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    8 MIN READ

    Be careful what you Syph for

    Like a Roman foot soldier, I got neurosyphilis in the 21st century.

    I hate doctors. Over the last two years, I’ve seen enough for a lifetime, and more often than not, I’ve found them to be unhelpful, overpriced and judgmental—despite whatever supposed oaths they’ve taken.
    Consider my general physician, who, when I first asked to be prescribed PrEP, cautioned that I still use condoms, as the medication only prevents the transmission of HIV, not other STIs. My overactive gay brain intepretated this advice as homophobic: the entire point of going on PrEP was to join the cavalcade of faggots fucking raw! Obviously, I was projecting, but Doc’s puritanical lecture on safe sex still felt a little gratuitous…
    So when he called me with the results of my blood test a few days later, I could practically hear his shit-eating grin as he told me I had tested positive for syphilis.
    * * *
    It was August of 2020, and I had been alone in my apartment for a solid four months after my roommates fled New York City due to the pandemic. I tried to maintain a cool head and impermeable pod amid the global etcetera, but I wasn’t always successful. Sometimes I simply had to open Grindr and invite a stranger over to cum inside me, or me in them—instances where my need for physical touch and connection would overcome my concern for my safety. Maybe that’s why condoms weren’t even a thought: I was already flouting social contracts, I may as well commit to the bit.
    I got tested in May, and though it took three weeks to get my results, I was negative across the board. Subconsciously taking this as approval of my quasi-celibate lifestyle, I carried on with my occasional liaisons for the rest of the summer.
    So when my head started to hurt, I wrote it off as a symptom of one too many Birdy’s blue margaritas.Even when the pain began to intensify, sweeping across my brain at random like some cosmic entity playing whack-a-mole on my skull with a knife as the mallet, I still never considered the cause might be an STI, least of all syphilis.
    I learned two things from reading Candide in the tenth grade: syphilis is a peasant disease for peasants, and that, if left untreated, it becomes degenerative.
    As I am not a peasant and had nary a sore on my body, I assumed dehydration, stress, extended hangover, lack of sleep, meningitis, excessive build-up of keratin spray, anything besides syphilis. Suffice it to say the call from my doctor came as a shock. I even put down the joint I was rolling, lest my trembling hands spill the contents all over my lap. 
    Not only did I test positive for syphilis, but he was concerned that my headaches might be the result of the infection entering my nervous system, known medically as “neurosyphilis.” To be sure, I needed to get a spinal tap, so I got my ass up and ran to Mount Sinai!
    Upon arrival, I was told I would be getting a COVID test, blood test, CT scan and spinal tap, which would provide the spinal fluid needed to determine if my syphilis was neuro—or simply corporeal, regular syph. After an hour of waiting, the reality of the situation hit me and I began to freak out. I realized I had to tell my mom, if only for insurance and consolation purposes.
    She talked me down and reassured me everything would be OK as a nurse approached me, pushing an empty wheelchair. They carted me over to the CT area, where I waited behind a girl who was bawling, clutching her hot pink cast. I tried to smile at her, but it came out as more of a grimace. I sang Grimes songs to myself until, finally, a doctorm arrived. He was holding a tray of various syringes.
    Lidocaine, he explained, to numb the area, and a 22 gauge needle to draw four 5mL vials of my cerebrospinal fluid, approximately 0.718mm in diameter… To quote the doctor, “Let’s make this quick and easy.”
    Yes, he was kinda cute. Yes, I hit on him a little. No, he did not reciprocate. Yes, I did ask him if you could test for LSD with spinal fluid. Yes, I did go on to say that I had tripped recently, in an effort to impress him. No, he did not care. Yes, it was awkward after that. “Any questions?”
    After that, more waiting.
    They were testing my spinal samples for traces of syphilis. If found, I would be strapped to a gurney or something, and if not they would treat me for garden-variety syphilis and send me on my way.
    An hour later, the doctor came back to tell me it was the regular kind. Yahoo! 
    A different nurse came to my bed with two syringes and told me to pull down my pants. She massaged each cheek at the point of injection, to help the penicillin infuse into the muscle. It all felt intimate, yet formulaic, like a routine Grindr hookup. Before I knew it, I was in an Uber back to Brooklyn.
    * * *
    For the next two weeks, I received weekly follow-up shots. My doctor was much less accommodating, jamming the needle into a single cheek and sending me off without so much as a kiss on the lips.
    My headaches receded, like the ocean at low tide where I spent so much of the summer, the waves lapping against my injuries and pulling them back out to sea, to the abyss. I felt good. My health crisis was just that—a blip in my medical history which would soon be forgotten. If anything, I was grateful. The experience grounded me, forced me to appreciate my health and reconsider my relationship with sex.
    JUST KIDDING! Obviously that would be wayyyyyyy too easy.
    Even a month after my last shot, when my head was relatively ache-free, I knew something was wrong. (It’s my own head after all!) I could feel it, a slight disjunction between how I felt and how I wanted to be feeling. But I was afraid to say anything, as if speaking it aloud would confirm my worst fears, or that my doctors might get mad at me and gaslight me into submission. So I just ignored the headaches’ return.
    I started dating again, or whatever dating means to faggots these days. Though I tried to pretend otherwise, the whole experience had shaken me. It continued to shake me, shame me, demean me for taking risks and facing the consequences. To reclaim what agency I had in the situation, I would tell friends my silly little syphilis saga—reframing it as something funny and not traumatizing, not something that made me feel powerless, humiliated, ugly.
    Dating was also a bid for agency: I was desperate recapture some of my mojo by way of attention and sexual validation from boys.
    However, the pandemic was still going strong and my roommates were somewhat more chaste. Not to mention some part of me also knew my malady was still raging inside, so I had to get creative.
    I invited a dancer who lived nearby to come smoke on my roof, carrying a stilted conversation until we both gave up and started making out, dry humping and feeling our erections over our pants like we were in 7th grade. I arranged a walk and a cigarette with another boy; an unemployed twink with a skinny dick. I made sure to cross paths with my roommate as she left for her run, so she would see me being wholesome and safe, before whisking him upstairs for a quick make out and a few licks.
    Despite reassurance from my doctor that the penicillin shots had wiped out the remaining syphilis in my body, eliminating the risk of passing it to others, I still felt intense guilt every time I hooked up with someone, especially unprotected.
    And yet, I kept doing it.
    Regardless of everything that had happened, my most enduring emotion was indignation. It was all so unfair! I knew plenty of others who were just as sexually reckless as me—why hadn’t they contracted neurosyphilis? Why do they get to live a carefree lifestyle while I didn’t?
    I felt ashamed, frustrated, homophobic, and most of all, angry. I couldn’t shake the feeling I was being singled out by the universe as punishment for my gay sex crimes, for aspiring to a lifestyle of unfettered hedonism which so many take for granted. At once both self-destructive and delusional, I fancied myself the main character in an overwrought medical drama, but don’t worry—it gets worse.
    * * *
    By the time my birthday came around at the end of October (could you tell I was a Scorpio?), the headaches were back in full force. More intense, even.
    With each day they got sharper and more frequent. It became physically painful to exist. I thought back to the hospital, wondering if the test results had somehow been wrong. A life of neural degeneration was not as scary as a potential two-week hospital stay, if only for the mortification of explaining my situation.
    I knew I should call my doctor and tell him that his precious hospital had failed me, but I was already so fed up with self-important physicians, those who would sooner show up unannounced to your parents’ beach house for a nightcap than actually solve the problem at hand.
    Ultimately, I swallowed my pride and told him the bad news. He seemed unfazed, as if he knew this could be a possibility. He connected me with an infectious disease specialist at Columbia, and I made an appointment for the following week.
    In the meantime, I threw a rave-themed birthday party for myself on my roof that weekend and made personalized rave candy bracelets for the guests. Mine read “SYPHILIS BOY.” It was easier to laugh than to confront the gravity and danger of my situation.
    I marched up to Columbia that week in a silly little outfit, complete with my new identifying bracelet, so the doctor wouldn’t get me confused with any of his other patients. He confirmed my theory; my spinal fluid had returned a value that was so close to the negative threshold for syphilis that the hospital staff had discharged me. 
    The penicillin shots had cured the STI form of syphilis in my body (phew!) but it was still in my nervous system. To finally force the remaining syph out, I’d have to be hooked to a penicillin IV drip for two weeks. My iconic new doctor connected me with a nursing service, which would send a professional to my home and get me all wired up. Competence! We stan.
    * * *
    Previously my condition had been invisible, but now there was a new physical manifestation to feel ashamed of. A nurse came to my apartment, stuck a needle in my vein, which, with the help of an electric pump, would administer penicillin from a plastic tube into my bloodstream 24/7. My new medical apparatus was all contained in a chic little backpack.
    While the backpack did allow me some physical mobility, I was trapped by fear and embarrassment. I had to assess where I could and couldn’t go, consider ways I’d conceal my condition while making sure the plastic tube infiltrating my veins didn’t snag on something—I felt disabled. I tried to own my truth or whatever, and posted an underwear mirror selfie, tubes visible, on Twitter. The response to my syphilis thirst trap was middling, I assume due to my followers’ confliction between stimulation and horror. Or maybe I just didn’t look very good.
    When things are at their worst, you simply have to laugh. And if you can believe it, during this period, I was still having sex. I wasn’t even that horny; the men more so satisfied my need for acceptance, my need to know that even now, with my needle in my arm, someone could still want me.
    After another month or so, my headaches finally started to subside. I went to a clinic for another blood test to see if there were latent levels of syphilis still in my body. After he took my blood, I cautioned the attending physician that my syphilis results may be skewed due to my complex condition. “It’s no fun being a medical mystery,” I lamented self-pityingly.
    The doctor fixed me with the sort of steadying gaze they must teach you in medical school. “Someone has to be the first. Your copay will be $20.”

    + IMAGE: Ryan McGinley