Don’t get me wrong: I love border towns. Places that straddle a frontier are more honest than anywhere else in the country. Cities on the boundary between two countries are always the most genuine geography. These marginal regions demonstrate exactly what each culture wants from the other. The Americans come to Mexico for cheap whores, cheap drugs, and cheap doctors. The Latins go to the United States for cheap clothes, cheap auto parts, and cheap junk food. You can keep your Mayan ruins, you can have your colonial cathedrals, you can go frolic on your white-sand beaches: I still think that Tijuana is the most interesting town in Mexico.

Everybody is up to something along the border. Everyone gets a little paranoid in the borderlands. The customs agents scrutinize everyone with suspicion, and for good reason. If you have to leave your country in order to do something, you are obviously up to no good. National boundaries make even the most innocuous activity somewhat sinister.

There is always a rotten core to a place like Tijuana. If everything seems dirty at a border crossing, it is only because the citizens that patronize such places are always dingy. If the streets of a frontier town are gritty, it is because the people that use them are grimy within. The border is like two mirrors facing each other.

Call me a fool, but I love the food in Tijuana. Much like a scientific laboratory, the border takes cuisine from all over the country and perfects it. Even though, for instance, a spicy stew called “birria” began in central Mexico, the meal was improved and enriched in the shabby backstreets of Tijuana. No trip to Baja California is complete without a bowl of this peppery beef stew. The best meals come out of tiny storefronts: the food arrives in chipped, thrift-shop chinaware, accompanied by tortillas dipped in the neon-red grease. Even though you are often served globs of fat and globules of rancid meat, you had better eat everything in the bowl, as you are paying by the kilo. Sometimes, though, because of my gringo sensibilities, I discretely slip a couple of the largest chunks of inedible flesh into my napkin. A customer is expected to add chopped onion and cilantro and a squeeze of lime to the bowl in order to disguise the flavor of meat that is usually, well, a bit off. The diners eat until they cannot stand it any longer.

As the saying goes, birria is the kind of food that stretches the stomach, so I needed to walk this meal off. And to be honest, I wanted to get a beer to wash some of the grease out of my mouth. I really wasn’t supposed to be drinking anyway, as I had been taking enough antibiotics to kill everything in my guts and the damn pills had suppressed my immune system enough to make me extra-susceptible to alcoholic inflammation and environmental irritants. For the last week, a fungal infection had taken advantage of my debilitated immunity and colonized my groin. The micro-organisms were like illegal aliens in miniature, taking up residence in the most vulnerable part of the body politic. I had the worst jock itch ever. A crotch rot so virulent that it left my underwear looking like it had been dipped in barbecue sauce.

No matter how much liquor I consumed, my balls itched—and my testicles could not be politely scratched. With each step, the chafing felt like a cheese grater against my scrotum. I wanted so much to soothe that tender flesh, but I felt that the locals were watching my every gesture and gesticulation.

I followed their example, carefully noticing everything in my surroundings. It was only when I started to become seriously paranoid that I noticed a doctor’s office that treated a particular affliction: “Enfermedades Venéreas.” And, as if it were a sort of advertising afterthought, I caught sight of a handwritten placard affixed to the stucco: “Hongos.” Mexican doctors tend to list their university affiliation in abbreviations, but I did not recognize the jumble of letters above the entryway. I had no idea where the croaker might have received his medical degree. His office was located on an upper floor of a building that was mold-streaked and graffiti-stained; the fact that the spray-painted slogans were completely illegible made them all the more dingy. And, like most of the structures in Mexico, there was a wrought-iron gate covering the security door: the metal bars seemed better suited to prevent something from getting out than stopping someone from breaking in.

I could feel the rasp of bloody flesh between my legs, so I wagered that I didn’t have anything to lose. I tried the latch on the iron grill; the door didn’t budge, and my finger came away feeling greasy. I timidly touched the buzzer beside the locked door, but there was no response. More out of annoyance than anything else, I gave the buzzer a longer press. After a tense minute, I heard some noise behind the door. I heard keys drop, and then a groan. Finally, the inner door opened and an unshaven man with red eyes looked at me, scrutinizing me from the top of my head to my shoes.

With a grunt, he unlocked the security grate and pointed down the hallway. I felt somewhat hesitant, but I reluctantly walked forward. Before closing the security gate, the fellow stuck his head out the door, looking at one side of the street and then carefully examining the other direction.

He pointed down a side corridor toward another door with yet another security grate. He unlocked this secondary gate and touched my arm, leaving the same greasy residue as was smeared on the latch. I noticed that he had a sort of cast on his right hand, with the plaster applied as coarse and craggy as the walls of the hallway. A couple fingers stuck out at odd angles, as if they were a sort of last-minute addition.

All along the border region, there is a strange quirk about language: a local tends to use as much of the neighboring tongue as he can remember. With a twitching effort to recall forgotten words, one communicates as if he had a sort of aphasic tremor. Even if a Mexican only knows a few words of English, he will try them out on the traveler: all of them, each and every word. Even if a tourist can speak perfect Spanish, he will be answered in a spasm of broken English.

Before speaking, we look at each other. He is dressed in a stained smock with Dennis the Menace pajama bottoms; close enough to pass for scrubs in the Third World. The doctor then sat down at a desk in front of me; there was a bookcase behind him with a display of withered plants, half-filled liqueur bottles, and decades-old medical tomes. At one side of the consulting room was a medical examining table, covered by a blanket pockmarked with cigarette burns. There was a door on the opposite side of the room, with the paint around the knob blackened and blistered by use.

Mexican medical offices are always bleak places, with cracked floor tiles and burned-out light bulbs. No matter whether they were rented by the cheapest practitioner or the most expensive specialist, all doctors’ offices in Mexico have the same scent: an odor that smells like a mixture of cooking oil and stale urine. A visit to a Third World physician will make a man question why he was even born.

Since I had come this far, I exchanged the usual pleasantries in Spanish. He responded with an English word: “Hello.”  I told him, in Spanish, that I had a fungal infection. He said “hello” again. Looking down at his cast, he scratched at the exposed thumb with his left hand and slowly summed up my existence: “You have a mushroom infection.”

All I that wanted from him was to ask whether I should purchase fluconazole or itraconazole from the drug store. In all border towns, pharmacies are more common than convenience stores. The doctor didn’t respond. Then a moment of doubt struck me; I started to wonder whether I should take a single attack dosage or schedule the antifungal pills over a couple weeks.

He moved some empty syringes around on his desk and frowned. “Mushrooms are many types,” he finally declared. Not sure what to make of this admission, I told him again about my symptoms. I began to feel some exasperation. “You have type we do not know acquaintance.”

I was still puzzled by his response, and I was getting ready to leave. I began to hear a noise like someone was in a closet off to the side of the consulting room.

“We take mushroom and do test.” Thinking there might be some logic to that assertion, realizing that there might possibly be more than one fungal species, I asked him if he would take a swab for testing. I began to feel nervous and couldn’t remember the Spanish expression for “swab,” so I used the English word.

The look on his face was negative. He scrunched up his eyes, and I heard some glass break in that side closet. He didn’t react.

“We scrape, we scrape,” he said with some excitement.

I feel a bit unsteady. Perhaps it was the dubious meat I just had for lunch, but it was more likely that I was hesitant to let this doctor anywhere near my ravaged scrotum.

“We bake mushrooms in little oven for seven days.” He seemed pleased with himself and held up his left hand along with the two fingers sticking out of the cast. God knows what he would have done if he needed to emphasize an eight-day time frame.

Without saying anything, he began rummaging around in a desk drawer. He pulled out some used tissues and an old can of Chef Boyardee stuffed with medical instruments. Good old American mini-ravioli, I assured myself. The top of the can was ringed with tomato sauce, but the thought of dried blood popped into my mind.

As quick as a lizard’s tongue, he extracted a scalpel from the opened can. A used scalpel. I began to make excuses and started grabbing at the Mexican currency in my shirt pocket. He held the instrument between two fingers of his left hand and seemed to be pondering something. He chewed as he thought. He looked as if he made up his mind about something. “We need sample,” he decided.

I told him that I had another appointment and that I needed to go right now. I took a 200 peso note and laid it on his desk. It was a little over $10 in American currency, and I thought that was money well spent if I could just get out of there.

He looked at the money as if it were some exotic creature. “More,” he said, tapping the point of the scalpel on his desk.

I didn’t have another 200 pesos in my shirt pocket, so I reached for my wallet to get more banknotes. The doctor got up and walked to the door. I thought that he was going to usher me out, but, instead, he turned the lock on the door. I noticed he was still holding the scalpel.

He looked at me, and then wiped his nose on the back of his hand. “We need sample,” he repeated.

“You give sample,” he elaborated. He extended the scalpel toward me, while moving the blade, scraping at the air.

“You do sample like this.” I didn’t understand. “You give me sample,” he said again while scraping at the air with the same motion. Finally, it dawned on me: I was supposed to extract the diseased tissue myself.

He looked at me as if I were stupid. He stood up with his legs spread apart. He stuck the scalpel between his legs and theatrically mimicked that same motion.

At that moment, I heard a cough in the closet.

I was now more shocked than scared, more astonished than alarmed. I had been to a dozen doctors in Latin America in the last few years: none of the professionals expected me to do any medical procedure myself. Sure, a given practitioner’s skillset might not be all that great, but no physician ever told me that healing would involve a do-it-yourself effort. Even if he did have a broken hand, surely the doctor couldn’t expect me to perform a surgical procedure on myself.

“You do now,” he insisted. “You do sample now.” Then he pointed toward the closet, where I had heard the unmistakable sounds of human presence.

He handed me the scalpel blade first. I gingerly took it, more out of relief than anything else. Then he fished a piece of linty cotton gauze out of a pocket in his pajama pants. “Take,” he told me.

I felt a little unstable as I walked to the closet, as if all those beers I had for lunch were beginning to take effect. I placed my hand on the knob and felt a glob of that same stickiness. That grime made me more anxious than anything else, and my hand jerked back involuntarily. I looked at my fingers: what I had touched appeared to be Vaseline. Elbowing me aside, he opened the door himself. “Now, now, right now,” he began repeating.

Slowly, he stepped away; there was a small bathroom, instead of the closet that I had imagined. And there was nobody in the room. No one at all. The lavatory was completely empty. “Fast always best,” he assured me, while touching my elbow with the cast.

Thinking that there was something seriously wrong with my perception, I stepped into the WC. The bathroom was small, and there was a plastic bucket full of shit-smeared newspaper beside the toilet. I stood there with the scalpel still awkwardly clutched between two fingers of my left hand. I didn’t know what to do.

The door closed. I think he told me to hurry, but I couldn’t quite make out what he was saying.

I didn’t know how I was going to get out of this. The bathroom had no other exit, not even a window. I noticed what looked like used bandages on the floor. For some reason, the sight of those soiled dressings reminded me that I needed to wipe the Vaseline off my fingers, so I reached into my pocket. I found a wadded-up napkin from my lunch, a meal that now seemed a lifetime way. I unfolded the crumpled napkin from the restaurant, and it was at that particular moment that I had the greatest idea of my life.

I felt as if I were a student of Zen Buddhism who had suddenly achieved and attained enlightenment. It was like a revelation. And that is exactly the nature of all divine illumination: a way to outwit the system.

There, in the napkin, was a lump of reddish fat from my lunch. I knew what to do. I scraped up the glop and gingerly placed it onto the cotton gauze. I was ecstatic. It was as if I didn’t have a care in the world. I theatrically moaned and then turned on the water faucet. Only a rusty drip came out of the tap. I didn’t care.

I opened the bathroom door and strode to the doctor’s desk. I placed the scalpel and the cotton wad in front of him; it looked like a religious offering. I smiled, and—God help me—it was a genuine grin. I found another 200 pesos in my wallet and told the physician that I would be back.

True enough, I would come back to Tijuana. I love border towns.