Explaining Retirement and Care Homes

jay1234 says on Apr 10, 2007, 20:06:

George Lopez did a piece in his stand-up routine on HBO. He was saying that Mexicans would never put relatives away in a home. Instead, they stay in that room in the back of the house that always smells funny.
I would guess that the idea of retirement homes would not translate well across cultures. This is all opinion, but I think in EEUU it has to do with ideas of privacy (both from the seniors point of view and from the rest of the family) along with a more distant family structure here compared to Latin America. Plus, in the case of voluntary retirement communities, due to the seniors having more accumulated wealth. Probably also something to do with the insurance companies paying out to the communities, i.e., there being a big profit motive for businesses in this area.

adrimm says on Apr 10, 2007, 20:33:

Hmm yes I agree with your points, but how do you explain it so it makes sense to a Colombian/Latin American?

The conclusion they arrive at is "you don't love your elders", and from their perspective I can see how it appears that way.

miamimike says on Apr 10, 2007, 22:26:

Colombia Culture Lends itself to caring for Their Elders,,, while the Culture in the USA does not. Its a Confusing concept for them to understand. In many cases,, due to a lack of an extended family, no one is in the home to care for a Elderly parent in the USA. In most cases here in Miami, both partners work at least 8 hours a day outside the home so who is in the house to care for the elderly? Only if you are wealthy can you afford it as a trustworthy honest competent live in Caretaker costs $500 minimally weekly. A friend of mine checked out a Nursing home in Bogota and it then was around $500 monthly and this was a top of the line Home. In Miami this same care would run $4000 monthly and this is a run of the mill entry level nursing home with only basic care. I agree, a difficult concept for many as here in the USA, we "Warehouse" our Elderly; send them off to a Nursing home and they are soon forgotten. In many cases here in the USA, the only time the Kids/grandkids visit is when they pass away and the Kids show up to claim the Belongings and Final Will(testement) to see what they receive of the Deceased's belongings. That is if there is anything left after the Nursing Home gets done with them,,,

"Wait a minute. What did you just say? You're predicting $4-a-gallon gas? ... That's interesting. I hadn't heard that." -- Feb. 28, 2008 --George W. Bush, Washington, D.C.,

goin_south says on Apr 10, 2007, 22:41:

Let's look at the other end of the spectrum as well, because I have always observed so many similarities between 'the very young and the very old'.

I have never heard EITHER of the concept of DAYCARE FOR KIDS.. in Colombia, although it may exist, I do not think it is prevalent. It has to do with something that was lost in America (north, of course) after World War II, when women went to work and stopped caring for the children as much in the home (which has alot to do with why we are even on this damn site).

In America (north, of course), the social trend is to 'be bothered less, by both ends of the age spectrum, the very young and the very old'. Middle-aged Americans (north, of course) are involved in PRODUCING... and so, have conveniently created these other entities which both are somewhat lucrative, as someone said: DAYCARE FOR THE LITTLE ONES; TOTALCARE..retirement homes or nursing homes for the elderly ones.

And, in the case of the Elderly, it is commercialized, because the end of life is drawing near, and so many people in America (north, of course) are too damned neurotic about such things as death, and so, they will go to any and every extent possible to prolong life, even when there seems to be no (quality of) life there. And, the medical people and the nursing homes, in many peoples minds are the places where that can be done. What a bunch of B.S. Yes.

It is all rationalized by the middle-aged,....
... and in the middle, the closeness of the family ties are or have been lost in such a big way. It hasn't happened in Colombia...yet.

That is why we read so much of: "THESE WOMAN HAVE 'TRADITIONAL' VALUES. That includes this or these issues, as well.

The same thing will happen in Colombia,...with enough time.
I hope I am wrong.

and, thank you.

honey says on Apr 10, 2007, 23:25:

I hope I didn't misunderstand... "I have never heard EITHER of the concept of DAYCARE FOR KIDS.. in Colombia, although it may exist, I do not think it is prevalent."

I am VERY surprised to hear that you don't think Daycare is pravalent in Colombia. I thought they were very common, and I'm not talking about "el jardin" I'm refering to daycare for children as young as a few months old. Of course when I'm in Colombia I spend most of my time in Cali, but I did see the same thing in Bogota and Barranquilla. Any thoughts out there?

Life is what happens when you're busy making plans - John Lennon.

Life is what happens when you're busy making plans - John Lennon.

Man Tequila says on Apr 10, 2007, 23:44:

Asian cultures share the same focus on family -- and many of my Indian and Chinese friends view nursing homes in the same way. But so do quite a few Americans and Europeans.

Living independently is a highly valued ideal in America. Kids want to move out from home as soon as they can afford to, to spread their wings and win their privacy. Elderly folk also wish to live independently, and most prefer to live with their spouse and spend some time with family but have the freedom to do their own thing in their own space. The idea of three or four generations living under one roof is not seen too often when people can afford alternatives.

Elderly people may suffer declining health or mental facilities as they age. They may become depressed after the death of a spouse. They may suffer from dementia. The idea of nursing homes is that professionals will look after people who no longer have the ability to look after themselves. This is convenient for their fsmilies, since nursing care for elderly people can be very time-consuming and stressful. Some elderly people enjoy being in communities with other seniors. Some elderly people despise nursing homes as symbols of their lost independence.

Not all elderly people have living family members, or family members who live close by, or who are willing to make the substantial sacrifices that must be made to take care of the elderly infirm. A nursing home may be a poor solution, and the issue probably comes down to individual versus family/community rights. A nursing home is not always bad. Much stress can be caused by being obliged to look after sick family members, and with complicated medical issues many families feel they do not cope as well as having professional nursing staff available at a home. I would not put my parents in a home given alternatives, though. The focus on the family thing is far stronger in non-gringo cultures.

Aunque no me creas/ si me lo propongo/ lograre olvidarte/ porque a fin de cuentas/ no soy tan cobarde./ Y termino todo una de estas tardes/ no sera dificil buscar algún sitio donde refugiarme/ donde nunca mas vuelvas a encontrarme. (Polo Montañez)

goin_south says on Apr 10, 2007, 23:55:

Miel Mio...yes, some more perspective on this... but, I am thinking also, it is not ANY WHERE NEAR AS PREVALENT IN COLOMBIA as in the USA, mostly jus because people can't afford it and make the opposite decision as north americans (of course) and decide that it is more to EVERYONE'S BENEFIT FOR THE MOM TO STAY HOME, rather than go to work and make a few measly pesos, only to spend more on daycare.

and, thank you.

goin_south says on Apr 10, 2007, 23:56:

sorry, adrimm.... I meant only to draw a comparison... , and a relationship; not to hi-jack the thread.

and, thank you.

adrimm says on Apr 11, 2007, 05:31:

Daycare does exist in Colombia, but some families also have nannies or help (cost of labour is low)- Help that can also help older family members.

So you agree with the Colombian perception then? That those of us North Americans don't love our elders? I disagree, but am struck trying to explain the cultural spirit of privacy/independence and self-sufficiency that we have. I think that the there are more opportunities for the elderly continue to have more vibrant lives in much of North America. In Colombia and many other places once you hit an certain age, you often seem to be "old" and babied, especially in more traditional areas and regions (ie outside of the cities).

For those that say the Colombian/Non North American/Western European perception is true Where did/do your elderly parents live? How did you arrive at that arrangement?

El Feliz- I'm trying to steer it back.. and Actually the site has nothing to do with this conversation - Peter started it as an informational platform to share his experiences as a foreign teacher in Colombia back in 1997/8. But it becomes a convenient place to discuss cultural differences (ie queueing behaviour and ideas about the elderly).

catorr says on Apr 11, 2007, 05:50:

Nursing homes are more than a place for North Americans to so called "pass off" their obligations to their elders. In many cases, nursing homes provide a high caliber level of healthcare that family members cannot provide. From my experience a large population of the elderly in nursing homes have suffered from strokes which leads to paralysis, inability to feed themselves, feeding tubes, and inability to even turn themselves over in bed. Another large part of the nursing home community has alzheimers and cannot care for themselves either.

I agree that Colombians do not use nursing homes, or daycare as much as we do in the north. But they do utilize low paid housekeepers and home assistants to watch their children and their elderly. If we had the opportunity to use housekeepers in the United States I am sure a lot more elderly would be home with their families.

griffbos says on Apr 11, 2007, 06:00:

hmmm not to go off subject but most asian cultures are the same when it comes to elders their childern are expected to care for thier parents in old age. with most US citizens for sometime it is easier to dump ones parents in a home then care for them at home

Robert Jorge says on Apr 11, 2007, 10:52:

My grandma (in-law) lives with my wife's oldest sister in Bogota. She is in her 80s. When she gets sick or achy from the cold in Bogota, the family takes her down to Porfia, a pueblo outside of Villavo to live with other family. It's a LOT warmer there than Bogota. I am pretty sure the thought never even crossed the minds of the family to put grandma in a nursing home. It wouldn't be considered an option.

--"I believe in making the world safe for our children. But not for our children's children, because I don't think that children should be having sex." - Jack Handy

adrimm says on Apr 11, 2007, 19:33:

Thanks Robert Jorge I was curious about peoples North American relatives.

Unfortunately my father has passed on, but my mother (Colombian) is close to 70. She lives independently and has a very active life. She has slowed down a bit, but I don't think she would relish living with me again - we get along far better living in separetely.
Ideally in the future I would be able to have a home with a small in-law suite so that she could live nearby but still have her own life and privacy.

I guess my issue is this:
On one hand I see some people here praising the "closer family values" of Colombia (while harshly critizing other cultural differences), and I have to ask myself:


1) How these same people manage their own elderly parents


2) Is the Colombian sentiment that we aren't as close to our parents true? Why so, or Why not.. Do you love your parent less when they don't live with you than someone who has their elderly parent living with them?

Catorr: I think I agree with you on the economics of it. Chalking it up entirely to family values seems a bit too romantic.

Man_Tequila I also agree with you, but from my Colombian relatives perspective they might see it as passing the buck and I'm still trying to wrap my head around explaining it.

Man Tequila says on Apr 11, 2007, 22:48:

I look after a lot of geriatric patients in varying degrees of health. Some have medical issues which makes loooking after them a genuine chore -- they may need to be turned in their bed every hour to prevent bedsores, may be too demented to recognize their family (which can be very stressful to look after), may have Foley catheters and feeding tubes which require special nutrition, may need thirty medicines which are hard for a sick spouse to keep straight, etc. Care in nursing homes is sometimes bad and sometimes as good as hospital care. Some folks benefit from this care. Oftentimes, the family has tried to care for this patient at home for months or years before deciding they can no longer cope.

Sometimes the family is trying to pass the buck too. They don't want to be bothered. In Colombia, where large families often have many people close by and not everyone necessarily works -- the difficulties in caring for an infirm parent can be divided, which makes things easier. But there is clearly a cultural component to all this too, so I wouldn't know how to explain it to a Colombian.

Aunque no me creas/ si me lo propongo/ lograre olvidarte/ porque a fin de cuentas/ no soy tan cobarde./ Y termino todo una de estas tardes/ no sera dificil buscar algún sitio donde refugiarme/ donde nunca mas vuelvas a encontrarme. (Polo Montañez)

goin_south says on Apr 11, 2007, 22:58:

I think there are distinct and different social trends in each culture in regards to the topic and then still each family has unique dynamics, within that culture.
And, I think in North America, people have moved so much more than in Colombia. What? We move on the average every 4 years? Most in North America don't even live close to their core family any longer.

We left for various reasons. And, contiued moving. Again, here in Acadiana where I have lived for 23 years, the family is more like that in Colombia; people don't like to leave here. It takes some very strong forces to get them out, and especially the ladies. They want to remain home, close to Momma and Poppa.

You got to admire that, I think, where you see families taking care of each other, from the womb to the tomb. But, I understand too, why some prefer to leave, and get out, and fend for themselves.

and, thank you.

Mononoke28 says on Apr 12, 2007, 15:29:

It's a culture difference... ... here in the States people always want to be independent and not deal with responsibility. You have your kids, then hand them off to a day care facility. You turn 18, you either move out to go to college or some parents kick you out because the thought of having a grown child in your home is not "right". You get old, you are then put in a nursing home. It's ridiculous.

Ancianatos in Colombia are considered for people who either don't have any family left or don't want to be around them. It's looked down upon and no matter how you try to explain the "US nursing home mentality" to a Colombian, it will be hard to understand because we don't do that. We take care of our family ourselves. Many other countries have the same mentality, I also have a friend from Sierra Leon and she told me that they would never think of putting an older person in a nursing home, they consider that some kind of an insult. Which in a way it kind of is if you think about it. =

Diana

adrimm says on Apr 13, 2007, 20:56:

I agree Tinto, but maybe nursing home is too narrow a range. There are all sorts of non-family living arrangements, from the 55+ buildings, to those from those that have apartments with but provide extra options such as planned activies, to those that have dining rooms and maybe some help on-call, to those that have assissted living, and then the ones that actually have nursing staff.

El Feliz "Acadiana?" Is this somewhere in Louisiana (the descendents of the Acadiens).. if so then there is another culture at play, the French culture... Interesting. You are perfectly correct about people being more willing to move away - most often for work So I supposse that the physcial separation plays into it too.

But what is the role of technology? I can talk to friends in other provinces as easily as I can talk to friends in town... still spill my secrets and tell them about my day, show them the new shoes I boughht, complain about work.. (Being close within the timezone helps tho).

So does it happen to Colombians moving away from home? Within Colombia? Out of Colombia.. I don't know. If you take the Colombian out of Colombia do their descendants become just like anyone else where-ever they have moved to. Is importing "values" a lost-cause - I think so (nearly most of the time).

Ah well thanks to those that have participated -
It's been a good chat and think... It's kind of too bad that more folks haven't joined in, but I think I may have some more concrete points to bring up next time I hear about "family values" (here or elswhere).
;)
~ A

poco says on Apr 14, 2007, 20:24:

If I didn't know better It's looked down upon and no matter how you try to explain the "US nursing home mentality" to a Colombian

I've lived in what might be called a Colombian retirement community for many years. Somewhere you would want your mother to live a tranquil existence outside the mayhem of the cities. My guess is that 30% of the residents are living on a pension and all but a few live in their home. Many other residents work outside Colombia and have built nice homes for themselves, parents and/or relatives.

There is a very nice home for "old folks" and there are NOT any vacancies nor do they expect any.

The home accepts people with a PENSION ONLY. I've walked by there many times and have gone inside to see how the people live. Pretty good deal I'd say. Several acres of fenced grounds, 38 residents (max) Community TV area, meals served, staff nurse on duty 24 hours per day, close to the Hospital, park like setting, benches, trees, etc. I've seen LARGE groups of family visiting on holidays and/or special occasions with the party conducted in an outdoor picnic type setting.

Because the family owns cars I'd say they are financially independent. No one looks unhappy and my brief look inside indicates they appear very content.

I understand they can travel about the town (if they can walk) and there are prostitutes who specialize in servicing "old folks". However you don't need to live in the home to acquire the service.

Nice isn’t it. Old folks taken out for some sun in wheel chairs.


Some might state conditions are Socio-Economic when in fact the deciding factor is economic in the majority of the cases but does not preclude Country Specific Social factors. My opinion is that percentage wise Colombia is not a lot different than the U.S. in this respect.

"Violence is the first refuge of the incompetent" - Isaac Asimov

miamimike says on Apr 14, 2007, 23:56:

Home Care keeps growing by leaps and bounds here in the USA and that is the direction that needs to be taken if an elderly has his/her own home they should be able to stay in it as long as possible. Many times this necesitates the services of a Home Health aide, Nursing asst.,or a Nurse. Still it has been shown they elderly are better for it(much less chance of contracting Noscomical types of infection/bacteria) and in the long run cheaper then Nursing homes especially when Quality of life is measured. Instead what our Fed Govt would rather do instead of paying out a few dollars(reletively speaking) for inhome nursing care is instead drop a Bundle to the Nursing homes for substandard care at the best. I've been into many homes in my line of Medical work(50-100 homes over the years) and they are Rip-offs as far as what is charged and what they receive carewise. It not that the Nursing home operators are not REIMBURSED sufficiently, its that they choose not to hire adequate staff so the patients go uncared for, laying immobile in urine and feces many times until their skin breaks down and Decubiti Ulcers(bedsores) develop. Many times its the clinical "END" when this happens to the patient as decubiti are a portal for bacteria and systemic infection (sepsis)ensues. Due to short staffing, there are times the meals in a Nursing Home are collected untouched because no one is present to feed Patients unable to do so for themselves. Patients rarely are offered water/liquid so they become constipated and dehydrated and this leads to poor skin turgor(dehydration) and breakdown(skin) follows, many times with Decubiti Ulcer. Its a Sin the Conditions and lack of Dignity many elderly are subjected to here in the USA... Pure greed on the part of the Nursing home operators! Here in Florida they tried to pass a Minimum nurse staffing law a few years ago but the Nursing Home Operator's Lobbying Arm in the Capial was so strong they defeated it and as a result the Residents continue to suffer and the owners Smile all the way to the Bank,,,. This is one Lucrative industry here in the USA, white collar robbery is a better description,,,Even in the VA Med Ctr where I staffed for a few years what transpired in the VA was criminal and they are considered good,,,This said, what are the others considered ??? BTW, along with Walter Reed, many VA Med Ctrs are presently being investigated due lack of care, cleanliness ect by Donna Shalala and Former Senator Bob Dole,,,

"Wait a minute. What did you just say? You're predicting $4-a-gallon gas? ... That's interesting. I hadn't heard that." -- Feb. 28, 2008 --George W. Bush, Washington, D.C.,

poco says on Apr 15, 2007, 02:00:

Miami Mike - I'd suggest you spend a modicum of time I've been in quite a few homes and none of these things are present.

I repeat none.

However, I'd assume the conditions are somewhat less when your sole source of funds is Social Security.

To alleviate you burden of having all these FACTS bottled up this is a link to the SSA web page. Go to the contacts page and select report abuse.

Another useful organization is the AARP. I believe your talents of writing long dissertations should prove a benefit to enlightening others who have real responsibilities in these areas and your first hand knowledge should be irreplaceable.

"Violence is the first refuge of the incompetent" - Isaac Asimov

miamimike says on Apr 15, 2007, 09:45:

Sorry Poco,,,,, I've spent more then a "Modicum" of time in many Nursing Homes from Penna to florida in my work and not as a Pass thru Visitor as you mentioned you were and are by your statement "Because the family owns cars I'd say they are financially independent. No one looks unhappy and my brief look inside indicates they appear very content" The word "Brief" is key; I have spent 8-12 hours Shifts as a Caregiver in more then a "FEW" Nursing Homes so this gives me a more accurate viewpoint(then a brief look) to make a statement as to what the conditions are not a 10 minute walkthru cursory type visit. Poor Nursing homes are the rule rather then the Exception here in the USA; talk with any Nursing asst or Nurse who has spent any time in more then a few Nursing homes and they may disagree with your statement,,,We have a few Nursing homes in South Florida where the well heeled spend their final years and they are Cadillacs as Far as Nursing homes but sadly in most cases, these are not the homes most middle-low class will spend their final years in,,,BTW I know all about those toll free Abuse hotlines(for many years now as one who has worked in the industry for more then a few decades)and many of us Healthcare Workers have called and reported abuse but in many cases, unless a lawsuit is filed, the cases and reports linger or are filed in the circular file known as the wastebasket. Sad but true,,,You have NO idea how powerful the Lobbying Arm of the Nursing Home Operators is here in the USA,,,BTW if you are going to defend a point of view accurately, many times its not possible in a few brief sentences or URLs,,,

http://ag.ca.gov/bmfea/elder.php

http://www.elderabusecenter.org/default.cfm?p=nursinghomeabuse.cfm#news

"Wait a minute. What did you just say? You're predicting $4-a-gallon gas? ... That's interesting. I hadn't heard that." -- Feb. 28, 2008 --George W. Bush, Washington, D.C.,

goin_south says on Apr 15, 2007, 12:17:

yes, adrimm... Acadiana is mostly the greatly extended ...area outside of what is known as the hubcity, Lafayette. Mostly, Cajuns, or descendents of the Acadiens who migrated from Nova Scocia, now live anywhere south of Alexandria.
And, others who have been here have concurred how markedly similar the cajun culture is to the latino caribbean cultures...through and through, only one is of french and one is of spanish. Otherwise, in so many respects, you wouldn't be able to tell the difference.

Imagine...it's easy.

and, thank you.

raulinho says on Apr 15, 2007, 13:11:

I don't think elderly relatives living with their family will be bored in fact they have the great stimulation of having grandchildren and greatgrandchildren to interact with, my grandmum adored my sons and she was very alert till the end. I see it all the time working in a hospital how people dump their grandparents and how these people are treated in nursing homes is sometimes awful. It definitely is not advancing the cause of the human race , but everyone is getting more and more selfish everywhere and nursing homes are becoming more common in mediterranean countries where you would never see them before.

Man Tequila says on Apr 15, 2007, 15:43:

Some nursing homes are better than others. Some are absolutely dreadful. Some folks in the nursing homes were essentially abandoned by their families, who seldom visit.

On the other hand, many of these elderly people require complex care. Many get it. Lots of folks have active social stimulation in the nursing home and enjoy it there.

Wouldn't be my first choice, but there are apples and there are grapefruit. Some "nursing homes" are essentially apartments for seniors, who keep their independence and get a little medical supervision. Many families do look after their own. And keeping as much independence and privacy as possible is usually given a high priority by patients, their families and the nursing home staff.

Aunque no me creas/ si me lo propongo/ lograre olvidarte/ porque a fin de cuentas/ no soy tan cobarde./ Y termino todo una de estas tardes/ no sera dificil buscar algún sitio donde refugiarme/ donde nunca mas vuelvas a encontrarme. (Polo Montañez)

miamimike says on Apr 15, 2007, 21:21:

man Tequila I would agree in the Best Nursing Homes Independence is a Priority but for most, they will never be able to afford the "Cadillacs" of Care. Instead they will be relegated to the "Run of the Mill" Nursing homes where patients are more or less neglected, bathed irregularly, not fed properly or adequately in maaany cases. Sadly the best many patients can hope for, after their Assets are spent down, is a Nursing Home Bed subsidized by Medicare or Medicaid,,, If they are gotten out of Bed at all, they are parked in front of a TV in a Wheel Chair or Geri Chair. If they are bedridden, they aren't exercised daily thru range of Motion exercises(then they become contracted and end up in a permenent fetal position), not turned from side to side and repositioned every two hours to prevent Decubiti(bedsores) from developing, Oral Care is often neglected as well. Why do you think Nursing Home Neglect Lawsuits is such a growth industry these days? Certainly not from Nursing Home Patients being overly cared for or having resided in an Nursing home with Excess Nursing Staff,,,

"Wait a minute. What did you just say? You're predicting $4-a-gallon gas? ... That's interesting. I hadn't heard that." -- Feb. 28, 2008 --George W. Bush, Washington, D.C.,

Man Tequila says on Apr 15, 2007, 22:33:

I can only speak for Canadian nursing homes. Few are Cadillacs, but fewer are Edsels. Most get you from point A to B, and have adequate if not stellar oral care, exercising, rolling, physiotherapy, food, turning and programs to minimize frequency of decubitus ulcers. I also see a lot of sick patients transferred in a timely fashion from nursing homes -- only a few have ulcers and most are looked after reasonably well.

Aunque no me creas/ si me lo propongo/ lograre olvidarte/ porque a fin de cuentas/ no soy tan cobarde./ Y termino todo una de estas tardes/ no sera dificil buscar algún sitio donde refugiarme/ donde nunca mas vuelvas a encontrarme. (Polo Montañez)

miamimike says on Apr 16, 2007, 08:03:

Man_Tequila ,OK-Thats a whole different Ball Game You are talking about the Candian Nursing Home and Medical system. Apples and Oranges between Canada and the USA. I wasn't aware you were talking about Canada's system!

"Wait a minute. What did you just say? You're predicting $4-a-gallon gas? ... That's interesting. I hadn't heard that." -- Feb. 28, 2008 --George W. Bush, Washington, D.C.,

poco says on Apr 17, 2007, 01:26:

I see a link wasn’t enough Instead what our Fed Govt would rather do instead of paying out a few dollars(reletively speaking) for inhome nursing care is instead drop a Bundle to the Nursing homes for substandard care at the best.

So I’ll cut out ONE of many examples that directly contradict this statement from the U.S. government site for Medicare.

skilled nursing care on a part-time or intermittent basis. Skilled nursing care includes services and care that can only be performed safely and correctly by a licensed nurse (either a registered nurse or a licensed practical nurse).

This is the Questions and Answers section. Do a search and when you come up with something interesting that appears WORSE than what Colombia dispenses then let us know the comparison.

What you’ve posted is nothing more than a rant about the U.S. and not a very accurate rant for 99% plus of the general population covered by Medicare.

"Violence is the first refuge of the incompetent" - Isaac Asimov

Man Tequila says on Apr 17, 2007, 11:58:

I haven't dealt much with the American medical system. In some ways, I'm glad about this.

Aunque no me creas/ si me lo propongo/ lograre olvidarte/ porque a fin de cuentas/ no soy tan cobarde./ Y termino todo una de estas tardes/ no sera dificil buscar algún sitio donde refugiarme/ donde nunca mas vuelvas a encontrarme. (Polo Montañez)