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West project. The other half would be devoted to teaching about AIDS.

Despite the advanced state of his illness when he was first diagnosed as having AIDS, it took two years for Tim to die. His tuberculosis caused fevers, weakness, and poor appetite. The relentless course of his infection was slowed by antibiotics but never reversed. Once, in despair, he stopped taking his medicines altogether but he felt so much worse, with higher fevers and less appetite, that he started back on them shortly thereafter. I found it difficult to avoid clinically assessing how far Tim had declined each time I saw him. The first outward sign of illness was how he trimmed his sideburns. He trimmed them unevenly, leaving a large patch of white skin on the left side of his face. This suggested either a problem in coordination or an inattentiveness to detail. Perhaps he just didn’t care about his appearance anymore. There were subtle changes in his hair. It became thinner and straighter. The fullness of his cheeks and waist slowly disappeared. His enthusiasm for work, however, masked many of these physical changes. He was always smiling. We rarely talked about his illness. The Key West project was going well, and we were collaborating on a new course to introduce first-year students to clinical medicine. Some cynics on the faculty were already dubbing this course “The Tim ______ Memorial Clerkship.”

Tim conserved his intellectual faculties for teaching and writing. His only complaint was his repeated conviction that he was losing his mental powers. I began to realize that this was, in fact, slowly but surely happening. He would refer to me by other people’s names or stop a sentence in the middle of a thought. Strangely, he would usually become aware of these lapses shortly after he committed them and would then apologize with a matter-of-fact disclaimer: “See, I told you I’m losing my mind.”

Major and minor lapses in judgment were also present. “I know he is not well, but he is driving us crazy,” sighed Anita. “He doesn’t follow university procedure. He doesn’t bring us back his receipts for his trips to Key West, and he wants to be paid cash in advance. He



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