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BUYING TIME PART II

He could make his patients more comfortable, help them die with dignity. He could even try to buy them a little more time. But he was still a doctor without a cure. A scientist without answers.

August 25, 1984--Infectious Diseases/AIDS Clinic

Myers stands contemplating a wall in the staff room. On the wall are more than 120 names and dates. Some are accompanied by newspaper clippings; others are surrounded by colorful stickers of flowers, balloons and flags. A number are circled by hearts.

The names represent the patients who have died in the little more than a year since the clinic began recording their passing in this way. The clippings are obituaries, most of which don't list a cause of death--or they disguise the true culprit behind such generic diseases as lung cancer or pneumonia.

Although most of the names belong to men, there are a few females, too: a 44-year-old homemaker who left a husband, two sons and a daughter; a young woman in her twenties whose boyfriend hung with her until the bitter end, signed her name to the wall and disappeared.

There are names of black men and white men, brown men and yellow. The majority were in their thirties and forties when they died. There are actors and writers, architects and engineers, home builders, auto dealers, waiters, laborers and chief executive officers of corporations. New names grace the wall all the time: Sam...Russ...Frank...Jeff... Kirk. And soon there will be more.

For those who still live, there is no escaping their destiny. They are reminded of this every morning they wake up and see the lesions on their faces, or every time they take a drink of water and have to wash down a pill. And still, Myers says, shaking his head, they keep their courage and their slight hopes that a cure will be found before it is too late.

The wall is frightening and sad, but in other ways it is comforting as Myers recalls faces and connects them to memories.

There was Michael, who told the story of being so tired on his way to the clinic that he decided to rest by sitting with his back against a building. A man in a business suit threw some coins in his lap. "He thought I was begging," Michael said. He thought it such a fine joke on himself that he repeated it often.

But now his name is on the wall.
Sometimes the heroics approach the unbelievable. On many occasions Myers has watched as a man holds his lover without complaint after a night of cleaning up vomit and diarrhea. Or watched as family members brush off their tears and hold on as their brother or son disappears into AIDS dementia.

It's almost worse for the survivors, especially for those who are HIV-positive. For them, it's a preview of what to expect someday.

Some hang in there. Others choose not to go on at all.
Sam's lover, Stephen, was found dead in Texas. The report they received at the clinic was sketchy, and Myers didn't know the cause of death. But the last time he saw Stephen, he was in good health, with no symptoms of AIDS. He suspects that with Sam gone, Stephen decided not to wait.

Every week there seems to be at least one new name on the wall and another patient for the clinic. The DGH Infectious Diseases/AIDS clinic is known as one of the model clinics in the world for its multidisciplinary care and social services. But the doctors, nurses, receptionists and social workers here all lose their objectivity and suffer as each new name is added.

With a sigh, Myers leaves the wall and goes to an examination room, where a new patient waits.

Fifty-year-old Don has a grizzled beard and wears his weariness like an old thrift store coat. He's accompanied by his companion, Gary.

Don has a non-Hodgkin's lymphoma on his gum. Myers wants to do a spinal tap to see if the cancer has spread to Don's nervous system. At the doctor's direction, Don lays on his side on the examination bed, curled into a tight fetal position to open the spaces between his vertebra.

Drawing a small arrow on Don's back to mark the spot between the vertebrae where he wants to withdraw spinal fluid, Myers injects a local anesthetic. Nurse Georgia Caven holds the patient's hand. "Relax," she says.

Don sighs. "I haven't been relaxed in so long," he says, almost wistfully.
He grunts and winces as Myers inserts the long needle and probes until, finally, liquid drips from the end. Four tubes are quickly filled.

The liquid is clear, a good sign that the cancer hasn't spread, Myers says.
He retracts the needle and tells Gary that Don isn't to do "any dishes or vacuuming for a while." Gary nods as though he'd gladly do all the housework for all eternity if someone would just tell him that Don will be all right.

"You can return to normal," Myers tells his patient as he slaps a Band-Aid over the small hole. "There's your Purple Heart."

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