Film captures health workers'
role in early days of AIDS
by Matthew S. Bajko
Theirs is often the overlooked dimension to the early days of the AIDS epidemic. But health care workers in San Francisco played a large role in shaping how patients with the deadly disease were cared for at the time.
A new documentary aims to capture their stories. Called Life Before the Lifeboat: San Francisco's Courageous Response to the AIDS Outbreak , the 30-minute film features interviews with nurses, doctors, and community activists about how the city's health care professionals reacted to an illness that was decimating the city's gay male population.
It should come as no surprise that that meant long established rules governing care were broken. Or that it was nurses and doctors at the city's public hospital in the forefront of combating AIDS at a time when many of their counterparts refused to care for gay men dying from the mysterious illness.
"Young doctors don't know anything about the early epidemic. It was so painful. Many people would like to forget it and move on," said Dr. Paul Volberding, who worked at San Francisco General Hospital when AIDS first hit.
As detailed in the film, restrictions on who could see patients and during what times were thrown out. Friends, rather than blood relations, were allowed to make end-of-life decisions for men who had been rejected by their families for being gay.
It also meant political activism on the part of health care workers, who marched in gay Pride parades and spoke out for the need for funding. They also worked with community members to form special hospices and support groups.
"The epidemic touched every fabric of our community and the very nature of the fabric was to do something," says former San Francisco public health director Dr. Sandra Hernandez, who lost a brother to AIDS, in the film.
The film features key players who shaped the city's response being interviewed by Volberding, a straight man credited with helping to create the "San Francisco Model" of care for AIDS treatment. He pushed to make the film in order to capture their stories not only for prosperity but to educate a new generation of medical professionals.
"I think the early epidemic was such a remarkable period in so many ways. We must have learned lessons about ourselves and as a community in how we respond to challenges," said Volberding, now chief of medical service at the San Francisco Veterans Affairs Medical Center. "I don't think anything has really tried to tell the story of medical professionals and community response in a way this tries to do."
The film also briefly touches upon the political fights that erupted in the city over the closing down of the gay bathhouses. Volberding, who held a meeting with the bathhouse owners to seek their assistance in combating AIDS, wonders aloud in the film if he was "naive" in thinking if they only understood more about HIV they would support the policy.
"I felt it important to bring the community in to resolve an otherwise explosive situation," he says in the film.
Dr. Mervyn Silverman, the city's public health director from 1977 to 1985, tells Volberding he was fearful that if the city acted too hastily in ordering the bathhouses to close in order to stop the spread of AIDS it would be counterproductive.
"I didn't want to close it too early. If we were seen as police rather than partners in their health care than we would lose the battle," says Silverman.
Diane Jones, a nurse who helped found the hospital's AIDS ward and also took part in the movie, said she hopes the film holds lessons for those at the start of their medical careers.
"We are on to the next generation of student interns and nurses, some of whom were not even born when the HIV epidemic started. It is important to capture that history and hold on to it," said Jones, an out lesbian who is the partner of former Health Commissioner Roma Guy and the mother of gay state Assemblyman Tom Ammiano's daughter, Annie.
Volberding said he sees similarities between the recent hysteria and reactions to swine flu, avian flu, and the SARS outbreaks to how people both within and outside the medical profession reacted to AIDS.
"I wanted to explore how it means to be a professional and how will we respond to the SARS, H1N1 and whatever the next epidemics are," he said. "There has been talk in the influenza epidemic [if] is it okay for health care workers to refuse to take care of patients? That is like asking would it be okay for a fireman to refuse to enter a burning building. For me it brings some of that AIDS hysteria back."
The movie cost $32,000 to produce and was funded by the San Francisco General Hospital Foundation and California HealthCare Foundation.
The public is invited to see the documentary over two days of special screenings being held in conjunction with World AIDS Day. On both December 1 and 2 screenings of the film will take place every hour on the hour beginning at 2 p.m. with the final screening at 5 p.m. at San Francisco General Hospital and Trauma Center's Carr Auditorium. For more information call (415) 206-4478.