Friday, October 05, 2007

The Gifts of the Body

I just consumed a book that is now on my short list, The Gifts of the Body by Rebecca Brown. I already blogged briefly about The Last Time I Saw You by the same author which I also loved, but The Gifts of the Body pulls the social worker strings in me. It goes back to the essential. The narrator is a home-care worker who assists people living with and dying of AIDS. The writing style is very simple. She describes moving people's bodies over to change sheets, sounding upbeat no matter what decline and disintegration the narrator is witnessing, the narrators loss and reacquisition of hope through mourning.

I was drawn to this book. I have always considered myself what we call in my field a mezzo (groups and families) and macro (larger systems such as administration and policy) systems social worker. But this book appeared at a time that I have been craving direct micro contact with the reason I do the work I do. There have been days recently that I have considered volunteering at a homeless shelter serving food or working at a hospice. The simple act of receiving through being present and giving is what I yearn for and what this book describes. In some ways, it is so different from The Last Time I Saw You, which is mostly about failed or screwed up from the beginning relationships, but the two books are similar in the fact that they are real and visceral. Plus, The Gifts of the Body gets us to the heart of the reason why finding ways to prolong the lives of those suffering with HIV/AIDS is not enough.

In the middle of my reading, at the Seattle-Tacoma International airport, a long haired bearded young man with a baseball cap on which was written Alaska started talking to me. He told me about a trip he took hitchhiking around the southern portion of Africa and how he traveled for months with an inflammed gum because he was afraid to have his wisdom tooth pulled in an AIDS stricken land. And while I rambled on about the Bush administration's abstinence policies regarding sexual health services to sex workers and monogomous married women, he described the people he met that were probably no longer alive...

Micro versus macro all over again.

5 comments:

frida said...

You know - after four years working on policy issues I came to Afghanistan and now work on individual cases and community responses. I think that I will always probably switch from one end of that spectrum to the other and I think if you feel the need for the one-to-one contact then you should trust that need and follow it in some way.

Love your recent postacrds!

Wendy said...

wow, m, this book really strikes a chord with me. i worked in an infectious disease practice for 4 years after losing a dear friend to a rare form of KS http://www.who.int/hiv/topics/prophylaxis/en/
that presented as what he thought was a sty in his eye. i remember the avalanche of events quite clearly...i can still feel the words that came out of my mouth, "i don't think that is a sty, please please go to the doctor". it consumed him in just a few short months. in the course of 4 years i witnessed the suffering and the fall of many people. i've also witnessed discoveries in the understanding of the disease and course of treatment. eventually however, the job became too painful...so i moved into family medicine.

there were a few things that i found altogether shocking:
1. the large number of patients who admitted to practice promiscuous unsafe sex regardless of data.
2. the large number of patients who continued to practice promiscuous unsafe sex regardless of data because they were already infected.
3. AND the fact the a public post exposure program (PEP) could save a LOT of lives, but to my knowledge this policy only exists among health care workers. http://www.who.int/hiv/topics/prophylaxis/en/
4. in addition there is a test that is more specific than the standard hiv test which only tests for antibodies post exposure to the virus which can take a body up to 6 months to produce...this test is called an ultra sensitive viral load and it test for the presence of actual virus and can detect as little as 50 viral copies per ml. this test is very expensive (at the time i was working in ID it was approx $1500) so doctors only use this test for monitoring of the virus post infection as it is a good way to make sure the medications are working and the virus isn't multiplying or becoming resistant. Still, I could see quite clearly how this test can be used to see if a person has become infected and to start early, rapid intervention rather than waiting for the virus to replicate and the body and a positive antibody test.
http://www.thebody.com/content/art32328.html

i'll get off my soap box now, but i just had to say something because your post brought back a flood of memories....of faces gone, but not forgotten.

i remember you:

- my dear friend who called everyone "blanche dahling", who made me laugh so much my face hurt.

- i remember you, our first patient who was diagnosed before the disease even had a name and how the entire area was decontaminated when you left. i remember how confused you were because the disease had already manifested itself as what is commonly known as dementia. Perhaps it was better that you didn't know what was happening.

- i remember sweet c.d. who fought so hard to live and i remember his heartbroken, loving and healthy partner who shortly thereafter died mysteriously in his sleep. everyone thought it was suicide but his autopsy came up clean.

- i remember the young mother who contracted hiv from her first and only partner.

i remember you all.

margaret said...

Wow, Wendy. I had no idea. Are you a nurse? If you would like to read the book I can send it to you. I have your address :)

Wendy said...

well, m, i worked as an MA (medical asst) since i was about 20 years old in a variety of practice specialties. i chose this vocation at a young age because i liked playing a part in wellness, but i also wanted to have enough time for the thing i'm most passionate about - art. (no crazy shifts, no work to take home, no pagers, on calls, etc etc) it's not a very lucrative career choice, but money has little to do with my happiness.

until recently i've alway worked two jobs, as an MA and artist. now that i am a stay at home mom and have learned that motherhood is like three full time jobs and i have to be diligent in order to find time for creativity.

thank you for your offer re: the book, but having worn similar shoes as the author, i'm afraid her experience will bring back some painful memories. thank you, though.

much love,
w

Lingual X said...

Hey there,

I love this book; I'm so glad that it resonated with you. I think it's one of the more important books written about HIV/AIDS specifically because it analyzes the micro--and that (I think) is one of the ways to effect social change. We have to make people care about things.

LX