Pamela M. Stevenson remembers the tittering when word spread among State Department janitors that a colleague was in the hospital with what they called "the alphabet thing."
"Really, I think everyone took it as a joke, not personal," Stevenson said in a deposition. ". . . Everybody started joking and laughing."
The "alphabet thing," it turned out, was AIDS.
When the man returned to the State Department, he felt humiliated. He was bothered by "little stares and innuendoes." He heard that a colleague, a part-time receptionist at Washington Hospital Center, had revealed his medical status.
The man sued and won. Last month, a D.C. Superior Court jury ordered the hospital to pay him $250,000, concluding that the medical facility violated its duty to keep his records private. The hospital continues to deny the allegation.
In its details, John Doe's case--a judge ordered that the man's name not be used in court--demonstrates the stigma still suffered by many people infected with HIV, the virus that causes AIDS. It also shows that one District jury expected Washington Hospital Center to do better.
"The fears and consequences of disclosure are very real," said Catherine Hanssens, director of the AIDS Project at the Lambda Legal Defense and Education Fund in New York. "Even though this disease has been with us for two decades, the general public--and that includes physicians--continues to have phobic misunderstandings."
The Whitman-Walker Clinic, the District's largest support network for people with AIDS, takes great pains with medical records, spokesman Michael Cover said.
"Because of the many sensitivities, both personal and professional," Cover said, "it is critical that only those who need to know someone's HIV status are able to access that information."
An estimated 800,000 to 900,000 Americans are infected with HIV. Among reasons for maintaining privacy, AIDS workers say, is to permit the patient to determine how, when and whether to discuss medical issues. Another is to safeguard jobs and insurance benefits for HIV-positive patients. A third is to reduce the reluctance of people to be tested and treated, particularly when early intervention can mean longer lives.
The man known in Superior Court papers as "John Doe, a pseudonym for a real party in interest," is a Northeast Washington resident who tested positive in 1985. Nearing 50, he works 65 hours a week at two jobs, moonlighting five hours a night as a State Department floor mopper.
In April 1996, he was treated for meningitis at Washington Hospital Center's emergency room. When he returned for a checkup, he visited a State Department co-worker, Tijuana D. Goldring, who doubled as a hospital receptionist. He considered her a friend.
The man testified that Goldring asked him to spell his unusual-sounding last name, because she wanted to send him a card. Within two days, workers on the custodial crew knew his HIV status, and they said Goldring told them. The man never received a card.
People made "little snide remarks," the man recalled in a Superior Court deposition. Troubled, he called a co-worker he considered a mother figure and asked whether she had learned his medical status. She answered, "Son, yes."
"It's kind of like an aura in the air, you know," the man testified. "I come into the locker room and they'd all be talking, and when I get there, everybody would be silent and looking at me like I am crazy or something."
The man's attorney, Dale Edwin Sanders, asked Stevenson, "What did you hear?"
Stevenson: "That [the man] had the alphabet thing."
Sanders: "What is the alphabet thing?"
Stevenson: "People refer to it as AIDS."
Goldring testified that, contrary to what her friends said, she never checked the man's medical records and did not know his HIV status. She said that a co-worker had asked her the man's last name but that she never relayed the name to the co-worker.
After deliberating for an hour, the jury concluded that Goldring gained unauthorized access to medical records and revealed the man's HIV status to friends. The jury said the hospital breached its duty to protect those records.
"I thought we were friends," the man said of Goldring. "I didn't think that she would do that to me."