Perla

Perla is my youngest patient and one of my most consistent patients. She isn't a "pequena", meaning she doesn't live here at the house. She's what is called an "externa", she lives in town and her parents pay money for her to attend school at NPH rather than the public school in Miacatlan. Pati, who seems to know everyone within a 20 mile radius, introduced me to Perla's mother the first week I arrived. Perla has been unofficially diagnosed with Muscular Dystrophy, which has left her with limited strength and difficulty walking. She is well known around the NPH home because of her obvious disability.

Despite being extremely shy, Perla and I have developed a good rhythm together when she comes for treatment after school. Despite very few words being spoken, she has shown increased comfort with me. She laughs more each week and now feels comfortable if her mom waits outside during our sessions. We always finish with a Wii boxing match between Perla and her sister Yeri who is in Kindergarten. Sometimes their cousin Diego comes in too and pretends like he's playing along (as seen in the picture).

Perla's mom pays me with occasional treats like fruit, yogurt or cookies. Yesterday she invited Pati and I to their home for lunch. Perla lives under an umbrella of strong women, including her aunts and grandmother. The men are either deceased or working in the United States. Perla's father works in Los Angeles, sending enough money for her to attend "private" school.

I can't help but to compare Perla to the kids in the house here at NPH. On one hand she has a mother who daily advocates for her to receive the therapy she needs. There is no way the pequenos in the house can receive this one on one attention. But at the same time Perla's mother lacks the resources to ultimately get her daughter the proper medical care she needs. Every child with a disability at NPH is followed by Shriners hospital in Mexico City. It's a complicated process that often involves social workers and a knowledge of "the system"...a task that is too overwhelming no matter how many times I mention it to Perla's mother. Honestly, it's hard to say who has a greater advantage. In the meantime Perla and I will keep plugging away.

***On a side note I'm feeling much more like myself again. I think putting it out there was good medicine. Thank you for those who expressed concern. No doubt there are bad days in life, but it gets hard when they stack up!