseline human right in 1948.
The employer-supplied insurance model that predominates in this country perpetuates a de-facto feudal system, within which many Americans (like my father) stay in meaningless jobs they despise, simply because they have no other way to ensure even minimal medical care for their families. The average Papa John's pizza delivery driver or cashier doesn't make enough money working full-time to afford a two-bedroom apartment anywhere in America... but Papa John's CEO John Schnatter plans to lay off or reduce the hours of these employees, because when Obamacare kicks in he'll be required to eat four or five cents of the profit on every pizza served to actually provide these poor bastards with basic medical care.
(Schnatter, on the other hand, lives in a 40,000 square foot house in Louisville, on a 16 acre spread, with a golf course, private lake, and 22-car underground garage. With a turntable to help park his stretch limos.)
If you're Schnatter -- or one of his ilk, sitting at the head of the boardroom table, planning to lay off your employees because they'd like to not die if at all possible -- how do you spin this? How do you look at your employees -- hell, at your shareholders -- and tell them that profit is not only your first priority, but your sole priority? That you pay lip service to all those pathetic old tired chestnuts of corporation-as-family and rewarding people for their hard work, but that you really don't give a damn if the people who actually bake your pizzas -- the people that keep you in stretch limo turntables and catered lunches -- can get their hearts checked or their rotten teeth removed?
And what about the rest of us -- those 50 million Americans who don't have insurance at all? We don't go to the doctor when we feel a bit under the weather; we go when we hurt so bad we can't work, can function, and we sit in the waiting rooms of cheap clinics, read outdated magazines and pray we don't hear those awful invocations: malignant, inoperable, if we'd caught it in time. We bail out banks when they're utterly mismanaged by psychopaths in Savile Row suits, but we're unwilling to bail out people who work hard their whole lives and still can't afford to pay their doctor's bills? Should we, all fifty million of us, collectively go screw ourselves?
Or maybe Congress will just set up some sort of program where the sick and broken are picked up and bussed across the Santa Fe Bridge to get their healthcare in places like Juarez and Los Algodones and Tijuana. We can wave hello to the maquiladora workers headed the other way, to buy all the junk we're happy to let them assemble but can't be bothered to sell them in their own country. Maybe we can trade them cancer medicine and painkillers for Hannah Montana school binders and knockoff Gucci purses.
Joshua Ellis' new book, The Vampire of Juarez: Getting My Teeth Pulled In Mexico's Most Notorious Border Town, is published today by NSFWCORP.