Growing Pains: Part 3

Growing Pains Part 1
Growing Pains Part 2

It was several months before my father could bring my brother home from Italy. He was in Florence with my brother and working with an army of doctors in order to get him the treatment that he needed to be well enough to travel. I heard through my mother that the doctors in Florence were extremely cooperative and he was probably getting better care there than he would have if he was in the states. My father's mission was completed and he got Doug well enough to travel home for the holidays.

I eagerly awaited my brother's return and it consumed my thoughts. I was very happy that he was going to be home with us for the holidays and I was eager to ask him all about his travels since he left. My mother prepared the house for his arrival. His room had become a sort of make shift hospice, an indication that screamed that although he was well enough to travel he wasn't going to be the man that I saw at the airport when he left for Europe the summer before. My father also had communicated to my mother that he wanted the house to be decorated for the holidays for my brother's return. My parents were determined to not let HIV ruin our holiday.

The day arrived that they were coming home. My mother received a call that they had arrived but there had a bit of an accident. I learned from my mother that the skycap that was supposed to be watching my brother in his wheelchair had neglected to lock his wheels. If you have ever been to the airport in Phoenix you know that there are large ramps that lead to the gating areas. My brother's wheelchair had rolled down a ramp and he had fallen out. My father was livid and engaged in some kind of litigation, my mother and I were worried about Doug. My father said he was fine, a few bruises but nothing major. The biggest problem was getting my brother to stop spewing profanity and racial slurs at the skycap.

Finally my father delivered my brother home. I guess I hadn't really prepared myself for the condition that he was going to be in. I expected him to be ill but not this ill. My father rolled my brother in on a wheelchair. The weather was actually cold that winter in Phoenix and he was bundled in a blue wool parka with wooden catches. He was thin, horribly thin, and his once supple cheeks had deflated and his hair was thin. I couldn't tell if the fatigue in his gaze was from the trip or if this was going to be his normal state, he glanced at me for a moment and managed to crack a smile and mumble, "Hi Adam." I almost lost it when I saw him. I couldn't believe what I was seeing. My father wheeled him further into the house and Douglas suddenly started howling in horror. I didn't know what to do but my father remained calm as did my mother. Somehow the managed to soothe him. I would later learn that the HIV had gotten into his brain and he had severe dementia and he would come in and out of consciousness. His screams of horror were because he had visions of doctors surrounding him around a bed while they tried to suffocate him with pillows. I was naive to expect this homecoming to be any better than this and looking back I think the effort of my parents to make this a normal-as-possible christmas were for my benefit more than for the benefit of my brother.

The days leading up to christmas were dreamlike. My other brother Paul had come in from the holidays from New York. This was a novelty as he is a provincial New Yorker and insisted that my parents house in Scottsdale was designed by Mike Brady. My other brother had moved from upstate New York to Scottsdale with his wife in the summer and my sister came from New York as well, all together for what was most likely our last christmas with the whole family. It was the first time since moving to Arizona that my entire family was together for a christmas, I always thought it unfortunate that we have never been able to get together like this again. My parents had overnight become professional nurses. Every morning my mother and father would care for my brother; cleaning him, soothing him, and give him his meds injectables and all. They were relentless in his care, constantly monitoring his every need to make sure that he was comfortable. This is pretty much the only memory I have of my parents from this time in my life. Their devotion was completely focused on the care of my brother. I was still in shock at the state of my brother and I kept myself at a certain distance.

Christmas day arrived and Doug had actually some improvement. His fits of demetia were less frequent and I think the holiday was really making him feel better. We went to church in the morning all together and we returned home to open gifts. My brother and I were sitting next to each other close to the fireplace and he had a bag at his feet from Florence. Everyone else was busying parsing up gifts from under the tree and my mother started to go into the bag at my brothers feet. Doug slapped my mothers hand and proclaimed in one his moments of lucidity, "I'm not that far gone yet." He started pulling out small boxes. Each one of them stamped with addresses on the Ponte Vecchio. None of them were annotated as to who the recipient was to be but he knew the destination of each one with out any problem. Last came mine, he handed it to me and smiled and said, "Like I promised you." I opened the box and inside was a solid 14K gold cross in the Franciscan style on a gold chain. I had asked him before he left in the summer to buy me a gold cross and he promised that he would get it for me. In all his health problems and fits of dementia he remembered he brought for his family from Italy and he remembered a promise he made to me. I held back my tears and for the first time since he came home I gave my brother and hug and a kiss.

One day my parents had to go out and do something I don't know what. They wouldn't be gone for long and they asked me to watch Doug. He had had all of his medications for the day and he and I sat in the family room watching TV. I was sitting near him and he was half paying attention to what was on the screen. Although I had seen my parents do it many times, I was hoping that I wasn't going to have to calm him from a fit of dementia. Doug grabbed his walker and said, "I want to shower." My brother in health and in sickness wanted what he wanted when he wanted it. I tried to convince him to wait for mom and dad to come home before he took a shower but he didn't want to wait. Usually my parents would have Doug shower in their large walk in double headed shower in the master bathroom and so my brother headed that direction shedding clothing along the way. I knew at this point there was no stopping him. I turned the shower on and adjusted the temperature. Doug was shivering and eagerly awaiting his shower. At this point I thought to myself, "How is he going to do this alone? He can barely stand on his own without his walker." I took off my clothes and had him lean on me while I moved his walker into the shower. I then had him grab my forearms with his hands and I acted as his walker until we got into the shower. I didn't have to coerce or verbally lead him in any way, he understood every move I was making and followed my lead. The water started to mat his thinning hair and roll down his thin frail body and he smiled and moaned in delight, "Thats better." I was happy to see that he was enjoying the water. I took some liquid soap in my hand and rubbed it on his back and began washing his body. I was relieved that I was finally able to do something to ease his suffering. At one point in the shower he began to cry and I was worried that he was hurt or was in some discomfort. I was also worried that if he tried to respond he might not be lucid. He turned and looked at me and said, "I'm sorry that I went and got this way. I want to die soon so that you don't have to do this anymore." I rubbed his back slowly and said to him, "Stop talking like that. I thought we were having a nice shower." He slowly stopped sobbing and smiled a bit. We got out of the shower and I dried him off and got him into some comfortable pajamas. When my parents came home I was brushing Doug's damp hair with a soft brush and watching TV. That was a good day.

The situation deteriorated from that point on. It was now January and a very cold and rainy winter in Phoenix. One night I was woke up by the sound of my brother moving from his bedroom into our bathroom. I thought to myself that I should have gotten up to help him but I slipped back into a deep sleep. I was later woken up by the sound of a body falling to the ground followed by howling. I couldn't move. I lay in my bed paralyzed with fear about what I would see if I got up. My parents heard the howling and I heard them wake up screaming my brother's name from across the house. They ran towards h is room and I distinctly remember my mother screaming through tears, "Not yet." My father reached Doug's room his voice trembling and crying. He turned on the lights and from what I heard he saw my brother on the floor where he had fallen. Somehow the sight of my father calmed my brother quickly and he stopped sobbing and my father asked gently, "What happened?" Doug replied with a tinge of accomplishment, "I went to the bathroom by myself." My father told him that was good but next time he should call for him or me next time he wants to do that. My mother was in the hall hysterical and my father assured her he wasn't hurt and that Doug was more scared than anything. I cried myself to sleep after that. I was disappointed with myself that I didn't get up to help my brother when he had fallen, humiliated that I had let my fear of seeing him dead on the floor prevent me from helping him regardless of his cries.

Doug's dementia was getting worse and his health was failing. The last time I saw him it was the morning that he was being moved to the hospital. I was dressed for school and my mother said to me, "Say goodbye to your brother before you leave for school." I realize now that she was really telling me to say goodbye to my brother. I went into his room and there was propped up on his bed while a nurse was doing something at the foot of his bed. He was in a daze and looked exhausted. His eyes indicated that he recognized me and I hugged him and kissed him on the forehead for what would be the last time.

Some weeks passed. My parents were rarely at home, they spent most of their time at the hospital with my brother. When they were home they were constantly on the phone with relatives calling frequently asking about my brother's condition. One such night my dad was on the phone with his sister, my aunt. He was in another room and I heard him cry like I had never heard a person cry ever before in my life. Even to this day when I remember that moment the sound of his cry is so unlike anything I have ever heard. It was then that I realized how much he loved all of us and how much it hurt him to see one of us in so much pain and suffering. Whenever I hear news that a parent has lost a child I think of how my dad cried that night. For me it was difficult to lose my brother but it is inevitable that brothers and sisters might see their siblings die, especially for me being the youngest. No parent should have to endure the torment it is to see one of their children suffer and die before them.

February 2, 1994 I woke up and was shocked to see my sister-in-law in my house at 7am. After I almost soiled myself after seeing her in the hall she explained to me that she had been working (she is a nurse and then was working the night shift) and my parents told her to come to the house after she got off work to check on me. She told me that my parents were at the hospital all night. The day at school seemed a blur. I was quiet and everyone was asking me if I was ok. I didn't know what to say. All of the events of the past two years were weighing too heavy on me. The rejection, my weight, HIV, my brother, my own sexuality. I walked home from me bus stop. I remember as I got close to my house I stared at the vaulted teracotta tile roof. Somehow I knew that my brother had died and for a moment I thought about not going home. For a split second I thought if I didn't go into the house I wouldn't have to hear that he died. I took a deep breath and walked further towards my house, heart pounding I opened the side door. I walked into the house and my entire family was standing in the family room sobbing. My mother came towards me, face covered in tears, grabbed me tight and cried in my ear "Adam....he's gone."

My brother died of respiratory arrest due to complications from AIDS on February 2, 1994. His birthday was October 31st, 1962. He was 32.

I love you Douglas.

(Epilogue to Follow)

Sunday Outing

Overcast today in Dallas but we had to get out of the house and the temperature was just right for taking a walk. We live near the Katy Trail here in Dallas. It was an old rail line that was slated to become a mass transit light-rail line but that idea was shot down by the residents of Highland Park. The rail line was moved to underneath Central Expressway.

Highland Park is a part of a two city "bubble" in Dallas referred to as the Park Cities. HP's sister is University Park. All you need to know is that the people that live there have lots of money, most of Bush's largest donations come from people that live in the Park Cities, and they refer to Nieman Marcus as "The Store." Its quite odd because this ultra-rich, ultra-conservative neighborhood is adjacent to the gayborhood. Its an unholy synergy that results in, my opinion, the most fabulous parts of Dallas.


I digress... The trail is now a paved recreational walkway that allows one to walk, bike, run, rollerblade from downtown Dallas through Uptown and eventually up to Knox-Henderson area. Its a delightful walk and is normally more crowded, especialy with the gays. However, being that last night was the big Halloween block party on the Strip most of the gays were probaly sleeping off their Bud Light-roofie-tina-valium-demerol-percoset-vicodin-Red Bull induced comas. It was nice to have the trail empty this one time though.


Right off the trail at Knox street is the restaurant I commented on in Gastronomic Adventures and Tepid Begininngs, Toulouse. We walked further down Knox street and although we had walked this street many times before we noticed something new this time. There is a furniture store called Weir's. I've always thought it was a front for a twisted religious cult that is involved in the mail order bride trade. Brad has always scoffed at my accusation but today I think he may finally come around to my theory. Outside of the store they have a clock, which is not weird, but if you look at it more closely it says on the face "Jesus Lord & Savior." I guess at Weir's all the time is Jesus time!


We made our way down the street and lunched at Wild About Harry's. This is a great place to get hot dogs and some of the best frozen custard I have ever had. There is a wide range of hot dogs, a fantastic cheesesteak sandwich, and the custard flavors are different everyday as they make it fresh daily. Although I love the food here it's somewhat difficult for me to eat here because the proprietor, Harry, has some crucifixes on the wall and a newspaper clipping from the Dallas Morning News when Reagan died. It's just some obstacles that one must endure when frequenting haunts of the residents of Highland Park. As long as I keep my eyes off of the walls I love the food here.

My Friday Night

Oy! Last night I was at work until about 10:30. There is a big meeting this weekend at the institute where I work and our lab was doing some last minute experiments, analyzing data, and then making it look pretty in Power Point. It was actually kind of fun. My boss is such a great guy. Every hour or so he'd emerge from his office and check on all of us to make sure we were all ok and offer to get us soda, coffee, etc. He bought us pizza at around 9:30 and insisted that we all stop what we were doing and take a break to eat. At the end of the night he was still in his office working and thanked us all for working late on our Friday night.

This is an absolute departure from my previous boss, the evil bitch queen from Brazil. Many times she'd have me stay late with someone to work on some stuff and then leave around 6 and say, "Okay I'm going home. When you get the data email it to me. Call me if you have any questions." No "Thank you for staying late", nothing. I hate her. You can read all about her reign of terror here Thick Animosity and here Emancipation.

While I was at work HM, via her boyfriend, sent me a link to this:

I tried to find out about Shetty Pharmaceuticals but every search led me to Hetracil. Part of me knows this has to be a joke but another part of me realizes that anything is possible in this era of designer pharmaceuticals. Visit the site here. I love how the man is holding a rainbow colored kite and although he is holding his wife's hand he is still not as close to his family as he should be. Now that homosexuality has been cured the government probably wont see a need to fund any more scientific research. I better start looking for a new job.

Uninformed Information

Metroblogging Dallas: What's the deal with Prop 2?



I rarely make two posts in one night but I cannot resist this one. This blogger is so misinformed on this issue that it enraged me greatly that he wrote such a horrid post. Eventhough he prefaced his post with a disclaimer stating that "I’m a pretty disappointing “gay friend” to have when it comes to upholding any sort of gay stereotype, much less being informed on anything that is happening in the “gay news,” but I figured I’d go ahead and check into this one for once, since it is taking place in my own backyard." I think he should have done more homework before making this post.



I had to respond to him with this.



This issue with Prop 2 is not simply defining marriage in the eyes of the law. The real issue behind this proposed amendment is discrimination. Putting it in such reductionist terms would be like saying that the integration of blacks and whites was about everyone being able to drink from the same water fountain. If Prop 2 passes then it will be WRITTEN in the state constitution that same sex marriages are not permitted. This is de facto discrimination, not any different from the Jim Crow laws of years ago.



You also need to know that this measure could put at stake the domestic partner benefits offered by the cities of Dallas and Austin. It could also undermine arrangements that many same sex couples have made for power of attorney. The state already has laws saying that gay marriage cannot be recognized and therefore this amendment would be redundant nonsense; a proverbial bone for the religious base.



I think in light of the recent passing of Rosa Parks it would be a TRAVESTY to allow such a measure to pass. It would certainly be an indication that the spirit of the civil rights movement just may have died with Rosa Parks.



Civil Marriage is a Civil Right! No Nonsense in November VOTE NO AGAINST PROP 2!!!



____________



The most infuriating sentence in his post "Defining marriage is just sparking the debate for me as to how one goes about getting legal documents for all my un-married friends in long-term relationships. But then again, laws get changed." Thats exactly what I imagine a straight person with no insight into how difficult is to be gay in this country would say.

Cameratoss

IMG_1026
Originally uploaded by adpal3180.

Some of you may have heard of the cameratoss. Basically you take your digital camera and toss it up in the air while its taking a picture. I saw many cool examples and I decided to give it a try and this is what I came out with. I didnt actually toss my camera for this. Its far too precious too me so I put the wrist strap on tightly and kinda let it go into a controlled falling motion. Not too bad. I think its great that digital photography is allowing everyone to experiment with all kinds of things whereas a picture like this would have warranted a groan because it was a waste of an exposure on your roll of $5 film.

If you go to flickr you can see tons of them. They're all tagged with "cameratoss."

I'l like to leave you all with this.
DeLay says conservative politics being criminalized. Thats because conservative politics are criminal, DUH!

Tracy Takes on Dallas?

I saw this new reporter on the conglomerate news station here in Dallas last night. Is this Tracy Ullman's newest comic opus?

My Own Private Army

If you don't already know I'm a research scientist here in Dallas. My job focuses on immunological research and some of the areas that I study are cellular therapies to combat autoimmunity (i.e. Lupus, Arthritis) and cellular based cancer vaccines. I thought I'd show you one of the technologies that I use at work on a daily basis. Its called Flow Cytometry, commonly referred to as flow.

Last friday at work I volunteered my blood for an experiment I was running. Although I had used flow many times before, I had never use my blood as a control for an experiment and being the nerd I am I could hardly contain my excitement to see my own blood on the cytometer.



So in order to analyze blood an instrument called a Flow Cytometer is used. Basically it sucks up a blood sample and injects it into a fluid stream that carries the cells in a line one by one to a fixed laser. The cells intercept the laser and scatter the laser light. Big cells, like Monocytes, scatter more light than smaller cells, like Lymphocytes. So the horizontal axis in this graph measures the size of cells. The vertical axis measures the internal complexity of cells, like granularity. Granulocytes have more stuff inside them so they are higher on the vertical axis than Lymphs and Monos. I posted a picture that illustrates this process well. With a flow cytometer I am able to characterize cells in the blood at a rate of 40,000 cells per second.


Okay I know it looks like a bunch of dots but each dot that you see is representative of one of my blood cells. I have circled three populations of cells. Lymphocytes, the one in the lower left corner, are composed of my B Cells (the cells that make antibodies) and my T Cells (Half of these cells kill other cells that are infected with something nasty and the other half helps infected cells kill something that is inside of it. HIV Infects T Cells).

Granulocytes, located kinda above the Lymphs, are also known as Neutrophils. These cells exist solely to eat bacteria and digest them with enzymes. Typically these cells only last about 3 days and I am constantly replenishing them, as you should be yours as well. If I had an infection I'd see a much larger amount of these cells.

Monocytes, on the right, circulate in my blood waiting to be called on. When I get an infection they get signals from other cells at the site of the infection and migrate out of the blood to tissue that is infected at which point they become a Macrophage. They then engulf bacteria or virus, chew it up, migrate to the thymus, and present chewed up nastiness to T Cells or B Cells so that I can have a specialized (adaptive) response to my infection. So you know when you get sick and your Lymph nodes swell up? Thats because you have a bunch of macrophages, and other cells that present chewed up nastiness, flowing into your lymph nodes. The T and B cells wait in the Lymph nodes to be shown chewed up nastiness and then become trained to recognize nastiness at which point they multiply and go out and fight the infection. T cells either kill or help infected cells and B cells make proteins that stick to the nastiness (known as antibodies). Antibodies are like tags that other immune cells can then use to recognize nastiness faster and thus kill it faster.

Training T and B cells results in the production of memory cells so that when you get the same infection again you have antibodies, T killer and T helper cells ready to go immediately. This allows you to fight off infection faster the second time around. Your B and T memory cells are with you for your whole life and eventually you build up a kind of immunity portfolio. Isn't that badass!!! I think so.

To appreciate how powerful the immune system is you have to look at the two extremes of malfunction of immunity. Some children are born without an immune system or the ability to produce one. This condition is called SCID (Severe Combined Immune Deficiency). Without an immune system the life expectancy of these infants is next to nothing. On the other extreme your immune system cannot distinguish foreign nastiness from your own tissue or it thinks that your own tissue is foreign. This results in autoimmune disorders like Lupus or Arthritis. It is quite possible for your immune system to literally eat you alive.

I use this technology every day but it still amazes me. If you have any more questions about this or want to know more about this technology, T cell counts, or how the body fights infection let me know. I'm a big geek and I love talking about my work.