“Oh, Pam! You’re alive! Thank God!” Marie wailed.
“Marie! Shut up! Good lord! You need to go to the beach and get my makeup bag right away, do you understand me? And, Andy, I am going to have to ask you to please wait out in the hall until I fix my face.”
Marie got up, snorting unattractively, but she grabbed her purse and almost ran out the door. Andy argued with her about leaving; he had been there looking at her all evening. She actually looked pretty good, all things considered. But then something told him that if he wanted to see her again, he would leave and would never, ever say anything about having seen her ill. He pressed the nurses’ button before he left.
“Well, hello!” A young, pretty nurse said as she came in to see that Pam was awake. “Do you know where you are?” she asked.
“Am I at Mercy?” Pam looked around the room.
“Right! Did your family tell you why you are here?” She was standing at the side of the bed, adjusting a blood pressure cuff on Pam’s arm, pushing some buttons on a scary-looking monitor that hung above the bed.
“No, I didn’t give them a chance. I hardly know that man and am angry that he saw me without any makeup.” Pam was going to be her usual honest self, no matter how silly it sounded to others. She shuddered, thinking about Andy standing there, towering over her bed, looking down at her with unbrushed teeth and uncombed hair.
“He is very concerned. You don’t look that bad, anyway! You were unconscious. Your friend found you on the floor in your home when she came to check on you this morning. They called 911, and you were brought here. I’ll go out and let your doctor know you are awake, okay? Can I get you anything?”
Pam was back at “your friend.”
Who found me?
She’d ask Andy. Or Marie. She shook her head no in answer to the nurse. Letting her head drop back to the pillow, she thought over the past three days, or was it longer? She wasn’t sure what day it was. She felt better though. Looking at her arms, she saw the IVs. She felt the catheter in her bladder, the oxygen cannula in her nostrils.
Real attractive
. She was more than a little annoyed at Andy for being there.
Marie was back with Pam’s makeup within fifteen minutes. She got her sister a basin of water with a toothbrush and washcloth and helped her freshen up. Pam put on enough makeup to feel human again. Marie brushed her hair for her and then helped her put it up in a clip. She felt better than she had since…
Saturday?
She remembered asking Andy to leave. Something must have been brewing in her body then. It was so unlike her to just give up like that. Marie was telling her about asking Sandra to check up on her.
“I knew I would have trouble getting away from the office, so she said she would come out first thing. They found you on the floor! And why would you unlock your door?” Marie asked.
“I don’t remember. It’s so strange that the door wasn’t locked.” Pam frowned.
Then the doctor came in, Pam’s chart in his hand. The nurse was with him. She turned to Marie and asked her to please step out for a moment. Marie did as she was asked, reluctantly. The nurse shut the door behind her. Pam was nervous. The doctor held out his hand for Pam’s.
“I’m Dr. Kempa. Do you remember anything about being sick?” He gave Pam time to think about the days prior to this and listened carefully to her, writing down everything she said.
“What do you think I have?” she asked. Her voice was shaking so badly it gave away her fear.
“I think what is making you sick may be nothing more than a common, run-of-the-mill virus. Your blood work is not too bad; you’re slightly anemic, but the rest of the labs are normal, if not in the low range. However, we did run an ELISA, which is a screening for HIV antibodies. Your test was positive. We ran a second test to double-check, and it was also positive. You have AIDS, Mrs. Smith. The viral load is light so far, so I think it has just converted from HIV to AIDS. I’m sorry, I know I’m throwing a lot at you. I want you to know that it is not as bad as it sounds.” He stopped, waited. “Can I sit down?” Pam looked through him, but nodded her head yes.
He pulled a chair up to her bed. The nurse took the bed controls and lowered the bed so the doctor and patient would be eye to eye, then stepped out of the room.
“Can I go on?” Pam nodded her head yes again.
“Your CD-four cell count is very low. These are the cells that fight infection in your body. Have you had a lot of stress lately?” he asked.
Pam nodded yes for the third time. “My husband died right before Memorial Day. I’ve had a lot of stress since then.”
An understatement
.
“That could definitely contribute to getting sick.” He didn’t like using that term, but didn’t want to use the word AIDS again. He didn’t think she could take it. “The new medications are wonderful, Mrs. Smith. We have a specialist here who will customize a regimen of drugs just for you. She’ll draw labs again in the morning and use those results to determine the drugs. The fact that you are ill now is concerning because it may be evidence that you are immunosuppressed. The key to staying healthy is taking the drugs exactly as they are prescribed.” He stopped talking and waited for her to react.
She was looking right at him, but not focusing her eyes on him. It was a little unsettling. He didn’t like to make generalizations about patients, but couldn’t help himself. Something about this woman shook him up. The diagnosis alone was horrifying. She said her husband had recently died. She wasn’t a drug addict. She had been married. He hated to think what a diagnosis of AIDS would mean to her as she grieved for her husband. She finally spoke.
“When can I go home?”
“Probably tomorrow, after you talk to Dr. Toms. Is there anything I can do for you now?” He felt responsible for her state of mind. He’d do just about anything to make her feel better.
“Yes, there is something.”
He stood up and waited for her to continue.
“Could you tell my visitors that they can’t come back in? That I am going to sleep?”
“I can do that.” He put out his hand to her.
She took it and grasped it.
“Good night, Mrs. Smith. I’ll see you tomorrow.”
“Goodnight, Dr. Kempa.” She put her head back on the pillow, dismissing him.
He left and closed the door behind him. He must have told Marie and Andy to leave, because they didn’t come back.
J
ack, you did this to me. Now I have to tell our children that I have AIDS
. Then she thought of Sandra and Marie.
If I have it, they must have it, too. Or would they be spared? Marie was screwing him almost as long as I was
, she thought. Pam thought of Sandra’s baby.
Oh God, please spare that little innocent life
. A chill went through her body. She rarely allowed the visions to encroach her thoughts but allowed them in now. First, the sexual embrace between Jack and Sandra, he in his favorite missionary position with Sandra’s long legs wrapped around his waist. And next a baby, a boy baby, perhaps. One that looked like Jack. As she imagined this baby being cradled in Sandra’s arms, she saw the vivid physique of Jack, so tall and handsome, posed behind her to the left, gazing down upon the Madonna-esque figures.
She looked up at the ceiling.
Jack, you’re an asshole
.
The ICU nurse had to threaten Marie with security if she didn’t leave. Dr. Kempa had made it clear that Pam wasn’t to have any more visitors; she needed to be allowed to sleep. They had already broken the rules allowing Marie and Andy to stay because he had flashed his badge. Now the nurse felt terrible about it; her patient’s dignity had been violated. It wouldn’t happen again on her watch.
She softly tapped on Pam’s door and then opened it so she could see it wasn’t her visitors.
“Can I come in?” she asked. “You’ve had a rough night.” She said it as a statement. “What can I do for you?”
Pam was lying back on the pillow, looking up at the ceiling. “I never, ever thought my life would turn out the way it has.” She turned her head to look at the young woman. “Why would someone as beautiful as you are choose to be a nurse? I would think you would want to be something that was more glamorous—or at least cleaner.”
The nurse laughed out loud. She sat in the chair Dr. Kempa had vacated. “I always wanted to be a nurse. I saw nurses taking care of my sister when she was very ill. I loved that they had some control over her destiny. They advocated for her. They did what they could to take away her pain. They fought to maintain her dignity. I wanted to do that, too.”
“Are you able to do all those things?” Pam asked.
“No,” the nurse answered without pause. “I found out quickly that I have little control over anything anyone else does. I can only practice within parameters set by the patient’s doctor. But the things I can do—try to make you comfortable, be your advocate, keep your dignity, protect you—I do with a vengeance. By the way, I owe you an apology for allowing that gentleman in here tonight. We have a strict rule about family members only. It won’t happen again, I promise you.”
“That’s okay. He meant well. I don’t like people seeing me looking a mess. A pretty package. I’m a vile disease tied up with a ribbon. How am I going to tell my family that I have AIDS?” Pam put her head back on the pillow and closed her eyes. She sat up again. “I thought of something
you can do for me. I would kill for a pepperoni pizza right now.”
“You haven’t eaten today, have you? Let me see what I can do.”
A half hour later, a lovely young nurse sat at an AIDS patient’s bedside, sharing a pizza with her.
The next morning, Dr. Toms came in first thing and gave Pam an in-depth education of the drug protocol they would have her on. She couldn’t offer any psychological support for her. The issues that Pam was faced with—having to tell her children and her mother, warning her sister and Sandra, and her own mortality—would be dealt with in the days to come. For now, she was in survival mode. It was still a minute-by-minute surrender to stay sane. Over and over, she reminded herself to stay focused, not to worry about anything but what was needed at that moment. Once the doctor left, Pam made her exodus from this room her main goal. She needed a ride home; Andy, in spite of her anger at him for invading her privacy, was the only option. Remaining civil was in her best interests.
The nurse came in with Pam’s discharge papers. She was free to go. She would begin taking the drugs immediately; the hospital dispensary would give Pam the first weeks’ worth. Getting there before Andy arrived was crucial; she was
not
telling him her diagnosis! The pharmacist went through each drug in detail and then offered them to Pam with a huge glass of water. He was a kind man, but she noticed him looking at her curiously. She supposed she would be susceptible from now on. People would want to know how someone who looked like she did would have
AIDS. They were dangerous generalizations. Everyone was vulnerable. Picking up the drug bottles, she stuffed them into her purse. All she wanted to do at that moment was get home. When she got there, she planned on unloading a fresh barrage of hatred toward her late husband. Fighting the urge to start screaming in the hospital lobby, she put all thoughts out of her mind. An empty head was crucial.
Andy met her in the lobby, and as much as she hated to admit it, she was happy to see him. She was still a little guarded; after all, he had seen her at her worst. She would take that up with Sandra, too, although Sandra would be getting bad news soon enough. Pam thought of all the possible relations, people who were joined together by the commonality of Jack Smith’s DNA, his HIV virus. Before she put these thoughts out of her head, she screamed silently,
Fuck you, Jack!
She put her biggest fake smile on.
“Hi, Ja—Andy!” She almost slipped. “Thank you so much for helping me out!”
He hugged her, and she gave in a little.
Let him think I’m stiff from being sick
.
“What would I have done without you? Taken a cab? Oh my!” She giggled a fake Pam giggle. They walked to the curb, where he had left his patrol car. “Do I have to sit in the back?”
“Not today! Right here in the front next to me. I’ll even turn the lights and the siren on, if you would like.”
She slid into the car, surprised at how awful she still felt. Was this the story of her life? She had a terrible disease. It was a brand, almost. To the world,
My husband was a reprobate
.
“Do you want to get a bite to eat first?” He was looking at her.
Was he crazy?
“No, thank you. I’m not feeling well enough to go out yet.” She looked straight ahead.
“Of course! What am I thinking? Sorry. Home it is!” He sped out of the hospital parking lot onto the road that led to the beach.
Pam was counting,
One, two, three, four, five…Hold on, girl
, she thought.
You are almost there
. They didn’t speak the rest of the way. Pulling up to the front of Pam’s house, she gave out a sigh of relief.
Home! Thank God!
Under no uncertain circumstances was he coming in.
“Please don’t get out; I really need to be alone. Thank you so much for coming to get me! I will be forever grateful.” She then turned to look at him. “Please.”
Andy looked at her and said nothing. He could sense this was it; it was the end of their relationship. Their friendship probably wouldn’t grow into anything else as he had hoped. “Okay, Pam. But if you need me, or if you need anything from me, please know I am waiting to do it for you. Tell me you understand that,” he said.