• leaflet

    . . .a thin triangular flap of a heart valve. . . a small book usually having a paper cover . . . a medical lit-art e-journal from The Permanente Press
  • 1

Judgment and Fear in a Doctor

Prose, Vol 6: Iss 1

In 1986, I tossed a copy of Joy of Cooking into the trash. I didn’t think I could catch AIDS from its pages, but I did not want to contaminate my home with Harold’s germs.

Harold had given me his tattered copy of the cookbook in gratitude for our time together. In the language of the time, I was his “buddy,” a volunteer assigned to him through Gay Men’s Health Crisis in New York City, and Harold was a “PWA,” a person with AIDS. I took him groceries and cleaned his apartment. I must have taken him to see his doctors too, although I have no memories of those visits. 

Harold and I usually spent our time together in his cramped apartment on the edge of Harlem, but one spring afternoon I suggested we take an outing. He wore a pair of green and white striped pants, a red and orange-checkered shirt, and a large brimmed hat for the occasion. I still am not sure if his outfit reflected his AIDS dementia, his fashion sense, or his demand that the world take him on his own terms. I felt both embarrassed and protective as I linked arms with him to head to the only formal garden in Central Park. When we settled into our seats on a public bus, I glared at anyone who attempted to stare at his purple-black Kaposi’s sarcomas or his garish clothing.

The short walk from the bus stop to the six-acre conservatory garden at the Park’s north end had exhausted Harold. When he caught his breath, he proudly informed me that he had once been a florist. He reeled off names of the flowers around us before falling abruptly quiet. We sat side by side on a park bench in silence for a good hour, enjoying the warmth of the spring sun. With his eyes still closed, he squeezed my hand and thanked me for bringing him to this place.

When we arrived back at his home, he handed me his used copy of Joy of Cooking. We hugged goodbye as I thanked him for giving me something he clearly loved. 

I threw the book into a trash bin before I was even a block from his home.

Harold died before our next meeting. Friends of his told me that he had found peace in the garden that afternoon. I am proud to remember myself sitting beside Harold in the garden. I know, however, that the compassionate healer on the park bench was the same person who discarded a perfectly serviceable copy of Joy of Cooking.

The image of my hand over the city trash bin came to me unbidden when I recently heard the story of a man who was diagnosed with AIDS shortly after Harold died.

It was 1987 and more than 16,000 Americans had died from AIDS. The epidemic seemed very distant to the daily life of one Manhattan surgeon. He had a five-month-old daughter, a devoted wife, and a thriving practice at a prestigious teaching hospital. He had recovered from the high fevers, aches, and oral sores that kept him in bed the previous December, and he did not think twice about doing the requisite lab tests to acquire a more generous life insurance policy for his expanding family.

The surgeon received a call at the hospital from his insurance agent. The agent brusquely announced that the surgeon had tested positive for AIDS. By the close of business that day, the surgeon had quit his job. If he had not quit, he would have been fired. Doctors with AIDS were not allowed to practice.

He shared the diagnosis with his wife, herself a resident physician, and she rushed home after telling her colleagues that her mother was seriously ill. The couple huddled in their apartment knowing that their world had violently changed. He was going to die soon. The baby must be infected. She must be infected. The wife was now the sole bread-winner. They were not sure they had health insurance now that he was unemployed. They pictured themselves homeless, the three of them dying together in their car, to be discovered days after their death.

They retraced their steps. No intravenous drug use. No transfusions. A limited number of heterosexual relationships for each in the distant past. A bloody scalpel slicing through the surgeon’s gloved left hand during a surgery a few months earlier.

They sought testing and care at a public AIDS clinic and waited to meet the doctor in a waiting room full of cachectic men coughing and sweating. Both the wife and the baby tested negative for HIV. The clinic doctor treated all three of them as ignorant lepers. 

They eventually found an experienced, caring physician who could treat the surgeon. This doctor advised that the couple not tell anyone of the man’s diagnosis lest the wife lose her job. The wife protested, repeating the negative results of her own testing. “Doesn’t matter,” the knowledgeable doctor said. “The hospital will fire you if they find out you are married to someone who has seroconverted.” 

They invited over an internist, a close friend who a few months earlier had rushed to visit when their daughter was born. They shared the news of the husband’s diagnosis. The internist refused to touch the surgeon, the wife, or the baby. She left their home abruptly after reproaching them for exposing her to the lethal virus. 

The administrators of the hospital where the surgeon had worked refused to acknowledge the bloody scalpel as the most likely vector of HIV transmission and refused to offer any financial benefits to the surgeon and his family. The hospital administrators allowed their lawyers to grill the surgeon and his wife on their sexual habits and about the possibility of illicit drug use.

The couple’s immediate families grieved the diagnosis, but remained steadfast in their support of the two of them and their baby. She went to work, but they rarely went out otherwise. They wanted to shield him from potential infections, and they had no friends they could trust with their story. They worried about the impact of the diagnosis, stress, and isolation on the baby. 

AZT, the first anti-HIV drug, became available in March 1987. He began taking it every four hours around the clock. Miraculously, he stayed healthy enough on AZT to live to the next generation of antivirals and then to the era of HAART, highly active antiretroviral treatment. He lives today, 30 years after his original diagnosis. In the intervening years, AIDS has changed from a death sentence to a manageable chronic illness, the hospital where he was employed has been ordered to pay financial compensation, and their baby has grown into a successful young woman. 

When I first heard the story of the surgeon, I could not get over how he and his wife had been stigmatized, isolated, and betrayed. I was appalled at how those in power had treated the couple. I felt superior to the people who had acted out of fear, ignorance, and prejudice. I remembered with pride my work as a buddy.

And then came that shameful memory: In 1986, I tossed a copy of Joy of Cooking into the trash. I didn’t think I could catch AIDS from its pages, but I did not want to contaminate my home with Harold’s germs.

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