World AIDS Day

I live in a historically Irish neighborhood, on a block flanked by the huge St Patrick's parish church, rectory and school and by Mclaughlin's Funeral Home. I have seen a lot of police and fire dept funerals, but today was huge. Multiple blocks in the area, including my own, were closed to traffic to make room for FDNY vehicles - including fire engines and their Family Transport Van - to crowd around the funeral home. Dozens of FDNY personnel in their navy uniforms and white hats stood in formation outside the funeral home and when I got to the water, several blocks away, a fireboat was pulled up close to the shore sending huge arcs of water into the sky in tribute. The deceased man, James Riches, was a retired FDNY Deputy Chief who contracted 9/11 related illness after digging through the rubble at ground zero for six months searching for his sonn -also a firefighter - who was killed responding to the attacks. After that, he spent the rest of his life advocating for 9/11 survivors and families, fighting for benefits that should go without saying but in our inhumane poliical system require an ongoing struggle. I walked past all this thinking that he certainly deserved the send off, but it's World AIDS Day, so I was also thinking about all the people with AIDS who were turned away by panicked funeral homes or - destitute - were buried at Potter's Field. I thought about the friends and clients I've lost to AIDS, the millions lost globally, and the hundreds of thousands who have died because of the cruelty of the Trump's administration's sudden ending of USAID and PEPFAR. Coincidentally, I was on my way to see the shoulder surgeon since my gay primary doc had looked at the MRI and said "Your shoulder is a mess. We should send this to the Capitol Police." The impact of the large male officer slamming into my shoulder as we shouted at the Senate Appropriations Committee about global AIDS funding had partially torn my rotator cuff. The shoulder surgeon sprawled on his low stool like many of the tall doctors I have seen, making me think this was a poor choice of bulk purchased furniture. "I could fix the tear," he said, "but it would probably hurt anyway because you have a lot of arthritis in there, didn't it hurt before this?" "I have arthritis everywhere," I said, "I'm used to it." "The way to really fix this is to replace the entire shoulder with a special one that does not rely on the rotator cuff." I must have looked dismayed, because he paused for a minute to let me think it over. "It sounds like it would be a long time before I could get handcuffed again," my first thought spilling out of my mouth. Realizing this was an unusual thing to say, I tried to explain "the ACT UP spirit doesn't leave you, even after 35 years." He nodded with understanding and I was greatful for my primary doc's tendency to refer to other LGBTQ docs. "I have a patient in her 70s and she's a spitfire," he said. "She's always yelling at me, telling me I should be out there protesting, too." "I was one of the youngest in ACT UP when I joined at 15," I said, "and I am still among the youngest in Rise and Resist at 50. There are people in their 90s out there." Leaving there, I got on the M14. Next to me a much older woman was telling the person beside her, a large young man, that she lived in the area but she was being harassed by her landlord. "He knows more about homelessness than I do," she said. "To get city rent assistance you need a notice and he wouldn't give me one." I know a lot about this, so I told her, "he can't evict you without giving you a notice," and then told her about an organization where she can get legal help. "I’m 81, I don’t have time for court," she said. "I'm trying to restart my career. I lost my job last year and I was always an independent contractor so I don't have a pension, just a little bit of social security. All my life, I was told I was not going to survive this or that so why would I plan for my old age?" "You must be tougher than they give you credit for," I told her. "I was homeless as a young woman, I looked about 8. That kept the men from molesting me because I looked too young." I nodded so she would go on, but in my head I was thinking that some men don't care how young someone is and a lot of them are in our government. "But people helped me. This man had lost his baby and he wanted a baby to raise so he took me in. I was a baby, I was very autistic." At that point, we had to get off the bus. Arriving at the office, T. was one of the clients waiting to be seen. A newer client, I don't know him very well because he disappeared into inpatient rehab. shortly after his intake and he has just returned. He started out talking to me about his housing, how uncomfortable and unsafe he feels at his current placement, but then the conversation veered into his benefits, which have been turned off. "With my insurance off, I can't get my medication, and I feel it in my body," he said. "Which medication?" I asked, since we can often pay for a month to get someone through. "Biktarvy," he said. "They told me what I had while I was in treatment but now I haven't had my medication in two weeks." Misty was already reaching for the phone to call her pharmacist, who will often give us a deal, although this time the price he quotes is an astronomical $5,000. "Who's your doctor?" I ask him. "I haven't had one since I got out," he says. I email Project Stay, the clinic we work closely with, and tell the social worker what's going on. "We can see him tomorrow," she says, and I put him on the phone to set that up. After we finish re-applying for his benefits and he heads out, I listen to the maintenance guy sweeping the hall and think about how ironic it is that on World AIDS Day, an HIV+ person falling through the cracks landed in my office.