Not Your Mother’s Beach Book

Romance novels turn erotic.
by Patricia Lynn Henley

HOT TOPICS: Belleville and Worthington relish using “the real words” writing their steamy scenarios.
Timothy Archibald

Like many women in their 30s , Nyree (Rabushka) Belleville and Jami (Way) Worthington juggle conflicting priorities. These former Stanford roommates chitchat about toddlers, husbands, career paths—and how to write a truly hot, steamy sex scene.

“Sometimes our language can be so foul,” Belleville says, laughing heartily. “We’ll walk ourselves through a scene and you simply think of it as your book and you’re just trying to write it. But we have head-turning, eye-popping conversations when we’re in restaurants.”

The two Bay Area residents speak on the phone an hour or more daily, exchange e-mails frequently, and get together at least once a month. Their rapid- fire conversations jump from the effective use of dream sequences and flashbacks, to size, structure and other details about intimate areas of human anatomy.

“You want it to be more than just a play-by-play of body parts and what’s going on where. You want to be sure you’re inside the characters’ heads; what she’s thinking and what he’s thinking,” explains Worthington. “And yet you also have to pay attention to ‘What’s that leg doing on that shoulder?’ It’s exhausting.”

Belleville and Worthington, both ’94, are part of a publishing trend: erotic romance. Gone are the formulaic storylines leading to sex scenes masked in euphemism. Now heroines eagerly indulge their sexuality in anatomically correct phrases, often with an earthy, streetwise ring.

“It freed me up as a writer to be able to use the real words,” Belleville says. She publishes as
Bella Andre (Take Me, 2005; Tempt Me, Taste Me, Touch Me, 2007; and Red Hot Reunion, 2007, Pocket Books). Worthington’s pseudonym is Jami Alden (Delicious, 2006, and A Taste of Honey, forthcoming in April, Kensington Books).

Romance novels, which generated $1.2 billion in sales and accounted for 54.9 percent of massmarket fiction sold in North America in 2004, are evolving to reflect the tastes of readers accustomed to the titillating scripts of television shows such as Sex and the City and Desperate

Housewives. The erotic romance trend started around 2000 with Ellora’s Cave, a website providing books in electronic and paper formats. Ellora’s Cave proved readers were willing to plunk down money for sexual stories that don’t necessarily end in marital bliss.

Mainstream publishers took note. Traditional tales still abound, but now there are options. Berkley/Jove, a division of Penguin Books, launched its Heat imprint in May 2005. Harlequin Books introduced Spice last June, and HarperCollins followed with Avon Red. Kensington Books debuted Aphrodisia last January, and sales are better than projected, says Kensington editor Hilary Sares. Erotic romance books “are in Borders, Barnes and Noble, Walden Books, you name it, and they’re selling fantastically well,” Sares reports.

This isn’t porn or erotica. Plots and characters are as integral to these books as the sex scenes. “Women love narrative. Women want a relationship. Body slamming is not what they want,” Sares explains. “The story may be quite untraditional. Aphrodisia doesn’t tend to picket fences and bouncing babies. It’s about the complexity of human relations. If that’s not there, women
aren’t interested.”

And men? “Men are reading these, too,” Sares adds. “Not in huge numbers, but once they find out what’s going on between those book covers, yes they are. Some couples read them aloud.”

There’s more to romance books than most people assume, says Abby Zidle, ’91. She began a PhD on romance novels, but found she was much more interested in reading the books than in writing the dissertation. “I went to good schools, I was a good little liberal, and I felt I was a feminist, so I was wondering what I was getting out of these books.”

The answer is affirmation and empowerment, says Zidle, now an editor at Harlequin Books. Traditional romance novels reassure women they can demand emotional satisfaction and find happiness as a wife and mother. With the proliferation of sensual images in all types of media, it’s a natural evolution to more explicit and diverse stories.

“This is the logical extension of what romance novels have been doing for years, which is modeling behavior for women and saying, ‘Is this what you want? Is this what you need? Then go for it,’” Zidle says. “The publishing industry is in some ways really nonjudgmental in that if enough people will buy it, we’ll print it.”

Some erotic romances, like Belleville’s Take Me, feature a sensuous, plus-size heroine. Others offer fantasy elements, such as the ability to change into an animal. Storylines also include masturbation, consensual bondage, sex toys, or a ménage à trois or more.

Despite their frank anatomy discussions, Worthington and Belleville are somewhat conservative in their genre. They prefer one-woman-one-man plotlines. “To me, romance is the important part,” Worthington says. “They may be having hot monkey sex all over the place, but I still want to know that they’re falling in love. I think we write really romantic stories that happen to have a lot of sex in them.

”They met as freshmen at Stanford. “We just clicked,” Belleville recalls. “We were the only two in our 100-person dorm who didn’t rush a sorority or a fraternity. We had the same crude sense of humor; we liked the same music.”

And they both loved romance novels. Being roomies in their sophomore year seemed like a good idea, but it wasn’t.

“We had the girl break-up,” Belleville says. “As we like to put it, we were both selfish you-know-whats.”

After graduation, they lost touch. Worthington worked in marketing and dabbled with a historical romance novel. When layoffs hit, unemployment fueled her writing efforts. Belleville spent 10 years as a pop- folk musician, then joined a writing group and published a nonfiction book about the music industry. One day in 2002, on a whim, Worthington used her cell phone to play an on-air radio game. Belleville happened to be surfing the dial and tuned in while Worthington was talking.

“She didn’t say her name, but I knew the voice,” Belleville recalls. “She made a joke and I said, ‘That’s Jami.’ I knew I needed to track her down.” Belleville found Worthington’s phone number on the Internet. “I left the gooniest message on her answering machine.

”Worthington immediately returned Belleville’s call. They discovered they were both working on fledgling romance novels. Eventually they set up a critique/support group with another Bay Area writer. Belleville was the first published, initially with Ellora’s Cave, then through Pocket Books. Worthington hooked up with Kensington Books’ Aphrodisia line. They both feel they’re in the right place at the right time for the erotic romance trend, which fits their open-to-just-about-anything attitude.

“I’m sure my husband will tell you that I have a fairly filthy mouth and I sometimes say things that shouldn’t be said in mixed company. So it’s nice to have an outlet,” Worthington says happily. She loves creating male characters who are just average guys.

“Guys are not thinking about ‘her soft flesh.’ They’re thinking in more crude terms,” she explains. “It’s nice to not have to make a guy think, ‘Oh my darling,’ because nothing pulls me out of a story faster than that. I grew up with guys. I’m married to a guy. My husband doesn’t think deep, poetic thoughts about my beauty, but he’ll tell me I’m hot.”

Belleville also appreciates the frankness of their genre. “I’ve been able to tap into a creative part of my brain that happens to be tied into sexuality,” Belleville says. “I feel this is a real feminist thing that I’m doing, embracing my body. My books start off with a bang. If you can make it through chapter two, then you’re not fainthearted.”

Both writers are mothers. Belleville has a 2- year-old son and a newborn daughter. Worthington has a 1- year-old boy. They commiserate on managing multiple life roles. “It can be a little weird,” Belleville says, “like when I’m changing my baby’s diaper and thinking about the choreography of sex scenes.”

Wherever they are and whatever they’re doing, Belleville and Worthington pursue their literary craft in style. “Our preferred method of brainstorming ideas for a new book is to go to the Stanford mall and walk around,” Belleville says. “Being at the mall sort of frees up our creative juices. Walking frees up your mind. Shopping obviously does the same for us, too.”

PATRICIA LYNN HENLEY is a writer in Sonoma, Calif.
©2007 Stanford Alumni Association

Between Sizes

Not fitting in a ready-to-wear world
By Patricia Lynn Henley

[Clothing sizes are] one of the ways the fashion industry uses to keep us in our place.—Susan, 44, Sonoma

Flip through the racks of clothes, pull out a few promising items, try them on in front of the merciless mirror of the fitting room.

And most likely, not much fits.

Shoulders too broad. Shoulders too narrow. Waist too broad. Waist too narrow. Hips and thighs—too broad, too narrow. Long legs. Short legs. Fat calves. Skinny calves. No calves to speak of. Most of us have a mental list of what’s wrong with our bodies, the reasons why off-the-rack clothing doesn’t match our individual physical realities.

We personalize the differences between our shapes and the available clothing choices, thinking there’s something wrong with us because nothing fits. Eventually, most of us find ways of coping, but still we struggle with diet and exercise, trying to use self-control to make our bodies match what we think of as the standard sizes.

In fact, clothing sizes are a relatively new phenomenon, says Joan Jacobs Brumberg, author of The Body Project: An Intimate History of American Girls and a professor of history and women’s studies at Cornell University. Traditionally, clothing was made at home or by professional tailors and dressmakers, based on measurements of the individual who wanted the garment. Mass production of Civil War uniforms led to the first commercial sizing scales for men’s ready-to-wear, but women’s ready-to-wear took longer to develop. As late as the early 20th century, women still relied on home sewing and patterns that were adjusted to fit the wearer. That changed in the 1920s with improved mass-production techniques and national marketing efforts, as well as the rise of an urban middle class prepared to plunk down hard-earned money for the latest premade fashions.

“When clothes start to be sized by the clothing industry, you begin to think of yourself as a number. When domestic bathroom scales were introduced [after World War II], you have a weight—another number—to think about or worry about,” Brumberg explains.

For women who struggle with self image and body shape, clothing sizes almost always enter into it, says Chynna Haas, support services coordinator for the University of Wisconsin Campus Women’s Center.

“When we start talking about body image, we’re always talking about how going shopping is always stressful.”

She adds, “Modern women’s fashion doesn’t allow you to wear clothes that are actually flattering to your body type. It’s for a body type that most women don’t have. Women just kind of accept it for what it is. They try to find clothing that’s flattering.”

I don’t really enjoy shopping because it is always a pain when nothing fits right. I have larger thighs—I always have—and so I must get pants to slip over my legs. When I zip up the pants and bend a little bit, the pants are hanging off my backside because the pant size is not right for my stomach. I usually end up having to get this larger, [and then] I risk my underwear always showing in the back. What’s a girl to do? —Amy, 22, Novato

Gretchen, 38, of San Rafael, is trim, healthy, physically active, broad-shouldered—and she hates clothes shopping. “I was athletic from the day I was born, so I immediately had bigger thighs and at least one size difference top from bottom,” she says. “I never wore dresses for the longest time, because I couldn’t find any that fit up top and in my hips.”

Gretchen says that it’s not as bad now as it was when she was younger, because she’s found specific clothing labels that tend to be made more for her body shape. It helps that many designers are making more separates, instead of pairing tops and bottoms in a single size. And Gretchen’s income as a practicing attorney means she can shop for higher quality clothes than when she was a student, and they fit her better. But it’s still frustrating to not be able to find the styles she wants in sizes that fit.

“I still want to look cute. I still want to be able to wear those cute clothes,” she says. “I should be able to wear those cute clothes.”

Being between sizes, she says, pretty much sums up her life. “No matter what, I’m always going to be between sizes because of the way my body is built. I’ll always be a different size.”

She adds, “I never wanted to be petite. I just wanted to be normal.”

I don’t think there are ‘sizes.’ I always try on at least two of anything, but the main thing is, no matter what the quality of the garment, if you try three of the same thing, same size, they will fit differently. Then across brands, there seems to be a different view on sizes, so even with a mail-order company that says they get manufacturing to their sizes, there’s variety across items. It seems like irregular manufacturing is a bigger deal than being between a size that isn’t really there except on the label.—Kathey, 62, Los Gatos

Most clothing manufacturers start with a “fit” model who has desirable measurements—usually in the middle of the size range—and then use a set of rules to grade up and down to create other sizes, says Jim Lovejoy, director of industry programs for the Textile Clothing Technology Corporation. This nonprofit has created a reference database of measurements from 10,800 people who were scanned with a three-dimensional body scanner. Unfortunately, the reality of all those measurements doesn’t match with how clothing is often sized.

“The fit models are typically hourglass-shaped, and the majority of the population is not that hourglass. They’re more of what we call a straight shape,” Lovejoy explains. “You can’t just add an inch to everything or two inches and make the next size, because as people get bigger, they’re different shapes.”

It’s a challenge to fit everyone—perhaps an impossibility.

“Most apparel brands have a target audience and they’ll look to service about 80 percent of that target audience,” Lovejoy says. “The biggest and the heaviest and the smallest and lightest get left out.”

Adding to the confusion is the fact that there is no official standard for clothing sizes. The government adopted one in 1958, but it was rescinded in 1983 because the typical American shape had changed significantly over the years. Having no official sizing standards lets companies set their own.

There needs to be an understanding that everybody’s different. There’s short people, tall people, medium-size people.—Gretchen, 38, San Rafael

Most female shoppers know that the more expensive the store, the smaller the size will fit them. It’s called “vanity sizing,” and it’s evolved to the point that a garment that would have been labeled a size 12 in the 1950s or 1960s might be an 8 today. Some brands have switched to a size range that starts with 0 or even 00, allowing some women to proudly wear a size nothing—or a size double-nothing.

Even though many consumers might yearn for a mandatory sizing system employed by all manufacturers, few would be happy if that resulted in them wearing a larger-numbered size. Most apparel companies aren’t willing to risk offending their customers, so they resist the idea of industry-wide sizing standards.

Plus, many clothing manufacturers have invested in research and development to create their sizes and don’t want mandated standards, because they believe that what they’ve developed over the years is best for their target market and they’re reluctant to share that proprietary information.

“In some cases, they spent a lot of money developing their product, so they don’t want a cheap import to fit as well as something they might be selling at Nordstrom’s,” Lovejoy says.

The good news is that several companies are funding research of their customers’ actual sizes and are adjusting their products to better accommodate reality. There is now a wider range available, including different sizes of children’s clothing and brands targeted at larger women or the changing shape of those over age 55. High-tech companies are eager to develop the market, and assist apparel makers in fitting a greater variety of consumers.

“There’s a lot going on in technology,” Lovejoy adds. “It’s not perfect yet, but there’s a lot going on.”

Every now and then, my figure comes into fashion, and then I shop enough to get me through the lean times—like now. All the pants—slim-cut, low-waisted, what we used to call ‘hip-huggers’—make me look like a bowling pin with my shirt tucked in, which is how I like to wear it. An untucked shirt is OK for some things, but not really my style, and I’m way past the bare midriff stage of life! —Lara, 54, Sacramento

Susan, 44, of Sonoma, remembers always having to hike up her pants when she was in middle school and high school. Money was tight, and at least a portion of Susan’s wardrobe consisted of hand-me-downs from older, differently shaped girls in her neighborhood. But even when the family budget let her buy new things, it was hard to find something she liked.

“I hated shopping, because I couldn’t find things to fit me,” she says, making a familiar refrain. “My waist was too little and my hips were too big.”
At times, going to school was a trial.

“The days when I could wear something that fit, I did feel better.”

Now a single mom and a registered nurse, Susan says that one of the ways she’s coped with feeling “between sizes” is to develop her own personal style: a sense of the ridiculous. Her hobby is clowning, so she’s adapted that aspect in her everyday wardrobe. Whenever possible, she wears brightly colored and clearly mismatched socks. Her nursing tunics are covered with comical prints, the more colorfully outrageous the better. Accessories tend to be whimsical, with a dash of the happily extreme.

“It’s easier for me to wear ridiculous things, because then the pressure’s off. I don’t have to worry if things fit,” Susan says with a laugh. “I’ve been able to nail the ridiculous look, and to do it consistently.”

It’s her way of coping.

“I can succeed at it and it’s fun and I get a little attention. It fits me on many levels.”

Photograph by Michael Amsler
Sharp: Point coordinator John Fenech and community outreach coordinator Dawn Beggs staff Marin’s mobile needle exchange van.

Getting the Point

Snapshots from life on the streets. The North Bay’s needle-exchange programs do more than just hand out syringes

By Patricia Lynn Henley

The first time he did it, David Van Arsdale was extremely wary. The site was an out-of-the-way corner of a Santa Rosa supermarket parking lot, next to cartons of wilted lettuce. Van Arsdale didn’t say much, just did his business and got out of there. Eventually, over the years, he started chatting with the other people there. But not that first time.

“You kind of had to expose what you were doing. It was difficult at first,” Van Arsdale recalls. He kept up a jittery watch in case law-enforcement types were lingering nearby.

What kept him coming back was the chance to swap his used syringes for new ones. No more rubbing a matchbook flint across the point of a well-used syringe, trying to get it sharp enough for another injection. No more using the same needle 50 or more times to inject cocaine. “When you’re using a dull point, you know, you get a lot more pain,” he explains matter-of-factly.

Before needle exchanges were legalized in 2000, volunteers throughout California operated them clandestinely. Sonoma and Marin counties now both have active needle exchanges, and both participate in the statewide Disease Prevention Demonstration
Project enacted in 2004 that lets addicts buy 10 syringes at a time from select pharmacies, no questions asked. If used syringes are properly housed, they are not considered as illegal drug paraphernalia. Napa County officials are studying the on-the-street exchange programs and the statewide pharmacy project, looking at what might work best there. In a bid to slow the spread of HIV and hepatitis C, both Marin and Sonoma counties are working to expand their exchange programs to reach ever more addicts.

Planting Seeds for Recovery

On a Friday night in January, a volunteer who asks to be known only as Pinky set up folding tables, bringing out boxes of syringes, piling up lunch-sized brown paper bags, and arranging cottons swabs, alcohol wipes, bio-disposal buckets and other items in an informal display in the lobby of a Santa Rosa office building. The tables also held abscess kits for cleaning infected injection wounds, and a notebook-sized book called Getting It Right: A Safety Manual for Injection Drug Users.

There were small containers of sterilized water for safely diluting drugs. A pot of soup simmered in a hot pot on one table. On another, Pinky arranged condoms, hotel-sized soaps, deodorants and a wide variety of wallet- and pocket-sized pamphlets on AIDS, safe sex and other health alerts for places that provide help for a wide range of problems or life situations. In a conference room nearby, a health professional was on hand to do AIDS testing if needed. Under one table was a box of clean clothes, available to anyone who needed them.
Almost every Friday for the past 10 years, Pinky has set up a needle exchange. “It’s something that needs to be done,” she says of her long-term commitment as a volunteer. “These people, most of the time they don’t get treated with the courtesy they deserve. We’re just trying to keep them safe, as far as getting sick and getting diseases.”

Pinky estimates that, in slightly less than three hours on an average Friday evening, about 45 to 50 people will drop by to replace their used syringes with new ones. Some come after they get off work, others before they start the night shift. About 10 or so arrive by bicycle, but most drive. “A lot of them have nice cars. They’re working and just trying to get by. Some are homeless, but I think the majority are working-class,” she says.

Sonoma County’s needle exchanges are run by the Sonoma County Hepatitis AIDS Risk Reduction Project (known as SHARP) under the organizational umbrella of the nonprofit Drug Abuse Alternatives Center (DAAC).

Over a year’s time in Sonoma County alone, SHARP estimates that some 100,000 to 150,000 needles are exchanged by roughly 250 to 350 different people. Last year, about 60 of those addicts got into some form of treatment for substance abuse.

“That doesn’t mean that person didn’t use after that time or not. We don’t know,” explains Lynn Campanario, who oversees SHARP’s exchange. The primary goal, Campanario says, is a clean needle every time an addict shoots up. Reusing a syringe can create a
barbed point at the needle’s tip that can cause an abscess prone to infection. Sharing a needle means risking AIDS or hepatitis C. Addicts who need medical care rarely have health insurance; if they get ill, the community ends up paying for their care.

Another goal of the exchange, Campanario says, is to “plant seeds” so that eventually an addict might start thinking about getting out of a dangerous living situation, might leave a destructive relationship, might at least toy with the idea of rehab.

Talk Therapy

Over the years, the number of needle exchange sites in Sonoma County has waxed and waned depending on funding. Both SHARP and DAAC coordinate their efforts with Sonoma County’s Department of Health Services, which also provides some financial support. The rest comes from grants and donations.

Last September, the agencies won a five-year, $75,000-a-year state contract to expand the services offered through the needle exchange. They’ve subsequently added mobile exchanges in Guerneville and Monte Rio. During the first two months in Monte Rio, they took in more than 5,000 used syringes. That’s 5,000 needles that won’t turn up on local sidewalks, parks, garbage cans or vacant lots.

The plan is to continue to expand the program by adding sites in Petaluma and western and northern Sonoma County. The $75,000 annual state grant will also be used to set up a training program for overdose prevention and for those known as “primary exchangers,” people who turn in used needles and get new ones both for themselves and for their friends. Under the grant, primary exchanges will be offered incentives to act as peer counselors, passing on information to addicts who might otherwise have no contact with public health representatives or other officials.

A “ladies night” has already been added by SHARP on Thursdays in Santa Rosa, in partnership with Women’s Health Specialists. For two hours each week, female addicts can drop by, exchange needles and hang out in a safe space.

“We talk with them about whatever they’re wanting to talk about,” Campanario says. “It’s a very relaxed environment.”

They’ve already offered a night of free manicures, and volunteers will provide massages one evening. Such treats are not just for relaxation. The manicure night included information on hepatitis C risk from sharing nail clippers or a toothbrush.

It can be extremely difficult to find a site to hold a needle exchange. Not every suburban enclave welcomes one in the neighborhood. Therefore, the exchanges frequently end up outside in parking lots, which is less than ideal in the winter months.
One alternative is the pharmacy program, where addicts can buy syringes over the counter. It works for some people, but not every addict is willing to walk into a pharmacy and ask to buy syringes. Needle-exchange programs in the community are more discreet and they provide more than just fresh syringes. “One of the big things that we do is give resources on housing, food, shelter,” Campanario says. “We’re not just talking to them about how to deal with their drug-use stuff, because people don’t use in a tunnel. They have a whole life going on.”

It’s vital that volunteers and staff never try to persuade anyone to do anything, Campanario says. She points out that people who feel pressured or judged are unlikely to be return clients. A slow approach usually works best.

“When you’re talking to folks who come in to needle exchange, the hardest next step is to talk to them about their sex partners. So if we’ve built a good rapport, then that’s what opens up that door. I couldn’t do that the first time I talked with them.”

Blasting Social Stigma

The first woman points to the smallest possible size and says she wants that one, but her friend gently dissuades her. The first woman looks middle-class, dressed casually in a running suit, while her friend is clad in a stylish leather coat and would easily look at home in a Nordstrom’s or Neiman Marcus.

They could be discussing shoes or blue jeans, but they’re actually eyeing various sized syringes displayed in a former delivery van in a deserted parking lot in Marin County.

“The small ones jam easily,” the friend explains.

“Oh,” the first woman says, deciding that she wants a slightly larger syringe. She exchanges 80; her friend swaps 110, for herself and for friends who aren’t willing to come to the exchange van.

“The needle exchange is all about blasting through the social stigma,” explains volunteer Julie Muskat after the two women exit the van with their fresh syringes.

Muskat started volunteering as part of an ethics class, and stayed on after she satisfied her community-service requirement. “The work here is so helpful to the community, and if I have the time, why not help out?”

Muskat’s biggest eye-opener was the range of people who exchange needles in wealthy Marin. “You really don’t know what to expect,” she explains. “You quickly realize you can’t tell an intravenous drug user from anyone else. All kinds of people come here.”

The exchange is run by the Marin AIDS Project under the direction of point coordinator John Fenech. He worked in Sonoma County’s program for several years, and about three years ago took the job running Marin’s Project Point. In fiscal year 2006–’07, they exchanged close to 80,000 syringes in 662 separate transactions.

“People come to needle exchanges in Escalades, in $50,000 Mercedes. You wonder, ‘Is this person parking in the wrong parking lot?'” Fenech laughs.

Although Marin County has more than a dozen pharmacies participating in the statewide exchange program and Sonoma County has two, Fenech says a lot of local addicts don’t want to get their syringes from a public store. “They can go to an exchange site and know they’re less likely to see their neighbors,” he explains.

One of the problems is that the average person has a jaundiced view of needle exchanges, believing that they perpetuate the use of drugs.
“I’ve been in recovery for 20 years, and I’ve never heard an addict say they got clean because they couldn’t find a clean syringe,” he says, laughing again.

“An addict will use any needle that they can find if they can’t get a clean needle,” Fenech asserts. “I’ve heard stories in recovery about people who’ve been with someone where the other person OD’d. Here’s a syringe hanging out of [an] arm, and the guy looks at it and says, ‘That must be really good stuff,’ and takes the syringe out of the dead person’s arm and injects himself with it.”

Needle exchanges, he adds, are about dealing with people as they really are, not as the community might want them to be, and reducing potential ways they might harm themselves.

“In reality, most people don’t get into recovery,” Fenech says. “So this keeps them safe, ‘healthy.’ A person could inject themselves for the rest of their lives and not get infected if they use needle exchange.”

He tells a story about his daughter, a hospital emergency room nurse. Sheriff’s deputies brought in a woman for a health check before taking her to jail on drug-related charges. The woman wore an oversized flannel shirt that she kept pulled down over one hand. “My daughter talked to her for quite a while about how important it was to let them see her arm,” Fenech recalls. “Finally the woman showed her arm. It was dead from her elbow down.”

An injection site had abscessed and gotten infected. Some of the bone was eaten away. Most addicts, Fenech adds, won’t seek treatment for an abscess because they don’t want anyone to see the needle tracks or know that they shoot up drugs.

On a lighter note, Fenech says there’s always a handy excuse. “I’ve never met so many people with infected spider bites in my life. Spider bites. That’s what they say.”

But They’re Just Junkies

Why are all of these volunteer hours, thousands of dollars and professional exertions being made to care for junkies? Who cares? Timothy Maroni, the syringe-exchange-program specialist for the Oakland office of the Harm Reduction Coalition (HRC), a national advocacy group, says that needle-exchange programs have a positive impact.

“There have been studies that have been inconclusive on different aspects, but overwhelmingly when they do a study, the evidence is clear that syringe-exchange programs save lives, save dollars, prevent infections, prevent destruction of families, keep syringes off the streets, are an excellent treatment entry point—all of those things.”

Based on studies, it’s estimated that only 15 percent of intravenous drug users are currently in treatment, and that syringe exchange has a two- to six-fold protective effect against HIV risk behaviors. Research also shows most people relapse several times before finally quitting. The goal of a harm-reduction approach is to keep them safe until they can get clean.
Maroni works with 39 needle-exchange programs statewide. He says such programs are one of the few places where addicts can be honest about who they are and what they do.

“Being in the closet is problematic and makes it hard to make behavior changes, to really look at yourself. And it’s hard to dialogue because you can’t speak,” Maroni says. “When people access services, they want to bring all of themselves, not just a part. They feel they have to lie in order to get services; they have to say they’re working on abstinence.”

Most injection drug users are socially isolated, and have small or nonexistent social-support networks.

“Every human being does have value,” Maroni stresses. “Everyone is worth saving. At [HRC], we’re all about being nonjudgmental, but that’s the one judgment we do have: that all human beings are complete, whole, worthy and valuable.”

From the Bottom Back Up

After his initial visit to that supermarket parking lot, David Van Arsdale continued using the needle exchange. Gradually he began to relax. “They treated me with respect. Nobody was there to corner you or to try to steer you towards recovery. They just took care of business.”
He started injecting cocaine back in his native Iowa, where it was legal to buy needles across a pharmacy counter, no questions asked. He relocated to California with a goal of getting away from the drug scene, but wound up in a motel his first day here, shooting up. And he quickly learned that clean syringes were a lot harder to get in California.

So he used and reused his needles. He knew friends who fashioned home-made versions out of little eyedroppers. “The value of a hypodermic needle was like gold,” he recalls. “You’d take the plunger out and use earwax to get it to slide back and forth. I used a syringe so often you couldn’t even read the numbers on it.”

Then another addict told him about Sonoma County’s needle-exchange program. For the next 15 years, he was a regular. The exchange had to move a couple of times, and he followed it wherever it went. He’d roll up on his bicycle, wearing headphones and be-bopping to the music. That became his connection with Fenech, who was then working in Sonoma County.

“We started talking about music. We kind of became friends,” Van Arsdale recalls. “When I came to exchange my needles, he never applied any pressure to get me into treatment. He always had time to come and sit with me. Sometimes they’d be serving food and I’d get a bowl of soup, and he’d sit down and talk.”

Van Arsdale was in and out of county jail on a variety of charges. A little over six years ago, he was arrested again, and this time there was talk of state prison. “I had kind of worn out my welcome on the county level,” he explains wryly.

At that point, Van Arsdale was 46 years old and out of options. He contacted the last friend who would accept calls from jail and had her get word to Fenech, asking him to visit.

Fenech came on a Saturday afternoon. “I told him, ‘Man, I need to do something about this problem,'” Van Arsdale recalls. By Monday morning, a representative of a local program was meeting with Van Arsdale in jail. He was admitted to the Turning Point rehab facility.
It was the threat of prison that steered Van Arsdale toward rehab, but it was his friendship with Fenech, nurtured through the needle exchange, that helped him find his way.

Last December Van Arsdale celebrated six years clean and sober. He now works for DAAC as a counselor in the Sonoma County Drug Court program. He truly understands how hard it can be to kick a drug habit.
His advice? “If you’re out there using, utilize the needle exchange. It saves money, not to mention lives.”

Exchange Centers

In Sonoma County SHARP keeps its exchange sites confidential. To find out where they’re held, call the recording at 707.527.5277. For more information, including names of syringe-exchange pharmacies, or to volunteer or donate, call 707.544.3295, ext. 342. The SHARP office is located at 2403 Professional Drive, Santa Rosa.

In Marin County The Project Point van visits Mill Valley on Monday from 6pm to 8pm in the Park & Ride lot at the Stinson Beach exit off Highway 101. On Thursday, it’s in Novato from 6:30pm to 8:30pm on Rowland Boulevard, 0.1 mile west of Highway 101.

Exchanges are also held Tuesday from 5:30pm to 8pm at the Marin AIDS Project office, 910 Irwin St., San Rafael. Exchangers can also come by the office Monday to Friday from noon to 4pm on a drop-in basis. For more information or lists of syringe-exchange pharmacies in Marin, call 415.457.2487 or visit www.marinaidsproject.org.