I was working as a medical student at Boston City Hospital in 1984 when I met my first AIDS patient. He was an injection drug user who mystified the medical staff with infection after infection and ultimately died of liver failure and pneumonia. He called me “Dr. John,” after the musician, even though I wasn’t a doctor yet and I had no musical talent. He had no veins, but I had a lot of beginner’s luck drawing his blood. After my first couple of days with him, he wouldn’t let anyone except “Dr. John” take his blood. We didn’t wear gloves back then, by the way. The AIDS epidemic hit Boston a little later than San Francisco and New York, and the doctors were stumped by my patient until a brand-new test for HIV (then called HTLV-III) came out. He tested positive shortly before his death.
Now, more than 30 years later, the world of HIV has changed completely. HIV clinics’ waiting rooms are no longer full of young folks facing frightening infections and early deaths. Today, they are full of young, middle-aged, and older people who lead full lives and control their viruses with just one or a few pills per day.
As a middle-aged HIV and infectious diseases specialist, I can now look back on my experiences taking care of thousands of patients living with HIV. In the early years, I lost more of them than I care to remember. Now, it’s rare for my patients to be hospitalized with HIV complications because they’re almost all on meds with good CD4 cells and undetectable viral loads.
I’m still losing far too many patients, though. Not from AIDS. From cigarettes. From lung cancer, heart attacks, strokes, emphysema and COPD [Chronic Obstructive Pulmonary Disease]. Half of my patients smoke. And yes, I include even the ones who smoke only a couple of cigarettes a day or a few times a week—they’re smokers too.
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The information in this blog is for educational purposes only and is not provided as a professional service or medical advice, diagnosis or treatment for specific patients. It is not a substitute for professional medical care, and if you have, or you suspect you may have, a health problem you should consult your health care provider.
This blog represents the opinions of the writer and does not represent the views or opinions of Montefiore Medical Center, the Albert Einstein College of Medicine, the National Institutes of Health, or any other organization.