Sensing Light (27 page)

X

G
WEN DIDN'T SEE
K
EVIN
again that day. After a family dinner of take-out burritos, Eva did homework in her bedroom, and Rick went off to play poker with his buddies, leaving her alone. She wanted to call Kevin but resisted the urge. She chided herself on what a basket case she had been. From now on, this had to be about his needs, not hers. Marco didn't have much time left. Kevin shouldn't be wasting any of it allaying her fears. She wished she could tell Rick. She knew she could swear him to secrecy. He wouldn't break the pledge. Still, it would be a betrayal, and she'd already let Kevin down once today.

She was tempted to open her Christmas present from Nan, a fifth of good Scotch. She picked up a glass then put it away. Gwen doubted drinking would do anything other than make her depressed. For the rest of the evening, she watched stupid television sitcoms that Eva had outgrown.

Tuesday was better. She had five minutes alone with Kevin in the morning and spent it giving him a neck massage. His optimism lifted her spirits. Her mood further improved in clinic as a succession of patients told her how much they appreciated her help. Then Allen Schwartz came into her exam room.

A New Yorker in his early twenties, Mr. Schwartz had recently finessed his escape to the Castro by persuading his father to open a branch of the family jewelry business in the Bay Area. At his first appointment, he had shown Gwen a purplish growth on his leg, which she biopsied. As expected, the pathology report was Kaposi's sarcoma. The disease usually spread slowly, but she saw many new lesions at his next visit and advised him to get chemotherapy. Allen was not interested.

Today, his cheeks and eyelids were involved. He wasn't able to shut his right eye completely. Though she had taken care of dozens of patients with
Kaposi's nodules on their face, Gwen couldn't keep from imagining Allen out in public, the reactions he must get, how it would feel if everyone looked at you with revulsion.

“Have you thought any more about chemotherapy?” she asked.

“No chemotherapy,” Allen said, pointing to his nose. “This isn't Kaposi's.”

“It's not?” said Gwen, flabbergasted.

“Nope. I went to Dr. Williams in San Jose. He's an infection expert. He told me these tumors are caused by syphilis. Take enough penicillin, and they'll go away.”

He opened his shirt, revealing a coil of plastic tubing taped to his chest, one end entering the skin under his collarbone.

“I do the infusions myself at home every six hours,” he said proudly. “Dr. Williams got a nurse to bring all the supplies and change the dressing every week.”

That bastard, thought Gwen. She had heard about Doug Williams and his syphilis scam. A small case series of AIDS patients who had syphilis invading their brain had appeared in a prestigious journal. It had been publicized by the lay press, even though this rare complication of syphilis had been known for a century to occur in people with normal immune systems and there was no evidence from control populations to prove it was any more common in HIV-positive individuals than HIV-negatives. A few predatory doctors had capitalized on the anxiety generated by the report. They prescribed long courses of intravenous penicillin treatment for AIDS patients who had no symptoms of syphilis and negative blood tests for the disease. In return, they received lucrative kick-backs from home infusion companies.

“My parents were ecstatic when they found out I don't have cancer. They're paying all the medical bills.”

Gwen tamped down her fury enough to speak calmly.

“I don't want to rain on your parade, Mr. Schwartz, but taking IV penicillin doesn't make sense. I've checked your blood for syphilis several times, and the results were negative. The test for syphilis infection is very, very accurate. People with syphilis don't have negative results.”

Allen was unfazed.

“Look in the mirror,” she said, unable to restrain herself. “Those lesions aren't shrinking. They're getting bigger.”

“Williams says that's just temporary. He told me the tumors might swell while the bugs are being killed and spill their guts out. See, he knows what he's talking about.”

“Please, Mr. Schwartz, think it about it. Months ago we did a biopsy. If it was syphilis, the pathologist would have seen the microbes. I'm sorry, but the truth is you're being duped by a charlatan.”

“You're the charlatan, Dr. Howard,” Allen shouted. “All you've offered me is poison. Dr. Williams says chemotherapy will destroy what's left of my immune system and let the syphilis get into my brain. That makes sense.”

Gwen backpedaled, trying to salvage some line of communication.

“Mr. Schwartz, I respect your deciding how you'll be treated. It's all right with me if we don't agree on this issue. I'm happy to keep being your doctor. Come back and see me in a month, OK?”

“I'll think about it,” said Allen coolly as he buttoned up his shirt.

The next morning, Gwen took Eva to her school bus stop before driving into San Francisco. While coasting downhill in her 1966 Volvo, bleached of its original turquoise sheen, she thought of Allen Schwartz. Her rage at the South Bay physician preying on him was spent. It was the poignancy of Allen's situation that still disturbed her. He was twenty-three years old. He couldn't process his impending death. He hadn't even finished growing up. She looked protectively at Eva, who was gazing out the window.

As they passed Lake Merritt, Gwen saw geese, skeins flying in V formations, gaggles waddling across the moist green meadows. She rolled her window down to inhale the air, fresh from last night's rain. At a stoplight, Eva spoke for the first time since they had left the house.

“I don't trust any of my friends.”

Gwen's initial reaction was fright. Did I just have an auditory hallucination? It's impossible that Eva would tell me something so intimate.

Gwen reined in her panic. I'm not having a psychotic break. My brain must have misinterpreted sounds coming through the window. Maybe it was the voices of joggers running around the lake.

Then she reconsidered what she had heard. The words had been spoken exactly as Eva would say them.

She rolled up her window and said, “Sorry. You said you don't what?”

“Trust any of my friends,” Eva replied, as if talking about the weather.

Gwen had another extraordinary sensation, like an unexpectedly delicious bite of food. She felt a rush of joy and immediately clamped down on it. Nonchalance was the key to keeping this dialogue going. But what to say? She scrambled frantically to find the right tone.

“So, why do you think that is?”

Creases formed above Eva's silky black eyebrows.

“I don't know. I guess because they're all shallow.”

Gwen quashed her amazement and maintained a pretense of mild, nonjudgmental interest.

“Yeah, I think I understand.”

Eva didn't seem to be offended but said no more.

Gwen double parked in front of the bus stop.

As Eva got out of the car, Gwen said, “Hey, kiddo. It'll get better, much better. Believe me. You'll see. Your friends will become comfortable being real about who they are, and so will you.”

Eva looked dubiously at the approaching bus.

“Thanks, Mom,” she said with a sigh and closed the door.

At the hospital, Gwen went first to the clinic to retrieve her stethoscope, forgotten after her row with Allen Schwartz. She passed the treatment room and saw her longest surviving retinitis patient, Hubert Wilson. Once Kevin's patient, Hubert had switched to Gwen after his kidneys nearly failed during an experimental drug trial. He waved to her from a recliner chair where he was connected by intravenous tubing to a bag of ganciclovir. While the solution dripped, Hubert drew. A sketchbook lay on his lap. A tin of colored pencils was balanced on his armrest.

Hairless from chemotherapy that kept the Kaposi's sarcoma on his legs from enlarging, Hubert was the least demanding of the retinitis patients per the nurses. Although cytomegalovirus had destroyed much of his vision, he showed no signs of the profound depression that often afflicted these people.

He had no light perception in his left eye, the result of a retinal detachment. A blind spot in his right eye was large enough to eliminate half of his visual field. But he could still read. More importantly to him, he could still draw.

Ganciclovir treatment required sitting in clinic three hours a day, five days a week. Hubert used all this time to work on an illustrated book. Whenever Gwen had a few minutes to spare, she stopped by to view his progress.

Some of his drawings depicted wild gatherings in the style of Breughel—a local bath-house bacchanalia, a Castro street party, the interior of a South of Market leather bar. Others reminded her of William Blake paintings with modern stand-ins for devils, angels, and the fall from Eden. The accompanying text told the story of an art historian with AIDS trying to finish a definitive tome on the Depression-era murals inside Coit Tower on Telegraph Hill. Gwen had seen the murals, a paean to California industry and agriculture, and had read about the artist's controversial allusions to a bloody longshoremen's strike.

She sat on the unoccupied armrest and watched him color in his sketch of a priest wearing a nylon flight jacket over his clerical collar. The man was in conversation with a disheveled drug dealer whose open palms held out pills and packets of powder for passers-by to ogle. Hubert took a break and handed her a book of completed drawings. She paged through to her favorite one. In the foreground, a woman with a crew cut and huge biceps was mounting a motorcycle. Sidesaddle behind her was a transvestite wearing a slinky dress, a blond wig, red lipstick, and white pancake make-up. She had a mole on her left cheek like Marilyn Monroe. In the background marched a line of starving men, chained together at the ankles, clad only in bikini briefs. Their bodies were covered by boils and Kaposi's lesions. Above this scene, a long-bearded, elderly black man in a dashiki stood on a cumulus cloud. He held a thunderbolt over his head.

How wonderful that he has this creative outlet, Gwen mused. She wished she had one. She thought about taking an art class. Just an evening a week. I could find the time for that, couldn't I?

XI

K
EVIN HAD GONE INTO
work early and came home at noon. When he opened the front door, the house was quiet, too quiet. Marco always had music on during the day—jazz, rock, tango, blues.

“Hello?” he called out.

Merciless quiet enveloped him.

He found Marco in bed, eyes closed, breathing normally.

“Wake up,” he shouted.

Marco didn't respond. Kevin screamed in his ear. Marco still didn't respond. He pinched the flesh between Marco's thumb and forefinger. Marco lay flaccid. He pressed his knuckles into Marco's sternum, twisting downward with more and more force until Marco moaned feebly and lifted his right arm.

Kevin curled himself into a ball on the floor and rocked in a futile attempt to repel the facts pummeling him. Marco couldn't speak. He couldn't move half his body. It was unlikely he would ever do either again. Kevin's only escape route was to think rationally. He ticked through a checklist he knew by rote. Marco must have had a stroke, or a mass was growing in the right side of his brain. There was one treatable possibility, Toxoplasma infection. If it was anything else, Marco would survive a week, two at most. Even if this opportunistic parasite was the cause, it was probably too late for any meaningful recovery.

Kevin phoned in two prescriptions to a pharmacy on Castro Street and ran to his car. On returning, he placed a pill on the back of Marco's tongue, added a teaspoon of water, massaged the sides of his throat to make him swallow, and repeated the process.

He hadn't called an ambulance. Marco had consistently been clear about not wanting extreme measures. Taking him to the hospital is pointless, he
had thought at first. Now he wasn't so certain. He put the internal debate on hold. Herb would be here soon. He could decide.

Kevin went to his desk and composed a to-do list—call Mexico City, cancel everything at work for the next two weeks, find Marco's signed will. Nothing else came to mind. He gave up and sat beside Marco, who lay inert except for the rise and fall of his chest.

Herb drove to Diamond Heights after ICU sign-out rounds. He stopped on the way at a gourmet deli to buy garlic roast chicken, roasted bell peppers, a baguette, and a bottle of Sauvignon Blanc.

He had been to their apartment the previous summer. Marco had been in good spirits that evening, but his sunken frame and the anemic pallor of his lips and nails were unmistakable signs he was nearing the end of life. The idea of Kevin witnessing his lover's daily deterioration had distressed Herb, though he was uplifted by seeing how competently Kevin dealt with Marco's many needs, parsing them into smaller components, each having a practical solution—a minor medication change, setting alarms and posting reminder notes for Marco, hiring help for whenever he had to be away.

The last time he was here, the upstairs glass wall of their apartment had been ablaze, reflecting an ocher sunset. Tonight, the windows were black. He wondered if anyone was home, but within seconds of pressing the buzzer, Kevin opened the door.

“Thanks,” Kevin said in a flat, numb monotone, his bloodshot eyes fixed on the bag of food Herb carried. “I should eat.”

Almost as an afterthought, he said, “Marco's in a coma.”

He led Herb to the only source of light, a reading lamp at the far end of the apartment. Standing by the bed, they watched Marco breathe.

“Would you examine him? I can't trust my judgment.”

He gave Herb his stethoscope and rubber reflex hammer and retreated into the darkness.

Herb left the bedroom navigating blindly until his eyes adjusted. He found Kevin in the living room, staring out the window. Herb coughed politely.

“What do you think?” Kevin asked in the same monotone.

“A right hemisphere lesion,” Herb said uneasily, “Could be an infection, tumor, maybe an infarct or a bleed?”

“That's what I thought.”

“I'm so sorry.”

Kevin's attention was directed at the waxing crescent moon setting in the western sky.

“It might be toxo,” Herb suggested.

“I know. I already started him on sulfa and pyrimethamine. Not that it matters. It's better for him to stay here, isn't it?”

“Did he say he wants to die at home?”

Kevin nodded.

“Can you…?”

“It's the least I can do.”

“He could be made comfortable in a hospice.”

Kevin's face hardened.

“Herb, do you have any personal experience with hospice?”

“I do. Remember Sister Anna? She spent the end of her life in a hospice. I thought the staff was incredibly attentive. She had a little tape deck playing Gregorian chants. It was…serene.”

“Sorry, Herb, but an impression based on a cameo appearance you made there is not a persuasive testimonial.”

“Kevin, I was there a lot, daily during her last week. I was very fond of her. It was more than a doctor-patient relationship for me.”

“Herb, no way! Don't tell me you had an affair with a nun.”

Kevin laughed until tears blurred his vision. He arose, stumbled into the kitchen, switched on the lights, and opened two beers.

“Let's eat,” he called out.

They each succeeded in swallowing a few bites of food. Kevin opened two more beers.

Halfway through the third round, Kevin asked, “Were you ever in Boy Scouts?”

“I was. Why?”

“Just curious. They have scouts in Mexico, but Marco never joined. Probably his parents thought it was beneath him. I belonged for a while.
Why were you a scout? Because your friends were, or did your parents make you do it?”

Bewildered, Herb answered, “Actually, it was my idea.”

Raindrops began spattering against the kitchen windows, and Herb recalled a wet, autumn evening, standing at attention in a damp church basement. The smell of mildew was nauseating. He concentrated on the freshly laundered khaki scent of his uniform and the bright merit badges he was proud to have on his sash. The boys were clustered by patrol. His was the troop's smallest with only four members—Herb, two boys whose parents were from Latin America, and a kid who rarely spoke or looked anyone in the eye. None of them had been invited to join other patrols. Herb hadn't minded. He was grateful to be allowed to wear the uniform.

Herb saw Kevin was waiting for an explanation.

“I must have believed being a Boy Scout would make me a real American boy.”

“That's great!” Kevin roared, “You wanted to be a real American boy. So did I, Herb. So did I.”

Turning reflective, he added, “Boy Scouts didn't help.”

Herb imagined coming of age in the early1960s, knowing you were gay. Had that fear of being discovered been worse than his own childhood nightmares of Japanese soldiers invading the United States to exterminate every Chinese who had escaped the war?

Kevin interrupted this train of thought.

“Do you remember any of the Boy Scout Law?”

“I think so.”

The third beer kicked in, and Herb automatically recited, “A scout is trustworthy, loyal, helpful, friendly, courteous, kind, obedient, cheerful, thrifty, brave, clean, and reverent.”

“Amazing! How did you do that? You are the
last
person I would have expected to know all twelve Scout virtues, and in the right order, too.”

“I didn't realize you had such a low opinion of me.”

“Touché,” Kevin laughed.

He immediately became serious again.

“Did you believe in the code? You must have if you still remember it.”

“I guess so. The Scout Law did embody the ethos of the times.”

“Was there a hierarchy? I mean, were some of those virtues more important to you than others?”

Herb was mystified, but he could hardly begrudge Kevin.

“Let me think…trustworthy, loyal, helpful, friendly, courteous, and kind. Those all fit with what I thought Americans were supposed to stand for. I'm not sure about the rest. I do remember the oath we had to recite made me nervous. ‘On my honor I will do my best to do my duty to God and my country and to obey the Scout Law.' I worried I'd be putting myself in jeopardy if I ever broke one of the rules. I even asked my mother if swearing to obey the law was OK.”

“What'd she say?”

“She told me not to take it so literally. She was all for assimilation.”

“Interesting,” said Kevin as he gazed off into space.

Afterwards, parked in his driveway, Herb sat in the car mulling over what he had wanted to ask Kevin but of course never would. Last summer, when Marco told him how the two had met, Herb deduced they must have become lovers before anyone would have known that gay men who didn't use condoms might be transmitting a fatal disease. On hearing Marco was sick, Herb had commiserated with Gwen, but she revealed nothing. Maybe she knew no more than he did. He clutched the steering wheel in frustration. He couldn't think of any way to help Kevin.