When the hygienist asked the question, I was supine, riding the wave of the undulating chair, eager to have my teeth cleaned. It was my first appointment with a new dentist. I’m a freak. I’ve always enjoyed visiting the dentist. When my former dentist stopped taking my insurance, my common-law husband Michael said, “Try my guy, Dr. Flowers*. I’ve seen him for years and he takes our insurance.”
With the still-pristine paper bib chained around my neck, I stared at the fluorescent-cool ceiling like a baby waiting to be fed, lulled by the sfft-sfft-sfft air-cutting sounds my medical intake forms made as Lisa, the hygienist, flipped through them. The page flipping abruptly stopped. The room went silent. I glanced over at Lisa. She cut a lithe figure in her dental whites, her stiffened back to me. She was in freeze-frame staring down at the clipboard holding my papers, a George Segal sculpture. Not looking at me, she said, “You’re HIV-positive?” She asked the question in the register one might ask, “You’re a convicted felon?”
The comedian in me wanted to say, “No, just kidding! That’s the kind of thing I joke about all the time.” She had not placed that lead x-ray apron upon me—the opposite of a life vest, the way it sinks instead of buoys—but my chest caved like she had piled on 10 of them. I also had a déjà vu feeling of shame, the provenance of which I couldn’t summon.
As her question lingered in the air like flatulence, I thought of answering, “Yeah, you got a problem with that?” ripping off my bib and walking out. Instead I took my usual turn-the-other-cheek road and answered simply, “Yes.”
After a beat she defrosted. “Oh.” She collected herself, put on a pair of latex gloves, and cleaned my teeth. I’d like to say that I closed my eyes during the cleaning rather than look into hers, but I’m fairly certain I allowed her to engage me in stilted small talk. I wasn’t sure what just happened, and I preferred making nice rather than making waves. I didn’t say anything to Dr. Flowers when he massaged my jaw and eyeballed my teeth before pronouncing me healthy (well, my teeth).
At supper that night, Michael asked me how it went. I told him Dr. Flowers was a genial, superannuated, avuncular man, but there was this weird moment with Lisa. “Oh, she’s kind of new. I’ve never liked her,” he said. I told him what happened. “Really?”
“Yeah. Icky, right?”
We shrugged it off. What can you do?
A couple of weeks later Michael received a note from Dr. Flowers hand written in shaky Halloween font. He thanked Michael for referring me and apologized for not spending more time with me; I seem like a fine man. We were touched by the gesture and then thought it unusual and the tone odd. Neither of us thought of Lisa.
Two months after my visit, Michael called me in the middle of the day. When I answered, he didn’t greet me with his usual, “How’s your day going.” Instead he was breathless: “We need to find a new dentist.”
It’s Lisa, I thought. I could hear traffic in the background. “Where are you?” He had just left Dr. Flowers’s after his bi-annual cleaning, his first appointment since my visit. I hadn’t heard him this upset since W was elected president. “Michael, what happened?”
He told me that Lisa shut the door to the examination room when she saw him in the waiting area. After a few minutes she opened the door and said formally, “OK, I’m ready for you now.” As soon as he was in that examination chair, she stood over him and said, “I met Jamie. Your partner or husband, whichever he is?”
“He told me that he’s HIV-positive. I need to know about you. Are you?”
Michael hates confrontation more than I do. “No, I’m not.”
She shoved some blank forms under his nose. “We need to update your file since we do that every five years. Are you infected with hepatitis since that’s worse than HIV?”
“I have to ask these questions so that I can take extra precautions to protect myself.” Then she suited up for the cleaning: two pairs of latex gloves, a surgical mask over her mouth, and the pièce de résistance—a large mask that covered her head like a welder’s helmet. As she cleaned his teeth in this beekeeper get up, she compulsively pulled down her jacket sleeves to her latex gloves to protect her exposed wrists.
“I’ve never felt so humiliated and angry in my life,” Michael said. That’s the way I felt sitting in the examination chair, interrogated by Lisa. That déjà vu icky feeling of shame I couldn’t identify when Lisa asked the question returned like acid reflux, but this time I remembered where I’d first digested it. In 1985, when I was in high school in a small town in Texas, I was not out, especially to my parents. I had a venereal disease that I’d let go too long, because I didn’t know what it was. I went to the only doctor in town who could treat it. I didn’t get past the nurse at his reception desk. I was ignorant that I needed insurance and parental consent. When I told her my problem (anal warts) the Nurse of the Bleeding Lips—her crimson lipstick bled into her thick Kabuki foundation—looked at me like she had just smelled a filthy bathroom at a bus station. “We can’t possibly see you.” She shamed me into feeling like a contaminated piece of meat. That’s how Lisa made me feel.
But the incident with Lisa didn’t happen in some small Texas town in 1985. It didn’t even happen in 1995 or 2007. It happened a year ago in 2017. And it happened in New York City on Park Avenue. I wanted to march into Dr. Flowers’ office and shout, “Lady, what century are you living in? You think you need to protect yourself? Unless you insist on mounting and bare-backing your male patients while cleaning their teeth, I really don’t think you have to worry.”
I thought my hand in the HIV shame game was played out. I’ve been positive since 2002 and was in the closet about it for ten years. Most of my shame was a hangover from the ’80s and ’90s. I came of age sexually at the height of AIDS fear, hysteria, and death. Of course, you had to hide it then. You could lose your job, your insurance, your dentist. By the time the worst thing that could happen happened to me, it was no longer the worst thing—just a treatable condition. Still, I kept it a secret from most people, but not my doctors. I’d always liked checking “no” beside the litany of diseases and ailments on medical forms. Checking yes to “HIV” made me wince. I was mad that I was now one of the afflicted. The only other healthcare worker (other than my GP) who mentioned my HIV status was my eye doctor, and it was casually. “How are your meds working? How’s your T-cell count and viral load?” At first, I was offended. Hey, we’re here to talk about my vision. But I quickly realized it was out of concern, no different than if I were diabetic, another manageable condition. “Meds are great. Viral load undetectable.”
Another memo to Lisa: If she were to engage in unprotected sex with me, she couldn’t get HIV. The Centers for Disease Control and Prevention (CDC) announced in 2016 that they concur with scientific evidence asserting that when an individual has an undetectable HIV viral count, there’s effectively no risk of them transmitting HIV to a sexual partner.
When I came out six years ago to my family and friends and then revealed it in a memoir, it liberated me. I’ve been blithely open about it ever since, because I realized nobody cared. Then I met Lisa.
At first Michael and I thought we couldn’t do anything other than stop going to Dr. Flowers, because Lisa didn’t refuse to clean our teeth. (We guessed that Lisa had flipped her welder’s helmet after my visit, and Dr. Flowers’s note to Michael was covering for her treatment of me.) But we were angry. Anger management is a problem for me. Not uncontrollable anger but repressing instead of expressing it. I’ve always had a difficult time finding the balance between turning the other cheek and standing up for myself.
We told the story to friends. One of them, a gay male anesthesiologist, said, “Oh, honey, she broke the law.” There’s a thing called HIPAA (Health Insurance Portability and Accountability Act), that prohibits a health care professional from revealing a patient’s medical information to another person. It doesn’t matter if that other person is the patient’s partner or husband, or whichever he is. She committed a double whammy, in fact, because in New York State there is the Confidentiality Law and HIV: Public Health Law, Article 27-F that deals specifically with HIV disclosure. It “requires that any person or facility whose work is covered by Article 27-F and who receives HIV-related information MUST keep that information confidential, as required by law.”
I wasn’t going to turn the other cheek. I was angry. And it felt good. I filed complaints with the Department of Health and Human Services, the New York State Department of Health, and the New York City Commission on Human Rights.
It was a lengthy, months-long bureaucratic process, but I got action. Through the New York State Department of Health and The Department of Health and Human Services I learn that via his lawyer Dr. Flowers admitted there had been a breach and Lisa no longer works there, and the rest of the staff is being re-trained, including Dr. Flowers. Frankly, I hope Lisa doesn’t get another job in the medical profession. As neurotic as she is about protecting herself from disease, she needs to go work at some place like Purell. Of course it was the disclosure of my HIV status to Michael that did her in, which I liken to a mob boss being sent to prison for tax evasion instead of his more heinous crimes. To me, her more egregious sins were prejudice, medical ignorance, and for making two other human beings feel like unclean pariahs. I hope she finds the balance between self-protection and common human compassion. Ironically, thanks to her, I think I’m finally done with HIV shame.
*Names have been changed in this story.