Thresholds
Murray Jose
September 2003

When members of what would become the Fellowship of the Ring crossed the threshold into Bilbo Baggins home, they knew that their lives were about to change forever. They would not be able to walk back across that threshold the same person. Thus it is with thresholds, whether physical or psychological. Once you cross them, everything changes and there is no turning back.

I expect that I will soon cross a psychological threshold that will change me forever. I will start the cocktail for the first time. This is not just about starting new drugs. This is changing a part of my identity. My identity has evolved with changes in my life and for the last 12 yrs has included being HIV positive and not being on medication. There are lots of emotional elements to that identity. For the last few years, I have considered myself a long-term non-progressor. Significant parts of my identity will now have to change.

I know that many of the fears related to crossing this threshold are irrational. Starting a cocktail does not mean the disease is winning and I need outside assistance. It does not need to be a daily physical reminder of the fact that I'm living with HIV. It does not mean that I will have side effects that make me feel worse than I do without the drugs. It does not mean that within years I will have facial and physical changes that will identify me as a PHA to everyone on the street. It does not mean that I am getting closer to a point when I will need to rely on others in a way that I dread. It does not put a more finite time on my mortality. Yet I have those fears; and more.

As part of my fear, I wonder how crossing this threshold will impact the identities that I perceive others have of me. What will it mean to those newly diagnosed who have gained hope and optimism from the slow disease progression that I have experienced? Somewhere along the line, I've taken that identity and accepted some responsibility of offering hope by my example of good health. Not really a responsibility that was ever mine to give yet something that now I feel I am losing and no longer able to offer.

It's difficult to discuss this without sounding melodramatic. It's also difficult to know who to discuss it with. How can I share my fears with friends who are on their last available cocktail and have been on drugs for years dealing with side effects? Or the friend who only seroconverted a year and a half ago but is dealing with the same medical issues I'm facing after 12 ½ years?

Ultimately, I know that in order to cross this threshold I need to trust: trust in my own judgement; trust that if I share my fears and ask for support, my friends will support me; trust that once I cross the threshold, I will see and understand things more clearly thus lessening some of my fears; trust that I will be able to deal with whatever I experience having crossed; trust that in moving forward, I am moving and therefore living.