by Paul Rousseau

Immigration is too big to ignore, and too big for a wall. And it’s not unilaterally solvable. 

—CNN commentator  


Doctormi nombre es Felipe, pero no tengo papelesmy name is Felipe, but I don’t have papers.” 

“Where are you from Felipe?” 

“El Salvador. Tengo, um, mi Ingles, my English, is not good. I have come because of the gangs.” 

“You left El Salvador because of the gangs?” 

Si. They tried to kill me; they want to kill me. They killed mi hermano, my brother. 

I’m so sorry.” 

I reach for a bottle of cold water. “Are you thirsty? Are you enfermo, sick? 

Siwater would be good. I have azucar, you know, sugar.” 

“You have diabetes?” 

Sidiabetes del azucar, sugar diabetes.” 

Are you taking any medicines for the diabetes?” 

Si, I take insulinauna inyeccion, an injection. 

“Do you have any insulin?” 

No, no tengo hace muchodias. Necesito una botellaNo, I don’t have any, it’s been several days, I need a bottle. 

What is the name of the insulina? And the dose?” 

Es NPH, 15 units cada dia, each day.” 

Felipe, a short plump man with buzzed black hair, a toothy smile, bronzed skin, and a quiet yet confident shyness, has diabetes, has not had insulin for several days, and is halfway between the Mexican border and Tucson, Arizona. His sandals are broken, and his feet splashed with blood and abrasions. His clothes are covered with dust and cactus spines, and splotched with stains of sweat, oil, gasoline, and who knows what else. He’s dehydrated and weak, but alive.  

I’m a physician at a volunteer way station, providing food, water, and limited medical care to undocumented immigrants. Our station, hidden, but not hidden, is on a lonely line of longitude in the harsh and hostile terrain of the Sonoran desert in the American Southwest. I’m told the Border Patrol knows of our location, though they’d deny it. I’ve seen the piercing reflection of the morning sun off their binocular lensthe agents standing on their trucks, peering through the brush and cactus, past the rattlesnakes and Gila monsterssurveying the activity of the station. I’m told they tolerate the way station, sometimes. 

“How’d you get here?” 

Los trenes.” 

Many, if not most immigrants, travel via freight trains that run the length of Mexico, from the Guatemalan border to the United States border, fleeing a horrible, and at times murky, past. It’s dangerous ride; a migrant can be gravely injured getting on or off the train, falling from the train, or being tossed to the ground after a derailment. In addition, there are thieves, killers, and rapistsand smugglers, soldiers and police who pander abuse, abduction, torture, extortion, and death. People disappear on the trains, never to be seen again, splinters of their bones scattered in the backcountry or in shallow gravesBut despite the danger, it’s the way many travel in a daring, albeit illegal, effort to reach the United States in hopes of reuniting with family members, requesting asylum, or creating new and better life.  

Felipe has a fingerstick to check his blood sugar, and is given an injection of insulin, a bottle of insulin with ample needles and syringes, and three large bottles of water and snacks. This is ‘underground railroad’ medicine, medicine that seems, at times, irresponsible and maleficbut it’s better than nothing.  

I suggest it might be easier, physically and legally, to turn himself into the Border Patrol and request asylum, that he fears persecution and death if he returns to El Salvador, and that his brother was killed by gangs. He declines; his trust in the fair and just laws of government, particularly the migra, the Border Patrol, is wanting. “Todos los gobiernos son mismoscorruptos,” all governments are the same, corrupt. Fortunately, it’s late October, and the temperatures have moderated; his trip will be easier, if any trip across borders and unknown lands is easy. 

He gives me a hug and a Gracias, asks for my address, which I reluctantly give, and within an hour, he’s on a rutted, foot-worn path through the desert, heading to Casa Grande, a town an hour or so south of Phoenix, where he’ll catch a ride in a cargo truck to Paterson, New Jersey, where his brother and sister await. He tells me he hopes to eventually bring his wife and four sons to the United States, and start a landscape business. I wish him safe travel” as he leaves, a wish that seems trivial and lacking in sincerity. So I stutter, grab his shoulders, and say, “Please be careful Felipe, it’s dangerous out there.” He smiles, gives me another Graciasand adds the word amigo. I smile. 

The day passed quickly, even though Felipe was followed by Maria, Jorge, Jose, Pablo, Josefina, Roberto, Enrique, Lucy, Jaime, Liliana, and many other names I’ve since forgotten. I left exhausted, but with a heart filled with joy. I returned to the way station two more times, but then, as often happens, life got in the way. But the way station and the immigrants were never far from my thoughts. 

Thenabout six-to-eight months after I met Felipe, I received a half-open tattered envelope with coffee stains, postmarked Paterson, New Jersey. I gingerly peeled the remaining seal, and found a piece of napkin inside, carefully folded into a square. I slowly unfolded the napkin, and found nine wordsboth English and Spanish, scribbled in black inkDoctor, I made it. Muchas gracias. Tu amigo, Felipe. There was no return address; Felipe likely feared detention and deportation if immigration authorities stumbled upon the letterI smiled, and pumped my fist in the air and shouted, Felipe made it, Felipe made it.  

But as I sat there reveling in Felipe’s triumph, my elation was tempered by the fact that countless others aren’t as fortunate—the Marias, the Pablos, the Robertos, the Josefinas, the Jaimes. They’re detained, deported, or die, or simply disappear into the shadowed netherworld of illegal immigration.