The Leper’s Burlesque

Part 4


John R. Guthrie





On the next hospital visit, Damien said to Dr Payne, “My Dad found out everything. He called and told me to find another place to live.”

Dr. Payne pursed his lips, took a breath and then said, “Oh, boy! Damien. I’m terribly sorry. What about your church, your minister?”

Damien took a breath, blew it out through his mouth, then said, “Pastor MacLeash’s secretary called me.” He nodded toward the bedside phone. “She said that Pastor MacLeash said it might be better if I don’t come to church until all this is straightened out. He says he’s concerned that I might spread Gay Plague, as he calls it.”

Disfellowshipped,” Aaron said.

“Yeah. I thought about telling him that his youth minister nephew is hot in bed. I’m not gonna, though. It wouldn’t do anybody any good.”

“How did they find out about all this?” Payne asked.

“From what my Mom said, my personal deacon, Otis Brine, told the preacher, then preacher’s wife spread the word.”

“Your personal deacon?”

Damien explained this to Dr. Payne, “At First Church, the big donors who give the church a special gift, like the machine shop owner who gave the church a diesel bus for the youth program, get visits from Preacher MacLeash when they’re sick. Lesser gifts earn an assistant minister’s visit. Ordinary Christians get one of God’s lesser representatives, a ‘personal deacon’ like Otis.”  

“Hmmm,” Dr. Payne said. “Sort of a minor variation on the system of indulgences and dispensations that caused Martin Luther to be greatly exercised. He was excommunicated for his trouble.”

“Yeah, I know about that from history class,” Damien said.

Payne continued, “Yeah, if Martin Luther hadn’t been hidden away by Frederick the Wise in Saxony, the Holy Father would have had him burned alive.”

“Maybe that’s why there are no Martin Luthers at First Church,” Damien said.  “Since the word is out, I guess the youth minister knows something’s up now.”    

“If not, he’s likely to find out something along that line pretty soon,” Payne said. “The public health nurse wouldn’t spread gossip, but the youth minister’s wife will, at least to family, and then they’ll spread it around.”

 “Doc, I was 14 the first time. He was already out of college. I wasn’t raped. I feel sorry for him now. Being gay in a place like Austerity isn’t easy for him or for me.” Damien looked down, sighed again and shrugged his shoulders.  

Nodding, Aaron Payne reached over and gripped Damien’s forearm. “Hang in there, Buddy. Let’s hope things get better.”

Without looking up, Damien twisted the edge of the sheet between his fingers. “Shit! That’s easy for you to say, Doc. You’ve got it made.” He was weeping silently again.

Dr. Payne leaned back and nodded. “Yeah, I’m fortunate. It hasn’t always been this way. May I tell you a little personal story, briefly?”


“I grew up in California, a Seventh Day Adventists, big time. Like First Church, SDAs are evangelical. When I was just a kid, I found out that the preacher was using my baby sister, Faith, as a sex toy during ‘discipleship” sessions.”

“You found out? Damien said. “How?”

“My mother and I walked in on them.”

“No kidding,” Damien said.  The church’s reaction? My family’s? ‘Forgive him,’ they told Faith. ‘Talk to God about it.’”

“Oh, boy,” Damien said, interested now. “That’s pretty low. A baby–bonking preacher. Not the first one, though. Did anything ever come of it?”  

“For the preacher, no. That started me thinking, looking at the church itself. I started looking at what we were supposed to believe, pretty much one thing at a time. I decided that most of what the church believed was ridiculous and illogical. The more I thought about it, the more I read, the more I started believing in rational things. I became a humanist, a rationalist, pure and simple. When I graduated high school, I outed myself--as an atheist and an apostate.  I tried to explain it all to my congregation and the minister.”

“How’d they all react to that?” Damien asked.

“My father told me to get out. I did. Even though my father forbade them to have anything to do with me, my mother and my sister both keep in touch. I haven’t spoken with any of the rest of them since.”

Damien bit his lower lip a moment. “So you know how it feels, Doc, to be kicked out.  So what did you do then?”

Payne smiled. “What a lot of lost and dispossessed young men do—women too, these days. I enlisted. U. S. Marine Corps!”

“No kidding? What did your dad think of that?”

“It made matters worse in his eyes and those of most of the others in my family. Joining a combat force, though not totally unheard of for SDAs, is a violation of SDA teachings and tradition.”

Damien looked worried again, his brow furrowing. “That’s like they’re letting someone else do the heavy lifting for them.”

Payne’s pager squawked again, loudly, startling Damien. Dr. Payne arose. “Damien, fellow, hang in there. I have to step down to the emergency room. We’ve gotta talk more later.” With that he was gone.

At the E.R. front desk, the triage nursed explained that there was an ambulance 12 minutes away, en route from the periphery of Chickasaw County. An older woman with respiratory distress was on her way.


            He sat at the desk near the exam cubicles and waited. Thinking of the conversation with Damien, he doodled on a discarded sheet of paper an eagle, globe and anchor and beside the rod of Asclepius, its serpent gape-mouthed and vicious looking.

He could see the events of some 20 years before quite clearly:

At recruit graduation, flags snapped in the breeze, the band segued into the Marine Corps Hymn as we passed in review, stirring my very soul.  

My unit getting ready to ship out for Vietnam: I received orders for a transfer to the part of my outfit that was to remain behind. I requested mast, going up a reluctant chain-of-command until I stood, palms sweating, before the general himself. Sir, I said, speaking more boldly than I felt, I joined the Corps to be a grunt.

‘Son,’ the general said, ‘I admire your spirit. The policy of not sending seventeen-year-olds into combat is a long established and pretty much inflexible.  General Macarthur established it during the Korean War.

Wondering if I would end up in the brig, I still wouldn’t give up. If it please the general, Sir, I heard myself saying, I’m large for my age. I’ll be eighteen next month. Sir, in the glorious history of the Corps there have been Marines at least as young as thirteen who were mature for their age and saw combat.

The general stopped for a beat, that weather beaten old face looking dead at me. When he finally spoke he said, kindly as anyone could, ‘Son, let’s keep what I’m gonna say between us two Marines. I faked my age and joined the corps at age fifteen in 1932.’  I nodded, probably my mouth hanging open as he continued. ‘I served in Peking, China under a capable and memorable officer named Victor H. Krulak. He was a great inspiration to me, a mentor. Exactly when will you be 18, Son?’

“March 8th, Sir.”

Something like a smile played across that stern face. ‘Semper Fi, Son,’ he said. ‘Dismissed!’

I said, “Aye, aye, Sir,” did a smart about face and marched off, not sure of what had just transpired. 

On March 8th of that year, 1965, I landed with 3d Battalion, Ninth Marines, 10 miles west of Da Nang in the Republic of Vietnam as part of the Ninth Marine Expeditionary Brigade.

Dry throat. Backs wet with sweat. Feet soaked. That Southeast Asia sun flashing like flashbulbs off the water, the heat coming down like a broiler oven.

The crash of the gurney against the swinging doors as his patient was wheeled in interrupted Aaron's reminiscence. 


Chapter IX


On the 5th post-surgical day, Dr. Rosenblaum determined that ninety-five percent of Damien’s skin graft survived; a good result. Damien was followed closely after his hospital discharge by Dr. Payne.

One day when Damien’s examination in Dr. Payne’s clinic was done, as Dr. Payne and Nurse Broome turned to leave, Damien said, “Doc, Ali, thanks!”

“You’re more than welcome,” Dr. Payne said.

“Likewise,” said Ali, smiling beautifully as she reached over and grasped Damien’s right shoulder.

Damien’s eyes were shining. “I don’t know what I would do without you two guys and my mom, ” Damien said.

Dr. Payne said, “We’re with you buddy, till this is done with.”

“Until I die, you mean!” he said, a bit of bitterness in his voice again.

“Until whatever,” Payne said. “It looks grim now, but there are new research developments every day. You never know.”

“I’m not afraid of dying,” Damien said. “Not one bit afraid, most of the time anyway. At least I’ve gotten to do a lot of things I wanted to.”


By calling the CDC in Atlanta and the pharmaceutical company, Dr. Payne managed to enroll Damien in a CDC field study of HIV positive patients. This study provided a supply of the new drug, Retrovir that was showing such promise.

The results were good--for a while.  Damien’s blood counts showed a steady increase in the T4 cells, cells essential to fighting the HIV virus.

It was six months later that Dr Payne was called to the emergency room early on a Saturday morning to see Damien. He admitted, him, semiconscious, to Austerity’s Regional Medical Center with, Pneumonia, rule out Pneumocystis pneumonia as causative agent. Sputum cultures confirmed the diagnosis.


His mother, Polly, searching for understanding, came by to talk with Dr. Payne. She had her sister with her, a nursing school professor from Augusta, Georgia.

The two women sat across from Aaron in his office, the sounds of the busy clinic muted by the closed door. “Doctor Payne,” Polly began, Damien was doing so well on his new medicine. He’s slipping backwards again. What’s happening with my son?”

“The virus changes, Polly,” Dr. Payne said.

“Changes?” Polly replied.

“Yes, it’s not good at making exact copies of itself.  There’s an error rate of something like one per thousand. Most of these imperfect viri simply die off. A tiny minority evolves to specimens better equipped to resist the Retrovir. Then the cycle repeats itself, the fittest viri are selected from each succeeding generation and so on. Eventually by this process of evolution, the virus evolves into something resistant to Retrovir.”

“Evolution?” Polly said. “Surprising. At First Church we don’t believe in evolution. Preacher MacLeash preaches against it. Can you tell me more about that?”    

Dr. Payne voiced his responses to Polly’s concerns with concern and respect. “Sure, Polly. These modifications in the HIV virus are exactly that described by Charles Darwin in larger creatures, be it finches, whales, or humans. The principles of evolution are precisely the same as those that brought us from the Australopithecines of the African Savanna to contemporary human beings.”

Polly grappled with that, then said. “Doctor, I don’t know. MacLeash always preached that we needed to look for answers in Genesis.”

Polly’s nurse sister spoke up. “Doctor Payne is right, Polly.  The evidence is as certain as that for the earth revolving around the sun instead of vice versa.”

Payne nodded toward Polly’s sister and said, “I’m glad you brought your sister along, Polly. This virus reproduces so frequently that the process of evolution is easy to see. So we have a situation where reports are coming in from across the country to the effect that an antiviral drug that seemed so promising at first is losing its effectiveness.”


Ali Broome, playing social worker, secured Damien a place in a homeless shelter in a run down and abandoned school. That part of the community was frequented by Austerity’s worst elements; unrepentant sinners in endless variety, prostitutes of all genders and persuasions, drunks addled by cheap gin or wine, Listerine, shoe polish, Sterno. Dope addicts. The unsaved, unwashed, and unrepentant detritus of Chickasaw County.

Damien’s mother visited two or more times a week. I’ve tried to be a virtuous and godly woman. I’ve made every effort to endorse and live the edict, repeated again and again the in the Old Testament and the New, to, ‘be submissive to your husband,’ to ‘obey (him) in all things.’ Yet I ignored Floyd’s direct orders not to see Damien. And know what? I don’t care, even a little bit.

She ignored the panhandlers, the grime-coated human wrecks reeking of urine and feces, who sometimes lay sometimes recumbent and snoring on the sidewalks around the place of human refuse where her son now resided.   




Damien came in to see Dr. Payne because of a deep cough. Before his examination began, he handed Ali an envelope. On the front, it said in Damien’s handwriting,


Aaron. Payne, D. O.


Alice Broome, R.N.


Ali started to open it. Damien said, “It’s for the two of you. I though about one apiece, but when I thought about it, well, not to be presumptuous, but you two are an item. You just don’t know it yet.”

Payne laughed. Ali’s face reddened. “Damien Smarty Pants Frey,” she said. “I have never smacked a patient before but…” Ali withdrew the note card, a fine vellum card with a picture of a crane flying on the front. It captured the grace and energy of the creature in the sparse and economical strokes of a classical Chinese artist.

“Beautiful card,” Ali said as she opened it. She read aloud:

Dear Dr Payne and Nurse Broome—


Sometimes I feel like there’s not much I can do to explain how much you’ve meant to me and how much you’ve helped me through this hard time. I love you both for it.    Just as important as any medicine, maybe more important, you never judged me. Like it or not, I count both of you among my friends and family now. It’s really been great knowing both of you.




“Oh, Damien,” Ali said, “That is so sweet.” She leaned over and hugged his slender form close.

“Thoughtful, Buddy,” Payne said, embracing both of them. “It does mean a lot.”

 They held the embrace for a beat, then Ali and Aaron stood back, swallowed and were silent for a moment.

Aaron said, “Well, we better check you over.

Damien said, “I have some spots.”

Dr. Payne looked at the dark purplish-brown welts. Damien’s left eyebrow partly concealed one that was hardly bigger than the head of a kitchen match. Another, above his right nipple was also small. There were two on his right shoulder, both big as a quarter.

Payne said, “This is called Kaposi’s Sarcoma, Damien.”

Damien said, “I thought so. I know Kaposi’s Sarcoma means it’s late in the game. I read that people who develop it are often dead within the year.”

“It’s good you can talk about it, Dr. Payne said. “Lots of people can’t.”

Damien continued. “After I left the church, I started thinking things through, a little like you did. I read a lot too. I’m not afraid of burning in hell any more, or worried about going to heaven either. I think when I die I’ll just be dead.”

Dr. Payne nodded, then listened to Damien’s chest. He could hear the fluid buildup in his lower right lung. He ordered a chest X-Ray. While he waited, he started writing Damien’s hospital orders.


The first three days in the hospital, Damien deteriorated until he was semi-comatose. In three more days, though, he rallied, responding to the antibiotics and intravenous fluids.

At the end of that first week he was again awake and alert when Dr. Payne and Ali made rounds.

“Hi, Damien. How are you feeling today?” Payne said.

Damien managed to smile. His voice barely above a whisper, was further muffled by his oxygen mask as he said, “Like shit, Doc, Ali. Like shit!”

Dr. Payne smiled and said, “You do have a way with words, Damien,”

 “Dr. Payne?”

“Yeah, Damien?”

His voice was subdued. “I’m not going to make it home this time.”

“You feel like you’re not gonna make it, Son?” He reached over and placed his hand on Damien’s forearm.  Looking grim, Payne sat on the side of the bed.

 “I wish my dad would come by just once, before I’m gone.”

“Let me follow up on that, Damien.” Aaron said. “I’ll see what I can do.”


It was a thoughtful Dr. Payne who stepped into the hallway and walked slowly toward the nurse’s desk. He leaned against the desk, and began looking through Damien’s chart for contact phone numbers. He heard a voice behind him, say. “Dr. Payne?”

Her turned and looked to see the dark suited man behind him. “Rev. MacLeash! How are you today?”

“Quite well, Dr. Payne.”

“You here to see Damien?” Aaron said, some surprise in his voice.

“Well, ah, actually, no. I’m here to see Broadus Axelrod. He’s just down the hall. The dear old saint is 83 years old, and soon to meet his Lord. He’s remembered the First Church family with a generous endowment. Very generous.”

“And Damien? He’s right here also.”

“Under the circumstances, I just don’t feel it appropriate to see Damien. No one fully understands this illness yet. Can a mosquito bite spread it? A sneeze, a handshake?  I felt moved to tell my congregation it’s wiser to stay away also I feel it’s my duty to stay away, and to caution my church members to do so also. I hope you understand, Doctor.”

Dr. Payne hesitated a moment, looked away, then looking directly at Pastor MacLeash again said, “Actually, it’s not spread like that, Reverend. But I couldn’t agree more. You certainly shouldn’t see Damien. And Damien certainly shouldn’t have to see you.”

“God bless you, Doctor,” MacLeash said, a little smile on his face, but managing at the same time to look as if something smelled bad. “I’ll pray for Damien, Doctor, and for you.”

“Really?” Dr. Payne said. “Save your breath to cool your broth, Dr. MacLeash. ‘I’ll pray for you’ in this context is sort of the ultimate left-handed compliment. It says that the supplicant is dealing with someone who is such a sinkhole of corruption and spiritual filth that only magical intervention by your sky god can remedy such an ignominious disaster. Don’t worry about me, Preacher, or Damien.”

 MacLeash drew himself up, straightened his lapel, said, “God bless you,” again, turned on his heel. He stopped and turned back and said, “Dr. Payne, I know how all this looks to you, better, perhaps, than you think. But I am, with all my faults, exactly what I have to be. And believe it or not, Doctor, so are you.” He then turned and departed toward to the greener pasture of Broadus Axelrod’s room. Thoughtful now, Aaron watched the back of his pin-stripe suit as he marched smartly away, Bible in hand, stiff-backed after the manner of a short man who wished to be taller. Nodding, Aaron found himself thinking, “Yeah. You actually have a point there, Reverend.”


            Damien became too weak to feed himself. For two days, he was spoon fed by one of the nurse’s assistants. Then he became too weak to chew his food.

Dr. Payne passed a nasograstic tube, a slender plastic tube a little wider than a strand of vermicelli through his nose into his stomach.  Then opened Damien’s mouth to make sure the tube was passing down his throat and not curling back on itself. It passed easily enough, but Dr. Payne felt some uncertainty. If the tube had in fact passed through the larynx and into the lungs, the steady flow of liquid nutrients would very quickly and efficiently drown Damien.

Payne ordered a portable X-ray. The machine, big as a steamer trunk, soon rolled down the hallway, its battery-powered motor whining. It was steered by a petite black X-ray tech. She already wore the obligatory blue vinyl-covered lead protective apron.  Payne retreated to the hallway as the tech worked.

When Payne looked at the X-ray, it indeed showed the radio-opaque tip of the feeding tube in the bronchus of the right lung.

He returned to Damien’s bedside, repositioned the tube by withdrawing it halfway and twirling it slightly as he reinserted it. The next X-ray showed good positioning, the tip of the tube clearly within Damien’s stomach. Damien’s nurse efficiently adjusted the feeding pump and switched it on, allowing the milky fluid to pour steadily in, providing Damien with life sustaining fluids, calories, vitamins and minerals.

Testing of his immune system showed a continued and alarming decrease in T4 lymphocytes, the specialized cells that cleverly program themselves to help the patient acquire immunity to new challenges, in this case, the HIV virus.

To Dr. Payne’s and Ali’s surprise, Damien rallied again. He had become so emaciated during his ordeal that his cheekbones tight against his skin. He was weak as pond water, but was again alert and able to eat on his own.

While the outcome for Damien was inevitable, Dr. Payne and Ali both saw value in his rally. He could say his goodbyes. Hopefully, he could make his peace with his father. He wasn’t going to have a good life, but the two of them fervently wanted him to have a good death. They wished for one that occurred with any available friends and family present, people who loved him and would tell him they loved for that long and final journey all must take.

Dr. Payne called Damien’s parents’ residence and spoke with his father, Floyd, for the second time. He explained the situation, and implored Floyd to visit his son.

He said, “Dr. Payne, the liberals and hippies and commies and queers have had their way too long. They’ve pushed the ho-mo-sex-yal agenda down our throats. I lay this directly at their feet. ‘Be not deceived: Evil companionships corrupt good morals. The wages of sin is death!’ My stopping by is not going to change that.”

Dr. Payne winced at Floyd’s usage of the term “ho-mo-sex-yal” though he knew it was part of the informal liturgy for most First Church parishioners. That  peculiar corruption of an ancient and appropriate word  encodes the belief that one is dealing with something akin to scorpions, killer bees, poltergeists, or demons; something infinitely more monstrous than “homosexual” or “gay.” A lack of distortion might imply, quite unacceptably, that one is speaking of human beings who, like heterosexuals, may or may not have some spark of the divine within.

Despite his inner dialogue, he spoke calmly. “No,” he said, “You can’t change the fact that your son is dying. But it’s quite possible you can make it easier for him. You know your Bible, Floyd. You remember that passage in the book of Mark; ‘I was sick and ye visited me.’ It goes on to say ‘In as much as you have done it unto the least of these, ye have done it unto me.’”


“That,” Payne added in a moment of inspired hyperbole, “is why everyone at First Church loves Jesus Christ so much. He changed things from the cruel exclusion for people who were sick and weak and downtrodden found in earlier times.”

There was silence for a moment on the other end of the line. Finally Damien’s father said, “I’ll think about it, Doc.”

“Sure, Floyd. I wouldn’t waste too much time if I were you, though.”


To Be Continued…