For David

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World AIDS Day

The year is c. 1985. I’m enjoying one of my favorite pasttimes as an 8 year old, feedIng the seagulls frozen bread from my Grandma’s 3rd floor beachfront apartment in Sounthern California. The flocks would suddently appear out of an empty Pacific Ocean horizon, calling out to one another, and circle round in front of the balcony. Some were brave enough to suspend themselves, flapping in front of me, screeching out for a nugget as I tossed them a freezer burned crust. Effortlessly they would catch these treats, simultaneously squawking and fighting in mid-air, only to retreat and circle round again for another try.

David lived in the apartment below Grandma. A dark, tan and handome thirty-something, he would often sunbathe on his balcony directly below, a green bottled beer on the side table, an open newspaper in front of him. Sunglasses always on. I would peer down through the wide spaces between the railing balusters and watch him in his utterly relaxed state.  David was gay, something Grandma understood and embraced as a nurse in the 80s.  The two of them would frequently exchange niceties and catch up on the stairway separating their apartment floors.  I could tell Grandma cared for him, and he for her.

One day while I was gazing down at David enjoying his routine, restful circumstance, I noticed large, raised purple lesions scattered over both shins.  He had his feet up on the railing as usual, crossed in a comfortable position.  The lesions didn’t seem to bother him as he uncrossed and recrossed he legs in perpetual comfort.  The plum-colored plaques glistened in the sunlight as he turned the pages of the Orange County Register and sipped from his beer.  Grandma called me into the apartment for lunch and I never ended up seeing David reclining on his balcony again.  A few years later she took me to visit David in the hospital.  He had been diagnosed with AIDS some time before, and was now very sick.

As I held Grandma’s hand we approached David’s hospital room.  Crossing the threshhold I could see David in a bed between two windows at the far end of the room.  It was midday and the natural light was calm.  He was dressed in a yellow hospital gown, writhing about in the bed, a look of anger mixed with hysteria.  He was restless, vocalizing, but the words didn’t make any sense.  He looked crazy to now 10 year-old me.  A nurse in the room was also gowned and wore a face mask.  She motioned to Grandma to do the same.  So we gowned up and approached David at his bedside, Grandma in front, me close to her side.  I observed the tangled web of IV tubing, David’s legs thrashing about under the stiff white sheets.  The nurse quietly fiddled with the monitoring equipment nearby.  David stared up at Grandma as she put his hand in hers.  She caressed his arm, leaned in closer to his face and quietly spoke to him in soft tones.  I couldn’t hear exactly what she said, only noticing the pacified look on David’s face in her presence.  He was suddently calm in those moments she stood at his side, touching him.  David died several weeks later, and as the years passed so did may other family friends and aquaintances.

It would be another 20 years before I truly understood what had happened to David in those years.  In med school full blown AIDS was a a rare sight as antiretroviral therapy had essentially re-categorized HIV from a death sentence diagnosis, to a chronic, treatable and preventable illness.  I studied the few AIDS cases I encountered with a hungry fervor, and would later understand that those spots on David’s legs were Kaposi sarcoma, a classic skin manifestation of some AIDS cases.  And the combative behavior in the hospital?  AIDS Dementia Complex, a well-defined neuro-cognitive disorder of some advanced AIDS cases.

Since 1988, December 1 has been designated World AIDS day.  Today I recall all the strides and discoveries made to temper HIV and help those afflicted to lead lives of their choosing.  May those lives be long and full and grateful.

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