A Real-Life Horror Story
Gabi DiMarco
My obsession with bioterrorism started when I was thirteen. I read Richard
Preston’s The Hot Zone and bit my nails as the deadly filoviruses emerged from the
African jungle. I watched Dustin Hoffman fight hemorrhagic fever in Outbreak. Then
I moved on to the zombie genre. The terror of the unnamed and incurable rage
disease that infected most of the world in 28 Days Later left me sleepless for several
nights. In the same way that some people are drawn to the carnage of car accidents,
I could not look away as zombies attacked innocent children in Zombieland and
Dawn of the Dead. But somewhere in the midst of my passion for human destruction
through disease, I turned away from exotic and made-up agents. Instead, I fell into a
long and complicated relationship with the craftiest, most intelligent virus of all:
Human Immunodeficiency Virus, or HIV.
What I appreciate most about HIV is its ingenuity. The virus is a perfectly designed
killer because it attacks the body’s own immune system. While other diseases act as
terrorists, bombing shopping malls and disrupting the lives of everyday civilians,
HIV goes straight for the army, causing chaos and disorder that eventually renders
all militaristic action on the part of the host futile. In the end, it is not HIV itself that
kills a person. Other invaders take advantage of the body’s waning defenses, and the
victim falls pray to cancer, pneumonia, or skin infections. The real difference
between HIV and the contagions portrayed in my end-of-the-world dramas is that
HIV is a lentivirus. It kills people slowly, lying latent in the body for years before
revealing itself. This latency makes the virus more intriguing to me than the fevers
and poisons that destroy a person in a matter of days.
The emergence of HIV in the early 1980s was just as terrifying as the discovery of
Ebola. During my senior year of high school, I wrote my U.S. History thesis on the
Reagan administration’s response (or lack thereof) to the emergence of HIV.
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Through reading firsthand accounts of victims, healthcare workers, and policy
makers, a picture was painted for me of a mysterious disease. First gay men, then
drug users, hemophiliacs, and Haitians fell prey to the unnamed threat. Knowing the
answer, in retrospect, to the mysterious symptoms did nothing to shake the thrill of
reading about those early years. I relived the terror with Bob Gallo, head of the
Centers for Disease Control and Prevention, in his television interviews. I stood
alongside gay rights activist Larry Kramer as he desperately warned the New York
City gay community to use condoms.
As my obsession with the virus grew, I sought any portrayals I could find of HIV in
the media. I read And the Band Played On, a political commentary on the disease
from San Franciscan journalist Randy Shilts. I watched “Rent”, paying particular
attention to the scene in which characters recite their T-cell counts before breaking
into a song titled “No Day But Today.” In Kids, a controversial mid-nineties film
about teen sex and drug abuse, HIV-positive Jenny struggles to track down Telly, the
boy who infected her. She arrives on the scene too late to save an unsuspecting girl
from Telly’s disease. HIV even made it into an episode of the Canadian teen drama
Degrassi. Paige’s newest boyfriend admits to having been HIV-positive since he was
a baby in his heroin-addicted mother’s womb. What many of these dramas, mostly
set in the eighties and nineties, fail to show is how treatment of HIV has evolved
over the past twenty years.
Today, HIV is not a death sentence for people living in developed countries, like the
United States. Scientists know how the virus works and doctors can slow its
progression. I learned this firsthand when I shadowed an HIV-specialist, Dr. Jones, at
a local AIDS clinic. Fighting HIV is no longer taking a shot in the dark at an
unidentified enemy. People who have been diagnosed HIV-positive have their
unique virus genotyped. Doctors target their antiretroviral drug regimens to hit
weaknesses in the virus. For the most part, people with HIV can live a relatively
healthy life.
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Even as medical care has advanced, stigma surrounds the disease. Dr. Jones’s
patients struggle with the implications of their HIV-positive status on relationships
with family and friends. One of my favorite patients, Billy, is a prominent member of
a Native American community. He travels to Washington, D.C. every six months for
his check-up with Dr. Jones. These are secret visits. No one within the community
knows about his condition. If someone did find out, Billy would be disgraced. He
would lose his position of authority and the respect that others have for him. Billy is
not alone in his situation. The people who walk through Dr. Jones’s clinic all feel the
stigma associated with HIV-positive status. Yet these victims are the lucky ones.
Watching Dr. Jones hand out samples of pills, it is easy to forget the early years,
when HIV was a frightening opponent. However, the terror and mystery
surrounding HIV still exists in places like Sub-Saharan Africa and Southeast Asia.
I remember clearly the first time the weight of the epidemic struck me. I was
attending a summer camp, taking an international politics class. My teacher asked us
to guess the HIV prevalence rate in the country of Swaziland. I was too distracted by
the hilarity of the country’s name to pay much attention to what my classmates
guessed. I do remember that our teacher eventually announced solemnly that 25%
of the population was infected. That number hit me like a punch in the stomach. My
mathematically oriented brain instantly calculated that five of my 20 classmates
would be infected if we were living in that country with the strange name. Allie,
Matt, Quinn, James, all sitting in a row to my left, were in that instant destined to a
short life of pain, social stigmatism, and disease. This realization was sobering. HIV
was no longer a far-off threat, something made up for the sake of a drama. It was
real.
The expensive and complicated prescription drug regimens used in the U.S. are not
available to millions of HIV-positive people living in the developing world. Advanced
therapies are not feasible in countries where even basic health care needs cannot be
met. A vaccine is the most promising solution. It can be administered just once, and
can provide a lifetime’s worth of protection. An HIV-vaccine would be like the anti3
serum that cured the town in Outbreak. It would give this real-life horror story a
happy ending.
The vaccine effort drew me into the laboratory. Armed with a thick gown, double
gloves, and a facemask, I learned the pass code for the door to the Biological Safety
Level 2 labs. Beyond the locked door lay a world of mystery and intrigue. Scientists
huddled around flow cytometers, analyzing important data and using large words to
describe their latest findings. Despite the industrial surroundings and constant
throb of machines, lab work became a personal refuge for me. I sometimes talk to
my infected cells. “How’s it going babies? Is the 37 degree incubator warm enough
today?” I ask as I inspect my cultures for signs of contamination. I named my
electronic pipette Mimi, after the HIV-positive exotic dancer in Rent. The research
that Mimi and I engage in is part of larger movement within the scientific
community to develop an HIV vaccine. If successful, this vaccine will stop the
epidemic.
Next year, I will be embarking on a new phase of my relationship to HIV. I will be
attending medical school to become a doctor. My experience with the virus will no
longer be limited to observation or laboratory manipulation. Instead I will fight it
head on, waging war with my prescriptions for antiretroviral drugs. In my future
career, I want to go to the frontlines and confront the terror once in for all. I will
educate people on HIV prevention strategies in Thailand. In South Africa, I will work
to expand health care accessibility to rural areas. I do not want the story of HIV to
have a 28 Days Later-like conclusion that leaves room for an equally terrifying
sequel. I want a happy ending.
Acknowledgements: Thanks to my writing group, Steven Budi, Ben Soltoff, and
Angela Yun, for inspiring me to take this piece in a new and more personal direction.
Thanks also to Joe Harris for his feedback on my initial draft and suggestions on
style given throughout the semester.
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