‘Eucharist’ was first published in Australian Book Review as the winner of the 2025 Calibre Essay Prize. You can read the full essay at australianbookreview.com.au.
Six hours, forty-six minutes.
The pharmacy counter at my neighborhood Walgreens opened at 9 am, a full hour later than the rest of the store. I should have known that. When I was sixteen, I worked behind a Walgreens pharmacy counter just like this one, deciphering physicians’ cryptic shorthand and counting pills and holding on the phone with insurance companies and getting yelled at by sexually frustrated men refilling Viagra scripts. I lived and died by that clock.
At thirty-one, I was a low-level bureaucrat and recent divorcee swallowed whole by heartbreak and debt. Because of the heartbreak and the debt, I was also a sex worker. And because of the heartbreak and the sex work, I was also a penitent. On Friday nights, men wined and dined me and paid me in fat stacks of bills to do all the things their wives would not, and on Sunday mornings I broke bread and drank grape juice from a tiny plastic cup and said my prayers.
Twenty-three minutes passed until a teenager who looked as bored as I used to raised the rolling counter door overhead and began serving the other customers. Neighbours unprepared for Chicagoland winters, covering babies under fleece blankets, shivering against colds and strep throat, inched forward. The wait between me and salvation.
When it was finally my turn, I gave the teenager behind the counter my handwritten prescriptions from the urgent care clinic, waited longer, trembling and hunched. He searched the shallow drug shelves, came up empty, stared at me, then asked the pharmacist, who didn’t look up from his screen.
‘We don’t have ’em,’ he said. ‘Try the next store over.’
‘What’s it for?’ the apprentice asked.
The pharmacist shook him off. The kid handed me back my prescriptions and sent me on my way.
•
Seven hours, nine minutes.
It was not far, two miles or so, to the next store. So plentiful are the Walgreens pharmacies in my hometown that you can navigate by them as ancient seafarers once navigated by stars, and when my college friends visited my picayune rust belt city from Chicago or its fancier northern suburbs, I did – Exit and take a right at the Walgreens, a left at the next one, go three Walgreens down, hit a fourth, you’ve gone too far. Even as a teenager behind the counter, I’d wondered how it was that suburbanites were always so sick we could support constellations of drug stores. We had, collectively, made a lot of bad decisions – Albuterol for the smokers, Lipitor for the processed pork eaters, Prilosec for the workaholics, Tivicay and Truvada for the sex worker who got herself raped.
Post-exposure prophylaxis, or PEP, is a two-pill combination of antiretroviral drugs that, when taken in combination as a month-long course of treatment, can reduce the risk of HIV transmission by more than eighty per cent – so long as the first doses are taken within seventy-two hours. It’s prescribed when an HIV-negative person is exposed to bodily fluids – blood or semen – from a person with confirmed or at high risk of an HIV-positive status. In occupational settings, this might be a nurse stuck by a needle poking out from a sharps box, or a sex worker raped by a travelling businessman named Michael who choked her when she asked him to wear a condom, then smothered her under a deluxe down pillow until she all but passed out, then crushed her body beneath his for the next several hours into a signature trademarked Westin Heavenly pillow-top mattress.
There had been dozens of jobs between pharmacy technician and prostitute, a mix of the kind you put on resumés (newspaper reporter) and the kind you left off, though they paid better (stripper). I’d been the first in my family to attend college and the first to experience runaway student-loan interest – I owed double my annual salary – but to say I took to sex work out of economic necessity alone would be a lie. I had a deep need to feel wanted that you could blame on my parents or my late blooming or any other place a therapist might look, and when my marriage and its precipitating affair ended, I was left with a mortgage on a single income in a house with newly empty rooms and a vast chasm of wantedness. A couple of pictures posted online, and men flooded my inbox, booked hotel rooms, wanted me, paid me.
At the urgent care clinic that morning, I’d recounted the rape to the nurse, recounted the rape to the doctor. He wanted to know why I thought that meant I needed post-exposure meds.
‘Because he sleeps with prostitutes,’ I said.
‘So, it was consensual,’ he said.
•
Seven hours, fifteen minutes.
It wasn’t traffic, really. It was just a day so cold nobody could move. Between the two Walgreens pharmacies, cars stalled. A few sat in ditches, skidded off the pavement’s black ice. Mine creaked like the breach of a ship’s hull with each turn. Even the radio presets stuck, and I could only turn down the volume on positive, encouraging K-LOVE and the implausible idea that I would ever willingly listen to contemporary Christian pop love songs to Jesus.
A blind friend had needed a ride to church, one of those low-brow, seeker-friendly places that played Evanescence in the worship set and served King’s Hawaiian bread and Welch’s for communion, so I drove him, and after the divorce, when he took my ex’s side, I stayed at the church, which was not really a church but a junior high cafeteria with a seven-foot wooden cross someone dragged from the trailer along with the mic cables and the folding chairs and grape juice early each Sunday morning. Beyond this – I drove him and then I stayed – the decision to go to church had been as ineffable as the Spirit itself. But as I blew apart my lacklustre-but-secure marriage and when my consuming affair turned to dust just as soon as it began, when it became clear I was no longer wanted, I discovered in the cafeteria-turned-sanctuary that I could sit in the front row and cry with nobody to see me but God and Pastor Greg and that this was exactly the right audience – omnipotent (and in this way, responsible for everything wrong in my life) God, to whom I brought my anger and pain and grudgingly begged for its end, and Greg, a single neutral observer who could bear witness while being duty-bound to avoid eye contact.
•
I’d first learned about HIV prophylaxis a decade before at a college frat party. The only frat parties I was ever invited to were at Triangle, the fraternity for engineering majors, where on this particular night the brothers had rigged a system to pump a soapy foam through a portion of house’s HVAC system, soaking the party in bubbles and booze.
I’m sure he told me his name, but all I remember of the guy I met that vodka-and-bubbles-drenched night was that he was an incredible dancer with even more incredible abs, which made sense since he worked back home in St Louis as a stripper. One of the frat brothers, knowing that I’d also spent the previous summer stripping, introduced us thinking we might enjoy some industry water cooler talk, but mostly I enjoyed his command over my hips on the dance floor, the way he could anticipate a slip, catch me before I hit the soapy tile, and hold me steady in his very large biceps.
He paused between our kissing and groping. ‘I’m in this clinical trial,’ he said. ‘For an AIDS vaccine.’
It was either the best or worst pick-up line I’d ever heard.
We refilled our Solo cups in the kitchen where he told me about friends, friends of friends, partners. More than a decade past the peak terror of the AIDS crisis, young men were still getting sick. Guys who’d grown complacent. Guys who were desperate for cash and grew feckless. Worse, guys who were actively seeking out the virus – rare, he said, but it happened – in pursuit of the same status as a boyfriend. The gay community in St Louis, a population centre in an otherwise rural expanse of middle America, was home to guys kicked out of conservative, religious families because of who they were, chasing a sense of belonging in a ravaged and traumatised community. Guys who were willing to risk Kaposi’s sarcoma at sixty-two to feel something at twenty-two. Guys who needed to be wanted. The nameless bisexual stripper covered in soap suds and holding my ass on the dance floor had volunteered as a healthy test subject because he wanted to save boys from mistakes they’d regret as men.
‘It’s not a live virus,’ he said. ‘It’s a DNA thing. It works by preventing the virus from reproducing in the body.’
‘Cool,’ I said. ‘That’s cool of you.’
It was.
The STEP Study caused a buzz when it launched in 2004, enrolling test subjects in thirteen US cities and sites in the Caribbean, Peru, Canada, and Australia. It was the first HIV vaccine to make it to Phase II human trial – a test not just of the vaccine’s safety, but proof of concept that it worked. Worldwide, only seven others have gone to Phase II in the two decades since. Merck’s trivalent vaccine used a modified strain of the common cold to transfer synthetically produced HIV genes to T-cells to persuade the cells to attack HIV particles that might try to enter. There is no risk that participants will contract HIV from the study itself, the Dow Jones Newswire reported at the trial’s start. More than eighteen hundred at-risk people volunteered to test the vaccine, half getting the placebo, half the real thing. Researchers expected some of the study participants would still contract HIV through other means. If they did, the study would assess whether the vaccine at least brought down their viral load, keeping them healthier longer, buying them more time.
•
Seven hours, twenty-five minutes.
At the Walgreens two miles north, the lines were just as long. A homeless man stalled, trying to find the medical card he didn’t have. Another old man looked so alarmed at the cost of his hypertension medicine that I imagined him having another heart attack there at the counter. A couple attempted to use the pharmacy technician – a girl who looked about sixteen – as a translator, reading aloud for them the pages of the prescribing information to decide which drug was more important if they could only afford one today: the insulin or the inhaler.
I am an impatient person; normally, this impatience reads all over me in frustrated looks, huffs and sighs, sarcastic comments and eye rolls. Not this day. I could not huff or sigh. My vocal cords were inflamed from the choking, and when I finally got to the front of the line and gave the girl the spelling of my name, all I could manage was a hoarse whisper.
Seven hours, forty-nine minutes.
I handed over the prescriptions again. Waited for my name to be called again.
The sixteen-year-old handed me a single bag.
‘So, the other one we have to special order. It’ll be here Monday.’
I began to panic, to shake, to make her very nervous.
‘No,’ I said. ‘That won’t work. I need to take it as soon as possible. There’s only a seventy-two-hour window for it to work at all.’
Eight hours, thirty-three minutes.
The teen looked at her pharmacist for help with the disturbed, dishevelled woman across her counter. The pharmacist’s hands never stopped moving as she scraped pills and signed bottles and stapled bags and glanced over her shoulder to give me the first look of concern I had seen in eight hours. The empathetic glance shook loose the stoic reserve I’d armored myself with, and I fell apart – my face hot, my eyes watering, the full weight of the rapist’s fat body, the full weight of the threat of disease and death – crushing me. It took everything I had not to wail in front of the waiting crowd, to lay bare my fear, my bruises under last night’s little black dress, my longing to be wanted, my loneliness in a life I could tell no one about and in which I had no one who cared anymore even if I thought I could muster the courage to ask for help, which I couldn’t.
She picked up the phone, hands still moving.
‘This is for post-exposure? Don’t leave. I’m making some calls.’
•
Saturdays like these were the reason I’d grown addicted to the rhythm of Sunday mornings. Monday through Saturday moved unpredictably one day into the next – every day was spent in my office sobbing and shaking and pretending to work while I sorted through the emotional fallout of my divorce. Every night was a different chaos. Nights in bed with strange men or alone and crumpled on the spinning floor of my bedroom. Nights spent puking from the passenger seat of the bar manager’s car as he got me home. Mornings waking up on friends’ couches, wondering how I’d gotten there. One night in the middle of the separation, I’d sliced myself open, begging the indifferent man I’d left my husband for to recognise and heal my pain, but it had been my husband who came and tended to me, putting me to bed, then leaving promptly, appropriately, out of respect for his new girlfriend.
I’d been dragged to worship when I was young, of course, and maybe this stability is why I’d sought it out again. I’d pulled at my scratchy tights and swung my saddle shoes from the pews of the sort of staid sit-stand-kneel church complete with red door, white steeple, and a single large stained-glass window that, when the light struck just right, revealed the unseen. Sweater and carpet fibres. Skin flakes. Dead bug parts. If you knew nothing of the composition of dust – and as a kid, I didn’t – you could believe you were witnessing the Holy Spirit made visible, that you were enveloped in something beyond human construction, and by extension, beyond anything you could irreparably destroy.
Church in the junior high cafeteria had none of those trappings. But Greg and everything that church was – lame music and awkward coffee cake socialising and offers from middle-aged moms to pray for me – promised that God would come into and heal those now-empty and broken parts of my life, and in this way Sunday mornings steadied everything.
I know it’s not true, not most of it. I know the earth is four billion years old, not six thousand. I know neither water nor blood becomes wine. I know my entire religion hinges on a resurrection story told in four discordant narratives across four different gospels, and that those gospels exclude others – namely, any attributed to women – not canonised at Carthage, as though divine revelation could be codified. I know religion, even one born of a table-flipping radical, is the scaffolding that upholds the power structures of patriarchy, capitalism, and empire. I also know Greg’s sermons, for which he credited not himself but God and sometimes his wife, Melissa, gave voice to undeniable truths always relevant to some chaos of my past week.
‘You see,’ Pastor Greg would say, preaching an oft-repeated line from his PowerPoint, ‘God brings people into your life that bring you closer to him.’
He would pause, look straight at me. A year in, Greg and I had established comedic rapport.
‘And I am not talking about wealthy, attractive single men.’
There was a crowd behind me. I knew my cue.
‘Ha, ha,’ I’d say.
Even this self-deprecating routine for the congregation had become a part of the Sunday morning routine I craved, a way into the actual relentless work of razing and rebuilding the life I’d so poorly constructed. The day after this one, I would walk into the cafeteria with the folding chairs set out and sit in the otherwise empty front row. Every week the same – coffee, music, sermon, bread, grape juice. Every week provoking the same chain-reaction response – reflection, reckoning, remorse, catharsis. Every week, the assurance that a body ripped apart could be restored again.
•
Nine hours, one minute.
The perpetual motion pharmacist wished me luck and sent me to a third store, where she’d already called ahead and confirmed they had both prescriptions and put them on hold for me.
It takes only a tiny number of virus particles to trigger an HIV infection. Once they enter your body, whether they will take hold of your immune system and turn your own blood against you is a game of probabilities. A single virus particle attempts to infect a T-cell. Whether it does is a random toss-up, the flip of a coin. If the virus wins, it uses the cell as a host to begin replicating and spreading throughout your body. If the T-cell wins, the single virus is cleared. Repeat until all the viral particles lose or win. The PEP regimen improves the odds that your T-cells will win each individual battle, but as anyone who has ever repetitively tossed a coin knows, flip it enough times and the chance that it will not fall your way has a probability of n=1.
Take the pills within seventy-two hours after sex with a known positive or high-risk partner – an intravenous drug user, a man who bareback-rapes prostitutes on his business trips – and you may prevent catching it yourself. Regardless of how fast you get the drugs into your system, a month later, you’ll need to return to the doctor’s office, take a blood test, wait for results, but the longer you wait for a first dose, the more time you spend driving from store to store, the more time you spend waiting in line only for a teenager to stare blankly at you – the longer the battles go on without your immune cells getting any backup. The more times the coin is flipped.
‘Every hour counts,’ reads the CDC website.
That such drugs exist at all is a sort of miracle worked by saints martyred in the early onslaught of the AIDS epidemic. I was born jaundiced, my blood too full of bilirubin, in February 1985, a month before the FDA licensed the first test to screen HIV from the nation’s blood supply for transfusions. And there, at the prevention of the spread of the mysterious gay plague into the rest of the population, was where the research money and support dried up. The Reagan administration would withhold a contractually obligated US$86 million from the World Health Organization earmarked to flatten the curve of the epidemic, of which the United States was at the centre. By the time the funds were paid near the end of 1988, more than 50,000 people in the United States – among them Rock Hudson and Liberace and other gay men the Hollywood-actor-turned-president must have known – had died. The anti-retroviral AZT, which slows progression of the disease, had been approved, but at US$10,000 for a one-year supply and no federal insurance mandates or funding to cover it, it remained out of reach for nearly everyone.
The AIDS Coalition to Unleash Power chained themselves to the balcony of the New York Stock Exchange to lower drug prices. ACT UP protesters shut down the FDA and testified in Congress to pressure the speeding-up of drug trials and experimental approvals. In New York’s St Patrick’s Cathedral, as Cardinal O’Connor preached against condom distribution to Mayor Ed Koch nodding along in the pews, the sick and their allies spat wafers to the ground, covered crucifixes with condoms. One protester took a consecrated host from a priest and crumbled it to pieces. He lay on the floor of the church to prevent others from receiving Communion and was arrested. He said later that in hindsight he might not have done it but that he had no regrets.
•
Nine hours, thirty-two minutes.
The stocked store lay just four miles east, but it may as well have been another country. There were no blanket-huddled masses here, no homeless, no uninsured. The lone woman in front of me picked up a retinoid wrinkle cream, swiped a credit card, and left.
My voice was getting worse. My battered vocal cords croaked my name at this third teenaged pharmacy technician in a white vest and name tag like I’d worn when I was his age,
still unaware of all the ways a life could go awry, unable to see my future reflected back at me in other faces or to predict who I could count on to save it. I waited, standing at the counter in the cheap dress, my make-up smeared across my eyes and my hair looking as though it had been pulled and smashed into a mattress because it had. I felt him watching me with suspicion and maybe disgust, as though I was confirming those suspicions by pulling out a fat wad of twenties and paying in cash.
Two co-pays and a bottle of water. Eighty-one dollars and eighty-two cents.
Ten hours, eleven minutes.
In the car in the lot, I tore open paper bags, pulled out bottles, scraped off foil and ripped out cotton balls, and I took a brief glance at the long list of instructions and warnings that came with the pills, stapled to the front of the bags.
It’s not a live virus. It’s a DNA thing.
‘This medication works,’ the package read, ‘by preventing the virus from reproducing in the body.’
•
When the frat party had died down and a room had freed up, I’d studied the fellow stripper with curiosity and just a little awe. Bathed in the amber glow of a streetlamp through the window, he looked exactly as perfect as you’d expect a male stripper to look – waxed chest, chiselled six-pack, and a strong, cut jaw. But to be honest, if I saw him today, I couldn’t pick him out of a line-up, because I wasn’t looking at his face, or even his six-pack. I watched his hands as he turned a still-wrapped condom over and over between his thumb and fingers, the way a priest holds a wafer under his thumb before pressing into it, snapping it in two. Maybe he was giving thanks for the grace and protection of a small piece of lube-covered latex, the thin membrane between life and death. Maybe it was just a tic, something to busy his hands as he tried to decide whether he really wanted to sleep with me. Or maybe he was stalling, trying to remember my name, too.
A few months after our encounter in the frat house bunk bed, the STEP Study vaccine trials would fail – two years in, forty-five men out of roughly fifteen hundred would contract HIV, and more than half of those cases would be in subjects given the vaccine, not the placebo. The study was halted, the test subjects unblinded. It was true that the volunteers could not get sick from the vaccine directly, but years later, researchers would determine that it had made certain genetically predisposed people more susceptible to contracting the virus, and the global AIDS research community went back to the drawing board.
•
Ten hours, thirteen minutes.
The breaking of bread celebrated by Christ-followers around the world goes by many names – Communion, the Lord’s Supper, the most blessed sacrament. But the oldest among these, the name ripped straight from the original Gospel Greek, is eucharist, literally, thanksgiving. In the parking lot of the third Walgreens, frozen breath made visible, heat on blast, I held the drug cocktail, unscrewed the cap from the bottled water steadied in my cup holder, and gave thanks. For empathetic pharmacists. For drug researchers and Big Pharma. For the life-saving grace of a twenty-year-old stripper from St Louis, whose name I couldn’t say, whose face I would never recognise. For the people God or chance had brought into my life. And when I had given thanks, I swallowed the pills, took a swig from the bottle of water, and I said my prayers of supplication. After the desecrated wafer had fallen in pieces to the church floor, the St Patrick’s protesters who refused to leave were carried away on stretchers. All around the sanctuary, they had lain down in the aisles, gazes cast up at the rows of clerestory windows, dying-in even as they were really dying, light through stained-glass catching the dust as it floated overhead.
