Authors: Arthur Ashe
After his examination and the echocardiogram, however, Dr. Collins decided that the problem was not with my heart but in my lungs. What exactly was wrong, he couldn’t say. Clearing the artery should wait until my lungs were healthy again.
The next day, still coughing and short of breath, I tried to get another X ray of my chest. However, when the physician learned that I had just had one, he refused my request; chest X rays are not done every day, he insisted. His refusal actually lifted my spirits, and I went out cheerfully to play a round of golf with a foursome that included former American tennis great Butch Buchholz, whom I have known since my senior year of high school in St. Louis, Missouri. Again I enjoyed the outing in the warm
sunshine, but again I was bothered by an inexplicable shortness of breath. I began to think that perhaps a cold was coming on. Perhaps I had simply breathed too much bitingly frigid air on Christmas Eve in New York. I told myself not to worry. With the daytime temperature in Miami resolutely in the eighties, I looked for my symptoms to lift within a day or two.
That night, when we had dinner at what some people call Miami’s most famous restaurant, Joe’s Stone Crab, I enjoyed feasting on the delicious specialty of the house. Later, I went to bed feeling pretty fine, except for some slight coughing and just a hint of congestion.
On New Year’s Eve morning, I went out for my last day of tennis clinics for the Doral. Even with my cough and chest pains, I looked forward to a full two days of golf before we headed back to the wintry cold of New York. After my last clinic, I headed for the links. I played a decent round, but found myself depending on a golf cart to move myself to the ball. I was beginning to recognize that in addition to anginal discomfort, the mere act of drawing air into my lungs was causing me some pain. I certainly could not take any deep breaths.
After finishing my round of golf, I stopped by the hotel swimming pool to catch a glimpse of Camera enjoying the water and the warm weather. Then, feeling drowsy, I quietly retired to my room alone for a nap.
That evening, Jeanne, Camera, and I went to dinner in the hotel coffee shop with Jeanne’s parents, two of their friends, her brother Claude, and her sister-in-law. After dinner, we all went over to Claude’s home to bring in the New Year. But midnight did not find me there. At some point, after watching me try to breathe without discomfort, Jeanne suggested that we head back to New York the next day, if she could arrange a flight. I agreed to do so, and around ten-thirty we left Claude’s so that we could call the airlines and pack.
I was drowsy again when I reached our room, but Camera insisted that we turn on the television and watch the
ball drop in Times Square to ring in the New Year. Earlier in the month I had taken her there and painted a festive picture for her of the coming New Year’s Eve celebrations. Now, all excited, she was determined to see that ball drop. Although the hour was late, way past her bedtime, Jeanne and I had no trouble giving in to her, and we enthusiastically joined the countdown into 1993. Then we all went happily to sleep.
At five in the morning, I awoke with a start. I was on fire, burning up. I took my temperature: 101.9 degrees. Around eight in the morning, Jeanne called Dr. Murray in New York. He advised that we should see a doctor in Miami, but we both wanted to return home that day.
With the aid of nothing more exotic than Extra-Strength Tylenol, I brought down my temperature and relieved the other symptoms sufficiently to fly back to New York. From the airport, I went straight to New York Hospital, where Dr. Murray was waiting for me. His examination did not settle the matter. Speculating that I probably had a form of atypical pneumonia, he put me on a powerful antibiotic, azithromycin. I started with two huge red capsules, then continued taking the drug through the weekend.
It had no effect on me whatsoever. More feverish than ever, coughing badly, and miserable, I returned to the hospital on Monday. I saw Dr. Thomas King, a pulmonary specialist, who ordered a bronchoscopy; this procedure alone could give the answers we wanted. Dr. King warned me that the procedure, while painless, is extremely unpleasant. A local, topical anesthetic was applied to my nasal passage, and I swallowed a dose to anesthetize my throat. A thick tube, about a third of an inch in diameter, was forced down my nose and into my lungs. At the end of the tube was a tiny television camera. To allow me to breathe, another tube went down my throat into my esophagus.
Dr. King had said that with the tubes in me, I would feel certain that I could not breathe, but in fact I would be able to. He advised me not to panic. I tried to be reassured by his confidence, but a minute or two passed before I gained
my own. Listening just outside the door, Jeanne told me later, she heard the most awful gurgling and heavy breathing as I struggled for breath while the camera mucked around my lungs, rummaging in what looked like a dirty sponge.
The procedure lasted between thirty and forty minutes. As he watched the television monitor, Dr. King spoke into a microphone and recorded his observations. That is how I found out I was suffering from the dreaded PCP, or
Pneumocystis carinii
pneumonia, about which I knew something.
Thus far, aside from the toxoplasmosis that uncovered the fact that I have AIDS, I had avoided every one of the opportunistic diseases that, in combination with the presence of HIV in the body, define the condition known as AIDS. Now I had one of the most feared.
Pneumocystis carinii
pneumonia is a very rare form of pneumonia, found in the past mainly among traditionally impoverished East European immigrants with already severely compromised immune systems. The disease acquired a fresh notoriety with AIDS. In fact, my shivering and burning fever were trademarks of PCP infection. In the last stages of their illness, AIDS sufferers often endure raging fevers all day and all night.
Fortunately, Dr. Murray assured me, my case was not particularly serious. I would definitely survive this bout. And New York Hospital-Cornell Medical Center was in the forefront in the world in research on this disease. Eight years ago, I probably would have been dead by this time.
His words encouraged me, but I was still miserable. Sweaty with fever and chills, coughing and shivering, I lay under my blankets, feeling drained and depressed. As if the bronchoscopy had not been enough, the nurses couldn’t find a vein from which to draw my blood for a test. They stabbed my arm repeatedly, coming up dry each time. To complete the test, which had to be done as close to the time of the bronchoscopy as possible, I endured a rectal examination, a procedure that has never lifted anyone’s spirits.
After an hour or so, Tylenol again brought down my temperature and gave me some relief. Then, intravenously, I was put on a regimen of the drug pentamidine, an antiprotozoal agent that has proven quite effective in treating PCP. At one time, I had taken it regularly in aerosolized form precisely to ward off infection from PCP. Now I was to stay on pentamidine for at least two weeks. This was not onerous; the side effects are tolerable. Perhaps the most common of these is an elevation of one’s potassium level above the ideal amount. Another side effect, potentially more serious, is interference with the heart’s electrical system. Yet another is the anesthetizing of the taste buds (in this respect, pentamidine is like chemotherapy). Since I entered the hospital, I had been eating by the numbers.
ON THE SIXTEENTH
floor of a wing of New York Hospital, I sat in a room named after the late Greek shipping magnate Stavros Niarchos. I didn’t ask for the room; it was assigned to me. Undoubtedly it was the most luxurious hospital room I had ever had, and I have had quite a few. Apart from an intravenous feeding stand parked discreetly in a corner, my iron bed, mechanized and grimly practical, was perhaps the sole reminder that I was in a hospital. The elegant wood floors are stained dark; the ceilings are high; the furniture, which includes a sofa upholstered in leather, would hardly disgrace the living room of a fine house.
Dr. David E. Rogers, one of the most eminent teaching physicians there—he holds an endowed professorship in medicine—stopped by to see me one morning.
“A beautiful room,” he said.
“Yes,” I responded. “It’s really special.”
“I remember this room from my early days here as a doctor. In fact, I had a patient in here once. A young senator. John F. Kennedy, no less. That was a long time ago.”
Through one set of tall windows in this corner room I could see, to the south, the skyscrapers of midtown. I could see the silver chevrons of the Chrysler Building; the blunter summit of the old Pan Am Building, now the Met Life
Building; the austere, fluted elegance of the Empire State Building. Directly below my window passes the East River. Mainly a somber brown and green, the dark water glitters and gleams here and there when sunlight flickers off its surface. Moving in each direction, boats ply the river. Downstream, they pass under the latticework of the Queensboro Bridge at Fifty-ninth Street. On Roosevelt Island, directly to the east, the fields were damp green. In the early morning, through the haze of the rising sun, I could see mist rising from the grass. In the evening, darkness swept quickly over the island.
By choice, I had few visitors. At first, Jeanne came three or four times a day; after a few days, when I was better, she came less often but stayed longer, hours on end. I saw Camera only twice. We do not want to disrupt her schedule. Once, after Jeanne and Dr. Murray literally smuggled her into the hospital hidden in their cloaks, I spent a wonderful hour with her in a conference room elsewhere in the building. She was fascinated by a plastic model of a heart I brought her, and by the mice in their cages, used by Dr. Murray and his colleagues in medical experiments. A few friends have come by. Cheerfully bearing belated Christmas presents for everyone, Donald Dell came up from Potomac, Maryland, to see me. My two close physician friends, Eddie Mandeville and Doug Stein, stopped by. Frank Deford visited me, and Alvin Schragis, whose wife’s family owns the Doral. Still another friend, Dr. Paul Smith, who is pastor of the First Presbyterian Church of Brooklyn Heights, also came to see me. One day, he brought along Andrew Young, who was visiting New York. Before they left, in a moving moment, Paul, Andy, Jeanne, and I held hands in a circle and prayed.
These are some of my friends, but only a few of my friends, most of whom had no idea I was in the hospital. Jeanne and I kept my illness out of the news, where my name seemed to have been everywhere lately, at year’s end. The honors and awards had come thick and fast. They pleased me, but they were not nearly as consoling as the
visits of these friends, and the knowledge that people I have known for a lifetime were thinking about me and wishing me well. Whatever happens, I know that I am not going to be alone at the end. That is not to be my fate. Of course, in a sense, we are always alone at the end.
I have invested in friendship all my life. I have been patient and attentive, forgiving and considerate, even with some people who probably did not deserve it. It did not take an enormous sacrifice, however; for whatever reason, it came almost naturally. I made the investment of time and energy, and now the dividends were being returned to me in kindness.
For once, at Jeanne’s encouragement (or was it her command?), I had left my cellular telephone at home. I made few telephone calls, and received fewer. I remember calling Randall Robinson to tell him that we had to do more about Haiti; we had to press the initiative we had won with President Clinton’s election. The African American community, I thought, had to extend its arms in welcome to the refugees, the same way the Cubans in Miami welcome those refugees fleeing Castro. We had been far too remote from the struggle of the people of Haiti. Randall was in complete agreement with me.
On a table in my hospital room, coincidentally, was an invitation to the inauguration of President William Jefferson Clinton on Wednesday, January 20. I was touched and grateful to be invited, but I did not plan to go. I would not have attended the event even if I had been well, which I was not. I looked forward to going home to Jeanne and Camera and spending a few days in quiet reading and reflection, while my strength returned. I meant no offense or criticism of the pomp and splendor of the inauguration; I was a Clinton supporter and I am happy to see him president. But I wanted to be in my own home. Of course, I intended to watch the inaugural events on television.
Stan Smith called, and we talked about tennis matters, which had seemed far away until then. We talked about a certain controversial father of a certain promising young
woman tennis player; some people find the man offensive, even intolerable, because of his often harsh behavior both to his daughter’s opponents and to the young woman herself. Because of him, the tennis establishment may move to curb the behavior of relatives of tennis players.
After the telephone call, I lay in bed and thought about tennis. The behavior of some adults is quite amazing. I remember one day years ago, at the Doral in Florida, almost coming to blows with a father. We had organized an informal tennis tournament for kids staying at the resort. One boy, about eleven years old, fought hard but lost his match. He walked off the court disconsolately. I watched him go up to his father, who promptly punched him in the head. I was stunned.
“Don’t do that!” I said, quietly but as sternly as I could.
He turned and glared at me. “Who the hell are you,” he said, “to tell me what to do to my kid?”
“Do it again and I’ll have you evicted from this place.”
“How dare you threaten me?” he shouted. “I’ll report you to the manager!”
“I hope you do,” I said. “You’ll be out of here a lot faster.”
People like that sometimes destroy the joy of sport and the joy in the lives of young people. Victory in a tennis match, money won in a tournament: these are not so important as good health, the honest affection and respect of friends, the love of one’s wife or husband, and the spicy innocence of one’s child or children.