STORIES

UAB Opens 1917 Clinic

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. Given the stigma surrounding the disease, I didn’t want people to call it “The AIDS Clinic” because I feared terrorizing neighbors and making patients reluctant to come in.  I named it for the street address, “The 1917 Clinic.” (When asked about the name over the years, I’ve been known to say we were commemorating the launch of the Bolshevik Revolution; occasionally, I’ve been believed.)

Colleagues already working in HIV/AIDS clinics had warned me, “There’s no good way to say, ‘You’re positive’”—no way to give a patient that AIDS test result without it sounding like a death sentence.  I understood how they felt, standing there as supposed healers yet having to admit, We cannot heal you of this. But I had one advantage most fulltime clinicians didn’t: I was also continuing to work in the lab, where a game-changing discovery might be unimagined one minute and under the microscope the next. I spent one hour with despairing patients but the next on promising science.  For me, the lab offset the despair of patients while the patients instilled passion in the lab.  I settled on my own way to tell patients their tests results: “You’re HIV positive—and there are a lot of things we can do.”

On January 28, 1988, a quiet, chilly Thursday afternoon, we saw our first eight patients at The 1917 Clinic.  Word spread, we picked up steam, and some 100 patients entered treatment in our first nine months. Nearly all who came, stayed as long as we could keep them alive. We loaded all their information into our new database, on a bare-bones computer that I kept at home. We preserved their blood samples in our repository, using a confidential numeric coding system to link patients to specimens, a system that I have kept to this day.

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