BUYING TIME

It will be hell for the patient as well as for his family and friends. The onslaught will put him in the hospital for six days every three weeks during a cycle of medication, recovery and remedication. But at least there is the chance that the bogeyman will be sent packing. And that is more than Myers has been able to promise any AIDS patient.

Myers's week is chewed up with meetings, grant writing, clinical research, reviewing patient files and attending a general-cancer clinic. As a professor, he has teaching responsibilities as well as his hospital rounds. But the HIV oncology clinic, which he conducts on Monday and Thursday, is where his heart remains.

Woofer, a skinny, graying man in motorcycle garb, shouts for joy from the waiting room scales that indicate he has gained five pounds since his last visit. He was concerned, because he'd skipped his chemotherapy session.

"They get mad at me around here because I ride my bike to the hospital, get all drugged up and have to ride home," he says, winking at nurses Georgia Caven and Jane Gilden. "But I only live a few blocks away."

"Hi, Doc," he says when Myers emerges from the staff room. "Sorry I haven't been around. I gained five pounds."

Myers reaches out and pats Woofer's hips. "Just checking to see if you were putting rocks in your pockets," he says.

Caven tells Myers that John is waiting in an examination room. As Myers walks in, John is returning a medical book to the shelf. "I wanted to see what disease I could come up with next," John says.

"You could write a whole new book," Myers grins.
The banter is so light that they might have been discussing a case of measles. John guesses that he contracted HIV sometime between 1980 and his companion's death from pneumocystis carinii pneumonia in 1983. Since then, he's had his own brushes with death a number of times.

Myers has a joke: "What two words do you not want to hear in the men's restroom?"

"I don't know," John shrugs.
"Nice penis."
John hoots, then deadpans, "Some of us don't mind hearing that."

Myers notes that John's lesions seem to be retreating. But he worries that a persistent cough might signal a return bout with pneumonia or Kaposi's, recalling the cloudy spot on the X-rays. He urges John, who is going back to Kansas for a couple of weeks to see his family, to monitor his health closely. They hug and murmur, "Take care of yourself."

Woofer, so-named because of his penchant for "woofing" beers, is waiting in the next examination room. The equivalent of the class clown, he keeps talking while Myers waits patiently to get his attention and discuss his treatment.

Cytomegalovirus has destroyed the sight in Woofer's left eye and caused tunnel vision in his right. Often a killer, the CMV seems to be under control. Most of the Kaposi's is confined to the genital area, which is polka-dotted with purple bruises, but even those splotches appear to have faded. Myers holds up a photograph taken a few weeks ago to confirm what his eyes have told him.

"I'm really pleased," the doctor says. Suddenly, he shifts gears. "You're not still using recreational drugs, are you?"

"Oh, no," Woofer replies, as though horrified at the thought. "I don't even go to bars much, because I know that's where the drugs are, and I don't trust my self-control."

Back in the waiting room, Myers runs into Peter Pfeiffle, the AIDS clinic coordinator. They're both in good moods. The clinic has received 90 percent of the Ryan White funding it requested--about $1.6 million. Among other services, the hospital will be able to add a pharmacy and dental clinic dedicated to AIDS patients.

Finally, it is six o'clock, and the last patient has been seen and treated. Myers has a moment to reflect with the clinic's oncology nurse, Georgia Caven.

Brad has had his ups and downs but is doing better. He's thrilled that the Daunoxome has reduced the edema in his legs enough that he can stoop to work in his garden, and he's already bragging about a pumpkin that promises to be exceptionally large.

Sam, too, has enjoyed a remarkable response to Daunoxome. He looks like a different man; the swelling in his face has gone down to the point where he can see.

"I didn't even know he had such big, blue eyes," Caven says. "Sam's happy as a clam."

Roger, the boyish new patient whose companion, Tim, had worried about catching Kaposi's, also has responded well to ABV. The lesions on his face, sinus and larynx have all regressed. Only his lack of appetite worries Myers; he knows the possible implications.

Wasting syndrome has just claimed Frank, the little inventor.
Myers had received a call from Seton House, the hospice where Frank was moved to spend his last days as comfortably as possible. "What is his core status?" asked the voice on the telephone.

Myers was speechless. Asking about "core status" is a way of determining what efforts should be made if the patient goes into cardiac arrest or stops breathing. Revive? Or simply let him go?