Suddenly a scream comes from the barred entrance of the Armonia Transformation Center in Jalalpa. Doctor! Help! Come! We rush up the stairs and out the door. We follow a man running down the street, turn right and enter a little two floor house. Up the stairs there is a small room. A hammock is there, torn on one end but fixed to the wall on the other. On the floor lies a small, motionless boy. He has no pulse. He is not breathing. He is warm. We chant ABC – “airway, breathing, circulation” as we ready ourselves. We commence two person CPR, two old retired doctors working at the Armonia center a short block away. And we continue. No pulse, no respiration after thirty minutes or more. Pupils fixed. This beautiful boy is dead.

His father bursts into the room. He picks up the little boy by his arms, raises him up and down using a method of artificial respiration we used 40 years ago. We go downstairs. Finally after an hour a police car arrives, then later an ambulance. We don’t need an ambulance. We don’t need the police. We would have needed a defibrillator, and EMS personnel, but not an hour later. There is no 911 in Mexico for the poor. For them, the nearest hospital is three hours away on a good day through the traffic.

That night we return to console the family. They, of course, are grief stricken. They say this had to be an accident with the hammock. But one relative tells us that the little boy’s uncle killed himself several months ago. A patchy story. They must cling to the accident theory. But we know. How to help this family? How to unravel the relationship between the boy and his uncle? Should we try? How did they know to come to the Armonia Transformation center just around the corner for help? How did they know there were doctors there? Could we involve the family in counseling at the center?

And what of the total lack of response by the authorities? The lack of emergency care in one of the largest cities in the world, Mexico City?
And how about us? How would he fare in downtown Detroit, or L.A. amongst our urban poor?