Days of Grace

by Arthur Ashe

  Other cures or therapies covered a wide spectrum of science. One serum was said to have “piranha-like effects” on HIV. Some involved the diversion of existing medicines toward the fight against AIDS. The drug reticulose, for example, which modulates the immune system, has been in use for a generation; an old tennis friend wrote to me about its astonishing effects on a patient infected with toxoplasmosis (as I had been) and who had suffered a stroke and been given forty-eight hours to live. Now, on reticulose, he was flourishing.

  Another treatment involved what is called RBC-CD4 complex electroinsertion technology, by which full-length CD4 cells are inserted into red blood cells as a therapeutic against AIDS. Still another therapy involved a complicated laboratory process over a period of twenty-four hours, in which blood is purified by distillation and calcination (the application of very high temperatures).

  Yet another treatment, sent by a man I had met and coached ten years before at the Doral resort in Florida, called for the introduction of a mixture of ozone and oxygen into the patient’s blood. This treatment had even been reported on in Blood: Journal of the American Society of Hematology.

  Many of the letters I received complained about the stranglehold of the big drug companies on credibility and credit. One man, committed to a process in which the technology involved in the sterilization of bone in bone grafts was applied “to sterilize the blood and organs of the body,” wanted my help in establishing a major facility to develop this therapy. He lamented that when the powerful drug companies (for example, Johnson & Johnson and Bristol-Myers Squibb) announce promising treatments, they receive respectful attention from the public, the medical community, Wall Street, and government agencies. However, when a fledgling outfit does the same thing, “it is perceived as ‘snake oil’ because it is not conceivable that David could achieve what Goliath could not.”

  Another company spokesman wrote about not having the “200-million-dollar bribe” that he claimed it took to establish a major new drug. I think he was referring to the huge amount of money typically needed in order to gain scientific respectability for a new product.

  “Inordinate stress caused you to have two bypass surgeries,” a doctor wrote me. “The faulty AIDS transfusion was the organic insult to your immunology system. Your body is overloaded with stress.” His approach involved the concept of “colored light therapy” and the use of an “imagescope.” Doubtless this therapy, which I think has been used in psychiatry, can be useful. Still, I myself think that stress can be overrated as a cause of illness. I believe that controlling one’s anger or rage or sense of being over burdened is much better than blowing up or sagging into depression. I agree with what Carol Tavris wrote in her book Anger: The Misunderstood Emotion: “The popular belief that suppressed anger can wreak havoc on the body and bloodstream has been inflated out of realistic proportions. It does not, in any predictable or consistent way, make us depressed, produce ulcers or hypertension, set us off on food binges or give us heart attacks.”

  I certainly do not believe that stress can lead to AIDS, but I remain eager to hear about the latest developments in the work being done on AIDS by researchers and scientists. Like everyone else who has AIDS, or who knows someone with it, I wait and wait for the news of a medical breakthrough or, at the very least, a new, life-prolonging drug. Late in the fall of 1992, for example, the best news was about a new treatment from Bristol-Myers Squibb, a drug called d4T, or Stavodine, supposedly more effective than any other therapy for AIDS. I want to know more about this new drug. On the other hand, I do not want to delude myself. I do not intend to grasp at straws. That helps no one.

  WITH AIDS, I have good days and bad days. The good days, thank goodness, greatly outnumber the bad. And the bad days are not unendurable. Mainly my stomach lets me down and I suffer from diarrhea. I take my pills, and I am disciplined enough to stick to my schedule. Sometimes I become a little tired, but I have learned anew to pace myself, to take short rests that invigorate me. In this matter of AIDS, as in so many aspects of my life, I am a lucky man.

  I believe that there are five essential pillars to support the health and well-being of every individual. The first is unhindered access to physicians who will render primary care, listen to and advise the patient, and follow up with treatments in a professional manner. The second is the availability of medicines, treatments, and other therapies. The third is the support of family and friends. The fourth is the determination of the patient to make himself or herself better, to take charge of his or her well-being in cooperation with others. The fifth essential pillar is health insurance, because few people can bear the cost of a serious illness without falling irretrievably into debt. Take away any of these five pillars, I believe, and the structure of individual health and welfare starts to collapse.

  I have been fortunate to have all five pillars solidly in place: excellent physicians, perhaps the best that can be had; the most efficacious medicines, no matter what the cost; the loving support of a skilled, intelligent spouse and the most loyal and resourceful group of friends anyone could have; self-reliance taught from my boyhood by my father but reinforced by decades of rigorous training in a sport based on individualism; and no fewer than three generous health-insurance policies.

  AIDS does not make me despair, but unquestionably it often makes me somber. For some time I have wrestled with certain of Susan Sontag’s ideas or insights in her remarkable books Illness as Metaphor and AIDS and Its Metaphors. In the former, inspired by her battle against cancer, Sontag writes about “the punitive or sentimental fantasies concocted about” illness, especially illnesses such as leprosy, tuberculosis, and cancer. “My point is that illness is not a metaphor, and that the most truthful way of regarding illness—and the healthiest way of being ill—is one purified of, most resistant to, metaphoric thinking.” AIDS is not a metaphor for me, but a fact; and yet I find it hard to avoid its metaphoric energy, which is almost irresistible. I reject the notion that it is God’s retribution for the sins of homosexuals and drug abusers, as some people argue, but on occasion I find its elements and properties peculiarly appropriate to our age.

  I live in undeniable comfort—some would say luxury—in a spacious, lovely apartment high above Manhattan. When I venture out to walk the streets below, I see how others live who have not been dealt as generous a hand. I see poverty, usually with a face as dark as mine or darker, sitting on a box in front of my bank with a cup in her hand; or trudging wearily along the sidewalks; or fallen down into foul gutters. Around the corner, huddled on chilly stoops near the Greek Orthodox church, I see loneliness gnawing at human beings who surely deserve a far better fate. I hear madness crying out in the indifferent streets.

  Sometimes, gloomily, I wonder about a connection between AIDS and where we in the United States are headed as a people and a nation as this century moves to a close. Too many people seem determined to forget that although we are of different colors and beliefs, we are all members of the same human race, united by much more than the factors and forces that separate us. Sometimes I wonder what is becoming of our vaunted American society, or even Western civilization, as an unmistakable darkness seems to settle over our lives and our history, blocking out the sun. Our national destiny, which at times seems as bright as in the past, sometimes also appears tragically foreshortened, even doomed, as the fabric of our society is threatened by endless waves of crime, by the weakening of our family structures, by the deterioration of our schools, and by the decline of religion and spiritual values. AIDS then takes on a specially ominous cast, as if in its savagery and mystery it mirrors our fate.

  Surely we need to resist surrendering to such a fatalistic analogy. Some people profess to see little purpose to the struggle for life. And yet that is precisely the task to which, in my fight against the ravages of AIDS, I devote myself every day: the struggle for life, aided by science in my fight with this disease. I know that we are all, as human beings, going to our death, and that I may be called, because of
AIDS, to go faster than most others. Still, I resolutely do battle with this opponent, as I boldly did battle with my opponents on the tennis court. True, this fight is different. The biggest difference is that I now fight not so much to win as not to lose. This enemy is different, too—dark and mysterious, springing on civilization just when civilization was sure that it had almost rid itself of mysterious beasts for ever. But it must be fought with science, and with calm, clear thinking.

  I know that I must govern that part of my imagination that endows AIDS with properties it does not intrinsically possess. I must be as resolute and poised as I can be in the face of its threat. I tell myself that I must never surrender to its power to terrify, even under its constant threat of death.

  Chapter Eight

  Sex and Sports

  in the Age of AIDS

  THE MOMENT I discovered, some fifteen years ago, that I suffered from heart disease, I passed out of a world in which sex had its normal place in my life—strong, if conventionally restricted—into a world in which sex and death sometimes seemed to go hand in hand, because of the strain I know the act of sex can place on the heart. Whenever I spoke publicly about my heart disease, the first questions from the audience were almost always about sex. How soon could one indulge in sex after heart surgery? Should one have sex at all with a damaged heart? I tried to assure worried questioners that yes, there definitely could be sex after heart surgery.

  However, the moment I discovered, in addition, that I had AIDS, I lost even the slightest hope of ever again enjoying a completely normal relationship to sex. In some respects, this is one of the most haunting aspects of AIDS. But the personal implications for me of AIDS and heart disease are as nothing compared to the questions raised about sex in the lives of the masses of people by the phenomenon of AIDS. The glare of a thousand-watt searchlight has been trained on the most intimate act of our lives. In this way, as in other ways, we are all, the healthy and the sick, touched and perhaps tainted by AIDS.

  The association of sex and death is ancient; the French playfully call a climax le petit mort (the little death). But the images of death fostered by AIDS have no romantic overtones, only ugliness and pain, grotesqueness and bitter irony. The pictures of the ballet dancer Rudolf Nureyev near the end of his life affected me deeply for this reason, since he was the epitome of power and artistry as a dancer. To think of being contaminated by viruses that can kill one’s beloved, or create in her a child who is condemned at birth to a horrible death, can be revolting. Such a situation can almost drive one mad. Perhaps this explains those people, HIV-infected or even with full-blown AIDS, who deliberately and maliciously have unprotected intercourse with unsuspecting partners. Such people do exist, and I think they are driven to their attempts at murder by the depth of self-hatred that AIDS, far more readily than any other disease, can engender.

  The power of sex in our consciousness obviously has much to do with its force as a biological drive, a primitive hormonal urgency. The hormonal aspect, however, is probably only slightly more important in many respects than the mysterious, romantic element that surrounds sex and plays off its involuntary, hormonal essence in Western culture. Sex and love are presumed to go together. That romantic element has always intrigued and challenged me. Proud of myself as a rational human being, I have almost always preferred a scientific approach to sex, one that gives up much of its mystery and romance for a cold knowledge of biology, physiology, and psychology. I remember poring over the volumes Human Sexual Response and Human Sexual Inadequacy, by the team of Masters and Johnson, painstakingly and with complete absorption. I wanted to know about the menstrual cycle and estrogen and ovaries and how sperm is produced and all the other mechanical and biological details of sex. I know that romance as often as not involves an evasion of facts, and can be kin to ignorance, fear, guilt, and shame. On the other hand, I consider myself a romantic man. At times, I have surrendered to romance, and indulged in it freely as one of the blessings of human life.

  AIDS has made many people see for the first time the wisdom of a scientific approach to sex and the limitations of romance. As a rationalist, I should feel very good about this change, but in fact I do not—at least, not entirely. We do not need ignorance and fear, but we do need a few ideals and those illusions that help us to attain our ideals. And yet AIDS is laying waste to that mysterious element almost as thoroughly as it destroys the healthy bodies of people, heterosexual and homosexual, who once gave themselves with abandon to sex.

  I wonder if we can ever achieve a balance now between the need to know the scientific truth and the need to preserve our sense of mystery, beauty, and trust. Some experts call for the inclusion of fairly graphic sex education in our young citizens’ early formal education. As rational as I try to be, I recoil from such a radical approach when I think of my six-year-old daughter and my wish for her to enjoy the innocence of childhood as long as she can. I shudder to think that at six or seven, her childhood, in this respect, may be over. In such moments, I see the full tragedy of AIDS.

  ONE MORNING IN December 1992, I picked up a newspaper and read a brief story that brought home, as few other reports had done for me, the fact that AIDS is no respecter of people, that the most exquisitely tuned and toughened bodies could be ravaged and destroyed by its deadly power. According to a report from Canada published in the Calgary Herald, at least forty prominent male figure skaters and skating coaches in North America had died of AIDS-related diseases in recent years. In addition, at least a dozen other outstanding American and Canadian male skaters and coaches were infected with HIV. The report was based on two months of interviews with about 125 people connected to the sport, including skaters, coaches, and their families and friends.

  The connection between male homosexuality and figure skating had long been rumored. Now, it seems, with those forty deaths, the connection may have been confirmed, tragically so. Nevertheless, not long after the publication of the report, the man whom many regard as the most brilliant of all living figure skaters, Brian Boitano, denounced it as “ridiculous” and “a joke.” Boitano bridled especially at the implication that skaters are any more likely to be gay than athletes in other sports. “Just like the majority of people in life,” he insisted, “the majority of people in skating are straight. That’s a fact. Nobody in skating would deny that.”

  My sport, tennis, has its own notoriety in the area of sex. As long as I have known it, tennis has always been considered, certainly in the crudest male circles, a “sissy” sport, one mainly attractive to men of ambivalent sexuality. While it is difficult to look at today’s hard-hitting players and imagine anything awkward or inept about them (“sissy” usually implies being awkward if not inept at sports), this image of tennis has a long history. In addition, Bill Tilden, hailed by many people old enough to have seen him as probably the most accomplished tennis player ever, was gay. Frank Deford delves into this subject in his important biography of Tilden, a man who tried to hide in the closet but got into trouble especially when his sexual preferences became known.

  This image of tennis is enshrined in the play Tea and Sympathy, a hit on Broadway and then later as a film in the 1950s. As I remember it, the drama is mainly about a young man, a college student, who is deeply troubled by his sexuality, perhaps by his latent homosexuality. A college athlete, he is a tennis player. According to the script, his game is not aggressive—that is, without fast serves and crunching volleys, relying instead mainly on spin and guile—as if that fact were proof in itself of his sexual deviance.

  I know that some people thought that I must be gay. I am also aware that some people—perhaps even many people—suspect that I contracted AIDS from a gay contact, and that quite possibly I am a closet homosexual. In fact, I first heard the suggestion that I might be gay several years before I contracted AIDS, and from a member of my family. In 1977, Jeanne and I, recently married, attended a grand family reunion in Richmond. My folks on my mother’s side came from all over the United States
to celebrate the existence of our family, which we proudly trace back several generations. The family tree is heavy with branches, dense with leaves. Arriving with Jeanne, my new bride, I could not help thinking that I was doing my part to ensure that the tree would grow thicker and the leaves even more dense.

  Most of my relatives had not yet met Jeanne and hurried over to congratulate us when we arrived. However, one of my uncles, who had come from California for the celebrations, seemed rather less impressed than others by the newlywed couple. At one point I sought him out and struck up a conversation. After we had talked for a while, he finally spoke what obviously had been on his mind.

  “Well, Arthur, my man,” he said, “you sure surprised me.”

  “How’s that?” I inquired.

  “Marrying Jeanne. You sure surprised me.”

  I looked at Jeanne across the room. As always, she looked radiantly beautiful, as lovely a woman as I had ever seen. I felt proud to be her husband. “Yes, she’s special, isn’t she? She’s definitely a ten.”

  “I don’t mean that. Sure she’s beautiful. But I always assumed you went the other way, if you know what I mean.”

  “Say what?”

  “You know, Arthur. I just thought you were, well, of the other persuasion. Don’t take offense, now, man.”

  “Where did you get that idea?”

  “Well, I just never heard of you being involved with any woman in particular. You never told us about your chicks and stuff like that. So I thought, Uh-oh, Arthur is one of those people!”