I should preface this story by saying that most people already know it — it’s not a current event, it’s not something I’m about to do, it’s not a thing that’s weighing on my mind or that I have unsupported opinions about or that I found out about last week and skimmed some internet articles and then rambled some incoherent thoughts about to the internet (and yes, I used “ramble” as a transitive verb — expert ramblers are allowed to do that). It happened to me about a year ago. It is, however, 100% true — I am not making any of this up. And because one day I will be old and gray, and The Disease will have rotted away my brains and I will no longer remember the story as my own, I find it necessary to gift this story to the internet, such that old, gray, brain-rotten me will be able to read it and laugh at the moron who wrote it, so many years before.
The story begins, as all great stories do, with a bump in the night. Specifically, with a bump on my head — or maybe I just thought it was a bump on my head? In any event, I woke up in the morning and the crown of my head hurt something fierce, and there was a lump; my explanation for this being that I must have hit the corner of my headboard while I was sleeping. Maybe a bad dream?
Whatever the cause, I didn’t think much of it until the next day, when it somehow hurt worse than the day before and had mysteriously begun itching. OK, so I serially hit my head on the headboard, and maybe there’s a scab, and those can be itchy I guess? Totally explicable. Nothin’ to see here.
On day 3 I had my roommate inspect my scalp. It was weird; this is not a thing roommates should do for one another. “It looks… red? And maybe inflamed?” he said. But no scab — no obvious wound of any sort, really. Thanks, roommate — I owe you one scalp inspection.
Day 5, a Saturday, found the pain in my head subsiding a bit, but the redness and inflamedness spreading from the crown of my head linearly to just below my hairline; it looked like I had two or three bug bites, or maybe some sort of splotchy rash. It wasn’t a good look, but it didn’t appear contagious. It was moderately painful, but mostly in an itchy way, like chicken pox, where the pain comes from the tightness of the skin. Also, from nerve damage, but we’ll get to that later.
At the behest of a tennis partner (I played tennis once. Literally, once), I found myself that day at the Urgent Care center a few miles from where I live (actually, down the street from where we had lunch after tennis). My roommate had driven us to play tennis, so he was kind enough to go with me so he could drive me back home. This factoid will come up later, so tuck it away somewhere special where it’ll be safe. Anyway, suffice it to say that I didn’t yet know the one cardinal rule of healthcare: don’t go to urgent care.
I checked in with the front desk attendant, filled out some paperwork indicating I was in for “possible rash, possible insect bites,” and was told they’d get to me eventually. I fretted about what to do if I had some sort of disgusting pillow infestation. I’d probably have to incinerate my pillow, like the Velveteen Rabbit; this brought me much sadness, because I love my pillow. It’s very soft, and I have trouble finding others like it.
In any event, eventually they got around to me, and I left roomie sitting boredly in the waiting room (thanks, roomie!). They took me to the back where a nurse asked me what I was in for (“possible rash, possible insect bites”), inspected me (“looks like you have some sort of rash, or possibly insect bites”) and told me to sit tight until the doctor came by. Sit tight I did, for about five minutes, before in walked a man about twice my age who looked at me and said…
“I know exactly what that is.”
And at this point in the story, that is either a really bad thing or a really good thing — it’s either, “Ah yes, you have a case of the incurable face-eating disease that’s been going around! We’ll have to purge you and everyone you’ve come into contact with for the last year, for the greater good! Come with me to the incineration chamber!” or it could be, “You’re allergic to your shampoo.” And there’s probably not a whole lot of middle ground here.
He put on rubber gloves and examined my scalp (two scalp exams in one week! Best week ever!), all the while murmuring confirmation that he did in fact know what it is. Then he asked me a series of targeted questions:
“What do you do for a living?” Energy trader. “Sounds stressful!” Indeed it is. “So what’s that like? In to work at 6, work til midnight, do it again?” It’s more like … 10-7 for most people. I tend to get in by 8, though? “Hmmm.”
“And your sexual partners are…?” (He did not finish the question. He literally just left it open. I stared blankly at him, but in my mind I thought, …really attractive…?) “…Male…? Or female?” He sure left a lot of time after male… Uh… female. “Mhm.” (He looked doubtful. Meanwhile my roommate was waiting for me in the lobby…)
“And when you have sex with these…” (he looks at his chart) ” … females…, you use a condom… sometimes? Never?” Thank God, options! Uhhh sometimes, I guess? “Wrong answer! I tricked you! The correct answer was ‘Always.'” Thank you for tricking me while asking questions about my health.
“And how many sexual partners have you had?” Oh balls is it X or Y? Y. Er… X? It’s either X or Y. It’s not like I don’t remember it’s just … like I knew all of them? Like their names? No strangers? Pretty sure it’s X. This is going poorly. I did not expect this line of questioning for my possible head rash or possible spider bites.
“OK, well the reason I ask is that …” (drumroll) “… you have shingles.”
“Do you know what shingles is?”
I knew what shingles was — or at least most of it. I thought it was when old people get chicken pox and it’s like way worse than when people get it as a kid — and that’s part of it. But it turns out that if you had chicken pox as a kid, the virus just hangs out in your nerves, and your immune system just sorta keeps it from expressing itself; every time it makes a break for it, a typical human immune system will contain it.
“But here’s the thing,” patiently explained the kind doctor who was so recently inquiring about my sexual tendencies, “in people whose immune systems are compromised, the virus can express itself, and when it does it follows the patterns of nerves that are close to the skin; this means the rash usually expresses linearly, and doesn’t cross the center line of the body. That’s how I knew you had shingles!” That’s actually kinda cool. “The reason it manifests so often in the elderly is because they tend to have weak immune systems. However, it does occasionally manifest in people under 50, and when it does it can sometimes be related to stress.” Ah, hence the questions about my work. “However, it most often arises in AIDS patients, or patients who are HIV positive, so we’re going to go ahead and get you tested.” Ah, hence the sexual history. Wait… MOST OFTEN?
And here is the part of the story where I, like an utter fool, think Oh great, this will all be cleared up when the results come back negative, because in college they had those tests that took like 5 minutes. I think it was a cheek swab. And what I say to him is, “OK, that’s fine — it’s just a cheek swab, right?”
And what he says to me (and I cannot stress enough that I am not making this up) is, “Oh yes, they have those.” They. As in not us. We do not have those. There are people that have those, and we aren’t those people. “We should probably get those. No, we’ll need to draw some blood.” Hooray! “We send the samples away; the results typically come back in one to two business days, so you should hear on Tuesday morning. We’ll call you.” Woohoo! “I’ll have the technician come in and then you should be good to go.”
And then, as he turned to leave, he stopped. “Let me ask you this,” he started. I didn’t really have an option; he wasn’t actually asking permission, it turned out. He kept going, “Do you think because you’re straight, you can’t get AIDS?”
No, I thought, it’s not 1986 anymore. I think because the people I have sex with DON’T have AIDS that I WON’T get AIDS. I’m a rational, educated human. But what I said was, “No.” To which he responded, “Good — because you can.” And with that he was gone.
Before I tell you the rest of the story about how I totally don’t have AIDS and am, in fact, certifiably 100% HIV-free, I should tell you that the person who has the single worst job in the world is the guy who draws blood for AIDS tests. He knows what he’s there for. He knows why your blood needs drawing. And he has to handle a pointy object coated in your probably-tainted blood, an object that is just so pointy because it is specifically designed to pierce skin — you know skin, that protective layer around your body that keeps other people’s HIV-ridden blood out of yours? Yeah, that’s useless against the tainted needle that he’s paid to touch that could go off for like… no reason.
Anyways, back to the story — here’s a tip for all of you future doctors out there. I dunno if they have a class in bedside manner, but if they do I think probably the first thing they tell you is not to diagnose people with incurable, life-changing diseases before you run the tests. Pay attention to this class. Because, assuming that stress can destroy one’s immune system and cause one to, say, develop a case of shingles, do you know what’s really stressful? It turns out that thinking you have AIDS is really stressful! And that does not help the shingles.
The rest of Saturday and all of Sunday were spent playing it super cool. I met some friends in the city: “How was your day? That’s cool. I found out I might have AIDS! Who wants a drink?” “Hey roommate, remember that time you inspected my scalp? Turns out I might have AIDS! Haha! I probably don’t, y’know?”
By Monday I had stopped mentioning it at all. I had also stopped talking to my then-long distance pseudogirlfriend, just to make it that much easier for her to hate me if I had to explain to her that it just might be in her interest to get tested. No not for that, for HIV. Yes, that HIV.
By Monday night I couldn’t sleep.
I was lucky, because the way to work on Tuesday was full of traffic, which meant I never got going fast enough for my mind wandering or my phone checking to get me in real trouble. Tuesday morning at work was a waste — they could call at any minute! No, they should call at any minute… Why haven’t they called?
At noon I resolved to go to the gym like any other day (If I have AIDS will they let me in the gym? Can you get AIDS from someone’s sweat?) When I got back, still no call, so I called them — yes my test results were in, no they couldn’t be shared over the phone. They said they’d call. They didn’t call. They can’t share the results over the phone, but who would care if I didn’t have AIDS? I’m sure they could share that! They’d leave the results for me at the front desk, and I could come in and pick them up whenever I wanted.
By 6 o’clock, I was literally shaking; I hadn’t done any work all day, and I gave up on it. At 630, I walked through the doors of the urgent care center. I inquired calmly and nonchalantly about some test results (“Totally not for AIDS, it’s a paternity thing. I’m super virile.”), and the front desk attendant picked up a stack of envelopes, on the topmost of which was clearly written, in all capital letters, in what appeared to be marker, my name. She asked me what my name was, and I read it off the envelope to her.
I know what you are thinking right now, and no, I did not have to show identification. For someone who was willing to answer security questions on the phone in order to hear his test results but was unable to do so for “security purposes,” I found this total lack of security quite disturbing. I didn’t have time to take offense at that until later, though, because I was still preoccupied with the mind-blowing anxiety of the test results, which were now sitting, wrapped, in my hand. I calmly proceeded to my car, where I frantically tore open the envelope and saw the following phrase: “reactive in the negative threshold.”
“Reactive?” That’s bad! “Negative?” That’s good! By this point I had broken out in stress hives. I was developing itchy blotches, and I was about two breaths per minute away from hyperventilating.
In the end it turns out that everyone reacts to the test, and there’s some threshold of reactivity (typically reactivity of 1, whatever that means) under which you’re like pretty much guaranteed to not have HIV — I had to look it up, and the best results came from Yahoo answers. (Here’s a fun fact: do you know who needs to know how to interpret the results of their HIV tests? People who use Yahoo answers. Also, me.) Then there’s a threshold in which you like maybe need to get another test done (1 < reactivity < ~10), and then above that you like pretty certainly have it. I was well under the “you totally don’t have HIV” threshold. But I was incredibly stressed out.
And in talking to people, it sounds like everyone knows someone under 50 who got shingles because they were stressed out. It turns out it’s pretty common. But I looked up the doctor afterwards, and I think I understand where he was coming from:
Actually, he was an AIDS specialist who earned his medical degree in the mid-’80s and spent the next 10 years on the front lines in the fight against an epidemic that we didn’t understand. I’m sure that in his experience, most 25 year olds who present with shingles do have HIV. I just wasn’t one of them.
In any event, as a fun coda to this story, that Friday night, about 8 o’clock, I got a call from an unknown number, so I let it go to voicemail. I checked the voicemail, and (and again, I cannot stress how not making this up I am), it was the doctor. He called to tell me the results of my tests. Turns out everything was fine, it was probably just stress.