Ernesto and Alberto make a fruitless stop in Puno, where they can neither swim in the freezing river nor obtain any mate to drink. Ernesto remarks on the “lavishness” of the English trading boats compared to the impoverished town.
The only signs of prosperity in this town are the English boats, which take resources and wealth away to other countries rather than contributing to the domestic economy.
From the local doctor in Puno, the men obtain a letter of introduction to Dr. Hermosa, a real leprosy expert. Hoping he can provide further guidance and possibly material resources, they decide to make their way to Cuzco, where he lives.
Although Ernesto and Alberto have been masquerading as doctors for the entire trip, this is the first time they go out of their way to seek guidance from a professional in their field. Taking this step shows they’re growing up and starting to think seriously about what they want to do within the medical field, rather than taking their careers for granted.