Bleeder Page 11

  My worry increases. I thrum my hands against my desk. I sharpen my pencil. I open my desk and sharpen all my pencils. Then I test all my pens, discarding those out of ink. I collect all the loose paper clips from my drawer and organize these in a box and then I flip through my notepads and rip out pages that are marked and now useless.

  When the lady from the Health Division arrives at my door at three o’clock, she is dressed in a navy-blue sports coat with brass buttons, and she chokes my room with perfume as she enters. Making herself comfortable at my desk, she reminds me of an oversized gourd, like the ones my grandfather hung for spring martins to nest in. She fishes out a file from her leather briefcase.

  “I’m Margaret O’Delle,” she says, crossing her legs while I recline on my bed, festering with curiosity and concern.

  I offer her soda, coffee, or crackers, but she declines.

  “It seems you’ve somehow slipped through our system. You are HIV positive, correct?” She thumbs through her folder, rifles out a form.

  “Excuse me?”

  “It has come to our attention that you are an HIV-positive male living in New Hanover County. You were recently admitted to the ER, I believe.”

  “I suppose.”

  “Well . . . You must understand the extreme threat this virus has caused, and this just lets us know that all precautions are being taken with persons such as yourself.” I smile feebly. “So, Mr. Smoak. Have you had any sexual partners?”

  “What?”

  “Any sexual partners?”

  I feel violated. My insides stew. I clench my fists together and squeeze the knuckles white. I am now the enemy.

  “Have you had any sexual partners?” she repeats, her steel face revealing no emotion.

  “I’m not sure.”

  “Either you have or you haven’t had sexual relations.”

  “I haven’t then.”

  She taps her pen upon my desk. “I don’t believe you,” she says, furrowing her eyes on a taped-up photo of Kaitlin. In the silence between us, I hear her steady breathing.

  “You asked if I’d had any sexual partners, and I’m saying that I haven’t.”

  “Mr. Smoak, what you don’t understand is that we have to follow the names of any partners you’ve had and ensure that they’re receiving the proper care and attention.”

  “Bullshit. You want to ensure that I haven’t infected them.”

  She folds her hands across her lap and lets out an offended gasp of air. “Calm down, Mr. Smoak. I don’t doubt your good intentions, but this is state law, and it can have serious consequences should you refuse.”

  “I’m not refusing. I simply don’t have any sexual partners to offer up to you. Actually, I’m one of those rare breeds that is saving myself for marriage.”

  “Are you involved in any relationships now, Mr. Smoak?”

  “The only relationship I have is with my studies,” I retort, drawing up and limping to fling open my door. “I think you should leave. This is over.”

  “It’s mandatory state policy to follow through these things,” she says, gathering her things and shoving a blast of air from her mouth.

  “Here’s what I think of state policy,” I say, giving her the finger.

  She scurries by, shouts: “I’ll be in touch! This isn’t over!”

  And then she is gone. And I’m on the phone, trying to raise my dad at the Goldsboro plant where he now works. They page him. He picks up.

  “Dad,” I say. “Dad, oh, I don’t know what I’ve done.”

  “Calm down, Son. Just calm down and tell me what happened.” So I tell.

  “What?” he asks when I finish. There is the sound of his angry breath. “Goddammit,” he says. “God fucking dammit. If that ain’t the shittiest, vilest thing this goddamn state of North Carolina has ever done.” He pauses. His anger travels the BellSouth lines to me. I understand him. “I can’t believe this shit,” he says. “Do you have her number, Son?”

  “Yes.”

  “Give it to me.”

  I don’t ask why? what for? I read the number aloud.

  “You’ve done nothing wrong here. You hear me, Son? You’ve done nothing wrong. Do you understand me?”

  “Yes.”

  “Okay. I’m gonna call and give somebody a piece of my mind.”

  When he hangs up, I curl onto my bed, wondering how much more I can take. I don’t even get up to put on music, sometimes my only solace. I am alone, singled out, an island again. I just fold into myself, sleep, and only later wake when Kaitlin comes by to check on me.

  “I can’t believe they did that,” she says, sitting on the edge of my bed, listening to my story.

  “Me either.”

  “So, you didn’t give me up, did you?” Kaitlin jokes, throwing her arms around me and showering me with kisses. “My hero,” she says with more playful kisses. “Oh, it’s like in the movies. Are we gonna have to run away? Hop trains? Fake our passports?” She falls against me in an exaggerated swoon and whispers into my ear—“My hero. My hero.”

  At home after the Thanksgiving holiday, my family and I circle the Sunday dinner table as Mom lays out the fried chicken and mashed potatoes with sides of butter beans, corn, and biscuits. We eat. But it’s not long before Dad starts in again against the state:

  “Shittiest thing I’ve ever heard of. Shitty, shitty, shitty,” he says.

  “Shelby, not at the Sunday table,” Mom warns.

  “It’s just shitty. That’s all there is to it. Shitty.” He bites into the fried chicken, tearing meat, chewing angrily. Then he points to me with his chicken leg. “Son, I hope you’ve learned a lesson. Time you sign your records over to some other hospital besides Chapel Hill, see what happens? Those other hospitals don’t know you. They just see you as a number and then they report it. One thing your mom and I have learned all these years is to keep our mouths shut and to keep as few people—doctors, hospitals, and whoever—from finding out. People can be mean and thoughtless when it comes to some things, especially when it comes to things about you.” Dad lays the leg on his plate, forks his green beans. “I know Chapel Hill’s not close for you, but I swear to God you gotta make that drive, no matter how.”

  “But it was an emergency,” Mom interjects.

  “I don’t care. He should have just kept his mouth shut and not said anything about anything else. If too many people find out about you . . .” He looks to me. “If too many know, I can’t even say what will happen when you graduate and start looking for a job. And I know. I see it every day at the plant.” He pauses. “Every day there’s discrimination. Every goddamn day.”

  The room stills. Only the sound of our eating fills the silence.

  LUNGS

  JANUARY 1994. I DRIVE TO MY APPOINTMENT AT THE HEMOPHILIA Center and marvel at the piles of snow along I-40. As I swish through thawed patches of slushy roadway, melting winter surrounds me: the sun softens the frozen ground with its feeble heat; the wind loosens powder from the barren trees; and the winter birds caw above the white earth, quieting only when they light in frigid puddles for a drink.

  At the clinic, we go through the familiar motions.

  “Today,” Dr. Trum then says, removing the tongue depressor from my mouth and bringing my visit to a conclusion, “I think it best to begin some preventative therapies.” He discards the depressor, sits in his chair, looks back to me. “Since your numbers are declining, we need to prevent common HIV infections like pneumonia, CMV, and TB. For TB, we’ll do an X-ray of your chest and check your blood as well, and for the CMV I’ve scheduled an appointment with the ophthalmologist where he’ll check for floaters and other signs of infection.”

  “What happens with CMV?”

  “While it can cause blindness,” he says as I immediately imagine it—all life washed to forever black—“I wouldn’t worry too much over that. Not just yet at least.” My palms whiten as I lock my fingers together. “Our goal here is to prevent infections, and catch them early before they
become uncontrollable. Remember it’s the infections that people succumb to and not AIDS itself.” He pauses, taps his pen on his notepad. “And when you’re finished with the X-ray and eye exam, I want you to return here and the nurse will assist you in your first Pentamidine dose. Now, normally I’d prescribe Septra for you—a pill that you could easily take daily—but since you’re allergic to sulfa drugs, I’m going to go about prevention the other way and give you Pentamidine instead. The efficacy of both is pretty comparable. Pentamidine is just a little more inconvenient, as you’ll have to come here monthly to receive it.” Dr. Trum jots notes in my folder, closes it, clicks his pen, and slips it into his shirt pocket. “So,” he says, taking a breath, “that’s the plan.”

  I feel danger approaching. My dropping numbers and these new preventative therapies remind me that I am, as I’ve always been, dying.

  I ride the escalator to the second floor, where the X-ray flashes over my chest, and then I follow the signs to the ophthalmology clinic, where, getting lost along the way, I eventually arrive at the check-in window. Later I grip the arms of a large, vinyl chair while the doctor drizzles dilating drops into my eyes and leaves. In a few moments, I lose focus and squint and shield my eyes from the piercing light, but soon the ceiling tiles’ tiny perforations blur into a flat and indistinguishable white. When the doctor returns, he darkens the room and, with his special scope, peers into the depths of my corneas.

  “No floaters, today,” he announces, as he flips on the overhead lights, returning me to a shockingly bright world.

  Shading my eyes with my hand, I feel my way along the walls, shuffling back to the hemophilia clinic, where, after my sight returns, I follow a frumpy nurse named Sheila. As we travel the hospital’s bright corridor, my mind turns and my breath labors in fearful anticipation of the Pentamidine treatment. The nurse unlocks an isolated door squeezed in at the end of a long hallway, and as she begins preparing the medicine, I sink into the room’s lone chair, which faces a TV.

  “You can turn it on if you want,” she says, but I hold up my book. The nurse smiles. “It’s always better to read than let that thing rot your brain anyway.”

  She draws a clear liquid into a syringe, much as I would my factor, and she dispenses this into a chamber that holds the Pentamidine and that connects to a flexible mouthpiece. Extending this to me, I watch the sterile tubing uncoil and end at a machine the size of a small box.

  “This nebulizer,” the nurse says, “will push air through that tubing and make a mist of the Pentamidine. When I turn this on, just relax and breathe as you normally would. That’s all there is to it. A piece of cake.” She forces a little smile as she flips on the switch. “Okay. Just breathe. I can’t stay in here with you, but I’ll be back in about forty-five minutes to check on you. You should be done by then.”

  “Okay.” And she leaves.

  A thin mist like flour rain spreads through the tubing and filters into my mouth, my throat, my lungs, leaving a taste like a pasty mouthwash. The book rests in my lap as I stare at the plaster wall and listen to the nebulizer hum, my lungs inflating and deflating, inhaling and exhaling.

  In an hour, the nurse returns, apologizing for being late. She turns off the nebulizer, takes the mouthpiece from me, and discards it in the hazardous waste container.

  “That’s it,” she says, rubbing her hands clean with a disinfectant wipe. “You’re all done and free to go home. Guess we’ll see you in about a month for the next treatment.”

  “Guess so,” I say, gathering my things to leave.

  Outside, the melting snow spreads out like dirty-white tree skirts beneath the evergreens. I pull my wool cap over my ears and blow into my hands and, arriving at my truck, watch as my breath fogs the windshield. Along my drive home, the twilight sky purples and then fades into hushed winter blackness. The half-moon struggles to shine before a few stray snow clouds pass over and blanket its light.

  I do not stop at the college, but steer across the Cape Fear River toward nowhere, listening to the thrum of my tires against the drawbridge’s metal grate and hearing the dark river slushing below me, still and black. I crack my window and the freeze kisses my left check while the bitter wind chills me and whistles through my cab. It is as if it wants to say something but cannot.

  I cough and taste the Pentamidine and spit out the open window. And when I cough again, I put a hand to my chest to be sure that it is only a cough and nothing more. My lungs rattle with cold fear, but they do not gurgle with pneumonia. I am safe. For now.

  When I pull into Southport, the main street is empty and its dock desolate. I carry my coffee to the pier’s end and gaze across the channel to the Bald Head Island lighthouse: a towering shadow underneath a half-mooned sky, a silhouette against a black, outgoing tide. I cup the coffee to my mouth, blow to cool it, and then sit along the dock, letting the cold dark numb me.

  As if weighted down with ice floes, the sable river slugs on. Steadily, it slaps the rocks below me with a sound like a low and mournful moan. I breathe in the night and breathe out a cold mist that plumes before me and disappears as fading vapor in the moonlit sky. The winter chills my lungs, chaps my lips, and stings my nose and ears—freezing off all feeling.

  EARS

  MARCH 1994. POLLEN MISTS THROUGH THE AIR. A PINCH OF GREEN dusts cars, flours the trees, and sifts upon the college lawn, only made airborne again when a strong breeze unsettles it. Allergic to it, my ears are strangled by fluid. I hear the world as if in a large vacuum, and the noise sounds thick and distant, while speech in a crowded room is impossible to discern. Voices have the low cadence of an immutable rumble.

  When I phone Chapel Hill, the Hemophilia Center sets up an appointment with an ear, nose, and throat specialist. A week passes. Then, with my clogged ears, my leaky nose, and my watering eyes, I drive through the springtime rain from Wilmington to Chapel Hill to see this ear, nose, and throat specialist. Dr. Cameron whips into the room where I wait (and have been waiting for two hours) and he introduces himself while rooting around my ears, nose, and throat with a funneled penlight. He pushes back his slick-black hair and as he begins to speak, I can tell that Dr. Cameron is all about speed.

  “You’re clogged up good,” he says, reassuring me that I’ve come to the right place for repair. He squirts a numbing spray into my nostrils and then forces a probe through me so he can view whatever it is he needs to see. “Adenoids,” he says, the scope retreating from my nose and leaving my nostril stinging. “Your adenoids are swollen.”

  “Not good?” I massage my nose stem, wiggling it around to soothe the ache.

  “Nope. Not good at all.”

  The doctor skirts through my chart, grimaces his mouth, and grunts underneath his breath. Then he sighs and addresses me.

  “Usually we just take them out, but here,” he points to the chart I can’t see, “it says you have hemophilia and that you’re HIV positive. Wow! That’s gotta hurt. Are you mild or severe?” he asks, continuing to read.

  “Severe,” I say, understanding that his question concerns my hemophilia. “The severest,” I add. “Less than 1 percent clotting.”

  “Know what your counts are?”

  This I pair with HIV, it being a virus most concerned with numbers and counting. “Low,” I say. “The lowest.”

  “Hmmm,” he thinks. “If we go in and remove those adenoids, we risk bleeding and we risk infection.”

  “What are the odds that the fluid in my ear will disappear and that I can hear again?” I laugh halfheartedly.

  “Not that good. Maybe by late summer, perhaps fall . . . but the problem there is that it, too, can become infected. We need to get that fluid out of there and keep it out.” He wheels a stool to my beside, sliding on it as he rolls toward me. “What do you think about tubes?” I shrug indifferently. “We can pop some tubes in your ears to equalize the pressure and allow your ears to drain. We use it all the time on little kids and it works fine.”

  “So, why don’t you use
it on adults?”

  “Sometimes we do. But the tubes only last four, five years and usually by adulthood, the problems are more permanent than when you’re a kid.” He looks to the wall, the clock. “I think it’s the best option for you. Whattaya think?”

  “How will it work? Will it hurt?” I am uncomfortable at a procedure seldom done on adults.

  “Won’t hurt a bit. You’ll be out to the world under anesthesia. It’ll be a day procedure. You’ll come in early, get your factor of course, and we’ll pop those tubes in, one in each ear. When you wake, we’ll monitor you a bit, then you’ll go home. You’ll need someone to drive you and I don’t think I’d plan anything for the next day because you may still be groggy from the anesthesia, but otherwise, it’s a piece of cake.”