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BUYING TIME

AT DEATH'S DOOR, AIDS DOCTOR ADAM MYERS BATTLES TO POSTPONE THE INEVITABLE.WHERE THERE'S HOPE IN THE FIGHT AGAINST AIDS, DR. ADAM MYERS MEASURES VICTORY ONE DAY AT A TIME.

He'd actually been thinking about it for some time and thought that Simels might be flattered. He was surprised when the big man shook his head and adamantly said, "Don't do it. You will make a fine doctor--of people. I think you should go to medical school."

Adam looked at the man. What was it that he saw in the veterinarian's eyes? Regret? But Adam just nodded and went back to his sandwich.

May 5, 1994--Infectious Diseases/AIDS Clinic, Denver General Hospital

Dr. Adam Myers pulls open the back door and slips into the brick building that housed the old hospital. After an interminable wait, the elevator arrives and carries him to the fifth floor and the clinic.

Supplies are stacked along the walls, and boxes of nutritional supplements block the entryway to the nutritionist's office. The boxes are mute testimony to one of the most common ways in which AIDS kills in the 1990s: wasting syndrome. The other top three killers are microbacterium avium complex, fungus and cytomegalovirus.

Like their predecessors of the early 1980s--pneumocystis carinii pneumonia and Kaposi's sarcoma--these four horsemen of the viral apocalypse were practically unheard of before AIDS. Now, like hungry ravens, they peck away at their victims' ability to withstand yet another infection until death wins by default.

On the east and west walls of the clinic are tiny examination rooms. Myers passes them as he walks to a slightly larger room on the north end that the staff uses to discuss cases out of earshot of clients, examine X-rays and records, and generally get away for a moment or two.

The doctor deposits his briefcase, noting the bag of summer squash on the table--Brad's apparently been in--and leaves to look in on the Library, once a quiet corner of the hospital where medical students caught up on their studies.

There are no books in the Library today, and only a smattering of magazines. This is now the place where patients are hooked up to intravenous bags for chemotherapy or blood transfusions.

It's early afternoon, and only two men sit in the room's overstuffed chairs. Above their heads hang bags filled with liquid. In one bag the liquid is clear; the other glows with a fluorescent orange reminiscent of sweet-and-sour sauce at a bad Chinese restaurant. The men will sit here for hours as the stuff drips slowly down through the tubes and needles and into their thin, outstretched arms.

One of the men dozes. The other, as gaunt as a concentration-camp survivor, sits patting his head with his free hand over and over and over again. Myers touches him on the shoulder, is hardly noticed, and moves on.

Outside in the waiting area, there is a good deal of laughter and teasing between staff and the patients who have begun to arrive. At the reception desk, they're playing with a whoopee cushion, giggling uproariously every time the device makes its noise. Suddenly aware of the doctor's quizzical expression, a receptionist shrugs. "Laughter's the best medicine, you know."

The staff does what it can to relieve the tension. After all, this is not a clinic where patients go to be cured. If they're here, they're going to die--much sooner and more horribly than they ever dreamed. The only questions that remain--the reason they're here--are how soon and how horribly.

No one on staff wears the typical white clinician coats, not even the doctors. It's part of their effort to remove any kind of barrier between themselves and their patients. The onus of AIDS has created so many obstacles already: Many have been abandoned by family and friends, stigmatized and despised by society. But here they are all called by their first names, and there is a great deal of touching and hugging.

The room is filling with patients for the Thursday afternoon oncology clinic. Some are in wheelchairs, others walk with canes, and some seem perfectly healthy. Today they are all men, most between their twenties and early forties.

Many of the patients wear scarves or hats to hide the effects of chemotherapy. Some sit and stare with dark-rimmed eyes in haunted, skeletal faces that reflect bout after bout with one infection after another.

Some have come with family members. Others have come alone. But most are with their male companions, holding hands or keeping an arm around a shoulder as they sit and wait.

The telltale purple of Kaposi's sarcoma splashes across many of their faces. Kaposi's is the principal culprit Myers deals with as the clinic's chief oncologist, though he must also treat non-Hodgkin's lymphoma and a host of other cancers that he suspects are attributable to AIDS but not yet officially recognized as such. On other days, other doctors deal with infectious diseases, skin and lung problems--even a psychiatrist to help with the stress of dying.

Myers's main weapon is chemotherapy--poisons that hopefully will do more damage to cancer cells than to healthy ones. There are a number of complex and sometimes interrelated chemotherapy alternatives; currently, the oncology clinic is taking part in a study of a new drug, Daunoxome.

The clinic is one of only sixteen sites in the United States where Daunoxome is available. Myers successfully lobbied to be made part of the study after a Houston hospital failed to follow the strict protocol and was removed from the project. Because DGH is a test site, Myers can also give the drug to patients who don't otherwise qualify for the study under what is known as "compassionate care."

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