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How Many of You Remember a Vivid Event that Shaped You in Your Job or Profession?

That happened to me in medical school in 1981. It was the early days of AIDS where gay men in NYC and SF were dying of rare lung infections and aggressive cancers. Medical researchers felt that the destruction of their immune system which put them at risk for those problems was being destroyed by something that was being transmitted sexually.

Fear ruled and for many compassion withered. Some even said that God was punishing gay men for the way they lived their lives. Doctors were also ostracized and some had to fight not being evicted from their medical practice for taking care of AIDS patients.

In 1983 the CDC, the Center for Disease Control, identified that the infection could be transmitted by blood or sex. That was also the year I saw my first AIDS patient. He was a young gaunt man with stringy brown hair who had sunken cheeks. His skin was covered with raised purple lesions the size of 50 cent pieces that were known as Kaposi’s sarcoma (a rare cancer). He was breathing fast and tried to lick his chapped lips with a tongue that was covered in a white, curdy substance which I knew was yeast.

I was sent in to draw a special blood test and felt my hands start to sweat under the latex gloves. I looked at the pink plastic pitcher filled with water on the bedside tray that was out of his reach. I poured him a cup of water, put a straw in it and lifted his head so he could drink. He drank it all and closed his eyes. I flipped around the pillow which was wet from his sweat to the other side and laid him back. He opened his eyes and the sadness and hopelessness in them almost made me start crying. The last thing I wanted to do was hurt him by drawing blood for an infection that we didn’t even have a drug for.

I asked him if I could do anything else for him before I drew his blood and he shook his head no. My hand was shaking after I removed the syringe from his arm. I had to inject it into a special small tube with a rubber lavender top. The needle didn’t seem to want to go in and when I pushed it harder it went thru the top at an angle and pierced my left index finger. I jerked the needle out and repositioned it, so his blood emptied into the tube.

A number of choice words went thru my mind which I can’t repeat as I milked my finger under the water faucet in his room. Now what? Do I tell someone? My heart started galloping. What would they do to me? There’s no test yet to know if I have it or treatment they can give me. My right leg started to shake. I’m not going to tell anyone. I just have to make sure I don’t infect anyone in case …. My leg started to shake even harder.

I looked back at the young man who was suffering and could only feel compassion. I knew doctors who did not want to take care of them because they were worried about the risk to themselves. I also knew doctors at the time who were not compassionate because they felt that gay men had done it to themselves. I did not endear myself to my professors when I asked them if they felt that way about patients who suffered from heart disease and diabetes from their life style choices.

Those early days of the AIDS epidemic were a defining moment for me in my career and helped me when I started as a prison doctor in 1987 and found I had 120 patients in the prison who were positive for HIV. It was also the year that the first HIV medication, AZT, came out and I became responsible for what would happen in the prison in regards to AIDS.

The early days of AIDS when I was a medical student solidified my views on compassion. They made me empathize even more with those early victims, because I could have been one of them. I was inspired by the people and organizations that were the first advocates to promote research, treatment and care for the AIDS victims. They were not ruled by fear or discriminated individuals and we have them to thank for turning a death sentence into a chronic, manageable medical condition. They are still working on a cure and their research on the HIV virus which caused AIDS has revolutionized our understanding of viruses and the diseases and cancers they cause.

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