Heart to Heart

2010: Short Breath. Fatigue.
It’s early on a Sunday morning in January of 2010. I sit on the edge of the bed, already dressed, with my hand on my partner’s foot as he sleeps. The night before, I couldn’t catch my breath, and I told myself that if I felt the same in the morning, I’d go to the hospital. I feel the same. My lungs are constricted. I pause a moment before waking my partner. I know that going to the ER means saying that this is real, this is an emergency. I thought it would all go away if I just waited. But it hasn’t, so I wake him up and say we need to go, and we do. 

Heartbeats
The lines about breathing are what first draw me to Melvin Dixon’s “Heartbeats”:

Mouth wide. Drink this.
Breathe in. Breathe out.

No air. Breathe in.
Breathe in. No air.

The poem, included in Dixon’s posthumous collection Love’s Instruments (1995), comprises 20 couplets of four-beat lines that enact the regular rhythm of a heartbeat. 

2010: Short Breath. Fatigue.
“I thought I was looking at 1985,” Dr. R tells me. He’s just one of many doctors trying to put me back together. I don’t have tuberculosis, they say, but my lungs have collapsed. I have a severe case of pneumocystis pneumonia brought on by an advanced HIV infection. By the time Dr. R comes on the scene, I’ve been moved from the ICU and into a telemetry unit bed in a suburban Virginia hospital. I’ll stay there for a little over a month, until my HIV infection stabilizes and my CD4 count rises. Thirty days of Bactrim treatment will knock out the pneumonia and the thrush down my throat. It’s a month of snowstorms, power outages, family visits, recovery. 

Heartbeats
“One way to trace a lineage is genealogy. Our queer genealogy is not who gave birth to whom, but what books gave birth to what poets, what books opened space in the world for new ways to live and think and love,” the poet Julie Enszer writes. This was certainly my experience coming of age, and coming out, in the pre-internet 1980s. Books taught me what it meant to be gay. As a 15-year-old sophomore at an all-boys Catholic school in Pittsburgh, I shoplifted Drummer magazines and highlighted the gay sex scenes in Judith Krantz’s novel Scruples. I studied the chapter on homosexuality in Everything You Always Wanted to Know About Sex (but Were Afraid to Ask). Sometimes, I learned as much from what was between the lines in books by Armistead Maupin and Ethan Mordden as I did by what was made explicit. 

In 2010, as a 40-year-old man newly diagnosed with HIV, I searched again for texts that could teach me how to live. I returned to books I had read 25 years earlier to see if they were different now. I reread David Feinberg’s Eighty-Sixed and Tony Kushner’s Angels in America. I read The Man with Night Sweats, by Thom Gunn. I read Persistent Voices: Poetry by Writers Lost to AIDS. I read A Fast Life: The Collected Poems of Tim Dlugos. And I re-watched Longtime Companion, And the Band Played On, Love! Valour! Compassion! I don’t know what I was looking for—a road map or a guidebook, something to relieve the crushing disappointment I felt in myself for somehow surviving the ’80s only to become HIV positive now. I can’t help but feel that all the writers and activists who lost their lives would be very angry with me. After all their marching and testing, the demonstrations, the testing, the quilting, the funerals, the testing, the testing, the testing, I feel I’ve made the ultimate mistake, a fundamental betrayal. I search online for more poems from men who’ve been where I am now, and I find “Heartbeats.” The name Dixon is the name of the road my father grew up on, and so, of course, I read the poem.

White Rooms
In “Heartbeats,” the speaker sometimes talks about the body: “Sore throat. Long flu.” At other times, he seems to address himself as a body: “Mouth wide. Drink this.” Sometimes, he addresses the body directly: “Sweet heart. Don’t stop.” These shifting perspectives, the way the poem moves from describing the body to directing it, echoes how I think of myself in that hospital room. I’m estranged from myself. The doctors are careful to speak about “the infection” or “the lungs,” as if neither belongs to me. My body belongs to doctors and nurses. My body is someone’s daily checklist: pulse, blood pressure, oxygen levels, the measurements of the tube draining my chest. Even the infection makes me split hairs. My body is infected with HIV—does that mean I’m infected with HIV? Maybe I’m just a passenger in this infected body. Dixon’s lines come back to me:

Black out. White rooms.
Head hot. Feet cold.

No work. Eat right.
CAT scan. Chin up.

Get Mad. Fight Back.
Dixon, a gay Black man, was a novelist and poet born in 1950 in Stamford, Connecticut. He had a bachelor’s degree from Wesleyan and a doctorate from Brown. He taught English at Queens College. I find an interview he did with Callaloo in New York City on January 6, 1992, about nine months before he died from AIDS-related complications. In the interview, he says, 

Every time I always say, “Well, this is the last poem that I’m going to write on this subject,” of course, it never ends; life deals you another set of circumstances that you have to respond to. …

When I read “Heartbeats,” I am in and out of doctors’ offices. My chest still has tubes hanging out of it to keep my lungs from collapsing. The steady drumbeat of the poem reminds me of my own beating heart. It’s a keen reenactment of the almost frantic self-consciousness that accompanies my diagnosis. 

2010: Short Breath. Fatigue.
In the hospital, doctors talk to me about my body and my infection using words I don’t know. The words have implications I can’t grasp. I feel dumb asking the doctors to explain. They probably think I should know all about AIDS and HIV, being a 40-year-old gay man. I repeat the unfamiliar words over and over in my head and then look them up on my phone after the doctors leave. Hypoxia is one word I learn. When I pair that with blebs, I learn something else. I learn bilateral pneumothoraces. It’s a slow, piecemeal process similar to how, as a kid, I looked at pictures of male anatomy and then later heard the word homosexual before I finally put the two together. 

At night, in my hospital bed, I scour the internet for information about my collapsed lungs; about my HIV-1 RNA Quantification 3,140,000 copies/mL; about my CD4 (helper cells) 62 cells/ µL; about what the words pneumocystis carinii and candida mean. The hospital still uses the term AIDS interchangeably with the new HIV positive/symptomatic. I keep asking about the difference between HIV and AIDS, but the nurses avoid my questions. I look up advice for people with HIV. I self-diagnose using WebMD. I’m convinced I can do a better job than these doctors. (I cannot.) One night, I look up “how not to cry.” I think of a line from Dixon’s poem:

Don’t cry. Take charge. 

Eat Right. Rest Well.
My little sister, Jordan, road trips from Pittsburgh a lot to see me at the hospital. On one of her early visits, she leaves behind a gift: a brown bag of clementines. After almost two weeks of not eating, my appetite returns, and the first thing I have is a clementine. My mouth is so pasty that the vivid orange flavor explodes, and I eat half the bag. A few days later, my mouth breaks out in sores. The doctors give me this stuff called magic mouthwash. It numbs my mouth and soothes the sores, at least for a little while. Once the HIV meds start to work, my immune system wakes up—Immune Reconstitution Syndrome, it’s called. The sores may be from that or from too much citric acid—no one can tell me. They don’t give out a lot of information here. One night, a nurse changes the bag hanging from my IV rack. She pulls off a sticker and misses the garbage can when she tosses it away. After she leaves, I ache over the edge of the bed and grab it. I slide the sticker under my pillow. My sister is a physician assistant. I save the sticker so she can tell me what they’re giving me. All I know is that my body is restarting, like an old car slowly turning over. 

What the Heart Says 
Another time, I ask Jordan why, with all the technology we have, doctors still listen with their ears to the sound of my heart beating. It seems like such an antiquated ritual. She tells me this:

I never really thought about how basic a tool it is, listening to the heart. There’s really a lot you can determine, though, at least clues that will send you down other paths of more invasive tests. Rate, rhythm, and regularity are the three big pieces of info you gather. And murmurs. The heart has the electrical parts in charge of firing off beats (rate and rhythm) and the mechanical parts, like valves, that can cause murmurs. After years of listening, you get a sense of rates without even having to look at a clock or watch to count beats per minute. Rhythms are next. They should be like a two-step, sort of one-two, one-two, one-two. Not like a metronome. Occasionally, you get a regularly irregular beat, like one-two-three, one-two-three. Those are called gallops. A trick they taught us in school for the two types of gallop is, one sounds like the cadence when you say Kentucky and the other sounds like the cadence when you say Tennessee.

Heartbeats
Dixon’s poem has a steadiness, a relentlessness, that’s almost calming. The rhythm of the spondees, like a heartbeat, lulls readers despite the terror of what the narrator says: 

Dress warm. Eat well.
Short breath. Fatigue.

Night sweats. Dry cough.
Loose stools. Weight loss.

The poem is essentially a gay man talking to his body. The mundane mixes with the perilous, and resolve mixes with resignation. And although the beat remains fairly regular, there’s a moment when it’s interrupted:

Today? Tonight?
It waits. For me.

If my sister were listening for an irregularity, this is where she’d find it. The rhythm shifts from spondees to iambs, and that line—“It waits. For me.”—is a single syntactical unit of information broken into two parts. Until this point, the information in each line is connected but loosely. Here, the phrases rely on each other, lean a little more on each other, the way you might put a hand against the wall just to stay standing. I email my first poetry teacher about this because I want to use the right words to talk about what’s happening. My teacher says the line could be called a fractured independent clause. Fractured independence seems about right.

The poem expresses an inner monologue that I thought I alone heard. It’s a voice talking to itself, its body, about breath, about long nights when thoughts of death linger and sleep never arrives. 

How I Wait
While I write this, I come across an article about the poet Li-Young Lee. This text jumps out at me:

Poetry, as Lee sees it, is a stethoscope. You want to hear the heartbeat of  the one you love, he explains, so you place your ear as close as you can— but all that comes through is a muffled thump. You need an intervening  instrument, and you need some space: “Poetry is that perfect distance. It brings a deeper clarity.”

I wonder if it’s OK for me to borrow and repurpose those lines. For my purposes, perhaps the heartbeat belongs to the poet’s own body, and poetry is the intervening instrument necessary to translate the body. I imagine pressing my ear against Dixon’s poem and hearing his rock-steady heart, each line solid, even at its most dire. And as in Dixon’s poem, the steady rhythm of my days is interrupted when I stop to consider my HIV and wonder, Today? Tonight? It waits. For me.

Heartbeats
In his interview with Callaloo, Dixon says, “[S]ometimes writing is a way for me to not only discover an idea, but discover a solution to an idea.” Six months after my CD4 numbers remain above 500, I start trying to make sense of things by writing poems. Much like those winter days back in 2010, I’m still working on the language for the place where I find myself. I transcribe what I seem to hear: this rhythm, and this conversation between my body and myself. I’m caught between what it means to be both healthy and infected—to have survived and still be surviving. 

Don’t Stop
Melvin Dixon died in October of 1992. His New York Times obituary reads in part:

Melvin Dixon, a professor of English at Queens College whose works on African and African-American literature were widely praised, died on Monday at his home in Stamford, Conn. He was 42 years old. Professor Dixon died of complications from AIDS, said his sister, Cynthia Peters, who also lives in Stamford.

In the months before he died, Dixon delivered a speech called “I’ll be Somewhere Listening for My Name.” He closes with these words: “You, then, are charged by the possibility of your good health, by the broadness of your vision, to remember us.” I think he’d also want us to remember that what he bore witness to, and what killed him, isn’t over yet. HIV infections continue, particularly among gay Black men. The Centers for Disease Control (CDC) predicts that one in two African-American gay and bisexual men will be infected with the virus in their lifetime if current rates continue. In 2016, African Americans accounted for 44 percent of HIV diagnoses, according to the CDC. Although medications and treatments have improved, stigma and ignorance remain. We are still living and dying in an age of AIDS. 

Dixon would probably want us to remember something else too. The final words of “Heartbeats”:

Sweet heart. Don’t stop.
Breathe in. Breathe out.