Pam came to our front door cradling three jars of applesauce. She’d been peeling and cooking all day, she said. She couldn’t believe how many apples were growing in her yard.
I’d never met Pam before, but my wife looked up to her. As a fledgling resident in psychiatry, Norma admired Pam’s skill as a therapist, her unflagging energy. I liked Pam right away, though she didn’t fit my image of a mental-health professional. A heavy smoker, she was a big, ruddy woman, gregarious and plain-spoken; it was easier to imagine her picking apples than consoling a grieving family in a hospital corridor.
But, according to Norma, Pam worked with some of the most difficult patients at the hospital. She helped mediate disputes between stubborn families and stubborn doctors. She healed rifts among the staff. She could walk into a room where people were staring sullenly at each other and gently shake them, like ripe apples from a tree — shake them up, and scoop them up, and get them to talk to each other.
She had a reputation for being a rule-breaker — calling patients on a whim just to say hello, introducing them to each other if she sensed the possibility of a romantic match. Norma didn’t know what to make of this. Still inexperienced, my wife did things by the book.
But Norma was inspired by Pam because Pam knew how to listen, which is 90 percent of being a good therapist. When we’re afraid or confused, we want most of all to be heard, not diagnosed and drugged, or treated like a broken machine. In the presence of a therapist who listens — respectfully and compassionately — we’re reminded that our feelings are important, that they matter at least as much as the headlines in the morning news. Perhaps our feelings are the news; guided by a skillful therapist, we learn to read between the lines.
Norma helped Pam run a support group for people infected with HIV. The group met once a week, free of charge, though everyone was paying dearly: many had tested positive for HIV only recently, but some were in advanced stages of AIDS. Most of the group was gay, though one married man had contracted the virus through a blood transfusion, and a woman had gotten it from using intravenous drugs.
Week after week, they’d gather to tell their stories: to talk about feeling abandoned by their families, or supported by them; to declare proudly that they’d stopped drinking and given up smoking — or to bum a cigarette and lament the difficulty, perhaps the foolishness, of changing their ways. Remarkably, one man had lived fifteen years with HIV; he seemed healthy and hopeful. Others were neither.
The sessions focused less on the medical aspects of AIDS than on the day-to-day grittiness of living with a terminal diagnosis. Maybe one week someone was dying — not of AIDS but of loneliness. Or the car broke down and cost a fortune to fix. Or someone’s mother told him something he couldn’t bear to hear, and he sat staring out the window — until it was time for group.
If, for some, testing positive was a summons to become more honest, to engage life more fully, others would rather have died than face their fears. Mostly, Norma and Pam listened, paying attention to small gestures, noticing when the words told one story and the silences another.
The ravages of full-blown AIDS told their own story. Inevitably, someone would become too ill to attend meetings, his absence settling over the group like a shroud. Norma and Pam would listen. They’d make the phone calls when he died.
After Norma finished her residency and went into private practice, she continued working with the group. She wanted to remain available to people with a life-threatening illness who couldn’t afford a therapist; she also wanted to work with Pam.
Occasionally, instead of regular meetings, they’d have a picnic; once, I was invited. Although the atmosphere was relaxed, I was ill at ease. Small talk seemed inappropriate, yet so did assuming any unearned intimacy with people I’d just met. Most of them were younger than I, yet undeniably closer to their own mortality, closer to the truth I conveniently ignore: that I’m also in a body that’s going to die, maybe not for years but, then again, it could be tomorrow — a traffic accident or a heart attack or a rock hurled from some overpass.
But a terminal diagnosis is different, I thought. A wasting disease that cuts people down in their prime is different. To deny that difference would be disrespectful: I could still indulge in daydreams of a long, healthy life. Yet to exaggerate the difference would just be denying our shared predicament: we all rent here.
Fortunately, Pam’s infectious sense of humor set me at ease as she joked with a young man whose sly Southern wit and wry asides about his sexual misadventures soon had me laughing, too. Instead of acting self-conscious around people who were dying, she was enjoying herself among friends who were alive.
When the movie Philadelphia played here last year, the group decided to see it together. Again I was invited, but I wasn’t sure I wanted to go. Norma and I had just been through a difficult time. Her father had died. Two months later, as we sat in his study sorting through his papers, my sister had called to say my mother had taken a turn for the worse. We’d dropped everything and packed our bags, but before we could leave my sister had called again: my mother was dead.
I remember driving all night, hardly saying a word to Norma. I remember stopping for coffee around 3 A.M. in the harsh fluorescent glow of some convenience store. Bleary-eyed, I wondered where my mother was now. I tried to picture the white light that’s supposed to greet us in the end. The body dies, but who we are isn’t the body. Isn’t that what I believed? Or is it what I believed I believed?
Now, a month later, I didn’t know if I needed to see a movie about a man dying of AIDS — with men and women who, barring some miracle, would also die of AIDS.
As we waited outside the theater for Pam to arrive, the late-afternoon sun buttery and generous, I was struck by how healthy everyone looked: we could have been the bowling team, the swim club. AIDS seemed remote for a moment: distant, unreal, a bad dream from which the world would one day awaken. What a nightmare, we’d say, shaking our heads: an invisible killer lurking in the tissues and folds of passion! Love consuming itself! How strange.
Pam showed up. She greeted us one by one — she always looked you right in the eye — then stubbed out her cigarette and, like a mother hen, shooed us inside.
In Philadelphia, a successful young lawyer named Andrew Beckett is fired from his firm when his partners discover he has AIDS. Andrew decides to sue. He tries to find a lawyer who will represent him and winds up with Joe, an ambulance-chasing personal-injury attorney who is suspicious of homosexuals, yet sympathetic to Andrew’s plight.
Honestly, painfully, the movie shows Andrew’s steady deterioration. Glancing around, I wondered what it was like for those beside me to see their future in focus and up close: the lesions, the increasing thinness and pallor, the plummeting T-cell counts.
For me, the emotional climax of the movie comes not when Andrew wins his case but earlier, after a party Andrew has thrown in his loft. Joe wants to discuss Andrew’s upcoming testimony in court, but Andrew, who has only a few weeks to live, is absorbed in listening to a recording of Maria Callas singing an aria from Andrea Chenier about the power of love. Andrew gets up, an IV needle still in his arm, and moves around the floor, wheeling his IV stand like a dancing partner as he translates the Italian for Joe, trying to communicate with his hands what the music means to him. There’s a fire lit in the room, and everything turns flickering red as the camera hovers above Andrew. “It was during that sorrow that love came to me,” Callas sings, her voice the voice of Andrew’s own anguish as he slowly spins round and round: one man, glorious and tragic, ascending spirit and crumbling flesh.
Joe goes home. He embraces his sleeping wife and child as the aria plays again on the soundtrack. There’s sadness in his eyes, and a kind of awe. Not only has he seen the devastation of AIDS: he’s looked at a condemned man and seen himself.
Several weeks later, Norma came home shaken. Pam had been admitted to the hospital. Pam had cancer.
It was hard to believe, but bad news usually is. I cling to my habits, to my schedules, to my stupid little Daytimer calendar, forgetting how mysterious life is, how unpredictable. Pam had seemed so healthy sitting beside me in a darkened theater with those who had one foot in the grave. They were the ones with the deadly virus, who weighed each of their doctors’ words on a fine scale. They were the ones I’d watched from the corner of my eye as a dying Andrew Beckett celebrated life’s fleeting beauty. Not Pam.
“How do you make God laugh?” goes the riddle. “Tell Him your plans for the next five years.”
When Norma talked to her the next day, Pam told her not to worry. But she was still in the hospital when the group met again. Norma told them the news. She listened. She made the phone calls when Pam died.