Buck Buckingham works out on an elliptical machine at his home in Silver Spring. (Katherine Frey/The Washington Post)

Not long ago, Buck Buckingham found himself facing some scolding from his doctor. He was out of shape and not doing enough to keep his blood pressure and cholesterol in check. Pills weren’t going to solve the problem; Buckingham needed to revamp his routine to live a long and healthy life.

Old age had never been on Buckingham’s radar. Infected with HIV in 1978, when he was 26, he expected to be dead by now. “I turned 61 on my last birthday, which is quite a few years longer than I had anticipated having when I got my AIDS diagnosis,” Buckingham said. “I do have a small number of friends and acquaintances happily dealing with the same unexpected circumstances.”

Until retiring recently, Buckingham worked nearly 21 years on AIDS-related issues for the federal government. Now he is doing what his doctor recommended : exercising, eating more healthfully, consulting part time, attending church in his Silver Spring neighborhood and dreaming of spending more time beside the Indian Ocean in Africa, near where he was once based for PEPFAR, the President’s Emergency Plan for AIDS Relief.

He recently talked with The Post at his home.

Tell me about when it really hit you that you better start thinking about your health and old age.

About a year and a half ago, I was in for a routine visit to my doc, and he said to me, “Buck, we have this HIV thing licked, but damn it, I am not prepared to lose you early to a heart attack or a stroke. You’re not doing enough about your blood pressure or your cholesterol. I am not willing to just deal with it with pills. You need to make some serious lifestyle changes.”

He said, “I am going to send you to see a cardiologist who’s about 4-foot nothing but who will terrorize you.” And she did. She shared stuff with me from the medical literature that I went out of my way to not be cognizant of. Having HIV and being this age makes me six times as likely to have cardiac issues. And having HIV and diabetes makes me 13 times as likely. She did just put the fear of God in me.

So what did you do?

I dragged an elliptical trainer into the house.

I would like to be able to claim I get on the elliptical five days a week. It’s more consistently three. And I changed my diet, and very, very quickly I lost 12 pounds. I took up an exercise regimen that I am not quite as disciplined about still as I would like to be.

I blew past every one of those impossible targets she set in terms of getting my cholesterol under control and my blood pressure way better regulated.

And you stopped working.

The idea of retirement is just something I never really thought about, just because I never really expected to live this long. But it just finally dawned on me that I had been in the world of work pretty much without a break for 37 years. I am much more focused on all the things I need to do to stay well and not just the things that I might be able to do to help others stay well [which was the focus of my work].

What’s your new healthy diet?

For breakfast I have, in a fairly small bowl, a little bit of granola on the bottom of the bowl and whatever good, fresh fruits that are in season, or not in season but available, like blueberries, and then some Cheerios on top of that.

For lunch most days, I will have a salad, sometimes a sandwich.

I eat out often, three times a week. But I try to eat pretty healthy, so I’ll have a salad or a salad with a meat, usually chicken, with the salad. I found a Vietnamese restaurant that I enjoy and will have a green papaya salad with shrimp on a small plate. It fills me up just right.

Linked with the diabetes, I learned to stay away from pastas and grains as much as possible. As much as I enjoy Chinese food or Vietnamese food, I will let them bring the rice, but I will limit myself to max one tablespoon of the rice.

When I cook at home, it’s usually something on the grill. I occasionally indulge in red meat, but as often as not I will grill fish or a piece of chicken and just have some green vegetables with that.

I do stress-eat, but small quantities of pretty unhealthful things, like a bag of Cheetos.

Tell me about your day.

I get up very early, so I’m usually in bed by 10. I set the alarm clock for 5 o’clock. I move slowly in the morning. I’ve learned to embrace that.

When I was still working, I’d come up, start the coffee. I’d log onto the computer, check my e-mail, come back, fix my breakfast, take my coffee and the cereal and go sit back in front of the computer. And just get into that stuff.

I just made a conscious decision I’m going to walk right past the coffeemaker, sit in a lovely little sun porch I have where I’d never set foot, and I spend 20 quiet minutes there, just trying to set a very different pace for my own head and my focus for the day. I’m an Episcopalian. There’s this neat little book that has prayers for morning, noon and nighttime. I do the morning prayer each day. It’s just a short devotional that takes five or six minutes. And then I allow myself to come back and make the coffee. And sometimes then with my bowl of cereal, I will look at Facebook or my e-mail.

What is your nighttime routine?

[The book of devotions for nighttime] gets me into a very reflective and grateful mood, instead of falling asleep rehearsing the things I did wrong during the day or the things on the today list that are unfinished.

Until I started this routine I was taking sleeping pills almost all the time. Not prescription sleeping pills. They were over-the-counter, like Sominex, but I was taking them all the time. I was not sleeping well.

You’re 5-6. How much do you weigh now?

I weigh 147 pounds soaking wet. I’d love to get — just because it’s in my head — to 145. I’d like to be a bit more toned-up than now, but damn, I can buy pants with a size 28 waist. The last time I was able to do that was [pause] a long time ago. I was really sick then. [In 1985, Buckingham says, he weighed 115 pounds and was smoking three packs of cigarettes a day]. Now I’m healthy.

How are you feeling?

Really, really good. I see my doc three times a year. We both kind of joke we’re doing this because we feel like we have to.

Where are you in your personal life?

I’m single. I’m just fine with that. I had a long-term relationship while I was in Kenya that meant a very great deal to me. He was Kenyan. We tried to make it work for him to come be here in the U.S., and it didn’t work. Along the way, we both learned that sustaining a relationship across eight time zones and 6,000 miles just was impossible.

What is AIDS to you now as an older person?

It will always be a defining part of who I am. It is not just a virus that I carry. For 26, 27 years of my life, it has been what I did, too, Monday through Friday, often including Saturdays and Sundays. Both my physical health and my sense of my self are very much wrapped up in this epidemic. As they say on Facebook, it’s complicated.

Every once in a while I have fantasized about not taking my retroviral drugs, and I still hold onto the hope that there might be [a time] in the future where I’m not taking them, at least not every day.


I imagine there would be a great sense of freedom to not have to be so worried about “Is the box of pill refills going to be on my porch in time?” If I’m traveling, have I counted correctly and “Do I have enough to get me through until I come home?”

If there is a silver lining in something like AIDS, and I think there is, it’s that it’s a devastating illness that also has demonstrated an amazing capacity for transformation. I have seen it transform my relationship with my father. I’ve seen that happen over and over again in families. It transformed how FDA approved new drugs. It has transformed how the U.S. government does foreign assistance under PEPFAR.

I have been this lucky, accidental person in the middle of a lot of that. I don’t want to ever forget that because it has, along the way, changed me a lot.

Any regrets?

Oh, yeah. [He laughs.] I regret getting infected in the first place, but that’s not something you can undo. I regret not having the capacity, while I was working, to have more of, or the discipline to have more of, the sense of balance I do have now. It would have been nice to discover that 10 or 12 years ago, not at this point in my life.