title: HIV/AIDS: a personal retrospective on a prototypical pandemic.
abstract: The HIV/AIDS pandemic richly illustrates the historian Charles Rosenberg's construct of epidemics as four-act plays: progressive revelation, the management of randomness, the negotiation of a public response, and subsidence and retrospection. In developed countries, we are now in Act Four. Among the numerous areas of HIV/AIDS that invite reflection, I've focused on its implications for medicine as a profession as opposed to a job or trade. The availability of effective technology determines the relative importance of competence (doing the right thing well; basic professionalism) and "compassion" (service that clearly transcends self-interest; higher professionalism). Those of us who became "AIDS doctors" during the pandemic's early years were privileged to live through what amounted to a truncated history of medicine. It was quite a ride. But most of all, I remember patients, both individually and collectively, from those early years. My proudest achievement is that none of my private patients died in a hospital. My most-cherished memento is a paperback book bequeathed to me by the widow of "Jake"-the early AIDS victim who never told his wife how he got those scars on his forearms. She'd inscribed it: "Dear Dr. Bryan, Thank you for letting me die gracefully." She and many others gave me lessons in courage and in what it means to be a doctor.
authors.forename: Charles S
authors.initials: CS
authors.lastname: Bryan
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology / Q000266:history; D019380:Anti-HIV Agents / Q000266:history* / Q000627:therapeutic use; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000266:history*; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D058873:Pandemics / Q000266:history*; D014481:United States / Q000453:epidemiology
chemical_list: D019380:Anti-HIV Agents