Living and Dying in Brick City (11 page)

B
y the end of 2000, my sister Fellease’s health had begun a rapid decline. I’d watched AIDS whittle her down from a robust 160 pounds to less than a hundred, mere skin and bones for a woman her height. She’d lost her teeth and developed vitiligo, white blotches like bleach stains all over her cinnamon-colored skin. Through it all, though, she never lost her zest for life—or her smile.

“I’m still pretty,” she’d say, flashing that big, toothless grin at me, even as AIDS was ravaging her once beautiful face and frame.

“We’re twins.”

Actually, fourteen years separated us. But of my five brothers and sisters, I was closest to her. I was the baby boy Fel never had. When I was growing up, she helped take care of me, bought me treats on demand, and talked the belt out of my parents’ hands many times after I’d misbehaved. She was the cool big sister who kept me up on all the latest music and dances and even covered for me a time or two when I was hanging out somewhere I shouldn’t have been. She always tried to tell me the right thing to do, even when we both knew she didn’t make the best choices herself. When I heard the police were looking for me after I’d been involved with the robbery in my senior year of high school, I called Fel. Terrified that I’d probably just blown any shot at a real future, I anguished over whether I should turn myself in.

“We’ll figure something out,” Fel assured me. She drove me to the police station and talked mightily, trying to persuade the officers to release me into her care since I was a juvenile. Even though they took me into custody anyway, I never doubted that turning myself in that day was the right thing to do.

Fel had dropped out of high school to get married. She then divorced, remarried, and moved to Hawaii with her new husband, who was in the army. There she earned a high school equivalency diploma. Unfortunately, that marriage didn’t last either. I was
in the ninth grade when she returned to Newark, got a job, and lived at home on and off. The two of us grew even closer, staying up together many late nights, talking about life and playing board games.

But the streets had already started to claim her. In her room at our parents’ house, I once discovered a burnt spoon and a tiny nip bottle of Bacardi rum that she had transformed into a crack pipe. I never told a soul, but it confirmed what I’d suspected: She was a crack addict. I just kept hoping she’d turn her life around, get a stable job again, find a great guy, have kids. Instead, she became more unreliable and unstable, moving from job to job, living here and there, and disappointing Moms and me again and again. When I discovered one day that money I’d been saving from my part-time job to repair my used car was missing from its hiding spot at home, I confronted Fel. She denied stealing it and denied using drugs, but I knew she was lying. Exasperated, I didn’t speak to her for weeks.

Fel wasn’t an IV drug user, but she was involved with men who were, and one of them undoubtedly infected her during sex. Maybe she didn’t think her man needed to use a condom because she trusted him, as so many women claim. Or maybe, as an addict, she was just doing what it took to get the next high, and safety was the least of her concerns. But anytime you make the choice to practice unsafe sex, you’re vulnerable; you’re taking the risk of sharing whatever infections and diseases your partners and your partners’ partners may have.

Fel didn’t look sick right away; oddly, her hair texture was the first noticeable change. It became suddenly fine and silky. In the hood, the sudden emergence of “good hair” on a person with risky behaviors is suspect.

“She’s got the package,” we’d say, talking in code about one woman or another we suspected was infected with AIDS. Yet, despite
the many times we said and heard that, it never occurred to us that AIDS had taken a deadly turn into urban communities. Poor black folks were dying at rates that nearly rivaled that of gay men when the disease first struck, and black women were being hit disproportionately hard. By 2001, AIDS had become the leading cause of death for African American women ages twenty-five to thirty-four, according to the Centers for Disease Control and Prevention, and most of them were being infected through sex with men who had been IV drug users or had sexual encounters with other men.

Fel denied my suspicion about her illness, just like she’d denied the theft and her drug use. I hinted one day that she had “that good hair,” and she knew instantly what I meant. She snapped back that she didn’t have “no HIV.” But time revealed the truth. Back in the early 1990s, before drug cocktails made AIDS more of a terrible chronic illness than a death sentence, the virus killed slowly. Its victims had a certain look: emaciated bodies, sunken eyes, and sometimes even distinctive lesions. They were like walking ghosts with the dreaded “A” on their foreheads. In medical school, I’d fantasized about finding a cure. I wanted to save my sister, and it hurt deeply that I couldn’t.

Just three months after I began my residency at Beth Israel, Fel started showing up in the E.R. with various AIDS-related ailments. She was loud and brash, demanding that the hospital staff bring Dr. Davis, her little brother, to her side. My colleagues thought it was a joke, that she was just another patient from the neighborhood claiming to be related to me to get quicker service, which sometimes happened.
Surely
, I could practically hear them thinking,
Dr. Davis doesn’t have a sister like that
. For most of the doctors and nurses, Newark was just where they worked. But for me, it was home, and
those people
were my mother, my sister, my cousins, my friends. Moms had shown me that you just don’t turn
your back on your people. And when I looked at Fel with that silly, toothless grin, what could I do but claim her, love her?

There were days, though, when I just couldn’t tolerate what my sister was doing to herself, and I had let her know it. One evening I was driving her and Moms home from a shopping trip when Fel kept nodding off to sleep. By then, she was gravely ill, but it was obvious to me that she was currently high. She’d slipped off to get her fix and didn’t even care that our mother once again had to witness the aftereffects. I reached over to the passenger side, where Fel sat, and squeezed her hand, hard.

“I want you to wake up right now, or I’m kicking you the hell out of my car!” I demanded, as she struggled to crack her eyes. “You need to cut this shit out!”

After that, she disappeared for a few days, the way she often did when she knew she’d let her family down. Eventually, though, I quit fussing about the drugs and her lifestyle. I stopped trying to be the know-it-all doctor full of advice and warnings about what could happen if she didn’t stop this or that. I tried to focus on just being baby bro, grateful for whatever time the two of us had left. This way, practically every time I saw her, she was her usual, cheery self. And this was the Fel I wanted to remember.

Beneath her smile, I knew she was really scared. She grew weaker with every bout of sickness, eventually not bouncing back as quickly. Sometimes, she would hug me as though she were trying to squeeze the life out of me, right into her own body.

“Marshall, I don’t want to die,” she’d say, holding me tighter than seemed possible for someone so frail. “I don’t want to die!”

I hugged her back, wishing I could offer some assurance. But I braced myself for what I knew would soon come.

I
n fall 2001, Fellease developed an intestinal infection, which caused a bowel obstruction. Once again, she was admitted to Beth
Israel, where she had surgery to remove part of her intestine. She never fully recovered from that, and soon landed at St. Michael’s Medical Center, one of three major hospitals in Newark.

One of their emergency room doctors buzzed me on my cell the afternoon of October 13. Fellease was critical, he said, and the family needed to get there right away. I was in my third year of residency and had made that call to families more times than I could count. I knew automatically what it meant: My big sister was either close to death or already gone. As a doctor, you don’t want to deliver such devastating news over the phone, so you say just enough to get the family there. This time, I was on the other side.

Hang on, Fel, please, hang on
. That’s all I could think as I dashed the few miles from my place to my mother’s house and then sped with her and my brother Carlton to the hospital. The ride was so quiet, it felt like all three of us were holding our breaths. When we arrived, I told the security guard in the emergency department waiting room that we’d received a call telling us to come. A nurse suddenly appeared to escort us to Fellease’s room. She paused outside the door and broke the news: My sister had gone into cardiac arrest about an hour earlier, and the medical staff had been unable to revive her.

I took a deep breath, trying to prepare myself mentally to walk into that room.

“I’m sorry for your loss,” the nurse said softly.

Even when you’ve said those words to others a million times, nothing can prepare you to hear them yourself. They made my knees weak. I hadn’t had a chance to say good-bye. My heart ached as I took my mother’s hand and moved quietly with her and Carlton to Fel’s bedside. A breathing tube still hung limply from Fel’s mouth, and her eyes were partially open. The doctor in me leaned over and gently pressed her eyelids shut. The little brother wept.

“Rest in peace,” I whispered, wiping away my tears.

Tears streamed from Moms’s eyes as she stroked Fel’s thin hair. I could only imagine the magnitude of her grief. A parent isn’t supposed to bury a child. No matter the circumstances, losing one must feel like losing part of your future. Carlton touched Fel’s arm. I wrapped my fingers around her cold hand, and for a few moments, the three of us stood there silently, each with our private thoughts and tears.

Fel was just forty-two. I couldn’t help thinking:
This didn’t have to be. She didn’t have to die this way
.

I tried to conjure up the sound of her voice and the sight of her smile before they were changed by AIDS. I thought about the many times she’d breathed life back into my hopes and dreams when I’d felt deflated, wanting so badly to quit during medical school. Now standing at her deathbed, I wanted to be a miracle worker and do the same for her, bring her back, healthy and whole. But all that anybody could do had been done.

Throughout her life, Fel had been my muse. In death, she is that once again. It is her face I see when I read the dreadful statistics. And it is her loss I feel when I tell young brothers and sisters: “Wrap your stuff up. Protect yourselves. One moment of passion isn’t worth the risk of losing your life.”

The surest way to avoid transmission of STIs is to abstain from sexual contact or to be in a long-term, mutually monogamous relationship with a partner who has been tested and is known to be uninfected. Latex male condoms, when used consistently and correctly, can reduce the risk of transmission.

The most frequently reported bacterial sexually transmitted infection in the United States.

Symptoms:
Usually absent or mild and may appear within one to three weeks after exposure; they include abnormal vaginal or penile discharge, burning sensation during urination, lower abdominal pain, low back pain, nausea, fever, painful intercourse, bleeding between menstrual periods, rectal pain, rectal discharge, or rectal bleeding.

Treatment:
Antibiotics