Recently, I felt the need to visit the AIDS Memorial Grove in Golden Gate Park. The stress of having to suddenly close my dental practice for 2 months was at a crescendo. The bleak situation brought me back emotionally to the time of another pandemic, which occurred at the very beginning of my dental training over thirty years ago.
Even though we tend to use the word “epidemic” when referring to the progression of acquired immunodeficiency syndrome or AIDS in the United States, the disease was a true pandemic that claimed the lives of 25 million people worldwide.
Diseases that target a seemingly small subset of the population can be easily overlooked by people who don’t see themselves at risk.
It didn’t take long before many other groups of people became infected with AIDS and cases appeared all over the world.
I started dental school at the University of California at San Francisco in September of 1984, not long after a new retrovirus had been tentatively identified as the cause of a very frightening immune disease that initially was thought to affect gay men and IV drug users. In October of 1984, it had also been proposed that AIDS could be transmitted by saliva and it would be two years before that erroneous theory would be disproved. It was certainly a surreal time to have chosen dentistry as a career.
By December of 1984, the San Francisco Chronicle newspaper deigned 1984 the “year of the plague.”
My proximity to two world class research dentists at UCSF, renowned HIV experts Deborah Greenspan and John Greenspan (pictured below and exactly as I will always remember them), afforded me information and insight into the disease in real time – occasionally even slightly ahead of updates reaching the news media. Fear and misinformation was running high. The public was afraid to shake hands with or even breathe the same air as affected patients. In 1987, the U.S. banned immigrants who were HIV positive from entering the country- a policy that didn’t change until 2010.
The Greenspan’s taught us so much more than oral medicine principles. They taught us not to fear the unknown or to allow conjecture, misinformation or media hype to interfere with finding answers. They methodically turned to their scientific research to provide the irrefutable data we needed about risk factors and transmission routes. They also helped give affected patients -and the public – significant peace of mind about a disease that initially caused extreme physical and emotional separation.
One significant advantage three decades ago was that scientific research and data was respected, trusted, and viewed as the foundation of effective public health policy. Science was not disregarded to make a political statement, as we see now with the issue of wearing masks in public. (If anyone doubts the efficacy of wearing masks, they only need to look to dentistry as proof of its ability to keep people in close proximity safe from the spread of disease). We looked to science to lead us forward and to help ensure that we emerged victorious over a frightening and tragic disease.
This moment in time feels like an appropriate time to revisit and learn from our past.
1987 brought “universal precautions” to healthcare – the very same protocols that have kept my patients, my family, and myself safe for the last 30 years – and continue to do so in this new pandemic. This isn’t a result of coincidence or good luck. It’s due to the fact that dentists are experts at implementing strict infection control precautions mandated by the CDC in response to the AIDS pandemic.
Dentists assume that every patient is potentially infectious and avoid making determinations about who may or may not be carrying disease based on appearance, gender, or lifestyle. We follow standardized infection prevention measures to the letter. Every patient. Every time. And we have decades of adhering to scientific guidelines to thank for our ongoing success in preventing the spread of many potentially dangerous pathogens.
By the time I graduated in 1988, we had World AIDS Day and a massive protest by Act Up at the FDA to facilitate treatments by speeding up the approval process for new drug treatments. Our leaders may still need a bit of arm-twisting at times, but we must remain focused on finding the new strategies and therapies that will ultimately be used to treat and prevent disease.
We won’t get it right all time – and certainly not the first time – but we will prevail in this pandemic with scientific principles as our guide.
Being in the amazingly peaceful and natural setting of our AIDS Grove was an antidote to the stresses of these times and a powerful reminder of the sacrifices of those patients who are among the first to battle emerging diseases – and of those who devote their life to finding treatments for infectious diseases.
It’s also a living testament to the ability of both local communities and countries throughout the world to embrace and adopt challenging public health mandates for the common good.
An excerpt of the poem below is carved into one of the boulders in the AIDS Grove and it struck me as a challenge to honor the lives of those lost by never being complacent about death of those we may not know.
And to pay our respect to those who suffer, both young and old, by not being cavalier about the relatively small sacrifices that are asked of all of us in challenging times.
Down some cold field in a world outspoken
the young men are walking together, slim and tall,
and though they laugh to one another, silence is not broken;
there is no sound however clear they call.
They are speaking together of what they loved in vain here,
but the air is too thin to carry the things they say.
They were young and golden, but they came on pain here,
and their youth is age now, their gold is grey.
Yet their hearts are not changed, and they cry to one another,
‘What have they done with the lives we laid aside?
Are they young with our youth, gold with our gold, my brother?
Do they smile in the face of death, because we died?’
Down some cold field in a world uncharted
the young seek each other with questioning eyes.
They question each other, the young, the golden hearted,
of the world that they were robbed of in their quiet paradise.
Humbert Wolfe, Requiem: The Soldier, 19271