Posts tagged “HIV

Reading Steinbeck…again…

Reading Steinbeck makes me long for the days when I worked with the health department, makes me long for the time when I used to be out and among the people, touching their lives, sometimes touching their hands or bodies in ways that let me know that they and I were alive in a human sense that also touched me in my deepest heart.

As I write this, tears are coming to my eyes and my throat is getting tight at remembering that life, that previous life when my days were filled with more than the talk of a police radio and the answering of 9-1-1 phone calls, when I could drive about the city where I lived, my city and county where the people were mine and I was theirs and charged with doing something for them.  I could see and feel them, could smell their smells and walk in the dust of their roads and unkempt back and front yards.

I long for the smell of a hot palm tree as it is baking in the August sun with the pigeons and other birds shitting down on those people and me and my car, where I could walk among the duck shit at Encanto Park when I was taking a break from my many field visits and rest in the shade or watch the white middle-class moms taking their three and four year-olds decked-out in Oshkosh-by-gosh jumpers and short-sets to play in the sand entrenched playground while watching the transients wander between the bathrooms and pay phones, watching who might be watching them and not.

I would sit in my car and watch the people who came to the park on their lunch breaks, wondering at who they were speaking to on their cell-phones, or wonder at what they were reading or writing as they sat at the picnic tables and looked up every now and then as the swarm of pigeons took wing and brought up the dust and dirt from their wings and the ground in their leaving.

I long for the days when I would walk down 12th Avenue and Buckeye and feel the stares on me as the locals wondered what they hell I was doing in their neighborhood.  Some would recognize my white car and white self parked along the curb and come out to talk with me, while many others stood inside at their windows waiting for me to leave.

I can see the area still as it used to exist, with Dixon’s Club on the south east corner of 13th Avenue and Buckeye, old gray and purplish stuccoed building with the one scraggly Palo-Verde tree there on the corner with the dirt parking lot and old wooden door jamb that had seen many fights and raids and strange white cops darken its doorway, and then across the street on Buckeye proper at 12-something west, the Social Club and its parking lot on the east side of the building where I got some blood on my hand after drawing someone at the trunk of my car, with my little black fanny-pack of a blood kit, elastic band to tie off their arm, the tubes and needles and alcohol wipes for cleaning the puncture spot…the wipes that came away filthy brown most times and lightened that tiny patch of skin where I would insert the needle to take some of their precious blood to see if it was tainted with the curse of syphilis.

I would then drive the sample back to the clinic and deliver it to the lab and watch patiently as the techs spun it down and then took a drop of the serum and mixed it with the reagent that would quickly, slowly, or not at all react with its charcoal grains that meant those people or persons had been touched with that curse, that same curse that made me scream in my soul at receiving the blood test results of the newborn that was four times higher than its mom’s blood results taken at the same time.

Reading Steinbeck causes me to see the little insignificant things in life and marvel at their simple-ness and integral-ness to what we call life.  He draws a big picture but fleshes it out with the details that I seem to be away from now that I’m in an office or call-center all day.  I hear the distress of people on the phones or the excited-ness of the officers as they’re chasing someone and the usually calm voice of the sergeant saying that we are not in pursuit and watch the new dispatcher get amped-up and tense in her typing as she’s trying to get it all down in the officers’ radio traffic….

I see the same two hundred people every day or week and they all look the same in their uniforms and combed hair and large and cumbersome work bags and headsets and their lunches and breakfasts and coffee for their two best friends and supervisor who used to be only their friend but is now their friend’s supervisor, and the radio consoles and phones and computers for call-taking and dispatching and the tables that move up and down and the many chairs that must be arranged so just so in the corners to hold their extra bags and the ones that nobody wants to sit in because they stink or have strange stains where the person’s crotch would be sitting or the one wheel doesn’t turn or it’s wide enough to be a loveseat and some of them bring all kinds of shit from home with them that their desks look like their office at home with pictures of kids and husband and dog and their personal box of Kleenex and Lysol wipes and their three pens and packages of gum and this book and that and the notepad….

My car used to be my office, too, as I drove around from one side of the county to the next, taking my little binder with green cards that represented infections or contacts to infections and carried my notes of efforts to contact and find them on the back, and my pens and pencils in the cup holder and the extra napkins from McDonalds and Jack-in-the-Box and Filiberto’s and Armando’s and Adelberto’s and Los Betos from my own various lunches and breakfasts amid the wandering of my city and then.

I now drive only two or three roads to get to work and back and the commute is a sterile representation of only getting from one place to another, not the driving about and looking for people and noticing the shrimp shack or burger shack where they served pancakes or menudo on the weekends or used a small pickup truck to block the entrance to the car stereo shop when it was closed for business….

Sometimes I’d drive to El Mirage or Surprise and wonder at the surprise of being there, or wonder at what was seen in that first mirage seen out there so long ago before it had a sign naming the year of its incorporation and how many people lived there at the last count…and its cotton fields along which I would stop and pick a couple tufts of the white stuff and wonder at the years of oppression of people who were dragged from African shores to pick the stuff….

I would stand there for several minutes and wonder at the dirt and the irrigation channels and see and hear the aircraft from Luke AFB nearby and be thrown further away and into my childhood where these sights and sounds were a comfort and a normalcy of everyday stuff and business, and then get back into my car and drive past the fields of roses and other flowering bushes and shrubs and be amazed at how fields and fields of the things could be grown here in our hot scorching desert and then cut and shipped to other parts of the country or world to adorn people’s dining room tables….

Then I would drive past fields of onions being picked by hunched over brown skinned people and there would be a smell of sour-cream-and-onion potato chips in the air and I would drive to the far western side of Maricopa county in the truly bum-fuck-Egypt part of our world and find myself surrounded by the huge and monstrous and beautiful female cottonwood trees in full bloom with their white cottony shit flying thick and cloudlike in the afternoon breezes among the trailers and mobile homes parked and anchored in their allotted spaces with the Big-Wheel trikes and Tonka trucks tucked under and beside the wheeled homes that did or didn’t have the nice grating or plastic wall skirts all around their homes….

And the people were gentle and welcoming or suspicious as to why I would be all the way out there in their neck of the woods with my health department identification looking for their daughter or son or whomever and is the water not ok to drink out here or what?

When I read Steinbeck I wonder how I could abandon those field and dairy workers and their little families of infected people and cousins, leaving them to other devices and treatments when I used to be able to tell them to go to the clinic and don’t have sex until you do and the smell of chicken and cow shit is strong on the hot breeze as I stand there in the scorching sun with sweat running down my cheeks as I also smell their beans and ham hocks and rice cooking on the stove, emitting their own clouds of steam or the chilies roasting on the fifty-five gallon drums with the smoke penetrating the neighborhood and my clothes so that I still smell them when I’m driving home to my house in Glendale or Peoria and find some of those same chilies at the ABCO market or Food City…and I could look in their dark eyes and see the hope and trust or wonder or doubt as my white self told them what they needed to do to take care of themselves as their little Juanito ran around in his diaper and nothing else eating a peach with stickiness on his face and hands and arms and belly as he chased their dogs from the trailer to the shed and back….

Now it perturbs me when someone steals my favorite spoon out of my desk drawer at work and I feel the need to send scathing emails to my coworkers accusing them of thievery or asking who dropped the coffee bomb on my desk and among my pictures and I used to not care about such things as I drove my client to Jack-in-the-Box on the way to the clinic so I could buy her two Jumbo Jacks and a large curly-fries and a large Coke because she only had a package of dry Ramen noodles yesterday….

I had found her at her shit-hole trailer at Sixth Avenue and Jones that day and looked into her home and saw daylight shining up through the plywood covered floor and the kids were missing some of their front teeth as they eyed me suspiciously and asked me in their maturity what I wanted with their mom….

The older one noticed that the last name on my ID tag was the same as his and asked if I knew his family…and his name was also Josh, like my 12yo son and he was going to be 12 in November, too…and he was cute and had the same gentleness in his eyes as my Josh did/does…and I wondered at how life could be so unfair and so fucked-up for this little Joshua when things seemed and were so nice for my little Joshua….

I could smell his house and home and filth and dreams for the rest of the day, even after I blew my nose several times, chewed sharp and tingly gum and had enchiladas and salsa for lunch…I could still smell those things of that other Joshua’s house as I drove home to mine those several hours later after taking his HIV positive mom to my clinic so we could also treat her gonorrhea and chlamydia and try to convince her to stop sleeping with her boyfriend who was already dying from AIDS….

But she wouldn’t and didn’t and we came to see her on the foster care review board and later saw that she died and was no more and that her other children went the way of the wind and some and now I’m concerned with ferreting out the problem with the radio and is it the jack or the bottom part of the dispatcher’s headset that suddenly crashed and made the sergeant call me to say that we lost our dispatcher so we’re going car to car, thought you’d like to know….

I know there are Steinbeck stories in the radio room and among the 9-1-1 operators…and their hair is so shiny and their perfume or lotion smells so sweet and their cars are so pretty in the parking lot and the digital picture frames of their children and vacations are so expensive and their cruises are so interesting and so far removed from the shit side of life…and they do have their trials and difficulties and their parents die violent deaths in car accidents and murder-suicides and their lives do suck sometimes too….

But somehow there is no parallel between this and sitting in the small interview room of the clinic or sitting in the dirt under one of the ancient eucalyptus trees in an alley on the south side of town while a hugely fat, dark purple-black man who just told me about the hood rat who sucked his dick and gave him syphilis changes the subject so quickly and asks me if I know Jesus….

I love reading Steinbeck.

***This is a Favorite Re-post from November, 2009.


The spice of life?

So…I took my camera to work the other day….


Skeletons in the closet….

What is that sound, that scratching, that tapping away, that scraping and prying I heard along the way.  I passed down the hallway, around the corner and into my room; I heard a shuffling, a movement, and a something-is-there kind of sound.  What is that gnawing, that board coming loose, that crack of a something being pressed against and pushed into, forced to be somewhere it wasn’t, and then.  I saw the doorknob turning, heard the pin and tumbler move aside, the light from the window caught on the bronze and tarnish and sought my eye, that twinkle where a twinkle wasn’t just a moment before.  What caused that thing, that coming to, that vapor from a floorboard, and that mist between the hinges, what could it be…that tiny kind of burning when I started to pee?

 A telephone call from a stranger’s place, an office with signs and slogans on the wall, pamphlets in display cases, numbered tickets on the floor, a welcoming eye and a wavering smile, those things greeted me and disturbed my peace, different words from that stranger’s place on that cloudy afternoon.  I took the elevator to the second floor and could have sworn there were rats in the walls.  The cabin loomed with its scratching sound, that scrape and tear at the insides from something there….

 The nurse was gentle, she was not unkind, even with the purple gloves that lifted the boys and pulled back the hood…but there’s no amount of peace or distraction that can help one not notice a swab being stuck into Mister Johnson and slowly turned and dragged along that tender opening in the effort to collect some kind of hiding or tucked away cells from their resting place within the membranes’ coating…it’s gonna hurt, plain and simple…probably…unless you’re one of those guys who like that kinda pain…with the rings and piercings and, well you know what I mean.  Anyway…it would have been so much easier if I had just waited to pee…no scraping and grinding and….

 …and what are you, I said to that thing?  “I am the thing that you thought you’d hidden away, that secret, that something that was lost even to your memory.  I’m that laboratory finding, the antibodies’ keys, the hooks and pins, and whatnots, and the swirls of helices in your pee, the elemental bodies in your babies’ eyes, the cysts in your belly and the rash between your thighs.  I’m the dysplastic cells in your girlfriend’s womb that means your cauliflower garden is about to bloom.  I am that drip, that burn, that strain, that clap, that chancre and rash, those blisters and bumps on your secret place and places and that goopy something leaking from your nether region…I’m the substance of things you never hoped for and the evidence of things you can’t see…I’m that disease you caught in your stolen or random intimacies, your rendezvous-es, and your closing-time hook-ups….  I didn’t come from a toilet seat or a hot-tub or a door-handle or a soiled seat in a locker-room…you got me, you caught me, and you catched me, too, when you got down and dirty, doing the nasty, plowing furred furrows and other kinds of things…and now here I am…the skeleton in your closet…come knockin’ again….


The STD Clinic and the New Year

Traditionally, the New Year is a time of renewed hope and heightened expectations for the next twelve months – sort of a new beginning – readdressing old resolutions with a revitalized desire – at least looking for the New Year to be better than the past one.

 

January 6, 1993 was a first for me.  According to my physician-assistant friend, Bob, it was also a precursor for things to come – the beginning of something that is not filled with hope and wonderful expectations or any of that other “new year” hype.  Bob says that it is a glimpse of the future, when it will be the norm for STD patients to be co-infected with HIV.

 

January 6, 1993 was the first time I conducted an HIV pretest counseling session with a patient I felt was positive.  Without knowing much about him, I had a suspicion that John was positive and already suffering the effects of AIDS.  He was a contact to syphilis in March of 1992.  His lover was treated for the first stage of the disease, primary syphilis, in Tucson.  The contact paperwork was sent here because John left Tucson, supposedly to move back up here with his parents.

 

I talked to John’s mom, Shirley, two or three times, trying to locate him.  The only information she had was that he was in Tucson.  As it turned out, nobody really knew where John went until May 1992 when he showed up at his folk’s house.  He was only there for a couple weeks when he disappeared again, this time for six months.

 

The day of John’s birthday, November 17th, he called his mom from Houston, Texas and asked if he could come home.  Shirley said he didn’t remember how he got to Texas, but he came home on a bus.  John was welcomed home with open arms again.

 

Shirley told me that John’s biological mother was an alcoholic and he was born with fetal alcohol syndrome.  His thought processes and reasoning abilities might be equal to those of a small child.  Sometimes he appeared to grasp certain ideas and was able to repeat what has just been said to him – but the context or meaning of the words seemed to be lost somewhere in the mist of his confused mind.

 

John appeared to live his life in complete reaction to everything around him.  If he got hurt or scared, he just left – sometimes returning in a few days or a couple weeks – sometimes returning in several weeks to several months.  The last time he left home, in May 1992, he said he was going to the store to get some cigarettes – he didn’t call or write or anything until November 1992.  John got his courage from alcohol.  Usually he was a timid person, not challenging anything – allowing himself to be trod upon or abused by whoever was around and willing.  His father, Jim, was particularly adept at unsettling him.  Evidently, Jim had a hard accepting his son and his problems.  Nothing was ever good enough – John never met his dad’s expectations.  So, John takes it for a while, goes out and gets drunk and then leaves.  One time he left school at lunch time, got drunk, and then passed out in the middle of Camelback Road on the way back to school.

 

When John came home in November, he was very thin.  His mom said he had always been on the skinny side, but this time he looked unhealthy.  Shirley all but forgot about me until she took John shopping for clothes at Christmastime.  She had told him about the health department looking for him when he was home in May – he told her he’d take care of it – so she put it out of her mind.  Now, in the changing room at the department store, she remembered me.  John’s torso was covered with bright red, crusty spots.  Some were fresh and others had started healing already.  Suddenly, things began to fall together.  Now maybe there was a reason for his weight loss, for his thinning hair, and for that “look” that said something just wasn’t right.

 

John called me around 9:30 on the morning of January 6, 1993 – he said he had my card now – he’d just gotten back into town.  I vaguely remembered his name – it had only been nine months since I had been looking for him.  When I asked him what date was on the card I left for him, he said it was April 1, 1992.  Now I remembered him.  I told him why I was looking for him and stressed the importance of him getting to the clinic ASAP.  He said he’d probably be able to get to the clinic the next day, but couldn’t do it today.  Again, I told him what was going on – still not fully understanding me, he put Shirley on the phone.  She mentioned the rash and I told her that John needed treatment now – today – not later.  They were to ask for me when they got to the clinic.

 

An hour or two later, I was paged to the front desk.  As I entered the waiting room, I looked around at the faces of whoever might be waiting to see me.  I spotted John and hoped like hell that it wasn’t him.  In that two-second glance, I saw the image of what my mind might conjure-up if I asked myself what a person with AIDS would look like.  The shell of what was once a body – thin, almost ghost-like with sunken eyes and hollow cheeks.

 

That scene above is done, yet unfinished.  Until some tidbit of news is uncovered or until I become brave enough to call Shirley and ask her about John, that story has ended.  It is alive only within the confines of my memory – and separately, in a very detached way, it goes on still in John, Shirley, and Jim’s lives, but to me the story travels unawares.  One of the disadvantages, or maybe true benefits, of working in the clinic as an investigator and not as a caseworker, is that we don’t see the end of the stories in people’s lives.  We don’t often know how they come to an end, as we don’t know how they come to be delivered from the circumstances that could so easily swallow them into nonexistence.