An Elegant Defense Read online

  2

  Jason

  The immune system story is one of life and death, of course, a story of survival under the deadliest conditions. As much as that, it is about the struggle for peace and harmony, for successful integration, immigration of organisms across body and border, manifest destiny, and evolution. It is a story of friendship.

  My earliest memories of Jason were in the infield and dugout. We were ten. Our Little League team was sponsored by McDonald’s. White uniforms with yellow trim. Jason had a puff of big hair and a smile nearly as wide. In team pictures, he stood in the back row. I knelt in the front, happy in many ways and confident in school, but hiding the growing insecurity of a short kid craving attention.

  Jason seemed to me to embody the ideal, an all-American boy, not just a great jock, but blessed as well with a natural curiosity, kindness, and mountains of charisma. In seventh grade, he was voted most outstanding student. When he was present, others yielded to him. He was nicknamed Golden. He was more appealing a person because he was the opposite of a bully. “Go get it, Rick!” he’d shout when I’d be at bat, likely to strike out, lucky to walk. “Next time,” he’d tell me when I got back to the bench.

  Jason, second from left on top; author, bottom right, below Jason’s dad. (Courtesy of the author)

  We had some things in common, notably fathers we looked up to, who loomed large in our lives and in the community. My dad was a judge in our relatively small town. Jason’s dad, Joel Greenstein, was a beloved divorce attorney, our Little League coach, the Little League coach in town, our own version of Walter Matthau, without the cursing or drinking. He chomped a stogie, had a wry smile and dry wit, was visible a ball field away in his navy blue Yankees windbreaker. He’d stand in the dugout with his knee up on a step, fist smacking into his cracked-leather catcher’s mitt.

  Joel doted on and gently but strategically steered Jason, like a judicious trainer who had lucked into a Thoroughbred.

  “Jason adored my father,” Jason’s sister Yvette told me. “He was so close to my dad, and my dad just adored him. My dad was a more reserved kind of person, and here was Jason, who always had it all out there, no filter, really, emotionally; he gave you whatever he had at the time.”

  Guy, Jason’s older brother, said of Jason: “My dad was his guru.”

  From a health perspective, there was a powerful material difference between our fathers—Murray (my dad) and Joel. Murray discovered jogging at the inception of the 1970s running craze and became as fanatical as anyone, eventually completing thirteen marathons. Joel was fit too, but he smoked cigars. Jason’s mother, Cathy, smoked a pack of cigarettes a day. Tobacco smells permeated the Greenstein house. Smoking tests the immune system like few human habits; the tiny nicks and cuts to the soft lung tissue don’t just create persistent injury but force cells to divide to replace the hurt tissue. Cell division heightens the possibility for malignancy, cancer. This is just simple math, and it can be deadly.

  In eighth grade, Tom Meier, one of Jason’s closest friends, was standing in the school gym. The door flung open and Golden rushed in. “He was sobbing,” Tom recalled.

  Before Tom could fully get Jason’s attention, Jason made his way to the locker room, and Tom followed. Jason sat on the locker room bench.

  “What’s up, J?”

  “My father is dying.”

  Jason had learned his father had colon cancer.

  Forty years later, Tom tears up as he tells the story. “Here was the strongest person I knew in the whole world,” Tom told me, “and he was absolutely shattered.”

  Jason seemed outwardly impervious to the malignancy eating his father alive, the victim of his own growing emotional disconnect. In ninth grade, Jason ran for president of the student council. His speech exuded confidence and grace. He told the school he would never give up.

  “If elected, I will try to be consistently committed and not lose my spice or vigor.” He had but one promise. “I will do my best and try my very hardest for you if elected president.”

  If. Of course he won.

  Then while we were in tenth grade at Boulder High School, Jason came up with the life philosophy that would define us all for a few naive and wonderful years. He gave a name to a group of friends: the Concerned Fellows League. The CFL.

  It was a world view adopted as an organizing principle by Jason and six others of us who were a tight-knit group in high school—Josh, Noel, Tom, Adam, Bob, Jason, and me. The CFL philosophy essentially was the opposite of what it seemed to express. Jason’s point was that we were not particularly concerned. Worrying was for people who had lost perspective.

  Like all of life’s enduring philosophies and religions, this macho idea folds in on itself and becomes a complete contradiction. Don’t look too closely. We were, to a person, worried about all kinds of things, scared as hell and insecure, despite our privilege. This kind of disconnect, as you’ll see, can lead to anxiety, and illness, all of it connected to the way the immune system deals with stress. But outwardly, at the time, we were a combination of the fortunate good students and athletes, the “cool crowd.” Jason carried the torch. In eleventh grade, he did something remarkable.

  As an undersized underclassman, he helped the Boulder High School Panthers on a magical run through the 1984 basketball state play-offs. He was five-nine in high-tops, not the lone star on the team—there were several top-notch seniors—but Jason arguably was the glue, point guard, and mascot, unmatched in intensity.

  His high school coach of that championship-game team, a Bobby Knight–like figure named John Raynor, thought of Jason as the kid who couldn’t be broken. “He played at times with reckless abandon,” Coach Raynor recollected. He’d dive to the floor “and come up lame, and I’d think, Gosh, is this guy going to survive?”

  In the stands at the championship game—for bragging rights of the whole darn state—the members of the CFL sat and cheered, our faces painted with the little purple paws of our Boulder Panthers.

  Sitting not far away from us, a shrunken shadow holding on for dear life, Joel watched his beloved son.

  The game went badly from the start.

  Jason, already outmatched in size and strength, labored with a wobbly ankle he’d hurt in the previous game. He scored only four points. The Panthers’ two great shooters were shaky. Final score: 52–42.

  Just a few months later, on July 13, 1984, Joel Greenstein died. He was fifty.

  Jason got the news and came home from work to find his father laid out on a stretcher in the living room, being attended by hospice. He sobbed. Jason somehow didn’t believe this could happen.

  Jason would later tell me, “There are two things I hate in this world, hospitals and cancer.”

  Some in his family wondered whether the death of his father, his ballast, left Jason so unmoored that he went on the run—physically, spiritually, emotionally. After Joel’s death, Jason ran harder and faster, a racehorse without his trainer. It was a full-tilt lifestyle, world travel—teaching in Japan, traipsing through Latin America—and multiple graduate degrees. Sort of. His fees unpaid, he could never get the law school diploma he’d earned. He became a serial entrepreneur and one-man sales band, selling mobile phone service, Crocs at the mall, juicers to restaurants. He built and ran a ski van company. Each of his ideas was devised with the enthusiasm of a guy drawing up the winning shot.

  It would seem, looking back, that he was putting his health at risk, but it was I who had the first brush with illness. After college, I broke down, succumbing to the pressure of inflated, misguided ambitions without any real clue as to my true passions. Insomnia and anxiety came too. I had to find myself to survive. Out of the process I emerged as a person largely content in my own skin and suddenly able to follow my own muse without fear.

  By the late nineties, I, healed and happy, and Jason, adventurous and coming up with one business idea crazier than the next, formed a deep, authentic friendship. Enthusiasm bonded us, and old times, along with an ab
ility to simultaneously not take ourselves too seriously while becoming consumed by the righteousness of our respective muses. Then fate arrived for Jason.

  He landed into a Phoenix airport under a gorgeous evening sky on May 9, 2010. It was a Sunday night and Jason had spent the weekend at a gambling industry trade show in Biloxi, Mississippi. His latest business entailed selling Chinese-made trinkets—small decorative enamel boxes—to casinos to give as prizes to loyal customers or to instant winners. The company name was Green Man Group.

  It was as Jason as Jason could get. He lived in Vegas, the frontier of the gambling man, selling shiny things to fellow dreamers, and traveling the country to visit the growing numbers of casinos to ingratiate himself and explain why his trinkets would send their customer loyalty soaring. He drove a 1982 Chrysler Concorde, which he described to me as “98 percent of Jews’ last cars. Every one of those Jews died or couldn’t drive or sold the car to a Mexican family. And every one of those was owned by a Mexican family except the one that I’m driving.”

  Then he squealed his high-pitched laugh, either with self-awareness at the slightly off-color comment or maybe the opposite—he just thought he was funny. And it was nearly impossible not to laugh along with him. This was Jason in his element, the windows down, the air warm, an adventure ahead. “I loved driving in the desert and being in the open road.”

  He’d stopped in Phoenix on his way home to Vegas because he had some business in Arizona. When he landed, late on the ninth, the airline had misplaced his luggage, which included his sample kits of trinkets. He had to stand there, waiting. He felt a tickle in his throat. He thought, Sometimes I get allergies in the desert, or I’ve got strep throat or a virus.

  He stayed half an hour from the airport at a Days Inn and felt crummy in the morning. It bummed him out. “It was a beautiful day in May, and I felt really yucky, had a headache.” To pep himself up, he did what he always did when he drove, popped into his lip a plug of Skoal Fine Cut chewing tobacco—“I chewed like a madman”—and then, when he still felt cruddy, stopped for a snack at a gas station.

  There he was, feeling like shit, on the open road, which was his place, his happy place.

  “Jason was one of those people who would’ve settled the west,” his sister Natalie described him. “He’d have left the city and risked the Indians or whatever.” She wasn’t sure if that was just his makeup or if his constitution was amplified by the death of his father and “when our dad died, something in him broke or switched.” Settling down, slowing down—that just wasn’t how Jason rolled. He had his own ideas and pursued them when others would think them wide-eyed in the extreme, just like the homegrown treatment he came up with a few weeks later to cure his sore throat.

  Jason lived in Vegas with—who else?—a stripper. She rented a room from him in the house that his mother bought for him, as an investment, for $175,000. It was a ranch-style three-bedroom with a pool in back, built in 1947, and it was sometime after that—but long before the Greensteins bought it—that this neighborhood had its heyday. At one point, a casino magnate had lived across the street, and Jason planned on renovating and flipping the house. That’s what he said.

  The relationship with the stripper was strictly platonic. That was mostly fine with Jason. Also, Jason had Beth.

  The Friday after he’d first gotten sick, he still couldn’t kick the symptoms. “I did what most people would do,” he said, laughing. “I went out late Friday and bought a case of beer and got hammered to try to get rid of the cold.”

  Jason woke up the next morning feeling worse. “I tried drinking it out of me, and that didn’t work very well.”

  He called Beth, and she told him, “You’ve got to go to the doctor.’” He went, and they did a blood test and noticed a large raised lymph node on his neck. The doctor thought he had mono and gave him antibiotics. The drugs didn’t work.

  “I felt no difference whatsoever.”

  Every summer, Jason drove east with his mother back to New York to see her family. She hated to fly. And she and Jason had a kind of codependence and mutual affection that was easy to mistake for professional wrestling, at least of the verbal kind. They would bicker, voices rising histrionically.

  Ma, you’re not listening! I don’t feel well.

  Jason, if you’re not feeling well, go to bed!

  I’m fine, Ma. I’m driving you to New York.

  That’s nice, Jason. That’s sweet of you.

  He drove to Colorado, picked her up, and they went east. I’m really weak, he thought. It was mid-June when they arrived in Bayside, Queens, their annual manifest destiny trek in reverse that brought Jason back to the family’s American point of origin. There, at his aunt Rose’s house, he could not get off the couch.

  “It reminded me of my dad when he got sick. He had never done that before,” Jason recalled.

  Jason didn’t have a regular doctor. In fact, he didn’t have proper health insurance.

  “I’d recently purchased a bogus health care insurance policy online. It said it was an emergency policy. Cancer didn’t count. It only paid up to a thousand dollars. That was my lifestyle—like betting your tenant a bottle of Captain Morgan that her tits were real.”

  Back in Colorado, he finally got a blood work-up. One of the tests measured inflammation through a nonspecific examination of his erythrocyte sedimentation rate. Jason’s number was off the charts.

  The doctor called Jason. “We’ve got a real problem here.” He recounted Jason’s test results. “I’ve never seen anything like this in my thirty years. Something is very wrong.”

  Jason was diagnosed with Hodgkin’s lymphoma. His immune system was being swamped by malignant forces. On the bright side, Hodgkin’s was among the most curable of cancers—for most people.

  3

  Bob

  Robert T. Hoff became an immune system marvel on Halloween night of 1977. He was dressed as a mummy.

  Born in 1948, raised in Iowa, son of an insurance man and a substitute teacher, he’d been in hiding since he was four. That was the first time he could remember that he and a boy next door fondled each other. He loved it, craved physical affection from other boys and eventually from men. He learned to hide the reality that for a few early years he dressed in his mom’s dresses and scarves. He overachieved in school. He didn’t tell anybody about his passions after he made the mistake of doing so once, in seventh grade, and the kid he told, Steve Lyons, blabbed it.

  “I was referred to as a flaming faggot.”

  Bob needed a new strategy. He found it in imitation. There was a kid named Art who was the most popular guy in school. Bob learned to emulate Art.

  “I picked up on everything he did. I picked out his extracurricular activities. I swam at the YMCA. I learned how to speak differently. There’s a gay accent, and I learned how to think in advance to not use a word that would contain a lisp.

  “Then I started to become popular, the star of the school play, elected president of the student government, the most popular kid in class.”

  He dated girls and stopped having sex with men until college, fearing he’d be ostracized.

  He went to law school and married a woman. He went on active duty in the Air Force. He and his wife tried to make it work. She didn’t want to be married to a homosexual. They divorced. He married again. At some point, Bob’s mother found out about his true proclivities. They didn’t speak for twenty years because she thought him sinful.

  By 1977, Bob lived in Washington, D.C., now an accomplished lawyer—assistant general counsel for a major federal office, the General Services Administration. On October 31, Bob went alone to a party; his wife at the time, a flight attendant, part of the cover of his life, was out of town.

  Bob wrapped himself in gauze he’d bought in a thirty-foot roll at Joann Fabrics and was hanging out at the party when he met John. John was a very fit redhead. Bob and John went upstairs and had unprotected sex.

  Two weeks later, Bob felt dizzy, lethargic
, and tired, with achy flulike symptoms—not enough to keep him from work. The discomfort lasted ten days. “I chalked it up to the flu,” Bob recalled.

  Around Thanksgiving, Bob went to his cousin’s wedding in Cedar Falls. On the drive back, he felt really sick. He threw up and had diarrhea. He assumed he’d eaten bad shrimp. Bob, an overachiever all his life, went to see the doctor who had given him a physical when he applied for his private commercial flying license.

  Bob had hepatitis. The version he had was hepatitis A, a strain that had been identified only a few years earlier, in 1973. It is an infection of the liver that takes some time to manifest. When it does, the symptoms that a person—in this case, Bob—experiences typically are those that come from the work that the immune system is doing when it fights back, inflammation.

  For Bob, this diagnosis wasn’t such bad news, all things considered. If the immune system does its job properly, hepatitis A is a strain that can be overcome.

  But this wasn’t all Bob had. Bob had contracted the human immunodeficiency virus, HIV, arguably the most serious direct threat to ever confront our immune system. It would take a few years before Bob would discover the truth. Then he would become a source of powerful inspiration and wisdom at the highest reaches of the scientific world. In the medical realm, Robert Hoff is a veritable state treasure. His body parried HIV, and death, as perhaps no one had done before him, so his precious immune system offered insights and promise for the rest of us too.

  4

  Linda and Merredith

  There was little to suggest that Linda Bowman harbored inside her an invisible suicidal assassin as she stood on first tee of a wind- and rain-plagued golf course in Ulster, Ireland. It was May of 1982, during the final round of the Smirnoff Ulster Open, a precursor to the Ladies Irish Open. Linda was tied for the lead.