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Positive traces the life of Michael S. Saag, MD, an internationally known expert on the virus that causes AIDS. But this book is more than a memoir: Through his story, Dr. Saag also shines a light on the dysfunctional US healthcare system, proposing optimistic yet realistic remedies drawn from his distinguished career.
DR. MICHAEL SAAG completed his medicine residency and fellowship in infectious diseases at the University of Alabama at Birmingham. While there, he made early discoveries in the genetic evolution of HIV in patients. During the last six months of his fellowship, Dr. Saag conceived the concept of an HIV outpatient clinic dedicated to the provision of comprehensive patient care in conjunction with research and high-quality clinic trials.
Since the establishment of the clinic, Dr. Saag has participated in many studies of antiretroviral therapy as well as novel treatments for opportunistic infections. He has published over 320 articles in peer-reviewed journals and has contributed over fifty chapters to medical textbooks. He has served on the editorial board of the journal AIDS and the Sanford Guide to Antimicrobial Therapy and has served on the board of directors of the American Board of Internal Medicine.
Among many other awards, Dr. Saag has received the Myrtle Wreath Award from Hadassah, was listed as one of the top ten cited HIV researchers by Science (1996), and has been listed as one of the Best Doctors in America since 1994. He received the Hettie Butler Terry Community Service Award, received an Excellence in Teaching Award from the Medical Association of the State of Alabama, was named a “Health Care Hero” by the Birmingham Business Journal (2003), and received the 2010 President’s Medal from the University of Alabama at Birmingham.
"I'm so glad I read it and so glad Micael Saag wrote it. I learned so much, I laughed, I cried and I loved hearing Dr. Saag’s voice in my head as I read the stories that he told. As the movie critics say, "A Triumph!"
We loved the personal story so well intertwined with pragmatic observations about healthcare today. Of course, I loved Dr. Saag’s analysis and future hope for medical care in the US. I have already told others about it in KP. Thanks so much for doing this book. It's great.
- Michael A. Horberg, MD, MAS, FACP, FIDSA
I've been losing sleep, and waking up in the middle of the night to get some more time to read Dr. Saag’s terrific book POSITIVE!!! It was worth the loss of sleep!!! At various moments my husband asked me what I was laughing about, then at another moment he asked, “Are you crying? What’s happening?” Definitely, a must-read.. !!
- Susan Callen, LCSW, LMFT
POSITIVE is a really wonderful book --- wonderful to read and thoughtful and thought-provoking re the US healthcare system. The chuckles are just fun and the tears are soul wrenching. My, they are powerful!! I literally could not put it down once I read the first few pages.
I read POSITIVE after getting home from my son's jazz performance.....stayed up till 04:30 which in hindsight might not have been the best plan....finished it this evening.
Enjoyed it a lot...cried a bunch.
Thanks for writing it...
I finished reading Positive this weekend / What a masterpiece! It is intelligent, compassionate, insightful, poignant, funny, and serious (and there are so many more words I could use.) There was also much to learn at so many levels. I hope the book will go viral...!
I just finished reading POSITIVE. It was touching, frustrating, exciting, sad, and still hopeful. I hope the book gets a lot of attention I’m recommending it to everyone, telling them it’s chatty (a.k.a., easy and interesting to read)!
- Melanie Bacon, Bethesda, MD.
I wanted to thank you for the years of work and sacrifices you have made for patients, the clinic, and the field of HIV today. I also want to thank you for taking the time and energy to write this book. It is AMAZING!! I laughed, I cried, I got buggy eyed when things blew my mind. It was a full gamut of emotions. I could not put it down!
-Heather Coley Chahine, MPH
I just finished reading POSITIVE about five minutes ago. The book is remarkable. More than other works on the subject of Healthcare, POSITIVE needs to be read now. I’ll be plugging it on Facebook for my friends to read as soon as it hits the marketplace.
Thank you for making the time to write POSITIVE --
- E. Robert Jacobsen
I finished the book this morning. I'll be buying copies for family members… Of all the literature I've read about the epidemic, POSITIVE explains what it feels like to be in the middle of it with the most clarity. It was not easy emotionally to read some of the personal stories. I'm sure it must have been even harder to write them. I'm glad Dr. Saag did.
- Harry Wingfield
I wanted to write you and tell you how much I enjoyed reading POSITIVE. It will now stand with a few other experiences during my medical training when I was exposed to the unfiltered passion of patient care that always reminds me why I do this job.
-Chris Roth, Chief Resident in Medicine, UAB
POSITIVE is not only Mike Saag’s "anthology" of the art of medicine he has both practiced and authored over the many years as an Infectious Disease doctor in Birmingham, Alabama, but is also true to his voice as someone who genuinely cares about those around him, especially his patients. POSITIVE will get you to care too - what you do with that is the next step.
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"Michael Saag's book is a fascinating firsthand account from a true clinical leader during the very beginning of the HIV epidemic and subsequent years. His unique perspective is one for American history books."
- Robert C. Gallo, MD, co-discoverer of HIV and developer of the HIV blood test, director of the Institute of Human Virology at the University of Maryland School of Medicine, and Scientific Director of the Global Virus Network
“A wonderful, intimate, daring and poignant memoir by a physician whose name is synonymous with the battle against HIV in this country. This book will surprise, entertain and challenge your notions about healthcare in America.”
- Abraham Verghese, MD, author of My Own Country and Cutting for Stone
"Based on his moving experience as a physician caring for people with HIV/AIDS, and confronted with highly inadequate health care services, Michael Saag makes a passionate and convincing plea for a radically reformed patient-centered health system. This is an unusual book about health care, AIDS, and above all, the people who are so dear to Saag's heart."
- Dr. Peter Piot, founding Executive Director of UNAIDS and Under Secretary-General of the United Nations (1995-2008); director of the London School of Hygiene and Tropical Medicine.
“POSITIVE is an amazing book on many levels. It is a heart wrenching trip through AIDS history that takes us through our darkest days and brings to life some of the most courageous Americans that we have lost, yet it is also a timely reminder that our work is not over. It is am enjoyable trip down memory lane of one physician and his family that offers insights into the source of his passion and creativity. And, it is an accessible portrait of the dysfunction of our health system that offers a path forward. For a reader that does not think about HIV every day, this is essential reading both to appreciate how wonderful things can happen when good people come together and also to understand that we are on the cusp of making great things happen. When we end the HIV epidemic in America it will be because of amazing leaders like Dr. Saag, other clinicians and researchers, policy makers, and activists…and everyday people like those he profiles in this book.”
-- Jeffrey S. Crowley, former Director of the White House Office of National AIDS Policy; Distinguished Scholar and Director of the National HIV/AIDS Initiative at the O'Neill Institute at Georgetown University Law School.
I devoured Positive on a coast-to-coast flight. As someone who has been treating people with HIV and AIDS since the 1980’s, my first thought was “Damn…I wish I’d written that!” But it quickly became clear that only Mike Saag could have written this book. The combination of his very personal memories from the darkest days of the epidemic with his insightful observations on our broken health system makes for a thought-provoking read: sometimes heartbreaking, sometimes heartwarming, sometimes infuriating, but never depressing, probably because Positive reads with the optimistic, enthusiastic, and compassionate voice of its author.
-- Joel E. Gallant, MD, MPH
Associate Medical Director, Specialty Services
Southwest CARE Center
George Meade Shaw was raised on a farm near Logan, Ohio. He sped through an MD-PhD degree program in five years, followed by an Internal Medicine residency, and then landed a Post-Doctoral Fellowship position at the National Cancer Institute in Dr. Gallo’s laboratory as part of his training to become an oncologist. George went to Gallo’s lab to study HTLV-I, which was known to cause diseases including T-cell leukemia/lymphoma syndrome, a rare cancer of the immune system’s own cells. But while George was working there, others in Gallo’s lab discovered that a cousin retrovirus, HTLV-III, was the cause of AIDS.
There is a power in dying that deeply affects most of us who care for patients with end-stage illness. To see them and hear them and hold them is to know: There’s no time to waste. There are no second tries. There is only the best shot we can take, however long the odds. When it doesn’t work, there’s frustration and anger, sometimes guilt or self-blame, almost always a searing grief—and grief morphs into the energy that drives us back into the search.
The cost of care was an issue for Brian, a patient referred to me after he sought emergency room treatment. Had he not been worried about the cost, Brian would have seen a doctor when his headaches first progressed from bad to worse. But let me back up. I met Brian and his partner, Joe, not long after they moved from Southern California to Auburn, Alabama. Brian was an artist, a Bohemian who worked construction and retail jobs to pad his income from selling paintings and drawings.
The hospital operated its internal medicine residents’ clinic in a free-standing building located at 1917 5th Avenue South. Nestled under the looping exit ramp of a parking garage, it still makes me think of Alvy Singer, Woody Allen’s character in the movie Annie Hall, whose house sits beneath a roller coaster track at Coney Island. The schedule for internal medicine residents left the facility open Thursday and Friday afternoons. To start, UAB administrators said we could have the space for those two half-days plus the services of nurses already on the clinic staff.
In the natural world, it’s called a “feeding frenzy” when wolves or sharks descend on a quarry with mindless, ravenous abandon. In the information age, I’ve seen a similar sort of frenzy in pursuit of headline news. A Twitter mob formed on-line in the wake of the 2013 Boston Marathon bombing, naming as suspects people who were totally innocent. As the Vancouver conference neared, journalists arrived in droves to cover the triple-drug therapy breakthrough. They came armed with preconceptions and superlatives, while the scientists and activists and drug companies came armed with their own, often deeply personal angles on the story.
From his youth, Eddie Saag was a vibrant man, fit and athletic. He entered the U.S. Army at age 18 and sailed through basic training. When it came time for his platoon to be sent overseas, he somehow wrangled a promotion to corporal so he could be in charge of training new recruits. That meant he had to be in superior shape and out-perform them at the obstacle courses, fitness and endurance tests. But that was fine with Dad, who already was living by the philosophy he later would preach to his kids: Never give up. No matter what the circumstance, don’t be a quitter.
February 18, 2013, 7:53 p.m. When I clicked my cell phone to take the call from Jim Raper, the first words I heard were, “The house next door is on fire!” I’d not yet gotten out “Oh no, Jim, are you and Scott okay?” when Jim continued: “I’ve been telling them for years, Mike. They wouldn’t listen. And now it’s in flames and the clinic is in jeopardy.”
Mary Fisher is the granddaughter of Papaharry and Flohoney Switow, the great-uncle and great-aunt who had been like an extra set of grandparents to me. Mary’s mother, Marjorie Switow, had grown up in Louisville in our rowdy, extended family. Marjorie’s first husband had abandoned her to raise two young children, Mary and her brother Phillip. Mutual friends subsequently introduced Marjorie to Max Fisher, an accomplished businessman and Republican Party leader from Michigan. In 1953, Marjorie married Max and moved her children from Louisville to Detroit for a new life with their adoptive father.
That same year, I traveled with Dad to Shelbyville, Indiana, to help at an outdoor theater, “The Starlite Drive In.” To run a sewage line to the Starlite, we needed to cross under a nearby highway, and that meant narrowing traffic to a single lane. The first few days in Shelbyville I was the flagman, stopping traffic in one direction and admitting it from the other. But after days of watching Cadillac, John and others perform what looked like a much more interesting task, I asked: Could I be the jack-hammer guy?
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