San Miguel's hospital: no place for northerner in complex emergency. San Miguel's hospital: no place for northerner in complex emergency.

‘Missing’ friend found dead in his home

Expats should have a plan for medical emergencies

I received an email in September from someone who had not heard from a friend in San Miguel de Allende who was in the practice of sending near daily emails.


She contacted other friends as well as me to see if we could find out if he was okay.

After the police entered his home with a friend and found no sign of anyone, friends of the missing person (a vigorous man in his early 70s with diabetes) began to search.

The police did not issue a missing persons report because the man was only known to have been missing for a day or two. But by day three his house was cordoned off as police decided it was a crime scene despite the fact that a hungry dog was trapped inside in unseasonable heat.

A few brave souls entered to feed and water the dog, which was locked in a porch area so they didn’t have to enter the house itself.

With help from the United States consular office we searched morgues, hospitals, favorite haunts where our friend liked to hang out, train tracks and deserted fields.

We could not go back into his house to see if there were any clues or signs of foul play. That was claimed to be the purview of the police and we were strictly prohibited from entering “the crime scene.”


As far as we knew the police did not re-enter the house to check for further signs of foul play or the missing body. It may be they did not want to deal with the stench rising from the house as it baked in the warm days of summer.

Two days later friends of the victim entered the house, ignoring the crime scene tape, and found his body. Five days later the police finally agreed to re-enter the house, where they too found our “missing” friend’s body by his bed, where it should have been completely visible the first time they searched.

As expatriates we might expect far better police work and more active involvement from the U.S. consular office. (Note this is not his fault as he is not able to assist in such cases. Once police have declared a crime his purview is extremely limited.)

I have lived in San Miguel de Allende for three years now and have witnessed more than a few unnecessarily agonizing deaths of expatriates. This most recent one has a lot of similarities to a death reported in the Chapala area.

It is not a death at the hands of narcos or through random violence but rather just death by a fall or a simple accident. I would say it is a death made more horrible by lack of planning and community awareness of our vulnerability as visitors and expatriates in a land that has far fewer resources to spend on its own citizens than we northerners may come to expect.

We may have to face the fact that we are not first in line for use of those few resources.

As our lives pass relatively peacefully here in Mexico we may or may not have the good fortune to remain in good health with only the occasional visit to a physician (charging us a fraction of what it costs in the north). We count our blessings and our foresight.

Years may go by but eventually ill health does catch up with us. How many have planned for this in advance? Many do: they get health insurance or go home at regular intervals to see family and take care of health concerns. But as age or illness take their toll, what if those health concerns can’t wait for a leisurely trip north?

As a patient advocate I have seen many an expatriate caught without a Plan B, such a plan being how to manage a chronic cancer, severe cardiac disease, strokes, fractures that shatter brittle bones, cognitive disorders, mental illness — the list goes on.

It is when these illnesses strike that the limitations of your new home may also strike, especially for those living on a limited income.

(There was a similar story in Chapala recently when an elderly expatriate was found dead by another expat and a Mexican physician days after his death.)

San Miguel’s general hospital, as with many smaller government facilities, is not a place a northerner would want to land in a complex emergency. There is no cardiologist or neurologist available, very few workers speak English and it is hard for any outsider to get to you when you need them the most.

Nursing care relies on one person to sit with you, preferably bilingual and a family member, in order to take care of your basic needs. Visiting hours are limited and there is a formidable guard at the front desk.

Give thought to your own Plan B, and whatever would work for you, but now, not when it is too late.

The writer operates Be Well San Miguel, providing patient advocacy services. She has worked as a physician assistant in the U.S. and Latin America and Africa. She trained at Stanford University Medical School and has a master’s in public Health from UC Berkeley California.

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  • 101st

    This problem is not at all uncommon, in the US.

    • alance

      In the US immigrants often obtain free Medicaid to cover their medical expenses.

  • Emily Penney

    As terrible as this mans death is this happens in the US and Canada and other places in the world quite frequently. I take offence at some of the wording in this article. Why on earth would an expat expect to get a different response from the authorities than a local would? They are not special. Of course you have to wait in line for these resources. You have to wait in line for any resources. As a matter of fact in my humble opinion ex pats should be at the end of the line. This is not our country.

    • ben

      mexicans especially illegals are in FRONT of the line in the US. elderly veterans be damed. mexico is an abusive culture as most cent america is.

      • Peden, PA

        Ben you’re just a troll. I have worked in my towns ER for almost 7 years in a hugely populated Latino Appalachian town. 8/10 White Americans come in with Medicare/Medicaid, while that same amount of Latino’s have private insurance. We never question residency- so don’t come back saying it’s a immigration issue.

        • ben

          this depends upon the location in the US. i know NYC treats vets very well. we have no room for migrants the hotel is full. i stand by what i say.

  • WestCoastHwy

    Comparisons not, death is universal. The only comparison to death is with Western and Non-Western Cultures. Western Cultures sees death as something to avoid where as Non-Western Culture embrace death. For instance, all Hollows Eve was metamorphosed from Non-Western Beliefs to when people embrace Jesus as the immaculate son of god. The fine line between Jesus Christ the Jewish carpenter and convincing people to give up their lives and cultures to follow the book of Jews gave cause to this division.

    If one has not studies this nor understand the vast Non-Western Culture’s demise, the true meaning of holocaustic is lost.

    What does this have to do with this article, plan and simple, a persons death without celebration. We have lost our true culture and are now embracing that which is not ours. I therefore give celebration to your friends death and can assure you he is now returned to the beginning. Don’t forget to smell the roses and remember that life as well as death is always a time for celebration and embrace.


      I too take offence at some of article’s verbiage. The inference is that medical care in USA is far superior although much more expensive. Expensive, yes! !! But superior? ??? Certainly not! ! More is spent per capita and less is received. People wait for months for appointments. Doctors are far more interested in prescribing medications, necessary or not, for this is how they make money. I have seen this with my own parent, as I looked after her for 17 years.
      We are fortunate to be here as part of a society far more gracious than we deserve.

      • ben

        speak for yourself. i deserve! maybe not you. its just as crappy here if not worse. depends upon the dr. & your condition. my dr is good w/somethings, a salesman for the others. the drs in mex get a kickback on meds like in the US, they over prescribe. same problem. the artical was about the possiblility of saving rhe persons life. maybe he was unconsious for a few days. maybe he was getting a heart attack? what about the PD leaving him there & not calling the dr to sign the death certificate? the PD blocks the house because they rob from the dead. its tradition, especially if an expat. youre nothing here. much of the time.

  • Patricia Conner

    i fell in south part of lago chapala and the district ambulance – which has a station in our city san luis soyatlan – took me to jocotepic new center where i was seen quickly. i had two vertebrates broken but no one new right away. they took the xrays and the doctor spoke to me in english. the reality was that i knew mexicans in my small village who knew what to do and guided me during this period. . i had to go to the states as no one had a great experience operating in my situation and flying to France is too far as air pressure in airplanes are dangerous for my situation. the reality for me is that i was lucky. my fall was so serious that i should not be walking. But i was near the best hospitals and english spoken enough where it counted. . unfortunately, when we live in our home town or abroad, there is a large amount of luck. i live in very rural so dangerous wherever you live. so yes, prepare as if you were at home. i am alive and the Mexican doctors were as good as the french. and the american better at this operation. it is not that much different and pray for yourself. that helps too. i have no complaints.

  • I’m trying to teach my dog how to use a can opener. So I’ll be in one piece when they find me. Otherwise, instead of ashes, they’ll be spreading dog poop.

  • I know it’s silly, but I don’t believe in death, for me anyway. One day I’ll wake up and I won’t be there anymore. it’ll all have been just a dream. And all my old dogs will be there, not just the one that ate me.

  • Dave Warren

    I have bad knees and my Canadian Doctor told me just lose weight . I went to my wife’s Brother (a Doctor ) here and he fixed me right up with a drug not sold in Canada and certain excercises. My knees are about 90% right now.

  • Pat Scott

    I am grateful that I have the right to use the services at Hospital General. It’s not perfect but an ER visit was free for me. As far as the tragic way this case was handled I would say we as expats (immigrants really) need to organize CARE GROUPS where we check in daily with members of the group. I believe the UU has such a group. These groups could be informal and in my estimation should be small groups 3-4 people in each group at the most. Or as we get older and if we can afford it hire a caregiver whose job it is to check in every day. This caregiver should not be overloaded with too people and should have a car and working knowledge of the person’s health history, financial abilities/restrictions and know the healthcare systems available in SMA well.

  • Frank Black

    I don’t get the point of this article. How can planning or resources prevent the death by falling in the home of someone living alone? It seems to me that this can happen to anyone, anywhere.

    • JG

      The idea is to sell the author’s services even though it is illegal for her to practice medicine in Mexico.

  • JG

    Written by a person to promote her own business. And, it should be noted she has no credentials in Mexico nor a cedula to practice medicine in Mexico. The Hospital General does a very good job, thank you. Typical fear mongering drive people to author’s business.

    • ben

      wrong you are. i would be happy to have that service here in my town in mex. someone who would call a dr if i needed it.

  • Terri Lane

    Great opinion piece. It is very important for expats to plan for the unforseeable future. We are fortunate to live in Cancun, and have access to specialists and decent hospitals. As well, we live in a gated community with a full time staff. So if, while I am away, my husband were to have a fall and be injured, we have plans in place that assure access for those that may need to enter. We have international insurance (so much less expensive than US insurance!) which covers what we need and we have made wills in Mexico, which is VERY important. It is sad that so many expats haven’t made any arrangements for various emergencies. I do hope some of them see this piece and “make a plan”.