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About Just out. (Portland, OR) 1983-2013 | View Entire Issue (June 8, 1984)
P R O F I L E An interview with an AIDS expert w h o ’ve been public during this debate have reconsidered their earlier decisions and have ch a n ge d their minds. You have remained steadfast with your position. Abrams: I think the bathhouse issue is strictly by M ichael Helquist and Rick Osmon D o n A b ram s has been involved with A ID S treatment since the very beginning. He began seeing his first patient with A ID S in the fall of 1981 and is currently the assistant director of W ard 86, the A ID S outpatient unit at Sa n Francisco General Hosptial. A bram s also cond ucts primary research into the lympha- denopathy syndrom e (swollen lymph glands) that som e consider to be an early form of A ID S or a milder reaction to the A ID S agent. B orn in Mew York City and raised in Cleve land, A b ram s cam e to Stanford Medical Center in 1972, graduated in 1977, and c o m pleted his residency at Sa n Francisco Kaiser Hospital. A fellowship at G C S a n Francisco followed with a focus in hem atology and o n cology. D uring the last two years of his fellow ship, he acted as the primary A ID S consultant for Moffit Hospital. A bram s is presently a board certified internist and oncologist and a clinical instructor at the G C Sch o o l of Medicine. H elquist and O sm o n : You recently became involved in the bathhouse controversy, partly through your work on Dr. Mervyn Silverm an's advisory board. How has your being a gay m an influenced your work with A ID S ? Abrams: There is certainly a lot to be said for m y being gay and being sensitive to the issue, but I would prefer to think that what I say is important because of m y medical education and training and not because of who I sleep with. T here's both pro and con factors about being a gay identified physician and faculty member. Credibility in the gay com m unity is very im portant but it's also important to have the credibility you need to be recognized as a medical authority. Just Out: Don, som e of the physicians medical. That’s the strongest point I have to make. At the Alice C lub roasting, I clearly stated that I thought the decision by Silver- m an w as a medical decision and not a politi cal one. Just Out: T he implications appear very poli tical to a num ber of others. Abrams: The com m unity can politicize this all it wants, but when the decision was made, it w as medical, m ade by a group of doctors. J u s t O ut: T he doctors have frequently ex plained how long it takes to d o research and to develop therapies. But do the doctors realize that political aspects of the bathhouse debate take time a lso? A b ra m s: I think that's unfair because we have debated this issue for nine months, and I think the greatest factor in the debate was the political ramifications. Merv Silverm an has dem onstrated an incredible am ount of sensi tivity about the political concerns. He has said, however, that he hated to think of how m any m en m ight contract A ID S and die be cause of his fear of m aking a decision with political ramifications. We know that there were as m any people dead from A ID S on January 1, 1984, as were diagnosed with A ID S on January 1,1983. We think the sam e pattern will happen again: we predict there will be about 3 5 0 deaths by January 1, 1985. The average life span of so m e o n e with A ID S in S a n Francisco is one year. That has not changed since the begin ning of this epidemic. Look, if you g o to the baths, you can have sex with five or six men. E ach of these may have already had sex that day with another five or six men. Your six contacts m ay be exp osing you to infections or viruses that m ight be carried by a total of thirty other men. A d n that’s just from one visit If you meet so m e o n e away from the baths and g o hom e with him, your potential exposure to sexually transmitted diseases is considerably re duced. Your contact is with one person, not with a potential total of thirty or more. Just Out: D o you think e nough work had been done with the bathhouse owners before this crisis erupted? Abrams: T he Health Department has been giving advice to the bath owners since M ay of 1983. R em em ber the preparations for last year’s Gay Pride march. T h o se A ID S warning s ig n s were up in the baths for a week; then, after the march, they cam e down. I think a year is a long e nough time for people and b u sin e sse s to change. We have to consider the free enterprise rights of these b usine ss men, but are we being exploited? S o m e of the things I heard said at the m eetings with the bathhouse owners I w on’t repeat I wanted to, but I w on’t repeat it for the media. But I w ould question the motivation of these men and wonder how m uch of it is strictly financial with com plete ignorance about what is g o n g on in the com m unity and how they m ight be contributing to it. It’s frightening. W e were told, “W h y are we a rguin g? We re both in it for the sam e reason. You get m oney w hen the patients are seen here (at the A ID S clinic); we get m oney when they com e to the b a th h o u se s’’ We were told that by a bath house owner. How long a go was it that one of the bath h o u se s discriminated against Asians, Blacks, people w ho were overweight? Then these are suddenly the cham p ions of our society be cause of hum an rights? I think it’s time for m e m b e rs of the com m unity to hinge their identity on som ething other than high vol ume, risky, potentially life-threatening activity in the bathhouses. Just Out: W hen you spoke at the Milk Club meeting, you were reported to have said that if your A ID S patients were going to the baths, you w ould no longer want to treat them. Abrams: I said that m y patients generally d o n ’t g o to the baths, but if they were continu ing with high-risk activity, I’d rather not see them. It’s a waste of m y time, their time, and that of oth^ -s in the clinic, if they're goin g to continue with suicidal, life-threatening behavior. It b ecom es a waste of time to deal with their every little neurosis, ache, and pain. support service network here so I refer them to a psychiatrist, a psychiatric social worker, or to Shanti. I tell them what m y feeling is about how this disease is transmitted and what particular sexual and d rug behaviors are increasing their risks. I think one of the major things the c o m m unity needs right now is really intensive sup port services to help people change c o m pulsive sexual behaviors; but that’s not m y job a n d I c a n ’t do it T h o se m en w ho have com pulsive sexuality have a disturbance. Not homosexuality, but com p ulsive sexual activity is a serious d is turbance. S o m e people w ho sm oke feel they cannot stop sm oking: so m e try nicotine flavored g u m as an alternative. O u r alterna tive has to be to change behaviors in the baths. J u s t O u t: S o m e people have suggested that gay m en need to "clean up their act" so that n o n -g a y s d o n ’t object to the high cost of m edical care costs for A ID S patients. A b ra m s: I think that’s why the city has to take action, because it supports A ID S care so m uch. J u s t O u t: How do you cope with the e m o tional d e m a n d s of your job? A b ra m s: It's difficult. Basically, I try to not take it h o m e with m e which is virtually im possible since m ost of m y friends are gay and they all have con ce rn s and m y patients becom e m y friends. Everyone has a question or wants advice or wants a prescription filled. It is be c o m in g too m uch. J u st the frustration of getting our medical advice m uddled with all this political stuff has alm ost brought m e to wanting to get out of this business. All we re trying to d o is save lives. I’m an oncologist: I look forward to the day when I can take care of people who only have tu m o rs or breast cancer or leukemia. We can do som e th in g for these people to prolong their life. T he se are often elderly people w ho have had long, fulfilled lives. I look forward to the time w hen I d o n ’t have to see the tragedy of y o u n g m en w ho have been healthy up until a short time a go being snatched from the earth. Just Out: W hat kind of efforts do you make to help your patients with behavior ch a n ge s? Abrams: I’m a physician and we have a large Reservations 14 Wed. thru Sat. 8:00 M-F 11-6 224-4001 Sun. 7:00 SW 3rd at Burnside Just Out. June 8-June 22