Saturday, July 2, 2011

Diagnosis, or The Apple Doesn't Fall Far from the Head

Sh'ma Yisrael!

Do you remember 1981? I do, pretty clearly, though I was only ... never mind.

1981 is when the CDC first noticed a lot of gay men in New York and San Francisco were getting diseases (and not getting cured of diseases) that did not suit their demo. No doubt this had been happening for years and doctors had merely been puzzled. But a cluster is a cluster.

One of the two diseases was Pneumocystis carinii pneumonia, a perfectly dreadful way to die. The other was an obscure cancer called Kaposi's sarcoma which, doctors explained, tended to afflict elderly men (between 50 and 70 - oh, fifty was an unimaginable old age to me then!) of Eastern European or Jewish or Mediterranean backgrounds, who would treat it (there is no cure per se), live another twenty or thirty years, and die of something else entirely. But these young gay men (my age!) were getting it and it was spreading like wildfire to all sorts of organs, leading to pretty horrible deaths. Eventually - but you know this part of the story - the two syndromes proved to be one, with ramifications. I spent years with the jitters about these ailments, and I still have a list (somewhere) of eighty friends (or very casual acquaintances) who did not survive.

And I alone am escaped to tell thee. Well, not alone (thank the Gods!). I tested negative, when there were finally tests. "You must have lied to me about what you were doing," accused one old (soon to be late) friend. No, I did all that. I just didn't ... pay the price. I believe there will turn out to have been co-factors making certain people immune, but in the meantime I credit the Will of the Powers that I endure, the chance workings of imponderable Providence, low libido factor and dumb luck. (These are four verbalizations for exactly the same concept.)

And science dragged its slow (to outward view) progress and came up with, if not cures, astounding palliations and preventatives, and the human race learned a whole lot about cancers in the meantime. Such as that Kaposi's sarcoma (named for its discoverer, a Hungarian - of course - in 1872) is actually activated by a herpes virus, a discovery at my old alma mater, Columba, in 1994. Herpes is everywhere; as a disease (actually, it's many diseases), it leaves AIDS three lengths behind on the track.

So I am bumbling along minding (or not minding) my own business, and I get this infinitesimal red dot on my little toe. I noticed it in March because that's when I went to my doctor to consult about my shoulder problems and mentioned that too. He recommended an orthopedist but did not seem unduly concerned. The dot grew to large pimple size, but it never hurt and it didn't seem a strange shape (completely round) so I let it alone. Then it began to burst due to the pressure of shoes and of walking, and after a couple of days trailing blood around the house, I went to see an orthopedist, a lovely young New Jersey girl of Indian extraction. (If the doctors aren't Jewish, they are usually Indian or Chinese, eh?) She took it off with no fuss at all and very little pain, sent it out casually for biopsy, gave me antibiotic ointment and Vicodin and sent me home. That was Friday last. On the Wednesday she called me: The biopsy was in. Bad news.

Kaposi's sarcoma.

True, I've always been the soul of retro ...

But I'm HIV negative! I wanted to scream. (Went to the public clinic on 28th Street just to make sure the very next day, and yes, I'm still negative. "I don't need the rest of the tests, just HIV," I told the nurse. "I've been a very good boy." She said, "That's what they ALL say.")

And though of East European Jewish descent on, oh, 100% of my ancestry, I don't think I'm a little old man, and I practice Paganism - doesn't that count for anything?

My Birth Certificate begs to differ: I'm dead center in the demo and Jewish as they come. Sh'ma Yisrael, eh! I guess this will save me spending $200 on the ancestral DNA test cousin Karen wants me to get. (Or maybe I'll do it anyway.)

"Can I just forget about it for a few months?" I asked Dr. Shastri. She said, "No, this isn't something you want to just ignore. It might have spread all over and you just don't know about it. The digestive tract. The respiratory tract. You'll need some tests, some scans, to see if it has spread. If it hasn't, maybe it will just pop up like this occasionally ... but you never know." The problem is I have no health insurance, having no income. (AIDS would have been useful at this point. The state funds that.) I have savings, and money I've just inherited, but ... I'd earmarked that. I thought I could wait it out till Medicare set in. But I'm not quite that old.

If it's spread all over, maybe I just want to check out, but that's not easily done either. There are bridges, of course. And lots of states where it's easy to buy a gun. Or I spend the goddam money.

Death is William Tell, it occurs to me (that being the next opera I'm going to see, next Saturday night), and my head has already survived the arrow two apples' worth: The AIDS epidemic and my own personal lymphoma, fourteen years ago. It's highly unlikely I'll dodge a third as well.

Nadja says, "You didn't get AIDS so you've only dodged one apple. This is the second. I command you to live until you are ninety (two years older than my grandmother), and I'll come visit you every year in New York as soon as Wolfgang is old enough."

At the moment it is very difficult to be cheerful about it though, as you may note, it is very easy to be funny about it, as is my wont. (I was funny about lymphoma, too.) Chats with various specialists and clinics are to take place Tuesday, after the holiday. Balms bursting in air.

Over, but not out.


Chas said...

It's probably slight consolation, but I thought of the (allegedly) Chinese proverb: "One disease, long life; no disease, short life." Meaning, I think, that if you take care of yourself, your chances of going on a long time are better than if you think you are indestructible (not that you do).

Sally said...

Definitely not out. The checkup is wise, to reassure yourself so you can get on with living. (And living is what money is for, and this expense promotes your living, so good use of it!) In the meantime it's not a comfortable place to be, and I hope you can get lost in writing till you get the results and know definitely where you are. The probabilities seem pretty good, but you don't feel reassured till you know the specifics. Hope this time I can actually achieve the technological feat of making a comment..