Doctor, Patient, Survivor
Andrew Faulk, MD, Talks to A&U’s Raymond Luczak About the Early Days of the Pandemic
When I read an advance copy of Andrew M. Faulk’s new book My Epidemic: An AIDS Memoir of One Man’s Struggle as Doctor, Patient and Survivor (Culbertson Publishing), I knew I had to learn more about Andrew.
Raymond Luczak: What drew you to medicine?
Andrew Faulk: I was a kid who had lots of animals growing up. I’m not sure how that propels one into medicine, but if you look at photos of me from then, I’m often with hurt animals. Everybody says they wanted to help people, and I wanted that, but I wanted more. I wanted to make a difference in people’s lives. And mixed into that was the drive to be necessary. I wanted what I did to be necessary. And I believed that in almost any other career I wouldn’t be necessary.
What was your reaction to seeing your first HIV-positive patients? What were your thoughts at the time?
In 1984, at the beginning of my internship in San Francisco, several men with AIDS were put under my care. There was still much fear at that time concerning treating AIDS patients, but, for whatever reason, I wasn’t terribly afraid——although I did find being coughed on disturbing. My initial theory was that it was due to poppers (amyl- and butyl-nitrate) and/or fisting. But even as I discussed these theories with colleagues and gay friends in New York, I had the nagging feeling that we were kidding ourselves. The only things we were identifying at that time were Pneumocystis pneumonia and Kaposi’s sarcoma. I didn’t think the two were related. I felt that the Kaposi’s sarcoma was just an uptick in a disease normally experienced in older Mediterranean men. But the PCP really was a mystery. Legionnaire’s Disease, identified in1976, proved that new infectious diseases were still being identified. So initially I felt that PCP was possibly airborne, but more likely to be due to chemicals and injury to the colon. That it created disease in a vulnerable subsegment of the population——like gay guys who were into poppers and/or fisting.
You learned that you were HIV-positive. How did that affect your identity as a doctor in those days?
By the time I learned I was HIV-positive, at the beginning of my first year of residency, much, much more about the disease had been learned. And after training was finished, I looked ahead to a career in medicine that would always be demanding.
Learning I was HIV-positive affected my identity in two ways: the first was the realization that I would die soon and that the further barrage of stress and long hours were probably pointless. Like many in medicine, my life was all about delayed gratification. But being HIV-positive meant that there would be a staggering workload before an illness and death which would almost certainly be soon.
Secondly, it led to a schizophrenia in perspectives and roles. I could no longer be the dispassionate doctor examining, diagnosing and reporting on patients. Suddenly I was intimately sharing in patient perspectives of illnesses, medications and prognoses. And this destruction of the psychological wall between patient and physician bled into those with other non-AIDS related illnesses.
But the schizophrenia also meant I had to make diagnoses and recommendations outside of any emotionally-influenced identification with my patients. Doctors should never treat family and friends because such a corrupted perspective can influence both diagnoses and therapies. Suddenly I was both doctor and patient——with all the distortion in medical perspective that can bring. I had to, consciously, separate the two and behave as a physician.
What prompted you to write My Epidemic?
For many years these various stories and philosophies rattled around in my head. But for years after I left medicine, I mistakenly assumed that if I couldn’t give answers I had nothing to say——that the telling of my story was only valid if it could calm horror, manage sorrow or allay physical pain. Slowly I began to see a truth that many had realized before me: our individual histories were actually rich in solace and hope. I began to realize that simple words strung together could have the ability to provide relief. I also realized that as time progressed, although mapped so well by other authors, the history of this time of terror and loss was slowly being forgotten by society——both straight and gay. During the worst of the epidemic, I assumed that those days would never, ever be forgotten. I realize that that wasn’t necessarily true, so I wrote to archive my history as an HIV-physician before it could be lost.
As an HIV survivor, you must have thoughts about how HIV is regarded in the gay community. Is it for the better, or has it gotten for the worse?
How the gay community thinks about HIV is one of the most compelling reasons why I wrote My Epidemic. It seems to me that my younger gay brothers have occasionally trivialized the destruction of my generation. I can easily see how it might be difficult to imagine the grim stories and overwhelming pain of those days. Most people don’t want to hear about sadness; but they’re inadvertently missing the courage, sacrifice, and emotional depth of their gay brothers of that time. And, let’s face it, we’re talking about a generation who is not only gone, but is silent in its absence. On the other hand, it’s terrific that our community has so completely embraced PrEP. Although the details of the epidemic may have been lost, it’s left a residue of caution. Unfortunately the gift of PrEP has unleashed something of a reckless attitude in some which has led to unprotected sex and another epidemic——this one of the more routine, but treatable, STDs such as gonorrhea and syphilis.
Raymond Luczak is the author and editor of over twenty books. His latest titles are Flannelwood (Red Hen Press), the anthology Lovejets: Queer Male Poets on 200 Years of Walt Whitman (Squares & Rebels), The Kinda Fella I Am (Reclamation Press), A Babble of Objects (Fomite Press), and The Last Deaf Club in America (Handtype Press) He was previously the editor of the queer fiction journals Jonathan and Callisto. A ten-time Pushcart Prize nominee, he lives in Minneapolis, Minnesota. Visit his website at: raymondluczak.com.