1996: protease inhibitors were confusing

For my zine, I wrote this; although my life changed in other ways shortly afterwards, and somehow that also meant that I stopped publishing my zine. Those were in the days before blogs, children; in the days of photocopiers when self-published writers had to go to the Leather Tongue video store and drop off five copies of the zine for the magazine rack, in hopes that there might be only two when they returned a month later.

Not long after this I ended up going to work for an HIV vaccine research group, which restored my sense of urgency. It also stalled the question of doctor or account planner (see previous 1996 post); then I learned immunology, did some needle exchange, and with much more excitement and no inertia, I decided to become a doctor.

October 14, 1996

At my job [at an HIV prevention agency in San Francisco] another person has quit; everyone seems disspirited and low. To some extent, that’s because of the particular politics of the agency: personnel absences, departures, events, personality changes, etc. But I’ve been wondering, on my return, whether there’s something deeper. The advent of the new drug treatments, and the incredible promise of the protease inhibitors, may have subliminally actually depressed people.

The idea that we are an important lifesaving effort is slowly losing focus; if people are staying alive with HIV, then we are disease prevention specialists, not the first line of defense in a community under siege. In itself, that would be great news, but unfortunately, no one knows for sure what the truth is.

How many people will really benefit from the protease inhibitors? The most optimistic school of thought has it that the protease inhibitors, if used for somewhere around the range of three years, might be able to help some people’s immune systems to entirely eliminate HIV from the body--in other words, that in a couple of years, we might have a partial cure blossoming in front of our eyes! Others are more skeptical and uncertain about the longterm prospects of the new drugs; if this group of people is more correct, we will only see people with AIDS die a couple of years later than they would have before.

So we can’t yet cheer the end of an era. On the other hand, the urgent language of our previous era is fading and cracking under the dim light of future prospects. We are left with no sure knowledge of our role, no clear sense of how important our work will be, and no overtly stated acknowledgement that things have changed. I am beginning to suspect that inertia is the result.

Why I write: props to a zine and a blog

photo: punk zines as depicted by Wikimedia Commons


Blogging is a wierd exercise. A while ago, a noted figure in healthcare blogging came to talk to my hospital; he and I know each other through our blogs and I introduced myself before the talk. During the talk I got a page from a nurse, and had to go out of the room to answer a call about a patient. Apparently in the meantime someone asked the speaker about his blog and he said something about how blogging is partly an inherently narcissistic act, and then looked over in my direction and said, "What do you think Joe?" A friend of mine said, pointing to my empty chair, "Oh, he's not here, he's outside looking at himself in the mirror."

A funny line, but if I liked myself that much, I wouldn't need a blog.

Given that most blogs, including this one, don't have that many readers, and at least in my blog's case, are more commonly found by people stumbling through Google Image searches than by actual devoted readers, blogging can really be only part narcissism. Or maybe it's just narcissism combined with masochism. I don't think either description is right, though. I think all writing requires pure and unproven faith that someone else will be interested in what the writer has to say. And in terms of its relationship to an audience, I think writing is more an exercise in hoping that you're not alone in thinking what you think--that others will read it and relate to it, and maybe even find that it says what they were looking for words to say. Good writing can't spend much time trying to convince readers that the author is fabulous.

Before blogs, there were zines, and I was a fan of zines too. Before some set of people thought it was a good idea to post their writing on the internet, an overlapping set of people thought it was a good idea to type or write a bunch of stuff and take it to some copier and staple it into a little booklet and sell it at some grungy video store or bookstore. I was one of those people too; my writing grew and flourished in my little zine, each issue carefully worked over, slowly, slowly, in between other things.

On that note, two shouts out, one to a blog and another to a zine.

The zine: Doris. Cindy, the author of Doris, has been doing this for a long time, since before blogs. I used to buy her zine when she bound it with red duct tape; now she actually has slightly less DIY-looking binding but she's still got the cut-and-paste, typed and handwritten, no PageMaker punk rock style. She's also doing more writing to support survivors of abuse, including a handbook/comic to support survivors complete with a version in Spanish. She actually now has a blog, but not to replicate the zine's contents--just to let people know about her projects, appearances, etc, from which I find that she's got enough of a fan base to be going on tour to do readings. I think since I've started reading her work she's become a little bit of a celebrity within the punk rock world but since I am mostly part of the hospital world, how would I know? All I know is that every time I manage to find her work I find out that she's been working hard on writing as honestly as possible, struggling but pushing forward. Find her zine in your nearby indie/punk/poetry bookstore or via her website. She also has a book with the contents of some of her earlier zines. Since I started my own medical training years ago, Cindy seems to have at the same time been working on a kind of medical training of her own, but more in the self-empowerment, up-from-the-ground-roots, skeptical-of-medical-power school of thought. I would like to think I was more a part of that world than I am, but my own internal contradictions are the topic of another post. For now I'd just like to give props to Cindy for keeping on keeping on.

The blog: one of my few actual devoted readers who is not my mom is Chris from Last Chance Texaco. Chris can be found entirely on the web, on his own blog, so less description is needed--just go read his stuff. He's still in Boise, still struggling with being in recovery, still trying to make sense of his own role in his own mistakes, still trying not to make the same mistakes again. He also posts about random other stuff, including gym shorts from the 70s, or dumb TV; the periodic light touches make the heavy stuff more compelling. In many ways, Chris's blog is something between writing for other people--he appreciates having readers--and just writing for himself, to mark each day, to mark his struggles, and perhaps to hold himself accountable by documenting those struggles.

Meanwhile, I'm now a junior resident. Apparently that means I'll have more time, and more space in my head that I can call my own. I hope my own writing will benefit, and that you'll be hearing more from me this year. I know that my writing has always been best when I share the impulse of people who write whether or not anyone reads their writing--people like Cindy and Chris who build their audiences through the constant work of documenting their own self-exploration and movement through the world. Though I actually hope to publish more this year in other people's publications or broadcasts--I am at least narcissistic enough to want a broader audience for my writing than Chris, my mom, my honey, and people who do Google Image searches--I want to always remember that my writing is most true and worthwhile when it is written by someone who is a zinester, a blogger, a guy who writes because writing is worth doing.