On Friday March 13, 2020, I perched on a barstool that my friend spaced six feet away from his.
“If anyone coughs, I’m leaving,” he said.
We clinked our martinis at arm’s length.
“Do you think we’re crazy to be here?” he asked.
“Maybe,” I said. “But we may as well make the most of it. I don’t think we’ll be back for a while.”
The night before, I took my laptop home for a projected two weeks of remote work, but I was also given instructions to be on standby to return to the hospital whenever needed. The doctors I spoke with said to expect disruption for longer, likely six, even eight, weeks. I waited until we were well into our martinis before sharing those predictions with my friend.
The bar was a favorite of mine, old school with battered dark wood furniture. Everything about the bar was a relic of an era before artisanal cocktails. It was frequented by artists, academics, and the local hard drinkers and, on this Friday evening, it was as crowded as ever. Patrons joked with the bartender, the one who pronounced my name with Boston syllables — Dawr-na. The banter around the bar, full of fake coughing and mock horror at hugs, was edged with disbelief, displaying a not-yet-real fear, a fantasy that disease couldn’t touch us.
It was a form of shock and denial I understood because of the decades-old AIDS crisis. That earlier epidemic was the reason I worked in healthcare, the reason I was running medical simulations to prepare frontline workers for crisis situations, which now included the emerging COVID-19 pandemic.
In 1982, in a not-dissimilar bar in suburban New York, I heard worse jokes. The banter there had been laced with homophobia, ugly comments about not eating in the restaurants in the Village for fear of catching “the gay plague.” At the time I was eighteen, newly arrived from Britain and supporting my American adventure by nannying in Scarsdale. Like legions of searchers before me, I brought to New York my own version of the urge to escape and belong. Though I craved Manhattan like a drug, most weekday evenings I found myself in that local bar in the suburbs. Pat’s, as it was called, was the unlikely gathering place for a revolving group of European and American young women who, like me, worked as nannies, for a few weeks or months, or a year or two, in the mansions of Westchester.
I met Johnny in Pat’s on Christmas Eve. He was six years older than me and had already been married and divorced. He looked like a Europeanized portrait of Christ, with flowing blond hair and truly-green eyes. And he had the most stunning smile I had ever seen up close. Onto his complexity and perfect American smile, I projected my dreams of a larger, wilder life and called it love.
But the secrets Johnny’s smile hid would undo me, undo us. Eighteen months later, Johnny clutched the steering wheel of his car, his profile mottled in the streetlight, as I slammed the passenger door, stomped up a driveway in Scarsdale and out of his life.
I returned to Britain and quickly relegated that relationship to a tale of being young and foolish and in thrall to first love. But, two years later, on a cross-country Greyhound bus bound for a new American adventure as a college student, I flipped the pages of a women’s magazine, idling time. Amid its glossy pages, a health article snapped my past with Johnny back into the present. The piece documented the ballooning AIDS crisis, noting a new danger to unsuspecting female partners of those in “high-risk groups.” Women like me.
I tried desperately to push the worry from my mind, until the symptom appeared.
The public health clinic I finally went to was in a rundown neighborhood in Chicago, where I was studying. On the first mild spring day of 1986, I arrived at the clinic with a persistent rash mottling my abdomen, that I’d fretted about for weeks, and terror in the pit of my stomach.
The doctor was a middle-aged woman with stiff, brown hair that did not move as she sat down at the small clinical desk beside me. I heard my voice hesitate and catch. A bundled sensation clogged my chest as I pushed out the words “ex-boyfriend” and “heroin.” I didn’t say anything of the memories behind those words, of the late-night drives with Johnny to the South Bronx or the time he disappeared for hours in a Times Square fringed with drug shooting galleries.
The doctor scribbled notes on a record sheet, her lips tight, then drew my blood with latex-gloved hands. After she pulled the needle from my arm she said, “come back in two weeks,” and left the room.
Two sleepless weeks later I was back staring at the doctor’s impenetrable hair.
“It’s negative,” she said.
But added:
“As far as we know. It’s about 97% accurate.”
In early 1986, the Elisa HIV test was newly licensed, and its specificity would take longer to refine. Years later, as scientists labored to refine COVID-19 antibody detection tests, I would realize that issues with test specificity were a concern with any new virus, not just HIV. That it takes time to fully understand a new disease. And the full impact that it will have.
For me, the impact of that negative HIV test was immediate and defining. After my graduation, I left behind ideas of a career in journalism in favor of postgraduate training in health education. I became laser-focused on fighting HIV/AIDS and the stigma that accompanied it, a stigma that cruelly intensified the suffering of those with the disease and prevented many effective social responses. I also tried to find out what had happened to Johnny, but with no success. I didn’t know if he had tested and, if so, whether he was HIV positive. I only knew that my relationship with him and its aftermath, the risk I had perceived and the blessing of escape, continued to shape the trajectory of my life.
A year later, my training completed, I got a job as a HIV/AIDS educator in healthcare. That job brought me back to New York.
On a June day in 1991, I sat in a window seat at Tio Pepe’s Mexican restaurant on West 4th in Greenwich Village. The sunlight warmed my back in the nearly empty weekday restaurant. A waiter ambled over to take my order. Just coffee. I thought of the Pina Coladas I had drunk in this spot with Johnny.
I’d come to the restaurant in search of familiarity after hours in the Emergency Room of St. Vincent’s Hospital helping a colleague. My colleague Jeff and I were members of a professional group meeting with leaders of HIV/AIDS organizations in the city to learn from those who had been on the frontlines of the epidemic from its beginning. We had never met before the tour but hit it off immediately. Jeff got a kick out of the fact that I, a straight girl from the uncool British Midlands, knew Greenwich Village so well.
That morning Jeff had not shown up for the day’s visit, to an over-stretched, under-funded public health clinic in the South Bronx where they were dealing with a tidal wave of HIV infections caused by intravenous drug use. I thought of that other over-stretched clinic in Chicago where I had gone, my stomach churning with fear. I wished Jeff was with me to lighten my darkening mood.
Back at the hostel where we were staying, I went immediately to Jeff’s room. Jeff looked flushed and drawn as he opened the door.
“Are you okay?” I asked.
He walked a little unsteadily across the room and sat down wearily on the narrow hostel bed, like an old, tired man, not the trimly muscled thirty-year old he was.
“I have a fever,” he said, his face flushed.
“And…” he paused as if considering carefully, “and, this rash.”
Jeff lifted his T-shirt. His torso was mottled with red streaks. An image came to my mind of all the times I’d lifted my own shirt in Chicago, to check the rash on my torso.
I could see he was thinking hard about what to say next.
“The trouble is, you see, I’m HIV positive.”
I understood something of the courage it had taken for him to tell me. If not for sheer luck, it could have been me nervously asking him for help.
Hours later, after taking Jeff to St. Vincent’s, waiting with him in the ER, and, finally, leaving him sleeping in an inpatient room, I lingered over the dregs of my cold coffee in Tio Pepe’s. Walking from the hospital to the restaurant, I’d passed flyers for HIV-related events and services on almost every street. It was impossible to ignore that an epidemic raged here. I thought of how my life had changed since my own HIV test, how the enormity of getting my future back had turned into a need to do something, anything, to help halt the spread of this terrible disease. The disease now attacking my new friend.
The worst of the AIDS epidemic was not yet over in 1991. Life-saving drugs came too late for Jeff, as for millions of others. It is estimated that more than 36 million people have died of AIDS since 1981. In 2020, more than three million people worldwide died of COVID. While we focused understandably on those COVID deaths, 680,000 people also died of AIDS that year. That earlier epidemic has receded but never gone away.
In the early months of the COVID pandemic, I had no time to think about any of this. I was called back into the hospital just two days after being sent home. I spent long hours organizing training for clinical staff on how to don and doff their protective clothing, how to intubate or transport COVID patients safely, and how, in the worst cases, to care for the dying without infecting themselves. The first few weeks felt apocalyptic: the usually noisy streets in the medical area were silent save for the incessant wail of ambulances, the previously thronged sidewalks deserted except for staff arriving for or leaving their shifts. They walked purposefully, heads down, and crossed roads to maintain distance from each other. Inside the hospital, the eerie tension showed in furrowed brows and avoidant glances, the masked faces no longer able to smile at one another in passing. Critical care staff struggled with putting on their protective gowns correctly or quickly enough, struggled more with the idea that they couldn’t simply rush in, as they had been trained to do, when a patient urgently needed help. The idea that their jobs now put them at risk of a potentially deadly virus was hard to grasp and harder to contemplate.
In my role, I focused on the management of risk to mitigate the worst safety outcomes. At first, going into the hospital to work with the clinicians was daunting. I reserved the same set of clothes to wear each time: pants and a shirt that were quick to take off and easy to launder. I returned from a training in an operating room or on an ICU wired with fear about bringing the virus home, texting my family as I walked to warn them of my imminent arrival. Once home, I went straight to the washing machine, stripped naked, dashed into the shower. My family cloistered in other parts of the house until I was clean.
I still worried whether I had done enough. At first, COVID tests were hard to come by and reserved for those who showed symptoms, yet the news was full of concern about asymptomatic spreaders, those who felt well while unknowingly infecting those around them. Like millions of others, I checked my temperature and quietly fretted over any cough. Monitoring myself for signs of infection became an anxious routine, and a situation I remembered well from my HIV scare. But, unlike the early days of the HIV epidemic, infection with COVID did not mean certain death, despite the millions who were dying. Like many other people, I weighed my own odds of serious disease, and my family’s, convincing myself that we would land on the side of recovery. And the whole of society was focused on this disease: The science was advancing rapidly, and broadcast news tallied both the toll and progress daily. It was an entirely different response than the secrecy, shame and stigma that once accompanied, and too often still accompanies, HIV/AIDS. I was decades older too, with a deeper understanding of viruses and healthcare. Yet I realized that any fear for our mortality can feel remarkably the same. That existential threats don’t soften, though they can be made worse.
As 2020 dragged on, as more became known about COVID’s transmission, precaution procedures at the hospital became routine. But outside of its walls, we tried to figure out high, medium, and low risk social activities. Some experts harkened back to HIV education initiatives as a model for ways to communicate the dangers associated with different behaviors. Seeing Dr. Fauci on television news almost nightly reminded me of his leading, and equally controversial, role in the HIV/AIDS epidemic. I felt a warmth towards him, a kind of camaraderie of survivors.
In late summer, my family ventured on vacation. We rented a house on Cape Cod, following travel guidance to stay within state. Towards the end of a COVID-careful week, we took a day trip to Provincetown. I’d always loved the liberal, light-drenched city perched like a fist on the eastern edge of the country. The town has long been a haven for artists, writers and the gay community, a place that has provided shelter to many, and that had suffered acutely from the ravages of HIV/AIDS.
In the busy historic district street signs proclaimed a mask mandate. Along Commercial Street, sash-wearing “safety ambassadors,” many on roller-skates or in drag or both, dispensed disposable face masks and hand sanitizer to anyone who needed them. Compliance was near total. The result was a low infection rate in the town, allowing people a semblance of normal summer life. I felt freer than I had in months.
On the last day of our vacation, driving reluctantly homewards, we stopped in a town on the Upper Cape to grab some lunch. Dining was permitted outside only. I placed our order at the serving window and waited for the food. Despite a statewide mask mandate for restaurant workers, I noticed that the server preparing my meal, and standing shoulder-to-shoulder with coworkers, was barefaced. I watched nervously, debating internally whether to say anything. The imprint of my daily work and the immediacy of the contrast with Provincetown lit a fire in me, a pressing desire to adopt the role of safety ambassador for myself.
“Sir,” I said addressing the man making my sandwich, “could you put on a mask please?”
He came outside.
“Is there a problem?” he said.
“I just noticed you weren’t wearing a mask and I’d appreciate if you could put one on.”
His jaw tightened. Without a beat, he said:
“I was wearing one.”
People seated at tables nearby stopped talking and looked at the man and me. I held my voice steady.
“I’m sorry but I saw you weren’t.”
He raised his voice.
“Look, lady, we believe in freedom here.”
Murmurs of agreement came from a young couple.
I said nothing. He continued, emboldened.
“You seem very angry — I don’t feel comfortable serving you.”
The couple, his audience, clapped.
“That’s fine,” I said, “I don’t feel comfortable being served by you.”
I retreated to rejoin my family. The couple cheered the conquering server.
I contained my anger at the cafe, no matter what the server said, but afterwards I was furious. More than furious, I despaired. The contrast with Provincetown, with a community that had learned lessons from a devastating prior epidemic, deepened into something starkly depressing. I realized that in the face of COVID — a virus so different from HIV in the airborne mode of transmission and thus a greater risk to all— we would again struggle to come together as one community and not divide and debate who to believe, or who to blame.
Three years into the COVID pandemic, the vaccines have rolled out and the restaurants and bars are thronged. Yet an emptiness seems to haunt my city, even as it bustles again. Too many beloved people and places have been lost. I walk crowded streets accompanied by a melancholia I can’t yet shake.
My favorite bar in Boston hung on. In the heady post-vaccination rush of summer 2021, my friend and I reclaimed our barstools. The bar, and my favorite bartender, looked the same as ever, as if time had stood still. The three of us exchanged warm greetings, a little misty-eyed. As I sipped a martini the bartender said: “Dawr-na, it feels like old times.” It almost did.
More than forty years since AIDS was first recognized in the US, I have weighed my risks, come to terms with my own fears, and tried to support and educate others in response to two public health crises. I wonder if it’s a calling or a curse.
Despite the many differences between AIDS and COVID, the lessons they have taught me turn out to be similar: that we deny and dissemble in the face of illness and death; that the dangers of prejudice and magical thinking are as real as any virus; that epidemics promote animosity as much as unity; that we segment and stigmatize at great cost to others, to our shared humanity, and at our own peril; that we choose to listen to facts over fear, to build community, to care for others—or we don’t. That choice, at least, is always ours.
When we emerge finally from this latest pandemic, those of us who survived will carry on, remembering and forgetting, hurtling into the always unknown, often unexpected, future. From my barstool, I’ll continue to raise a glass to Johnny, who changed my life, and to Jeff and the millions of others who won’t see what happens next.
*Some names have been changed to protect people’s privacy.
Click here to read Donna Luff’s Compositional Note about the essay.
Image by Barthelemy de Mazenod on Unsplash, licensed under CC 2.0.
- Safety Ambassador - August 8, 2023
Wonderful essay!!! the weaving of AIDs and Covid19 works wonderfully well. A moving and important essay that goes beyond specific epidemics to raise questions about community and mutuality, carefree joy and barriers to it, within our densely populated world.