By Terrence McCoy
By Allie Conti
By Chuck Strouse
By Scott Fishman
By Terrence McCoy
By Ryan Yousefi
By Ciara LaVelle, Kat Bein, Carolina Del Busto, and Liz Tracy
By Pepe Billete
Floral Park, like other medical offices with virtually all of their patients on Medicaid and other forms of public assistance, is where the most difficult AIDS patients end up -- difficult to treat because, owing to poverty and ignorance, they've never received decent care and their illness is now far advanced, or because years of drug addiction combined with HIV have rendered them physical and mental invalids. They're easy prey for the lurking hustlers who are paid to steer patients to certain brokers who will buy their prescriptions or medications. Even at Floral Park a buyer is never far outside the front door. "When you come out of a clinic," says an AIDS patient who sells his meds, "there's always someone there to ask you what you got."
Dr. Shelley Wolland, Floral Park's chief physician, scoots around on a wheeled stool in the clinic's infusion room. Patient charts are balanced on her lap. Her strawberry-blond hair is braided and beaded, and multiple earrings adorn her pierced lobes. About five clients, resting on black-vinyl recliners, are hooked up to intravenous blood compounds. Others wait to be seen in a lavender-painted examining room. On busy days the large infusion room is clogged with nurses filling out charts and hooking up IVs; patients trying to maneuver around tables, recliners, chairs, and wheelchairs while grabbing sandwiches and drinks from a refrigerator; everyone arguing, napping, gossiping. On the walls Wolland has tacked snapshots of many of her patients when they first came to her. Most are grimly skeletal, black blotches marring their skin. They have visibly improved, some in just a few months, and they all praise Wolland for saving their lives.
"When I first come here I had the attitude, 'Just give me some medicine so I can sell it,'" says one man, speaking slow and thick, his eyes moist. "I ain't with that anymore. Dr. Wolland here, she made me see I have some hope."
But when the man leaves, an acquaintance quietly asserts that he's still selling his meds. That may or may not be true, since the acquaintance might simply be expert at spinning yarns, or may himself have gone back to smoking crack. One new patient, Ray, a young, fine-featured man who has been leaning back in a recliner, nods and lifts his upper back from the sticky vinyl of the chair. "I need the money [from selling meds] because my [disability] check isn't but $565," Ray announces. He seems vigorous and healthy, though the pants and shirt he's wearing look old and threadbare in places. "But if I do that, I'll get sicker. That's what I keep telling [my roommate]. I knew he was selling his [AIDS] drugs but I just found out there's this whole network they've got. I come home one night and there's this guy sitting in the living room -- Doctor K. He the man. You beep him, he'll come to your house and buy what you got."
Recently, after the boyfriend of a clinic patient was observed trying to find a buyer for some Epogen he was carrying in a paper bag, Dr. Wolland told her nurses and the police officers to banish the man from the clinic. "I can tell what's going on," Wolland says, "when somebody asks me for [a certain medicine] that he never had before. It's got to be a street thing. They come in and say, 'I need my Neupogen and Epogen.' I look in their file and see their blood work and I know they haven't been taking it and aren't [suffering from a condition those medicines can help], and I know someone's been offering them money for it."
Besides the hard data in their medical charts, not much is certain or reliable about many of these patients who drift from apartment to boarding house and in and out of drug rehab. But there's no doubt the indigent people of color who flood clinics like Floral Park are increasingly the future of AIDS in Miami-Dade County. The Miami metropolitan area now ranks second only to New York in per-capita AIDS cases in the nation. Of the almost 23,000 people with AIDS in Miami-Dade, blacks account for 49 percent, despite being just 19 percent of the population. (Hispanics, 49 percent of the population, represent 32 percent of AIDS cases, while whites, 30 percent of the population, account for 18 percent of AIDS cases.) Almost twice as many black men as white men have AIDS. And black women now account for 78 percent of all AIDS cases among women in the county. Even more dramatic, of 464 babies recently born with HIV, 400 were black.
"It's not an epidemic within our community, it's a pandemic, and the only way to stop it is with education," asserts Tomasa Del Toro, supervising pharmacist at the Winn-Dixie pharmacy on NW 35th Street at Seventeenth Avenue in Allapattah. Del Toro's pharmacy fills most of the prescriptions written at the nearby Specialty Medical Care Center, and she says she and her staff have learned from experience to be suspicious of many customers. "People only see the tip of what's going on out in the [AIDS] community," she claims. "I've heard everything from patients. We filled some prescriptions for a man, all [costing] more than $5000. Within two hours he came back saying somebody had stolen them. People think you're making this stuff up and you're not."