Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Lessons From the AIDS Epidemic


In times of crisis, it can be helpful to listen and learn from the stories of those who have come before us.

Newark, New Jersey, 1996

We were on our medicine clerkships, learning auscultation, phlebotomy, and CPR on H-blue, the unit devoted to AIDS. There was room after room of patients, many with only sporadic human contact from staff, who were gowned, gloved, and masked. There were few visitors, either because their loved ones were afraid, didn’t know they were sick, or worst of all, they didn’t have any loved ones.



AIDS, a novel disease, was cutting a large swath through the poor, the sick, and those struggling with addiction, but it was also striking down the young and healthy. We looked to our residents and attendings for guidance during this frightening time. We imitated their kind, calm, and scientific approach. In hindsight, I realize that when the HIV epidemic escalated and hospitals developed their first AIDS units, some of those attendings must have gone home after shifts, showered obsessively, and had tense conversations with worried spouses. They watched their sleeping children, perhaps considered walking away from medicine, and then remembered their calling and their mortgage.



Where did they get their cool from? Maybe they remembered their own student days, before widespread childhood vaccines, and they in turn were taught by attendings who remembered the time before antibiotics. Many of my attendings had trained in undeveloped places, and they taught us how to function when the resources and safety net were thin. A family friend of mine, still living at age 103, is a pulmonologist. I grew up hearing his stories of working in New York City’s tuberculosis wards. TB still stalks our patients and our nightmares. And pestilence has always been the physician’s enemy. I will share the stories I remember from him, and my stories from H blue, with my students, so that they too, will remember.



I remember the relentless, slow tide of research, innovation, and policy that pushed back against AIDS. There wasn’t a magic bullet that appeared overnight to save us. Just people who showed up to work in hospitals, labs, industry, and government day after day, year after year.



Stories sustain us in times of pestilence. So, I will remember my teachers, tell my stories, thank my colleagues, smile warmly at my patients, remember my calling (and my mortgage), and show up. And I know that coronavirus, and our response to it, will be the story that today’s students, trainees, and young clinicians will pass on to our sleeping children when they report for their clerkships.