My mother orders a disco volador with guava and cheese and I order a greasy pile of churros that I dip into hot chocolate so thick it’s more like sweet mud. We sit outside on uncomfortable metal seats like playground benches under the multicolored tarp that reminds me of one of those circus-looking termite tents that engulf the unluckiest homes in Miami. The traffic on Calle Ocho zooms by, headlights blink and circle, neon signs light up the night. Another pain clinic across the street. Another dark window. I’ve accompanied Mario to his clinic a couple of times to pick up his paychecks. I notice them everywhere now.

They have blossomed like someone scattered seeds from above and hit every strip mall, every billboard, every back page of the free weekly. There are discounts and two-for-ones, promises of no wait time and in-and-out appointments, cash only, three hundred, twenty-four hours, doctors on call. Walk-ins welcome, HGH and testosterone, too, discount with MRI, commissions on every customer referred, blackout windows, flashing OPEN sign. The massage parlor next door. Check cashing across the street.

Mario tells me some of the doctors don’t even bother with pretense, just ask, What do you want? How much? The pharmacies on-site behind bulletproof glass. The clinic managers who carry heat. The parking lots crawling with out-of-state license plates: Kentucky, Virginia, Maine. The Oxy highway, the Oxy Express. The patients, all tapping feet and abscess scars, lining up outside the doors some days, some already sniffling and rheumy, itching—no, dying—to stave off the sickness. The doctors barely glancing their way, the doctors with their fat gold watches. So unlike my father the doctor, my father the classy super-clean. The money is fucking insane, Mario says. I just have to get a bigger piece of the pie, he says.

My mother cuts her sandwich with a knife and fork. She looks so out of place among the greasy discarded trays and the line of men in undershirts, women in stretch pants, the cafecito-to-go attendants in their starched white shirts and hairnets.

My mother chews and swallows. She runs her tongue over her teeth, a habit when she’s nervous. One I can’t stand. Her lips are my own lips, naturally plump, slightly crooked when she smiles. We’ve been told, always, our smiles look fake. But even doubled over in genuine laughter, that crooked smile.

How are you? she says. Veins on her hands. I wonder if mine will look like that. If I will notice as they change or if I will just wake up one day, wondering when green lattice emerged from under my skin.