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Voices in the Band: A Doctor, Her Patients, and How the Outlook on AIDS Care Changed from Doomed to Hopeful PDF

266 Pages·2015·1.2 MB·English
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Voices in the Band a volume in the series THE CULTURE AND POLITICS OF HEALTH CARE WORK Edited by Suzanne Gordon and Sioban Nelson A list of titles in this series is available at www.cornellpress.cornell.edu Voices in the Band A Doctor, Her Patients, and How the Outlook on AIDS Care Changed from Doomed to Hopeful Susan C. Ball ILR Press an imprint of Cornell University Press Ithaca and London Copyright © 2015 by Cornell University All rights reserved. Except for brief quotations in a review, this book, or parts thereof, must not be reproduced in any form without permission in writing from the publisher. For information, address Cornell University Press, Sage House, 512 East State Street, Ithaca, New York 14850. First published 2015 by Cornell University Press Printed in the United States of America Library of Congress Cataloging-in-Publication Data Ball, Susan C., 1957– author. Voices in the band : a doctor, her patients, and how the outlook on AIDS care changed from doomed to hopeful / Susan C. Ball. pages cm — (The culture and politics of health care work) Includes bibliographical references and index. ISBN 978-0-8014-5362-5 (cloth : alk. paper) 1. AIDS (Disease)—New York (State)—New York—History. 2. AIDS (Disease)—Patients—New York (State)—New York. I. Title. II. Series: Culture and politics of health care work. RA643.84.N7B35 2015 362.19697'920097471—dc23 2014034038 Cornell University Press strives to use environmentally responsible suppliers and materials to the fullest extent possible in the publishing of its books. Such materials include vegetable-based, low-VOC inks and acid-free papers that are recycled, totally chlorine-free, or partly composed of nonwood fibers. For further information, visit our website at www.cornellpress.cornell.edu. Cloth printing 10 9 8 7 6 5 4 3 2 1 For Shari, Jules, and Paris Contents Acknowledgments ix Author’s Note xi Introduction 1 1. 1992: Beginning 4 2. 1992: So Much to Learn 18 3. 1992: No Easy Answers and Little to Offer 33 4. 1994: Too Many Drugs, No Medication 47 5. 1994: Being Mindful of the Subtext 61 6. 1994: Weekend on Call 75 7. 1994: Christmas 88 8. 1995: Another Support Group 100 9. 1995: Mothers and Children 113 10. 1995: Decisions and Revisions 125 11. 1995: Colleagues and Families 138 12. 1995: So Many Stories and Some New Faces 151 viii CONTENTS 13. 1996: Some Hope in the Despair 166 14. 1996: Hit Early, Hit Hard 181 15. 1997: Amazing Changes 195 16. 1999: Despite Our Best Intentions 208 17. 1999: Coping with a Different Paradigm 221 18. 2000: Going Home 234 Epilogue 248 Acknowledgments I could say that I began writing this book when I started my job at the Center for Special Studies—or maybe even before that, when I was writing about some of the patients I cared for while I was a resident or a medical student. I began consciously writing a book about ten years ago with the encourage- ment of my boss, Jon Jacobs. I wrote on and off, plugging away at times and leaving it in a drawer at others. Ultimately it was my partner, Shari, who, on seeing the advertisement for the Narrative Medicine Program at Columbia University in the New Yorker magazine, excitedly showed it to me and said, “You should do this, Suze; then you can finish your book.” And she was right. I had great teachers at the Narrative Medicine Program. Maura Siegel, Craig Irvine, Sayantani Das Gupta, Nellie Herman, Marsha Hurst, and Pat Stanley offered inspiration in this important field, and I thank them all. Rita Charon shepherded the program into being, and her support for the book has been enthusiastic and unflagging. I am indebted to her as an advisor, a colleague, and a friend. My superb writing teacher, Lynne Sharon Schwartz, spent countless hours reading and rereading, coaxing stronger sentences and intelligible phrasing from my passive-voice-prone pen. I am so grateful for her patient, meticulous help. I hope it is clear in the story how much I admire Jon Jacobs. Jon has stood by me as a friend and mentor for more than twenty years. From the very start he has kept our focus on one essential ideal: to do what is best for the patient.

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"I am an AIDS doctor. When I began that work in 1992, we knew what caused AIDS, how it spread, and how to avoid getting it, but we didn't know how to treat it or how to prevent our patients' seemingly inevitable progression toward death. The stigma that surrounded AIDS patients from the very beginni
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