Longform

BUYING TIME

Page 6 of 7

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?

"I'll have to check," Myers answered. He knew it was his responsibility to have that information on hand, but it just didn't feel right to encourage a patient to fight as long as possible and then turn around and ask what he wanted done if his heart stopped beating.

Frank died the next day. "I'm going to sleep for a little while, and I want to be comfortable," he told his mother, courageous to the end. They buried him in his pajamas.

The little guy had put up a good fight. And yet, as slow as AIDS might kill one patient, it can overwhelm another in a matter of days.

Jeff, the young Hispanic man who only a month before had told Myers that his "whole body felt glad," was now on the brink of death. The heaviness in his legs had progressed up his back in a rapidly ascending paralysis. It wasn't the Kaposi's after all, but a cytomegalovirus infection of the spinal cord that failed to respond to the usual treatment of gancyclovir--an antiviral medication.

By the time Jeff was taken to a hospital, he was unable to move. He was in a hospice now, waiting to die.

Caven promises Myers that she'll visit Jeff at the hospice over the weekend. Myers nods his head. He can't bring himself to visit any more hospices or attend any more funerals right now. There's only so much emotional baggage he can carry.

The conversation turns back to Frank. He had loved life so much that despite repeated attacks from various painful infections, he was always willing to try something new and encourage other patients who were having a hard time. Yet, since he was gay, many people had thought of him as a pervert, a queer, a faggot. Someone to be despised, not a real man.

They compare Frank's approach to that of a patient in the regular oncology clinic who is suffering from prostate cancer. The man is an immigrant from Cuba who has a three-year-old baby girl and an alcoholic wife who can't even care for herself, much less their child. His best chance for survival lies in the removal of his testicles--but he refuses to go under the knife.

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Steve Jackson