An Immigrant's Heart

To survive the ordeal of escaping Guatemala, Julia needed a big heart. But not this big

Julia is always tired. Her older sister says she is "tranquil" from the pills she takes every day, but there is also in her a kind of resigned defeat. She is at risk of being deported, but only if she doesn't die first. She speaks about her decaying heart as if it were another bruise on her frail arms—a result of some recent blood tests. The only time her face scrunches with worry is when she thinks about her children losing their mother. Then she breathes out a long puff of air as if to deflate her whole body.

Julia's long, flat hair is jet-black, without a fleck of silver. Her skin is golden and smooth, but she has dark circles under her piercing brown eyes. Her fingernails are polished and maintained, but her hands look aged and worn-down. Her voice is high-pitched and slow, and her shortness of breath makes her sound a little choked-up.

When she leaves Bellevue each week, she carries a brown paper bag full of medication refills. She's used to the routine: one pill to thin the blood, one to control the thyroid, another to control the water levels in the heart, two to maintain her blood pressure, another to help get to sleep, and a pill to control depression.

Julia Amparo-Alvarado at her Greenpoint apartment
Willie Davis
Julia Amparo-Alvarado at her Greenpoint apartment
Bellevue's Dr. Danielle Ofri: "I felt ... entirely defeated" meeting Julia.
Willie Davis
Bellevue's Dr. Danielle Ofri: "I felt ... entirely defeated" meeting Julia.

She also comes back with sheets of printed paper that describe her blood-test results, her next appointment, the names of nurses who have poked her with needles. It's all in English. She and a social worker go over each one, and she writes down translations where she can: Marzo instead of March, cinco instead of five.

"My daughter asks me, 'Why don't the other parents have to go to the hospital when they are sick?'" she says with tears in her eyes. "I have to tell her that someday, hija, I will have to go to the hospital and not come back."

Over the past six months, Julia has lost a lot of weight, bringing her to a mere 100 pounds. Her arms hang loosely from her bony shoulders. Her belly is the only part of her body that is swollen—a side effect from the H2O blockers she takes to control stomach acids from eating her insides. She rarely leaves the apartment. Dressed in soft cotton pajama pants and an enormous faded T-shirt, she spends days coloring in her daughter's old coloring books. She watches television—memorizing the schedules of favorite telenovelas such as Hasta que el Dinero Nos Separe (Until Money Do Us Part) and talk shows such as ¡Despierta América! (Wake Up, America!) and the goofy El Gordo y la Flaca (The Fat Man and the Skinny Lady). She is too weak to do anything else—to climb stairs, to cook, or to walk. Even as she sits at her kitchen table, she fidgets—searching for an ideal position in which she can remain comfortable until the side effects from her medication kick in and she becomes nauseous or drowsy. Her door is always unlocked, and the neighbors and their children are constantly streaming in and out of her kitchen. They keep an eye on her, occasionally bringing Tupperware containers of food or books for her children.

"I do miss Guatemala," she says. "But it is good here because there is security. You can earn money, and you can get a better job—make money. I can have a place to live. There is hope here."

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