“Don’t get me wrong, Abraham,” Will said. “We think the world of you, and none of what I said is against you. My Dad always said that it was part of Christ’s intervention that when he came to Johnson City for treatment he should run into you. I think he meant in part your compassion, but also your foreignness—as if you were a messenger from another world.”
We were quiet for a long time now. The lunch crowd was gone and we were on our second beers.
Out of the blue, Will Junior asked me, “What do you think of gay men?” I wondered whether his question was prompted by someone he had seen, a waiter or a customer perhaps.
“What do you think about gay men?” I asked, turning the question back on him.
“Well . . . I know statistically, there must have been gay men in VMI, but I didn’t know any. And I have had a lot of hate for them after my Dad got ill. After all, they are the ones who donated the blood that allowed the virus to get in there, right?”
I was noncommittal.
He continued, “When I went to Duke one time, there was this gay man sitting next to Dad and Mom. I thought it was the strangest sight: my parents who are like angels, innocents, and this outrageous guy who was complaining and carrying on in a real hateful way, but you could tell where he was sick too. Well, when they called the man in, Dad turns to me and says, ‘Junior, no one deserves this disease. No one deserves this suffering. It is not from God, or God’s punishment. It’s straight from the devil.’ It was like Dad was reading my mind.”
“I agree with your Dad,” I said.
Will leaned forward and lowered his voice. “What I don’t understand is how can they resist women? I mean, goodness, Abraham, you picture this gorgeous woman—a Raquel Welch, say—all perfumed and lying on a bed in a skimpy two-piece, and say you never had sex in your life and you open the door and there she is, just waiting for you—how can a man resist that? I can’t imagine it.”
“Maybe it doesn’t work that way for gay men.”
Three attractive Johnson City women headed for their car. We watched them drive away.
“Beats it all, don’t it?” Junior said.
I asked Will Junior how his mother was doing.
He shook his head sadly. “Mom has no symptoms and Dad is requiring so much attention that sometimes we forget that she has this virus. The other night, I had just taken over from my wife in watching Dad. He was tossing and turning and had finally gone to sleep but he never slept more than twenty minutes at a time. I heard the alarm clock go off in Mom’s room next door at three in the morning. And I knew she had put it on so that she could take her AZT—you know how it has to be taken around the clock. Well, I went in and said, ‘Mom, let me get it for you,’ and I got the pill and water and she was crying. ‘This is the first time anyone has done anything for me, the first time anyone has acknowledged that I have this awful virus too.’
“I am just amazed at their strength, at their love for each other, and the way they kept this secret from us for so long. I am haunted by this trip Mom, Dad, and my wife and I took to England two years ago. It must have been just after they knew they both had the virus. We were in Bath, England, at a place where they had their honeymoon thirty-five years ago. And that afternoon a waitress had looked at them and the way they were holding hands and looking at each other with so much love and asked them whether they were on their honeymoon. She said they looked like newlyweds. That evening at a restaurant in an old castle, a string quartet began to play ‘Send in the Clowns’ and the tears just poured down both their cheeks. They were looking at each other and smiling and crying at the same time. I knew it had always been their special song. And I was thinking, how sweet but how corny—you know what I mean? In a million years I would never have guessed what the significance was of the look they were giving each other.
“When we were leaving the Corpus Christi beach house for what would probably be my Dad’s last visit there, I knew how significant the occasion was. This was the beach house Dad had bought when we were young. It has become such an important part of our growing up, of our memory of childhood. I made a special tape for them, and that night we drove out to the pier and I played the tape in the car as we stared out over the water at the lights off Padre Island and in the bay. We all cried. The tape had all their favorite songs on it. I just can’t get that music out of my head.”
RAJANI AND I HAD made an offer on a house in Roundtree. It was a great time to buy a house: so many of them sat on the market with sellers getting desperate. The house was fabulous, but secretly I hoped that we had made an offer the seller would easily refuse. I was now certain that I didn’t want to buy a house. A fancy house would not solve our problems, only camouflage them. And Rajani had begun to sense my ambivalence about the house, though I had said nothing to her.
Rajani encountered the world of AIDS firsthand when Will Junior came to the house on his next trip to Johnson City. She knew of the Johnsons; I had spoken of them often. I think the disease became real for her when she saw how AIDS had shaken the world of this handsome young man, his beautiful wife, and their children. She took pains to put them at ease in our home, and I was grateful.
And then another time, Rajani and I were walking in the mall when we spotted Luther Hines walking—a miracle in itself. He strode purposefully in a jerky, unbalanced fashion, stopping every ten steps or so, to sit or to reach a hand out to the wall. People stared at him, at the crusted lips, the frondlike growths of molluscum contagiosum on his face, his impossible thinness. How could you not look? It seemed to defy all physical laws that he could be so upright. If anyone stared too long at him, he snarled: I saw two teenage girls rear back in fright, almost spilling their sodas. I pointed him out to Rajani as one of mine. I waited for her to say something, but his appearance had stunned her into silence.
ONE MORNING, I got word that the assistant medical administrator at the Miracle Center wanted to see me. As I walked up to the executive suites, I tried to imagine what the interview might be about. All around the country, hospitals were hiring ID physicians and paying them a salary to run the hospital’s infection control and surveillance program and to see the infectious disease consultations. This made perfect sense, because so much of ID—certainly in the pre-AIDS era—was hospital-based.
The administrator was in his forties, the epitome of the MBA health management type. On his office wall were planning charts; the computer monitor on his desk had a clock ticking in the bottom right-hand corner and my name in a bar. On his desk was a picture of his wife and children.
“I appreciate your coming,” he said. “I wanted to chat with you about the AIDS situation. What do you think the future holds? Are we going to see more patients?”
“Undoubtedly,” I said.
“But is it really necessary for us to see them here? Do other hospitals—say, in Bristol and Kingsport—see as many cases?”
“I don’t know about ‘necessary.’ Felix and I are the only staff doctors in infectious diseases in your hospital. We are both almost full-time VA. The main reason we are here is providing service to your hospital.”
“Oh, don’t get me wrong, we appreciate what you do here. It’s just that AIDS patients sometimes are a big drain on our funds. Scotty Daws, who stayed in the ICU so long, for example, cost us about 250,000 dollars.”
“Well, Scotty is a good example. I didn’t admit Scotty; he showed up in your emergency room. He was admitted to neurology and I was consulted on the third day. He would have been your problem whether I was here or not. In fact, we probably saved you money because we got him out of the ICU and to the floor as soon as we could.”
The administrator looked skeptical. He was thinking that, but for me, Scotty might have died on day two and saved even more money. “Is it fair to say that part of the reason we have so many AIDS patients is because of your reputation?”
I shot back with a question of my own: “Isn’t it true that as a community hospital that takes public funds, you really can’t
turn away patients like that?”
“I’m not saying we should turn them down. I don’t know that we should attract them from other towns that have good-size hospitals.”
“Well, the fellows we are training in infectious diseases are taking up positions in some of those hospitals. With time they may take over some of the case load. Then again they might not.”
“Why not?”
“Because, as you pointed out, many of these patients don’t pay. If you are losing 250,000 dollars on Scotty, you don’t imagine I got paid for all the hours and hours I spent with him?”
“Well,” he said, using the same phrase with which he had begun the interview, “I appreciate your coming.”
I appreciate your coming. I made my way to the parking lot. As I started my car and looked at the Miracle Center through the windshield, I was furious and humiliated. I wanted to walk out—let them see if AIDS went away. They seemed to think I was bringing AIDS to this hospital, disrupting the precious bottom line, the perfect symmetry of the cancer center, the one-day surgery center, the birthing suites, all the high-tech smorgasbord of offerings to channel paying patients into the system. I wasn’t a profit center. And my patients simply did not matter. I wanted out.
AS A REFLEX, I drove over to my friend Allen’s service station. My frequent visits at the end of the day were therapy for me. He had been a patient listener over the years to the saga of AIDS: first its absence, then its appearance, now its abundance. His response to gay men had been the same stereotypical, knee-jerk response that I had once had. But over time, as the people behind the label became more apparent to him, he even extended credit and worked free on some of my patients’ cars. His prejudice had vanished.
I told him what had happened. My desire to take a break, to change the arena, to start anew.
I expected him to protest that I should not think this way. Instead, he was silent, pensive.
“I don’t blame you, Doc,” he said at last. “I don’t see how you do it day after day. Hell, my heart breaks when I blow an engine—but it’s just an engine, it’s not a life. I don’t see as I blame you, though you know I wouldn’t want you to leave.”
We watched cars pull in and out. Allen held his cigarette pack out to me. I lit up and took so deep a drag I had to sit down to keep from passing out.
“You know what, Doc?” Allen said. “One day, about ten years from now, I’d say this town is going to be just like San Francisco. People won’t pay no mind to gay or AIDS or nothing, people just won’t think too much about it. It’ll be like diabetes or cancer, you reckon?”
After Allen’s, I drove to see Darryl, my motorcycle mechanic. I had always tried to keep AIDS out of our conversations. But today, as I told him what happened, he surprised me.
“You don’t have to tell me nothing, Doc. My baby brother, who you never met—I come to find out he is homosexual. I loved him and protected him when he was young. But when I realized what he was, I hated him. But, see, I couldn’t keep hating him because I had loved him for so many years before that. And I realized he couldn’t help it, you know what I mean, Doc?”
I certainly did.
“So I just more or less one day told him I still loved him. I said, ‘Be careful,’ though I didn’t really know nothing about AIDS when I said that.”
“Does he live in town?” I wondered if Darryl’s brother was someone I might have seen at the Connection.
“Hell no. He couldn’t really live here and be homosexual, you know what I mean? He had to get away—I don’t think he really wanted to, but seemed like he had to.”
“Where is he?”
“San Francisco.”
“How long has he lived there?”
“Let’s see: he left in 1978 or so.”
“Do you hear from him?”
“I haven’t in years. We’re not much for writing. After Mom and Dad died, we have all just kind of lost touch. And for the longest time I didn’t have a phone. I have a sister in Cincinnati, Ohio, and another sister up in Massachusetts that I ain’t heard from either. . . .”
“You ought to give him a call, tell him you still love him.”
“Do you think he’s still alive?”
28
JULY 1989.
Rajani and the kids had gone to visit her sister in Washington, D.C., for the weekend. I was alone in the house.
The previous day, I ran into the pretty VA secretary with whom I regularly joshed and bantered whenever we met. She was walking up from the hospital to the domiciliary area, and I was heading the other way. This was the same woman who had been in the back of the VA squad car and offered me a ride the night I walked over to see the Johnsons for the first time. She looked radically different now. I complimented her: she appeared to have lost at least ten pounds and her arms looked sinewy and toned. She was wearing a tube dress. She said she had been working out at Gold’s Gym. And eating differently. “High carbohydrate and watching my fat-grams.”
Her new physique seemed to have given her personality a parallel change. She was bolder, more self-assured and confident—a state of being that seemed too much for our little town. We stood facing each other. Our rhetoric no longer seemed playful, but deadly serious. Like her makeup.
“I’m a new person, Abe,” she said, turning her arms inward, so that I could see her triceps. “Last night I went and bought myself a little black dress. A crepe number. I have this mirror on my ceiling. I looked at myself and, damn, it made me hot.”
I knew what I was supposed to say: something about wanting to see the little black dress. The thought of the little black dress, the delicious way she had said it, already seemed to alter the space we stood in, blocked out the cars passing by, the heat of the day. I was thinking of Will Junior’s acid test for a gay man: send him through a door where a skimpily dressed voluptuous woman is waiting.
I was tongue-tied. “Oh,” is what I finally came up with.
She seemed to be enjoying my discomfort. Before, we had dealt as equals. Now, I felt at a disadvantage. She came up close. “Face it, Abraham,” she said. “We’ve got the hots for each other.” She whispered, “I’m in the phone book.”
Her hand came up from her side now and I froze, wondering where her fingers were going. She reached for the skin under my nipple and pinched me there. Pinched me hard. She strolled away, looking over her shoulder as if to see if I would follow.
All that day she loomed in my mind. I had even checked the phone book: yes, she was listed. And for the first time I felt I could even rationalize what I was tempted to do. All around me, my patients were dying; AIDS made things like bank accounts, compound interest, retirement funds, 30-year mortgages seem absurd. I felt like a death camp inmate: in this setting what did a friendly fling, a flying fuck, a quickie, matter? Lust was such a genuine and life-affirming emotion compared with the ambivalence, confusion and sadness I was experiencing.
At home I felt lonely. As if everyone had left me. But at the same time, I felt guilty for some reason, as if I had driven them off. What saved me that weekend from temptation was not just fear and loyalty to my family, but the fact that there was something else on my mind, something that hovered near the surface like a familiar name I was struggling to remember. There was a pattern in my HIV practice, a paradigm I could see but wanted to flesh out. I had carried copies of patient files and records from the clinic to my house. I kept feeling if I could concentrate hard enough, step back and look carefully, I could draw a kind of blueprint that explained what was happening here in Johnson City, Tennessee, and perhaps in the process explain what was also happening in every little community like ours across the country. And maybe work would make me forget the Little Black Dress and what lay underneath it.
Here we were in late 1989, and the picture of AIDS in our town had changed radically from the day when I walked into the Connection. In 1985 we were in our age of innocence: I was an AIDS expert with no AIDS in sight, a rookie looking for a challenge. Now, we had over eighty H
IV-infected persons in our practice, we were AIDS-seasoned, and all sense of innocence had vanished. Including my own. Our little town in the heart of the country with 50,000 residents had a hundredfold more cases than the CDC would have predicted for us. The belief that AIDS would not touch this town had been absurd—almost as absurd as the plan to bury the respirator when the first unfortunate young man had ridden down from New York and fallen ill with AIDS. The deaths seemed unreal now, so many I could not process what I was feeling. And meanwhile, new patients each week.
I began to think about the patients we were following. Our town’s high-risk folks—gay men—were not infected: several surveys by Carolyn Sliger of the Health Department at both the Connection and New Beginnings had shown us that. Then where did our eighty-odd patients come from?
Spread out on my living room floor, I compiled a list of every person with HIV that we had seen in the office, the VA, the Miracle Center or the hospitals in our neighboring communities. I made a line-listing with three columns: patient name, address, and a blank column in which I penciled in what I knew about each patient’s story, how and where he or she had acquired their illness. I consulted my personal journal, in which for four years now, usually late at night, I had written down the stories behind the medical facts I knew.
I went to Steven’s room and took down the map from his wall. Steven loved maps and had a precocious knowledge of the world’s geography. He knew India, Ethiopia, Boston, Tennessee, all the places that were significant in his life or that of his parents.
I traced out in pencil a map of the quad-state area—Tennessee, Virginia, North Carolina and Kentucky. I labeled this quad-state map: “Domicile.” I penciled in tiny red cannonballs for the current residences of my patients.
The dots clustered around Johnson City and included Bristol and Kingsport—the Tri-Cities. But the dots also spilled over the ledge of upper east Tennessee into southwest Virginia and Kentucky and across to North Carolina. Big Stone Gap, Blackwood, Wise, Pennington Gap, Pikeville, Whitesburg, Norton, Pound—our HIV-infected patients were tracking down from the small mining towns of southwest Virginia and Kentucky; they were coming up from the farming towns of east Tennessee like Greeneville, Morristown and Tazewell. They were even coming across the mountains from North Carolina.