The AIDS epidemic and its depiction through Medical Literature

The AIDS epidemic crossed the physical borders of the United States of America in 1969.  This entrance into American society affected not only the health of the citizens, but, its presence led to social, cultural, and political movements that have been analyzed and criticized to this day.  Because of the varying ways in which the disease was perceived, received, and resolved, a mixture of medical literature has been produced.  Each selection of this literature may addresses a different underlying topic listed above, but almost all of them describe the horrid results of this infectious and deadly virus.  Most of this literature was written during beginning years of the outbreak of AIDS, but what one must realize is that it is still thriving and killing within the world’s community today.

Throughout my life, AIDS has been an established disease and aspect of civilization and society.  During late Elementary and Middle School years, the science behind the AIDS virus is explained and described so that we as students can understand what it is and how its transmission can be prevented.  Throughout high school and college, I learned of initiatives and organizations that are working diligently on preventing the spread of this disease within the United States and throughout the world.  During my freshman year of college, I took a class entitled On the Verge of Infectious Disease, with Professor Dr. Jeff Mayne.  This class addressed issues such as the spread of infectious diseases and the biology behind some of the world’s greatest, and most terrible epidemics.  It was in this class that I learned of the origination of HIV and AIDS.  So when I read this literature of the disease after knowing the biological and historical roots, it is interesting to compare all of these perspectives to which I have been exposed, especially the diseases influence and effect on American society.

When the Auto Immune Deficiency Syndrome, AIDS, was recognized in the United States, it was had not titled or referred to as AIDS.  Rather it was a “gay cancer” because the disease was mainly present within the gay community.  Because of its association with the gay community, it later became know as a “Gay Related Immune Deficiency.”  The emergence of the AIDS epidemic within the gay community led to a change in the way the gay community was perceived and received within society.  During this time, there was already a stigma and a negative associated with the gay community, especially within particular areas of the United States.  The presence of this highly transferrable and public disease within the community probably only hindered the perception of the gay community among others who were opposed to this lifestyle, even within the medical field. 

Abraham Verghese writes in his work “From My Own Country” about the first case of AIDS reached Johnson City, Tennessee.  In this story, the patient, a gay man originally from Johnson City and who had gone to New York to live, was coming back to Tennessee to visit his family.  During his trip home, the physical symptoms of the AIDS virus begin to present themselves, and by the time he got back home, he was admitted straight into the emergency room.  During his time in the hospital, he was treated as an average patient, even though his symptoms were quite severe and he required special attention, until it was determined that he had AIDS.  After this discovery that he was a gay man from New York and Johnson City’s first AIDS patient, everything changed.  A nurse in the work told the narrator of the story, Ray the doctor, that “the young man’s room took on a special aura.”  What is more, there was a intense prejudice toward the patient.  “Some of the veteran ICU nurses, perhaps because this case broke through their I’ve seen-it-all-and-more-honey attitudes, astonished me with their indignation.  In their opinion, this homo-sex-shual” with AIDS clearly had not right to expect to be taken care of in our state-of-the-art, computerized ICU.”  This quote represents the ethical dilemma that took place in Johnson City, Tennessee.  The quality of the treatment of a patient was lessened because of the lifestyle that he led and because he had an incurable disease that was viewed with an abhorred stigma and disregard.

Abraham Verghese wrote about the personal and ethical issues that arose simultaneously with the spread of this disease.  Another author, Randy Shilts, wrote “And the Band Plays On” where he blames the Reagan Administration for not supporting research that would aid in finding a treatment or cure for AIDS.  He writes, “People died while the Reagan administration officials ignored pleas from government scientists and did not allocate adequate funding for AIDS research until the epidemic had already spread throughout the country.” He also criticizes the gay community leaders because they, “played politics with the disease, putting political dogma ahead of the preservation of human life.”  Shilts addressed many frustrations that arose during the initial years of the epidemic and he concludes that these major forces were indifferent to the situation and did very little for its resolve. 

The AIDS epidemic led to the creation of a wide assortment of medical literature from varying perspectives.  The literature that has already been referenced deals with more of the effects of the disease within a hospital and the reaction of a medical staff, in Verghese’s work, and Shilt’s describes how the invasion of the epidemic was, or was not, handled by the American Society.  Still, other work such as Elispeth Ritchie’s “On the Ward” provides the reader with an image of the blunt reality of life as a doctor who is working with patients with HIV and AIDS.  She writes about three patients with AIDS that she cares for.  One man was a gay man.  Another patient, a black man had received AIDS from a bad blood transfusion. Her third patient is a woman.  She writes about each patient and expresses her interpretations of their situations through her writing.  She writes of the black man.  “He is still attractive and personable, if thin.  This morning he told me how nice I looked.  I replaced his feeding tube; his throat hurts too much to swallow.  We are doctor and patient.  Two years ago I would have hoped that he would ask me out.  I tell myself severely that it is no good crying for him.  He has five sisters who will weep.  I have other patients to care for.” 

She also writes of her concern for her own personal health. “I am glad that I am married and tested negative twice.  If I were single, would I insist on a blood test before sleeping with a man? I hate to sound so pessimistic when friends grill me at a cocktail party—but I don’t want my friends to die that kind of death.”  This work by Ritchie is unlike some of the other works that have been mentioned.  The purposes of Stilt’s and Verghese’s works are to inform and persuade the reader to see the flaws in society whether those societies be the American society or the society within a hospital as in Verghese’s work.  Conversely, the purpose of Ritchie’s work is simply to provide a perspective and share thoughts and the reality of the situation. 

Because of the nature of the AIDS disease and its prevalence, even today, throughout the world, medical literature regarding this issue is widely produced and read.  By reading the literature previously described, and other literature pertaining AIDS, I feel that I better understand some of the societal concerns and happenings that weren’t necessarily addressed in my freshmen seminar class that was biologically based.  This literature personalizes and humanizes the disease.  Reading about a doctor’s interpretations of the disease through her patients, from seeing how a conservative, southern culture affects the treatment of a patient wtih the disease, to identifying some of the large-scale, governmental and societal issues that affected the progress in treatment and prevention of the spread of the disease provide me with a much more in-depth and well rounded perspective of the disease. While this literature addresses issues, concerns, and presents a variety of perspectives about this controversial and highly volatile disease, its existence is important to remind people that this disease has not been conquered and the lives of people are threatened daily.

Lee Goatley

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About Lee

I am a collegian who is in the process of deciding whether or not to pursue a career in the medical field. Because of the enormity of this pending decision I am going to utilize this blog as a medium for reflection and rationalization. I will combine two of my passions, literature and science into a blog. The content of this blog will be stimulated by medical literature that has been written throughout the ages.
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One Response to The AIDS epidemic and its depiction through Medical Literature

  1. Maureen Tuthill says:

    I agree that the purpose of Ritchie’s work is “simply to provide a perspective” on AIDS. She helps us to break out of the information, data, and empirical side of disease and see how it affects human nature. She responds so beautifully and compassionately to her patients, and through her eyes, we see all of the other angles you describe in your post (social ostracism, government paralysis, and so on). I am also struck by your description of AIDS as “an established disease” in your lifetime because I was in college when it first became a terrifying epidemic that no one knew anything about. I have seen it develop into something that is, in some cases, manageable. But in Africa, it is still raging with ferocious intensity. We are making strides toward prevention and cure here–why not there as well?

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