Bleeder: A Memoir


Bleeder: A Memoir
by Shelby Smoak
Michigan State University Press

Reviewed by Sally Hessney


The pacing of Shelby Smoak’s poignant memoir Bleeder is as measured as a heartbeat. He marks the passage of time with almost metronomic regularity. The month and year are recorded at the start of each chapter, and the book thrums with lyrical descriptions of the progression of the seasons. Taking place in North Carolina, the coastal imagery in Bleeder contributes to the book’s overall cadence. Tidal forces exert an almost imperceptible pull on the reader’s imagination, establishing a rhythm that underscores the staggering importance of time and the role it plays in the author’s narrative. When the book opens, Shelby Smoak introduces himself as an eighteen-year-old hemophiliac who has just learned he is HIV-positive. The year is 1990.

Abnormally low levels of clotting factors in the blood put hemophiliacs at risk for excessive or prolonged bleeding. Shelby Smoak was born in the early 1970s when the advent of clotting factor products radically changed the lives of hemophiliacs. They could now lead independent lives, giving themselves regular transfusions of clotting factors by injection. School, work, play—there was no downtime anymore, no delays in treatment. The condition was treatable, and life became manageable for hemophiliacs and their families. A medical breakthrough gave hemophiliacs a normal life expectancy, and a medical calamity made it so that nearly half of them had contracted HIV from tainted blood products by the mid-1980s. Impossible to pinpoint, it is likely Shelby became infected with HIV in the early eighties before a screening test became available, before he had even turned twelve.

In Bleeder, Shelby Smoak chronicles his life as a young man—he goes to college, falls in and out of love, lands his first real job, struggles with credit card debt, moves back in with his folks, puts in an obligatory stint as a bookseller at Barnes & Noble—all of which will seem achingly familiar to anyone who came of age in the 1990s. But Shelby is literally in a race against time because of his deteriorating health. The antiretroviral drug AZT gives him headaches while inducing nonstop vomiting, and his decision to stop taking it cheats him of time he doesn’t have to spare.

The Food and Drug Administration is on the verge of approving protease inhibitors, but, in the meanwhile, Shelby loses weight and becomes increasingly fatigued. At the confluence of Cape Fear River and the Atlantic Ocean, he sits on a pier at night watching the “black, outgoing tide,” which he sees as a metaphor for his ebbing health. He develops thrush. His T-cell count drops while his viral load increases. He ages out of being covered by his parent’s insurance, yet his HIV status threatens his ability to hold down a job as a teacher’s assistant at an elementary school. One year slides inexorably into the next, but the urgency mounts, and all of the clichés about the nature of time clamor to be heard in the reader’s head, creating dissonance and dramatic tension between hope and despair. In the final pages of his heartrending memoir Bleeder, Shelby Smoak concludes, “I consider how my life has depended so much on timing. My factor invented the same year I was born, that’s timing. My health falling in dangerous decline just when protease inhibitors and cocktail therapies swooped in to sustain me, that’s timing.”

Sally Hessney is a program assistant at a nonprofit organization, where one of the educational missions is to educate teenagers about the dangers of binge drinking, prescription drug abuse, distracted driving, STDs, and other consequential issues.