Subject: AIDS Has Been Cruel To Greenwich Village And Its Homosexuals Date: Published: 3/13/87 268 lines Source: Wall Street Journal. Copyright Dow Jones & Co. Inc. Plague Years: AIDS Has Been Cruel To Greenwich Village And Its Homosexuals --- Signs Abound of the Dying; Businesses Are Shuttered; Some Neighbors Help Out --- Hospitals Fearing the Future --- By Ellen Graham and Roger Ricklefs Staff Reporters of The Wall Street Journal NEW YORK -- On the playground at P. S. 41 in Greenwich Village, children eight and nine years old have devised a game called "AIDS. " When a child is tagged, he "has AIDS" until he tags someone back. In her office a few blocks away, internist Joyce Wallace sends a stock letter to mothers of her patients who die of AIDS. How many has she sent? "Hundreds," Dr. Wallace replies. A young job applicant frets about having told a prospective employer that he has AIDS. He gets the job. It turns out the employer has AIDS, too. AIDS has cut a cruel swath through Greenwich Village, an affluent old neighborhood of 61,000 on Manhattan's West Side. Traditionally a haven for artists, writers and bohemians, the Village is generally assumed to have a homosexual population as high as 25% or 30% -- altogether perhaps 18,000 people. Accordingly, the Village has become an epicenter of acquired immune deficiency syndrome, the fatal immunity disorder that in the U. S. struck first among homosexual men. Some 270,000 Americans are expected to have contracted AIDS by 1991 -- nearly nine times the total so far. Thus, the Village's experience may serve as a harbinger for other communities as years go by. Of more than 9,000 cases of AIDS reported to date in New York City, at least 700 have been clustered in the Village, according to the New York City Health Department -- roughly the same number counted in the whole state of Illinois. More than half have died, most of them men, many of them young. The survivors include legions of the "worried well" fearful that they, too, might be incubating the disease. It all happened so fast. Less than six years ago, just a handful of cases had been reported, and the dying had just begun. Here in the Village, life goes on in bistros and coffeehouses on boutique-lined streets. But more young men these days get around with the help of canes or walkers. Wartime metaphors spring to people's lips. And the keeping of lists has become a grotesque commonplace. Art critic and historian Robert Rosenbloom sat down with his wife a few weeks ago and tallied 20 dead and 10 sick with AIDS in their immediate circle of artists, museum people and collectors. "That seems overwhelming for our tiny world," he says. "It's so grisly switching back and forth from the present to the past tense -- trying to remember who has died, who is dying." Psychotherapist Michael Shernoff calls it bereavement overload. "You can't finish mourning the death of one friend," he says, "when you're hit with another." Because the disease is invariably fatal, he adds, mourning begins with the diagnosis. AIDS has killed Mr. Shernoff's own brother, many friends, 13 patients and seven residents of his 46-unit apartment building, he says. Many Villagers haven't felt the epidemic that intensely, of course. But AIDS can intrude unexpectedly in daily life. JoAnne Bennett, a nursing-magazine editor, tells of visiting a local shop after returning from vacation. "I remarked to the clerk that he looked a lot thinner," she says. "He said he had been sick and, suddenly, it clicked. You come to realize it is the butcher, the baker, the candlestick maker. It is your neighborhood, and people will get sick." About once a day, police in the Village precinct answer an AIDS emergency call. At the school attached to St. Luke in the Fields Episcopal Church, children pray during chapel for a cure for AIDS. "Many of their parents' friends have died," explains Lucia Ballantine, the assistant rector. Since the first of the year, the church has held six funerals for men who died of AIDS. No fewer than 60 AIDS support groups are offered each week in the Village area: healing circles, bereavement groups, groups for parents of people with AIDS, groups for women with AIDS (one provides baby-sitting), a group for veterans with AIDS and a group conducted in Spanish. Hospitals spill over with patients in acute stages of the illness. At St. Vincent's Hospital -- where 75 years ago survivors of the Titanic sinking were taken -- the surge of AIDS admissions has helped push the general occupancy rate up to 97%. Officials say it is now often difficult to find beds for new patients of any kind. At Bellevue Hospital, a big municipal facility close to the Village, the average daily AIDS census is 65 patients, up from 30 two years ago. AIDS patients now occupy more than a third of the beds in Bellevue's internal-medicine service. Hundreds more are seen for outpatient treatment. Sheer numbers, of course, don't tell the full story. AIDS patients are needier than most, requiring hospital stays twice the average length. An AIDS patient's stay at Bellevue averages 22 or 23 days, compared with nine days for other internal-medicine patients. "They have multiple immediate problems," says Mindell Seidlin, the medical director of Bellevue's AIDS program. "The medications they receive are big guns, with a lot of side effects and toxicity. They receive many diagnostic procedures. They are weak, debilitated, can't feed themselves; they need help to the bathroom and have severe diarrhea. And 30% develop dementia." Robert Cecchi, the health ombudsman at the Gay Men's Health Crisis advocacy group here, estimates that AIDS patients require seven to 14 hours of direct attention a day, whereas hospitals are designed to deliver only about three. (Bellevue places the most seriously ill in a special 10-bed unit where they each get more than six hours of nursing care daily.) Mr. Cecchi says the labor-intensive aspect of the disease creates "problems in every hospital, on every floor." The GMHC receives 80 complaints a month about hospital care. Meanwhile, hospitals here face the worst nursing shortage since World War II. When St. Vincent's went to Britain to recruit operating-room nurses, it had no takers. The hospital's medical director, Lambert King, says the reason was fear of AIDS. The cost of care is staggering. Bellevue is reimbursed at an average daily rate of about $600 for each Medicaid-eligible AIDS patient; it receives about $500 for those covered by private insurance. Yet the hospital says it costs around $800 per day to treat each one. The shortfall -- now totaling about $12,000 a day -- comes from city coffers. To qualify for the supplementary Medicaid reimbursements, patients must be diagnosed as having AIDS under the Centers for Disease Control definition. Doctors say that such cases represent just a fraction of those actually sick. According to the CDC in Atlanta, there now are five to 10 times as many cases of AIDS-related complex, or ARC, as there are of AIDS, strictly defined. "When I think five years out, it frightens me," says Bellevue's Dr. Seidlin. "The system isn't designed to take care of this many acutely ill patients." No amount of training prepares residents, interns and nurses for the stress of treating the stream of young, dying patients. Some hospitals now offer counseling to their staffs, but those who deal with the repeated crises of the acutely ill have little time to do more than suppress their own despair. By contrast, David Kaufman, an attending physician at St. Vincent's who also has a private Village practice, sees AIDS patients outside the hospital as well. "I get to know them," he says. "I see they have lives -- good lives. I'm very touched by them. It sustains me." When patients are ready for discharge from hospitals, they often have nowhere to go. They may have lost their jobs and, with savings depleted by medical bills, many can't afford to pay rent. About 650 homeless people with AIDS live in New York City, according to the AIDS Resource Center, a Village-based group that attempts to find them housing. Many sleep on friends' couches, though some live on the street. And a few -- city officials estimate 30 to 35 at any given time -- are warehoused in hospitals because, as Mr. Cecchi puts it, "you can't discharge terminal patients to Central Park." Long-term residences for such people are almost nonexistent. The only one of any size in the city is Bailey House, recently converted from a small Village hotel. It will eventually hold 44 men and women with AIDS. Even in Greenwich Village, one of New York's most laissez faire neighborhoods, the AIDS crisis has provoked a stinging backlash. Reported violent incidents committed against homosexuals here have nearly tripled in the past two years, says the New York City Gay and Lesbian Anti-Violence Project, a New York state-financed group. Between 10% and 15% of the violence occurs in the Village, says David M. Wertheimer, the group's executive director. He adds that it is committed by Village residents as well as by outsiders. Deputy Police Inspector Elson Gelfand, the commander of the precinct serving Greenwich Village, says, "AIDS gives people an excuse for violence." One night early last year, for instance, a group of youths yelled at two men they assumed to be homosexuals, "Here come the AIDS carriers. Let's kill them," Mr. Wertheimer reports. The gang assaulted the pair on a Village street, hitting one on the head with a garbage can. AIDS has also struck business, especially in the most heavily homosexual areas. Police officials say pedestrian traffic on Christopher Street, long a gathering place of homosexuals, has plunged by as much as 40% on weekend nights. The decline "has affected all of the shops," says storekeeper Rob Kilgallen. These days, he says, he closes his candle shop at 8 p.m., compared with 10 or 11 p.m. two years ago. He says he knows of three shopkeepers on his block who have died of AIDS -- a florist and the owners of a card shop and a store selling movie memorabilia. At least three bars catering to homosexuals in the Village have closed for lack of business, among them a place called Peter Rabbit -- and others feel the pinch. "In three years, my tips went down 30%," says Michael Loria, who last year quit his job as waiter at Julius, a Village gay bar. The backlash may be weakening as fear of getting AIDS from casual contact continues to fade. The opening of the Bailey House residence this winter provoked less public outcry than the opening of a much smaller facility did a year earlier. Three doors up Christopher Street from the new residence, Charlotte's Cafe, a restaurant specializing in food of the Southwest, opened March 1. "We knew about Bailey House," says Larry Peters, the restaurant's general manager, "but we got a good lease." Real-estate prices in the Village seem generally to be unaffected by AIDS and the omnipresent signs of the disease. Vacancy rates are low, as always, prices high. Any softness seems typical of New York market conditions generally. Besides provoking reaction, the AIDS crisis has prompted an outpouring of volunteer sacrifice that is itself changing lives. Jane Ellen Best, 29, who was a financial adviser at Sanford C. Bernstein & Co., and Ganga Stone, 45, who managed a food-vending business, quit their jobs to organize God's Love We Deliver. With 50 volunteers, the group distributes meals donated by restaurants to people with AIDS. With hospitals and social agencies ill-prepared for the burdens of this epidemic, much of the long-term care of the sick has fallen to friends, families and volunteers. It has been a heroic mobilization. Mr. Shernoff, the psychotherapist, and his roommate, Phil, took over the exhausting daily care of Mr. Shernoff's brother, Henry, who had AIDS. Henry Shernoff lived out the last 11 months of his life in the two men's living room, which was equipped with oxygen tank, wheelchair and other apparatus. "Phil didn't like Henry much -- I didn't even like Henry much," Mr. Shernoff says. "But my family was amazed by Phil's behavior -- how a 'complete stranger' could display such kindness. It taught my parents another definition of family." The biggest volunteer effort is the buddy system run by the Gay Men's Health Crisis. Throughout the city, 600 volunteers are doing laundry, cooking and shopping, and offering emotional support, for some 600 people with AIDS. About 100 of the clients are in the Village. "This is the best work I have ever done," says Bruce Woods Patterson, who became a buddy after his own roommate died of AIDS. He later quit his work as a film production coordinator to work full time at GMHC for half the pay. Besides homosexuals, GMHC volunteers include heterosexuals, a prominent socialite, at least one grandmother and scores of other women. AIDS, which is transmitted through sexual contact or intravenously, is also changing the lives of people who aren't involved, and hope to stay that way. The Anti-Violence Project's Mr. Wertheimer says half a dozen of his friends who are homosexual now abstain from sex. Others have sought refuge in stable, monogamous relationships. Yet, Mr. Wertheimer says, "there is still great misinformation, especially among the young." A city-commissioned videotape on AIDS is being shown at schools in many other cities, but New York youngsters have yet to see it. The controversial tape still is being revised for local consumption, a school-board official says. By all accounts, heterosexuals, who statistically still are in less danger, have been much slower than homosexuals to change their sex lives. A Village nurse who deals with many AIDS patients admits she "isn't cautious about safe sex" with her boyfriend of four months. "We are where the gay community was five years ago," she says. "It's funny how we all self-destruct." (This article is made available here by Dow Jones Co. for the personal and non-commercial use of callers to this bbs, in the hope that it will be of some help to those who are suffering from the disease and others who are seeking to help them.)