Tuesday, May 08, 2018

PIANOS



Pianos by Judith Pedroza 

“I am a piano tuner”, a young man explains while he is waiting for his appointment with the psychiatrist. He is accompanied by his mother. Two other families with patients are waiting and Moisés' family has been the last to get a “token.”  Tokens are literally like an old game. The hospital gives 15 tokens for specialty, but psychiatry has already fixed ten patients for a Friday consultation. The hospital used to be an old school, now transformed. It is run by a group of nuns and doctors who have jobs in large hospitals where they charge more than five times what they charge here in the community hospital. They practice one day a week for half a day, giving the hospital a very good reputation. Their furniture is very old, but it serves the needs of patients. Every Friday, families who already know each other and who have children with similar illnesses, meet there. Curiously, all patients are young males. Moisés is the oldest of all. There is a 12-year-old who his mother says is uncontrollable and cannot stop talking all day. Yet, the whole time in that room, the mother is the one speaking and the boy is quietly attentive. Big, curious eyes, the child just seems bored and his mother seems stressed. Moisés is the patient of this other family, 45 years old already. He left behind a past of economic triumphs, money, and maximum creativity. He does not know how to do it again. He became ill at age 24 at the time when he opened his own business, started a family, and then his wife divorced him after one year of marriage. He closed his business, brought all their furniture there and locked himself inside for months. He would not eat, did not want to, his parents did everything even losing some of their assets to pay his debts. From there he went in and out of different hospitals and treatments that never gave continuity, his parents could not get him stabilized. Her younger sister tried everything.  Presently, she makes another attempt, because he does not want to go to the other side of town, to the best specialty hospital. So he was brought to this small hospital, a ten-minute walk from home. 
   Families there talk, looking for something, remedies, tips, dialogue. They have stories to tell, details of the disease, hobbies, droll things. The disease does not allow the mood to disappear. Emotions run from worry, crying, to laughter. “We are alive”, the piano tuner’s mother says. She explains how her son has been in therapy for a year and a half and how he decided to leave the university. He just wants to make music because he has a special ear that allows him to earn money, tuning pianos in small state orchestras, and he participates as a guest musician in popular presentations. The piano tuner is 22 and discusses science and philosophy with Moisés.
  The piano tuner has read Nietzsche’s Human, All Too HumanEcce Homo, the work of Freud and one of St. Thomas Aquinas, The Summa Contra Gentiles. The Piano Tuner makes Moisés attend to him.  There is a kind of alternate joy. It is a small waiting room for happiness. It is a therapy itself, where patients and families are recognized as a common group who share a half day on Friday waiting for an appointment.
   The piano tuner explains that in order to tune a piano, first, you have to check the central note, hence the LA 440. Then, you begin to check the octaves of each note: do, re, mi, fa, sol, la, all frequencies with the same pulse, and there are parts: fifths, fourths, sixths, sevenths. When the central note is tuned, this tune becomes the bone side of each note, which is called temperament. It is like a cube. Harmonics must have the same speed and the piano has to be very sweet with subtle colors, marrow notes. When the piano tuner talks about a sweet piano, the first image that comes to mind is Rafal Blechacz playing Szymanowski’s "Piano Sonata." It was love at first sight, the first time I heard this young polish musician playing and talking about his music with impressionist-expressionist and melodic tunes, slow comings on the piano and then using his full hands. In this room, which only seems to have a disease, there is music, melodies of talk that lead to another life.
   There is another group in the small waiting room of happiness: the pharmacists, those who sell new medicines, fresh from the laboratory, new features for the psychiatrist. Medications for those who suffer from a mental or emotional illness are the most expensive in the market. In Mexico, more than half the population does not have health insurance and even this kind of medicine is scarce in public hospitals due to high costs and the fact that mental health is not considered a disease or a priority. It is classified as an incurable disease. But there is always hope. Many patents for these drugs are nearing expiration, which means that local or national laboratories can produce them at lower costs. At the time a patent expires, the laboratories in Mexico begin to produce affordable medication and patients begin to consume since they are cheap and a better stabilizer for their condition. Finally, families and patients can access the drugs, giving them more faith to hear the promises in the corridors of pharmaceuticals, who sound like the politicians of health, offering health as a commodity controlled drug. If the patient had tremors from using the older drugs, the pharmaceutical representatives would draw from their brochures to reassure the patient, generating trust between families, patients, and pharmacists. A fiction to heal is also part of the Friday half day. Pharmacists are the hope inside the room.   
   Four weeks pass and patients are already using this medicine.  They feel better and there are some signs of improvement in their quality of life. Some of them feel dignified because they have the energy to do things, to follow the course of their lives, making plans. It's another Friday before noon, the room is filled with patients each time, the same families, the same products. Today, it is time to buy the sweets of health. The mother of the boy who never stops talking is happy. The medicine has had a positive effect on her child. The doctor gives the prescription for the next dose. The mother orders the medication from the pharmacist, who has a leather briefcase, impeccable suit and shoes bought from the San Diego outlets. She tells about her weekend trips to California. Everybody is observing her high heels while she organizes her first order.  It will be 380 pesos.  The mother reacts, “But last month the medicine was 190 pesos. If I am correct, the patent had already been released.” The pharmacist with pretty shoes and leather briefcase answers, “Yes indeed, the patent had been released, but the product offered and taxes that the government extracted from these labs this month make the drug double in price. It won’t be a fixed price.  Next month, it’s possible that the price doubles again, and so the product will rise until its cost of production and profits are not eaten by taxes and can stabilize at a fixed price. It is a fact that next month it will double.” Families are angry. Another family member breaks into the discussion, “I am sorry, but if you had this information before why did you not inform us? If the drug is tripled, it will be impossible to continue with treatment and that causes harm to the patient's health.” The pharmacist answers, “I am sorry ma'am. I'm only selling the product, the doctor is the one who suggests and makes the prescription.” Moisés says, “But you promised to improve our quality of life, gave a kind of political speech and we trusted you.” The pharmacist answers with a violent tone, “Excuse me, I'm not a politician. I am a vendor. My responsibility is to sell. I am not able to resolve your life.”
  It's like finishing and leaving someone with a new life, and a new voice, the piano tuner says.

PIANOS

Pianos by Judith Pedroza  “I am a piano tuner”, a young man explains while he is waiting for his appointment with the psychiatri...