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Not Thinking Straight
A little AIDS night music
by Madelyn Arnold - SGN Contributing Writer

As people have kaleidoscoped through my life, only a few I've needed to engage with fit into categories like teachers, my students or my patients; I confess I remember only a few. But then, how much of our mental core can we afford for acquaintances? Still, some do last because they fit somewhere into the equations of our lives.

Some in the category of "patient" carry with them other segments of a given time, such as what a lab was shy of and whether I was paid that day. One fellow carries the fact that I could buy wonderful falafel in the area of his clinic, and that a high percentage of the clients there were Gay. I remember all this because he fits that variable called "people whose needles stuck me" - that is, needles I stuck myself with. And because of what later happened to me.

Not Just Inept ... Probably
Its not as if sticking myself were rare, or even much of an event. Starting in 1963, when I worked at a laboratory in the New Castle State Hospital for the Epileptic, New Castle, Indiana, it was then that I started siphoning blood out of people's veins. That first time was not auspicious, and I stuck myself with the needle I used (but didn't tell the boss). It remains vivid, as does the unfortunate face of that first man.

I had been engaged to work on a project doing the first human tests on a brand-new, highly promising anti-seizure drug called dilantin. Convulsions seemed to vanish like magic, but the physical side effects (at the high concentrations then used) were fairly awful. It seemed there was a loss of the amino acid phenylalanine - at least in rats. So we needed to assess if, or how much, was lost in humans; this meant assaying blood and at the very least urine, and comparing same. If I were assisting, that meant doing scut duty, and fooling with living creatures is only glamour-work in fiction. I needed to measure piss and take blood from the patients.

"I don't know how to do it," I said stupidly. "Look," said lab director, "Pip" Pippinger, "it's easy."

Briskly he tied the lower legs and upper arms of a profoundly mentally deficient man to a sturdy chair, produced a syringe, and showed me where, on the man's arm, was the best area to place to stick. "You stick here." He stabbed the needle in and plunged it up and down a bit with the plunger drawn back - the patient bellowed & red flooded into the tube.

I really wanted to go to medical school, and wanted the lab job; I was afraid not to follow instructions. I repeated Pip's motions and stuck the large-bore point into the frightened man. He bellowed like an ox. "I'm hurting him!" I exclaimed. "Nah, he doesn't feel it, do you, Jake?" said Pip jovially.

Just Following Orders
So much cruelty is done because of cowardice, because of the fear of looking incompetent - or worse, soft (or femme?). And, I'm ashamed to say, in my own little sphere of reference, it has often been accompanied by the claim that the patient, the child - and especially the infant or animal - doesn't feel it. But after I had tried very hard not to hurt "Jake," had therefore stuck myself secretly and been laughed at publicly, I decided I would become one gosh-darn whiz-bang of a phlebotomist (blood taker). And I got pretty close to that.

Thereafter I stuck myself several times a year, most often with the most difficult patients. I nicked myself with the needle before or after plunging it into someone else, with #10 (?) scalpels, broken glass tubes, or shards of glass I couldn't see. Never let it be said that the newer forms of needle sheaths, etc., aren't truly protective of staff.

Over the years, in obtaining specimens considered important, I must have "met" thousands of people. And although smiles and scowls and expressionless faces - and skin sites as well as tints - merge, some do stay with me. Especially folks I'd see time after time, and children who did not cry - who didn't care anymore. Like snapshots - the smoldering anger of prisoners, the suspicious alarm of immigrants new to "modern" medicine (the Hmong in the late '70s come to mind); and as I said, some of those whose used needles stuck me.

Sicker Patients
And when the AIDS epidemic struck, some staff refused to work with anyone they suspected might have it (read: Queer). I was one of those who were quite otherwise; I won't say that most of us were Gay, because I can't know - and I do know dedicated people who eventually worked with PWAs exclusively. It bears repeating that the first AIDS patients known about were Gay & witness AIDS being known as "the Gay disease." In any case, the first AIDS folk I worked with were desperately ill, and needed very close monitoring - a great deal of microbiology and hematology lab work.

In time, I was working more with HIV+ (and other Gay patients) than with any other group; and in hospitals where I worked, I most often took those patients "that made [some] other staff uneasy". If AIDS had been some secret new form of tuberculosis or measles, I would have coughed my lungs out by now.

Back then, Public Health was a friend rather than a master; reaching out to trace seropositive individuals, it supported for example, the "Gay Clinic," run at Country Doctor on weekends, where I was one of several people who volunteered to draw blood. But there were many clinics, and it used to be that the small clinics had real autonomy (and hegemony), and to avoid being thought of or exposed as seropositive, higher numbers of Gay men attended them. I worked at six or seven.

One Face I Don't Forget
I remember one event as happening in the last of the '80s, or beginning of the '90s. By then, if you were in medicine, you kept a mental checklist: Gay? Sick? Especially, very sick? AIDS - Q.E.D. In an attempt to keep the (computer-free) patient records private, staff was officially not told who had what. But after seeing one case of end-stage AIDS, it was impossible not to develop that private checklist.

This one very young man had the face of a fey blond angel; he was weak from vomiting, with skin wet and hot to the touch. Dark red blemishes marred his skin, but though he was about 15, this wasn't from acne. He was shaking; I asked him if he would like to lie down, and with a grateful smile, he accepted. As I prepped him to perform several involved blood tests, I saw that Queerdom wasn't his only risk category: there was thickened, scarred skin from his sleeve to his thumb. I added to my checklist: junkie and (probable) hustler.

As I was recapping his bloody needle - yes, we did that then - its cap shattered and the thing jammed into my finger. Hard, so hard that the whole rig dangled over the small lab table, from my hand.

A few minutes before, I'd been looking forward to local Greek food - now I was aware only of my heartbeat.

Most people probably figured you were inept if you stuck yourself. This boy only smiled encouragingly. I swallowed. "If you have any weird diseases, don't tell me, okay?" I said. After a minute, he shook his head. "Okay, lady," he said sadly.

Uncheerful Night Music
There's the obvious reason that I got a horrid disease from such contact over all those years: hubris. Arrogance. Nobody could do the job better than (or as well as) I, so I took up with those who had become difficult to work with. Head veins on infants; junkies, kidney and cancer patients; and of course, PWAs.

But there's another sort of comeuppance in it, one of those woo-woo karma-in-rebound things. Sometimes, when I've been pretty AIDS-sick myself, I think about it: the people I was hurting, the infants and animals I did mean things to (I mean, I didn't have to do lab work - I could have been a milkmaid); and especially, those for whom all that modern record-keeping did absolutely no damn good: maybe they're satisfied now.

God knows, they should be.

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