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Walking Wounded : AIDS has robbed them of friends and lovers. They survive, but many want to die.

July 01, 1993|RICHARD NATALE | SPECIAL TO THE TIMES

The young San Francisco man was certain he had AIDS.

He was obsessed by the thought and showed several symptoms, including dizziness and night sweats.

Because he lived in a city with one of the nation's highest HIV infection rates, his physician, Dr. Larry Waites, took the man's complaints seriously. But a battery of tests, including an HIV antibody test, all came back negative.

The young man was unconvinced. He traveled from doctor to doctor, undergoing more tests and becoming increasingly anxious and agitated. Despite all the medical proof to the contrary, he continued to be overwhelmed by the specter of a prolonged, agonizing death. One night, he overdosed on sleeping pills.

His suicide was an extreme example of a peculiar form of hypochondria. But as anyone who's ever worked on an AIDS hot line will tell you, it was not unique.

For the Record
Los Angeles Times Monday July 5, 1993 Home Edition View Part E Page 2 Column 2 View Desk 2 inches; 37 words Type of Material: Correction
Walking Wounded--In an article on people who have lost loved ones to AIDS, The Times incorrectly said that David Silver was trying to recover from the deaths of both his lover and best friend. Silver, who was not in a relationship, lost his best friend to the disease.

One of the neglected consequences of the acquired immune deficiency syndrome epidemic is the ever-widening circle of men and women who are negative, but whose lives have been emotionally ruptured by the successive deaths of friends and loved ones from the disease. Waites calls them "the walking wounded."

As they cope with the grief and guilt generated by multiple losses to AIDS, many have experienced chronic bouts of hypochondria, clinical depression, anxiety, insomnia, patterns of self-destructive behavior and anhedonia, an inability to derive a sense of pleasure from life. Despite these problems and the existence of support groups to cope with them, the walking wounded are largely ignored.

According to Dr. Mark Katz, an HIV specialist and a member of the Los Angeles County AIDS Commission, there is a significant other, friend or family member for each of the estimated 40,000 HIV cases in Los Angeles to date.

"Everyone is personally affected somehow," he says. "And the people who are negative must handle feelings of vulnerability as they watch friends die."

Consider the case of David Silver, the human resource director at Checkers Hotel in Los Angeles. He has yet to fully come to terms with the loss of both his lover and his best friend over a two-year period. He battles frequent crying jags, anxiety attacks and anti-social behavior.

"I isolate," Silver says, noting that he goes directly home after work and refuses to pick up the phone when it rings or even listen to his messages. "I played them once and I learned that a friend had died. I don't want to know what's going on."

These complex feelings have been compared to the guilt experienced by survivors of the Holocaust, to the post-traumatic stress disorder that affects those who endure natural cataclysms like earthquakes and tornadoes and to the battle fatigue syndrome experienced by soldiers.

The difference with AIDS is that the epidemic continues unabated, leaving no respite to complete the normal grieving process. "It's like suffering post-traumatic stress but without the post," says Los Angeles therapist Dan Alonzo.

"Grief can be a finite phenomenon. But how do you accommodate two losses at once or, after 12 years of the epidemic, the loss of an entire peer group? It's psychologically impossible. You shut down. You numb out or become addicted to alcohol, drugs or sex."

Simon Pastucha, a 31-year-old Los Angeles city planner, has lost his longtime companion and several close friends to AIDS. He suffers from a general lethargy, comparing it to "an open wound that's so deep you can't express it and people can't comprehend it. But then how do you explain a complete loss of hope?"

Unlike most men and women his age, he has lost sight of any long-term goals. Progress for Pastucha is making it out the door in the morning. "I don't have a five-year plan or a two-year plan. I take it month by month. I just try to do a good job."

But as he struggles to cope with the grief and sorrow, he sees the path ahead strewn with more losses. "Three to five years from now, people who are very important to me are going to be gone," Pastucha says with an air of almost defeated certainty.

Because of the magnitude of the AIDS crisis, little attention has been directed toward these problems. Funding and energies directed at the gravely ill are already stretched to the limit.

"Significant others are neglected," says psychotherapist Sandra Jacoby-Klein. "Their needs are not considered important. And if you're saying their feelings don't count, that can be even more stressful."

Often the walking wounded don't believe they have a right to their feelings. They drift into Waites' office with ailments, real or imagined, and apologize for taking up his time because they know what a heavy AIDS caseload he carries.

"You feel like the child of a Holocaust survivor," says filmmaker Steve Levitt. "I mean, how do you turn to a lover who's dying and say, 'I'm depressed because my boss is giving me (grief) at work'?"

Those who have been spared take little solace in that fact. Roy Cameron, a physical trainer in San Francisco, wasn't relieved when he tested HIV negative.

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