Lenacapavir and Thom Gunn
I assume many people working in medical research fantasise about talking to Saloni Dattani. I assume that because I did, after reading Saloni's writing and listening to her interviews. Now, I thought, there is someone who focuses on issues that matter and pays attention to the details! Someone who's not trying to sell me something. What does she think, I wondered, a saner world should focus its attention on? And what would she think of my own little answers to that question?
I was down so bad I once thought about a graph Saloni made for a year. Another time, she made an offhand comment that I should start a blog, and now you're reading these words. (Other friends encouraged me on that one too. Thanks, e.g., Joe and Casey.)
Here I am telling you that I, now, do get to talk to Saloni Dattani about medical research. Not just in my head! We live in different places, but one of my favourite things to do when Saloni comes out West is walk, and when I go back to England, talk.
Lenacapavir
As of this week, you can hear me talking to Saloni too, because one time we set up a webcam and microphone while we were doing it. Well, two times actually – we chatted for so long our editor had to go home on the first day (sorry Adrian), but there was more we wanted to talk about, so we recorded on a second day and spliced the two together.
This is the first episode of a new podcast called Hard Drugs, where Saloni and I talk about how to make drugs that save lives. This episode is about lenacapavir, a new "miracle drug" that blocks HIV infections with an efficacy rate of nearly 100%. How do scientists get to such an extraordinary technical achievement, for a virus that has killed so many people?
Please subscribe to the podcast, to get future episodes on other hard drugs! That will help give us motivation to record more.
Thom Gunn
It is a little hard to look at directly, that lenacapavir and the other wonderful drugs we have today work so well. That someone who died aged thirty in 1995 would only be sixty today.
The podcast episode is focused on science, but I live in San Francisco's Castro District. Here is an addendum for readers of my blog, of some of my favourite San Francisco writing about HIV/AIDS. In chronological order of publication:
And the Band Played On, Randy Shilts (1987). Shilts wrote for the San Francisco Chronicle, the first openly gay reporter hired at a major American newspaper. He reported on AIDS starting from the early case reports in 1981. And the Band Played On ends around 1985 with Rock Hudson's diagnosis.
The book has a bad reputation these days, since a lot of it focuses on the story of "Patient Zero", a HIV+ man who Shilts names and claims intentionally infected lots of people after knowing his own diagnosis. Due to advances in genomics since then, it is now known that this person was not patient zero, in that he was not the first to bring HIV to North America (that happened in New York, 1970). Narratively pinning HIV's rapid spread on this one guy is clearly not correct. (That said, rewatching the 1987 episode of 60 Minutes about Patient Zero, I wonder if people have gone too far bashing Shilts here; the retired head of an infectious disease unit in San Francisco quotes the man in question saying some pretty disturbing stuff.)
The larger story the book tells remains untouched, and this book is its telling from the front lines: the indifference, the slowness to act, as people died.
'The J Car' by Thom Gunn (1992). I love this poem, about Gunn and a friend who's HIV positive.
Our conversation circumspectly cheerful,
We had sat here like children good but fearful
Who think if they behave everything might
Still against likelihood come out all right.
Thom Gunn attended Trinity College, Cambridge in the 1950s, and became famous for a poetry collection he wrote as a student. (Which contains a poem that must be cryptically about his lover Mike Kitay, who he'd just met, and ended up spending the next fifty years with.) Then he moved to San Francisco and started losing credibility. Stephen Spender wrote of Gunn's 1971 collection Moly: "It is as though A. E. Housman were dealing with the subject matter of 'Howl,' or Tennyson were on the side of the Lotus Eaters." I must have been out here too long, because I think it's cool.
In any case that trajectory meant, come the 1980s and 1990s, England had despatched one of her best to a place that needed poets to make sense of an impossible set of experiences. 'The J Car' is from a collection of similar poems, The Man with Night Sweats.
... Of course I simplify.
Of course. It tears me still that he should die
As only an apprentice to his trade,
The ultimate engagements not yet made.
'Queen Christina', Randall Mann (2009). Short poem, so I shan't excerpt, just click. Funnily enough, it's from Mann's collection Breakfast with Thom Gunn, which also has a great title poem (which, indeed, references walking to the N car, if not the J. The N goes to the beach).
How To Write An Autobiographical Novel, Alexander Chee (2018). Essays on writing, some covering Chee's time as an AIDS activist in San Francisco. My friend group's favourite is 'After Peter', which I recommend (though brace yourself).
AT THIS TIME IN SAN FRANCISCO, it seemed that the world might either go up in flames or be restored in a healing past imagining. The world seemed ripe for fixing and rescue. I think now, twenty years later, this feeling might always be true.
Indeed.
Not related to HIV, but an observation from one of my other favourite essays, 'The Guardians':
I loved him, in part, for what he might be someday, which is never a good way to love someone. It was in fact a way of rejecting him, a way of rejecting who he is now, and I think in some way we both knew this.
Disasterama!, Alvin Orloff (2019). This is an autobiography of San Francisco from 1977 to 1997. It is not about AIDS, at least not on my reading. On my reading it is about living life for joy and silliness. Here is what Orloff writes after his best friend, Diet, receives his positive diagnosis:
The poet Muriel Rukeyser once put it that, "The universe is made of stories, not atoms." Diet and I wouldn't have disagreed, but what we really believed was that the universe was made of jokes. ... Many jokes were ironic, like the inability of human societies to organize humanistically, or the way people's faults are also their strengths ... And some jokes were just plain absurd, like how well-intentioned stupidity can inflict more suffering than intelligent malice, or the way entropy always wins in the end.
We also believed the only proper response to this universe of jokes was laughter. Not the buffoonish har de har har of clowns (we hated clowns), but the wry chortle and understated smirk of the wisecracking wit. Existence was hilarious and if you weren't laughing, you were missing the point."
Then, the chapter continues:
I couldn't stop sneaking peeks at Diet, waiting for him to speak. When he finally did, his usual bantering tone was shot through with frustration and melancholy. "We were pioneering a new way of life with all the sex and free love, but science didn't keep up. They were too busy building bombs and sending men to the moon." His eyebrows lifted ever-so-slightly. "Clearly a case of misplaced priorities."
Diet died in 1995.
'Elegy for the Castro Funeral Home', James Siegel (2020). I can't find this poem online, so you'll have to buy the collection (which has many other good poems; review #13 here). This one was written about Sullivan's Funeral Home, shut down in 2016 after being so active in the preceding decades. The first two lines stopped me still. I hope for the women and men in parts of the world where HIV infection is common and lenacapavir is not, that one day, soon, the funerals end.
One hundred years and you are gone.
Death is not the business it once was.
Thank you, Alvin