'You expected me to be depressed?"

Well, yes. Who wouldn't be, Doc, with your kind of caseload?

People became doctors to make other people well. Larry M. Bruni, MD, can't do that with most who come to see him. He can soften their pain, but if success is measured by how many he actually cures, the guy's a loser.

Each year, he loses 20 or 30. He and two colleagues have roughly 1,200 more patients who, save for a miracle, will join the already-dead within a few years, no matter what the trio does.

"I've seen so many of my patients die," Bruni said between appointments on Friday afternoon, sitting in a conference room overlooking Pennsylvania Avenue SE at Eighth Street, his office site. "Some of them die as sniveling cowards, and some of them are incredibly courageous and I admire them."

Either way, AIDS gets them.

So you can see why a visitor might be amazed that Larry Bruni, MD, isn't a basket case. He has blue periods, he said. He doesn't go to the funerals because "I can't afford to do it, psychically." But he shows up every day to fight the medical fight. He even can laugh and chatter as he sits there dressed in jeans during a break.

How was the last patient?

"He's got very few T-cells."

You're supposed to have a lot.

When he got out of medical school 10 years ago, Bruni, now 40, knew his career would be different, because he is openly gay. He assumed that most of his clients would be too because straight folks wouldn't feel comfortable seeing a gay doctor. But he also assumed that the illnesses of homosexuals would be pretty much like those of straight patients.

Sick was sick and healing was healing and AIDS was just the faintest of evils then.

"We were coming from an era where the gay subculture was just a constant party," he said. "I'd take care of some gonorrhea and syphilis," but nothing special.

He had this very doctor-ish dream back then.

He imagined buying a red Porsche and driving to Connecticut on weekends after spending his week making people well. He never figured out why Connecticut, because he doesn't like the place, but there it was. It was a vision of success, countryside and normalcy.

"I hold onto that image," he said.

You've got to hold onto something with this kind of practice.

All told, his office has 1,500 patients, he said. Not all are homosexual. And about 300 have nothing more than everyday problems. But the rest have tested HIV-positive, which means each will get AIDS.

They all have two options.

They can curl up and wait. Or they can try every delaying drug and treatment there is, trying to live as long and as well as possible on the chance that some new drug will pop up and they'll live longer still, which might mean they'll be around when the day comes that someone says they've done it and AIDS is history.

Bruni dispenses option two: "We'll try our hardest to keep you alive until the next new thing."

"They're used to such pessimism coming from health-care professionals, from friends, from relatives," he said of his patients.

"How can people live like that? You have to have hope. I don't know how I keep it . . . . In an area where other doctors say it's hopeless, forget it, they're dying like flies, I look for little ways to make a difference."

A victory is adding four months to a life with drugs: "When you have only 12 months to live, four months is a lot."

In other words, Bruni is still doing what doctors do, easing the pain and extending mortality. Sure, death hovers over his patients with more certitude than most. But he noted the obvious: We're all departing some day, and try finding a doctor who can stop that.

He said it helps that he is homosexual, because he hurts for the gay "family." So, while the medical community can get ensnarled in rules and procedures for fighting AIDS, he'll try almost anything, he said, even if it hasn't gone the official rounds yet.

After all, his patients are doomed anyway. Roll the dice.

He is, by the way, HIV-negative. That helps him loan out optimism to his patients, he said.

Bruni told a popular story. It's that one about a boy who gets a huge pile of horse manure for Christmas. A neighbor stops by and finds the boy digging through the pile furiously, gleefully. The boy's father explains that his son is an optimist and that he's certain that at the bottom of that pile of horse manure, there is a pony.

That's why Bruni comes to work each day.

"There's got to be a pony."