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Some time ago, on a perfect fall day, I hesitated. Instead of heading to my office, I stole a few minutes to stroll through my garden. The light was golden; the sky a blazing blue and there was just a hint of chill in the air. In my wondering and reverie, I came across several newly divided clumps of peonies in a bed that had been worked the week before. Their foliage was also golden but wilting, in sharp contrast to their undisturbed brethren that were still green and robust. As I gazed upon the wilting foliage, a thought took the forefront of my mind: “You know, a lot of people really did die.” Along with it came memories of faces, names and encounters. Patients, friends, teachers, team members, colleagues, men I had helped, men I had admired and men I had loved. All lost to AIDS.
At some point I was jolted from this reverie, this daydream, and shocked by the intrusion of such stuff. In the midst of such beauty on a day that had demanded I walk around and take in years of effort that was in full autumn glory, thoughts of so many deaths and losses came seemingly out of nowhere and flooded my mind. As I drove into the city I contemplated the intrusion and scanned my memory in an effort to locate what may have triggered it. On one hand, isn't that the way these things happen? In the midst of joy and good feeling painful memories, or something less formed but full of unhappy feelings and dread, rushes in and suddenly takes the forefront. We all have worked with patients whose calm or enjoyment is suddenly interrupted by the most horrendous memories or ill-formed but intense feelings that carry with them a