I remember my first
From the Editor
Dr. Schwarzenberger is the former physician editor of DermWorld.
By Kathryn Schwarzenberger, MD, June 1, 2021
When I was a medicine resident in the late 80s, HIV/AIDS was still a new disease, one which almost certainly conferred a death sentence on the mostly young people unlucky enough to contract it. There was still much unknown about the illness, and with that uncertainty came fear. I will never forget walking into the hospital room of my first AIDs patient. I found myself holding my breath for a few seconds, wondering if this devastating disease could spread through the air. My rational self knew I was not at risk, but my emotional side allowed me to, for the first — and thankfully only — time to feel fear while caring for a patient. But then I saw the young man in the bed. He was so young, so vulnerable, and so very afraid. He was sick, and he needed us. And so, I took a deep breath, and went back to work.
Being engaged in the evolution of HIV/AIDS over the past few decades has been an inspirational journey. The early years were incredibly difficult, as medical science struggled first to identify the cause of this plague, then tried to understand and eradicate it. We had some missteps early on, and many lives were lost. But we did, ultimately, succeed in morphing a fatal disease into one we are largely able to control. While the cure has evaded us, we now have among us many persons living chronically with HIV infection, who are doing well. We should be incredibly proud of the crucial role that many of our dermatology colleagues, some of whom contributed to our feature article this month, played in this transformation. It is hard to believe that 40 years has already passed since we first recognized that something was just not right when many young, otherwise healthy people became abnormally ill. Our younger colleagues missed out on this saga, but will now have one of their own related to the present day COVID-19 pandemic, or whatever might follow. It will be interesting to see how this will be remembered. I hope you enjoy reading Assistant Editor Emily Margosian’s wonderful narrative on the history of HIV/AIDS, but if you can find an hour to spare, I also highly recommend you find a recording of the Turtle Creek Chorale’s “When We No Longer Touch.” This heart-wrenching, beautifully touching requiem for the many young men lost to HIV/AIDS epidemic will allow you to feel the full emotion of the time. It is sad, but very cathartic, and I think it will resonate with many of us after this long year. I do, however, recommend you have a box of tissue on hand; you will need it.
At the same time, our understanding of diseases like HIV/AIDS has evolved, so has the system in which we provide care for this and other conditions. Our feature article “The Odd Couples” chronicles structural changes happening today in health care delivery systems. Perhaps daunted by the complex regulatory activities required of a practice, many physicians today are bypassing private practice, preferring employment in health care organizations. Those who remain in the private market face a different competitive market than that of their predecessors, one increasingly focused on consumer satisfaction. How this will impact the doctor-patient relationship, and whether it will be good or bad, remains to be seen. Personally, I’m not sure. I will always get out of bed at night to care for my patient; my “customer,” however, may have to wait for business hours. But I guess I’m old school! Be well!
