A pack of border patrol agents dressed in dark green uniforms invade the trauma bay, bringing with them chaos and our newest patient. The surgeon calls for order and shouts at the agents to leave the room. It takes a while but they do, only to hover just outside the door to make sure the patient isn’t moved or discharged without their knowledge.

I look at the patient lying on the gurney, his legs so badly wounded the bones are exposed. After years of living in Tucson, it doesn’t take long for me to identify the cause of such a gruesome injury: falling from the border wall.

The trauma team works together, stabilizing the patient and assessing his injury. We toil carefully around scorched and chapped skin while tending to remnants of cactus spines and thorny bushes. These are all wounds from a tumultuous journey to the U.S. — a destination our patient likely thought would promise greater safety than his home country.

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When the team members finish their tasks, they leave the room to write notes, check on labs, and order tests. I’m left alone with the patient and for the first time I notice how fast my heart is beating. This is our third trauma patient from the border in a week, and each time I feel more hopeless.

I lock eyes with the patient and register his fear. I introduce myself in Spanish and ask him if he is in pain. He asks me to retrieve a rosary from his pants pocket. It’s a faded blue, with worn beads that tell the story of a journey that started long before the Mexican desert. I hand it to him and pull a chair to his bedside.

He tells me his name is Guillermo (I am using a pseudonym here) and he is from Honduras. He musters a smile as he talks about his daughters — twins who couldn’t be more different from each other. When I ask if I can get him anything, he asks me for a piece of paper and a pen, scribbles a phone number, and pleads with me to contact his family to let them know he is alive.

The minute I step outside of the room, the agents congregating around the door berate me. “This man is an illegal alien in the custody of U.S. Border Patrol!” one agent shouts at me. “He has no right to a phone call.”

As a medical student doing a third-year rotation in trauma surgery, that’s news to me. The agents tell me that upon stabilization, Guillermo will be held in detention until he’s deported, likely to Mexico, for the remainder of his medical care. “Maybe there he can get a phone call,” an agent tells me. I wonder how long his family will have to wait for that call.

Other stories like Guillermo’s are etched in my brain from my medical training in the borderlands: The undocumented woman who was admitted to the inpatient psychiatric unit for a psychotic break born from fear that immigration agents were stalking her and bugging her phone so they could deport her. The infant who contracted severe pneumonia after being held in la hielera — a detention center intentionally kept at cold temperatures — and his young mother who became inconsolable when she learned she would be separated from her son once they were discharged from the hospital. The man who had been bitten by a rattlesnake but was kept in detention for a day before being brought to the hospital for care because Immigration and Customs Enforcement officials didn’t believe his story about the rattlesnake bite. The woman who lost two fingers when they got stuck between the vertical slats that make up the border wall during her 30-foot descent.

In medicine, we are taught to care for all patients — to heal their wounds and manage their pain — but there are limits to what we can do. The time we spend patching up patients does nothing to prevent these injuries from happening.

We can tend to the injuries of a man who falls three stories after trying to climb over the border wall, but that isn’t the real treatment we need to prevent this trauma from happening to thousands more. That treatment is more than surgery, medications, and rehab. It’s not an erroneous national emergency or a taller wall. It’s immigration policies that are designed to protect lives and ways to humanely enforce them.

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The real border crisis is what hospitals near the southern border see every day. It manifests as broken bones, lost appendages, and severe dehydration. It is the thousands of people marooned in ICE detention centers. It is the families seeking asylum who are met with violence. It is the people who have vanished on both sides of the border. It is the thousands who have died on their journeys to seek better lives in the United States.

Even though Guillermo was stripped of his liberty, he held onto his life. Our medical team made sure he got the best care we could provide. That included asking the border patrol agents to leave his hospital room, protecting his privacy, and building trust. We also found a local immigration lawyer who agreed to take on Guillermo’s asylum case.

Many of the doctors and nurses I work with know that healing a patient is more than mending broken bones — it is about treating the whole person. Every time I see border patrol agents bring in a new patient, I think of Guillermo, his rosary, and his twins, and I look to a day when no immigration journey ends in the emergency room, or the morgue.

Claire Lamneck, a fourth-year medical student at the University of Arizona College of Medicine, is also working toward a master’s degree in public health at the Harvard T.H. Chan School of Public Health.

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  • Thank you, Claire Lamneck, for telling this story and speaking the truth with compassion. I’ve been following the news since it came out nationwide in March 2018. Your story is heartbreaking and repeats in the thousands… Our country is being ruled by a wouldbe dictator, and his enablers and cohort, who ignores the law and the rights of refugees and asylum seekers under both US and international treaty laws to which the US is a signer. And thank you for what you and your colleagues did for Guillermo and everyone who is brought to your clinic. You are already a physician/healer, and I wish you a lifetime of doing good. We must never capitulate to evil and cruelty. Never give up!

  • Trump won the election, his approach to unwanteds entering was very clear, so this obstruction of illegal entry should be expected. The desperate will always try, get wounded in the process, and should consider themselves darned lucky that they got patched up for free. Meanwhile legit Americans pay through the nose for the same medical services – and that is utterly un-fair and distorting. Therefore lines MUST be drawn, however unfortunate for those breaking this country’s entry-rules.
    But the separating of parents and totally innocent children is utterly despicable. It is disgusting that Trump gets away with this Hitler-like action, and it renders all those silently tolerating this utterly cruel bullying and life-long damaging of mostly innocent minors unbelievably cowardish. The land of the so-called strong and free has a very, very sick population of cowards.

  • No one asked these people to come here and I resent paying all the costs associated with these events. Let’s take care of our Veterans, homeless,
    mentally ill and drug addicted first.

  • Thanks for maintaining the humanistitic perspective. Any of us, including the hardened Border Agent, could have been the injured Guillermo.
    When I was USPHS Border Medical Officer in Nogales ’66-’68, I lived in Tubac, AZ where many undocumentd immigrants, traversing the Sasnta Cruz River bed, would knock on my patio door before daybreak, asking for food which I was happy to give.

  • Thank you for the work you are doing. I fear our country has lost its way and hope that we will find a path to an immigration policy that is once-again humane.

  • The true horror has not been told in mass media, instead misinformation, racism, and lies have created alternate facts. I never thought I would see the day, when in America, this kind of abject horror would be commonplace and justified.

    • I am proud of the author and I am honored to be part of her medical training. Claire holds the highest humanistic values as a health care provider. The four principles of medical ethics are: do no harm, do good, patient’s autonomy and justice all exemplified by her actions. We need to keep humanity in our health care system and provide equity care that is compassionate to any individual who needs our professional help. We see maltreatment, dehumanization of migrants, the horrific effects of family separation every day when caring for migrant families and individuals in Tucson. We need more of these stories to bring back the real human dimension in how we view of the border crisis.

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