To Bear Witness: A Journey of Healing and Solidarity

A Bridge to Peace

172 173 might suggest promising avenues of investigation for researchers, lend practical aid to clinicians, and chart a course out of this crisis. The history of medicine reassures us that, with time and effort, the terrible mystery of AIDS will be unraveled, and a cure found. I have no doubt that those whose words are presented here will have been major actors in bringing this life and death drama to an end. When that day comes, we may look back and reflect with the same satisfaction that Camus’s character, Dr. Rieux, experienced as the plague epidemic finally vanished from Oran: And it was in the midst of shouts rolling against the terrace wall in massive waves that waxed in volume and duration, while cataracts of colored fire fell thicker through the darkness, that Dr. Rieux resolved to compile this chronicle, so that he should not be one of those who hold their peace but should bear witness in favor of those plague stricken people; so that some memorial of the injustice and outrage done them might endure; and to state quite simply what we learn in time of pestilence: that there are more things to admire in men than to despise. A Bridge to Peace 1988 A bridge is a blend of poetry and practicality. By appreciating - and harnessing - tensions and forces man can span abysses, link separated lands, and create a thing of beauty. But soaring girders and graceful arches must be firmly anchored in a solid foundation, or even an expected load will cause collapse, destroying both bridge and travelers. The imagery of a bridge seems appropriate for those deeds or memorable feats but on steady, loyal service to patients. When those patients are dying in large numbers and when the mode of transmission of their disease is unknown, then the daily routine of involved health workers assumes a quiet dignity and decency that deserves special respect. The clinician has a privileged role in an epidemic, for he shares, uniquely, the victims’ sufferings, their despair, and their dwindling hopes. In this epidemic, we, as physicians, have had daily to face patients in the prime of life who are suffering from a disease we do not understand and cannot cure. We have often had to sustain them solely with the ancient commitment of our profession to remain at our posts, seeking answers and offering help until this modern plague has been conquered. Added to the medical challenge has been a growing crisis in hospitals and social service departments faced with large numbers of AIDS patients. Because of the need for isolation precautions, every facet of their care from nursing and nutrition to laboratory work and housekeeping becomes extremely costly. The duration ofanAIDShospitalstayisusuallymeasuredinmonths, and hospital bills in excess of $100,000 occur with ever increasing frequency. Health insurance coverage for the young and poor, who constitute the majority of AIDS victims, is usually inadequate, often nonexistent. Society had not planned for this epidemic. To address some of these problems, a group of nationally known medical specialists recently gathered in New York City for a symposium on AIDS that resulted in this book. Each participant brought a special perspective to this most complex problem. The symposium participants came to New York with the hope that their shared knowledge and experience 174 175 health, and other humane endeavors, may well be the best - and sometimes the only - tools that can bridge differences and unite warring parties. The geographic distances encompassed within these essays emphasize how similar are the problems around the world and how a non violent bridge to peace can find application in all societies. Imminent Peril: Public Health in Declining Economy 1991 The metaphors of the human body come naturally to a physician as he views the ills that plague modern society. Just like patients, cities can rot from within until nothing remains but a hulk artificially maintained by emergency infusions. The signs and symptoms of serious disease are usually obvious, in medical as well as political life except to those who wish to deny the evidence of steady deterioration and the possibility of death. To those who indulge in such folly, the healing arts offer no immunity. While diagnosis is often quite easy, devising and administering an appropriate treatment plan can be difficult for both doctor and patient. Cities and states have collapsed before because of benign neglect. Spasmodic efforts at revival are no substitute for a careful and even courageous course of therapy. It...