“HIV is certainly character building. It’s made me see all of the shallow things we cling to, like ego and vanity. Of course I’d rather have a few more T-cells and a little less character.” —Randy Shilts, author of And the Band Played On and The Mayor of Castro Street

I recently finished reading Season of the Witch: Enchantment, Terror and Deliverance in the City of Love. David Talbot’s history of San Francisco is dark and stormy, frighteningly full of events that belie the free-loving-60s-hippie spirit the city is known for.

Among the stories recounted in the book is that of the HIV/AIDS epidemic that turned formerly fun, flamboyant neighborhoods into ghost towns. The gay population of San Francisco—of the country, really—was hit the hardest; healthy people struck down in their prime. That felt familiar.

I know that AIDS and ALS are very different. ALS is not contagious, and it’s not an epidemic. There are so few people who have it, in fact, that it’s considered an orphan disease, and commands very little attention from the NIH or the public. We all know this, just as we know that after this summer’s Ice Bucket Challenge, the game briefly changed for ALS.

But it takes a lot of money and a lot of attention to impact a fatal disease. That was true of AIDS, and it will be true of ALS. The attention and the funding came through for AIDS, and Wikipedia helpfully explained to me that it is now considered a chronic disease, rather than one that’s acutely fatal. People are living—really living—with it. People live with ALS, too, of course, but we have nothing like the cocktail of HIV/AIDS drugs that can keep symptoms and a scary prognosis in check. ALS is still disabling. Still acutely fatal.

ALS treatments are estimated by some scientists to be 7-10 years away. The CEO of ALS TDI told me that a cure is decades away. Sometimes it’s hard to stay hopeful when you hear time frames like that, although given the past century’s progress on ALS, it is truly remarkable. The money that came in from the ice buckets is being used to fund exciting and promising programs, and I know that eventually there will be real developments in the race to slow down this disease.

As I read Talbot’s book, which culminates with the AIDS crisis, I felt both hopeful and demoralized. It can happen—a disease that kills can be tamed and managed. But it requires so much awareness, so many people who care and who really want and need it gone. A contagious disease simply has a better chance of creating that kind of awareness. Please don’t misunderstand: I’m not wishing for AIDS. Or Ebola.

But what ALS has going for it—and I’ve written about this before—is that it is only one of a group of neurodegenerative diseases, mass murderers that affect millions of people. My fervent hope is that attention towards Alzheimer’s, Parkinson’s, ALS and others will eventually lead to a reprieve for us all.

If you read Carrey’s post from last week, you know that many of us who are facing a terminal illness are really not asking for all that much. Perhaps in a former life, we wanted and wanted and wanted more. Now, we just want to take a walk with our dogs, brush our kid’s hair, weed the garden. That last one is me. Seriously, I think on a near daily basis of how happy I would be to just get down in my yard and dig in the dirt. It’s becoming a bizarre obsession, so much so that I asked Rob yesterday if he would just pick me up and drop me in a pile of weeds. He did. It was awesome. So satisfying, even when my fingers were cramping and rebelling.

Someday this disease will be manageable. Someday it will be curable. For now, I have my family, I have my books, I have my weeds, I have my character. I do wish I had some more T-cells, though.

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