The Price of Title 42 Is the Battered Bodies of My Patients

As the stretcher was wheeled into the room, I glanced up from the patient chart. Following right behind was a burly man in the distinctive dark-green uniform of the U.S. Border Patrol. The patient, a young woman, lay shivering. A spinal collar had been placed around her neck to immobilize it in case it was broken. Her face, fixed upward, grimaced. “Wall fall?” I asked as the nurses prepared to move the patient from the stretcher to the bed. “Yeah,” the officer said. “How high?” “Eighteen feet. We found her on the ground. Not sure how long she was out there like this.” It was the end of the monsoon season in El Paso. On my way to this night shift several hours earlier, I had driven through a torrent of rain that must have slicked the surface the young woman had climbed. Ieva Jusionyte: What I learned as an EMT at the border wall I took a closer look at her. She seemed to be in her late 20s, about my age. Loose dirt and sand clung to her drenched clothes, a dark hoodie and sweatpants. I leaned down next to her so that I was at eye level. I’m Dr. Elmore, I said in fumbling Spanish. She turned to face me, still trembling. We’re going to take good care of you. But first we need to take off your wet clothes to make sure you’re not injured anywhere else. Confused, she looked to the nurse, who explained to her in flawless Spanish what we were going to do. She nodded and closed her eyes. As a medical resident, I have spent the past year treating the victims of U.S. border policies on both sides of the frontier. I co-founded and run Clínica Hope, a clinic in Juárez, Mexico, where my patients include migrants who have been turned back from the U.S. border and forced to wait in Mexico. I am also an emergency-room resident in the University Medical Center in El Paso, Texas, where I treat those who couldn’t wait any longer. This woman was my first patient to have fallen from the border wall. I had only recently begun my residency, and the motions weren’t yet automatic. The nurses and I took off the patient’s Converse sneakers and socks. Coins and Mexican pesos tumbled out of them. With trauma shears, we cut through her hoodie and sweatpants, revealing a Chicago Cubs jersey and jeans underneath, the prototypical American outfit. I cut through the jeans as the patient winced. Her right leg was swollen and misshapen; it was broken. As we cut, we found more pesos, some jewelry, a tiny cross, a picture of the Virgin Mary, a soaked Colombian passport. The nursing staff carefully placed each item in a bag for the patient as the Border Patrol officer looked on. RECOMMENDED READING A diagram of the fatal collision between an Uber self-driving car and a pedestrian in Tempe, Arizona Uber’s Self-Driving Car Didn’t Malfunction, It Was Just Bad ALEXIS C. MADRIGAL Three marshmallows with happy faces. 4 Rules for Identifying Your Life’s Work ARTHUR C. BROOKS An illustration of a mass of worms beneath a forest. Cancel Earthworms JULIA ROSEN The nurses rolled the patient onto her side. I moved my hand down her spine, looking for any deformity or tenderness, and performed a neurological exam, watching her eyes follow my finger. I examined every joint, listened to her heart, and pressed on her belly. The CT scan would reveal a pelvic fracture, a right-leg fracture, and a liver laceration. When I arrived in El Paso a year ago, the Trump administration’s “remain in Mexico” policy was in its last days. Under it, asylum seekers who presented themselves at ports of entry would be returned to Mexico to wait, many of them for months, for their hearings. The policy ended in August 2022, but Title 42, an emergency public-health authority that allowed border officials to rapidly expel migrants without due process or the promise of a future hearing, remained. The stated rationale behind Title 42 was to stop the spread of the coronavirus across borders, but in Texas, this measure outlasted every other COVID-19 safety protocol. Title 42 left hundreds of thousands of migrants waiting in border communities that can be exceptionally dangerous for them. Human Rights First has documented more than 10,000 instances in which migrants removed to Mexico by Title 42 were subject to violence including rape, kidnapping, murder, and torture. David A. Graham: Biden is making a Trumplike mistake at the border American border policies are designed to impose a high price on those seeking asylum. But people are willing to pay incalculable costs. At the intensive-care unit in the El Paso hospital, I encountered one such person, a woman who stared blankly at the ceiling. With her 10-year-old daughter, she had traveled—who knows how far? Hundreds, thousands of miles? They made it over the border wall intact, but to get to El Paso, they had to traverse the Border Highway and I-10. A car hit them in the night, killing the daughter and leaving the mother with multiple fractures. “We were going to Virginia,” the woman said to me just as I prepared to leave the room. “Can my daughter be buried there?” In September, the demographics of my patients seemed to change overnight; most of the migrants I saw in both El Paso and Juárez were now coming from Venezuela. These were among the most traumatized I had treated. To reach the border, Venezuelans must first cross the Darién Gap—a stretch of jungle between Panama and Colombia that lacks roads and must be traversed by foot. Some of the people I spoke with described the bodies of less fortunate travelers they had passed on their trek. The Darién is notorious for bandits and inclement weather, but it also harbors another peril: disease. In our emergency department, we began seeing cases of tropical illnesses that are rare in America, such as malaria and dengue. This spring, when Title 42 was set to expire but no one knew what would take its place, migrants came to the border in droves. The El Paso community rose to the occasion, welcoming newcomers in shelters. From the August 2022 issue: An American catastrophe The policy that the U.S. government then unveiled required migrants to request asylum in the first “safe” country they reached outside their own, which for most of those from Central and South America is technically not the United States. As a result of the shift, U.S. Border Patrol’s encounters with migrants in El Paso are down by more than 60 percent since Title 42 ended. But the migrant population at shelters in Juárez has increased. Last week, the shelter that houses my Juárez clinic held about 850 people, compared with its typical population of 400 to 500, and the situation is similar in other shelters. Many of these asylum seekers will lose hope and try to climb over the wall. Some will end up in my emergency department. Every time I cross the border to get from the Juárez clinic to the El Paso emergency department, I think about how easily and swiftly I can do what many people risk their life to do. My patients come to the border because they believe that America will do the right thing. Their injuries and deaths are avoidable—they are the cost American society has decided to impose on those seeking a better life. Brian Elmore is an emergency-medicine residency physician in El Paso, Texas. He co-founded Clínica Hope with the Hope Border Institute in Juárez, Mexico. For more information, visit us at https://www.beverlyhillsimmigrationlaw.com/.