The Reckoning

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Frontline Dispatch: The Pain & Peace of Being in the First Wave of Monkeypox

Ryan Lee (Image courtesy of subject)

The most painful symptom during my two-week bout with monkeypox has been the grim understanding that if this were a different era, and the arrival of a different epidemic, any column or essay I wrote about my experience with the illness might’ve been among my last words.

I grieve thinking of how many of our gay ancestors attended a Sunday kickback like the one I went to a couple of weekends ago, played dominoes and laughed at memories; announced goals and made plans for getaways; attributed the queasiness they felt after the gathering to having drank too much on an empty stomach; went a couple of days expecting their sickness to pass, only for those at the kickback to soon learn that their friend was dead.

My sickness seems to be passing, and I’m operating under the assumption that this current outbreak does not have a 100 percent fatality rate or lifelong consequences. However, as a gay man who came of age in the 1980s and ‘90s, I feel the terror of being in the first wave of an emerging epidemic. I’ve spent my adulthood in the fast lane and have always recognized it could lead to early exposure to previously unknown threats, but it’s sobering when you find yourself in a situation that could’ve led to a fiery crash. Fortunately, it has felt more like getting a flat tire, as my monkeypox infection has been relatively mild.

Ryan Lee sharing monkeypox lesions (Image courtesy of subject)

First The Flu, Then The Pox

I didn’t get home till about 8 o’clock Sunday morning, then slept until around 1 p.m. before heading to the park for the barbecue. Later that night, I wasn’t sure if the extreme fatigue and head pressure I was feeling came from not getting enough rest or drinking too much at the dominoes table, but I knew I wouldn’t be going to work the next day. My Monday was sluggish and achy, but I resolved to go to work Tuesday, even though I woke up several times throughout the night in a pond of sweat. 

By the time I got to the office (where I work in an isolated wing), I was drained of any energy I had woken up with and was experiencing fevered chills. I went to the restroom, and it was during a bowel movement that I first realized something new was happening to my body.

My lower back and buttocks area had already been aching, so I was prepared for my trip to the bathroom to be painful. However, the discomfort I was experiencing in my backside suddenly rushed through my leg, sending what felt like an electro-toxic surge through my left thigh, calf, and foot. The sharp tingling lasted less than half a minute, but I knew I was going back home before the agony ended.

I took an at-home COVID test that came back negative. I never expected it to be COVID because, frankly, COVID has never felt like my plague. I’ve known that I or anyone could get it, but I’ve never felt like its primary target, and only passingly worried it would be serious or deadly if I contracted it. I hadn’t responded with such arrogance to monkeypox, which I considered a direct threat from the earliest reports. Still, I had convinced myself it was not an immediate danger, that I could have fun one more weekend before taking a break until a vaccine got things under control. 

Available research suggests that a skin rash develops about 2-3 days after a person begins experiencing flu-like symptoms, and I constantly surveyed my body as I spent the week in bed. By Thursday afternoon, I was no longer overwhelmed by fatigue, my body pain had subsided to only mild discomfort in my lower back and forehead, and I thought I might’ve beaten a simple cold or flu.

Ryan Lee sharing monkeypox lesions (Image courtesy of subject)

I had expected to wake up feeling significantly better Friday, and although my body aches and warmth had lessened, the lymph nodes near my hips were inflamed and tender, and I had a painful callous on the bottom of my left foot. While it’s not unusual for me to get a foot sore from running or cycling, I couldn’t help but notice this bump arose on the same spot where it felt like the surge of pain exited my foot earlier in the week.

I felt fully recovered by Saturday, and even accepted a friend’s invitation to go on a bike ride the next day. However, that evening I noticed a pimple on the inside of my forearm that took me back to childhood. I remember seeing that same dot in that same location when I was 8 years old, followed by the onset of chickenpox. I noticed a similar dot on my shoulder, but both marks looked like the result of the mildest skin irritation – more like acne than a serious infection. That night, fewer than 10 isolated pustules became visible on my arm, shoulder, leg, torso, butt cheek, and foot. All of them resembled a pimple more than the alarming blisters I’ve seen in the media, but the unseen cluster of bumps I felt on my scalp convinced me I was not having a simple acne outbreak.

The physical manifestation of monkeypox across my body feels remarkably similar to how I experienced chickenpox: a handful of barely visible lesions, with the most intense concentration of sores mercifully hidden beneath my hair.

I woke up on Sunday with a lot of energy and no pain. I felt like I could’ve gone about my life and I wouldn’t even have had to conceal the pimples because they were indiscernible to anyone but me, but I text my friend to let him know I wouldn’t be able to make the ride.

I canceled my plans and have remained in isolation since then because monkeypox is not a sexually transmitted infection, and if it can be spread the same way chickenpox once was, I do not want to be the source of any community outbreak.

Monkeypox Is A Direct Threat To Gay Men

It is important to be accurate and measured when talking about gay men and diseases because most heterosexuals—and just as many gay men—assume we have a natural inclination for infection. We saw this prejudice in the self-policing that arose in the early days of COVID when many gay men linked risk with promiscuity as if coronavirus were an STI and not something you could just as easily contract at a grocery store or bible study. 

The burden and shame that gay men have borne regarding our sexual health have created generational trauma and anxieties, and three months of monkeypox have already stoked the bigotry and judgment in those who love telling gay folks how sick and dirty we are.

So I understand the reluctance of queer folks to be closely associated with a new illness, but we must recognize monkeypox is currently a disease that disproportionately impacts gay men. Of course, anyone can – and many eventually will – contract the illness. Indeed, the state of Georgia just confirmed the first case in a female resident – after more than 200 infections were confirmed overwhelmingly among men who sleep with men.

While monkeypox could potentially spread through respiratory droplets or a contaminated surface, and without any sexual contact, I contracted the disease through skin-to-skin contact during homosexual sex, so I have no qualms alerting other gay men that there is currently a risk associated with choosing to engage in sexual activity, with or without a condom. There will be new risks with heterosexual skin-to-skin contact soon; but as with HIV, even when heterosexuals and homosexuals engage in equally risky behavior, gay men will have a far greater probability of encountering a sex partner with an infection, solely based on the size of the pool of potential partners.

We must be vigilant and disciplined, and do what we can to protect ourselves and others. I did  not modify my behavior quickly enough to avoid contracting the illness, but I’ve continued to quarantine long after I’ve felt healthy to ensure there is no lingering risk of contagion.

Vaccine campaigns should at this point exclusively target gay men and health care workers, and our community organizations need to amplify their advocacy and operations to crisis level. It is infuriating to see how slowly the federal and local governments are coordinating pop-up vaccine clinics, where appointments have filled within minutes of registration opening. There are no testing sites similar to what we’ve seen with COVID, and even though monkeypox has been declared a nationally reportable disease, the only way I could confirm my case to the state of Georgia as an uninsured American was to visit an emergency room or pay more than $200 for an urgent care doctor to tell me what I already knew.

COVID has not only taught us the government can mobilize when it cares about a public health threat, but it has also stripped straight people, particularly conservative Christians, of their ability to shame gay men or make us feel guilty in the face of a pandemic. We’ve seen how you motherfuckers handle a plague – your recklessness and indifference, the way you rationalize risks and ignore viral trends, how you sacrifice safety for the satisfaction of your mere routine – so your moral take on the epidemiology of monkeypox is beyond worthless.

Stigma and uncertainty have many gay men on edge. I wish for my brothers to shield themselves from infection and judgment, and I share my sincerest optimism that they – that we – gon’ be alright. Monkeypox is not our people’s first health crisis, and no group has fought back against a virus the way LGBTQ Americans and our allies have waged war against HIV/AIDS.

Stay encouraged. Stay safe. Stay gay.

 


Editor's Note: For more information on the current monkeypox outbreak, please visit CDC.org. You can also visit our partner, Capital B, for more background on the impact of monkeypox on Black gay men in Georgia.


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