Every two weeks or so, I publish an essay from an emerging writer. This week’s essay, “Knee Deep,” is from Sandy Silverman. Sandy is a writer and psychotherapist. She is currently writing a memoir about the connections between her work as a psychotherapist, her family history of traumatic loss and her experiences as a queer parent. She lives with her partner in the Hudson Valley and has a psychotherapy practice based in New York City. This essay was edited by Meg Pillow.
I first went to a doctor for my knee problem when I was 25. I told the doctor that if I walked too far or stood on the subway for too long, my knees began to ache. He bent my leg a few times and pushed my kneecaps back and forth.
“Kneecaps are not supposed to move like this,” he said. “They should be more stable.” He gave me a prescription and sent me to physical therapy.
I’d been dating the beautiful woman from England who lived in the apartment upstairs, and she’d just broken up with me. She told me the music was right but the tempo was off, and I wondered if that was deep and profound and British or just shallow and absurd. Our affair was brief, but I was shattered when she ended it. I didn’t want to return to the loneliness I’d known for most of my life.
In the months that followed, I sometimes ran into her on my way in or out of the building. She was always with someone new—I met the photographer, the psychic, and the communist who left the party to become a real estate agent. I acted nonchalant, like she and I were pals, like I didn’t mind being alone.
My parents flew in for a business trip. They invited me to dinner with the other Jewish furriers, all of whom liked to flirt, George Burns style, cigar held between thumb and index finger. “Thanks darling,” my father said each time the waitress brought him another martini. When my father wasn’t looking, my mother reached for his drink, took a gulp or poured it into her glass, all to keep him from getting so drunk he would try and seduce the waitress, or compliment her on her breasts, or wink at her and raise his eyebrows up and down like a twelve-year-old boy.
That weekend, I joined my parents at the Met for the Degas exhibit. Halfway through the exhibit, I told them that my knees were hurting.
My father said, “I didn’t know Degas painted landscapes. I thought he just painted dancers.”
“I can’t walk any further,” I said. “I need to sit for a while.”
“So, sit,” my mother said. “You’ll catch up with us.” She looked toward the next room of paintings, and she was gone.
I was working on the Lower East Side at the time, in a storefront office on Avenue B. I was a social worker in a family services agency whose aim was preventing kids from being placed in foster care. High-risk families were referred to us for support, counseling, and case management. I had a client named Evelyn. She was 27. She had four children, two that were school-aged and twins in diapers. The father of the first two was her high school boyfriend, now ex-husband. The father of the twins was Danny, her boyfriend. Evelyn had been weak since the birth of the twins. She seemed to have an autoimmune disease, but the doctors hadn’t been able to diagnose her. She was given several blood transfusions in the months after the delivery.
In the eight months I’d been working with Evelyn, she had been hospitalized twice. She had called me while in the hospital the second time.
“They are asking me questions,” she said. “They want to know if I’ve done drugs, and if I have been with many men. I don’t know why they are asking me this.” She sounded scared.
“You don’t have to answer their questions,” I said. “I’ll call the nurses station to find out what is going on.” It wasn’t until I hung up the phone that I realized they were thinking she might have AIDS.
When I visited Evelyn at the hospital, I spoke with the nurse who told me that they assumed she contracted HIV from one of the blood transfusions she received after giving birth to her twin boys. The staff made me wear a gown and a mask before I went into her room. It was 1985, early in the AIDS crisis. Everyone was afraid. After the visit I walked to my office instead of taking the train. My knees throbbed. I tried to ignore the pain, but part of me was grateful for the distraction. Evelyn looked so small in her hospital bed. I was afraid she could see how awkward I felt. I feared that my being so covered up, so protected from her, made me seem far away and left her feeling more alone. She always had a naïve quality, seeming younger than her age but on this day, she seemed like a frightened, abandoned kid. She asked me questions I couldn’t answer. Why am I here? Will I feel better? When can I go home?
Why didn’t I handle it better instead of standing there, inept and uneasy, I wondered, while walking down First Avenue and rounding the corner to Twelfth Street. I rubbed my knees just below the kneecap to relieve the pain and to get my mind off the hospital, off of Evelyn.
A few months later, Evelyn arrived for an appointment carrying the New York Post. She had a cold sore on her mouth and looked exhausted from the four-block walk to the agency. She sat down and handed me the newspaper. Rock Hudson was on the cover, emaciated and barely recognizable.
“He has what I have,” Evelyn said. Evelyn was poor and Latina and lived in the projects. A movie star had the same disease as her.
The school social worker contacted me because Evelyn’s daughter Maritza was struggling in fourth grade. I arranged to meet with her teacher who told me to come to the staff lounge. The teacher was sitting alone, paging through her own issue of the New York Post. I introduced myself. She gave me a slight nod and remained seated. She was older than me, in her forties. She continued to page through the paper while we talked. I felt as if I’d barged in on her, as if she and I had not arranged this meeting. She had little to say about Maritza and her performance at school other than that she was not doing well. She knew Maritza’s mother had AIDS. I told her Maritza was the oldest of four and tried to emphasize how stressful her life had become.
The teacher shook her head and said, “I don’t know why those kids love their mother when she is a drug addict.”
“She’s not a drug addict,” I said.
The teacher didn’t respond. I could feel heat rush into my face and neck. I wanted to yell at her, what difference does it make how she got it, she’s her mother and she is dying. I thanked her for her time and left.
On home visits, Evelyn and I sat at the kitchen table while her kids were nearby and the TV was blaring. Her twin toddlers stayed close. When one of them was crying or throwing a tantrum, the other found a stuffed animal and ran to him with it. These two small boys, not yet able to use words, had worked out an arrangement. It only went one direction. The comforter never got comforted. I wanted to break this pattern, but the family seemed fine with it. Evelyn and the two older kids smiled when a bunny or a bear was delivered to the crying boy. His twin smiled too, pleased by what he had done for the other one. Maybe that was enough for him. Maybe that was how he got comforted.
When I was a child, I saw my sister torment my brother. She was the oldest, he was two years younger than her, and I was five years younger than him. She teased him for stuttering, for not being as smart as she claimed she was, for not having friends. I watched my brother in pain, my sister taunting him. I didn’t know what to think or what to do. I knew something was wrong, but my parents never intervened. Years later, sitting in Evelyn’s apartment in the projects, I wanted to intervene, but that seemed to be my need and not theirs. I asked Evelyn, “what if they could learn to comfort each other?” and she laughed along with the older kids. Maybe this wasn’t something for me to ask about, I thought, and I too laughed as I saw the caretaking twin look pleased that he had made the other one stop crying. Perhaps this was how they both got comfort, something these two children would need in the months and years to come.
I started dating someone new. We went for a walk in Central Park and my knees started hurting. I was afraid she’d find me unattractive if she knew how much pain I was in. Robin was different than anyone else I’d dated, and I didn’t want to lose her. I wanted to be easy, uncomplicated, someone who hadn’t known loss or trauma. I tried to act casual.
“I may need to sit down soon because I have this knee problem,” I said.
“Then let’s sit down now,” she said and plunked herself on the grass.
“Are you sure?”
“Why should we keep walking if your knees hurt?”
I was baffled. I didn’t want her to resent me for interrupting our walk. It took me a few minutes to realize that she was listening to me and didn’t want me to be in pain.
I have a black and white photo from that day. I must have had my camera with me and set the self-timer. The two of us are lying on the grass, stomachs down, facing the camera. We are propped up on our elbows. My head is tilted toward Robin’s. I had no idea then that we would build a life, move in together, and have children.
I started physical therapy. At my first appointment, the physical therapist brought the rest of the staff to my examining room. One by one, each therapist moved my kneecaps around. They were impressed. I imagined them talking about me at lunch. I started seeing a physical therapist three times a week.
I made my weekly visit to Evelyn’s apartment. She was lying on the couch while we spoke, her head propped up with a pillow.
Her eight-year-old son yelled, “It’s on! It’s on!”
Evelyn perked up, “That’s the commercial I told you about,” she said and pointed at the TV. A woman is in bed with a bad cold, and so her husband and kids are trying to fend for themselves. They make a mess of the kitchen and the living room. The woman takes the cold medicine that the commercial is advertising, gets out of bed and sees that the house is in disarray. Now that she has taken the magic pill, she cleans everything up and the house is sparkling again. Everyone is happy.
“She looks like you,” Evelyn said.
“She does!” the older kids said with big grins.
She didn’t look like me except that she was a white lady. She was taller, thinner and had long straight hair unlike my curly short hair. But I didn’t say that. I liked that they thought she looked like me. The woman on TV mattered to her family and made such a difference in their lives. Maybe I mattered and made a difference too.
On a Friday morning when I was in my office at the agency, Maritza, Evelyn’s oldest, called and said that her mother was in the hospital.
“There was blood in the toilet,” Maritza said, “it looked like jelly. An ambulance came and took her.” Maritza was at home with her grandmother, Evelyn’s mother. I told Maritza I would call the hospital and then call her back.
Evelyn was still in the hospital when she died. I spoke to the nurse at Bellevue, a woman I had gotten to know and like over the preceding months. “It seems so sudden,” I said.
“We knew it was coming,” the nurse said. “Women with AIDS die quickly.”
I had heard that. I knew the research on women with AIDS was minimal, but I hadn’t let myself think about how soon Evelyn might die.
“I just didn’t realize she was that close to the end,” I said.
I liked Evelyn. She was easy to be with, talked with me about her kids, her mother, her physical symptoms. In recent months, I had begun bringing my camera on home visits. I took pictures of the kids and of Evelyn, and of them all together. On Saturdays I printed them at the darkroom on 17th Street that I rented by the hour. I brought the prints on my next home visit. I knew what I was doing, but I didn’t let myself think about it. I wanted the kids to have pictures of their mother, of their life with her, after she was gone. There was one of the twins, sharing a big recliner, both in their diapers, holding bottles in their mouths, and leaning back. The light was shining on them, making the faux leather chair glow. Maritza wanted to be photographed with her doll. She held her in her arms like a baby and smiled at me through the camera. I took a picture of Maritza’s brother bouncing a ball near the entrance to the projects the family lived in. He talked to me while he bounced the ball, and I remember him saying that sometimes a ball goes up on the roof and it’s gone forever.
The funeral was held at a church around the corner from the school. I walked there from the agency office. I didn’t know how to think about the loss of Evelyn, a woman so close to my age. I felt strange because I held our conversations, the things she told me about her life, so different from my life, and now they were mine alone. I wasn’t sure if that made them more meaningful or if that depleted those conversations of any meaning at all.
I remembered a day in Evelyn’s apartment, sitting at the kitchen table. She was drinking coffee out of a mug with words on it. I asked her what they said. She turned the mug towards me, and I read it out loud, “Life’s a bitch and then you die”.
“Do you agree with that?” I asked.
She glanced at the cup, and to my surprise, she laughed, “Yeah,” she said, “I do”.
The school social worker was standing inside the door of the church when I walked in. I’d had many conversations with her about the kids. She said hello to me and then asked, “Did she ever stop using drugs?” I imagined that she must have been waiting a long time to ask me how Evelyn got AIDS, the hushed and disgraced disease, and decided this was her last chance.
“She wasn’t a drug addict,” I said and walked into the church to sit down.
Maritza’s class came to the funeral. Her brother’s class didn’t attend. Both kids were sitting with their grandmother. Danny was there but not the twins. I wondered if Danny was HIV positive too. Was he going to get sick and die too? How many people were these kids going to lose?
I found a spot on a pew with few people. The priest started to speak. I looked at the casket and thought of Evelyn’s thin body inside.
A few days later, I took Maritza to a cafe. I told her she could pick whatever pastry she wanted. She sat down with an éclair, started talking to me and then sneezed, “I’ve got my mother’s cold,” she said. I thought about how much she wanted to hold on to her mother, to keep her from slipping away, how hard she was trying not to be what she was, motherless. Perhaps she had a cold and perhaps it was of some comfort to her, just like the stuffed animals were for her twin brothers and, I hoped, like the photos of her and her mother that I had given her.
The next week the father of Evelyn’s older kids contacted me, and we met at the agency office. He told me he had spoken with Evelyn’s mother, and he was going to take the kids to live with him in Queens. He had a full-time job, was in the National Guard, and wanted to give his children a good life. He seemed sincere and caring, but I felt confused by his absence during the time that I had known and worked with Evelyn. Now and then I heard that he came to get the kids and take them out for the afternoon, but the visits were not frequent. The decision to take the kids had been made, and I felt hopeful. Maybe they would have a good life with him, I thought. I was too young and too inexperienced to think of talking to him about what the adjustment might be like for the kids, the dramatic change and the well of loss they were about to experience. I wished him well. He shook my hand before he left. I never heard from him or from the kids after that, and my agency did not allow me to contact them.
The first New York AIDS Walk was held two months after Evelyn died. I signed up as soon as I heard about it and Robin decided to walk too. At the end, people were greeting each other, going to lunch, chatting with friends. I was rubbing my knees.
“You’re the only one rubbing your knees,” Robin said. “Please go back to the doctor”.
I returned to the same doctor and told him physical therapy wasn’t helping. “Well, he said, “I think it’s time to see a sturgeon.”
Did he think he was funny? I had a memory of my father and brother bringing home sturgeon from their fishing trips. I pictured the fish, big, ugly and dead.
He gave me the name of an orthopedic surgeon. “The surgery only works about 70 percent of the time,” he said.
“I live in a fourth-floor walk-up,” I said.
“One reason you are having problems with your knees is that you are too flexible. As you get older, your joints will tighten. You’ll have less pain”.
We talked about the pros and cons of my flexible limbs, my ease at doing the splits, or bending in half like a bobby pin.
“It’s a good thing in a lover,” he said.
I looked at him, his ruddy skin, his reddish hair, and his pink nose. And then I looked back at my knees. I thought I could just live around the pain, the ache, the smoldering.
Thank You for your beautiful essay. I began my nursing career at the beginning of the AIDS epidemic. I met and cared for many Evelyns. They did not take drugs. Your story is so heartfelt. Thank You 🙏🏾
This really brings back memories of this sad period in our history. I lost people and the assumption that they "caused" their disease, therefore did not deserve care or our compassion was shameful. Sandy, I sense, you were much more to Evelyn than a social worker. Many folks die alone at this time. And I totally relate to your knee pain. Ultimately, I had to have surgery by a surgeon not the sturgeon ☹️Thank you for sharing this essay! 💜