| NOTE: Some postings may have been deleted at the discretion of Ben
Boxer. Erotic pictures posted on the regular version of the list are automatically
deleted from the digest and are archived separately. Viewing them requires
a password available only to members. Profiles posted to the list are
also moved into a separate viewing area, but do not require a password.
Click here to browse through
them.
In this issue: -Comments on ER episode (4)
----------------------------------------------------------------------
Gentlemen, The following was a posting to another list to which I subscribe. The author has kindly given me permission to cross post it for your consideration. I found it to be insightful and thought provoking. dave aka luvhog
The ER Episode that Included a "Bugchaser" My life has always been filled with amazing serendipity. Give me a few days, and I can tell you dozens of amazing things that have happened to me for which the probability is so miniscule, it is literally unbelievable. The times I have predicted the death of a friend, the omens which prompted me to seek new employment or new love, and even a plane crash I predicted in Pittsburgh based on a peculiar improbable event, all were based on my noticing a coincidence which seemed so odd as to jump out of life and explode in my face. To me, the fact I actually watched last night's episode of ER, which covered a topic very important in my life, was just another example. In all the years the program has been on the air, I have watched at MOST two episodes of ER, and both would have been at the very beginning of its first season. It seemed like a good show, but since I work in a hospital, and at the time I was working for an actual trauma surgeon, the dramatized version just was not that appealing. However, as luck would have it, I left the TV on last night while I was cooking, and the show grabbed my attention - the show just so happened to include AIDS - more specifically the issue of "bug chasing" - so I was drawn in and watched it to its dramatic conclusion. I turned down the oven, and kept my veggies sitting in cold water. My roast chicken just had to "simmer down" for a bit as I investigated this episode with more attention. I knew that somehow this episode was going to provide me something extremely important and applicable to my life. After a few minutes, I quickly realized that actually the whole show was about dealing with death, and even more specifically the individual's decision to accept a possibly earlier death by justification of "quality of life." The show probed this issue with three main plots. There was a Catholic Bishop, whose diseases gave him two complicated, and conflicting options: treat his diabetes, and therefore be weakened and in too much pain to walk (and hence not be able to minister to his parishioners), or take steroids to alleviate the pain of the other disease, and then worsen his diabetes. There was a 16 year old boy whose past heart transplant was failing. He suffered congestive heart failure, lung edema, and was sinking fast. He complains of hating his medication regimen, of feeling like an outcast from his peers, and of looking like a freak. There was a man who comes in with mononucleosis, but then convinces the doctors to perform an HIV test because he thinks he has contracted the HIV virus. He reveals that he has knowingly had unprotected sex with another HIV+ man, and he seems to be filled with conflicting emotions about it. Then, in support of the main plots, there were numerous cases of victims arriving in ambulances, who were on total life support, where the doctors had to decide to end all resuscitation efforts and call the death. Each one had its own set of circumstances, which uniquely reinforced the fact that doctors really do make the final decision on death - even if it is a fair assessment of the hopelessness to continue. All the issues were very poignant, as death is the most difficult part of life. Their diversity was striking in their personal parameters, but all three were remarkably similar in two aspects: the decision of the patient to risk earlier death, and the challenge they make to the health care providers' beliefs about life. Then of course, the continuous stream of DOAs provided the show an almost macabre background that was both dark and harshly cold. The cavalier and calculated way the doctor would call death - scene after scene - patient after patient - with the family present - with friends present - - even without lifting a finger to begin resuscitation efforts, was truly enough to give even us seasoned healthcare professionals a lump in the throat. Before I go further to describe why I believe this show was so remarkable, I must first take issue with the show's writers in one particular area which pertains to how a hospital functions. When it comes to lab tests - and especially HIV related ones, I know that a person coming in off the street cannot just request them, and then have them performed stat in a matter of hours. That is a major plot inaccuracy, which the writers must have felt was necessary to keep the show moving - the whole show takes place in just one day (is that modus operandi for every show?). Having pointed out my major criticism, I can now proceed to the very deep meanings which I believe ER actually has confronted the public last night. First, I was most amazed at the presentation of the issue of a gay men "willing", maybe even "trying" to get HIV on purpose - in this case from his lover who is POZ. Their casting a couple for this plot thread, a young man of 23 years whose lover who was probably a few years older (by appearance) was very telling. The writers did NOT choose an older man, and they did NOT choose a single man. They must have wanted to portray two important issues: love & intimacy in the face of AIDS, and the views of a young man who has only known a world with AIDS and how at such a young age it is easy to feel defeated by a large and looming disease. He has never known a day without it, and the only thing he can imagine is decades of condoms and fear the rest of his life. The young HIV- gay man makes the defense that he and his partner truly love each other, and that only if he accepts getting HIV can they be truly intimate. It is obvious the man has probably had unprotected sex numerous times with his HIV+ lover, not as an effort to contract the virus, but in order to have intimate connection with him. Obviously, the risk of seroconversion resulting from such behaviors, is so great that in reality it is more a matter of "when" he will get the virus, and not "if" he might, and it is from this that we can discern the young man's almost fatalistic attitude toward seroconversion. The resident physician rises to the situation amazingly well. Upon reporting the man's negative results to an antibody test, he immediately notices something hidden in the two lovers' behaviors and it doesn't take him but five seconds to ask, "What's going on here? Am I missing something? Are you.... are you a `bug chaser'?" I was shocked to hear those words on broadcast TV. What started only a couple years ago as lingo among certain members of the POZ world, has now entered the public domain - SPLAT - there it is for all to see! The POZ lover retorted, "We don't use that word!" I found that reaction entirely unrealistic. If it were I in that situation, I would have said, "Oh, you know that expression? Why? Are you gay too?" I think the writers must have glossed over something either in their research, or in the point they wanted to make. In my experience, people use the expression `bug chaser' very freely, among both the POZ and negative of our community. Yes, some use it with criticism, or even derision, and some seem to say the words proudly, but I have not heard anyone argue against the term for being pejorative, morally questionable or heaven forbid "politically incorrect". Therefore, in this rather tense scene I found that response jarring. However, the issue was still presented, the word "bug chaser" was used, and the American public has now been exposed, probably for the first time, to an issue which has been driving a rift through the gay and POZ worlds for several years now. "Why would a gay man willing place himself at risk for getting HIV? IS HE NUTS??!!" Although the physician is finding the whole situation a very tough pill to swallow, he keeps his cool and talks rationally to the couple. Here, I am amazed that he is able to constrain any tones of judgment and criticism, to the level that he did, in his efforts to try to convince his patient of considering another choice of action. He tries very hard to reason with the man, asking good and probing questions, giving him facts and using all the best logic he can muster. It is obvious that he considers a 1-year relationship very weak grounds for taking on a life-threatening and quality-of-life-diminishing disease, but even in the face of that he tries not to pose criticism, but rather tries to convince the young man that he has more to live for in himself, and many more years of quality life ahead, if he does not make such a decision now. It is obvious he fears that if he comes across judgmental, he will surely lose the battle. The younger HIV- man was portrayed very well as a man caught up in emotions, filled with ambivalence, whose resolve is not very clear. He was nervous about possibly being HIV+, and yet was upset when he turned out to be completely HIV-. (They even performed a viral PCR, also called viral load test, to confirm NO viruses since the antibody test does not give positive results until several weeks after infection. This was the biggest plot problem, as the PCR test is very expensive normally, and to perform it "stat", i.e. in as an emergency, would cost several thousands of dollars.) In contrast to the HIV- young man, I found that the POZ lover came across TOO controlling and TOO insensitive. Yes, I know there are 100s of men out there who try their darndest to spread the virus, and I wholeheartedly condemn such behavior completely, but this guy did not seem that type at all. Those men are usually single, somewhat older and rather embittered men, who do not have much interest in a long term relationship. Instead, this man seems to have transformed his anger into a twisted form of pride, as if he feels that anyone who wants his love should accept the virus. His animosity toward the doctor suggests that he has no tolerance toward outside forces that might try to advise otherwise. Further, I got the clear sense that he was so much caught up in his lust for the (slightly younger) partner, that he has become hell-bent on securing his own fulfillment even at the expense of his partner's health. To me these two attitudes do not work well for the situation, and are probably a bit unrealistic. However, the scene was good overall, and this particular plot development really hits home to me, because of my own personal experiences dealing with HIV- lovers. In fact, my experiences have brought me to two very differing opinions regarding the risk of seroconversion, based upon a single important factor: AGE. In my earlier experience, I had a lover who was 8 years younger than me (he was 21 years old when I met him), and throughout the relationship I found myself living in fear of his getting the disease. It was a continuous, albeit very low level fear, but its presence meant one very important thing to me: I was very reluctant to have active greek anal sex with him (me as "top"), even wearing a condom. Very quickly, it got to the point I almost never fucked him because of that fear, and although we had anal sex with him as top almost daily, the other way around really disappeared as an option for me. This reaction was a truly emotional one, as the last thing I wanted was for him to convert. Whenever I would worry about that possibility, my only thought was, "But he is so young - I could not bear knowing I had shortened a young man's life". The resultant solution was to have an open relationship, and we both "played around" almost from the first weeks he moved into my house. Admittedly, I did a lot more of the playing than he did, probably very much for the reason I needed to be top at least once in a while. On the other hand, I more recently had a lover who was in fact many years MY senior. With me at 35 and him at 57, I found that I had a totally different attitude about risk with my partner. First, there is the simple fact that he is older, and therefore he holds FULL responsibility for his own life. But then much further there is a very pragmatic consideration: he is at an age where HIV really may not shorten his life. He could have a heart attack tomorrow - his own father died at age 58. He could get HIV and live with it for 30 years, and at 87 die after a full life span. With him, the issue of shortening his life simply was not as grave. Then, to top it all off, there definitely IS a very interesting quality of life issue pursuant to a man who is over 50, and it is in this area that the ER episode was so important to me. My older lover was a very sexual man, and always had been since he was 9 years old. However, despite all his sexual escapades, he felt that with me he was experiencing more sexual fulfillment than ever before in his life. He was married twice (with the second wife over 20 years), and he played around with men and women in every context including bath houses, prostitutes, summer flings and of course long-term relationships. Yet, he was thoroughly convinced that in me he had finally found that one person who provided exactly what he wanted, on every level physically and emotionally. On the surface, with his attraction to younger men, and my own attraction for older, it stands to reason that he could form such an opinion about sex with me. Then, considering that my own sexual appetite and stamina are also very high, I have no doubt that he was getting more in the sack when he was with me, than he could from anyone else. Therefore, if his high stamina was likely to hold out for many more years, why would he not want enjoy it to its fullest? Why at the age of 57 should he place barriers on living life, when finally he felt he was living life better than ever before? As a result, when he made it painfully clear he was willing to take risks toward HIV and "bareback" (sex without condoms), I was very much less resistant. Of course, in the beginning of the relationship, I would refuse over and over. I was not yet emotionally prepared for the responsibility, and our relationship was hardly on solid enough footing to justify such decisions, but after 9 months of almost a cat-and-mouse approach to bareback sex, I finally gave in and plunged that risk right into him - I fucked him without a condom and ejaculated. Since that first time, we did it only rarely, probably under a dozen times total, and he always took precautions to enema promptly afterward as well. Luckily for him he remains HIV- to this very day. But if he had converted, I know it would have been a TOTALLY different experience for me, than what might have happened with my earlier, much younger lover. We had numerous discussions about it. We talked about how much better our sex life would be if we no longer had to worry about the virus. He saw in me that I was living well, never sick, and only on one medication regimen in all the 10 years I have had the virus. I shared with him my feelings that by giving him my virus, he would become mine, a possession, and even figuratively a product of my loins. I think that feeling actually is a strange sublimation of a man's natural desire to reproduce. Sex between men does not bear progeny, but where the virus is present there is an added sense of passing on one's seed. Since he would be carrying my virus and no one else's, it would be as if I gave him my seed. I am sure that this feeling is what has brought forth the euphemistic term "breeding" to describe the act of passing on the virus. I shared with him my childhood fantasies of being a vampire. In my youth, I was very aware that most men were not gay, and I think that it was my fantasy that as a vampire, I could convert the objects of my desire to being gay - just as a vampire creates converts for his own purposes. It is a power trip thing - it is the desire to seduce - and to me it's really no different from the classical plot device of using a love potion. We all have at some time wished we could obtain the object of our affections, and therefore avoid the pain of unrequited love. Yet here, the act of breeding my virus, the act of making my lover "mine" in a very physical way, brought back those vampiric fantasies. It stirred long-lost emotions, and even childhood fears, in a way that seemed only to amplify our feelings for one another. For him to convert would be both a proof of his love, but also an inescapable bonding between us. Whatever happens, I will always know he carries my virus, and that he allowed himself to take my virus because he loved me. Even after our break-up I told him that should he turn out to be HIV+ at a later date, I would be there for him. I could not take the responsibility of such a thing lightly. I had some fear, or maybe hope that a seroconversion would bring us back together. Maybe it would give is something to cement our relationship that might have been lacking before. Maybe it would humble him, and help him to relate to me better as a person. Maybe it would eliminate a glass wall that was always keeping us apart, even as we did not realize it was doing so. Maybe our problems ultimately stemmed from our sero-discordance where we did not believe they did. So far it has not happened. He is still HIV-. Our relationship has not rekindled, nor improved. It is most likely that he will leave Pittsburgh, and that will be the end of any interaction between us for ever more. Where once he was willing to take risks with his own life because of me, he is now not even part of my life at all. That is probably the most telling point of my story: you never know what might happen in the future, so are you really prepared to make a permanent, life-long decision based upon events happening in the very short term? That is the question at the core of this ER episode, which made it so important for me and applicable to my life. From my point of view, there is a sharp contrast between the life-death decisions of a man under 30 and one over 50, and this ER episode covered that issue very well with the generational gaps between the main characters. In this show we have a teenager, a twink (man in his 20s) and a more elderly man who could have been 55 or 75 for all we knew. The age spread was very integral in how the plots ultimately played out. Of course, the show leaves one feeling critical of the HIV- man's choice to embrace the virus. Certainly, the physician could not give up on the issue, and even as the man is walking out of the hospital doors, he tries to convince him to change his mind. However, at the same time the characterization and dialog of the show helped the audience to see that some people may consciously accept risk of infection with HIV for the sake of sexual or emotional fulfillment. It is presented honestly, and though most people will never agree with the decision, at least they have seen an accurate explanation of the reasons behind such a decision which they may never get from any other source. Even parents of HIV+ sons will probably never get an honest explanation about how they were infected, because so often we do not share such things with our parents, either to prevent hurt, or to prevent judgment. The other plots were very striking in similar ways. The youth wants to refuse another transplant surgery, because he is very tired of the medicines, the difficult lifestyle, etc. Yet, his parents literally force him into it, and in the final scene of that plot thread you see him protesting and angry as they wheel him into the operating room. The Bishop is afraid of dying, but fears much more the idea of lying in bed those last days, unable to continue his life's work. He is very willing to shorten his life substantially, if it means tending to the needs of just a few more parishioners. In both cases the primary doctor is persuaded by the patient to the new point of view. The one tries to persuade the parents against the surgery, out of respect for the young man's wishes (his failure to succeed is very realistic, as the parents logically would not change their minds). The doctor for the bishop finally acquiesces and gives his patient the steroids which will no doubt greatly shorten his life, but at least will assist him in living his last days in the manner he chooses. Therefore, my overall conclusion, by virtue of the juxtaposition of these different plots, is that ER actually was advocating the patient's right to choose quality of life at the expense of length of life. The inclusion of a bugchaser was a VERY bold move, and in the context of the show, had to be a clear statement that men who willingly take the virus are simply exercising their right to chose, and that others, not even health professionals should take away that right. It does not mean that the decision is the best one, nor does it fully justify the decision. Clearly, health care workers still have a duty to try to dissuade their patients from such decisions, but if that argument fails completely, one must finally accept the patient's choice and move on from there. I was even more intrigued by a couple other implications contained in these plot comparisons. For any man to take on HIV, he is also taking on a HUGE medical expense, which even if covered by insurance or the government, is a cost burden on society as well as the individual. I am sure many in the audience would find such a burden irresponsible and unjust expenditure of money. However, if one compares this issue to the parallel one found in the heart transplant story, a very interesting moral dilemma is revealed. If the boy is forced to take a heart he does not want, there is a great chance he will not recover well. He may reject the new heart. He may refuse compliance on medications and other health regimens. He may get depressed and actually commit suicide. Where is the cost benefit there? First we have the huge expense of surgery and medical treatment. Then, we have the fact that heart DID NOT go to someone who would have cherished it more, and had a better prognosis for recovery. By forcing this youth to take a heart, someone else who did not get a heart could have died in the waiting queue. Therefore, this episode presents some interesting issues for us to ponder in regards to the cost of health care. I have often said that a motorcyclist's right not to wear a helmet ends when the state pays for his medical bills and disability after becoming quadriplegic. This was my way of explaining my support for helmet laws, because I had way too much experience seeing motorcyclists come through our ER, become quadriplegic, and having to live the rest of their lives on social security disability. Now, I am confronted to rethink that assessment. Cannot the same argument be made about a man who willingly contracts HIV? Most assuredly yes, and even though one is a medical issue and the other a physical safety issue, I can no longer be quite so judgmental against those persons who want to feel the freedom of wind, sun and air as they explore the expanses of this beautiful continent. In the end I am amazed that this one hour show managed to portray some very deep and complicated issues regarding death and quality of life. Obviously, I am interpreting implicitly a few issues which were not explicit, but yet all the material was there and any thinking person should be asking and probing the same questions. What I came away with is no fabrication on what the writers gave us - it is merely all the factors they WOULD have given us if they had the time to develop the characters on all fronts. I am sure someday this episode will be repeated, and although I am not a convert to the ER series, this one touched on so many important things affecting those of us who are POZ, and likewise to all of us who have had to deal with death on a very personal level. And for everyone else, it is an honest portrayal of the quality of life decisions we make, when faced with a life-shortening/life-lengthening choice. I strongly recommend to everyone to make an effort to see this episode whenever it is repeated.
Lee W. Kikuchi Hi, list friends. I read Lee W. Kikuchi's piece on ER and found it very interesting and thought provoking. I never knew that there were those who willingly had sex with their lovers who were positive without protection. I found the metaphor of transferring the virus being compared to transfering a part of oneself very interesting, and a bit disturbing. What made me uneasy was that the decision to have unprotected sex was made while the two people were not together very long, and this was the same thing that the author talked about in his own life. I know that I am really out of the loop and the gay mainstream in knowing what is going on. I have two questions of vocabulary, and beg of you who read this not to laugh at me, but if I don't ask, I'll never learn. What is seroconversion? And what is bugchaser?
Hugs,
At 01:37 AM 2/15/2001 -0500, Robert wrote:
Dear Bob, Seroconversion is the change (conversion) of the status on one's blood (serum) from testing negative for the AIDS virus to testing positive for it. Just a fancy term for becoming HIV positive. My regards to Harley. My gay cat Chico hopes that Harley is not a cat chaser.
George of Boston.
My web site http://bostbill.home.netcom.com
has information on the CR Cruise in June 2001.
A reply to your two questions. Seroconversion refers to the development of detectable antibodies to HIV in the blood as a result of infection. It usually takes several weeks to three months for antibodies to the virus to develop after HIV transmission. When sufficient antibodies have developed in the blood, a person will test positive on standard HIV antibody tests. Bugchaser is a slang term referring to a person who knowingly engages in high-risk behaviour (unprotected anal or vaginal intercourse) with an HIV positive person, and understanding that the activity will put them at risk of HIV infection.
A good souce of information about HIV/AIDS is www.thebody.com.
End of silverfoxesclub-digest V1 #141
|