I can see the Wall more clearly these days and it is beginning to unnerve me.  At one time the Wall was far off in the distance and hard to see.  If I bothered to look at all I had to be drunk, melancholy, stupid, or all of the above.  I had to squint and make a grand show of it.  I was young and the Wall I was seeing was the bullshit thinking of a young man with too much responsibility. 

The Wall was real because I was a young man dealing with human conditions I had no business fooling with.  At age 20 I was the head nurse of the intensive care unit at New York University Hospital.  I was in charge of the medical ICU while my major goal in life was to drink and get laid after work while living in Manhattan.  The people laying in beds, called patients, were just distractions.  I did not see them as real.  I thought the patients simply checked into the critical care unit as hopeless medical clumps of problems and not people.  It would take me years to figure out that I was a fool in charge of a circus.  A ringmaster without a clue in the world how to control the lions or the clowns.  I had accepted a ticket to the circus without ever having been to one.

Now time is different and so is the Wall.  I see it clearly.  It becomes more visible daily and it is no longer far off in the distance.  The Wall is getting closer to my hitting it every day.  At first coming to the conclusion that hitting the Wall was in my near future did not bother me.  However, as time soldiers on I find the Wall to be truly frightening.  A looming reminder this game can be over anytime. 

I am not just talking about getting older.  Older is older and that is just life.  But I am a man with AIDS, severe pain, recovering from addiction, and way too many "fill in the blank" diseases bringing me closer to the Wall.  This takes my breath away.  I was once a clinical warrior in the fight against HIV; some would even say a general in the struggle.  But has time has marched on so has my health.  I sometimes look into the future and all I can see is the Wall.  It is solid and steadfast.  I know it will not bend anymore.  Cracks in the wall are no longer for me to escape through, but they are there to crumble on impact. 

There are times when I wonder what will happen to me.  When I get full of myself I wonder what will happen to all my patients.  I know my patients will be okay, but I am not sure about me.  I am coming to an end.  This I know is real.  I can feel it.  The virus I have been treating and fighting for the last 30 years is dismantling my body and life.  Pain is no longer a tolerable companion but a fearless enemy that stabs me every minute of the day.  I am slowing down.  I am approaching the Wall steadily. 

So here I am at the end of my clinical career and I am lost.  I do not know what to do.  All I know is that I can no longer keep up the physical pace that is demanded.  I am crumping.  I don't want to fall down, but gravity does what gravity does.  I am being pulled down.

Here is what is frustrating about my issue with approaching the Wall.  No one will take me seriously.  I look good - great even.  I have muscle.  I am smart.  I push myself through.  People can and do count on me.  But my bones are raging a new song.  They are screaming that slowing down is something that HAS to happen.  It is no longer a choice.  I am a man weakening with little choices or skills.

I know many other people with HIV feel the same way.  We all stand around and try not to look at each other like strangers at cocktail party.  I shuffle my feet and wonder what will happen.  Then I glance up and see the Wall and know I will likely he hitting it soon.