An Essay from Puerto Rico


      We’re in Puerto Rico, a place Barbara and I visited many years ago. Now in the evening of our lives we came one more time, taking an apartment for three weeks.  We stroll through ancient churches, small galleries and shops set in what we feel is unique and beautiful. Just pause when you come, stand back — the town is defined by ancient buildings, historic character, and gracious young women in the shops who smile, as if they truly knew us and want to chat one more time, Historic character is the heart of this beautiful town, Old San Juan.


     It has a passing sadness because the Island loses its professionals, mainly physicians, who graduate and soon leave to practice elsewhere. The governance of Puerto Rico has tried its best to keep the university graduates and in particular, those who graduate in medicine. I did some library research and learned that hundreds — if not more — graduates in medicine left the country to enter a practice in various parts of the US. The state has lost in the words of a local man: “The struggling financial crisis has set off an exodus of medical personnel leaving.” I was told that the University of Puerto Rico has a well-established medical school.

                                                                   I spoke with a man who knows and he told me that the problem affects the city and the tourism industry:  “The government is trying to work at keeping trained doctors so the state will be strong in the security of medical treatment, a principle of both caring and curing.” As he put it, “Our doctors, most of them, have excessive patient load, and many problems arise from that.”   The situation has been faced and has been communicated to the citizenry.     Nonetheless, according to a journalist named Mariela Patron, there are serious concerns. Ms.  Patron, wrote on the issue. There is, in the conversations I had, a significant concern over the problem.  One paper has put the situation in these terms: “Puerto Rico’s problem is that in the eight years from 2005 to 2013, 1,200 local physicians moved to other countries.”

        Having a problem with gastritis, I had occasion to experience the situation.  I went, on the advice of my landlady, to Ashburn Presbyterian Hospital in Condado. The waiting room was full of patients and we waited about an hour before a kindly and rather elderly doctor saw me and prescribed a medicine. I (Ken) am most satisfied with both his treatment and his personality. Obviously he may not be practicing much longer and it appears his younger colleagues are already in greener fields in mainland U.S.A. leaving the doctors the country now has with quite a burden so that their region will be secure for ill residents or as I myself saw, those who come from aboard. He was so competent and gracious with his treatment and prescription I mention him: Dr. Dacosta Ruben.

       San Juan itself — (the whole metropolitan area) -– has a population of just under 400,000. Its Old City  – Vieja San Juan — has the atmosphere of history, cobbled streets, colorful houses, waving trees and the huge enclosing wall from where we look out on the brilliant blue waters. Barbara and I were in the heart of Old San Juan but we obviously made the effort to visit the newer neighborhoods, where we saw the enormous major campus of the University of Puerto Rico (the largest in the Caribbean) which covers an area in which almost 50,000 students enroll along with external campuses in other districts. It is interesting that Metropolitan San Juan has 14 hospitals, with a somewhat tight and limited number of physicians. I saw the waiting room filled but smoothly run. In the days I’m spending here with Barbara, it seems to me that Jose Andres was right when he said what still prevails: “Puerto Rico is the perfect meeting place between Spain where I came from and America the country where I belong,,,,,” 


                                    Photos by Barbara Bagnell

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