AIDS, at 25, Offers No Easy Answers
Instinctively, the first thing we want to know about a disease is whether it is going to kill us. As the Talmud says, pretty much all the rest is commentary. Twenty-five years ago, this was the only question about AIDS we could answer with any certainty; how disorienting it is that now, vast quantities of commentary later, it is the only question we really cannot answer well at all.
I admit I don't often follow the HIV/Aids stories. This one caught my attention and, although I'm not entirely surprised, I found much of the story very disturbing with information like, "Not everyone who is infected gets sick. Not everyone who is treated gets well," followed by:
I gave one of them his diagnosis on a hospital ward last year. "Try not to worry too much," I told him as he stared blankly at his computer screen; it turned out he was more concerned by his weak wireless connection than his new status as a person with advanced AIDS.
He was scrawny, spotted purple, with AIDS-related cancer all over his mouth and lungs, a flash from the grim past. We gave him all the magic drugs; he died five months later, age 23.
When HIV/Aids was first discovered, my kids were teenagers. I worried constantly because I knew that as a Mom all I could do is arm them with good sense, a certain value system, and good information about this new disease. I also knew that if they wanted to have sex or unsafe sex, they would, and there wasn't going to be a whole lot of what Mom wanted being given consideration. As to the information side of things, there wasn't much to give. But today, there is so much known and yet kids seem even less likely to consider the consequences of indiscriminate and unsafe sex. Afterall, they've heard about the life-saving drugs, that HIV/Aids is now treatable and therefore, in their immature logic, they are safe. The doctors don't know:
But even there, things are getting stranger. That skeletal fellow reading a magazine, skin pulled taut over his skull, folds of denim covering his wasted legs, is actually one of our big successes. He is perfectly well, at least as far as his H.I.V. infection goes. Ten years ago he was dying of AIDS; now he is living with it — or, more accurately, living almost without it, his immune system normal, no trace of virus detectable in his blood. It is the lifesaving drugs that have transformed his appearance like this, leaching the fat from his body even as they clear the virus from his blood.
He is another memento mori, for it is impossible to look at him and not see fatal illness, and yet as far as we know he will live a full life, untroubled by AIDS. Except, of course, that he now has other problems. The drugs have knocked his metabolism all out of whack: his body may be skeletal but his bloodstream is full of sugar and fat damaging his heart, liver and kidneys.
In 25 years, we have learned so much, made so many advances, been subjected to endless public messages and constant publicity. Yet as the article concludes:
You can win big, and why shouldn't you, with the usual fail-safe combination of luck and money (and lots of it). You have our very best hopes, so step right up: we peddle big miracles but, alas, offer no guarantees.
They still don't know if you'll survive ... it's a crap shoot.
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