by James Ballard
Brian doesn’t like pills. They come in too many colors and sizes. In the morning he starts with two orange oblong, one blue bullet, one rose marquee, dull white in three sizes, two small footballs golden and clear, and a small round tab. That is his morning cocktail, sans the liquor, which can trigger renal failure. He also has hemochromatosis, so no olives—too much iron—but that’s about genetics, not the virus that is eating his immune system.
He can’t absorb the meds on an empty stomach, so breakfast is required, but too much food can lead to diarrhea, so he scrambles an egg and microwaves some oatmeal.
Lunch is a large round tab, which makes him nauseous without the miracle of dairy, so he coats his stomach with yogurt first. Thankfully, he is not lactose intolerant, but his doctor says he should eat fish. He needs the fat since his weight is dropping, but he hates the taste of anything pulled out of the sea, so he throws a chicken breast under the broiler. He wants something chocolate, but that also gives him diarrhea, so he cuts up an apple.
He likes to nap in the afternoon during his two-hour fast, which is required for the flat white pill he takes an hour before dinner and his second cocktail of the day. Today, however, his nap is interrupted. It’s a call from his doctor.
“Brian, labs are back.” His doctor cuts to the chase: his meds are failing, his CD4 count is down, and his viral load is up. The call is really about “a promising new medicine.” It’s injections, twice a day, and can be woven in with a few additional pills.
Brian doesn’t tell his doctor he already knows the drug needs to be injected below the skin around the stomach, the thighs, and the back of the arms. He knows the drug makes the skin blister and itch. He knows he will look like a strawberry within a week and the touch of fabric will burn. He knows this as his doctor says, “This regiment could keep the virus suppressed for six months to a year.” Brian knows, but his doctor has kept him alive for the last five years, so he listens. “We can still get you into a clinical trial. The drugs, the needles, and all your visits will be covered.” Cost has always been part of the conversation because Brian didn’t plan on retiring at age twenty-seven. “You’ll need to fill out the usual forms in the morning,” his doctor continues. “It’s a stack, so plan on an hour of paper.”
“But I have a marathon to run tomorrow,” Brian says as he moves to the edge of his bed and reaches for his cane. The deflection takes him back to running through the redwoods and down the trails to the beach, five miles in the morning and five more in the evening, his other life. “So, I am thinking Plan B.”
“I expect the next generation of antivirals to be out within the year,” his doctor says.
Brian is not hearing the optimism as he crosses his studio apartment and takes a seat in an old club chair that faces a gray TV screen. There is no talk of muscle mass, training for a 5K, or getting back to work. It’s all about salvage therapy, no dancing on tables. But, who thought he would make it to thirty, let alone thirty-two? Isn’t that something to celebrate? But, who is there to call? All his friends are angels.
Brian thanks his doctor before he ends the call, turns off his phone, gets dressed, and tosses on an old strand of disco beads. The beads are so ugly they make him laugh. He remembers how much he likes to laugh as he hobbles to the store for two quarts of vodka, a bottle of dry vermouth, and a jar of olives. He is back home by five, just in time for his first happy hour in years.