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On the first day of our clinic the nurse practitioners and I saw 187 patients. Nearly 100 more were given vouchers assuring them of a good place in line for the next day. There was as little or less wrong with most of the patients I was seeing than was usual back home. Most of them were well-nourished, bright, healthy children who didn’t eat what their mothers thought they should or who coughed, usually without fever or waking up or any other symptom. Two children in the first hour were for second opinions on hernias. In both cases Sandor Martinez was right: the umbilical hernia would get better by itself; the inguinal hernia would not.

Once people pay, even if it’s only forty cents, the expectations and entitlement follow as night follows day. The people controlling the gate had no incentive to not ram as many people as they could through the one-week-only-see-the-Yankee-doctors moneymaker.

I had three twelve-year-old girls from the local Catholic school translating. They sometimes did it by committee and would argue among themselves about what it was that the patient or I was trying to say. “Bones ache,” “Baby no eat,” and “Cough” were the most common chief complaints.

The first “Baby no eat” I saw was a beefy thirty-pound two-year-old with wrist rolls, chipmunk cheeks, and a Buddha belly. “Baby eats,” I said. “Maybe the neighbors are feeding the baby or the baby gets up and raids the refrigerator when the mother is sleeping.” The translators looked back and forth nervously.

Of the babies and children complaining of cough, almost none of them coughed. I never figured out what “Bones ache” meant, but I weighed and measured everyone and asked about whether or not they ate or coughed and if the bones ached more during the day or at night and showed them where their child was on the growth chart, and everyone seemed happy.

One of my first patients was brought up to the front of the line by our triage nurses right after he had a grand mal seizure. He was back to himself by the time I saw him. He was a strong, handsome, nonverbal boy who had had six to eight seizures a day for many years. His mother was a small, shy, pretty woman who looked like a teenager herself. It wasn’t the seizures she was worried about but the fact that for months he had been holding his penis and screaming while smashing the wall with his other hand whenever he had to pee. She couldn’t look at me for more than a millisecond. It was just as well that I didn’t speak Spanish so we didn’t have to say penis back and forth.

There was no discharge; the penis looked fine. It could have been a bladder infection. I had brought a couple hundred urine dipsticks from my office that could tell me in minutes if there was blood or protein or sugar or white cells in the urine.

“Just a small amount of urine in the cup,” I explained to my translators, who passed it on.

He seemed to understand what he was supposed to do and put a small amount of urine in the cup and a much larger amount in a giant arc on my cardboard partition while he screamed and punched the wall.

His urinary stream was excellent. The urine in the cup was normal. I had brought the full weight of medical science to bear on his simple problem and had come up empty. I didn’t have the faintest idea why he held his penis and screamed when he peed.

I tried to explain that he could have a lot fewer seizures a day with medication and wrote out a note to Sandor Martinez. The boy’s mother was politely trying to seem interested. I gave one of our tennis balls to her son, who nodded appreciatively and rubbed his cheek with it.

The boy with the seizures and over half the other children I saw had scars on their shoulders from smallpox vaccinations. I’m sure there’s been no smallpox in Honduras for many, many years. If you’re a pharmaceutical company, nothing goes to waste.

His mother asked if she had to go back outside and get into line and pay her lempira all over again to be seen herself. I took her across the building to introduce her directly to Max with my translators.