Para leer en español, haga clic aquí.
Esperanza Mendez worries she may be dying, though she doesn’t say it out loud to her two young children.
There is a cyst on her neck, which she said feels like it’s putting pressure on her brain and causing pain in her head. The lump has been growing for three years, and now her whole body aches, especially her arms and legs. She has trouble opening and closing her fists.
“I feel terrible. My head hurts so much,” she often says while pressing her thumbs on her temple. “Me siento muy mal. Me duele mucho la cabeza.”
A few weeks ago, worried about her health — as well as that of her kids, who she suspects are malnourished from their journey migrating to the United States from Venezuela this summer — Esperanza set out to get medical care in her new city. She entered a public health system that is already feeling the strain of caring for thousands of other uninsured people with exacerbated health needs — emotional, physical and more.
She recently spent 14 hours waiting for care in the emergency department at one of the busiest Level 1 trauma centers in the nation.
The prolonged wait time, exhaustion and uncertainty that Esperanza, 47, and her kids experienced are symptoms of a U.S. health care system that caters to people with citizenship, medical insurance and means.
More than 24,000 migrants — mostly from Venezuela — have come to Chicago since August 2022, and are depending on health care from a patchwork of hospital emergency departments and free and charitable medical clinics.
Esperanza was unable to receive proper attention for the lump in her neck in Venezuela, where she also struggled to make enough money to feed her family. So she and her kids walked across seven countries for a better and safer future.
This summer, the Tribune followed the Mendez family on their journey from the border town of El Paso, Texas, to Chicago.
Since arriving July 15, they family has had to adjust to the Englewood neighborhood they live in, where people mostly speak English and gun violence can be shocking and prevalent. They’ve celebrated the growth of their family over Labor Day weekend with the birth of a boy. And they’ve tried to make sense of the bureaucratic public records system and fought for bilingual instruction at their elementary school.
Despite Esperanza’s acute pain, she remains strong and reassuring to those she loves — not only about her illness but about the daily onslaught of difficulties facing her family after walking thousands of miles to make it to the United States from Venezuela, and struggling to adjust to a foreign and unpredictable life in Chicago.
On the Tuesday before Thanksgiving, Pedro, 9, and Yuledy, 10, followed their mother down the stairs of the second-floor apartment where they’ve been staying with the children’s father in Englewood. The family hoped to see a doctor.
“There’s so much mud! Hay mucho lodo!” Pedro said as he walked onto the sidewalk and noticed how he could see his breath — a phenomenon he never experienced in Venezuela.
Yuledy, who wore polka-dot rain boots, smiled at the gray sky and misty air.
“It’s beautiful,” she said to her mom.
The previous day, Esperanza, Pedro and Yuledy had tried to get medical care from St. Bernard Hospital, but, with the help of a mobile translation device, learned from a nurse that they didn’t have health insurance. They were assessed briefly, and referred to Stroger because Esperanza needed more care.
“She was appropriately treated, discharged with a prescription for medication and referred to Stroger because she required a higher level of care,” David Rudd, a spokesman for St. Bernard Hospital, said in a statement.
As the family walked to the bus stop to catch a long ride to Stroger Hospital, Esperanza noticed a brick bungalow that had a window boarded up. She said it reminded her of houses in Venezuela.
“Everything over there declined. The houses are that way, abandoned. Todo se cayó. Las casas están así, abandonadas,” she said.
Falling crude oil prices and crippling sanctions have left many Venezuelans without basic supplies, food and health care. Considered the largest displacement crisis in the world, approximately 7.7 million Venezuelans have migrated and are currently living outside their country. This amounts to over 25% of the total population of Venezuela.
Experts say scarcity brought on by the pandemic further exacerbated Venezuelans’ inability to access reliable health care and resources. But it is impossible to know just how dire their needs are because the government has released no public information, said Julian Fernandez Nino, assistant scientist at Johns Hopkins Bloomberg School of Public Health.
Migrants interviewed by the Tribune staying at city-run shelters and police stations say they are worried about their health and that of their children.
Esperanza said health care was not an option for her in Venezuela. Hospitals were understaffed and treatment was too expensive, she said.
“The operation I needed at Hospital Universitario in Maracaibo would have cost me $2,000. That just wasn’t feasible,” Esperanza said.
The wind in Chicago whipped her legs.
“Ooh, God,” she exclaimed
The worst of their new reality, Esperanza said as she walked to the bus stop, isn’t the large gas and electricity bills in their new house. It isn’t the struggle to find work, or even the violence on the street corner.
It’s the pervasive sense of soledad — loneliness — in their new home in Englewood, away from their family. How the world exists so apathetically around them. The judgment they feel.
“(Our neighbors) look at us in an ugly way. With anger,” she said.
The three of them narrowly caught the bus, laughing as they sprinted across the intersection to make it. They climbed on and found their seats. The bus smelled of cigarettes, cannabis and sweat.
A woman sitting next to them handed a Clif bar and a bag of potato chips to Yuledy, who smiled. Her 11th birthday was in four days, and Esperanza didn’t have money to buy or make a cake.
They passed by the Swap-O-Rama, an indoor-outdoor flea market with a large parking lot in New City. Pedro looked out the window at a large cow statue by the sign.
“Look, Mom, a red cow!” he said, pointing.
When they arrived at Stroger Hospital, they were prompted to use another mobile translation device — a screen on wheels — to communicate with medical professionals. Conversation in two languages felt stilted and awkward.
“Those kids shouldn’t be running around like that here. They’ll get abducted,” a nurse said under her breath in English as the children explored the hallways while Esperanza tried to explain in Spanish she was worried her daughter wasn’t eating.
The Stroger Hospital emergency department has received 107,000 visits this year for conditions ranging from chest pains and respiratory illnesses to orthopedic injuries and gastrointestinal issues, as well as overdoses and other ailments.
An estimated 2,000 of those visits were from migrants, said Cook County Health spokesperson Kate Hedlin.
Esperanza and her kids were sent to the pediatrics department first. Their wait in a curtained partition would last for four hours.
Pedro and Yuledy wrestled each other on and off the hospital bed. They covered their cheeks and foreheads with stickers they’d been given by employees. They played with the masks on their faces and ate the few snacks offered to them.
“Restless. Inquieto,” Esperanza said sternly to Pedro, then smiled at him.
They could hear the woman in the partition next to them interacting with a nurse. She was also Venezuelan, but staying at a city shelter. The Venezuelan talked about her daughter, who had blisters in her throat.
“She’s not eating anything. She hasn’t eaten for days,” the woman said in Spanish.
Esperanza pointed at the Disney show that was on the small screen hung above the bed to distract her children.
“Listen to that little cartoon girl and you’ll learn English,” Esperanza said to them.
A nurse came into their partitioned area and Esperanza was put in a light blue hospital gown. She pulled Pedro up into her lap and kissed his cheek.
She said he and his sister have grown despondent over the past few months. Instead of playing their usual games of tag or rock, paper, scissors, they’ve been spending their days lying on a mattress on the floor of their room, watching shows on their mother’s phone. Yuledy often refuses to eat.
They’ve stopped going to school.
One day in October, Esperanza went to pick her children up from their nearby elementary school when she saw a group of about 10 boys and girls circling her kids.
“He fell on the ground. She fell too,” Esperanza said.
Before she knew what was happening, all the kids started hitting each other at once. People were screaming.
Her motherly instincts kicked in, and she fought through the crowd to pull Pedro and Yuledy up from the ground. She took them by the arm and led them away from the noise, walking the two blocks home.
Though Pedro wasn’t hurt, Yuledy had a scratch on her face and a black eye. That night, Esperanza couldn’t sleep. She wasn’t sure what to do, so she let them stay home from school. Their absence stretched on for weeks, and the children now wanted to go back.
“I just don’t know,” said Esperanza, looking at them lounging on the hospital bed waiting for the doctor. “It makes me scared. Me da miedo.”
Esperanza has heard about gang activity on the streets near their house so she rarely lets them outside alone.
“About a month ago, one of them went to the store,” said Esperanza. “And shots started. Three people were killed, in just one moment.”
Esperanza said the moments after she heard the gunshots were unbearable. Her mind raced. Then she heard little footsteps coming up the stairs.
“Thank God, (my child) was safe,” she said.
Nurses came and checked the children’s blood levels for magnesium and electrolytes. The needles made Yuledy sob with fright, but the tests came back normal. The doctor gave Esperanza the name of a pediatrician for follow-ups.
She grimaced and stabilized her forehead with her palm.
“I feel bad. My head hurts,” said Esperanza.
After the children were seen, the family was moved down the hall to the adult wing of the emergency department for Esperanza’s care.
They waited two hours before being brought to a room. Esperanza lay on the hospital bed, and her children sat in chairs nearby.
She was connected to a beeping machine. Her children noted the numbers on the defibrillator. How cold it was in the room. The vials of their mother’s blood stored in a plastic basket on the counter. The cup with her urine sample.
“Take a photo of that, look. Toma una foto de eso, ve,” Esperanza said to Yuledy, gesturing to the blood samples.
Yuledy had tears in her eyes as she snapped the photo. She handed the phone back to her mom, who sent the photo to her sister in Venezuela.
“God, my head hurts,” Esperanza said.
The hours dragged on as they waited.
They remembered how far they had walked to get to the United States. Pedro and Yuledy had both fallen sick with fevers in the jungle. They’d slept on rocks. They’d watched people drown in rushing rivers.
Back in the hospital room, the children played around their mother, touching her boots and caressing her cheek, roughhousing as Yuledy’s long black hair whipped back and forth.
“Don’t touch me. Don’t touch that. No me toques. No tocques esto,” Esperanza scolded Pedro as he tried to take out the needle inserted in her left hand.
A hospital worker came over and told him to be quiet, and he curled up in the corner and sulked.
The average wait time for an adult to see a doctor at the Stroger emergency department is 82 minutes, which can vary based on a patient’s acuity — conditions that may range from strep throat to a heart attack, according to Hedlin, the system’s spokesperson.
Venezuelans are entering a health care system that is struggling to meet demand for adults without legal status and who do not qualify for most government-funded health benefits.
Hospital emergency departments have become the safety net for uninsured or underinsured patients after Congress enacted the Emergency Medical Treatment & Labor Act in 1986. Because emergency departments are required to provide care to patients regardless of their ability to pay, patients without means or insurance will often depend on emergency departments for nonemergency medical care.
Some arriving migrants qualify for medical assistance through the state’s victims of trafficking, torture or other serious crimes office. But many who arrive at police stations waiting for placement in city-run shelters also go to emergency rooms for preventive care.
“Compared to before, we’re seeing more (migrant) patients seeking emergency medical services,” said Nabil Abou Baker, assistant professor of internal medicine and pediatrics at the University of Chicago, “and I presume it’s the same across the city.”
As Esperanza waited, a man in chains wearing a Department of Corrections jumpsuit was escorted by officers down the hall. Patients in other rooms groaned in pain. One man screamed, “I want to die!”
Pedro barely looked up.
“In a free hospital, there are a lot of people and they can’t see everyone. En un hospital gratis, hay muchas personas y no pueden atender a todos,” the 9-year-old said to his mom.
Almost 14 hours from the time the mother and children left their house that morning, doctors rolled Esperanza’s hospital bed out of the room so she could get a CT scan.
The scan came back mostly normal, the doctor said, with a few black spots.
“It’s probably just a lipoma on the neck,” the doctor told Esperanza with the help of a man who translated. “So we’d like to send you for some additional tests so they can take a sample of it.”
The doctor said a different specialist would call her within the week to schedule a follow-up.
They would do a biopsy to see if the black spots were cancerous. If there was nothing more concerning, they would operate. If there was evidence of cancer, they would start chemotherapy.
“I imagine it’s just a benign pocket of fat that just needs to be taken out,” said the doctor. “It’s a good thing you came in, so that we can take care of this with the right specialists.”
The doctor asked Esperanza if she had any questions, then left the room. Esperanza sat stoically, facing the wall, staring at Pedro and Yuledy. She was at a loss for words.
She looked at her two children, her face full of grief. She felt tightness in her throat; short of breath.
She hadn’t told her kids she felt like she might pass out on the bus ride to the hospital. She answered softly to the nurse that she was at a level 8/10 on a sliding pain scale. The harsh hospital light shone down on her dyed red hair, which she often uses to hide the lump on her neck.
Normally, Esperanza tries to hide her fear in front of her kids, but the hourslong wait in the hospital — with little food, little information and no clear plan for what’s next — had weakened her resolve.
“I’m scared,” she said finally, breaking down in tears.
Pedro stood by the hospital bed and gently placed his arms around his mother’s neck. He put his face near hers, and they held each other and cried.
“I feel really bad. Me siento muy mal,” Esperanza whispered in his ear.
After hours of waiting, and with no direction of what to do next, Pedro helped Esperanza remove the IV from her arms, touching the rash that had formed around the injection site from hours in the hospital.
“Does it hurt, mom?” Yuledy asked.
“Yes, my arms hurt. Everything hurts a lot. Sí, me duele muchos los brazos. Me duele mucho,” Esperanza said.
The nurse came back into the room, told her she should take Ibuprofen for pain and thanked them for their patience. It was past midnight. He called them an Uber, a service the hospital provides free for patients.
They walked through the emergency department, past the front desk. They waited on the curb, remarking on how they could see their breath. Everything outside the emergency room seemed strangely normal.
Esperanza looked at the building across the parking lot and pointed out to her children how a corner window light had just been turned on.
“Look, the first light of the day. Mira, la primera luz,” she said to them.
It’s been 19 days since the hospital trip. Esperanza still has not received the follow-up call from the specialist, and her kids haven’t returned to school.
An earlier version of this story misstated Esperanza’s diagnosis of lipoma.