Going to Great Lengths to Serve the Sick

The odyssey of Dr. Juan Martinez started with a routine house call. In going to check on a boy with a fever, the Mexican physician unwittingly set in motion forces that uprooted and transformed him.

He fell in love. He migrated to the United States. He nursed a broken heart. And now, 10 years later, on the eve of his 40th birthday, he is on the verge of abandoning his medical career.

Martinez, a small, trim man with courtly manners, told me his story Thursday morning over a big breakfast of T-bone steak and eggs at a Denny’s near his home in Buena Park. He dissected the large slab of meat with surgical precision, methodically slicing pieces away from the bone as he revealed layers of his loneliness, his half-fulfilled aspirations and his insistence on re-creating himself--against the odds--in a new country.

Martinez is one of hundreds of people who come to the United States with foreign medical training. They leave home for sundry reasons, from romance to political repression. Once here, many try to earn a state license to practice medicine, but they struggle against the barriers of money, language, immigration status and unfamiliar professional practices.

Throughout Southern California, medical doctors are working as cooks, carpenters or taxi drivers while they try to get a fresh foothold in health care. Martinez himself has worked as a handyman, doing plumbing and other home repairs while earning his certificate as a physician’s assistant.

Acquiring the certificate, along with a work permit from INS, allowed Martinez to get a job with St. Joseph Hospital in Orange. For four months, he has been assigned to a mobile clinic that dispenses health care and information to farm workers at their job sites.

Still, the dream of getting his medical license--a step that would require improving his English and passing difficult tests--fades with each passing day. Now, he’s even considering optometry as an option. He’s taking things step by step, he says.

His story shows that the dilemma of an immigrant doctor is not solely a matter of schooling and licensing. In every life, there are matters of the heart that also determine motivation.

Many times, Martinez said, he felt empty as a single man in a strange land. He knew many other physicians in his same professional situation, but most of them had spouses and families to fall back on. His isolation occasionally undermined his desire to keep going.

Why work so hard to build a life nobody would share?

“The feelings were like an anvil that would weigh me down and crush me,” he said in Spanish.

In 1990, the year after he moved here from Mexico, Martinez became a founding member of an Orange County group called COPHYLA, Consortium of Physicians from Latin America. The goal of the group was to help members get medical licenses or alternative certificates in health care, as medical assistants, nurses or ultrasound technicians.

Attrition in the ranks has been high. In the past 10 years, COPHYLA has worked with more than 2,000 professionals, of whom about 400 pursued a medical license. Only 80 have become practicing physicians, said Rolando Castillo, the group’s founder and executive officer.

The group lost members in a defection over how it was being managed, said Martinez, among several original participants who broke away. Many have fallen behind in their pursuit of success. Yet he still believes in the mission of helping doctors “find a sure and direct way of reaching their goals.”

I met Martinez at the drab apartment he shares with his sister in a blue-collar area of Buena Park. At the nearby Denny’s, we took a booth near a window. He made a point of saying he doesn’t make a habit of eating out very often.

Normally, he wears playeras, or T-shirts. No white-collar job to dress up for. On this day, however, Martinez wore a long-sleeved white shirt, meticulously pressed not by a laundry, but by his mother on her last visit six months ago.

Martinez has that reserve that is typical of many Mexicans. His movements are deliberate and compact, as if he’s concerned about the volume of space he occupies. His speech is studded with polite phrases.

I asked him what made him leave his native country.

“I didn’t come running from anything, nor seeking something different,” he said. “I came to follow a young woman.”

But before boy met girl, boy was married to his career.

Martinez earned his degree as physician and surgeon from the National University of Mexico in 1985. That year, he was sent to San Juan de los Lagos, a small town in the state of Jalisco, where he performed his six-month social service required of all Mexican medical school graduates. He settled there, operating a successful private practice until coming to Orange County in November 1989.

Martinez picked tough duty to start his career: a public health clinic that serves poor communities and ranches like those that are the source of so much immigration to the United States.

His experience reminded me of my father, who, to earn his own medical degree in Mexico in the 1940s, served as the young student physician in a poor town in Veracruz. The health needs were overwhelming; the working conditions rough, even frightening since the novice doctors faced pregnancies and disembowelments by machete on their own.

Martinez was handed a doctor’s bag with skimpy stock--penicillin, aspirin and medicine for blood pressure, diarrhea and intestinal parasites. He had to provide his own stethoscope and his own transportation.

He made his far-flung rounds by bus, on foot, even hitchhiking. One day, he recalled, the director refused to let him use a Jeep parked outside the clinic, which also served as his sleeping quarters. Martinez threw down his bag and quit.

Medicine was not for him, he told a staff nurse. He can’t help people the way he should--the way he dreamed he would--with no resources and no support.

“If we cured people, it was by the grace of God,” he said, his palms out to signify miraculous healing.

The nurse talked him out of his rash decision. He quotes the exact words of the woman who inspired him with her own commitment to community service:

“Doctor, you are making the biggest mistake a man can make. You are providing a service to people who need you. They have learned to trust you and they have faith in you. And remember, right now there people out there waiting for you to help them.”

Martinez retrieved his bag and resumed his rounds. Today, he remembers that experience while assisting farm workers in Orange County. He understands their enormous health needs and knows that the mobile clinic is their only lifeline to regular health care.

“We need him. He’s great here,” says Rocio Magdaleno, director of the program called Puente a la Salud, or Bridge to Health. “The patients trust him. They confide in him.”

Martinez never envisioned himself in the United States. He followed his heart here. While on that house visit back in Mexico, he met the sister of a patient and fell in love. The young woman worked at a Kmart in Anaheim and was on vacation when fate brought them together.

After a quarrel, said Martinez, she returned to Orange County. He came here on a visitor’s visa to patch things up. But his visa soon expired, and eventually so did his relationship. Martinez said he briefly considered going home in 1994, but the Mexican economy collapsed, shattering the lives and prospects of the country’s once solid middle class.

Martinez still hopes he can find professional success in the U.S., and someone to share it with.

Back at his apartment, I asked to see his medical degree. He brought out a Kinko’s bag and removed the large unframed document, printed on deerskin. I was amazed to find it was almost exactly like my father’s impressive diploma, with its oval-shaped photograph of the graduate and calligraphic lettering.

Even in Mexico, said Martinez, he did not display the diploma in his office. As we admired it together, he remembered the words of his own father, a humble farm worker:

“You know, it makes me very happy to hear people say you are truly a good physician, and not just a diploma with no doctor behind it.”

Agustin Gurza’s column appears Tuesday and Saturday. Readers can reach Gurza at (714) 966-7712 or agustin.gurza@latimes.com