AIDS in the Western Hemisphere

Is there a more certain harvest of death looming on the southern horizon of the hemisphere? God, I hope I am wrong. Maybe we'll develop a vaccine, but anything short of a medical breakthrough will be little more than deploying picket fences to check the course of an avalanche. This is a knowledge that I possess at ground level, splitting the hemispheres of my consciousness. And therein hangs a tale...


 


 

Nelson Plays Host


 

Between bad luck and bureaucracy Naomi and I were going to be stuck in New York until Monday. It was 1985, on one of those famous sweltering days in July, and this was Saturday. With nothing to lose, she called up her uncle Nelson, whom she had never met, and explained our dilemma.

Nelson lived in Brooklyn Heights and couldn't have been more gracious. In fact he was ecstatic about the whole set of circumstances. He and Carlos took us out to eat that night, gave us a tour of the neighborhood, and opened their liquor cabinet. For years Nelson's relationship with his family had been a little tenuous. Now to be suddenly given a chance to make friends with his hip niece, without any pretenses about his homosexuality, he leapt into top form. He laughed and chortled, whipped up crêpes and omelets and plied us with imported beers for breakfast. On Sunday afternoon we smoked some of his best dope and went out for a walk. He reeled off the astronomical prices of the real estate he had handled up and down the block and lustily greeted all the boys behind the counters at the corner grocery store. At dinner he held hands with Carlos, told dirty jokes, and pinched my ass. When we turned in he mocked goo-goo eyes at Naomi and insisted on finding clean sheets for our bed. Nelson did everything but tuck us in and he would have done this too if Naomi had only let him. It was so much fun. He made us feel as if we were on the set of "Queen For A Day."

Carlos was more reserved only because he had never met anyone in Nelson's family and wanted to strike a good impression. They had fallen in love when Nelson had gone on vacation in Rio de Janeiro five years before. Since then they had lived together in New York. His English was improving all the time and he was enjoying himself with his unexpected house guests if for no other reason then to see Nelson so euphoric.

What a weekend it was. It had held the unhappy promise of a grim siege and proved to be one of the most comical encounters of my life.


 

Several years flew by before I saw Nelson and Carlos again. This time it was in Boston on Thanksgiving Day. Everyone wore sweaters and jackets to ward off a cold, tin colored sky. All the furniture that got moved around to accommodate the dozen or more card tables and their paper tablecloths needn't have been. The holiday dinner that Naomi and her mother had cooked didn't get eaten. Most of the guests they had invited didn't show up. A few stragglers dropped by for a half hour or so and then left. My circumstances weren't much different. Kate had promised we'd be at her father's. I kept putting her off because Naomi was sure Nelson and Carlos would arrive at any moment.

Brazil 2624Fed up making small talk with people she didn't know, Kate finally reached the boiling point. We put our jackets back on and walked out onto the sloping porch of a triple decker, in a neighborhood of triple deckers, on a vast urban plain of triple deckers. Out on the sidewalk Nelson and Carlos were just making their way to the door. I shook hands with them, tried not to stare at Nelson's gaunt appearance, and couldn't make a coherent explanation for leaving. Kate was standing impatiently by the car door. Naomi was poised in the open door of the house, anxious not to let the heat out. When he realized I wouldn't be back, Carlos' face twisted into a pained expression. I think I kind of waved at them.

Afterwards Nelson plummeted into the disease, lingered in a hospital, and said good-bye to the family that he didn't have. Carlos lived a little longer. He went home to Brazil at the end.


 


 

In the current issue of The New York Review of Books Alma Guillermoprieto has contributed a new piece about Cuba.i Her report begins with some observations on the growing ranks of prostitutes who are servicing the flood of tourists the government is courting. "Observations" is the right word to use here because she is recounting what she has seen with her own two eyes on a recent trip to the island. However, the subject of Cuba's unofficially/officially sanctioned sex industry is quickly subsumed under a larger question about the nature of "seeing." She is asking herself what it is that the Cuban government chooses to see and what they permit the outside world to look at. For a reporter vitally concerned about freedom of expression this isn't idle curiosity or an abstract investigation. She writes that her purpose in returning to Cuba was to interview some of the dissidents who have been released at the request of the Pope. By and large, these strained conversations make up the meat of the article.

The case that occupies most of her attention involves a man who is not among that group that was released. His "crime" and subsequent imprisonment loops Guillermoprieto back to matters of tourism. This man is a doctor who accurately and publicly warned of a devastating outbreak of dengue fever in the Cuban city of Santiago a little over a year ago. Afraid that this information might cripple tourism, the government charged the doctor with subversion and sentenced him to 11 years in prison. Guillermoprieto has interviewed his feisty wife.

It's an unsettling article. Her description of the Cuban prisons is unnerving enough but I also found myself shuddering at matters that lie just outside Guillermoprieto's immediate purview. If the Cubans will suppress information about dengue fever what are they likely to do when confronted with an explosion of AIDS cases linked to increased tourism?

The most recent AIDS statistics the Cuban government has compiled are astonishing.ii This has to be the lowest incidence rate in the Western hemisphere, but, like crime rates in the region, who could make a comparison with any degree of assurance? Still though, given the Galapagos like isolation that Cuba has maintained for the past forty years, given their own internal policy of segregating AIDS patients, these figures may well be fair approximations. But they're history now.


 


 

Why exactly am I thinking about such things? For one reason, because I'm reminded of Reinaldo Arenas' autobiography, Before Night Falls. That book has stayed on in my mind with persistent force as a monument to sanity, humor and dignity. The work also has the sad distinction of being the first one I'd read written by a Latin American with AIDS. In a moment of utter despair Arenas blamed his disease on the Cuban government and the fact that he had been forced into exile. Had he never left the island he would not have been infected. This is probably true. Now I don't think the argument could hold water. At another point in the book he states that he is thankful he had an opportunity to live through that flowering of gay life in New York during the 1980's. I don't know how Nelson or Carlos might have seen it.


 


 

How ominous it seems that there is no Latin American parallel to our outpouring of AIDS literature. In this country some of the best writing we have seen in the last fifteen years has been about the disease. But in Latin America, Central America, the Caribbean, the silence is deafening.

There are a few examples of authors who have been willing to take on this material. All that I can think of have come out of the Caribbean. Patricia Powell's second book, A Small Gathering of Bones (1994) is one instance where an author has turned to this subject matter. I have seen reviews of a collection of essays written by Dr. Rafael Campo, a Cuban American who worked in Boston, but have not yet gotten my hands on a copy. The best-known effort to date has been Jamaica Kincaid's, My Brother (1997).

Reading her book has been one of those experiences in literature that I thirst for. And it makes me ask all sorts of questions that hadn't previously occurred to me. For example is there such a thing as an AIDS narrative? An AIDS novel? Maybe there has been. Maybe there are books, both fiction and nonfiction that seem to follow a particular pattern, share a subject matter and so on. But Kincaid's book makes me question how meaningful any category like this might be. The work is surely about AIDS, about her brother's death from the disease, but stating this feels no more informative than if Alma Guillermoprieto had said, 'The samba is a dance.'

At some point near the midway mark in this text her prose strategy alters, the sentences become longer and more convoluted, phrases and ideas are consciously repeated; seemingly solid concepts like "my brother," become unwound. It's a strange process and doesn't always make for easy reading, but I have to admire her for this exploration, for attempting to fill in her brother's name, a kind of forged signature that she hasn't been quite capable of writing for her mother. Maybe now that this book is written she might be able to.

But let me go back to this matter of "filling in" Jamaica Kincaid's brother's name and the narrative strategy that's used to try to accomplish this. Is there anything more crucial to understanding who we are, more critical to our identities, than are the names we go by or are called? Not much. The words sum up a great deal and without those words to work with, without those labels, try naming someone.

There are lots of ways you could go about it. You can describe someone physically: Devon, Kincaid's brother, in the throes of the disease, appears to have been a very ordinary AIDS patient, wasting away, his eyes starting out of his head... Or you can speak of someone in terms of their relationship to you, as in "my brother" or "my youngest brother" or "the son of my mother." And each of these variations has a different emphasis, labeling another in more or less direct ways, through more or less significant people. This last route is the heart of what Kincaid is up to here.

For all the distance that she had put between herself and this brother, Devon, it gradually becomes clear to both the reader and the writer that much of that space is the consequence of another sort of strategy that accounts for who Jamaica Kincaid has become and who she did not become. The surprise she has to face is that Devon had also built himself away from his family.


 

Guatemala C845If there is a flaw in this book it's this: Kincaid has not fully developed the problems of naming this disease... She has decided that this book is about naming the "disease" that is her relationship with her family and not about AIDS. Fair enough, that's her prerogative, but if she's going to portray this relationship in terms of AIDS then it would have been useful to clearly understand the disease. By not having done this, she missed a chance to recognize that the naming of "AIDS," or "HIV," or "the virus that causes AIDS," and so on are psychological/political markers as well as scientific designations of medical knowledge. This is to say that all the words for AIDS, even the medical terms, are just as much rhetorical inventions, persuasive theories about the world and our place in it, as are the words that seek to define our relationship with family members.

I realize this may not be an entirely fair criticism to level. If it isn't fair, the injustice arises as a consequence of looking at a writer's work through a particular theme--the reason why I'm reluctant to do this sort of thing in the first place. Her achievement depicting an estranged relationship with her family is considerable. What more is it reasonable to expect?


 

Indeed. What is it reasonable to expect here? Is literature supposed to fulfill a public health function? Proselytize about the dangers of unprotected sex? Or commiserate with the stricken? No, but is it too much to ask that books reflect life as it really is? Surveying this appalling blindness, and accounting for it, is a mind-boggling enterprise.


 

Argentina 1786Disease in general is hardly unknown terrain in Latin American literature. The subtext of many political novels is hunger, not quite an ailment that will show up under a laboratory microscope, but still the prime factor in large numbers of deaths and an even greater number of debilitated lives. Starvation is surely the driving force of Moritz Thomsen's Living Poor, the central character in his social drama. But he doesn't skip lightly over schistosomiasis, the stomach worms infecting everyone in Esmeraldos. Roy Heath's Armstrong spends his last years as a social outcast afflicted with elephantiasis. Henri Charrière and Che Guevara made notable records of the leper colonies on the South American continent. So why is AIDS absent from the calculus of recent Latin American literature? Is this the effect of a translation lag? Or the by-product of ceding literary authority to a handful of heterosexual men long past the worries of sexual contagions? Or is it possible the disease hasn't yet tracked south?


 


 

Abandonment


 

Lionel made Venezuelan medical history in the late 1980's. Carmen's brother, a doctor, assured me that they had never seen a brain fungus mushroom to that size in the cranium of a living patient. Although, it must be said, Lionel wasn't going to live long. And in the meantime, in spite of his celebrity status among the medical staff, Lionel couldn't expect free room and board in the hospital.


 

Read one way, Lionel's life was a medical detective story. He was a Canadian. He was gay. He gravitated to San Francisco in the late 1970's, where he was presumably infected with HIV, and ended up in Caracas. These bare bones of a geographical and sexual history are now fairly transparent lines on the epidemiological tracks of a contagious social disease.

However, exactly because AIDS is both contagious and social, Lionel's life also presents a more complex human story about thwarted aspirations, prejudice and love. Like many marginal people Lionel was attracted to the arts. The freedoms afforded to musicians were an irresistible lure for a gay man who had grown up in rural Canada. Although the classical tradition is dominated by men this suited Lionel perfectly. He played with orchestras in San Francisco and Caracas and managed to support himself. This was where Carmen met him. After one of her performances he complained of crippling headaches. She mentioned that her brother was a doctor.

Argentina 1787Even after he was diagnosed he couldn't bring himself to communicate with his family in Canada. Instead he went home to his apartment and resigned himself to death. Soon he could not attend rehearsals. In his last weeks his only contact was with Carmen, who had inexplicably found herself running daily errands for him. None of his old lovers in the symphony orchestra could seem to find the time to help, but in truth they were terrified of him.

Lionel's legacy was not a musical one. The orchestra found another oboe player. His family flew down and retrieved his body without ever knowing what killed him. The giant fungus is recorded as a bizarre footnote in the medical annals. And there one might think that Lionel is buried. However, the twin themes of homosexuality and AIDS would eventually resurface as the dramatic content of Carmen's delusions. She fled Philadelphia in her pajamas because I had betrayed her with a man. Six months later, she called me from Caracas to defiantly announce that she had quit the local Gurdjieff Society when they decided to require an AIDS test of all their members.


 


 

No, the disease is well entrenched. By 2000 the entire region--from Mexico to Chile--will be to home to nearly 400,000 people with AIDS, equally men and women, and all young. The largest numbers of the afflicted will be Mexicans, Hondurans and Brazilians. After 2000 nobody seems keen about predicting what will happen.

Brazil 2645
No doubt the Catholic Church is presiding over a medical catastrophe. Their constructions of sinful behaviour have wrecked havoc with the meager educational efforts that are operating in Latin America. They have squashed condom distribution programs. But if anyone imagines that the brands of Protestantism that are sweeping southward preach more enlightened ideas about sex, expound more realistic views of homosexuality, or hold out more compassionate understandings of intravenous drug use, they are dreaming.

It's a terrifying scenario, ostensibly unwritten. The few heroic voices I can hear are those of the AIDS workers. Reinaldo's book also has the added distinction of being the only book I've read by a Latin American who has confronted this disease. And he's dead.


 

-June 2, 1998


 

Endnotes

i "Love and Misery in Cuba," New York Review of Books, June 11, 1998.

Editor’s note: This piece and several others by Guillermoprieto that are mentioned herein were collected in her recent book, Looking For History: Dispatches From Latin America (2001).

ii If I remember correctly, for 1996 they reported about 6oo cases out of a population of some 11 or 12 million citizens. Unfortunately I can't find the article, but I clearly remember that they also reported that as of 1993 they have relaxed their policy of strict quarantine for about a third of these patients.




 

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© Copyright 2003 Eric Metcalf