LIVING POSITIVE

After she was diagnosed with HIV, lifelong drug abuser Pam Leedham
figured killing herself would be the easy thing to do. She decided to
take the hard route instead, fighting both addiction and disease, one
affirmation at a time. "I am a recovering drug a

There's this pamphlet. It's called HIV and Mental Health. And there
are two happy white people on the inside back cover riding a red
tandem bicycle. They're coasting along a sunny downtown street. And
they are smiling; they are glowing, like they're in an ad for milk or
toothpaste. The woman, on the back of the two-person bike, has her
legs out straight in front of her and she's smiling right at the
camera. It's like her whole body--her whole being--is saying Wheeeeeeee!

She doesn't look like Pam Leedham.

And it's not because she's smiling and Leedham's not (and she doesn't
once, for the whole time I'm sitting with her at her two-person
kitchen table in a housing co-op in north Dartmouth). And it's not
because these people are like two cut-outs from a Dockers ad and it's
autumn and Leedham is tanned the colour of an avocado pit ("seems
like no one tans anymore," she shrugs) and she's dressed in cut-offs
and a garish bright tank top. And it's not because the bike riders
are probably in their 30s but look like they're 20 and Leedham is 42
but her face shows 55.

Pam Leedham doesn't look like the HIV and Mental Health bike-riding
couple because those two are together. They may be models, a clipart
symbol of happiness and hope, but they're selling something else by
default. Love. Coupledom. At least companionship.

And Pam Leedham is alone.

Well, I'm there. But I don't count. Because it took a long time to
find her, several tries to get in touch with her, and one missed
meeting she forgot about to finally hook up. I tried to reach her
again a few times after we spent an afternoon together, but she
didn't call back and didn't answer the door and I wonder if I'll ever
see her again. Maybe she was too busy to call back. Or maybe she just
wants it that way. Like she says, "Right now I'm just focusing on me.
I've never done that before in my life."

Sitting in her small eat-in kitchen, Leedham's story spills out like
cake batter into a baking pan. It comes in a thick, slow unrelenting
mass. She's talking, talking, talking. Talking non-stop. Are you
hearing rapid fire bursts when I describe it that way? Because that's
not what Pam Leedham is like. No. Her words are measured. Not
pensive, but drained of the dips and peaks of emotion.

You have to listen closely.

But the story of Pam Leedham--and, no, that's not her real
name--isn't easy to hear. By part, it's the story of how she became
addicted to drugs. The story of how she has lost everybody who loved
her. The story of how she contracted HIV. And the story of how she's
collecting loose hairs between her nicotine-stained fingers in a
serious bid to re-braid her life.

Pam Leedham's good with her hands. Her front door's open when I
arrive at her ground floor bachelor apartment.

Hello?

She's sitting on the edge of a living room chair cutting Raphaelite
angels out of dollar-store wallpaper border. She says
"hicomeinI'mjustcuttin'outtheseangels" with scarcely a glance up from
the scissors. Once she makes the last snip she takes me directly into
the bathroom to show how she's pasting them to the wall above the
toilet and sink. Next to the kitchen. The same cut-out angels keep
watch from the wall above the stove.

Is it a good place to sit to do this interview?

Yup. Yup.

The place is surprisingly lived-in, given Leedham's been there just
one month and had only a bed, the chair and her TV when she arrived
on the doorstep. Her kitchen's got everything it needs. The place is
fully stocked with knick-knacks already. "It's homey; I like it this
way," she says. Someone was going to give her a couch too. "I don't
have company over," she says, "so what the hell do I need a couch for?"

I have time to get a good look at Leedham's kitchen supplies and
ceramic bears because the 42-year-old doesn't make eye contact once
during the first 10 minutes we're officially talking. She's belly up
to the kitchen table working intently at rolling a cigarette. We are
an absurd-looking pair, like performers in the starting position for
a modern dance piece. I'm sitting, facing her. My knees are an inch
from her thigh. But I'm talking to her left ear. And she's talking to
the tobacco she's crumbing onto the table with her forefinger, middle
finger and thumb. She tears down six or seven inch-long butts--rip,
pick, pick, pick. Rip, pick, pick, pick--and slides the pile of
tobacco onto a Zig-Zag. Rolls it. Lights it. Smokes it. Looks at me.

And I think, OK, now she can better concentrate on the conversation
and maybe she won't repeat herself so much. But she does. She says
it's short-term memory loss.

Devastated. Devastated. Devastated.

That's the word she repeats the most.

And she is devastated. Has been devastated. Knows devastation. But
every time she talks about the wreckage and desolation and the
unluckiness Pam Leedham has faced in her life, she counters it with
an affirmation. ("I know in my heart I'm a good person and a caring
person. I am a recovering drug addict and I will be until the day I
die. But that doesn't make me a bad person. I'm a good person.") And
it makes me think all the stories about injecting drugs and losing
friends and family and contracting HIV aren't Pam Leedham's story at
all. Pam Leedham's story is only starting now.

She calls it a year, but it was 10 months ago Pam Leedham was
diagnosed with HIV.

She had just made a big decision. She had decided to begin--for the
second time in her life--the gruelling process of getting off drugs.

"I couldn't get out of bed in the morning without a fix," she says.
"I couldn't function. I couldn't do anything without the Dilaudid."

That was the physical reality of her addiction to Dilaudid (a
synthetic pain reliever with effects similar to morphine which she
would buy in pill form, then crush, cook and inject). The theoretical
what-it-comes-down-to moment for Leedham was this: "I never did acid
or any hallucinogens growing up. I always wanted to be in control of
the high. And I think that's what it come down to with the Dilaudid.
The Dilaudid had control over me."

She admitted herself to the detox program at Simpson Hall, located at
the Nova Scotia Hospital on Pleasant Street in Dartmouth. Later she
began a methadone treatment program though Gottingen Street's Direction 180.

All good. Then she got sick. But more than that, Leedham says, she
had a sick feeling.

"I got pneumonia and I knew it wasn't withdrawal sickness. I knew it
was worse."

HIV-positive, they said.

"I thought, what's the point of trying to stop drugs and clean up my
life now? Because it's all over."

She figured she might as well just kill herself. She kept going to
Direction 180 instead.

The distance between those choices is a seldom-travelled route. And
how Pam Leedham got from point A--doing herself in--to point
B--committing to the difficult work of a daily methadone program to
wean off drugs and the equalled effort of beginning Highly Active
Anti-Retroviral Therapy for HIV--is a fuzzy trip. Even she can't
quite explain what got her off drugs, on HIV meds and methadone and
into the orderly knick-knack-proud home she's in today. She just
says, "I always had [Direction 180] for a kick in the ass.

"When I need them, they're there. The days that I wasn't feeling
good, they could tell. And I would say, I don't want to do this
anymore. I'm tired. I'd be almost in tears. But now I haven't had one
of them days in a really long time. In four or five months.

"180," she says, "they became my family and my friends."

She's not joking.

"All my life, pretty much, I had a drug problem," Leedham says.

And while that's a vague description, it's perhaps the most apt,
because it's difficult for Leedham to keep it all straight. Best she
can figure, it pieces together something like this:

Leedham was drinking alcohol and smoking pot and hash from the age of
12. Later in her teens, her mother (who still lives in Saint John,
New Brunswick, where the family grew up) used to ship all the kids
off to summer camp from June through September. Leedham hated it.
When she came home to visit she would steal her dad's nerve pills,
Benzodiazepines. Benzos, she calls them. They're anti-depressents.

"When I was 16," Leedham says, "I convinced a doctor that I needed
them and he wrote me a prescription from the time I was 16 until I was 30."

Leedham says, "I liked the nerve pills. I never did hard drugs."

But when she was 28, Leedham's husband was lost in a boating
accident. No euphemism there--he went out boating and literally
disappeared. It took 10 months to find his body.

"I hit the cocaine pretty hard," she says. "I was tired and someone
gave it to me, said, 'It'll keep you going.'"

Two years later, at age 30, Leedham figured enough was enough and
admitted herself into detox in Saint John.

The hard part wasn't the cocaine, it was getting off the Benzos. "It was hell."

She met a man after her 28 days as a detox in-patient and fell in
love. He had been working in Saint John and was moving back to
Halifax. He asked her to come with him. At some point in
there--between the end of cocaine and Benzo detox and coming to Nova
Scotia for her sweetheart, she also fell in love with Dilaudid.

"I thought," Leedham says, "if I move, I'll get away from the
Dilaudid. But it was just as bad I knew more drug dealers down here
than I knew in Saint John. I ended up knowing a doctor who would give
me my prescription."

Leedham kept on keepin' on--living in Halifax and shooting
Dilaudid--for the better part of a decade. When she was 39, her
partner (by then her fiancee) went into a diabetic coma. He died.

Soon after, she found out she had Hepatitis C, a serious viral
infection that can cause cirrhosis of the liver and liver cancer.

"All the years I did needles," she says, "I never shared needles. I
always thought I'll never catch anything because I always use a clean needle."

That's a good rule but it's only half the message. If you're trying
to avoid viruses from a high-risk activity like injecting drugs,
you're not supposed to share any part of your kit. Viruses can be
transmitted through needles, yes, but also straws, pipes, spoons and
other equipment.

"I must have got [HIV], and the Hep C, through a filter or a spoon,"
Leedham says. "I wouldn't touch a spoon if had blood on it but [I did
share them]. I didn't know you could get it that way, or I wouldn't
have done it."

And surely she wouldn't have done it if she knew that one member of
the group of friends she used to shoot up knew she was HIV-positive.
"She gave it to me and three other girls. She's out west and she's
never coming back."

Leedham hasn't told any friends she's HIV-positive. And even if she
wanted to, she couldn't. Now that she's clean, they're gone. "All my
friends are users. I don't buy them drugs anymore so they're never
around," she says between hauls off her cigarette. She hasn't told
any of her new neighbours in the housing co-op, either. She's
friendly there, but keeps mostly to herself.

She's been warned away from disclosing her positive status by the
reactions of some she's told, like her social worker. She says he
treats her differently now that he knows she's HIV-positive. "Just
his attitude," she says.

"I lost my bus pass. And he said I'm not issuing you another bus
pass, you're going to have to deal with it . I said I've been getting
a bus pass for four years now. I've never lost a bus pass before.

"He never treated me like that before he found out I was HIV-positive."

She says it, but she says it like it doesn't bother her much. The
slight--or at least her re-telling of it--rolls off her like the
smoke that's curling up through her brassy blond hair. Her social
worker isn't someone Leedham expects a lot of compassion from anyway.

Her family? That's different.

Leedham's family members are the only other people--besides a few
health care professionals--Pam Leedham has told that she's HIV-positive.

She had hoped it would go better.

"My mum, she looks after two handicapped kids," Leedham says, "and
it's like, 'We can't have it here. What if you infect the kids?'
[With her] it's like the '80s when nobody knew nothin' about it.

"My dad passed away four years ago," she says. "The rest of my family
don't want nothin' to do with me. Basically they just said, you got
yourself into it by doing drugs, you're going to have to deal with
it. It's your problem."

There's one family member Leedham hasn't let in on the secret.

Her son.

He's 24 and lives in Saint John and she "loves him right to death"
and she talks to him on the phone from time to time. But she hasn't told him.

She's part interested in sparing him the grief---"If I got really
really sick and they said I only had three or six months to live,
then I would sit down and talk to him. But right now I just don't
want to put that burden on him." And she's part interested in sparing
herself the grief of him possibly reacting the way her mother and
siblings have.

So she's alone. She goes to get her methadone every morning on the
bus, is diligent about her doctors' appointments and gets support
from the AIDS Coalition of Nova Scotia.

And later, she comes home and cuts out angels and rolls smokes and
fixes up her place and watches TV and listens to the radio. And she's
healthy. Even with HIV. Even with Hepatitis C. Even though she's had
two stents put in her heart this year. She's the healthiest she's
been in ages. Perhaps since she was a kid.

After close to one year on HIV meds, her immune system is holding and
her viral load is undetectable. (That's when the virus still there,
but it's being kept in check. It's a best-case scenario.)

And it's making her experience something she has yearned for for a long time.

"I feel very much in control," she says.

"I want to live a healthy life. I'm only 42. I want to live to be 80."

She probably won't.

No one's sure exactly how long people with HIV and AIDS can live.
There is a small group of people in Nova Scotia who are going on 20
years with the disease. There are a handful in the world who have
known they were positive since the early '80s. But no one's really
sure how long people with HIV and AIDS can live. The newest class of
HIV drugs---called protease inhibitors---were only introduced in
1996. Ten years isn't long enough to tell how they'll affect patient
longevity or, importantly, quality of life.

Pam Leedham is undaunted.

"I think maybe before another 20 years is up, they'll have a cure,"
Leedham says. "I was talking to a nurse last week and she was saying
that she [treated] the first case of HIV back in the '80s and it was
back in the Infirmary. They had the person isolated and they didn't
know if they were going to burn the mattress. It's come so far in 20 years."

Still, she admits, "I don't know that a cure would change my life a whole lot."

Leedham sounds like one of those easy-going lottery winners who's
going to keep trucking to the fish plant every weekday until
retirement even through she's got a cool four million Super7 bucks in the bank.

But it's not that Leedham would choose her lot. It's that she doesn't
have much choice anyway.

Pam Leedham is poor. And that affects her life more right now than
being HIV-positive.

No one who goes to the Infectious Diseases clinic at the Queen
Elizabeth II Health Sciences Centre (where most HIV-positive Nova
Scotians are treated) pays for services (that can run anywhere from
$1,000 to $3,000 per month for medications alone). If a patient's
extended medical coverage won't take care of the cost, the province will.

People with HIV and AIDS can also receive extra support from the AIDS
Coalition of Nova Scotia: access to a professional hair stylist and
massage therapist once a month. And there's the AIDS Coalition Health
Fund---$75 every two weeks for people who live below the Statistics
Canada-determined poverty line. The money can offset costs such as
the ID clinic pharmacy's dispensing fee, which is about $10 per
visit, and other medications patients might need, like drugs for nausea.

For the rest, people fend for themselves. And being poor only makes it harder.

With or without HIV, many of Pam Leedham's health issues would be the
same. Because many of the things that contribute to good health as a
person with HIV or AIDS are the same things that contribute to good
health as an HIV-negative person---proper nutrition, access to
non-prescription drugs, lower stress levels, exercise, adequate
personal support. All challenges for people living poor.

So, a cure for HIV? While life-changing, it wouldn't necessarily
change Pam Leedham's life. "It would be nice," she says.

Really, she's making all the changes by herself right now.

"I've been thinking about going back to school and taking a
counsellor's course," she says. "I want to see if I can get into the
schools to talk to kids in grades seven, eight and nine and high
schools and tell them my story.

"For the longest time I never thought I could speak out in public
about my disease, but I almost want to be heard."

Almost. But for now, she still doesn't want me to use her real name.

"There are days still when I feel really depressed," she says. "But I
made a decision: do I want to live? Or do I want to die? I made the
decision that I wanted to live. I want to fight this. I don't want to
give in to it."

In other words, Pam Leedham is making up her story as she goes along.

HIV didn't put Pam Leedham on social assistance. HIV didn't buy her
hash at age 12. HIV didn't get her into a methadone program. HIV
didn't affect her short-term memory. HIV didn't get her this sunny
bachelor apartment.

HIV does not define her.

And neither does being poor.

Drug recovery does not define her. Being abandoned by her family does
not define her.

What does? Pam Leedham does. Starting now.

Editor's Note

This is the third and final part in Lezlie Lowe's series about locals
living with HIV/AIDS. There are several ways to pigeonhole the
HIV-positive, and Lowe began her reporting with subjects who fit some
of the common archetypes: October 12, she profiled a heterosexual
woman infected by her husband, she wrote about a gay man last week
and here is profiling an intravenous drug user. But she also went
looking for the real people behind the tidy categories, and found
lives that can be messy and complicated and difficult and wonderful.
Just like yours.