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The ‘H’ in HIV

Dr. Mark Katz '71 is a veteran of the AIDS epidemic  Dr. Mark Katz '71 is a veteran of the AIDS epidemic Dr. Mark Katz '71 well remembers the first international AIDS conference he attended—in Washington, D.C., in 1987. A huge map of the U.S. on display in the exhibit area was accompanied by a […]

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Dr. Mark Katz '71 is a veteran of the AIDS epidemic
 

Dr. Mark Katz '71 is a veteran of the AIDS epidemic

Dr. Mark Katz '71 well remembers the first international AIDS conference he attended—in Washington, D.C., in 1987. A huge map of the U.S. on display in the exhibit area was accompanied by a headline: The Problem: AIDS. The Solution: Banish All Homosexuals. "The map actually had circles on each of the big cities depicting the estimated number of homosexuals," says Katz. "It just shows how primitive we were—and how AIDS has evolved."

Thirty years ago—on June 5, 1981—a study published in the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report focused on what would be later recognized as the first documented cases of acquired immunodeficiency syndrome, among five previously healthy young men in Los Angeles. AIDS has since taken the lives of 30 million people, including more than half a million Americans. But the battle against the epidemic has changed dramatically over the years—along with society's attitudes toward it.

Katz has been on the front lines almost from the beginning—as a physician, medical adviser, board member, educator, and volunteer. He started Kaiser Permanente's first HIV-dedicated clinic at West Los Angeles Medical Center in 1988 and served as the Southern California regional HIV physician coordinator from 1992 to 2006. He estimates that he has delivered more than 1,000 lectures and medical presentations to patients, health-care workers, students, activists—anyone who will listen. A four-year scribe for the Daily Sun during his days on the Hill, he wrote more than a hundred installments of "Being Alive," a monthly medical update for the HIV/AIDS Coalition newsletter, until the Internet changed how medical information is disseminated. He now moderates the online Q&A forum "Ask the Doc," sponsored by the AIDS Education Global Information System.

Dr. Mark Katz

Katz's medical career has always been most about the first word in "human immunodeficiency virus," as he has endeavored to put a face on the AIDS crisis and lend a sympathetic ear. Among the photos lining his desk at home—alongside those of his husband, Bob (they were married in California in 2008), and his son, Marcus (adopted in 2003)—is one of a man named Brian, whom Katz met only once, after a lecture. Brian called him from time to time, asking questions about the disease, but Katz learned of his death from his obituary in the L.A. Times. He called the funeral coordinator and asked for a photo. "I look at it every day," he says. "It's a symbol of all the people who, although I didn't know them, just didn't get the right treatment soon enough."

Katz has been honored frequently for his work, most recently with the 2010 College of Medicine Humanitarian Award from his medical alma mater, SUNY Upstate in Syracuse; it lauded him for "integrating humanism and medicine seamlessly together." Indeed, he likes to say that he practices the art of medicine, as opposed to the science. "It goes back to Cornell, where I got an A in French literature and a B-minus in organic chemistry, which made me question if I should become a doctor," he says. "I've always felt there are enough people who have done amazing research and discovered drugs that have turned this epidemic around. Maybe the quasi-contribution that I've made is being a voice of compassion. I think the medical profession doesn't do a very good job of selecting or training people for that."

To that end, he co-teaches a class called Professionalism and the Practice of Medicine at the University of Southern California, preaching concern for a patient's emotional well-being as much as his or her physical condition. That has been a particular challenge when treating HIV patients, who often battle hostility and blame along with a deadly disease. "I never ask them in the first interview, 'Do you know how and when you got it?' " he explains. "Because I feel that anyone who is diagnosed today is dealing with those issues of shame."

Katz keeps a list of names in his desk drawer—his patients diagnosed with HIV in the early days of the crisis. All but two are long dead. But the paradigm changed in 1997, as combination drug therapy led to the first annual decline in AIDS deaths. Currently, the world epidemic has hit a plateau, with 2.7 million people newly infected in each of the past five years. According to the CDC, there are 1.2 million Americans living with HIV, and 50,000 new infections each year. Almost 20 percent of those infected are unaware of their status.

Today, potent, durable, and well-tolerated medications prolong the lives of HIV patients considerably; most people are now living with AIDS rather than dying from it. "It has turned into a chronic, manageable illness," says Katz, who spends roughly two-thirds of his time as an in-patient hospitalist and the remainder on clinical and administrative HIV/AIDS work. "Now, the people I take care of, I'm not just their HIV doc, I'm their primary care doc as well. They're developing the normal maladies of middle and older age."

Katz still loses one or two patients to AIDS each year, but what was once at least a weekly occurrence has become the exception. Recently he has begun to cast an eye toward the past, in the hope that one day the AIDS epidemic will be studied as history. For World AIDS Day last December 1, he organized a thirtieth-anniversary community remembrance in Los Angeles, a program that included a handful of patients and physicians from the early days of the epidemic. Working with the ONE National Gay & Lesbian Archives, Katz asked participants to donate memorabilia—letters, photos, clothing—belonging to someone with AIDS, which will be preserved and (a dream of Katz's) perhaps displayed in an AIDS museum. "This can be one of the most meaningful contributions," he says, "because it's giving people, including myself, an opportunity to know that the names—and these lives—will live on."

— Brad Herzog '90

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