Bleeder (22 page)

“I was sorry to hear about that operation,” he offers. “But I agree with the orthopedist. It’s not a risk worth taking. Your CD4 counts have dropped below fifty.”

“What’s normal?”

“Oh, it’s hard to say. It fluctuates. But perhaps a thousand is a likely number.”

He feels my lymph nodes by kneading his hands underneath my arms and along my neck as if I were bread, and he tells me that they’re inflamed and that this is a sign of my declining immunity. There is nothing to do about it, he adds. It is only a sign.

He shines a light in my eyes and asks about my visit to the ophthalmologist: “Any floaters?” he asks.

“None so far,” I answer.

“That’s good. Very good.”

And in my mouth, he rolls the tongue depressor around and then traps my tongue with it while he examines my throat with his tiny flashlight.

“Thrush,” he pronounces. “You have thrush. We don’t want that spreading down your throat and causing problems with eating. You don’t need that.” My face droops. My eyes feel blue and watery. “It’s nothing to worry over yet. It’s just a sign of your declining immunity. We’ll give you a rinse for that. No sweat.”

He turns to my folder and asks me if I’m keeping up with my Pentamidine; I answer that I am. “Now that you’re doing it at home, it’s up to you to remember it.”

“I’m keeping up. No missed doses.”

“Good. Very good,” he says again. “Don’t need you catching pneumonia.”

Then he leans back and then forward and, staring me down, explains that he is recommending me to the Infectious Disease Clinic. “With them on board and with us working on this together to prevent infections, I feel our chances are better. After all, I’m just a hematologist who became involved with HIV when all this was breaking and coming down the pipeline. You might say, I’m sort of a backdoor study. That doesn’t mean I’m not capable. I just think that more heads are better than one. And the ID Clinic are the up-and-coming experts here.” He shuffles my file. “I would suggest restarting you on AZT and see how that might improve things, but I know your aversion for it and, happily, I’m hopeful about what I’ve been reading in the current literature about a new way to treat HIV with protease inhibitors. I think if we can get you to hold on—that is getting plenty of rest, eating well, exercising, and keeping a close eye on you to stop any infections before they become problematic—I think if we can do this, then, once the FDA approves the inhibitors, you may have a good shot here at beating this thing. The inhibitors aren’t an end-all cure, but I think it’s something to work towards.”

Immediately, my mood grows dark and afraid. It has been almost six
years since I was told of my HIV, at least fourteen if not more since I was infected through my transfusions, and now it comes to this. HIV has sacked my immunity and left me with only a shaky defense like some flimsy buckler gripped before my heart.

I let myself off the table and go to the ID Clinic, where I again fall asleep while waiting. I cannot say how much time passes with my head leaned back at a crooked angle and my light snore filling the waiting room, but eventually I feel upon my shoulder the gentle touch of a nurse who holds my chart. She is slender and pretty, and I force a weak smile for her.

“The doctor’ll see you now,” she says.

I am led through the hallway and then weighed, temperatured, and blood pressured and am then deposited in another room to wait. Still tired, I sleep again, but it is not long before the doctor wakes and examines me. In silence, he roams his hands across my swollen lymph nodes and studies the thrush in my mouth.

“Your CD4 counts are quite low,” he says. “Are you experiencing any problems like fever, night sweats, difficulty breathing?”

“Only that thrush. But other than that, no. Not really any problems. I’m just tired. Really, really tired.”

“Hmmm. Well, that could be something starting in you.”

“What?”

“Well, I’m not sure. It may be nothing. But I think you should plan on coming here once a month to get blood work and see me. I need to follow you closely.” He pauses, reaches to a desk folder, and passes me a packet. “Also, I’m worried about your weight. What’s normal for you?”

“Oh, I don’t know. One forty-five or so, I guess.”

“Well, you’re down to 128. We need to bring that back up. Inside that packet I just gave you, there’s a sheet outlining diet supplements that will help. Yogurt shakes and picking up cans of Ensure can really add weight to you and help fight off infections. You should read through it. It should give you advice on things to eat and things not to eat like raw fish. Also, I think I’d avoid traveling if you can. Do you travel for work? Or are you planning on vacationing anywhere before summer ends, especially somewhere like Mexico where the sanitation is pretty poor?”

“No. No plans.”

“Okay, then. So that’s not a problem.”

“No, I suppose not.”

“Then I’ll see you back in a month.”

In this way, our visit ends. From the pharmacy, I pick up the medicinal rinse for thrush and a case of the recommended Ensure.

As the days and weeks pass, a depressive cloud overtakes me and I become a dispirited vessel of routine. On the days I don’t work the few hours of respite care for an autistic boy, I wake at eight and lie in bed until nine, ten, and sometimes eleven. I throw out the coffee Mom leaves for me in the pot—it is usually scorched from sitting out so long—and I brew more and, from the dining room, I watch as the sun evaporates the dew from the night before and bronzes the once-green grass. At this point, if there is any morning left, I read until it feels late, and then I travel into town for lunch and then to the library, where I read the papers and write in my journal. For weeks, Monday becomes Tuesday, Thursday, and then another Monday. My heart pumps. Blood flows in, cycles out. I breathe.

LOOSE LIPS

A
UGUST 1996
. W
HEN
I
MOVE TO
C
HAPEL
H
ILL
, I
AM MORE ALONE
, more depressed than I have ever been. It is as if a melancholic miasma trails me and makes a blue cloud upon my heart. If for no other reason than to leave my parents’ and to shake off the idea I have of myself as a failure—a thing reinforced by my living at home—I have moved here. A friend who went to college at UNC said it was a nice place to live. Another concurred. And after visiting, I decided it as good a place as any to move. Yet Mom is against it. Before I drove away, she pleaded for me to stay: “You need to take care of yourself,” she said. “Why can’t you stay a little longer?”

“I just can’t.” And I pulled away.

I accept an assistant’s position at Aster Elementary and in August settle into a tiny apartment, two miles from the school. Here there is only me and the blue carpet that covers the floors. Outside, stout evergreens fence my home and their dark boughs block out light. The cell of pine and the blue, blue carpet—throughout, the color is blue—make me sad for no other reason than I am encoffined by this shade.

I soon discover that I am cut off from my neighbors by language. They speak Spanish; I do not. So we nod at one another when we pass or when we lock our doors tight beside the other, and at night I calculate their footfalls on the floor above me, reckoning that they are eight or nine or perhaps as
many as ten living in a similarly small blue apartment as me. They rise early, work late, stay to themselves, and are from a country I long to visit. They are the only company I know.

At Aster Elementary, I am assigned to Thomas, an autistic first grader. He is part of the public schools’ move toward inclusion: integrating handicapped students in “normal” classroom environments instead of isolating them from the student body, as is the typical case. Endlessly irascible, Thomas likes to punch students, throw crayons, and kick whatever might be in his feet’s path.

On my first morning, Thomas slumps at his desk while Mrs. Price—the first-grade teacher whose classroom Thomas and I are placed in—goes over vocabulary words. Already, I am fatigued. I spent yesterday afternoon at another ID Clinic visit, bought a few groceries, and then went home to take my monthly Pentamidine dose before dinner and then bedtime. I yawn. I encourage Thomas:

“Please do your work, Thomas. You won’t get recess. Please do your work.”

Thomas tries to stab me with his pencil and then tosses it across the room, interrupting the lesson. Mrs. Price stops to admonish Thomas and me.

“Thomas, stop,” she reproaches. “Mr. Smoak, you need to keep him under control. He is
your
responsibility,” she says to me. In a meeting we had the day before—one of several—Mrs. Price acknowledged she only allowed Thomas in her classroom because of a promise that, with an assistant, he would be handled. In this way, she constantly reminds me of my job. “Perhaps you should take Thomas outside and let him calm down.”

“Yes, ma’am.”

I yawn again when we are outside.

At noontime, I lunch with Thomas. I insert the straw into his juice box, unwrap the bologna sandwich his mother packed, and open his bag of chips—all while keeping a close eye on him, as he loves throwing food. At the undersized table made for children, I squeeze into the plastic seat and nibble my own lunch while around me, children talk loudly with their mouths open; the cinder-block room rumbles with a chittery-chattery roar that would give anyone borderline tinnitus. Soon a lady walks over and extends her hand as she joins us.

“Catherine. Catherine Eaves. I’m a second-grade teacher here. And those,” she says pointing at a nearby table, “are my little young’uns.” She begins to unbag her lunch. In her mid-fifties, she has blonde-white hair done up on top and wears thick glasses rimmed in brown. Her long gold earrings dangle loosely above her shoulders, and she wears a black shirt with a lively embroidered pattern raised on it. “So, is this your first day, honey?”

“Yes.”

“Going okay for you?”

“So-so, I suppose. I’m getting by and learning the ropes.”

“Well, I hope you still don’t think this is an elementary school because it’s not. Really it’s more like a country club. At least that’s what some of the teachers think.”

“Oh, really. I hadn’t caught on to that yet.”

“Well, you will. And you have to be asked to join their club. Have you been asked yet?” she teases while taking a bite of her carrot.

“Well, no. At least I don’t believe so.”

“I doubt it. Or you’d be sitting with them at their table instead of here all alone with Thomas.”

“Well, I have to keep an eye on him.” We both look over to Thomas who chews and stares off at the ceiling. “But then, why aren’t you with them?”

“Oh, honey. They hate me. Absolutely can’t stand me.” She leans in closer and lowers her voice so as to not be overheard. “But I know they’re just jealous since I’m the only one with my head screwed on straight.” Her eyes widen and a little laugh whistles from her tightened red lips, and immediately I trust her.

When we finish our meals and I rise to leave, Catherine lightly grabs my arm. “Listen to me, honey. A word to the wise. Watch your back. Some here are nothing more than glorified high-schoolers. They’re still imagining that they’re captain of the cheerleading squad, and they don’t care two hoots about anybody else. Just watch yourself. Keep your head low and do what you’re told and you’ll be fine.”

In September, I am swimming in the depths of fatigue. I dream of dreaming, of having that luxury. Yesterday, I returned to the ID Clinic and the week
before I saw both the ophthalmologist and Dr. Trum, and I was tired then as my ankles thumped with pain and my mouth yawned for rest. I napped in the waiting rooms and then upon the examination tables. Assigned to bus duty, I now rub my eyes and I watch the children unload from the buses and spill into the cafeteria for breakfast. An unseasonably cool wind blows. I cough. Snot runs from my nose as I cough again, blow.

After lunch, I deposit Thomas at speech therapy and walk to my supervisor’s office adjacent to the school’s playground. It is time for my first review. Although I’m a bit nervous, I’ve been through such things before at New Hanover High School, and it always went well. At the meeting, my supervisor is informal and jovial. We vent about Thomas’s behavior and laugh a bit while we firm up his classroom goals. My supervisor concludes our meeting by suggesting that I communicate more frequently with Thomas’s mother. “Send notes home,” she offers, “or chat a bit more in the parking lot when she picks Thomas up after school.” She sips her diet soda. “His mother calls here every other day,” she says with raised eyebrows and a deep sigh expressing her annoyance. “What can you do, right?” She sips again. “Otherwise, I feel you’re doing a terrific job with Thomas. I know he can be hard to work with and it takes a lot of patience, but you’re getting him controlled. We’re glad to have you here. Not everybody can do this job; that’s for sure.”

I leave her office feeling that something in my life may be going right.

In the afternoon before school officially lets out, I meet Thomas’s mom in the parking lot and update her on his day. She seems pleased and talks right up until the bell rings and I must excuse myself for afternoon bus duty. I hurry to the pickup zone and gather the waiting children against the benches and watch as young mothers arrive and tug their loved ones away. When a fight breaks out between two fifth-graders, I wedge my thin body between them and pull down their tender fists before they can inflict bruises, and then I isolate them. When they settle, I hear a woman’s voice behind me.