Table of Contents
For Meghann
STAYIN’ ALIVE
I get it. Broken hearts mend and in six months I’ll see that we were never right for each other anyway. But this middle distance blows. Like the way Emily asked me to meet her for coffee tonight to talk about god knows what. Or the fact that yesterday morning, I saw her and the new girlfriend—a Silicon Valley software tycoon—in the UCSF lobby. It was just after 8:00 and I’d been on call all night, which means I looked like hell and was drinking coffee on a slatted bench, trying to hide from the particularly anxious pack of internal medicine interns I’m supervising this month. One kid, not yet twenty-one because he skipped all of high school, almost killed a patient last week. We call him Danger Mouse now.
Emily and the tycoon emerged from the elevator laughing. I ducked, slid behind the nearest ficus tree and began a close inspection of its leaves. But one of my interns spotted me and began her approach like a heat-seeking missile. This is the one who last week asked for a letter of recommendation and began listing her extra-curriculars as we peed in adjacent stalls. I scowled at her through the ficus leaves until she retreated.
Even I, who have yet to erase her from the #1 position in my speed dial, could see that Emily was happy as she strolled across the lobby, her arm around the tycoon’s tubby waist. We were together for seven years—my final year of med school, my residency and the first two years of my infectious disease fellowship. That final year, I probably shouldn’t count because it overlapped with the affair. A month ago, she moved out of our apartment on Guerrero and into the tycoon’s Castro condo. Now they are everywhere and growing, like a mold. This was the second time I’d seen them in as many weeks. San Francisco is like this: small in precisely the ways you wish it wasn’t. Shit-fuck, I call them.
But I can also say this. Last night, I got out of clinic early and picked up a steak burrito on the way home. I crashed on the couch and watched the second half of the Redskins-Cowboys game without having to say a word to anyone. Small triumphs, I know. But they’ve got to count for something.
Most of my patients are heroin addicts trying, at least some days, to get clean, and gay boys with HIV who do well on cocktails until they don’t. One of my patients calls himself Weasel and just cycled out of our inpatient rehab unit for the second time. I discharged him this morning, along with bus vouchers and a quick hug. At the end of appointments, I always hug my patients. Even in San Francisco, this has earned me a bit of a reputation. But in the last year, it also means I’ve said a proper, final good-bye to six people.
We have Weasel on a new cocktail and on Testosterone, and he’s gaining muscle mass like a sixteen-year-old. He calls his biceps guns and flirts with our entire staff, regardless of age and gender. Three months ago, he arrived at the ER with PCP and a T cell count of 15. There is a 90% chanced he will relapse in the next six months. You stay matter of fact about these things until you can’t any longer. Which is another way to say that even steady exposure to suffering is no inoculation against it. You see the whole world in a hospital. Emily. Weasel. My interns. The thirty patients I’m following this week. A banquet of souls, my attending likes to say. He means the ghosts too, the ones who die here.
My uncle Roger died on the street a year ago, but he was called at our ER, a fact I discovered only after I identified his body at the city morgue. With Roger, it was always about near misses. That’s how it was in 1982, the year that he lived with us. At the time, I thought that he was seventeen, but he was actually twenty-five. I was seven then and all that I cared about was football and convincing people that I was a boy. The Redskins were my team, the closest NFL franchise to our apartment in Durham, North Carolina. For Halloween, I dressed as Joe Theismann and my two best friends, Peter and Keisha, dressed as Hogs, the nickname for the offensive linemen that protected the small quarterback.
Roger looked enough like John Travolta to occasionally persuade drunk women that he was him, in town for a shoot. He usually wore a pair of tight Levi’s, a white undershirt, scuffed brown cowboy boots and a denim jacket that smelled of cigarettes and motor oil. His standard expression, in response to praise, scolding, flirtation, and accusations, was a suppressed grin. My infatuation with Roger was mistaken as a crush by my parents, who seemed encouraged that I was showing signs of a burgeoning heterosexuality. But it was something other than that: I wanted to be him. I wanted his efficient, rakish handsomeness to be my own.
I had spotted two tattoos on his body—a blue cross on his forearm that had been inked by an ex-girlfriend and an Apache symbol on his chest, at the spot where you would perform chest compressions. He caught me staring at this one as he passed me in the hall en route to the shower. Towel around his waist, hairbrush as microphone, he was singing “Stayin’ Alive.” “Music loud and women warm. I’ve been kicked around since I was born. And now it’s alright, it’s ok . . .” My mom was laughing and I was dancing down the hall behind him. Later, he showed me the book he’d found the Apache design in. It means potency, he told me seriously. I decided that I would get a tattoo exactly like his, just as I would buy a pocket knife like the one he carried on his belt. The tattoo I eventually got on my hip matches one on Emily’s.
Roger slept on the fold-out couch in our apartment. Each morning he folded the couch up and stored his suitcase in the hall closet, leaving no evidence that he lived there. Whenever I was alone in the apartment, I always went straight for his stuff. I’d put on his boots and his aviator sunglasses and pose in front of the mirror nailed to the back of the bathroom door. Standing there, I didn’t see a girl with patches on the knees of her jeans and a missing front tooth. I simply saw a body that might grow to be like my uncle’s, a body that could get you through the world. It was essential, I knew, that everything be back in place by the time my mom returned with my baby brother strapped to her chest and grocery bags in both arms.
My uncle had already been kicked out of my grandparents’ house twice by the time he landed with us. They lived in a southern Ohio town so debilitated by the shutdown of a GoodYear plant that it made downtown Durham, with its abandoned tobacco warehouses and snaking train tracks, feel like a vibrant urban center. Roger was trying to get clean and it was this that he and