Hektoen International

A Journal of Medical Humanities

My little old lady

Nestor Ramirez-Lopez
Champaign, Illinois, United States


Picture of a typical ambulatory street
vendor with foldable box and a rolling
carrier. Source: www.carlosmunera.com

In Colombia, as in other third-world countries, it is common to see street vendors of many types of goods. On Sundays and holidays, they concentrate around cinemas, sports arenas, the bullfighting ring, and other places where people tend to congregate. The most frequent articles for sale are food items, and the vendors may have small portable grills for foodstuffs that need to be heated. Fruits, large avocados or baked goods are sold in various corners of residential areas of the city, and people drive by in their cars to purchase what they want. Nowadays, with modernization, the busy streets are invaded by vendors who risk the intense traffic and approach vehicles during a red light stop to sell cards for cellular minutes, cellphone cases, chargers, and other gadgets.

When I was growing up in Bogotá during the 1960’s and 1970’s, I used to purchase candy and snacks from an elderly woman who stood on the street corner where I took the bus for school. Within three or four blocks of that corner there were five schools, so she had a ready-made clientele. She appeared daily with a large, heavy basket and its stand, and she would uncover a multicolored array of temptations for the palate with intriguing and fascinating names: Bonfruit, Bambi, Jet (Candy bars and chocolates), Piquitos, Pandeyucas, Argollitas (cookies and baked yucca starch puffs), Colombinas, Chupetas (lollipops and suckers), Panelitas, Morenitas (dark brown molasses chewy caramels), Delicias, Melcochas, Alfandoques (stretchy red or tan taffies), Maíz de Escoba (little cones of popped and colored broomcorn), Refresco de Frutas (sugar mixed with colored citric acid fruit flavor and a pinch of bicarbonate to make it effervescent, all packed in a striped straw), Arequipitos (soft shapes of dulce de leche sprinkled with corn starch to prevent sticking to the wrapper), and many other goodies for sale to the children and adults waiting for their transportation or walking to school. Just writing about those tasty treats makes my mouth water and my brain vibrate with warm memories.

Many of these products were homemade by her or her family and neighbors and were hand-wrapped in pieces of waxed paper, cellophane, brown kraft paper, or dried banana or corn leaves. The wrapper ends were twisted or folded and the packets were tied with a short length of fiber from the leaf used.

She must have traveled very early to that corner from her home because I usually took my bus around 7AM, and she was already there. I used to chat with her until my bus came, and I found out that every day, around 4 PM after all the schoolchildren had gone home, she would lug her basket and its stand onto a bus for a trip that required three transfers before reaching her house, at about 6PM. She occasionally sold some items to the bus passengers and would give the driver a treat so that he would allow her to enter through the exit door and avoid going through the turnstile with her load.

I could not afford much, just a little something to enjoy during recess at school. Some days I did not have any coins and she would give me credit. She would call me “Mi Niño Néstor” (my boy Néstor), and I would call her “Mi Viejita” (my little old lady). In Hispanic countries, members of the lower socioeconomic classes, as a way of showing respect, would refer to members of a higher social status as “Niño” or “Niña”, even if they were adults. As I grew up and advanced in life, through high school, university, and medical school the daily habit continued, with a slight change: sometimes she would sell me a single cigarette, because I could not afford a whole pack (this is something I am not proud of nowadays). She would also occasionally loan me small amounts of money or give me a discount on a large beautiful candy bar that I could use as a gift for whichever gal was captivating my heart at the time.

All through medical school, the daily routine continued. While I waited for the public bus or for a friend who had a car and would pick me up to go to the university, “Mi Viejita” and I would always chat and I would buy something from her. When greeting me, she would still call me “Niño Néstor,” but when saying good-bye, she would say “Adiós, mi doctorcito Néstor,” a diminutive term of endearment. As she aged more and more, some days she would not show up, or she would leave earlier, or the basket would get progressively smaller and lighter. I would notice but was never really overly concerned about the changes in her schedule, because after all these years, she seemed to me to be indestructible and I sort of took her for granted.

One night during my internship, I was called to admit a severely unstable elderly patient with multiple complications who was not expected to survive the night.

Imagine my astonishment when I saw “Mi Viejita.” She was in serious respiratory failure and her face showed the strain of her breathing. She smiled at me, called me “Mi Doctorcito Néstor,” and her pain and distress appeared to decrease. I held her frail and gnarled fingers and she weakly squeezed back.

For the next few hours I sat by her bedside, holding her hand as she slowly but peacefully slipped away. That time helped me to evaluate and reconsider my life goals and aspirations. I felt absolutely and undoubtedly certain for the first time that my choice of career had been correct: if I could not heal, I could support; if I could not cure, I could comfort; and if I could not ease their pain, I could empathize with and share the anguish of my patients.

In the early morning hours her face was peaceful, relaxed, and a half-smile was on her lips. I felt one last short squeeze in my hand, and then her fingers loosened their grip. After shedding a few heartfelt tears, I kissed her forehead and said a short prayer for her soul.

Good-bye, “Mi Viejita.” Godspeed and thank you.

Never in my life will I forget that look of peace on her face or the feel of that last squeeze from her fingers. I felt sad, but I also felt happy that I had shared her last moments. I was grateful and proud to have had this experience. I felt blessed for being able to practice my profession, that I had received a lot in my life and should therefore always be a giving physician.

After she passed away, I realized that I had never even known her real name.



NESTOR A. RAMIREZ-LOPEZ, MD, MPH, FAAP, was born in Bogotá, Colombia and studied medicine at Jesuit University and worked as a physician in the jungle area of Southeast Colombia. He came to the United States in 1979 and worked as a board certified neonatologist for thirty years. He is currently retired and lives in Champaign, Illinois and serves as a delegate to the American Medical Association and is the President of the Illinois State Medical Society Board of Trustees.


Winter 2018  |  Sections  |  Personal Narratives

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