Authors: Bill Barich
San Francisco General dealt with about four thousand HIV-positives in all. They were divided into two groups, half with full-blown AIDS and half with AIDS-Related Complex (ARC). They accounted for about twenty thousand visits annually, most of them on an, outpatient basis. That could only be accomplished, Jacobson said, through an amazing support effort by the gay community. Lovers and friends had formed a network that did everything from fetching prescriptions to delivering meals. Jacobson had never seen such a high standard of home care.
There was also a solid network of support in the medical profession, a consortium of about a hundred doctors in the Bay Area whose practices were largely devoted to AIDS. But both networks were beginning to give out, Jacobson said. They were being worn away by attrition—another tragedy of the epidemic. A person was capable of attending to just so many deaths, and in the world of AIDS, death was the only constant.
The beds on Ward 5A were still full, but other hospitals had similar wings now. When a gay man was diagnosed, he often requested a bed, but the promise of one in the future wasn’t good enough anymore, and he might go somewhere else. So Ward 5A harbored more poor gay men these days, said Jacobson, sometimes street hustlers and injection-drug users.
There were also more hetero- and bisexual injection-drug users. They could be difficult and demanding, acting out their anger while shouting for another shot of morphine. The veteran nurses often had less sympathy for them, and the ward had become more tense and polarized.
Jacobson offered to show me around Ward 5A. On the brink, I had an urge to turn and go, knowing what was in store. Everybody in San Francisco had witnessed the wasting away of a friend or an acquaintance or a brother or a colleague.
AIDS in its final stages cruelly accelerated the aging process. Bodies were leached of their vitality. Eyes grew hugely exaggerated, and hair sometimes fell out in patches. Some new therapies helped patients to live a little longer, but that only added to the devastation that they endured—more AIDS-related dementia, neurological breakdown, and, especially, tuberculosis.
Jacobson wanted me to meet a patient and pulled aside the curtain shielding one bed, but the man in it was weeping so hard, curled into a fetal ball, that the doctor apologized and quickly closed it.
In the next bed was John F., who was preparing to go home. He sat on the edge of his mattress in a pair of pajama bottoms and smoked a cigarette in the desultory way of someone who had nothing more to lose, politely brushing the smoke from our faces. His chest was all ribs and as skinny as a ten-year-old’s, and that made the gaudy eagle tattooed on his right shoulder look overly fierce and perched on muscles that were barely able to support it.
John F. had a moustache and big ears. He spoke of himself in a fatalistic, self-deprecating way, with a touch of black humor. In his voice, I heard a battlefield fatigue, the same weary acceptance that comes to a soldier who understands that his wound was an accident, not a singling-out by fate. In that sense, AIDS was a bullet inscribed with no particular name. The epidemic had the fragmentary torque of a hand grenade. Two steps to the left and the shrapnel might have punctured your jugular.
We made some small talk for a while, and then, as we left Ward
5A, I asked Jacobson for a prognosis of the epidemic. He said, “A facile solution seems unlikely at this point.”
With a frightening precision, he explained to me how insidious the virus was, sequestering itself inside a benign cell, where it could linger harmlessly for years. No one had managed to figure out why it turned pathogenic, or how it could be extirpated without damaging the entire immune system. Doctors and researchers were thinking less about curing AIDS than about finding new methods for slowing it down. Maybe it could be controlled like diabetes, they thought, or beaten into remission like certain cancers.
The work in Ward 5A had taken a toll on Jacobson and his associates. It was a constant struggle not to surrender to depression. San Francisco General was as strapped financially as every other public hospital in California and needed more money from the government, both state and federal. Its staff was exhausted and in need of relief. Every month, another hundred or so patients died in the city. They were young, in their late thirties on the average.
What Jacobson disliked most about his job was counseling those who had tested HIV-positive and were going to die of AIDS someday. He found it very hard and very painful. Whenever he had to face the task, he advised patients to simplify their lives and do what they most wanted to do, considering his own mortality all the while.
In the land of light, a darkness unfolding.
I
N THE MISSION DISTRICT NEAR NOE VALLEY
, there were also changes. The Mission was thickly Hispanic, a sanctuary for Mexicans from every part of Mexico, as well as for Guatemalans, Nicaraguans, Salvadorans, Peruvians, Bolivians, Colombians—every Latin country was represented.
The Mission had many Catholic churches for the confessing of sins and many teenage gangsters doing
la vida loco
who had sins to confess. The cars cruising the streets were decorated with bumper-stickers
proclaiming their owners’ attachment to a home turf, I Luv Yucatán or I Luv Managua.
Early one gray and misty morning, I came upon a big gathering of Hispanic men where Valencia Street dovetails into Mission Street. About seventy-five of them were grouped on both sides of the street, shivering in the chill. They stood in front of a Taco Bell flying an American flag, in the shadow of a billboard for Alaska Airlines that advertised flights to Guadalajara and Acapulco—two “hot spots” symbolized by chile peppers.
From a distance, they all looked to be about the same size, maybe five-foot-six or -seven, and the same age, between eighteen and twenty-five. Some of them held little plastic grocery sacks that probably contained all that they owned and marked them as illegal immigrants just in from the border.
A few men were always hanging around in the Mission District and looking for work by the hour, but I had never seen so many of them before. Supply far outweighed demand, and when a pickup truck stopped at the Taco Bell, the men descended upon it in earnest.
The driver, a white man, rolled a window halfway down and was immediately engulfed. Six would-be workers raced toward him and began shouting. They shoved each other and battled for space. A head would thrust toward the window, and a competitor would grab it by the neck and yank it back.
Four men, so desperate that they didn’t even ask what the job might be, grabbed at the rungs of a ladder in the truck bed and climbed in. Some others, latecomers, rushed the truck and swabbed at the windshield with handkerchiefs, partly to clean it and partly as a wan attempt to curry favor.
At last, the driver struck a bargain with two fellows. They fought off the furies, literally throwing punches, and got into the truck on the passenger side, ready to dig ditches, carry hods, or strip asbestos from furnace pipes. The driver stepped on the gas, and the crowd split in half and peeled away. The desperate crew in the truck bed
got to their feet in a frenzy and jumped to the pavement, like sailors deserting a sinking ship.
The men left behind did not appear to be angry or discouraged. Nobody swore or pounded a fist. Instead, they staked out their positions again and went back to waiting and shivering in the drizzle. Their attitude was fatalistic. They had taken a chance on the great California sweepstakes and no doubt expected such whimsical treatment by fate.
So they would stand by the Taco Bell through the afternoon, watching the cars go by, pitching pennies, peeing as necessary in an alley, and conveying their respects to any pretty woman who might pass, just as they would do at a
zocalo
back in Mexico.
T
HE FOURTH OF JULY CAME UP ACES
, all bright skies and no need for a pea coat. We went to a barbecue at the house of a friend, who had an impressive deck that looked out over the Castro District to the city skyline. The partygoers were an eclectic San Francisco mix of straights and gays, solid professionals and dedicated slackers, and we were treated to ample beer and wine and trays of good food all done to a turn over mesquite.
People talked about real estate, naturally, but they also talked about films, books, and movies. They even talked about California, particularly one guest, who was a reporter for a New York paper stationed by chance in the thankless West. I had met her shortly after she’d arrived, and she had gone on about all the New York things that she would miss—the intelligent conversations, the sophistication, Broadway, the publishing scene. You might have thought that she was toiling in the Outer Hebrides.
But now, six months down the line, here she was discussing her favorite jogging trails in San Francisco, looking tanned, healthy, and not at all forlorn. Oxygen and sunshine had proved to be a decent enough substitute for the Big Apple’s sizzle.
People talked about Los Angeles, too. There was a guest who wrote screenplays, and she described her agent in Hollywood and how a conversation with him was like being on TV and having to produce sound bites of information for a talk-show host. You made a remark to him, and sometimes he didn’t even respond to it, saying only, “Next!”
Another woman talked about how the old San Francisco was disappearing, but I knew from my travels that the old everything was disappearing in California and no going back. I recalled a line that Will Irwin, a curmudgeonly reporter in the city, had once used when somebody asked him if San Francisco was as good as it used to be. “No, and it never was,” he said.
Then it was evening, and we were sitting in our separate rooms at home. How wretched I felt, how stupid and blind and panicked! Everybody knows that failing marriages are a dime a dozen, but the knowledge offers no solace, I had discoveed, when the marriage is your own.
J
OSHUA NORTON
, Emperor of the United States and Protector of Mexico, lay buried at the public’s expense in Woodlawn Memorial Park, in Colma, a cemetery town south of San Francisco. On my last morning at home, feeling slightly crazed myself, I paid him a visit. A Woodlawn attendant in a green blazer gave me a map and marked a route past the Portals of Remembrance, the Sanctuary of the Hills, and the Veterans Section to a grave on a little rise framed by palms, eucalyptuses, and Monterey cypresses.
The emperor’s tomb, a tannish rectangle, was scarcely a tribute to his stature. Other visitors had left offerings at its base—some red plastic carnations and a shotglass embossed with the name of a vodka drink I hoped never to try, a Stoli-Kazi. In death, Norton had settled down among such ordinary folks as the Richters, George and Nellie, and Wanda Steinley, who had lived to be one hundred and three.
A photograph I had of Emperor Norton showed him astride one
of those old bicycles with hooped wheels. He rode it with fierce concentration, his brow furrowed and his hands clenching the handlebars. The intensity that had touched so many of his contemporaries was evident. The mad do not often possess such dignity.
I wondered how the emperor would have fared in San Francisco now. The homeless were not treated so gently anymore. They ate at soup kitchens if they ate at all and lodged in doorways on pallets of cardboard. The flophouses that used to take them in were gone, refashioned as apartments for immigrant families from Asia—Laotians, Cambodians, and Vietnamese.
Emperor Norton, old boy, you’d be in for a surprise if you were to come back for a few days. Abundant saloons were still around to tempt you, but the exclusive shops on Union Square, everything from Gucci to Tiffany to Burberry’s, might puzzle you. The fancy restaurants might make you swoon. And all the tourists in town riding cable cars, feeding the sea lions by Pier 39, and buying tiny souvenir versions of the Golden Gate Bridge, what would you make of them?
Joshua Norton’s city was lost, I thought, just as mine was, but other pilgrims would still find new magic and light, believing that they had reached their destined home at last. San Francisco really was an island in the great sea of California, a place for the rich and the poor, for drifters and immigrants. Most middle-class Californians had as little to do with urban affairs as they did with small towns or cattle ranches. They lived in the suburbs.
I
F YOU WANTED
to see the future of suburban California, Hercules, in Contra Costa County, was as good a place to start as any. It was among the fastest-growing towns in the Bay Area, and its appeal could be simply described. The houses there, mostly new in construction, were deemed affordable, and Californians, like Americans everywhere, were slaves to the long-simmering national dream of owning a single-family home, no matter what the psychological cost.
In Hercules, you paid for your pleasures in accrued freeway time, all the lost minutes squandered on the commuter meatrack. Highway 80, the main arterial to San Francisco and Oakland, backed up by seven o’clock on a weekday morning, and a trip of twenty-five miles or so to work could take up to two hours in a worst-case scenario.
Every single weekday morning, fifty weeks a year, the same old grind. As I drove to Hercules, I was awed by the stalled line of cars trying to move in the other direction, creeping forward by inches in a cloud of spent fossil fuels at 7:14
A.M
. The drivers did not look the least bit content. Instead, they looked angry, anxious, bored, or miserable. Some of them were about to return to the Land of Nod in spite of the forty-eight-ounce Big Gulp mugs of coffee or Diet Coke
balanced on their dashboards. A face not clenched or twisted in stress was rare.
There were devices in place to mitigate the pressure—radios cranked to the max and earphones plugged into Walkmans dispensing investment tips or visualization exercises or the audio version of a John Bradshaw seminar—but they did not seem to be getting the job done. Sometimes a driver cracked and made an aberrant dash toward a vanishing speck of light between cars, triggering a chain reaction that resulted in a jockeying for position where no position could truly be said to exist.