There are about 1 million people living with HIV today in America. I am one of them.
In 1981, I was a psychiatry resident in San Antonio. I had never really planned on studying medicine. But after receiving a fine arts degree from Brandeis and later a graduate degree in public health, going to medical school made sense. By 1981, I was finally doing what I wanted to be doing, happy with my professional choice. One afternoon I read the weekly Centers for Disease Control report that focused on a cluster of gay, male patients. Previously healthy, they developed weight loss, night sweats, pulmonary problems, uncommon pneumonias and tumors. They would get very sick very quickly. And then they died.
Periodically I would read about GRID, or gay-related immunodeficiency, but my own denial kicked in quickly. “All of these men lived on the East Coast or West Coast,” I thought to myself. I definitely had a case of the “it can never happen to me” syndrome. I threw myself even more into my work, fascinated by my patients, amazed at the incredible extent to which even “normal” human beings can regress psychologically.
By 1982 GRID had become AIDS, as heterosexuals were also becoming affected. With AIDS now a frequent topic on the evening news, it quickly became harder to distance myself psychologically. It was becoming apparent that this new disease was not going away any time soon.
Young adults today know of “AIDS hysteria” only from history, or if they rent a film like “Philadelphia.” They cannot imagine that you might see a friend one day, hear about them getting sick a few weeks later, and attend their funeral in a matter of months. And that this would happen over and over and over.
Suddenly, it wasn’t just gay men in New York and San Francisco, but a global biological pandemic.
When the HIV test appeared in 1985, I was pretty sure that mine would come back positive. There were no treatments then, but many of us had to do something in order to have even some hope of survival.
A group of us from Houston would travel to the Mexican border towns every few months to purchase Ribavirin, an antiviral medication. We’d find a pharmacy and spend hundreds of dollars. Coming back into America, the border guards would look at us with a mixture of pity, fear and contempt.
That medication was shown long ago to be useless against HIV. But when you are facing death, it’s hard for any of us to know what we would do in a specific situation.
That thought came back to me on September 11, 2001, when I watched people jumping out of the burning towers. Being an asthmatic myself, I know how scary it is not to be able to take in air, so I was not surprised at the number of people who just wanted to keep breathing, if only for a few more brief moments.
The public remembers some of the famous among the 25 million people who have died so far from AIDS: Arthur Ashe, Rock Hudson, Elizabeth Glaser, Isaac Asimov, Rudolf Nureyev, Halston, Paul Monette. The list, though, goes on and on. Since 1981, I have lost countless friends, patients and colleagues.
As a physician, I know that statistically I should not still be alive. I am blessed to be one of the long-term survivors. Whether it’s due to genetics or viral strain or luck, nobody seems to know. Unfortunately, however, whether you are in America or sub-Saharan Africa, if you do not have access to good medical care your chance of surviving is still slim.
The world has been on an AIDS journey since 1981. Academy Awards nights when every star wore a red ribbon. Princess Diana visiting gay men in London hospices. Concerns about our blood supply and going to the dentist. Horrible photographs from Africa. The brilliance of “Angels in America,” which put AIDS into a whole new perspective as the millenium finally came and went. And then the “cocktails,” as if going to the pharmacy was like ordering a Cosmopolitan or a Bellini.
These powerful new medicines have been a godsend, but young adults in America continue to be infected at an alarming rate. In 2005, there were approximately 45,000 new cases. Sadly, our public health efforts have not been nearly effective enough.
After all these years, more than anything else, I miss my friends. As on most days, on December 1 — which for the past two decades has been the date for World AIDS Day — I will think of some of them and laugh and cry and remember our shared good times.
I will especially mourn for the energy and creativity of an entire generation of gay men no longer with us. Unfortunately, this global AIDS journey that we are all a part of will most likely continue for decades to come, long after we are gone.
Dr. Alan Hurwitz is a psychiatrist in Houston.