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Doctors' attitude towards AIDS patients


The advent of AIDS
Harold Lambert Physician
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There were other dangerous pathogens, Ebola and Lassa fever, or the threat of them and this was, curiously enough, much more worrying than smallpox because smallpox you could protect, I saw all these patients. I wasn't worried because I was vaccinated up to the eyes. In fact my children got terribly fed up with this because I'd come home and say, 'You've got to be vaccinated', and they'd say, 'Oh dad, not again!' They were, they were the most vaccinated children in the world. But Lassa fever, which actually turned out to be pretty non-infectious unless you're looking after a patient with advanced disease, was much more a worry because you couldn't protect your staff or yourself so that really, although it was a rare issue, it was a more worrying one, but I suppose, if we're going on a bit, the biggest thing was the advent of AIDS. Do you want to go onto that now at all?

[Q] Yes. Yes. That was...

Well, AIDS started and came, started to come in a relatively big way in about three or four years before I retired, and it had huge effect on, well, the world and our unit. On the sort of scientific side, you had to rejig your whole diagnostic process for things which were quite unfamiliar and not seen before at my advanced age; it was really interesting in that way. I remember being in America, in Atlanta, when it had already got going there, but hadn't really got going here, and my old friend took me to a clinical meeting in the Grady Hospital, and they were talking about this patient who, who'd been taken in of the street. He wasn't a chap with leukaemia or anything like that, and I could see what they were going on. He had a sort of pneumonia and I said, 'Are you trying to tell me this chap's got pneuomocystis pneumonia?' and they said, 'Yes, doctor, (idiot limey)', not realising... I mean, in reality I couldn't think of the idea of apparently a previously healthy person coming in with this rare disease which we associated with profound immuno-suppression, and then of course we started seeing it here as one of the previous, as one of the primary presenting features of AIDS.

[Q] And at that stage were you seeing it without having... before the idea of, of AIDS had been understood?

Oh no. We knew the idea of AIDS... all the San Francisco. No, it was a familiar idea, it just hadn't arrived. So we saw, I don't remember, it was nothing like what they see now, I know from my successors, but we saw a lot of AIDS in my last three or four years. And as I say, it was extremely interesting clinically, but it was... there were many, many problems. One was our unit was, on the whole, an optimistic unit. We tended to have patients we reckoned would go out well because, not because of us being clever, but the sort of diseases that they had and we had to get used to the idea of young people, all young people dying in the most horrible, horrible ways, and it was... it was a shaker to the morale of our unit. And then we had big troubles administratively, getting funding for community care and had an enormous amount of trouble screwing money out of people to undertake this care.

[Q] Why do you think that was? What happened?

Well, I think one thing was a purely sort of technical thing, which was that at that time most of the patients went to the old major STD clinics, as they were then called, which were the Middlesex and at Mary's and the London, but of course, the patients came from everywhere including South-West London so they came to us as well and the, the, whatever it was, district or... no, no, the Regional Medical Officers had great trouble in accepting this and I... I wrote them a really stinking letter telling them they had to get a grip of this and asking the Sir the somebody, somebody, the regional chairman, to come to the unit, which he did, and the sister of our unit, Jenny Yates, now Jenny Moore, was a tremendous, marvellous character, very good technical nurse and very calm. She took this whole thing on board. She trained as a counsellor as well and I have to say it sounds a bit arrogant the... the unit was a bit of a haven of... of common sense and sensibility in a sea of prejudice and horribleness.

[Q] Really?

So the chairman came down. I made sure Jenny was on duty, and in about five minutes she had him waving his paws in the air, and about two days later we got £1.6 million. So, you know... I went round saying to people, 'Look, I've written this letter and all this money's come in. I must do this more often', and the chaps were saying, 'No, no, Harry, it's because you don't do it often you got the money!'

British doctor Harold Lambert (1926-2017) spent his career tackling infectious diseases, helping in the development of pyrazinamide as an effective treatment for tuberculosis. He also published work on the rational use of antibiotics and was a trustee and medical advisor for the Meningitis Research Foundation.

Listeners: Roger Higgs

Roger Higgs was an inner city GP for 30 years in south London, UK, and is Emeritus Professor of General Practice at Kings College London, where he set up the department.

He gained scholarships in classics at Cambridge but changed to medicine after a period of voluntary work in Kenya in 1962. He was Harold Lambert's registrar for 18 months in the early 1970s, the most influential and exciting episode in his hospital training. He set up his own practice in 1975. He helped to establish medical ethics as a practical and academic subject through teaching, writing and broadcasting, and jointly set up the 'Journal of Medical Ethics' in 1975.

His other work included studies in whole person assessment and narrative in general practice and development work in primary medical care: innovations here included intermediate care centres, primary care assessment in accident and emergency departments, teaching internal medicine in general practice and establishing counselling services in medicine.

He was made MBE in 1987 for this development work and now combines bioethics governance, teaching and writing with an arts based retirement.

Tags: Atlanta, London

Duration: 4 minutes, 57 seconds

Date story recorded: October 2004

Date story went live: 24 January 2008