“Dr. Beall, can you do something about that patient, the strange one? She’s giving us a hard time,” Phyllis barked over the intercom from the front desk. She was fuming. She was busy and found it difficult to deal with disruptions in the routine of the HIV/AIDS clinic.
“Do you mean Lavinia?” I asked. “She’s Doris’ patient, and Doris will see her, or him, as soon as she’s finished with what she’s doing.”
“Oh, no I won’t.” Doris looked up from the desk. “I’ve got to fill out all of these forms for Armando and get him admitted to hospital. You better see her. If I know Lavinia, she’ll cause a riot if she has to wait half an hour. Besides, she never does anything I suggest anyway.”
My aggrieved look was not acknowledged by Doris, who returned to her papers.
I gave up. “Okay, Phyllis, I’ll see her in Room 10.”
As I walked into Room 10, it struck me that Lavinia Hughes was the most flagrant transsexual that I had yet encountered. He (I had this hangup about referring to transsexuals as she, as they requested) was just short of six feet tall. Her mini-skirt and stiletto heels emphasized her smooth long, bare, black legs. The similitude to nudity was enhanced by a low cut, red rayon blouse exposing her shoulders and a large portion of her estrogen and silicone-enhanced breasts. Her large lips were vividly set off with abundant purple lipstick. Dramatic eye makeup was surmounted by an outrageous red wig.
I took a deep breath. “So, Lavinia, have you finally decided to do something about your HIV? It says on this chart that you found out you were HIV positive two years go. Your T cells are now 120, low enough so that you should be receiving antiviral drugs to treat your virus.”
“Look Doc, I been waitin’ out there with that riff-raff for twenty minutes before your dumb-ass nurse let me in to see you. I don’t need no lecture. I jus’ need to get my shit done and get outta here. I just ain’t got the time to wait around in this dumb clinic.”
“Well, you’re here now. Did you come to start treatment? Do you have the time now?”
“Nah, that’s what I’m tellin’ you. I jus’ come to get my bus pass so I can move around town. I need to get goin’ to my work.”
“What kind of work?”
“Oh, this and that.”
I had heard this before, so I said, “Lavinia, Carol, your social worker, believes that you’re working the streets. You’ve got HIV. You can’t continue to go out having unsafe sex.”
“Oh, Doc. What you talkin’ ‘bout? I done with all that, Doc. That Carol, she tryin’ to tell me doin’ stuff is a ‘criminal act’. Now what kind of crap is that for her to be handin’ out?” Anyways, I’m workin’ McDonalds now.”
I realized I wasn’t going to get anywhere with this discussion, so I changed the subject back to HIV. “You need treatment. When will you have time to do some tests and get the information you need to start? You’re going to get pneumonia or a brain infection pretty soon, if you don’t do something to take care of yourself.”
“Look, I ain’t sick and them drugs you give people make them sick. I think your tests are wrong. There’s nothin’ wrong with me.”
“The tests don’t lie, Lavinia. You need to start the treatment process.”
Lavinia rolled her eyes, “Soon, soon, Doc. Just sign this here form so I can get the bus back here.”
This was at least the fourth time I’d had this conversation or a version of it with Lavinia. Her denial of illness and distrust of white doctors, including me, had not been shaken by me or by Doris, an African-American Nurse Practitioner.
I signed the form, sent Lavinia to the front desk, and called Phyllis. “When Lavinia comes back up there, make her an appointment for lab work, x-ray and a visit two weeks from now.”
“Okay, but she’s not here yet.” After a pause, Phyllis added, “Dr. Beall, one of these sales guys has just showed up out here. Will you tell him the rules?”
I stepped into the waiting room to see a thin white man with a scruffy beard and long hair wearing T-shirt and jeans, carrying around several large bunches of red roses. He was talking to the small group of patients in the waiting room, “Valentine’s day Thursday, get some roses for your sweetie, only ten bucks.”
I was upset and told him, “Look, fellow, this is a hospital clinic, no sales or salesmen allowed here.”
“Whaddya mean? It’s a free country isn’t it?”
“That’s the rules. You need to leave now or I’ll call security and have them escort you out.”
“Okay, okay. Jeez, you’re an uptight jerk. Fuckin’ doctors, think they’re God,” he muttered. “Can I just use your bathroom first?”
“Okay, go ahead and then leave,” I told him as I went back to the treatment area.
Three hours later, Doris dropped into a chair in the common room next to Phyllis. “Damn, what a long clinic. I’m pooped. Are we done yet? What did you do with Lavinia, Dr. Beall?”
“Signed her goddamn bus pass was all. She refused any tests and said she’s coming back, but I doubt it. Phyllis, did you give Lavinia another appointment.”
“She never stopped at the desk. She just waltzed through with that big bunch of roses.”
‘Roses? You mean from that salesman I kicked out?”
“I guess. He didn’t leave right away after you talked to him. He was still around for a while.”
“What in hell did you guys do in Room 10?” The question came from Grace Pedoria in the hall. “I went in there to do some cleaning and found a big mess like there was an orgy in there.”
“An orgy? Come on, Grace, be real.” Doris laughed
“I’m not kidding. The linen is all messed up and there’s purple lipstick stuff and wet spots everywhere.”
“Any rose petals?” I asked.
“Yeah, maybe a few.”
“Are you serious?” Phyllis turned to me, ”Do you think Lavinia did that rose salesman…..?”
The bell on the desk clanged urgently, summoning Phyllis, and the rest of us, back to her station. The rose salesman stood at the counter shouting, “Some jerk outside told me this is a fuckin’ AIDS clinic. Is that right?” Phyllis nodded assent and started to speak, but her reply was cut off by his continued fury. “That’s terrible, I’m going to sue you jerks for everything. You’ve exposed me to that homo’s disease. Wait until I get a lawyer. Who runs this place?”
Phyllis looked at him levelly and suggested, “If Lavinia did what I think she did for you, don’t bother with the lawyer, but get an HIV test in a couple of weeks. Don’t bring roses. We don’t charge for the test.”