Julienne suffered before she died probably more than anyone. She had AIDS on top of diabetes and was afflicted with the worst case of oral thrush and genital herpes one could imagine. The herpes blisters were so extensive and weeped so much she could not sit down without staining her bed clothes. During her last few months I had her in the hospital five times—twice for toxoplasmosis, from which she made a dramatic recovery, twice because the thrush was so bad she could not eat, and once for tuberculosis. Through all this suffering she never failed to smile when she saw me or thank me as I left. She died of a disseminated virus.
Herminio did well for a while but then began to decline. He started to age visibly between visits like so many of the patients Margaret used to follow in the office. We diagnosed tuberculosis, and I hoped he would stabilize with treatment. He still had not told his mother what he had. After each visit he apologized for the inconvenience he had caused me. Each time I told him it was not his fault. He looked at me directly and answered, “Yes, it is.”
The Special Immunology Clinic was held every Thursday afternoon. The waiting room was filled with patients in all stages of the disease and their lovers and families. The clinic staff showed varying degrees of apprehension. One secretary wore rubber gloves to run the appointment computer. She didn’t even work near the patients. On the other hand, although concerned about contagion, the nurses in the clinic demonstrated an extremely professional attitude. They took the temperature, pulse, and weight of the patients before they were seen by the doctor. Even in this high-technology era, these simple measurements were the best way to separate who was doing well from who was doing poorly. They helped us draw blood and cleaned up after the patients. After the clinic was over, they were instructed by the clinic administrators to wipe down the examining tables and furniture with disinfectant and alcohol.
In addition to seeing increasing numbers of patients with the real disease, we began to see more and more of the “worried well.” The newspapers ran stories about the spread of the epidemic among