Lewis Holmes: I began working in HIV when…


In my medical residency program, we had a Family Practice Service where we would care for our own clinic patients and those of local family doctors.  AIDS was new, virulent, implacable. Many of the AIDS patients that we treated came at the end, their mouths dry and red with yeast, kidneys failing, emaciated, full of pain and nausea.

The hospital rooms were warm, quiet, full of love and compassion, suffused with fatigue and suffering.  Patients lingered, 24 hours a day, until peace finally came. Sometimes the rooms would lie empty for a while; other times they’d be filled with the noisy families of the transiently ill, those with pneumonia or a kidney infection, riding the brush with mortality and then gratefully returning home. Soon another AIDS couple would arrive, one patient, one partner. Each couple came from different walks, moved with different tempos, but shared the same deep pain and exhaustion. ARVs were just coming out, and there was not quite enough available yet. AIDS was almost a chronic disease but for these men, the opportunistic infections still inflicted their gruesome wounds, the available medications their nasty side effects until, finally, their bodies gave out.

As a physician I never felt so helpful, or so powerless.  I could blunt the sharpest edges for a bit, providing some brief respite, but time was ever so present.  Even now, many years later, I can recall the dark hospital hallway as I walked from the call room to the ward in the middle of the night, acutely aware of the pulse and rhythm of life, and the arbitrariness of death.

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