Twenty Years Later

The Emergence of a Deadly Disease

By David Brown
Washington Post Staff Writer
Tuesday, June 5, 2001

Michael S. Gottlieb remembers the day he discovered AIDS.

He was 33, a first-year assistant professor at UCLA Medical Center, specializing in immunology. It's a field of uncommon diseases, and sometimes you have to go looking for patients. So one day in January 1981, he asked the immunologist-in-training to prowl the wards for "teaching cases."

"I remember sitting in the basement office, and my fellow returning," Gottlieb recalled, sitting in a different Los Angeles office, this one spacious and above ground. "He said: 'The intern has this patient who is really kind of interesting.' "

The patient's name was Michael. He was a tall, handsome model with cheekbone implants. He'd moved to Los Angeles in part to be openly homosexual. He'd been hospitalized because of unexplained fevers and weight loss.

A blood test revealed he had a severely damaged immune system. He looked like a cancer patient recovering from a bruising round of chemotherapy. The trouble was, he didn't have cancer and hadn't undergone chemo. Until recently he'd been healthy.

He was a diagnostic enigma.

Gottlieb remembers another scene from that admission vividly.

Although the department's immunology team had not been formally consulted on the case, its members went to see Michael every day. One visit was interrupted by a telephone call. In a stage whisper, Michael said to the caller: "These doctors tell me that I am one sick queen."

The doctors chuckled uneasily. "We were not accustomed to some of the self-deprecating humor that gay men can use," Gottlieb recalls. Perhaps, though, what made the statement memorable is not its language but its truth.

Michael was discharged in about five days. He was back in a week. He was dead in less than a year. But before his mysterious downward spiral was over, he entered medical history.

Twenty years ago today, Michael appeared, nameless, as one of five patients in a brief report in the weekly newsletter published by the federal Centers for Disease Control. It described a strange disease that eventually would be named AIDS.

Nobody could have imagined that acquired immune deficiency syndrome would have killed more than 20 million people two decades later and become one of the worst epidemics in the history of mankind.

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© 2001 The Washington Post Company