In July, I took the bus from my home in San Francisco’s Mission District to the Haight Ashbury Free Medical Clinic. Filled once again with test-results anxiety – this is where I learned I was positive – I walked up the stairs of the funky old Victorian into a cheery waiting room, with its street view of the shoppers, skate rats and drug deals that give the neighborhood its charm.
The clinic was started in the ‘60s to fill a need among the hippies, and despite the neighborhood’s transformation form love pads to slightly alternative outdoor mall, it continues to serve the neo-hippies and street kids who live nearby. My doctor isn’t quite a doctor; he’s a nurse practitioner, but knows more about HIV than any of the real doctors or interns I’ve had service me. He wants me on combo therapy, and he’d like it if I took testosterone shots to help me put on weight. Fortunately, he seems to respect my decisions not to.
When my most recent labs came in, he called back to make sure the numbers weren’t misread. Two years ago my first viral load read 66,000. A year later it fell to 41,000. I went to 4,500 in January and now was 700. He was surprised as I.
Except for five excruciating days on AZT/3TC 10 months earlier, I had been (and still am) drug-free.
This is the point at which I could become a self-righteous preacher of some particular mindset or herbal tea. Mind power alone can cure you of AIDS! Acupuncture and Echinacea tea achieved amazing results! But there’s nothing more annoying than long-term survivors or amazing comebacks ready to take credit for the Secret to why they’re not dead.
It’s tempting to decide that my health is a reflection of my virtue and strength. Any time a friend has died, I’ve wanted to distance myself, find some crucial factor that inclined them more to death. He never tried protease inhibitors. He had unsafe sex for years. He was on crack.
It’s nice to feel special and smart and in control, but it’s not at all accurate. Let me slap myself and overcome the temptation.
Instead of smug assertions, I’d like to offer you nothing other than giddy confusion. You may know how it is, waiting for those awful T-cell counts and viral loads, secretly sure they’ve gone in all the wrong directions, practicing excuses for the bad results before you even get them: Oh yeah, I was tired and under the weather that day. They took my blood two hours earlier than they usually do and my T-cells hadn’t woken up yet. My allergic reaction to that cat probably sent my viral load skyrocketing.
So when Bill told me my viral load as 700, I had to ask, "Seven hundred or seven hundred thousand?" I started giggling. As he called back to check, I couldn’t help but re-prepare myself for the worst. As much as we tell ourselves again that numbers are meaningless and one bad score isn’t worth depression, still, if the news is good, it can’t help but get you signing the song that viral load is everything and you’re never gonna die.
And, inevitably, good news help you ask yourself: “What did I do? Drank Echinacea tea, lowered my stress level, stopped thinking that I was going to die?” Whatever. These may have been factors, or they may have meant nothing – just one more upswing on the seesaw of information about invisible processes inside our bodies.
OK, I’ll admit it: Privately I do wonder if the simple existence of protease inhibitors has lowered my viral load. Yeah, I’ve never taken one, but their existence has changed the psychological climate of having HIV. I don’t expect to die of AIDS anymore. Wouldn’t it be nice if that expectation alone could make me a healthier person?
Maybe that’s bullshit. Causality’s a messy thing. When our private exercises in positive thinking get made public, that’s when we’re in danger of becoming fraudulent preachers or smug spiritual advisers. Please, do not read this story as one with a moral. There is no moral, no evidence, nothing really… but a small amount of blood and a mysterious process of counting somewhere in a lab. Mind control alone will rid my body of the virus. I can believe that, privately and ironically. But if you believe it, I become complicit in your doom. And that isn’t fair to either of us.