Plague Years

by Ross A. Slotten, MD

  In 1984, scientists in the United States and France announced that a virus caused AIDS. That virus, called both LAV for lymphadenopathy-associated virus and HTLV-III for human T-lymphocyte virus III, had the perverse ability to take control of a cell and turn it into a factory that made more viruses, which in turn would infect other cells. You could find the virus in semen, vaginal secretions, rectal tissue, and blood and blood products, which explained the connection between the four major groups of people afflicted at that time. Because of competing claims of discovery of the causative agent—was it found by Luc Montagnier, a French scientist, or Robert Gallo, an American scientist?—for a couple of years the virus bore the unwieldy name HTLV-III/LAV. It was later renamed the human immunodeficiency virus: HIV.

  In the summer of 1985, when Art came to the clinic in such bad shape, there was still no way to know with absolute certainty if a person had been infected by the AIDS virus, because a test for it wasn’t commercially available, although research laboratories and the American Red Cross, which controlled the nation’s blood supply, were already using an unlicensed test. You made the diagnosis of AIDS when someone presented with some horrific infection caused by organisms, ordinarily harmless, that are given the opportunity to wreak havoc when the person’s immune system loses its ability to protect them: hence the term opportunistic infection. Until the advent of chemotherapy and AIDS, we had no idea we were such a complex ecosystem, full of microbes kept in check and balance by a highly efficient and hypervigilant immune system. During childhood we are exposed to many of these microbes—viruses, bacteria, and fungi—that at worst cause a brief illness, are subdued, and then hide like sleeper cells, waiting for a call to action that usually never comes in a normal life. But once that checks-and-balances system is disrupted, it’s as if the prison guards (in this case, so-called T helper cells and a type of white blood cell called a macrophage) have been killed and the dangerous criminals inside the prison set free.

  Although the natural history of AIDS, the time period from onset of infection to overt disease, hadn’t been worked out by 1985, I had to wonder if Art had harbored the virus for some time before we broke up in April 1983. The implication of that for me was obvious.

  Our final split had been long in coming. One Sunday afternoon in late February 1983, on the way home from the hospital—I was now living just a few blocks from my old haunts, Northwestern Medical Center and Alfie’s—I ran into Art, who was carrying a newly purchased record under his right arm and walking with a handsome man who was around thirty years old, like me. I was surprised because Art had told me he was spending the weekend with his daughters. After he introduced me to Max, I hurried on and didn’t look back.

  My chest felt heavy, as if I’d swallowed a lead weight. A year earlier I would have been shattered, but Art’s long absences had eventually made me more independent. I spent a good deal of my free time reading novels, hanging out with new friends, and playing the piano. I was happy as a family practice resident, caring for patients and making difficult decisions that could have positive impacts on people’s lives; and I enjoyed volunteering at Howard Brown, counseling gay men and treating their venereal diseases. But now I felt sad and angry. Since we saw each other so infrequently because of his travels, I was offended that Art dared to spend his free time with another man in Chicago. If I’d been in Art’s place, he would have been the first person I called after I stepped off the airplane.

  I stopped at the grocery store and picked up a few items. My head swam as if I’d just awakened from a deep sleep. As soon as I entered my apartment and took off my coat, I went to the bathroom to look in the mirror. I wasn’t displeased with what I saw. In fact, I thought I looked rather good, except for a few wisps of hair that crossed my forehead. I brushed them back and turned my head from side to side, trying to be objective about my appearance. My face didn’t glisten as it had when I was younger, and I had no embarrassing pimples. I flashed a smile of white, well-aligned teeth. It occurred to me that I was measuring myself against Max, little as I knew about his relationship with Art or what he knew of my own. I had the unpleasant notion that my battle might have been one-sided—Art could easily have passed me off as a doctor friend. “We’re heading up north,” Max had said, not realizing how insolent those words sounded to me, implying he and Art were a couple. And perhaps they were.

  Several days passed before Art called me. The first thing he said was that he couldn’t talk long. My heart paused for a moment before pounding wildly. I still yearned for love, a fulfilling sex life, and a lasting relationship with another man. But I knew that Art was going to tell me something I didn’t want to hear.

  Max was going to move in with him and occupy the second bedroom. This news surprised me. Art had always refused to share an apartment with me because of his daughters and the reaction of his ex-wife, who might sue him for exclusive custody. I’d accepted that excuse and even considered it wise. Now it was clear that he’d had other reasons for keeping me distant. Too angry for tears, I restrained myself from slamming down the receiver and shattering it.

  Two years later, on the night of his hospital admission to St. Joe’s, I telephoned Art there, but the operator informed me that “this particular patient” had requested anonymity. His name hadn’t been entered in the computer, and he wasn’t accepting phone calls. His request struck me as yet another example of the complex web of deception he wove around his life.

  I decided to visit Art the following day. I hoped to put a period at the end of the sentence, to end a chapter in my life. He had once been the primary object of my affection and had consumed so much of my waking life, and I had so many questions for him, some philosophical, others crude, but none professional: when did you fall out of love with me; could I have done something to save the relationship; how many men did you fuck when we were together; how many fucked you? Although I realized that the answers to such questions can become unimportant in an emotional if not medical sense, not enough time had passed for me to cease yearning for some sort of closure. The breakup still stung.

  But when I walked into Art’s room dressed in my long gray medical frock, I didn’t have the heart to confront him. He was in good spirits and overjoyed to see me. Except for his weight loss, he looked surprisingly well. Hydration had filled out his sunken cheeks; his eyes sparkled with life. I sat on the edge of his bed and talked to him for fifteen minutes or so, resisting the temptation to review our joint history because it was his health that mattered now, not my selfish needs. He asked me if I thought he had “the Big One,” meaning AIDS. I didn’t know, I answered in a professional monotone. No test results were back. Then he said that he’d “really cut back” on his sexual activity and had “done nothing” for two years. He said he was on the verge of working out a huge deal in Louisiana that had preoccupied him for seven or eight years, and he couldn’t believe that now he was sick.

  “I guess I’ll have to let them know the full story, if I do have AIDS,” he said nonchalantly, a remark that struck me as bold since I presumed he was still in the closet at work.

  At once a surge of irritation filled me as I thought about all those times I sat alone waiting for his call when in fact he was having sex with other men. Those extended travels to cities across the country on business had been a ruse. I doubted that he had a huge deal in Louisiana, or anywhere for that matter. Maintaining my composure, I said nothing.

  A few months before our breakup, I had passed by his apartment on the way home from Seton. He had moved to a Gold Coast address, a ten-minute walk from mine, that was tonier and more appropriate for an executive director of a healthcare facility than that roach-infested apartment on the edge of Uptown. When I noticed the glow of light from his living room that evening, I was surprised and delighted. Assuming he’d returned to Chicago earlier than expected from one of his out-of-town jaunts, I went over.

  The doorman, a friendly but formal man who knew me well, let me in without calling Art first, and I took th
e elevator to the fourteenth floor. When I knocked on Art’s door, no one answered. After knocking harder, I heard a commotion and a thud of approaching footsteps. Cracking the door open, Art blushed with embarrassment and expressed annoyance at my unsolicited appearance. He was half-dressed and disheveled, but not in the manner of someone who’d fallen asleep on the couch after a hard day’s work or long hours in airports. Through the crack I glimpsed other men who scurried out of sight and laughed as Art waved them off. I also sniffed the skunky odor of marijuana.

  Without waiting for an excuse or an apology, I backtracked to the elevator on the verge of tears and rushed out of the building past the doorman, who made no comment but, like all doormen, understood more about the human condition than most people. Feeling shocked, humiliated, and angry, I knew that I could never face that doorman again. And yet despite all the evidence to the contrary, I still believed that somehow I could salvage my relationship with Art.

  The blinders lifted after our breakup. Friends filled in the details afterward, confessing that they never had the heart to tell me what they knew—the sex parties in Chicago and other cities, the frequent tricks he brought home—because I wouldn’t have believed them. But they were right about my degree of denial.

  Now, in the hospital, Art made no references to past escapades or their effect on me, and I didn’t press him. It was difficult for me to remember all the wonderful times we’d spent together—the intimate moments in his apartment (although not once in four and a half years did he spend a night in my apartment), the operas, plays, and concerts we attended, the dinners in trendy restaurants, and our travels. It was the negatives that had thrown us back together.

  The conversation remained lighthearted, with only brief references to weightier issues, but I felt burdened. I looked around the cramped room with its ugly furnishings—the cheap tray table with its half-empty cup of tea and dirty napkins, the metal cabinet with faux plywood finish, the clunky hospital bed. All were illuminated by the glaring fluorescent light above the headboard. The awkward feeling was mine, not his, as if I were the patient under examination and he the doctor impassively observing my idiosyncrasies and imperfections.

  The following day a clerk from Cook County Hospital called our office with the results of Art’s stool specimen. In 1985 the microbiologists at St. Joe’s weren’t adept at identifying uncommon parasites; if they suspected something unusual, they sent the specimen for a second opinion from Cook County, whose pathology department was among the best in the country. County’s expertise arose from its clientele—including immigrants, criminals, substance abusers, and the indigent who flocked in the thousands every year for medical care not otherwise available to them. Its emergency department was the medical equivalent of a bazaar, where you could find anything from the mundane like the common cold to the violent like gunshot wounds and fearsome injuries from stabbings, to the locally rare like malaria.

  Tom and I happened to emerge from our exam rooms almost simultaneously when Art’s result was posted. We both looked at the pink message slip: “positive cryptosporidium,” which our receptionist had recorded with dispassionate simplicity. In healthy people, cryptosporidium causes an annoying case of diarrhea that can last a few days or weeks without serious harm. In someone with an impaired immune system, the results are catastrophic. In Art’s case, it meant he had AIDS.

  Years earlier I had been in a bicycle accident, catapulting over the handlebars at high speed and tumbling head over heels to the ground. The flight seemed to occur in slow motion, as if I were watching it happen to someone else. When I got up, I was in shock. I checked to see if I was still whole and noticed that a triangle of flesh had been sliced off my left wrist. Then my heart pounded, the wound burned, and I was overwhelmed with fear: oh my God, I could have broken a bone, been paralyzed from the neck down, or died! But I was alive; only the bicycle was mangled.

  I was in that slow-motion flight again now. Tom thought I was going to faint. All the blood had drained from my face, and my mouth felt parched. Tom extended a hand, but I didn’t take it. My brain raced a trillion miles away to some black hole before returning to earth. I gripped the back of a chair and trembled, as if the temperature had dropped 30 degrees. Art had just been given a death sentence, and I believed I’d gotten one too. I spent the rest of the day performing my professional functions in a fog, going through the motions of interviewing and examining people but not paying attention to their symptoms or physical findings.

  I didn’t know how to present the news to Gavin, my boyfriend, when I returned to the apartment we shared in the Old Town neighborhood. I usually didn’t walk down North Avenue at night—the darkened recesses of its dilapidated buildings were too disturbing—but I was so absorbed in thought that I forgot my usual fears. With the awful task uppermost in my mind, I would have gladly surrendered to some mugger without a fight.

  After dating for more than a year, Gavin and I had moved in together just two months earlier. Although marriage wasn’t possible, cohabitation was close. When I informed my parents about the move, it was under the guise that Gavin and I were roommates, two young doctors splitting expenses, something matter-of-fact and of no other significance. I’d never told them anything about Art, whose presence in my life would have been hard to explain without lying.

  Although my father seemed to have no clue about the true nature of my relationship with Gavin, my mother had her suspicions. As they visited the duplex apartment one Sunday afternoon, I heard her shushing my father when he wondered aloud about the absence of a second bedroom. Gavin and I glanced at each other in silence, but I let an opportunity to have a heart-to-heart discussion with my parents slip by.

  Before meeting Gavin—and based on my experience with Art and many novels—Anna Karenina, Madame Bovary, In Search of Lost Time—I had concluded that suffering was an integral part of a forbidden relationship, perhaps the essential part. I also believed that relationships were lopsided, with one person always more attached than the other. In my limited experience, gay men seemed to prize infidelity over monogamy, hoping to fuck as many men as possible. Stroll down Halsted Street on any Saturday night, enter a bar, and observe the throngs of men, some packed into dark corners giving or getting blowjobs; or notice the men streaming in and out of a popular bathhouse, a place I knew all about but had never set foot in. I didn’t need that sort of affirmation; and I didn’t have that kind of sexual appetite. All I wanted was a “normal” relationship, like that of any heterosexual couple.

  Gavin had moved to Chicago in June 1983 before starting his residency at St. Joe’s. I’d interviewed him the previous October and given him my card, but thought nothing more about him until he sent me a letter in May, asking if he could stay with me for a few days while looking for an apartment. It was an unusual request, but I consented. Art and I had broken up, and I was single and alone. That first night, a bare-chested Gavin slipped into a sleeping bag on the living-room floor, propping himself up on his elbows and casting coy glances at me as we talked about the training program, the medical staff, and other matters related to his future. The next morning I took him to breakfast at Ann Sather’s, the gayest restaurant in Chicago at the time, but he said nothing about the clientele. As we walked through Boys’ Town, the heart of gay life in Chicago, in search of apartments, he ignored the gay bars we passed. I felt foolish and wondered if I’d misinterpreted his cues.

  After he left, I had wild, disturbing thoughts about him prompted by seeing Querelle, a violent homoerotic film by the gay German filmmaker Rainer Werner Fassbinder. It was a daring film, one of the first to advance gay themes, a must-see for a gay man. Photographed in a gauzy light, it felt more like a hallucination to me than a coherent movie, its action shifting from a ship to a bar with male and female whores, to a urinal and later a prison cell. The men lusted after each other yet threatened to murder each other, love and death (or Eros and Thanatos as in Greek mythology), vying for domination. At one point Querelle, a sailor more b
eautiful than handsome, performed a stylized dance with his brother, each man clutching a jackknife in his fist at groin level, left foot crossing right foot in an ever-tightening circle like the gang members facing off in West Side Story. I exited the theater with my heart pounding and my throat constricted with anguish. My erotic feelings for Art had not yet been extinguished, and now they were transferred to Gavin, which made me feel ashamed because my gay-dar might have misled me. Months later, after we started dating, Gavin admitted that he’d been afraid to tell me he was gay during that May visit, because if he’d guessed wrong about me, it would have ruined his residency.

  The son of a doctor and the sixth of seven children, Gavin was a handsome twenty-six-year-old with thinning blond hair, green eyes, and a Martha Raye–like mouth, which he could purse into an adorable pucker or contort in comical ways. He looked great in photos, and had he been taller than five feet four inches he could have been a model. Although angelic in appearance, he had a vicious wit that could miniaturize the most imposing figure. He made me laugh when I should have been appalled; and he alarmed me when he raged to me about someone who angered him. He cursed like a sailor, drank like a fish, and smoked cigarettes, none of which I discovered until well into our courtship. In the early days he didn’t exercise and had a bit of a belly. “We don’t hike,” he once said as I tried to cajole him into trekking to Kilauea Crater on the Big Island of Hawaii. In so many ways he was my opposite, but our relationship worked.

  When he was on his eight-week internal medicine rotation, I manipulated the schedule so that we were occasionally on call at the same time. On the wards we behaved as colleagues, except for the long stare or wink across the ward when no one was looking. In the call room we were affectionate but never had sex. That would have been risky.