Bleeder (26 page)

Afterwards as Anne and I wait in the lobby, Anne twists her nervous hands together, twirls fingers through her hair.

“I think we should call Mom. This sounds serious.”

“No, let’s wait for the results. Then we’ll either have the good news or the
really, really
bad news.”

“This isn’t funny. Why are you making this into a joke?”

“I’m not. I’m really not. I just don’t know how else to be.”

Dr. Trum ambles down the hallway with the films and kneels beside us, his tie swinging as a pendulum between his knees.

He balls his knuckles and knocks them atop my scalp. “There’s nothing wrong with that head of yours. I think you just had a touch of something. Not that that’s good for someone with your immunity, but well . . . it could have been worse. I want to give you something for nausea, and I’ll call you later with the results from your blood tests, but I doubt if we’ll find anything there. You’ve already stopped throwing up, haven’t you?”

“I have.”

“That’s good. Maybe this thing has passed.” He stands and stares down at me. “There’s hope on the horizon,” he says. “Hang in there.”

When we return to my apartment, Anne falls into the couch and sweeps her eyes around my apartment while I get us drinks. The cats run through
the room and disappear again. Then they are in front of us and Anne reaches down to pet them. Ice clinks in our glasses as we sit in the calm aftermath.

“Can we call Mom now?” Anne asks.

“Yeah. Now is fine. It’s over.”

She goes in my room and comes out a long time later.

“Mom wants to talk to you. She’s on the phone.”

I pick up the receiver.

“Hey, Mom.”

“Come home and rest,” she pleads. “Anne says you look terrible. We’re all worried sick, and it’s no good you staying up there by yourself like that. What are you trying to prove? It’s Christmas for God’s sake. Why can’t you come home?”

“I can’t. I’m not trying to prove anything. I’m just trying to live, to pay the bills, to survive. And I can’t come home. I have to work tomorrow.” I breathe quietly on the line and listen to Mom trying to hold in her tears. “Don’t cry, Mom. It’s not that bad. Please, don’t cry.”

“Just come home, Son. Can’t you do that for us at Christmas? Just come home. That’s all we want.”

COCKTAILS

J
ANUARY 1997
. W
HEN THE NEW YEAR BEGINS, IT IS AS ANY OTHER
year in winter: cold and frigid. Outside, ice freezes to the sprouts of twigs and to the sprigs of grass long since frostbitten, and the cold wind chaps the ground. Inside, my life feels frozen. I awake, eat a breakfast of cold cereal, and read a few pages of a novel; the rumble of cats is gone—their owner picked them up a few days ago—and now I am here alone.

I let myself out into the chill morning for an appointment with the ID doctor. And when the exam room door swings open and startles me from my little nap, I rise and catch the hint of a smile on his face. He leans against the wall, folds his arms across his chest, and studies me with his gaze.

“It’s time,” he says. “The Crixivan is approved, and I want you to start this protease inhibitor right away with two other drugs. A cocktail, we’re calling it. How do you feel about that?”

“I’ll take it. I’ll do whatever is required.”

He writes out the prescriptions, and as he passes the slips of paper into my hopeful hands, I recall the failure of AZT, but Crixivan
is
something I say, puffing up hope. Along with Crixivan I take d4T and 3TC—names that seem invented by George Lucas—and when I fill them at the hospital pharmacy, and when Crixivan arrives from a pharmacy on the West Coast—the
only current distributor of this protease inhibitor—I squeeze the bottles in my hands, close my eyes in silent hope, and begin the cocktail treatment.

For the d4T and 3TC, I must take one pill twice a day with food; the Crixivan, however, requires three pills ingested three times a day at
exactly
eight hours apart. Consequently, Crixivan punctuates my days. When my midnight alarm goes off, I wake to take the Crixivan that I keep by my bedside, and after I sleepily choke down the large pills with several gulps of water, I reset the alarm for eight when I must awake for work and must also take my next dose. And when 4:00 P.M. arrives and I am caught on the book floor, my watch’s alarm going off, I must discreetly excuse myself to the water fountain and swallow my three pills in as inconspicuous a manner as possible. And so it is done.

The months pass. This schedule becomes as familiar to me as each pill’s size and weight, which I can register by their feel in the palm of my hand when I reach out for them in the dark or snag them with my fingers when they become buried in the deep pocket of my jeans. The Crixivan is a large capsule, the d4T smaller and also a capsule, and the 3TC tiny like a diamond-cut aspirin.

Naturally, Mom is hopeful about this treatment. She mails me an article about Dr. Ho and protease inhibitors, and as I curl on my couch with my coffee, having just swallowed my morning doses of all three meds, I read the interview about this modern-age Merlin and his potion for the HIV world. I cling to this as a man must grasp rope when hung from a building ledge, a cavernous drop.

In late April, my alarm wakes me and I refill my water glass, take the d4T, the 3TC, and the three pills of Crixivan—and I amble for the toilet on my stiff ankles as the sprinkle of weak sunlight filters through my blinds. A gripping pain seizes me in the back. I gnaw my tongue and curse out loud for the internal burning; I brace against the wall while my knees buckle and drop me to the floor. I stand again, aim, then out pisses blood.

Oh, fuck. I’m bleeding.

Although I’m a bleeder, seldom do I see blood. Instead I witness its effects in the swelling of a joint, in the stretching of skin, and in its pain. I
calm myself by taking deep breaths. I hike up my boxers and return to bed, thinking of what to do. First, I cancel work, telling them that I have an emergency, and then I call the hospital to say that I’m on the way.

In the emergency room, a hematologist waits for me. He is a young man from a foreign country who explains to me that he is in America for a year to study medicine. In his country, he says as we settle into an examination room, no one really knows what hemophilia is, nor do they understand how to treat it. I am lucky here in America, he says starting an IV. In America, he says, they take care of you. In his homeland, he says, boys just like myself hobble about with swollen knees and they must drag themselves through the hot sands of his country because they go so long without medicine. And I imagine it: my other.

Turning his attention to me, he says, “We are going to run a great many tests on you and will see what the results give us.”

“But what do you think it is?”

“I cannot say.”

“But can’t you guess? Is it bad?”

“I cannot say,” he repeats, helping me into the bed and checking the drip on my IV. “But I think it is probably something with your kidneys. Perhaps a stone or some very bad bruising. But really, I cannot say.”

When he leaves, I call Mom, and she tells me in a breathless panic that she is in the car and on her way and will be here soon. And when I try to reach Dad at the plant, the operator returns and explains that Mr. Smoak isn’t answering his phone or his pages.

“Listen. This is an emergency and I need to speak with him immediately. Does your plant have a smoking area?”

“Yes.”

“Try there and tell him it’s his son.”

I wait. The hall nurse comes in and introduces herself and says that an orderly is on his way to take me to X-ray. Then, as she leaves, Dad picks up the phone line. He coughs and is breathing fast from what I imagine to have been his brisk run from the outdoor smoking patio to the nearest phone.

“Son. Son, are you okay? What’s happened?”

“I’m in the hospital, Dad.”

“Oh goddamn.”

“I feel fine, but there’s blood in my urine.”

“Do they know what’s causing it?” He coughs.

“No. Not yet. They’ve got me scheduled for an ultrasound and an X-ray later, and then they’ll know, but they’re thinking it’s my kidneys.”

“Have you called your mother?”

“She’s on the way.”

“All right.” Dad catches his breath, coughs heavy. “I’ll be there quick as I can.”

Later, everyone is in my room. Mom and Dad grip nervous hands together; Dr. Trum arrives with the medical student; the ID doctor ushers in his team; and the urologist enters, followed by his three shadows. The senior doctors talk while his understudies record notes on their clipboards. Soon they form a horseshoe around my bed. Mom, Dad, and I look on as Dr. Trum begins to speak.

“We’re pretty sure it’s your Crixivan,” he says. “You’ve got kidney stones from it, and I’ve worked with the urologist to develop a plan of action.”

“The Crixivan? What am I going to do about that?”

“We’re going to start you on another protease inhibitor, Viracept, immediately. It has just been approved and should be, we hope, equally as effective as the Crixivan but, of course, without giving you those stones. You can’t go back on the Crixivan. It’s too much of a risk. Unfortunately, stones are one of its side effects.” He looks away to the clock, then back. “Of course, we’d hoped you’d be in the clear on that one, but, well . . . you’re not.”

“These stones,” the urologist says as he holds up an X-ray film to the light, “are not like other stones.” He passes the film to his shadows, who examine my photo. “They are crystal in form and consequently have jagged edges. And, more importantly, they are too big to pass in your urine. If they did pass, I assure you . . . it would be quite painful.” I imagine something like a shard of glass slicing its way down my urethra. “As you can see, and especially given your hemophilia, we must get rid of that stone before it cuts you even more.” The shadows scribble furiously, this being, I imagine, good stuff for them. “Normally we would use sonic vibrations to break apart the stone, but that, I’m afraid, will simply cause more bleeding.” Here, I
envision several thousand shards of glass sluicing my urethra, snaring on tissue, and furrowing rows of deep vermilion. “I’ve talked with Dr. Trum and we agree that it’s best if we go through your urethra and retrieve the stone and bring it out safely.”

Oh horror!

“Good God,” my father belts out. “I can’t handle this. I’m leaving for a smoke.” He rises from his seat, grabs his cigarettes, and shoves them into his shirt pocket as he spreads apart the doctors and makes his way for the exit.

“Will I be awake? Will I feel what’s happening to me?” I ask.

“No. We’ll put you under while we insert a tube and you shouldn’t feel a thing,” the urologist says, addressing my mother and me. “We will, however, have to leave a stent in to help the healing which, I’m afraid, will have to be removed while you’re awake, but that’s only a little discomfort.”

“And we’ll keep you factored up throughout the whole procedure,” Dr. Trum chimes in. “We’ll be sure your levels stay up to stop any bleeding.”

“What about my job?”

“I think you’re going to need at least two to three weeks off.”

“Oh, I can’t do that. I don’t have vacation days and I’ve used up all my sick leave.”

“Forget about your job,” Mom interrupts. “You need to get better. This isn’t the time to think about that bookstore. It couldn’t give two hoots about you.”

I don’t argue with her. On the verge of tears, she blows her nose to distract herself. “Okay,” I say. “Okay.”

Then, the plan in place, the physicians file out uniformly.

In the evening, Mom drives out to find us some food worth eating. Dad and I sit with the TV on.

“Son,” Dad says during a commercial. “I know you don’t want to hear this, but I think you should just move back home. You can’t keep working at that job like you are. Your kidneys are going to need time to heal and you’ve just started those cocktails and your mom and I have talked and we just think you need to rest and give that stuff a chance to work.” Dad rubs his mustache and stretches out his lanky legs. “Anne says that you’ve been writing short stories or something like that. She says you gave her something
you did and she thought it was pretty good. Maybe you should just come home and do something like that. It would keep you from being so bored while you tried to get back on your feet. You need rest, Son. We all can see it. You’re too thin. And, well, you’re just too run down.”

“I’ll think about it.”

“Think hard, Son. You’ve got insurance through COBRA and that’s good for over a year, so there’s no reason for you to stay up here. No reason at all. Work will always be there for you. Trust me on that. But your home and a place to rest and recover won’t be.”

Outside the sky starts to purple and is soon stricken in darkness. We sleep.

The following morning, I am wheeled into the operating room. The anesthesia burns into my vein, but then I remember nothing. And when I wake, I am back in my room, the TV is on, and Mom and Dad are propped in chairs beside me.