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Last November, when he began using ABV--one of the older and most common treatments for Kaposi's--he showed remarkable improvement. But now he's worse than ever and barely holding on.

Lately Kirk had been refusing to come to the clinic for treatments and had actually begun turning blue from a lack of oxygen due to the Kaposi's in his lungs. Finally, he agreed to give the clinic one more chance. Although he would never win a popularity contest with the staff or patients, he's gained a measure of respect for his tenacity. Kirk was damned if he was going to let AIDS get him without giving the world a piece of his mind in return.

Two hours and almost a dozen patients after he started his clinic rounds, Myers stands in the staff room looking at X-rays of a man's chest. He's troubled by a cloudy area in one of the lungs.

The X-ray belongs to John, the patient who has been on the Daunoxome study the longest.

John is another of Myers's favorites, a professional survivor who'd already battled back from bouts with pneumonia two years ago that nearly killed him, thrush--normally a childhood disease that causes sores in the mouth and throat but a thousand times more powerful and painful in an AIDS patient--and cytomegalovirus, which reduced his sight in one eye and might yet be the death of him.

His medical file, which Myers holds, is nearly two inches thick. It includes a two-page list of the medications he takes, some to fight the disease, some to fight the side effects of the other drugs.

The cloudy area on the X-ray could be pneumonia again. Or it might be Kaposi's. That's what worries the doctor.

"They feel that if Kaposi's gets in the lungs, it's over," he remarks as a nurse walks up to look at where he's pointing on the X-ray.

Myers puts on his best "don't worry" face and walks to the examination room where John waits. He's tall, blond and has a tan that George Hamilton would kill for. Well-muscled, his grip is strong as he shakes Myers's hand with a hand covered by white scar tissue from an AIDS-related fungus. His model good looks are marred by large patches of purple that cover his nose and cheeks.

In moments of candor, John has admitted to Myers the pain that hits when friends as well as strangers recoil from the sight of his face. But such moments of self-pity are rare.

Today, though, he seems to sense something amiss. "Was everything clear?" he asks of the X-ray. His smile remains frozen though the lines around his mouth grow tight as Myers clears his throat and tells him about the cloudy area.

When the doctor finishes, John tries to recapture his good mood. "Gee, and after all that coughing, I was wondering if this is what congestive heart failure feels like. I haven't had that one yet." He laughs, but it sounds strained.

In another examination room, Jeff waits impatiently. He's a new patient who received his first chemo treatment two weeks ago. Thin, goateed and nervous, the young Hispanic was diagnosed with HIV in June 1991 but showed no signs of AIDS until recently.

"I feel good, really good," he says before Myers can close the door. "My whole body feels glad."

When it's apparent that Myers bears no bad tidings, Jeff feels safe enough to admit that his legs seem heavy. "I have trouble getting in and out of the car or out of chairs," he says.

Myers begins his examination, noting that Jeff's lesions are fading and feel softer to the touch, which means the area around them is draining better. And no new lesions are apparent. But he's more concerned about the reported "heaviness" in his patient's legs than he lets on. It could be nothing or maybe a reaction to the experimental drugs. But it could also mean that the disease is manifesting itself in a new way.

Myers has seen Kaposi's attack everywhere except the brain and the nervous system. But then again, until AIDS, the cancer was a minor player in the oncology field and not known to attack anywhere but the skin.

Still, there's no sense frightening the patient. Myers performs a careful neurological exam without raising any alarm--or finding anything to be alarmed about.

To ease the tension, he asks Jeff if he can "piss well enough to write your initials in the snow." It gets the hoped-for response of a laugh.

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Steve Jackson