HIV in the Absurdist Oligarchy

“What do you mean you can’t fill my prescription?”

“I’m sorry, Aaron, but your new insurance company won’t let us. I think we’re a competitor of theirs.”

“Are you serious? I’m just trying to get my medication.”

“I’m really sorry. There’s nothing I can do.”

“It’s OK. I know you can’t do anything. I’m just really upset and confused right now.”

“Trust me, I’ve been there. I don’t know why it works this way. Just how things are.”

“I feel ya.”

“Good luck, Aaron. Take care of yourself.”

Day two, hour six of my acid trip through Medco’s member-services line, the above conversation replays through my mind.

I felt like I was the doomed protagonist of a surrealist short story; coasting from one five-minute hold to another, I drifted into a trance where my consciousness had been transported to an immaterial plane — a florescent prison of bleak hallways and garbled elevator music. To escape, I either had to hang up the phone or repeat my insurance information ad nauseam, which only seemed to illuminate more obstacles that Medco’s representatives alone could overcome.

By day four, hour nine of this telephonic gauntlet, I became delirious. Staring at an empty bottle of Truvada like a snake-bitten traveler without serum, I digitized my consciousness into the Medco member services one last time.

Garble elevator music. A rep picks up. I start to cry uncontrollably. I tell her to transfer me to a supervisor immediately. Garbled elevator music. Now I was speaking to the fourth or fifth supervisor I had spoken to that week. The others had failed to call me back when calls were dropped or had simply transferred me to wrong departments. With this in mind, I anticipated failure. Other than begging for sympathy, it’s not like I wield any real power.

“Mr. Stella, please calm down,” the supervisor said. “I promise you, I’m not going to get off the phone until we’ve secured a pharmacy that can fill your prescription today.”

In less than 10 minutes, the supervisor had located not one, not two, but 10 different pharmacies in Center City Philadelphia than would fill my prescription.

The issue was a clerical error on Medco’s side, an oversight that 20-plus people over the course of four days and nine hours couldn’t rectify because no one thought to double-check my information.

The question remains, however: Why did I get so upset? What sparked that outpouring of pathos that made me into an elemental of rage? I shouted my every word through a fit of tears; told them, “I will stomp on the necks of Medco’s executive directors”; pleaded for someone to, “Please, just make this all stop. Just get me my medicine. Why do I have to go through all this bullshit just to get on with my life?”

Then it hit me, the nature of my anger.

For those four days, HIV-poz folks from across America sat on the phone with me. I imagined myself not as an empowered gay man with a fiery disposition, but as an aggregate body comprised of every permutation of HIV-poz human that has ever been infected with HIV — punished by the system, helpless before Big Pharma. In that moment of communal lament, I realized that stigma is only part of the reason why HIV-poz people stop seeing their doctors and stop taking their medication: complicated processes; the bureaucracy; the profit-based system of care that takes precedence over a wellness-based system of care; the culture of sick vs. healthy; the rich and powerful that have the ability to change said systems, but instead, wage their little turf wars at the expense of the commonwealth.

I’m just as much an author to this Absurdist Oligarchy as the executive directors of Big Pharma, the conservatives in Harrisburg and pretty much everybody on Capitol Hill. Invoking an “us vs. them” mentality won’t spin the wheels of change any faster. If anything, it’ll spur them backward.

Am I going to quit my job and join a task force for restructuring health care? No. Am I going to yell at Medco representatives again, who bear no power to change the system? Probably. Can I learn and understand the nature of my anger, show kindness towards others and accept my part in the Absurdist Oligarchy of America? Yeah. As absurd as we are, we’re also a community. And community, I won’t forsake.

We’re all in this together, folks. Now get out there and talk about it.

Aaron Stella is former editor-in-chief of Philly Broadcaster. He has written for several publications in the city, and now devotes his life to tackling the challenges of HIV in the 21st century. Millennial Poz, which recently won first place for excellence in opinion writing from the National Lesbian and Gay Journalists Association and best column writing from the Local Media Association, appears in PGN monthly. Aaron can be reached at [email protected].

Newsletter Sign-up