Birthday in Boyaca, part 1


Been catching up on my writing.. Haven’t written as much as I would like to recently but for good reasons.. After a difficult year – last year, I had vowed to enjoy myself and embrace life again. I’ve always been someone with “ganas a vivir” and I had lost that joyful spirit. This year, I have been doing my best to reclaim that spirit and my sense of who I am. One of the things that had really hurt me last year when I turned 50 – in the midst of all this turmoil was the lack of celebration. Not of me, per se, but the celebration of life, of living, of exploring, of the great privilege of being able to experience joy, wonder, pleasure and laughter.. I have that back – and I am going to hold on to it fiercely.. Whether that means embracing my “epoca de estupidezes, boadas y locuras” by doing all the things I want to – putting myself and my wants first for a while, or just by lighting fireworks – and being true to my redneck rural roots, then that’s what I am going to do.

For my birthday, we decided to take a three day trip through Boyaca. it’s nothing life shattering, but Boyaca is one of my favorite states in Colombia. It’s green, green, green and the rolling hills remind me of my beloved Virginias.. Most of the places we went, I have been to before – but this time, it wasn;t on a tour bus. It was the two of us trying to re-connect and remember the love and friendship we had before it all went so very, very wrong. It’s not a reconciliation, because some things can’t be undone – but it’s a re-definition of our relationship. Maybe it seems weird that we would go on this journey together after everything – but my life isn’t tradicional in any sense of the word, anyway. I mean, I am an American living in Colombia, so my life isn’t going to look like most people’s anyway.

We work together, we lunch together most afternoons. I bring special supplements back in my suitcase when I come back home from my trips back to the USA, and I accompany him to most of his medical appointments. I am the one that interprets what the doctors say into something resembling common dialect for the family. I sit with him during the long chemotherapy sessions and I like to think that we have developed a deep friendship. I am probably deluding myself, but that’s how it is.

So we set off from Pacho for our first destination: Raquiria.

Raquiria is a tourist town known for it’s ceramics and craft work. Raquiria is one of my favorite places for silly reasons, I suppose. It’s a town filled with light and color, so it’s a place I like to photograph.

We stayed at a cute little airbnb, and he indulged me in one of my pet hobbies – portrait photography. I love taking photographs of just about anything, nature, architecture, events, but taking photographs of people is what I really really love. I love the challenge of trying to capture the essence of the person in a still photograph. Years ago, he used to patiently sit and pose for hours while I practiced. He was one of my favorite models. Today, he indulges me for 30 minutes. It’s just the start of a great day.

This is my favorite of all the photos.. He looks a little older than the Andres I know, but he looks good.

Here’s one of me..

We drove thru Sudamarchan – so of course, we stopped for the famous sausages..

Villa de Leyva

On our way to Villa de Leyva, he stopped the car suddenly at a dusty looking road, with a big grin on his face. Soon, I had one too! Go-karts!

We started out clean – he drove – carefully avoiding mud and small puddles after recent rains.. But of course, as soon as he turned over the wheel to me – into every puddle I could find! Very quickly, the go-kart was covered in filth, and so were we! It was a lot of fun..

Villa de Leyva is one of those heritage towns – a colonial Spanish town with a large central plaza.. People don’t come to Villa de Leyva for Go-Karts.. They go there for the history and the charm. So we did those things too.. There was a wedding at the church in the central plaza, with the bride arriving in a horse drawn carriage.

This is going to be a two part post – with all the pictures and such.. Next post – Mongui (home of the soccer ball).

Las buenas y las malas: Or how Clinica Reina Sofia tried to kill my dad


Long time readers know that I have spent the last 13 years of my life evaluating, writing about and promoting medical care in Colombia. In addition to this blog, I have written multiple papers. presentations and books about my experiences and direct observations of care in the various facilities in Bogota, Colombia. The majority of experiences have been excellent.

I have been bringing clients here several years, including my own mother – who had a life-saving TAVR for critical aortic stenosis in 2019 at Fundacion Cardioinfantil. If she hadn’t had that procedure then, she would be most assuredly dead now. Instead, she is a vibrant 84 (almost 85) year old female who continues to run several miles every day, participate in a multitude of exercises (aerobics, zumba, dance etc.) and sports (pickleball, running group). 

Of course, when you are taking about something as vast and varied as health care, it’s never going to to be 100% all of the time, for every condition at every clinic, office or hospital. As part of the process of writing a book about healthcare and surgery in Bogota, I have spent literally thousands of hours in hospitals and hundreds of hours in the operating rooms around the city. I have interviewed hundreds of doctors and staff members. Some of these experiences have been so-so, some have been below average, and a very few have been bad.. Our recent experience at Reina Sofia on Calle 127 falls into the incredibly bad category. It was so bad and potentially life-threatening that it almost sounds like farce. Until it’s your dad. And the nurses that are ignoring the patient are ignoring your dad as he experiences crushing chest pain.. The clueless ER doctor is just irritated by your very existence because she wants to get back to chatting on What’s App – and continues to talk down to you. (I am fluent in medical spanish – and cardiology/ cardiothoracic surgery) and that seemed to anger her.)

When the nurse performing your dad’s EKG gets angry when your bradycardic, pale and dizzy dad doesn’t get his shirt back on fast enough so that he can dump you back in the waiting room and he can go on his break. Then when the cardiac enzymes are positive, they move you to the observation area and never check on him again. I had to check his chest pain/ vital signs/ everything while we wait, futilely for someone to help us. 

Nevermind oxygen saturations in the mid 80’s.. Seems like the plot of a bad 1980’s movie – as you realize that they are ignoring you, because you are a crappy old gringo, and that they would rather and leave….

Until you have to call a friend to help you leave the hospital so you take your family member to another hospital because the staff keeps ignoring you – and telling you “wait ten more minutes” hour after hour.. Until the so-called specialist rattles off a prepared speech, and doesn’t seem to listen when you dad explains that he still has chest pain (after receiving only tylenol in the ER). It was a devastating experience – and a terrible learning experience.

I freely admit it was my mistake. I initially wanted to go directly to Clinica Shaio when my mom called me – but after thinking about the distance – I made the (wrong) clinical decision that if my father’s clinical status looked poor – that I shouldn’t risk the trip – and should take him to the closest well regarded facility. Clinica Reina Sofia is just minutes from my house, and my dad looked eminently bad. So much so that I rode in the backseat of the car with him in case he needed CPR on the way.

Photo by Pixabay on Pexels.com

But I trusted that ER staff would know how to manage a common and basic emergency condition like this. After all – it’s part of basic life support classes – you know, the classes that lifeguards and babysitters take. That assumption almost cost my dad his life. It’s particularly hard for me because I have been to Reina Sofia before (in the operating rooms, etc.) and the care was pretty good – good enough that I took my dad there in the middle of the night. Maybe they (Reina Sofia) do know how to treat this very common emergency condition.Maybe they know that time is the essence.Most likely they do.Which means that they just don’t care.Because they certainly didn’t care about my dad.They just wanted him to sit down and shut up.

As I write this, I am waiting for the cardiologist to tell me about my dad’s cardiac catheterization – here at Clinica Shaio, where the care has been wonderful and immediate! 

Reason # 1 – and Holidays in Colombia


Over the years, people have asked me the same question repeatedly. “Why, Colombia?” Different people have asked me this question for different reasons, about different things. Sometimes it’s Colombian people – government officials, surgeons and others, and they are asking in relation to my work in medical travel.

Sometimes, it’s my fellow North Americans asking for the same reason. Sometimes, it’s my co-workers in the USA, who want to know why I spend so much time here. Sometimes, it’s Colombians for the same reason. Sometimes, it’s just people who are curious.. There are many many reasons, and I won’t talk about them all today.. But..

The #1 reason I love Colombia, live in Colombia and promote Colombia and Colombian culture is: The People!

Obviously, people are unique, and there are good and bad people etc.. everywhere. But I have found my Colombian friends, acquaintances, neighbors, and even many many strangers to be some of the nicest, and kindest people I have encountered. I would have never been able to write the books, if that hadn’t have been the case. Before smart phones (and related technology), and speaking very minimal Spanish, I was able to navigate, research and write several books about this country, all due to the countless times absolute strangers helped me out, whether I was lost in the far part of town, needed to complete a task complicated by complex instructions, or just needed additional information. There was always someone that volunteered to help. Many of these people went on to become close friends, or colleagues. But sometimes, it was just a stranger on the bus who was giving me directions to where I needed to go.

Of course, there are nice and helpful people in the United States – I always tell people, that in general, “gringos” are friendly and welcoming to strangers. And the rest of the world, has no shortage of nice people either. But it’s more than that – here there is a sense of family and inclusion that we seem to have lost in the United States. When I was a child, during the holidays, families (like mine) always invited visitors, strangers, single people etc. to join us – and celebrate with us. But much of that sense of inclusion has diminished over the last several decades.

Where my parents would invite people to picnic with us at one of our soccer games, etc. my generation is more closed off – our immediate nuclear family becames a secret club. Instead of saying, “I can’t do lunch because of my child’s X activity, but would you like to sit in the stands with me so we can catch up?” people have become exclusionary – and often times, pretty darn proud of it. It becomes almost a badge of honor among young adults to start excluding even very close friends once you marry and had children.

It’s more like, “Look at how special I am – I have a spouse, and kids, [and thus don’t have time for you].” I am not the first to remark on this phenomena, there has been miles of articles, books and literature written about it. It ties in with the helicopter parenting and other childrearing trends that are more prevalent in North America. This anti-social, narcissistic trend probably isn’t entirely absent in Colombia – but it’s not common. So, in Colombia, at least, your friends with kids are still your friends and vice versa..

Thus, for someone like me – who likes to travel (and likes to travel alone) and live a very independent life – being able to maintain friendships with people, and being able to include them in my life and theirs, despite their childbearing status is important. (I love my friends, and even though I don’t have kids of my own, I enjoy being around children, especially when they get to that fun pre-teen age).

But during the holidays, these trends tend to be enhanced, which is why they talk about the depression and risk of suicide during the holidays – in the USA – because we have a lot of lonely people being left out of a lot of socializing for superficial reasons (like divorce, widowhood, or single status) even before the pandemic turned our world upside down.

But let me give you a recent example (just one of many many experiences I have had) and tell you about my Christmas – because maybe it’s better to just talk about actual events – instead of sociology theories..

Of course, let me acknowledge, that the Holidays in Colombia are a very special time anyway.. It’s not about a bunch of presents under the tree or buying a lot of stuff you don’t really need. Colombia is a Catholic nation – and religion is definitely part of it – but not overwhelmingly so. (I am not terribly religious – and none of it makes me uncomfortable here – which means something; when you consider that many times at home in the USA – I can’t get through a business meeting without someone feeling the need to invoke Jesus, repeatedly, in a lengthy and aggressive manner, whether or not it’s appropriate.)

Christmas, New Year’s and the Holiday season is a time to celebrate – with friends and family. It’s a time for homemade cooking, exchanging hugs, stories and spending time together. It’s gotten more complicated recently – but this year, everyone was vaccinated – and boosted – and several of us remained masked too (with doors and windows open for extra ventilation).

This year, 2021, my neighbors, the Gonzalez family invited me to join with their big, boisterous, lovely and sweet family for Christmas. I moved here in the middle of the pandemic – with strict lockdown rules in place – so I didn’t really know my neighbors well – only enough to share greetings in passing. We had exchanged holiday greetings and neighborly gifts (they gave me a lovely anchete (gift basket), and then they invited me to spend time with their family.

Look at this lovely anchete, filled with great things..

Side Note:

I learned a long time, when I first came to Colombia – to say yes to these opportunities. (When I was new to Colombia, I would often say no because I didn’t want to be “a bother”, or inconvenience anyone. I thought saying yes was bad manners – so sometimes, I turned down invitations to do things that I really wanted to do because I thought people were just inviting me to be nice – and again, I didn’t want to inconvenience them…. and then a nice Colombian girl I knew explained that by turning down invitations, people got the impression that I wasn’t interested in what they had to offer..

So I got over my uncomfortableness at feeling like I was “putting people out” and started saying Yes.. To just about everything… and it has made a heck of a difference – and I’ve had some amazing experiences and gotten to know some wonderful people).

So off we went to his brother’s house.. Both John and his brother were born in the atlantic coast of Colombia, even though they have spent most of their lives here in Bogota. So, in a salute to their costeno heritage, they were cooking some delicious cuts of meat – using a smoking technique called al trapo..

Our host, Richard Gonzalez

Don’t worry, while I may have been too busy enjoying myself and talking to everyone to take pictures of all the members of the Gonzalez family – I did manage to get lots of food pictures..

Big bowl of cuts of beef and pork

My neighbor is one of five siblings – and three still live in Bogota. He and his wife, Brenda have six grown children, who all live nearby.. So it was a fun gathering of some very nice people, who all love each other a lot. Mr. Gonzalez brother, Richard was doing the honors cooking the meat with one of Mr. Gonzalez’s sons.

My neighbor’s middle son..

So first you dampen a piece of linen or loosely woven cotton cloth in wine.. Red wine, preferably, but any wine will do. It just needs to be moist, not dripping.

Cloth moistened with wine

Once the cloth has been moistened with wine, sprinkle coarse salt and some pepper on the cloth. Then place the meat in the center of the cloth. Roll the meat in the cloth, adding additional salt and pepper between layers.

Meat rolled in wine soaked cloth and tied with string

Then the meat roll is placed directly into the fire (on a wire rack over the flames)

The first meat roll placed in the fire

Cook the meat for 20 to 30 minutes. When the roll is removed, it will look crusty and burnt, but it will be juicy and delicious inside. Cut the fabric and the strings.

After the covering has been removed, let the meat rest for five minutes before slicing and serving.

There was a bevy of other delicious things to eat.. I took pictures of some of my favorites

mmmm.. Chorizo
with mango salad

There was a delicious mango salad, with lettuce, pineapple pieces, mango chunks, and raisins. I don’t know what the dressing was – but it was delicous and mild enough not to overpower the delicate flavors in the salad.

holiday desserts including Natilla
delicious cheesy bunelos

Besides enjoying all the delicious food and drink, we had a lovely time. John and Brenda’s kids are a lively, good-natured bunch.. I wish I would have gotten more pictures at the time..

the Gonzalez family

At midnight,, everyone including the sweet little grandkids gathering in the living room to watch the little ones open a few presents.

the grandbabies, enjoying some desserts..

Then we played some games, chatted and the adults enchanged secret friend gifts.. (They did charades during the gift exchange, so you had to guess who the gift was going to..) Danced a little bit – enjoyed some jokes.. and then it was time to go home..

All and all a lovely time, with a charming family, celebrating Christmas here in Colombia..