I am 29 years old, a visual artist, and this month I started medical school. Over the last few weeks I’ve felt alienated from many things about the process that I’ve studied my way into. The social ignorance of my classmates is hard at times. The political landscape change that comes with moving from a life in New York City to Atlanta is disorienting. Things that are obvious to me are not as clear here. Prisoners should be given organ transplants as though they were regular patients on waiting lists, not second-class citizens. Apparently there are those who disagree with this. I find that unbelievable, and it makes me want to go revolutionary on them.
An older doctor came to speak with us this week. He’s a short Jewish man from Virginia, wearing a seersucker blazer and walking on a cane. He was talking about the HIV epidemic, of which he was the first person in Atlanta to take seriously. He remembers seeing an unexplained case in the late 70’s in a medical student that he later realized was likely HIV. In the early years, as a new disease became apparent, he was one of the few if only people working on it in Atlanta. People were dying and they had no idea how to help. He said that his colleagues shunned him in the hallways because he worked with those patients; what if infection came from contact? Or the air? The local university told him to keep those patients outside of their hospital system, both because they were dangerous and at that time mostly gay white men. He said that if he had a gun there are a number of people he would shoot for what they did, for the human beings that they abandoned on his doorstep. He said that in retrospect he was ashamed that he wasn’t more of an activist, and even more ashamed that he didn’t realize at the time how the disease was quietly beginning to devastate the black community. This wasn’t false humility; he wore that shame like a raw wound.
We’re being taught to preserve our own health, to be careful of burnout, and to not give so much of ourselves that we get lost. He said he did none of those things, and each day he went in and gave his soul to his patients, and each day he left with less of it. For 7 years throughout the 80′s he worked 12-hour days, 7 days a week, trying to understand and apply new treatments to his people. He said that when he was a kid he called people sissies and queers, not thinking about them as sexual beings, but simply as people who were different in the wrong way. And when the disease exploded in that community he had to change himself and learn to care for them in ways that made him grow, but also made him realize how awful he had been.
He had a patient who had likely contracted HIV from her husband, her only sexual partner. She knew she was HIV positive, and they tried earlier AZT drugs on her that in retrospect likely made her worse, but it was all he knew to do. She wasted to 70 pounds, and was wearing a diaper toward the end because of her overwhelming diarrhea. He could barely bring himself to see her, but during his rounds he would always go, sometimes pushing her back to last patient just to avoid having to face her. She had never been angry; at her husband, at the world, or at him for failing. One day she asked him to sit down, and he thought to himself that this was it, she was going to let it out. He sat, and she said, You don’t look so good. My disease is killing you too. I’m not afraid, I know I’m dying. It’s okay.
He said he wasn’t a hero. That he made too many mistakes and missed too many opportunities. I went up to him after and said, All people carry fear, all people carry guilt. Heroes are the ones who continue anyway.
New York and San Francisco have been so successful at their public health efforts against HIV that Bellevue recently closed its AIDS ward where patients used to go to be treated and often die. It’s not necessary there anymore. Atlanta on the other hand qualifies as an epidemic region under WHO guidelines. The disease is spreading like wildfire here. 60% of gay black men will contract it before the age of 40. Over 200 people die every year in Grady Hospital alone from HIV/AIDS related complications even though a full drug treatment course is available because of unaddressed social and mental health problems. Even with drug availability, the profession has failed to reach out and effectively communicate with poor people and minorities. Gay white men, while still being infected, will be cared for. There’s work to be done with everyone else. Patients who don’t follow their drug regimens can’t be blamed; we are the professionals. It is our job to help them, not to dismiss them if they don’t meet us half way.
I’ve been questioning why I was here. Wondering why I upended my life to spend time with people who are not like me, who will never understand me and who I can’t open up to or be myself around. He reminded me. The world is a beautiful place, and it’s unbearable that there are those who’s suffering is so naked that they can no longer see it. Not everyone can be healed, but everyone can be helped. I am tired of being more ignorant than is necessary in the face of that pain.