By Jeanne Lemkau

Jeanne Lemkau, Professor of Family Medicine and Community Health at Wright University of Medicine in Dayton, Ohio, met Gary while on a trip to Cuba. She wrote about the encounter in a chapter in her thesis for a master's in fine arts, which she is to receive later this month from Goucher College of Baltimore Maryland. The following is what she wrote:

The tiny old man perched forward on a plastic chair, elbows on his knees, reading a newspaper. A wooden cane leaned against the seat next to him. His soft white hair and beard framed a rosy wrinkled face into which his features had retreated.

He sat alone, dressed in soft brown clothes that would become familiar to me in the days that followed: brown slacks, a brown wool sweater that buttoned at the collar, thick marled socks, and brown Birkenstocks. The sandals made me wonder if he was an ancient academic or if perhaps a friend or family member had suggested such footwear for stability.

It was the beginning of January and I was returning to Cuba after spending the holidays at home. The old man and I were both waiting at the Mexicana gate for the next flight that would transport us and a half dozen other travelers from Cancun to Havana. When our flight was announced, a diverse dozen people moved toward the gate, no two appearing to fit together. Except for me, all were men. I nodded to the old man as he shuffled forward, pushing a piece of brown carry-on luggage, apparently his only bag. He looked so frail and moved so slowly that the thought that he might die on the flight crossed my mind.

We boarded the small plane and the old man settled into the seat in front of me. The cabin was half-empty and each of us was sitting alone. And I felt alone, until he turned around to meet my eyes, introduced himself, and inquired as to my purpose in traveling to Cuba. In no time, I was engrossed in his story.

Gary MacEoin was 92 and a journalist, traveling on assignment to Havana to write a story for The National Catholic Reporter about changes in Cuban religious life since his first visit over fifty years ago. This would be his eleventh trip to the island. He would be a guest of the Martin Luther King Center in Marianao, the municipality just west of El Vedado. The Center staff had arranged for him to interview various religious and civic leaders during his week-long stay. And yes, he was traveling by himself.

This was an early evening flight and, anticipating the inevitable delay at customs, I knew we wouldn't be out of the airport until well after dark. I was already feeling protective of my new friend. Being younger and able bodied, the least I could do was make sure he arrived safely at the guesthouse where he would be staying. But he didn't have an address, only a phone number. By the time the plane touched down at José Martí International Airport, I had suggested that he accompany me to the hostel where I had a reservation. There he could take a room for the night and tomorrow, in the light of day, he could call his contact and make his way to the guesthouse. He agreed.

Standing in the customs line waiting for official clearance, I juggled my laptop, a handbag, my luggage and Gary's push carry-on while someone else found a wheel chair for him to ease his wait, a concession he was willing to make to his two artificial hips. I wondered how this frail little man would deal with the physical challenges of Havana -- the heat, the stairs, the broken and uneven sidewalks and street hazards. Maybe I could help him out, make his trip a bit easier.

As we arrived at the front desk of the Hostel San Miguel, Gary turned to me. "If you want, we could share a room. Over the years I have often shared rooms with women traveling."

I paused. He must have read my thoughts because he chuckled and added, "It wouldn't be too exciting for you!"

His invitation was too quick for me, and I was caught off guard. "Thank you, but I don't think so," I replied.

He paused. "Perhaps you would like to join me for a nightcap - I have a bottle of Scotch in my bag."

"Thank you, but I don't think so," I repeated, trying to be firm but friendly. "I'm awfully tired."

The next morning, we shared coffee, omelets and papaya on a small marble table with a view of the street through a wrought iron gate. Cubans were walking by wearing sweaters and jackets.

"How did you sleep?" I asked.

"Not very well," he replied, matter-of-factly. "I was cold and I didn't have enough blankets." Instantly, I regretted that I had not been able to get him an extra cover during the night because of my sense of propriety.

Gary made his phone call to the guesthouse and wrote down the address. The hotel doorman hailed a taxi for him from the street. As I offered Gary my arm to help him to the cab, he muttered, "I'm not entirely helpless!"

"Certainly not," I was thinking, as his fingers slipped around my forearm.

Our contact could have ended there but I was too drawn to him to so easily let him go when he let go of me. By evening, I felt compelled to call and check on him. This time, his invitation to drop by evoked no hesitation.

Over the next several days, we shared meals and reminiscences about our travels in Cuba and Central America and about Gary's childhood in Ireland, interspersed with his intense questions and spontaneous mentoring.

"What is a woman like you doing in Cuba?" he asked, looking at me intently.

I explained that I wanted to learn about Cuban health care and the effects of the U.S. Embargo in order to write. He looked thoughtful.

"So you want to write? Then let me show you my notes so you can see how a journalist prepares for a working trip."

He showed me his notes. I felt relief: they looked remarkably like my own scratchings about Cuba from books and websites that I had perused. I asked him to tell me more about his career. At first he made me work hard to elicit information. He had written for Life, Look, and Time, as well as for numerous liberal and leftist publications. His expertise covered Latin America, human rights, and Catholicism. He had earned a doctorate in Spanish literature, raised a son, and cared for an ailing wife until her death some years ago. His life had taken him from rural Ireland where he was born to Texas where he now lived.

"How did you end up in San Antonio, Texas?" I asked.

Gary looked at me sternly. "I didn't end up anywhere!"

In a single conversation, Gary would lapse into Latin, quote the opening to The Merchant of Venice, recount a story from his Irish youth, and correct my grammar in Spanish and English. His pink skin, white hair, disappearing eyes, and small stature gave him the appearance of an ancient Leprechaun.

One afternoon when I arrived at the guesthouse, he exclaimed with satisfaction, "Today I interviewed Juan Valdéz, a real Juan Valdéz."

What was he talking about, I puzzled. He must have read the expression on my face. "I know that the other one was made up because I made him up!"

Still perplexed, he reminded me of the old Folger coffee commercials on TV which featured a Columbian coffee picker standing among the plants inspecting individual beans. His name had been Juan Valdéz and Gary said that he had invented him during a detour from his journalism career when he had worked with the Columbian Coffee Growers' Association.

Impressed by the depth and breadth of his experience, I shared with him my fears that, already in my mid fifties, I would not be able to chart a new direction for myself and my writing.

"What! You have your whole life ahead of you." It was a cliché but one that made me take measure of the years between us as a gift that I might also be given.

Each evening we shared a nip of Scotch from the liter bottle that took up the space in his suitcase that a lesser person might have used to pack an extra set of clothes.

*****

The sidewalk was clean, dry and even, but I slipped anyway, right smack dab in front of El Club de Amistad. As I tried not to fall, I staggered forward, propelled myself horizontally until all was lost, and I landed hard on my bare right shoulder. The pain was immediate and sharp. Stunned, hurt, and bleeding from a large contusion on my forearm, I sat frozen on the pavement for several minutes, then struggled to my feet and sought help at the front desk of the Friendship Club, where I had been headed to meet Gary.

The woman at the front desk looked up at me and dropped her jaw in alarm. The expression on her face triggered the flood of tears that until that moment I had tied to hold back. Quickly she offered me a seat, found alcohol and cotton to clean my wound, and gave me a gauze pad to staunch the bleeding. I later learned that such gauze was in exceedingly short supply.

I was recovering my emotional equilibrium when Gary arrived, surprised and concerned but exuding calm as he took in the situation. Although we had met only five days earlier, in my vulnerable state, I felt like he was an old and dear friend. His presence heartened me.

My shoulder was paralyzed in pain and I sheltered my arm against my body, worried that something was fractured. Several years earlier, in eagerness to fly down the stairs of a pension in Venice to enjoy the Piazza di San Marco before the heat of the day, I had slipped and fallen. Not wanting to get entangled by my health insurance and a foreign medical system, I had skipped seeing a doctor and nursed pain for weeks. Subsequently, on returning to the United States, a doctor diagnosed a fracture. It was a mistake I would not make again. Besides, this was Cuba and even in my pained and bleary state, I knew that this would be a rare chance to experience Cuban health care from the inside. Even as I hurt, I was curious.

Gary offered to go with me to the emergency room of Hospital Fructuosa Rodriguez. Someone called a cab and while we waited, a swarm of concerned Cubans circled me and someone produced a bag of ice that I balanced on my shoulder with my good hand. They assured us that, since my injury was an emergency and not a pre-existing condition, I should be able to get help at a regular Cuban hospital rather than at one of the clinics that catered to tourists.

When the taxi arrived, the driver looked conflicted as to whom he should assist first and how -- the old man with the cane or the younger woman with the bloody arm and the ice bag balanced on her shoulder. He helped us both. Settled in the back seat next to Gary, I relaxed in the comfort of knowing I did not have to cope with this experience alone.

The taxi left us in the gray cement entrance of the hospital emergency room and we walked into a large shabby waiting area. Half of the ceiling was missing, exposing a skeleton of bare pipes and wires. There were a dozen people sitting and waiting on hard wooden chairs. Not one looked like a foreigner, until Gary sat down among them to wait for me. Meanwhile, I stood in a short line while a woman at a desk took down the names of new patients. When my turn came, she skipped that formality and sent me directly to a side room where a woman in white gently explained that, as a norteamericana I needed to be seen at the special clinic for foreigners. She had someone call another cab for us and shortly we were headed for the tourist clinic, Cira García in Playa.

The taxi left us in the pristine white stucco drive-up entrance. We walked through a well-lit entry hall decorated with lovely pastel paintings of Che Guevara, Fidel Castro and José Martí -- the usual suspects. Gary settled into one of the cushy black leather-looking chairs in the waiting room. There was a desk to sign in but no line. The receptionist requested my name and passport information and, within three minutes of arriving, I was whisked into a spotless and bright exam room where a male nurse scrubbed the contusion on my arm and painted it with an orange antiseptic, then escorted into a small office with a large sunny window and seated in front of the desk.

The doctor entered the room immediately after my arrival, a handsome seventy-year-old Cuban in a white coat that matched his abundant hair. He introduced himself as Dr. Corona, a doctor specializing in rehabilitation medicine. Perfect, I thought, since I'd been injured. He asked me what had happened and how old I was. He took no medical history, although I volunteered that I had chronic tendonitis in the shoulder I had fallen on. He examined my arm carefully, moving it, asking me what hurt, noting when I winced. His voice was soft, his manner kind, and our conversation strangely bilingual, as he was as eager to use his English as I was my Spanish.

He wanted to take an X-ray to rule out a fracture. A woman appeared and escorted me to the radiology area while the doctor followed closely behind and positioned me on the X-ray table. As the technician took the picture, Dr. Corona paced back and forth in the anteroom, eagerly waiting, as if nothing was more important to him than the state of my health at that moment. Five minutes passed. The picture was ready. He clipped it up to the light-board and gestured for me to look -- no fracture but an old injury that might explain my tendonitis.

"Have you ever had your shoulder injected?" he asked. "Once," I replied.

"Don't do it again," he said firmly, as he pointed out

an area on the film that suggested some decalcification.

He led me back to his office and we sat down. He explained that my injuries were to the soft tissues of my shoulder but that I needed to be careful, lest this injury make my tendonitis worse. For the next few days he recommended a sling and intermittent ice packs.

"And you need to take daily doses of the Cuban sun, once in the morning before ten o'clock and again in the afternoon, after four." For what possible conditions, I thought, wouldn't that be good advice?

Dr. Corona then escorted me to the clinic pharmacy to get a sling. When they did not have one in my size, he said not to worry -- I could get one across the street at the international pharmacy, or at any international pharmacy."Just don't go to the national pharmacies," he explained, "because they won't have any."

The doctor suggested that, after I stopped at administración (no mention of "to pay"), I could return to pick up the X-ray. I reached out to shake his hand. He leaned over and kissed me on the cheek -- Cuban style. Nice touch, I thought.

At administration I was asked to pay $50, half for the consultation and half for the X-ray. I requested a receipt in order to engage in the fruitless exercise of attempting reimbursement through my health insurance carrier at home.

Gary had dozed off like a cat in sunshine in the black chair where I had left him. I crossed the street to the international pharmacy by myself, only to discover that they didn't have any slings. "No se preocupe." Don't worry, the pharmacist explained, he would get me to a location that would have one for me. He dashed outside and hailed a cab that was parked nearby, obviously part of the coordinated care system Cuba had in place for its tourists. I quickly crossed the street and awakened Gary and we were taken to a German-Cuban orthopedic supplies facility. There, after briefly talking with another doctor, I was fitted with a sling and charged "el mínimo," $15.

During my brief experience as a patient in Cuba, I was never left alone. There was no biopsy of my wallet before I was provided care. I was attended to promptly and I felt cared for from start to finish. Given the impact of the trauma, the pampering was welcome.

Nevertheless, the experience reminded me of shopping for silk in India, where, when you walk into a store and ask to see a piece of cloth, a dozen men scurry to take the bolt down from the shelf and roll it out for you. While the sense of continuity and coordination was impressive, shouldn't the doctors have had something better to do than treat me so solicitously? Or was I so accustomed to the fragmented and impersonal encounters that pass for health "care" in the United States, that I found an immediate and sensitive response to my needs disconcerting?

And of course I kept pondering how my care would have been different had I been a Cuban and provided treatment through the emergency room at Fructuosa Rodriguez. Could I conclude that the result would have been inferior, just because the building was old and there was a waiting room full of people? After all, this was Cuba, known throughout world for its health care system, for the number and dedication of its physicians, and for its impressive health statistics. But then why were there two health systems, one for tourists and one for Cubans?

These were the questions I contemplated in the days that followed, as I nursed my shoulder with bags of ice, daily doses of the Cuban sun, and an evening shot of scotch from Gary's secret stash.

"What do you know now that you didn't know when you were younger?" I asked Gary.

"You have to learn to roll with the punches," he replied.