In your book, you say you hold the dubious honor of having signed more death certificates in 1992 than anyone else in Illinois.
I became very friendly with the hospital office staff, because I was there two or three days a week just signing death certificates. To have multiple patients die every week for years on end was pretty horrible. I’d say to my doctor friends, “How much longer can we do this?”
Sounds like a recipe for PTSD.
I think I probably do have PTSD. But strangely, I never got burned out. There were times I was on the verge, but we all felt like we were part of a mission doing something extraordinary.
Do you remember your first AIDS patient?
It was 1982, and I was a resident at St. Joseph Hospital. By the time I saw him, he was on a ventilator. We didn’t know how AIDS was communicated, so we were all masked and gowned. The thoracic surgeon who’d done a lung biopsy on him said, “This is not contagious to us,” and tore off his mask. But later on, when we understood the nature of HIV and how it was transmitted, he wouldn’t take care of [AIDS] patients.
What made all of this especially poignant is that you were a young gay man, just like most of your patients.
I was in a relationship for four and a half years with a man who died of AIDS after we broke up.
And you had to wait 10 days to get the test results saying you were negative.
It was agonizing. Now we can get an HIV test result in 10 minutes — and that 10 minutes is agonizing.
What are the expectations for your patients now?
I have lots of people in my practice with HIV, but they’re doing beautifully. Occasionally I’ll have somebody who just will not go on treatment, and it’s really frustrating. I had people in the ’80s and ’90s who would have done anything to get lifesaving medication. One resistant patient, I kept watching his T cell count go lower and lower. Finally I got on my knees and said, “I can’t go through this with you. I can’t watch another person die of HIV.” He was so shocked he took the medicine.