obama-fied

Gen X, for all of its pretensions, was the most conservative of generations for a long time. People my age are a lousy-ass voting bloc, plus our generational size is tiny. But my sister's generation--you know, the kids today, the Generation Y, the twenty-somethings of the moment--they're a different breed. And I'm hoping that through the power of inspirational slow jams, they will change the world.

(Also, for the hyperattentive, how awesome are Tyra and Landry from Friday Night Lights that they are both in this video?)

in memoriam

Anybody who's lived in San Francisco might be forgiven for getting jaded about how many times Del and Phyllis had presided over one occasion or another, or been honored at some other occasion. As the National Center for Lesbian Rights put it, more kindly, "It is difficult to separate Del Martin and Phyllis Lyon and write about only one of them. Their lives and their work have intertwined and their enduring dedication to social justice has been recognized many times."

But the couple deserved their iconic status, and more, and I was sad and moved by Del Martin's death today. And I was even more moved by the fact that Del and Phyllis--a legendary San Francisco couple, and lesbian pioneers--were finally married, by law, when she died.

As many in the media make note of the progress from the March on Washington to Barack Obama, in many ways Del Martin's trajectory is even more improbable and surprising. In 1955, when Martin Luther King was publicly leading the Montgomery bus boycott, Del and Phyllis were starting what was basically an underground lesbian cell, which later became an early civil rights organization. Theirs was a long and amazing road. Condolences to Phyllis Lyon.

Here's the SF Chronicle obit.
And here's the National Center for Lesbian Rights more detailed obituary.

Pictures from sfgate.com/SF Chronicle

Michelle Obama

How does Barack Obama do all that traveling instead of just hanging at home with Michelle?

That's the question I have tonight.

Not coincidentally, I am in Cape Cod and Ms. Dr. Hemodynamics is not.

Carnival

I've been working for the past couple of weeks in Provincetown, at Outer Cape Health Services, getting a taste of a funny kind of rural primary care. Though Provincetown itself has an urban feeling in many ways, because it's a resort and tourist town and a gay mecca, still, the nearest actual hospital is a community-level hospital 50 miles away, and emergency transport to tertiary care (like my hospital) requires a helicopter.

And if the fabulousness of P-town summer means lots of young men walking around the streets with hundred dollar sunglasses and no shirts, looking so relaxed and languid that is seems as if they've never had to work a day in their lives, it also means lots of people working double shifts so they can make the money they'll need when they're unemployed or underemployed in the winter. It means that in clinic, a lot of people want to push their follow-up appointments and specialist referrals a little bit farther away: "Can we do it after Labor Day?" It's like harvest time in other small towns, but the harvest is tips and hotel guests.

Provincetown has an annual Carnival, which is sort of a mixture between gay pride parades and Mardi Gras and a small town parade, except that it happens at a time with no apparent historic or religious significance other than being at the peak of high season, and presumably it helps brings in that last bit of income in before Labor Day. Like gay pride parades, the community's institutions get in the act right along with the clubs, liquor companies (Bacardi had a big float), and random assortments of people who just want to dress up in crazy outfits.

There were lots of guys in their underwear, sometimes with cowboy boots (the theme was "Wild Wild West" this year). My hero was the guy in his underwear, presumably with Type 1 diabetes, who had a device the shape and size of an insulin pump taped to his leg with tubing running up into his underwear. A heroine came while we were waiting around in line: a queen dressed as Ann Richards who was going around shaking hands with everyone and acting like she was the governor of Texas. I assume "Ann Richards" has been doing this schtick for some time now, given that the original Ann Richards is no longer with us, but maybe for your average Wonkette queen, Ann Richards has become a kind of eternal reference point, a nouveau-nerdy Judy.

Anyway, Outer Cape Health Services had a float because that's how these things work; in a gay community, if a community institution doesn' t show up for the parade, it's a troubling hint that the institution may be either a) filled with incompetents who can't get their shit together to organize a float, much less an all-year organization, or b) homophobic, or worse, both a) and b). Outer Cape Health Services has many highly competent and definitely not homophobic staff people, and therefore there was a float, and an enthusiastically staffed float at that.

Of course, I had to represent at the Carnival, not only for myself but also for other residents who will rotate out here; I would hardly want the people out here to think that the residents of my hospital are not ready to be a part of the float at Carnival, since I hope that we too acquire a reputation for being competent and queer-friendly. Other staff members kept asking me if I was ready for what was about to happen, and I acted nonchalant: "I'm from San Francisco," I said, "and I worked a lot of Pride Parades." Which is true. I've thrown a lot of condoms to crowds of hundreds of thousands.

But in fact, I wasn't ready for what was about to happen, because when we took our float down Commercial Street, unlike at San Francisco Pride, there was no wide street and there were no police barricades separating us from the crowd. And we were throwing out Mardi Gras beads to the crowd, as had a number of other floats before us, and for some reason we must have been arriving at the crest of the wave of bead frenzy because there were a fair number of people who had literally become insane with bead-madness. So although the crowd was much smaller, they were right in our faces, shouting, "BEADS! BEADS!" At one point in the route something had happened to the crowd in one particular area; they had clearly made the ugly transition from crowd to mob, crazed for beads, reaching into our float to try to grab beads that were on the floor of the float. We were literally having to push and slap people's hands away from us. It was very Lord of the Flies.

Still, other than the terrible bead mob moment, I had a great time tossing beads to people.

I had visited the nursing home in the morning, and the biographies of some of the residents are reminders that this has been a bohemian outpost for a very very long time. The old people here are not the same old people that I see in my clinic; and the young people are not the same young people either. This is a refuge, a destination, a hide-away and a place to be seen. It is not your average small town. And at the same time, it's still a small town. Two days earlier I'd had a long session with a patient, in which she was talking about secrets and deeply personal things. And this afternoon, as we drove by, I saw her, and she was shouting "BEADS!"

I tossed her some beads.

NO OBITS

I remember that week because the epidemiologist I shared an office with put the headline up on her bulletin board:

"NO OBITS"

We took good long looks at the headline, quietly reflecting, finding ourselves happy to realize that we had definitively arrived in a new era. As a guest opinion in this week's Bay Area Reporter reminded me, it was 10 years ago this week that the BAR ran this headline as a huge banner on its front page. In August of 1997 in San Francisco, none of its readers had to be told what the headline meant.

The BAR is a gay newspaper in San Francisco, and for various reasons it essentially became the newspaper of record for gay men's obituaries there. And so, from early on, it served as an ongoing record of the community's losses from AIDS. The obituaries were written by the friends of the deceased; there were only a few rules, including a strict word limit and the stern instruction, "No poetry." In the worst days of the mid-1980s, the obits went on for pages.

10 years ago, San Francisco already had a couple of years experience with protease inhibitors and the concept of three-drug combination therapy. First they'd appeared in the medicine cabinets of savvy gay men who got them through clinical trials and parallel track access. Then in 1996, more and more people with HIV and AIDS got these medicines from their doctors and the neighborhood pharmacy, just like any other prescription drugs. There were still people dying, especially those who had already accumulated too many medical problems to benefit from the new treatment approach.

But by August 1997, the change that HAART brought was so pronounced that an obituary section that had once run pages long was suddenly gone.


This week, the BAR has two obituaries. Both men died of cancers that don't seem to have been HIV-related. This week, we can't say, "No obits"--but that's because these gay men got older and died of things that older men die of.

I remember some people fussing over the headline in one way or another. Various people who had been highly engaged in AIDS work were afraid that the new era would bring complacency about HIV prevention. They worried that celebrations of the effects of the new medicines would cause HIV-negative people to think that there was nothing that bad about having HIV. And of course, on the day the headline ran, thousands of people were dying of AIDS in other places besides the Castro District, including in neighborhoods of San Francisco where no one sent in obits to the BAR.

But one can always find a dark cloud within every silver lining. Sometimes it's still worth celebrating the silver lining.

"NO OBITS"

It was worth celebrating then, and worth remembering today.

iTunes has a radio feature, and I'm listening to BeirutNights.com radio, which plays lots of satisfyingly eurotrashy dance music. Because there is no better place to keep track of eurotrashy dance music than Beirut. The only person I knew who had heard "Dragostea Din Tei" before the Numa Numa Dance swept the Internet was a guy who spent a lot of time hanging out in eurotrashy dance clubs in Beirut. Apparently, that's the epicenter of the good stuff, except if you know where to find the tiki lounge in Oakland where my sister's boyfriend is evidently spinning Italodisco under the nom de guerre of Dr. Fill.

So, I'm listening to BeirutNights.com, and a familiar chorus comes through: Hey Hezbollah! Eat this! It's a sped-up tinny remix of the Pet Shop Boys singing, "We'll run with the dogs tonight, in suburbia."

"Be kind..."

One of my chief residents was sitting in one of our workrooms, and turned to me and gave me a fortune from a fortune cookie, and said, "Here, Joe, I think this one is for you, you'll appreciate this"--and the fortune said:

"Be kind, for everyone you meet is fighting their battle too."

I taped it to the cover of the binder I carry my notes around in.