Losing the Battle
“It was the biggest thing that happened in my life. I will never get over it,” said Dr. Kathleen Clanon. “I cared for over a thousand people who died from AIDS over 10 years. In 1992 alone, we lost 200 people, that’s basically one person every other day.”
Clanon recalls first reading about AIDS in TIME Magazine while a student at UC Davis School of Medicine. She graduated in 1984 and then started her residency at Highland Hospital where she encountered her first AIDS patient.
An advocacy group known as the East Bay AIDS Response Organization lobbied for an AIDS program which was ultimately approved by the Alameda County Board of Supervisors. In 1984 Fairmont became the first hospital in the East Bay to have a designated clinic for AIDS patients. As more people became infected, the program expanded to Highland. Clanon became the lead physician of the Highland program in 1988.
Clanon, a general internist, also became a HIV specialist. She was always interested in health problems of intravenous drug users. Working at Highland during the peak of the epidemic seemed to be a natural fit. She admits she was still terrified.
More than 35 million people have died from AIDS since it was first reported by the CDC in 1981. Clanon knew the disease wasn’t airborne, but being around so much death eventually took its toll.
“I’ve been pricked by needles twice in my career, it was very scary,” said Clanon. “I used to have this reoccurring nightmare. In my dream, I would look in the mirror, and my face would become smaller and smaller. Then it would be covered with purple blotches.”
During this difficult point in her life she gained 100 lbs. The extra weight comforted her as she sadly witnessed patients wither away. Fortunately for Clanon, she worked with a very supportive team and they learned to lean on each other during those tough days.
Winning the War
Clanon never let her grief become a barrier to fighting AIDS. She drafted key components of some of the material needed to pass the Ryan White Act, the largest federally funded program in the U.S. for people living with AIDS.
She was and still is an educator. She teaches medical staff how to test for HIV and how to treat patients with HIV.
Since San Francisco and Oakland are so close together, SF General Hospital often overshadowed Alameda Health System, which really did some amazing work in regards to HIV treatment and care.
Highland was the East Bay national research center site for AIDS clinical trials. Highland was also one of the first places to treat HIV/Hepatitis C co-infection and is one of the few emergency departments that does routine HIV testing.
When the new HIV drugs were released in 1996 and began to make a dramatic difference, Clanon started to feel relieved. “I was so happy when the drugs came out, but then I ran into an interesting problem. It was sort of a reverse Tuskegee problem.”
Clanon’s patients were predominately black and were wary of taking drugs due to the “Tuskegee Study of Untreated Syphilis in the Negro Male.” During this study, black men who had syphilis were studied by medical professionals to see how syphilis affected the human body, but they were never properly told they were in a study and they were not offered penicillin as a treatment once it became available. Because of this, a lot of her patients feared being used as guinea pigs. “I was trying as a white person to convince them it was ok. I’d say I know you’re worried about Tuskegee but you have to take this medicine, it will save your life!”
In addition to being the medical director for the Alameda County Health Care Services Agency, Clanon still sees patients at Highland. While she says progress has been made, there is still work to be done.
“I have a patient who recently lost his apartment and had to move in with his mother. He’s grateful to have a place to live, but he is also having a tough time because his mom won’t allow him to use her dishes. She bought him paper plates.”
The CDC now confirms that people who take their HIV meds daily as prescribed and achieve and maintain an undetectable viral load have effectively no risk of sexually transmitting the virus to an HIV-negative partner. This is now referred to as U=U or undetectable equals untransmittable, which is a much more positive message.
In the ‘80s if a person tested positive, the message was to always use protection and of course there was a possibility they could die. She said her patients were terrified of having sex and infecting others. Now, the message is, you’ve tested positive, we will start you on meds today, we will get you linkage to care and you can live a long healthy life.
For Clanon, December 1, World AIDS Day has a dual meaning, “It’s remembering deliberately, recklessly opening that part of my heart to think about all the people we lost and now thinking about the end of the epidemic, at least in the United States.”
This year’s theme for World AIDS Day is “Everybody Counts,” a common message for a health care provider like AHS which is committed to serving all.