I confess, I’ve had work done.
All things considered, my world was pretty wonderful in the late 1990’s to early 2000’s. I was thirty-something, HIV-positive but healthy for more than a decade, and in a seriously splendid relationship with my partner Will. Our life together was full of love and creativity.
Among the many things that we had in common, was a shared passion for creating live theatre. In spite of our day jobs, we both managed to find time to take on a variety of artistic projects in a number of the small, equity-waiver venues that were scattered across Los Angeles. Sometimes together and sometimes on our own. And between the two of us, we were willing to do just about every kind of work that was available in these intimate performance spaces: acting, writing, designing, directing, set construction, stage management, and producing. And sometimes all at once. We were the west coast, bargain basement, gay, Y2K version of Lunt and Fontanne. Sort of. All the while, of course, we knew that AIDS was waiting in the wings. And with each passing performance, we watched far too many of the vibrant lights in our company fade to black.
On one warm summer day during this time, Will and I headed out to the valley to spend a weekend afternoon relaxing by a friend’s pool. Just for the record, sunbathing in a Speedo with a bunch of gay men was still a little outside of my comfort zone. I spent plenty of time at the gym, of course, so I was relatively confident showing off certain parts of my body. Specifically, those above my waistline. I recall, however, feeling a tad self-conscious about some of the less impressive contours of my lower physique. I was given an opportunity to address that insecurity head on some months later when Will cast me in a show that he was directing. The role I was given would require me to go full frontal. The reviews of my stripped-down performance in that play were less than kind, but the experience was undeniably liberating.
So, there I was, sitting on the steps in the shallow end, with the modest contents of my formfitting swimsuit stealthily submerged just below the water line, when Will swam over to chat. During that conversation, he casually mentioned to me that our friend Gary had recently been to a doctor who treated his facial wasting.
“It made a big difference,” Will said.
Facial wasting, or lipoatrophy, is a loss of subcutaneous fat in the face, primarily in the cheeks and temples. It was one of the many unfortunate side effects caused by some of the early drug therapies that were being used to slow the progression of HIV into full-blown AIDS. A person’s otherwise energetic and upbeat appearance was often belied by an unmistakably gaunt visage. Back then, the telltale skeletal expressions on the faces of a growing number of men in our community seemed to eerily foreshadow where many of us were headed.
At first, I thought Will’s report about Gary’s visit to the dermatologist was simply idle, poolside chatter. After all, I had known for some time that Gary was HIV-positive, so that was not news. But as it turned out, there was a bit more intention in Will’s revelation. And what he said next caught me by complete surprise.
“Maybe you could ask Gary for the name of his dermatologist,” Will nonchalantly added.
What?! It hadn’t even occurred to me. Was my appearance publicizing my HIV status? How could I not have noticed? In spite of my cheerful smile, was the sad truth of my disease already evident on my face? Sunken and hollow for all to see? The thought was mortifying.
I knew in that moment, as I know now, that Will never intended to be anything other than supportive and caring. After all, this man loved me. He loved me more than anyone had ever loved me before. In fact, when we first moved in together, Will wallpapered our bedroom to match the color of my eyes. Wallpaper that he created and painted himself just to be sure that the unique shade of dusty green was exactly right. Which it was. And I loved him.
As soon as I could find a towel, dry myself off, and make my way to a mirror, I looked. And it was true. How had I not noticed? The striking Katharine Hepburn cheekbones that I had always dreamed of having were finally exposed. Revealing to the entire world the last thing that I wanted anyone to know about me. I was one of the infected. Suddenly, the concern I’d had about sporting a less than impressive bulge in a pair of tight Speedos at a gay pool party seemed like awfully small potatoes. Shameless pun intended.
Ashwagandha This has been employed for quite some time and buy cipla viagra guarantee to be with us as long as individuals need recuperating. best prices for cialis check out address now Adrenal imbalance can be corrected by taking a regulated amount of ashwagandha. Cyclic guanosine monophosphate increases the blood levitra professional supply to the penile tissues. An ED assumed a prime menace for cost viagra amerikabulteni.com the male reproductive task, which makes them fall short to enjoy their sexual life.Needless to say, I made an appointment with Gary’s dermatologist right away.
Once again, I was one of the fortunate ones. Not only did I have health insurance, but it turned out that the rather expensive treatment for my facial wasting was almost fully covered. At the time, it was considered reconstructive. A medical procedure to correct a disfigurement. The process used by my doctor to hide the ravages of HIV on my face consisted of multiple injections of small drops of liquid silicone under the skin around my cheeks and temples. With the consistency of motor oil, when injected into the skin, liquid silicone causes the body to surround the foreign material with collagen. The new collagen, in turn, bulks up the skin; filling in unwanted lines and hollows. My doctor described it as something akin to subcutaneous scar tissue that creates tiny, permanent implants. After the injections, I was instructed to sleep sitting up for a few nights, and to keep any external pressure off of my face, while the silicone droplets were allowed time to set. Needless to say, a handful of restless nights was certainly a small price to pay for a disguise that would slyly mask, what was then, an ugly, shameful secret.
I had four or five of these treatments over the course of a couple of years, as my doctor worked to get things just right. In the intervening decades, there has been some controversy surrounding the use of silicone in the type of procedure that I had. A small percentage of patients experienced painful and dangerous side effects in the days, months, and even years following their silicone injections. Things like irregular swelling, silicone migration, and permanent scars or lumps. Thankfully, I never had any adverse reactions.
Well, almost never. Although it may seem benign compared to some of the above-mentioned complications, I do have one recurring side effect from the restorative work that I had done. It flares up only occasionally. I have self-diagnosed and labeled these intermittent, psychological episodes as “reflective despair” and noticed that they can manifest in a variety of ways.
First, they come as moments of sadness, when I find myself looking too long into a mirror and too closely considering the shape and contour of my aging face. Speculating how I might appear if I were not altered; first by my disease, and then again by the subsequent procedure I went through to cover up the telltale distortion. Silly perhaps, but still, sometimes when I see myself, I begin to imagine what my face might really be if it weren’t for HIV.
Second, and perhaps more disconcerting, my reflective despair sometimes causes feelings of regret. Perhaps triggered by passing a gaunt looking stranger on the street, I suddenly begin to question whether or not that corrective procedure took more from me than I bargained for. What if that drawn and haunted expression that I was so eager to lose was really a sign of strength? Not something ugly and shameful, but rather evidence of what I had been able to endure. Was it proof of my courage? An unmistakable indication of my fighting spirit? And, if so, was I wrong to want to cover it up?
Finally, there is confusion. Usually, this type of episode is brought on by some old, forgotten photograph. Some snapshot taken of me after my HIV diagnosis, but before that day in the pool when Will called my attention to the sad story carved across my face. Me in the trenches as it were. For example, a picture I recently stumbled across of me at my niece’s wedding a couple of decades ago. In it, I am wearing a crisp, white, button-down shirt, and my signature, closed-mouth, down-turned smile – the one that I mastered to hide my crooked teeth whenever a camera was pointed in my direction. In that photo, I am also sporting sunken temples, hollow cheeks, and a couple of woeful divots on either side of my nose. Looking now at pictures from that period, it is difficult to believe that my facial wasting had to be pointed out to me. It is also interesting to note that no one before Will had ever mentioned the change in my appearance. Even at a large family gathering. Like a wedding. A crowded affair full of the people who knew me best. I have no recollection of anyone asking about, or commenting on, my appearance. Perhaps, like me, they honestly did not notice the change. Or maybe they did see it and simply felt that it was more caring not to bring it up. In any case, in that circumstance, I now consider their silence as evidence that my family has been, and always will be, a safe and loving harbor.
You see, as it turns out, my reflective despair is a more complex side effect than one might initially think.
As the years continue to pass, my bouts of reflective despair have become more infrequent. And I have made peace with the face that I have. The parts of it that are naturally mine, and the parts of it that have been cosmetically modified to hide the evidence of my dormant disease. Lately, however, as the physical evidence of my advancing age continues to emerge, I find myself facing a similar side effect related to the very normal process of growing older. And again, I am psychologically conflicted. I would like to gracefully embrace the natural evolution of my appearance. After all, they are changes brought on by a miraculous gift that I have been given. A protracted existence. Like many of us, however, I find that grey hair and crow’s feet prey on my vanity. So, sometimes I dye my hair, and, when my budget allows, I dabble in Botox. And always afterword, when I look in the mirror, I am slightly mournful for the authentic me that I have intentionally worked to hide beneath an altered surface. A life-worn soldier. Buried. He, like all of us in our own way, who so valiantly earned every blanched strand and each shadowy wrinkle.
Yes. It’s so complicated.
At the end of the day, however, regardless of whatever may or may not be easily discernable when I look into a mirror, I am comforted by the constant, hopeful light in the eyes that are always gazing back at me. Unchanging. A dazzling, dusty green. Like torn, brown, paper bags smeared with pigments of green and gold. Inspired by love and artfully applied to an otherwise unremarkable surface. In a process not meant to cover up, but rather to proclaim. To share. To celebrate. Love, yes. And so much more. Everything.