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office into the clinic was a radical move for a tenured professor. I told Margaret I’d have to give up my sessions in special immunology. She and I had been the only ones of the original group left. In truth, I was no longer needed. Her research grants allowed her to fund several new faculty positions, all specializing in AIDS.

We had 10,000 charts in the clinic. Each chart represented a patient who had been seen at least once, a life that had fallen through the cracks of society. Some, like Jennifer, were mentally ill or severely addicted to alcohol or crack cocaine. Others were merely poor or were the victims of bad luck.

The patients coming to the clinic reflected Miami’s diversity—black, white, multiethnic, Latino—with one notable exception: There were very few Haitians. In fact, in the six years I worked at the clinic, I had only two Haitian homeless patients. One was a lawyer with bipolar disorder who was too proud to tell his family that he had lost his job. Instead, he just disappeared into the streets. The other had AIDS but didn’t want his family to know. I asked the social workers at the clinic how they might explain this. After all, Little Haiti was by far Miami’s poorest community. Their consensus: First, there was a very low incidence of alcoholism and drug use among Haitians. It wasn’t just that they couldn’t afford the alcohol or drugs; their culture didn’t condone them. Second, family was the ultimate Haitian safety net. If you fell on hard times, someone in your extended family would always take you in. Finally, as a last resort, returning to Haiti was preferable to life on the streets.

The clinic offered comprehensive services to homeless people, including HIV counseling and testing. Every month Ruth, the head nurse, would give me a copy of the monthly report on counseling and testing activities. For several months they passed in front of my eyes but did not register in my conscience. Then I started to notice.

“Uh, Ruth, are these numbers right?” I asked her as she passed by my open office door.

“Which numbers, Art?”



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