Lungs
95 lungs January . 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 Shelby Smoak 96 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.” Bleeder 97 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...
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