It’s six in the morning and you’ve been up since two with the baby, who would only shut her eyes if you walked her up and down the apartment, your feet in their plastic slippers logging miles back and forth above greenish-gold shag carpet infested with tiny bits of paper and graham cracker crumbs. The other two children need to get off to school in time for the breakfast program, since one of their fathers stopped by to tell you he really loved you and was coming home—before he dug your food stamps out of the Tupperware jar and sold them for a $20 rock. You yell at the kids, threaten to kick their asses if they don’t get out of bed, and you keep your voice loud and hard to keep yourself awake, to keep the silence from settling in through the gray windows.

When the kids are off to school, it’s time to take your meds. Five large blue pills with no coating. Each is the size, shape and texture of a small piece of chalk. No matter how large a sip of Sunny Delight orange-flavored fruit drink you take, the pills sometimes stick in your throat. Sometimes you choke and they fly out of your mouth, occasionally even lodge in your nose.

You smoke cigarettes and wait for the phone to ring, which it seldom does no matter how much you focus your will on it. Girlfriends stopped calling as long as three years ago when they found out you had the virus. Your mother is in another city and has her own problems, problems just as big as yours, and she calls only once in a while just to let you know that. Sometimes the baby’s father calls, and for a minute the room will flood with warm, orange light as he promises to stop by this week. When he hangs up, reality buzzes into the dial tone, a hollow drone, like the sound of the fluorescent tubes that turn the kitchen a bright bone-white. The house needs picking up, strewn as it is with plastic toys, fast-food containers, summonses and notices and forms from social services—black spidery markings you can barely decipher that make your head hurt.

Then it’s time to get some groceries. You walk the six long blocks, baby in a Snuggli pouch with nothing to break the wind under a wide-open sky, thinking that at least it’s not summer with the sun baking down. A gallon of milk, bread and Flavorite cheese food by the slice, with just enough money left for a pack of generic cigarettes. You suck one down, greedy and grateful. On the way home, pushing your cart over the cracks and rises in the broken sidewalk, you run into your neighbor. Summoning all your energy, you talk bright and loud and brave—no one had better see you sinking. When you get home it’s time for your afternoon meds—six pieces of blue chalk. You gag on the third one, bile rising into your throat and nose. The other three sit there forgotten while you rinse out your mouth and turn on Jenny.

Then it’s time to get to the clinic. You have just enough time to get there and back before the kids get home from school.

After taking a trip involving three buses, two transfers with 10-minute waits between, dragging the stroller up and down steps, you are relieved to sit down in the warm clinic waiting room with its “healing” magazines full of bright, saturated images of fresh vegetables and protein drinks. When the doctor comes, she looks at your charts. She explains again the importance of a low viral load and a high CD4 cell count. You’re doing well, but you could be doing better.

You have trouble listening. Your mind is already racing ahead to the rest of the day: the kids home from school. Dinner. The baby waking up, needing to be fed. Formula—are you running low? Will her father really stop by, to tell you how pretty you both are? The rug needs to be vacuumed—it’s filthy. He won’t stop by. What’s on TV tonight? You can’t remember.

“Listen,” the doctor is saying, “with complete compliance it’s possible to knock your viral load down to undetectable. You could easily live another 30 years.”

You do hear that. That’s the deal: Three times a day you take these pills that make you shudder, cough, retch, and leave a taste in your mouth like chemically treated soap. And that will guarantee you 30 more years of this. You nod, thank the doctor and get back on the bus.