My First Date (with the Virus) by Alan N. Yount
“Men don’t normally get urinary tract infections,” the urologist informed me as I sat on the metal examining table, a hospital “gown” (how could you really call these things “gowns”?) draped over me and my feet dangling. I was feeling very exposed. I had been running a fever for several days, and it hurt to pee. But, it was the last week of finals, and I had to get through them; I couldn’t afford to miss a final. So, I had been chugging cranberry juice and eating Tylenol. I was, after all, a nursing student – painful urination plus fever equals urinary tract infection and cranberry juice acidifies the bladder, making it inhospitable to bacteria. I don’t remember where I had picked up this bit of homeopathy; I wasn’t a particularly attentive nursing student. I did, however, have lots of girl friends in nursing school who got lots of urinary tract infections – “honeymoon cystitis” they called it – from sex. They were a more likely source of my information.
But, as the urologist informed me, men don’t normally get urinary tract infections. Our urethras are just too long for the bugs to crawl up ‘em! So, the etiology of this infection needed to be found. I had dropped a urine sample off the day before, and, now that I was done with that last final, I was back at Student Health. The nurse practitioner had informed me that I did, indeed, have a UTI and would need to see the urologist “since men don’t normally get urinary tract infections.”
The urologist came as something of a surprise – not that I was seeing one, but that it was a woman. I was used to working with women – I was, after all, a nursing student, one of less than ten men in a class of over 200 – but I wasn’t used to getting naked in front of them. I was, after all, gay. She was young, probably just out of her residency in urology, with a head full of big, black, frizzy hair. At the moment her back was to me, and I was staring at the back of all that frizzy hair as she fiddled with some sort of equipment.
“So, as I said, men don’t normally get urinary tract infections.” I know! I know, already! “You don’t . . . um . . . stick anything up . . . there, do you?” Hey – I’m gay, but I’m not quite that kinky! This last question came as she turned to face me, holding the equipment that she had been fiddling with – a metal wire with a loop on the end of it – which she proceeded to, very unceremoniously, stick up “there”! She grabbed me under my “gown,” straightened me out, and shoved the damned thing up there, brusquely explaining that “we need a sample from further up your urethra”!
I gasped in answer to her previous question, “Can’t you see how much I enjoy this?!” and passed out. I came to, slumped on the urologist, while she, now very agitated, tried to move my dead weight off of her and into a fully prone position on the table.
“We are going to have to admit you to the infirmary. You seem to be very dehydrated.” THAT is NOT the reason that I passed out! “You need to get IV fluids, and we need to figure out how you got this.”
With that, she was gone, and I was whisked upstairs on a stretcher to the infirmary, where I spent the next two nights.
Those nights – and days – were filled with anxious speculation. It was 1983. AIDS had just been christened with that ominous title – Acquired Immune Deficiency Syndrome – having previously been known as GRID – Gay Related Immune Deficiency – and before that simply the “gay cancer.” There was no test – the cause had not been identified and wouldn’t be identified until the following year. A diagnosis was made based on the occurrence of “opportunistic infections” – unusual infections that occurred because the patient’s immune system was compromised. Infections with their own ominous-sounding names: Kaposi’s sarcoma, Pneumocystis carinii pneumonia, cytomegalovirus. No wonder they, like AIDS itself, were all better known by their abbreviations: KS, PCP, and CMV. Was a UTI in a man an opportunistic infection?
After an anxious night of IV rehydration, I was seen the next morning by a battalion of infectious disease doctors circling my bed. “We don’t think that a UTI is a basis for a diagnosis of AIDS. And, you seem to be improving quickly, which would not happen if you had AIDS.” Whew! “There is a test we can do to see if your immune system is compromised. Are you interested?”
I supposed so. What else could I do? I was already familiar with the disease. The previous year I had done a paper that mentioned the disease in passing, before it had a name. I had come across an article about the “gay illness” striking gay men in New York City while researching a paper for a class called Health of Populations. I had chosen gay men as my population to study. After all, I had my own experiences as a gay man to draw upon. I, myself, had been called by the county health department after being reported as a “contact” from someone with syphilis. I had dutifully reported to the Student Health Center, to the knowledgeable and sympathetic physician I was told to call – a physician who worked with gay men. While it turned out that I did not have syphilis, I did now have a knowledgeable and sympathetic physician who knew that I was gay and would attend to the unique health needs of a gay man – a sore throat would require swabbing for gonorrhea, not simply looking for strep or some other run-of-the-mill cause. It only seemed fitting that I should honor this relationship by looking at the specific health needs of gay men for my HOPs research paper. And, there they were in the literature, the panoply of gay-related needs, all of them venereal in nature. I was even pleasantly surprised to find out how much research had been done on my own health needs – journal articles and studies, all about gay men and our needs. I noted, perhaps with a tinge of superiority, that there was little research done on the health needs of lesbians. Most articles assumed that they had no special needs. While looking through the latest updates and abstracts for health journals, I had found a reference to a recent New York Times article, “Rare Cancer Seen in 41 Homosexuals,” from 1981. I noted it in my paper, in a short paragraph without much concern, concluded the paper, and handed it in.
And I had already seen the results of opportunistic infections in men – some of them friends – who had had no idea that they were immune compromised. Hoagie Gaskins, the first man I had slept with at Carolina in my freshman year of 1979, was already dead. I had used my nursing student’s uniform to get through the gauntlet of blood, body fluid, and respiratory precautions into his room and see him when I found out that he was in the hospital. I found him in a coma that he would never come out of. So, I supposed it was the best course of action – find out if my immune system is compromised. “Go ahead and do it,” I told the infectious disease docs.
More blood was drawn and sent to the lab to see what my T cell count was. T cells are white blood cells that play a central role in immunity. The infectious disease guys informed me that they would be below normal in an immune-compromised patient with AIDS. Another anxious night was spent in the infirmary, awaiting the results of the T cell count.
The next day, the lady urologist informed me, “Your T cells are normal.” I was no longer of any particular interest to the infectious disease team. I was put back into the hands of urology to determine the cause of my UTI – none was ever found, but AIDS was not the cause. A bullet dodged. For now.
Alan N. Yount