Once you’ve pissed yourself, I’d say the illusion that you’re doing just fine has pretty much been shattered. It’s not really the kind of thing you can brush off and say “Oops!’ Okay, maybe the first time. But once you’ve peed yourself a second time in less than 48 hours, everybody pretty much knows that you’re not doing that fantastic. Yet that’s exactly where I was a few years ago. Here I was six years sober and peeing myself while in the hospital. It was an odd place to find myself considering for months, I’d been telling anyone who would listen that I was fine.

Just a gnarly cold. Just pesky allergies. Just the flu. For the better part of 90 days, I desperately tried to sell a story that I was fine and that you shouldn’t worry about me. But mainly, I didn’t want to worry about me because some sad ass alcoholic thinking still yells in my brain and tells me I’m not worth taking care of and that I can muscle through whatever horrible feeling or ailment that I’m having. This all sounds like insane horseshit of the highest order, to be sure. But that’s just the kind of brain I’ve been gifted with.

Suffice to say, I wasn’t fine and I was about as far from fucking okay as possible. What I had was a nearly deadly case of pneumonia, which among other things, made me too weak to make it to the restroom to go pee. Urine soaked sheets and hospital gowns as well as more than a puddle or two left on my hospital room floor were my body and bladder’s way of saying, “No, bitch. We ain’t okay.” I text a friend, who was studying to be a nurse at the time, about how embarrassing it was to piss myself. He basically told me to shut up, that they saw stuff like that all the time and to stop texting him and focus on getting better. Pneumonia was here and it was now out in the open that I hadn’t been fine in a while. The best way I can describe pneumonia is if you gave the worst flu you ever had cancer and also told it to drain your life force like an evil alien. Wheezing, having a hard time breathing, one day at work my body finally threw up the white flag and went on strike. It was like, “Lady, do what you gotta do but we’re not working anymore.” Carried out of work on a stretcher and rushed to the hospital, there was still part of my brain that said, “Maybe this isn’t that bad.” Because it’s not that bad when you’re leaving work early in the back of an ambulance. Nuts but that’s what was going through my mind. Once I arrived at the hospital, it was clear I wasn’t going anywhere anytime soon. When everyone you come in contact with, including your own husband, has to wear some sort of hazmat mask, you pretty much get over the idea of being able to bounce out of the emergency room in a couple of hours. I was here. I was really sick. And I wasn’t going anywhere.

One doctor with the whimsical last name of Bloom described me as on “death’s door.” Not entirely sure that “death’s door” is the definition of gentle bedside manner but I certainly have never forgotten it. On some level, I guess the former goth teen in me took being on death’s door as a compliment but me the 40 something adult was mortified at. How did this person who overcame drugs and alcohol and lived with HIV get to this point? How did this person who preached self-care and handling his business let his health fall so totally off the rails? Before you say really nice things like, “Yeah but you alone can’t stop pneumonia!” or “None of this is your fault!” let me give you some background information. As a person living with HIV and a special, high maintenance version of that disease (because why have a normal virus when you can have an Extra Virus?) I kind of don’t currently have an option of living without meds. It’s a necessary evil for me right now but please feel free to send me 55,000 articles about natural remedies or other ideas you a person without my disease might have that would magically fix me. Actually, don’t. There’s currently no way around me being able to function without medication. That, however, didn’t stop me from trying. I had a blip in my insurance which rendered me unable to get meds and figured, “Meh. How bad would a few months off meds be, anyway?” After all, I felt great. I had been on medication for years. What’s the worst thing that could happen? A few months got closer to six months and my energy got lower and I got skinnier. Before I knew it, it was almost a year and there I was peeing on myself in a hospital room. Things were bad. Death’s door, true to what you’ve heard about the destination, was awful. My little body was breaking down and it would take months on an even larger combination of pills to get me back where I was. But the bigger problem in my mind with all of this was my utter inability to be real about where I was at. For all this living in a program of honesty about my alcoholism, I certainly had no problem defaulting to my bullshit, “I’m FINE!” setting. A setting that damn near killed me.

Too many gay men are still dying from complications of HIV and AIDS. Too many more are dying because of alcohol and drugs. More still lose their lives to suicide and untreated mental illness. But I’d go out on a limb here and say the bigger cause of death for gay men is acting like they’re okay. Already saddled at birth with something that makes them different or less then, lots of us come into this world already at a deficit. We walked into this party wearing the wrong thing and spend much of our time trying to convince ourselves and others that we belong. To survive and get by, we develop an attitude of “I’m not just okay, I’m AMAZING!” and it’s one that is complete nonsense. But one we need, though, to sail through this world. We work hard to make that attitude the truth by having perfect bodies, perfect jobs, perfect dinner parties. Passing for normal, passing for straight, passing for sane, passing for undamaged, perfect goods.

For me, I was a perfect smartass. If I could pass as somebody with a whip smart sense of humor, then maybe nobody would ever know the truth. This attitude of “funnier than thou” got me out of sticky situations, helped me shrug off heartache and constructed a tough wise-cracking persona that made you laugh but also kept you at an arm’s distance. God forbid you actually go to know me and know how broken, sad and horribly insecure I was. Best to keep me at the cocktail party where I could spout of zingers and funny stories. It wouldn’t be wise to turn to me for anything remotely resembling emotional honesty. Part of what made my hitting rock bottom with drugs and alcohol so painful was that the news came out of nowhere for a lot of people I loved. I had worked really damn hard to act like I was okay and that everything was FINE, DAMNIT. When that veil was pulled back, I could breathe. It was out. I was a drunken, drugged out disaster and I needed a lot of help.

Having to come out as gay then as an alcoholic then as a person living with depression and HIV has afforded me a luxury of barfing everything out of the table. In fact, much of career as a writer is based on this very thing. A quest for the truth and the push to tell it is what drives me but obviously I fall down on that job all of the time.

The fallout for not being real about my health was considerable and not just on my poor body that took years to really bounce back. My marriage was put through the test. My poor husband beat himself up for not seeing the signs. My family was once again hit with shocking news when previous reports stated that everything was hunky dory in my world. I struggled to reach out to my sobriety family who really, really wanted to take care of me because that’s how they roll. Unfortunately, my act of “it’s not that bad” kept them at arm’s length too. As usual, I was the one suffering. I was humbled that even though I had years of sobriety under my belt, I still sucked about being honest about where I was really at and what was really going on with me. I felt embarrassed that for all my bragging that I had grown so much as a person I was really still at my core a little gay boy afraid to let you know he was hurting.

Pneumonia nearly killed me a few years ago. Alcohol and drugs tried to do the same for two decades. But in the end, it’s a total dishonesty and bullshit pursuit of presenting that I’m okay that will 100% kill me dead. If I’m suddenly unable to say,”Hey I need help. Hey, I feel like shit.” Then you need to be worried. I need to be worried. I need to be pissed.

Sean Paul Mahoney is a writer & recovery mentor in Portland. NOW THAT YOU'VE STOPPED DYING is his new essay collection, is available now from Zephyr Bookshelf.

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