Managing Our Miracles: Healthcare in America; No. 105; AIDS: In Search of a Miracle

<v Narrator 1>This is a production of the Columbia University seminars on media and society <v Narrator 1>in association with the WQED Pittsburgh and WNET New <v Narrator 1>York. <v Narrator 2>Funding for this series has been provided by Equicor. <v Narrator 2>Equitable Health Corporation of America, which believes that only by confronting <v Narrator 2>today's health care challenges can we assure tomorrow's miracles. <v Woman 1>[music plays] Since when should doctors be the ultimate arbiters of what is good for <v Woman 1>society? <v Man 1>But it's gotta be in a way that enables him to be a good doctor. <v Man 2>One of the imperatives have has got to become for medicine to use its genius <v Man 2>one more time and bring the cost of some of this down. <v Man 3>We might have to look back and say some of these things are not worthwhile and should not <v Man 3>be done. And that is the hardest thing to come by. <v Fred W. Friendly>When I was 11 years old, my father died of pneumococcal meningitis.

<v Fred W. Friendly>Physicians always tell me that if he had contracted that <v Fred W. Friendly>disease today, antibiotics, penicillin could have cured him. <v Fred W. Friendly>In my lifetime, we've conquered polio with the Salk and Sabin vaccines <v Fred W. Friendly>and virtually wiped out smallpox and measles. <v Fred W. Friendly>We still haven't cured the common cold. <v Fred W. Friendly>We haven't found the key to cancer. <v Fred W. Friendly>And now medicine is desperately searching for an answer to the newest bafflement: AIDS. <v Fred W. Friendly>Acquired Immune Deficiency Syndrome. <v Fred W. Friendly>How can we manage without a vaccine or a cure for this new and <v Fred W. Friendly>deadly disease? <v Fred W. Friendly>That's the question in our hypothetical case study. <v Fred W. Friendly>It's a question not just for AIDS doctors and their patients, but for each of us. <v Fred W. Friendly>The moderator is Professor Arthur Miller of the Harvard Law School. <v Arthur Miller>Welcome to Metropolis.

<v Arthur Miller>Congressman, Metropolis is your district. <v Arthur Miller>And when you're at home in Metropolis, where you have your district headquarters, <v Arthur Miller>you and a couple of the aides of yours tend to go to Leo's <v Arthur Miller>place for lunch. It's a watering hole where all the biggies <v Arthur Miller>go. Today, it's a beautiful spring morning and <v Arthur Miller>you and a couple of the assistants are goin' out to lunch. <v Arthur Miller>One of them sorta takes ya aside and says uh, boss. <v Arthur Miller>Maybe we'd better not go to Leo's place. <v Arthur Miller>A couple of the medical offices from the city, they ate over there the other day <v Arthur Miller>and they told me that one of those waiters has all the signs of AIDS. <v Arthur Miller>Safer. Let's go to the Italian place up the street. <v Newt Gingrich>There's a greater chance of being killed driving to Leo's than the ?inaudible? <v Newt Gingrich>get AIDS from that waiter, assuming that we keep our relationship the one of eating.

<v Arthur Miller>You're not afraid to go to Leo's? <v Newt Gingrich>Not for the reasons you described. [laughter] <v Arthur Miller>How about you, Mr. Mayor? <v Edward Koch>A food handler can't possibly uh pass it on simply by handling the food <v Edward Koch>that even though you might be squeamish about it, I mean, it's just normal to be <v Edward Koch>squeamish about it. You still have an obligation to lead, to educate and <v Edward Koch>therefore to go to that particular restaurant. <v Arthur Miller>You're his chief medil- medical officer. <v Arthur Miller>Should you be so confident? <v Walter R. Dowdle>Oh, absolutely. In fact, I would think he's doing precisely the right thing to <v Walter R. Dowdle>avoid creating any unnecessary fears, in fact, every day, all the information <v Walter R. Dowdle>available reinforces the position that he's taking. <v Walter R. Dowdle>That is simply not a route of transmission. <v Walter R. Dowdle>The rule is it simply doesn't occur except through very, very close, intimate sexual <v Walter R. Dowdle>uh activity. <v Speaker>Well, despite the fact that the congressman and the mayor are still going <v Speaker>to Leo's place the word about Sam's servers.

<v Speaker>AIDS is circulating and business is falling <v Speaker>off. Mr. Hentoff, you in addition to writing <v Speaker>in the Metropolis Daily, you own Leo's place. <v Speaker>Let's get your reaction as proprietor. <v Speaker>As proprietor. <v Speaker>I we have a talk with my waiter, with Sam, with Sam having the talk. <v Speaker>Sam, as I'm sure you know, there are these <v Speaker>reports about you and as I'm sure you also know, the reports have led to a calamitous <v Speaker>fall in business. But the primary thing, it seems to me, is you at the moment. <v Speaker>How do you feel? Have you seen a doctor? <v Speaker>And I would urge with as much persuasiveness as I could that he. <v Speaker>Do you want me to see a doctor? Yeah. <v Speaker>I certainly do. <v Speaker>I know I haven't been feeling too well. <v Speaker>Yeah. And. <v Speaker>It's true, I have AIDS. <v Speaker>Oh, you do have. I do have AIDS.

<v Speaker>Well, in that case, I would <v Speaker>then have to consult. <v Speaker>Very quickly, the local public health officials. <v Speaker>Does it seems to me that Sam is now a problem not only of my restaurant, <v Speaker>but of the community as a whole? <v Speaker>Well, you've heard what the public health people will say. <v Speaker>Want to repeat it? Well, as the chief public health officer, I did a very good job in <v Speaker>educating the mayor and the congressman. <v Speaker>Now I have to educate the public. <v Speaker>Now you have to educate him. He's part of the public. <v Speaker>What I'm trying to say is you don't as a layman, I don't know whom to believe. <v Speaker>What do you do as the owner of Leo's place <v Speaker>as you're watching business go out the door? <v Speaker>And you have an AIDS affected waiter. <v Speaker>What do you do? Well, what I would do then is trying to find the best <v Speaker>physician and treatment center in Metropolis. <v Speaker>Tell the waiter that he has got full salary, that he doesn't have to worry about

<v Speaker>anything. And then I would try to persuade him to go into this treatment. <v Speaker>But you get him out of your dining room. <v Speaker>Yeah, I would. <v Speaker>Congressman, there was a time in this country where it was widespread belief <v Speaker>that if you had cancer, you could catch it by associating yourself with someone had <v Speaker>cancer. Now, some people may still believe that, but most people reject that idea. <v Speaker>But let's say there was a belief in Metropolis that a cancer patient who worked in <v Speaker>that restaurant could transmit the disease. <v Speaker>Now, the belief that the public may have may lead to the economic loss <v Speaker>of the restaurant owner. And then we've got to educate the public, not feed or <v Speaker>give in to irrational prejudice. <v Speaker>Ms. <v Speaker>Goodman, what are you gonna tell your readers? <v Speaker>I'm gonna write about it in a larger context, probably. <v Speaker>I'm gonna take Sam as a example, Sam and Nat as an example <v Speaker>of what's going on and talk about exactly the things that we're chatting about, how this <v Speaker>is an irrational fear and how we have to do something about resolving

<v Speaker>the irrational fear rather than closing down <v Speaker>the restaurant. <v Speaker>Now you're going to cause you're gonna call Napa's concern about <v Speaker>the possibility of casual transmission irrational. <v Speaker>I'm gonna go with the medical experts on this one. <v Speaker>Well, I wrote about Science magazine, which said last winter that the disease <v Speaker>keeps changing its character. So it's almost impossible to be sure about almost anything <v Speaker>concerning it. <v Speaker>Well, I'm gonna go with the. But I figure that the medical people <v Speaker>are at least three years ahead of me on this one, and I'm gonna go with them. <v Speaker>Let me give you a different story, Miss Spencer. <v Speaker>There's somebody else in Metropolis. <v Speaker>His name is Freddy Flyer. <v Speaker>He's from the community, went to the State University. <v Speaker>All American led the team to two Super Bowls. <v Speaker>He's now a headmaster in the community. <v Speaker>Athlete's foot cries. Great figure.

<v Speaker>It turns out you hear the way journalists hear things <v Speaker>that this extended overseas trip that Freddies on. <v Speaker>Is in French. <v Speaker>He has a. <v Speaker>His wife is at home. <v Speaker>Talk to her. <v Speaker>Is this flyer. <v Speaker>This is a difficult subject to approach, but we have reliable reports <v Speaker>that your husband, who is something of a pillar in this community, is in Paris being <v Speaker>treated for AIDS. Is this true? <v Speaker>The sad truth, Miss Spencer, is that it? <v Speaker>Is he? He has AIDS. <v Speaker>He's at the Pasteur. He's hoping to get better. <v Speaker>And when did you first know that he had AIDS? <v Speaker>A couple of months ago when we realized how we got it. <v Speaker>And how did he get it? Well, as you know, we're deeply religious <v Speaker>people. And we always go to church.

<v Speaker>And one of our fellow religionists at aid <v Speaker>and we always sat near each other in the church, Fredi of <v Speaker>on a number of occasions <v Speaker>took communion right after this other unfortunate <v Speaker>Soledad. <v Speaker>So there's no question in our minds <v Speaker>that he got the aids from the communion. <v Speaker>Mrs. Fletcher, as far as as medical evidence is aware of this, this <v Speaker>really wouldn't be possible. Is this. <v Speaker>What's your story tonight? I'll give you. <v Speaker>Twenty two seconds passed from one of the most prominent and well-known citizens <v Speaker>of Metropolis has been diagnosed as having AIDS. <v Speaker>What his prognosis is, what his what his <v Speaker>belief is as far as what he says. <v Speaker>The reason is that you're going to include that in the store. <v Speaker>Yes.

<v Speaker>Along with the caveat that this would be the first known communion communicated <v Speaker>case of AIDS. <v Speaker>I assume you will have a counter clip from Chinh or Dougall or KREM. <v Speaker>Debunking it. In my 42 seconds, I'm not sure realistically <v Speaker>that I would that I would spend all that much time. <v Speaker>The first night the story broke debunking the communion communication theory. <v Speaker>It certainly wouldn't be pointed out that this has never happened before and that <v Speaker>this would be somewhat suspect. <v Speaker>Bob, you must believe it. That's the way it's going to be broadcast this evening. <v Speaker>I think it does. I think you could be reinforcing a lot of negative <v Speaker>perceptions about AIDS and incorrect perceptions about AIDS <v Speaker>or how it's transmitted. If you do not spend time in that room in those 42 <v Speaker>seconds, actively debunking the myth that AIDS can be that <v Speaker>age, Shelvey three can be transmitted through Communion Cup, you're going to have a lot <v Speaker>of frightening people in your community and you'll have a lot of stories the following

<v Speaker>days about how panic people are realistically in 42 seconds. <v Speaker>I think it's unlikely that that first piece is going to be able to spend <v Speaker>an enormous amount of time on that because you have such a limited amount of time. <v Speaker>How do you know the communion cup stories following you dismissed it? <v Speaker>And the fact is the darn stuff probably came out of the green monkey. <v Speaker>Now, how about American television? Who covered the first AIDS victim? <v Speaker>If they said, you know, I think this may have come from a monkey. <v Speaker>I mean, the fact is the well, I would say statistically a particular server <v Speaker>is not likely to give you AIDS. AIDS is a virus about which we know remarkably <v Speaker>little. It has been in the human population a very short time. <v Speaker>And it is conceivable that a non-scientist not bounded by the assumptions <v Speaker>of a particular elite may in fact be telling you the truth about a disease we don't know <v Speaker>very well. So I'm not so sure you should automatically assume that this woman is <v Speaker>necessarily wrong. <v Speaker>Let's move on to Paul. <v Speaker>Paul Porter is a waiter.

<v Speaker>He's a co waiter with Sam's server. <v Speaker>He's worried, Dr. Landesman. <v Speaker>He comes to you. You have never seen him before. <v Speaker>He says I'm worried. <v Speaker>All this talk about AIDS. <v Speaker>Why are you particularly worried about having AIDS? <v Speaker>Is it because you've shared food with Sam or you've done other things with Sam? <v Speaker>You mean were we sexually intimate? Yes. <v Speaker>No, no. <v Speaker>Good friends, roommate. <v Speaker>Do I have AIDS? <v Speaker>My answer would be at that point. Absolutely not. <v Speaker>No. I mean, you've tested me for AIDS. <v Speaker>Well, there is no test for AIDS. <v Speaker>It's important to understand that AIDS is the last card, <v Speaker>the most extreme manifestation of a an infection with a <v Speaker>virus. That virus is called HDL B3. <v Speaker>And you can have that virus for many years without having AIDS per say.

<v Speaker>But what I read in the newspaper, there's all this talk about testing. <v Speaker>You know, there is there is a test which can reliably <v Speaker>detect the presence of the virus that causes AIDS. <v Speaker>Such a test does exist. <v Speaker>Dr. KREM, what does the test to <v Speaker>that test? <v Speaker>It detects the presence of antibody to the HDL B3 virus, <v Speaker>which is the virus associated with AIDS. <v Speaker>It does not directly detect the virus. <v Speaker>If I test positive, is there a chance that it was wrong? <v Speaker>There are several tests available there. <v Speaker>The first, when used on blood, is called a nice at this time. <v Speaker>This test has a high percentage percentage of false <v Speaker>positive results. <v Speaker>When when has obtained a positive result on an analyze it, this one <v Speaker>has the repeated festival and then use another confirmatory

<v Speaker>test on the western blood. <v Speaker>It's unfortunate, but also more complicated to do and more expensive <v Speaker>for the mortification when he's in. <v Speaker>The good doctor's office. Yes. <v Speaker>He's going to get confused very quickly. <v Speaker>Yes. When it is his doctor's obligation, responsibility to <v Speaker>explain exactly what that means and to use it only <v Speaker>when really called for. <v Speaker>Dr. Galen, I would encourage my patients who have anxiety because I deal with <v Speaker>anxiety. Take a damn. <v Speaker>I don't know what he'll do to me psychologically. <v Speaker>I may become a basket case. I may be nonfunctional. <v Speaker>You, Mandy, but fortunately, you have a very good psychiatrist. <v Speaker>Coming back, willing to extend the relationship, you have a <v Speaker>contract of decency and honesty. <v Speaker>I don't lie to you. I tell you, Paul, that even if you have doubts,

<v Speaker>the test as it now exists with the Western blot <v Speaker>is about as good as any test we have. <v Speaker>And if it says you test positive, you and I assume <v Speaker>you are a carrier of the virus, are you worrying about me or society? <v Speaker>Well, I'm always only worried about you, but I hope that you're the kind of person that <v Speaker>worries about society. But as an analyst, I have no responsibilities to society. <v Speaker>Except you're telling me it's better for me to know. <v Speaker>We work with the assumption that the real world is better than the fantasy world. <v Speaker>It's what makes analysis tough. <v Speaker>Dr. Chen. <v Speaker>Public health. <v Speaker>Who should be tested? <v Speaker>Individuals who have had multiple sexual partners in the past, <v Speaker>especially at this time. Homosexual partners, but not exclusive, not <v Speaker>exclusively. We would consider an individual at some risk if that individual <v Speaker>has had multiple heterosexual partners. <v Speaker>Because we are dealing with a sexually transmitted disease.

<v Speaker>Anybody who shares needles clearly would be an individual that would be at high <v Speaker>risk to be infected. So these are the two main risk groups. <v Speaker>I think also sex partners of those individuals that we talked about, sex partners <v Speaker>of intravenous drug users, sex partners of hemophiliacs, all <v Speaker>at risk doubted. <v Speaker>Are there groups who should be required to be tested? <v Speaker>No. I would have to bring out here the public health service recommendations, which <v Speaker>even apply even to a mythical town. <v Speaker>And the recommendations there are that the test should be offered. <v Speaker>It should make it be made available to those in the high risk group. <v Speaker>It does not recommend that anyone actually be required to take the test. <v Speaker>Congressman, I want protection. <v Speaker>Public health ought to be reaching out to every American saying if you don't have AIDS <v Speaker>this morning. Here are the three or four basic things you'd better not do. <v Speaker>And you know, because you are literally risking your life if you use a needle.

<v Speaker>Anybody else has used. You are literally risking your life if you engage in <v Speaker>certain sexual practices without without very serious precautions. <v Speaker>You are literally risking your life and you can't trust the partner you met this <v Speaker>evening at the bar, to be honest or even to be knowledgeable. <v Speaker>You have to operate on an assumption that we now have in this in this society, <v Speaker>a virus which at certain kinds of use is highly violent since you can't <v Speaker>quarantine 30 or 40 or 50 thousand carriers. <v Speaker>How do you function on a daily basis, in effect, functionally quarantine yourself <v Speaker>by your practices found from that virus? <v Speaker>Now, I think we have literally followed exactly the wrong public health policy in not <v Speaker>being emphatic enough and frankly frightening enough, not about getting it from <v Speaker>the waiter. Will you go to go will you go down and have lunch saying adamantly and <v Speaker>publicly and in 30 second spots as vividly as we can. <v Speaker>If you engage from this day on and any of the following practices, you are not

<v Speaker>only stupid, you are potentially suicidal. <v Speaker>Dr. KREM, how would you engineer the congressman? <v Speaker>Well, first of all, I would tell him and <v Speaker>and our audience that the numbers of people infected already is much larger <v Speaker>than 40, 50 thousand. We are probably talking already in this country of between <v Speaker>1 and 3 million people infected, most of whom don't know who they are, <v Speaker>which is a very dangerous situation because <v Speaker>they cannot control they or they don't behave appropriately because they don't know <v Speaker>they are infected. <v Speaker>And what we're saying here is true is that we must be <v Speaker>very says to the public at large, to everybody, and particularly to <v Speaker>adolescents who are the kids in school who are more likely to experiment <v Speaker>with drugs and sex. <v Speaker>I'm a headmaster of a school. I invite you in to talk <v Speaker>to the sixth graders, 11, 12 year olds.

<v Speaker>That a good group? <v Speaker>Yes. One should stop. Then what are you gonna say to them? <v Speaker>Explain. How was sexual intercourse occurs with <v Speaker>the organs? <v Speaker>This body surface that surfaces that they're likely to be in touch with each other. <v Speaker>And how blood from one person can go on rest of the other semen <v Speaker>from a man can be passed on to somebody else. <v Speaker>And you would have randomizing and. <v Speaker>Yes. <v Speaker>And what has to be done to stop the transmission? <v Speaker>And this can be done through physical barriers. <v Speaker>And these are condoms and diaphragms. <v Speaker>And with the help that perhaps I've said and Cavic, our preparations, Jimmy sites <v Speaker>that this type of virus should be taught to secure a seventh, eighth grade <v Speaker>before the end does. <v Speaker>Yes. In sexual activity. <v Speaker>Ms. Are you willing to fund that program? <v Speaker>I'm willing to fund it. I don't know that the public will accept it. <v Speaker>It's very hard to get parents to

<v Speaker>accept explicit sexual explanations at that <v Speaker>grade level. <v Speaker>But I think the doctor and the others, the congressman spoke moments ago are absolutely <v Speaker>correct about the congressman. <v Speaker>What are you going to do when you get 20000 letters <v Speaker>screaming about this immorality in the classrooms <v Speaker>in Metropolis? <v Speaker>So I think very explicitly, I hope your 11 year old. <v Speaker>Doesn't die. I am willing to take extraordinary steps. <v Speaker>Not for sexual education on a non-value basis. <v Speaker>To tell your child whether or not to engage in certain things. <v Speaker>But on the very specific public health issue, your child needs to understand <v Speaker>there are certain practices which could kill them that are their drug use practices that <v Speaker>can kill them. And there are sexual practices in general. <v Speaker>Koop. <v Speaker>Well, federal funds be made available for this. <v Speaker>Federal funds are available for this. <v Speaker>And you may know, sir, that even in this little town of Metropolis, that my

<v Speaker>relatively meager fame has reached the ears of the president of this country. <v Speaker>And he has asked me to prepare such a message for the people of this <v Speaker>country. And I am in the process of doing that now. <v Speaker>I want you to be the script writer. <v Speaker>You give me a 45 seconds or thereabout message, <v Speaker>which is a good surgeon general coming on camera will read. <v Speaker>What should it say? <v Speaker>It should say no when AIDS threatens everybody, potentially <v Speaker>not only certain groups, as most people think. <v Speaker>Number two, that it is a sexually transmitted disease and that it is transmitted <v Speaker>through blood. <v Speaker>I'm talking about avoiding anal intercourse. <v Speaker>No, it's not necessary to separate intercourse from other forms <v Speaker>of intercourse since that all dangerous. <v Speaker>It's only a question of degree. <v Speaker>To give you an idea of how that message doesn't get out. <v Speaker>We have a hotline in our hospital where we receive calls from people who are concerned

<v Speaker>that they may have acquired the virus. <v Speaker>We get calls from suburban housewives who say who say that I had sex with <v Speaker>my husband yesterday in an unusual manner. <v Speaker>Can I get AIDS? Now we have to try to explain to them that <v Speaker>it's not the type of sexual activity that's the key thing, but it's whom you have sex <v Speaker>with. <v Speaker>Of course, if this focusing on anal intercourse, because that is a dominant sexual <v Speaker>activity that is involved in the gay community, people have tended to focus on <v Speaker>that as a dangerous act. <v Speaker>You keep focusing on anal intercourse. <v Speaker>What you do is you keep splitting off the homosexual community, <v Speaker>letting the heterosexual population think, well, it's them. <v Speaker>And that activity me with my nice ordinary Badgley intercourse. <v Speaker>I'm safe. I'm OK. And it creates an artificial barrier of them versus <v Speaker>us. <v Speaker>I think also you must include oral genital from contact, <v Speaker>not only just vaginal anal, but oral must be in very explicit <v Speaker>and made.

<v Speaker>And that General Koop, you willing to deliver this message? <v Speaker>I'd rather write my own. <v Speaker>How different would it be? Well, I'd say, ladies and gentlemen, this is the first of five <v Speaker>appearances I will make with you this week on the subject of AIDS. <v Speaker>I know that many of you out there are panicky about AIDS. <v Speaker>There are two general groups, those who are high risk, such as homosexuals <v Speaker>and intravenous drug users. <v Speaker>And I think that the more panicky you are, the better, because you will then pay <v Speaker>attention to what we've said and you will alter your lifestyles and take care of your own <v Speaker>problem. But for the rest of you panicky people who are afraid <v Speaker>you're going to catch AIDS at Leo's or walking through a hospital where <v Speaker>there's an AIDS patient. AIDS will have to never be <v Speaker>accused of seeking you out. You have got to seek it out. <v Speaker>And for my final message tonight, until I get into specifics for the next four nights, <v Speaker>the safest way to avoid AIDS is with mutually faithful, monogamous <v Speaker>sexual relationships of either sex.

<v Speaker>Good night, ladies and gentlemen. See you tomorrow. <v Speaker>But isn't there a problem with that? <v Speaker>How do you for two people who are single and they meet and they fall in love and they <v Speaker>decide let's have a mutually monogamous relationship. <v Speaker>You still don't know whether one or both of those parties is infected. <v Speaker>If you are that concerned about that monogamous relationship and that individual, <v Speaker>you have available to you a testing situation and then you can decide whether <v Speaker>or not your love is so great, it doesn't matter. <v Speaker>And how realistic is it to assume that everyone in this society, given the divorce rate, <v Speaker>given everything we know sociologically, how realistic is it to assume that people are <v Speaker>going to engage in mutually monogamous relationships? <v Speaker>Mutual can be just as difficult to deal with as the monogamous. <v Speaker>I'll probably. How do we make the assumption? <v Speaker>I'll go to her. Is doing it, can't we? <v Speaker>Isn't it safer from a public health standpoint to tell each individual <v Speaker>how they can protect themselves irrespective of the behavior or the faithfulness <v Speaker>or whatever or antibody status of their partner, how they can protect <v Speaker>themselves? Isn't that the message that I need to go to Hallmark Health Officer?

<v Speaker>I'll start with the biggest message I can give him the shortest time with the greatest <v Speaker>number of people and protect them. <v Speaker>Now, Tuesday night, I will talk to the people who haven't heard me explicitly. <v Speaker>And by Friday night, I'll get down to types of sexual. <v Speaker>Tact, protective mechanisms and so forth. <v Speaker>And you don't think the networks will have a little difficulty with this? <v Speaker>No, I don't think so. Not the things I've heard on networks recently. <v Speaker>Let me introduce you to <v Speaker>Paul Porter's sister, Linda. <v Speaker>Linda is an intravenous drug user. <v Speaker>Mr. Prem, what are we gonna do for Linda? <v Speaker>Well, I certainly think that she should be called in and <v Speaker>told about safe practices. <v Speaker>Called in where? Well, she's a wanderer. <v Speaker>She's a wonder.

<v Speaker>I personally would like to take a mobile unit to that <v Speaker>wondering.. station where they pick up their drugs on a daily basis. <v Speaker>And I'm going to give out condoms to that population so that they <v Speaker>will be able to practice safe sex. <v Speaker>I'm going to make available to them treatment right on the spot so that they <v Speaker>will not have to be in a waiting line or on a waiting list to get treatment. <v Speaker>What kind of treatment? Drug free treatment or methadone maintenance treatment <v Speaker>or naltrexone treatment? <v Speaker>Either one narcotic antagonist treatment. <v Speaker>Doc, my friends and I going to be shooting up tonight. <v Speaker>If that's your wrap. We've seen a dozen down here like you before. <v Speaker>Well, if you're going to shoot up, make sure you use a clean needle and do not <v Speaker>share your needle with anybody else. <v Speaker>And if you add the way to clean your needle, I would tell him exactly <v Speaker>the use of Clorox and water and a high enough strength of Clorox

<v Speaker>to make sure that they get rid of the it's the VADs band to share the needle. <v Speaker>It's absolute absolutely no sharing of any needle whatsoever. <v Speaker>But, you know, we don't have enough needles. <v Speaker>Then don't do it. OK. <v Speaker>I had my mayor is sitting here and we have had this discussion <v Speaker>and I would eventually probably want <v Speaker>to recommend the use of all the make needles available over <v Speaker>the counter. <v Speaker>I've got some needles. <v Speaker>Well, I wouldn't give out, but I would. <v Speaker>Why not? If this problem continues to go at the rate it's going, I <v Speaker>would I would begin to make needles available to <v Speaker>people over the counter like it has done in other states. <v Arthur Miller>Free needles. <v Prem>Not free. You'd have to buy them and the needle would have to self-destruct. <v Prem>If we could have a needle that would self-destruct after each use that

<v Prem>you couldn't use it again, uh then I would be all for makin' needles available <v Prem>immediately. If the problem continues to get out of hand and drug abuse continues <v Prem>to rise like I'm seeing it in certain communities, then indeed I would recommend <v Prem>selling needles over the counter at this juncture. <v Arthur Miller>Why, why the selling as opposed to giving? <v Arthur Miller>That's just gonna [Prem: I don't think-] make it worse for the poor-. <v Prem>I don't think that we should uh encourage drug abuse by making <v Prem>particularly intravenous drug abuse by making needles available to the public. <v Prem>And I think that's exactly what would happen to make 'em easily available. <v Prem>The greater the availability of the substance, the greater the availability of the <v Prem>implements, the greater the use of those implements. <v Arthur Miller>But now we have another campaign on safe drug use <v Arthur Miller>with the possible selling of self-destructing needles. <v Arthur Miller>You're gonna fund it, Mr. Mayor? <v Edward Koch>Let me first uh address the uh substantive part of it. <v Edward Koch>Uh in Metropolis, uh I received uh from uh the uh health commissioner uh

<v Edward Koch>a proposal uh that uh we eliminate the uh law <v Edward Koch>that uh says that uh hypodermic needles can only uh be uh <v Edward Koch>purchased uh with a prescription uh and cannot be sold over the counter without one. <v Edward Koch>And uh the members of the the uh health department agreed with uh the health <v Edward Koch>commissioner and what I did uh was I uh sent it to every law enforcement <v Edward Koch>official uh in uh Metropolis and every one of them opposed <v Edward Koch>it. Uh they uh said uh that any uh drug user uh who is bent <v Edward Koch>on using uh drugs is not gonna go looking uh for a uh new needle uh when <v Edward Koch>uh he or she uh needs uh uh drugs. <v Edward Koch>And therefore uh, they thought uh that it would uh simply be advocacy <v Edward Koch>of drug use to uh do this. <v Edward Koch>I don't happen to have that position, but I know that until uh the law enforcement uh <v Edward Koch>people change their position and adopt the medical position, which is what <v Edward Koch>the health commissioner I think was overall uh advancing.

<v Edward Koch>There is no chance in the world of getting legislators uh <v Edward Koch>in the state capital uh to uh change the law and be accused <v Edward Koch>of advocating the use of drugs. <v Speaker>Could I add a little bit of realism to this discussion? <v Speaker>As difficult as it would be to have a campaign about drug abuse, <v Speaker>we have the networks refusing to take advertisments about contraception <v Speaker>because I think that's too controversial. <v Speaker>Despite public health experts like Dr. Koop, we have a Reagan administration that called <v Speaker>for a cut of 20 percent of the funds to go to the AIDS <v Speaker>research and education at a time when we have an epidemic sweeping this nation. <v Speaker>So we're all sitting here agreeing the minimum we ought to inform the public. <v Speaker>Certainly the high risk groups, the rest of the public ought to be informed as well. <v Speaker>We're talking about using the media. It's going to cost money that we don't see this <v Speaker>administration willing to spend. <v Speaker>It's going to require the cooperation of the networks that have been very, very timid in <v Speaker>even talking about contraception and running paid ads for

<v Speaker>contraceptive cancer. <v Speaker>Media be encouraged to be less timid by both sides of the aisle. <v Speaker>If the president enlists his allies and there is a general consensus from <v Speaker>from the conservative movement and they would call in the networks and ask the networks <v Speaker>to help in a public service basis, my guess is that you could lead this country <v Speaker>in enormous distance in a year. <v Speaker>These are the same people who don't want the spots on condoms on the air. <v Speaker>Yes, they'll be very well IVF. <v Speaker>They'll be much more. Well, and I think I'll have a problem with the networks because <v Speaker>they'll be very willing to have conversations about sex. <v Speaker>And you might even be willing to have sex education in schools as long as it was based <v Speaker>on the notion that sex was dangerous and not based on the notion that sex was <v Speaker>pleasurable. Fine. Great. <v Speaker>Yeah, from the standpoint of fundamentals. <v Speaker>The purpose of the advertising is to make it relatively easier for 15 year olds to go out <v Speaker>and discover sex gift from the standpoint of conservatives. <v Speaker>The purpose of this whole project is to make it easier to become a drug addict.

<v Speaker>Then there's going to be enormous resistance. <v Speaker>Let me just say in the context of this discussion here today. <v Speaker>When somebody walks in and says, hi, I am violating the law by being <v Speaker>an intravenous drug abuser. I probably am paying for that by doing things that are <v Speaker>illegal. I am totally I'm willing to listen to any of your advice. <v Speaker>And in a world where there are lots of other more decent, more read, more reasonable <v Speaker>people who need help in a resource scarce environment, I want you to focus on some <v Speaker>extravagant and bizarre way and making sure I get the message. <v Speaker>I have a little bit of difficulty worrying about that person. <v Speaker>I think it's important to realize, your Congressman, that drug addiction is a disease <v Speaker>entity and it's not necessarily one to one. <v Speaker>One might voluntarily get into it initially, and sometimes it's I actually genic where <v Speaker>people might get into a second good to have taken drugs for pain <v Speaker>or whatever. You must treat that a case no matter how that person <v Speaker>got AIDS. If whether it was through homosexuality or heterosexuality

<v Speaker>or whether with two intravenous drug use, just like we treat that person who needs a <v Speaker>liver transplant. Let me take that's that's what we must look at. <v Speaker>He's a handicapped person, but for them. <v Speaker>Yeah. <v Speaker>I I'd just like to say before we totally write off I.V. <v Speaker>drug abusers here to point out that that most of the pediatric AIDS in this <v Speaker>country is through drug abuse, either through the mother herself or maybe <v Speaker>a drug abuser or the father who may actually pass the virus <v Speaker>onto the mother. Seventy percent of the pediatric cases, AIDS <v Speaker>cases are through drug abuse. <v Speaker>Drug abusers don't exist in a vacuum. <v Speaker>They are having sexual contacts. They are they are potentially infecting other people. <v Speaker>And in fact, if you are deeply concerned about the spread of AIDS into the heterosexual <v Speaker>population, that is probably the window. <v Speaker>Let me introduce you to the last member of the Porter family. <v Speaker>He's the youngest. His name is Christopher Porter and <v Speaker>he's about 17.

<v Speaker>And he comes to you, Dr. gaylan, for counseling and <v Speaker>says, Doc, you've been a friend <v Speaker>of the family. Long time I haven't been sexually active. <v Speaker>More I think about it as I grow older, the <v Speaker>more I think that I'm gay. <v Speaker>Could you talk to me about that? I'd be delighted to. <v Speaker>And I'm glad that you came in when you're 17 and not sexually active. <v Speaker>First of all, you don't know that you're gay. <v Speaker>That isn't a black and white gay straight. <v Speaker>Your sexual identity hasn't been established. <v Speaker>And whether you become gay or not. Maybe more on the basis of whether you decide <v Speaker>to or wish to. You don't have any indications that most of this is genetic. <v Speaker>So you do have an option. That's the first thing you ought to know. <v Speaker>The idea that this is sort of a God given thing is one that is a misrepresentation. <v Speaker>Plenty of young gay people have come in for treatment and have become not gay.

<v Speaker>That's nonsense. That's not nonsense. <v Speaker>I've treated plenty then. <v Speaker>They weren't gay in the first place. They may have been bisexual. <v Speaker>I'm talking to Chris. How did you get into this country? <v Speaker>I guess controversy. <v Speaker>You are henceforth known as Lethe. <v Speaker>The Greek chorus. <v Speaker>I'm saying to you, Chris, you're young. <v Speaker>A lot of young people do not know their sexual identity. <v Speaker>But if you then want to go on and tell me that you have had a very active <v Speaker>homosexual life up until now, and that's your fantasy since you were 4 years <v Speaker>old, who are all homosexuals? We might be talking a different story if. <v Speaker>Either at the first or the fifth or 15th meeting, <v Speaker>I say to you, I've decided I'm going <v Speaker>to lead a homosexual life. <v Speaker>I'd like to know what you base the decision. <v Speaker>Has someone talked you into this or is this or your fantasies have led you?

<v Speaker>Are you trying to talk me out of it? <v Speaker>I'm neither trying to talk you out of it or talk you into it. <v Speaker>I want to know what your diagnosis is. <v Speaker>It's difficult. One, it's not a diagnosis. <v Speaker>It's a great cause. Ask the doctor a question. <v Speaker>When a 17 year old kid comes in and says, I'm heterosexual, but I haven't had any <v Speaker>sexual experiences, do you ask him why he knows that? <v Speaker>How he knows that? Did you ask do you inquire as to what his homosexual fantasies <v Speaker>might be? You ask him. I mean, why is the assumption when someone comes in and <v Speaker>says to you that I think I am gay? <v Speaker>That that might be wrong. But if someone comes in and says, I think I am heterosexual, do <v Speaker>you question that just as thoroughly? Do you explore with that person that <v Speaker>it's quite possible that he also might be homosexual? <v Speaker>Had you had the advantage of an interview with me? <v Speaker>A therapeutic the interview. I'd asked you all of those questions. <v Speaker>Good. Independent of how you came. <v Speaker>Now, I do make an assumption there is a direction towards heterosexuality. <v Speaker>Don't forget, very few people come into me saying, Doctor, I'm nervous.

<v Speaker>I'm heterosexual, heterosexual fantasies. <v Speaker>So I wouldn't even bother questioning that. <v Speaker>People come into me because of anguish or pain. <v Speaker>If they come into me as a counselor and announce that they think <v Speaker>they may be with no experience, you're damn right I'm going to question what <v Speaker>that means. <v Speaker>If in the course of our meetings, my direction is clearer <v Speaker>and clearer and clearer, what should I look out for? <v Speaker>Well, you live in a tough time. <v Speaker>And heterosexual or homosexual, you know that we've trivalent trivialize sex terribly. <v Speaker>Most young people find it easier to go to bed with each other than they do to get to know <v Speaker>each other. <v Speaker>It's easier. It's easier to fall into bed with someone and expose your genitals than to <v Speaker>expose your flaws. So I'd caution you about that. <v Speaker>Sex isn't trivial. Sex should be fun, but it's serious. <v Speaker>So I caution you about that to be very little different if ever heard of sexual or

<v Speaker>homosexual. Is this going to become a safe sex lecture material economy? <v Speaker>As a friend of the found, you are going to answer. <v Speaker>Uncle. Well, OK. I'm happy with that way because as a psychiatrist, I hate giving advice. <v Speaker>I don't like raising questions. But OK. <v Speaker>So as uncle will I say to you, Chris, look, people are getting into trouble <v Speaker>with sex. We're finding increased cancer of the cervix because of promiscuity. <v Speaker>Fortunately, we have tests now, so it is malignant. <v Speaker>We're rediscovering disease like a genital herpes. <v Speaker>And then you know about AIDS, which is a disease which is terrifying <v Speaker>in its current occurrence and consequences. <v Speaker>So you've got to be careful when you start your sexual life. <v Speaker>Now, Mr. Leavey, if Chris come to you, is the <v Speaker>other friend of the family. <v Speaker>I think I would have asked very similar questions about how is he sure that he feels <v Speaker>that he is gay, even if without any experience? <v Speaker>Would you give me warnings?

<v Speaker>I would certainly give you warnings. And I would certainly probably give the safe sex <v Speaker>talk a little bit earlier than Uncle Will, because I think that part, you know, one <v Speaker>of the all teenagers at least fantasize about, if not act <v Speaker>upon some sort of sexual experimentation. <v Speaker>And I think it is particularly dangerous in these times to be experimenting without <v Speaker>taking precautions. And I think it can be very difficult. <v Speaker>Homosexual or heterosexual to convince a teenager that they are not infallible, <v Speaker>that they are not immortal. And I think they will they need to fully understand <v Speaker>that these are much harder times to be experimenting with their sexuality. <v Speaker>Despite two lectures by two great lecturers, <v Speaker>Chris, two or three years later <v Speaker>has come to you and gone through the testing. <v Speaker>And he is anybody positive that would have to tell him what a positive <v Speaker>test means, which is that a positive test, although it detects antibodies

<v Speaker>against a virus, probably means that he is infected with the virus <v Speaker>and he is potentially infectious to others, principally by sexual means or by <v Speaker>mixing of blood. And that gives him that puts him <v Speaker>in a very, very, very difficult moral, ethical and sexual <v Speaker>dilemma. That means to be follows many of the normal instinctual urges that he <v Speaker>now has in terms of expressing his sexuality. <v Speaker>He can potentially infect somebody else. <v Speaker>And that's a difficult thing to tell a 25 year old person, perhaps even a 45 <v Speaker>year old person who you can tell about me. <v Speaker>You're going to tell doctrine. No. <v Speaker>And nobody by telling anybody else about you. <v Speaker>Ultimately, I defeat the broader purpose that I'm aiming at. <v Speaker>And that is all to me to try to help to protect the health of everybody. <v Speaker>Again. I'm infectious. <v Speaker>Yes. But if I if my goal is to protect society from

<v Speaker>people who are potentially infectious, and if I violate the confidentiality <v Speaker>of somebody who is infectious, then nobody else will seek to find out if they're <v Speaker>infectious. And as a result, my actions are going to be counterproductive. <v Speaker>Time passes. <v Speaker>Christopher is back in your office. <v Speaker>Dr. LANDERS, on his ankles <v Speaker>are purple lesions. <v Speaker>Kaposi's sarcoma. <v Speaker>What does that mean? <v Speaker>Well, if he has a Kaposi's sarcoma, then he meets the government's definition of having <v Speaker>AIDS. That means he has AIDS and that means he <v Speaker>has now progressed or the virus infection has progressed down <v Speaker>towards the more severe end of the of the consequences of that infection such that he is <v Speaker>now. <v Speaker>He now has what we call AIDS. And his outlook in terms of his life <v Speaker>over the next three years is is dismal.

<v Speaker>Do you tell anyone if the public health law says <v Speaker>that you must report cases of AIDS? <v Speaker>Then I would report the case. To whom? <v Speaker>To the Public Health Authority. To the commission. <v Speaker>Commissioner Chen, why do you want to know that I now, <v Speaker>according to the government, have AIDS? <v Speaker>The data with regards to reporting cases of AIDS was established <v Speaker>back in 1982 83, primarily to keep track of <v Speaker>the infection and the disease experience. <v Speaker>So it's a matter of trying to monitor what's happening in the United <v Speaker>States. <v Speaker>We've got two clinical cases, events, Chris, having <v Speaker>heard your rather depressing message, <v Speaker>has now just reverted or has taken <v Speaker>up what you would have to describe as a promiscuous <v Speaker>lifestyle.

<v Speaker>He is not following the safe sex lecture. <v Speaker>Life's too short. <v Speaker>He would say if you asked him. <v Speaker>He is frequenting places where sexual activity goes on. <v Speaker>Somebody tells you about that, Dr. June. <v Speaker>You get a message? Yes. We've had several of those messages. <v Speaker>What do you do? <v Speaker>It's a very difficult area. <v Speaker>We try initially to counsel with other <v Speaker>individuals who might be basically giving capable of giving peer counseling, <v Speaker>not getting that. <v Speaker>Give me the mechanics of this. <v Speaker>You receive word that Christopher Porter <v Speaker>may be spreading a. <v Speaker>We've tried to get to that person in. <v Speaker>Meaning? That's right.

<v Speaker>Try to call and tell to try to convince the person <v Speaker>that what they're doing is harmful. <v Speaker>Now, if that is not effective, then that we tried to refer that person <v Speaker>to a support group who will also then try to give the same message. <v Speaker>Now, if that fails, then I think we are in deep trouble because <v Speaker>I think, well, I do not have any effective measure at the present time, too. <v Speaker>I'm out there every strictly with my <v Speaker>knee length socks covering the Kaposi's sarcoma. <v Speaker>What are you going to do about me? Christopher Porter on the street. <v Speaker>Night after night, I would then ask the mayor to convene a legal group <v Speaker>to determine what measures we might be able to take in the metropolis <v Speaker>that some health officer has been passed. <v Speaker>Don't you have any authority?

<v Speaker>We have authority to general powers to isolate <v Speaker>an individual, isolate, isolate a quaint euphemism <v Speaker>for one. <v Speaker>That's exactly what it is to isolate. <v Speaker>Would it be fair to say synonymous to quarantine? <v Speaker>No. Quarantine means isolate a person until the symptoms either <v Speaker>come or don't come. So there's a quarantine, the person there's a finite <v Speaker>limit to the isolation. <v Speaker>Oh, so isolation can be longer than. <v Speaker>Absolutely. Like forever? <v Speaker>Absolutely. <v Speaker>For this particular problem, I am going down in history as metropolises <v Speaker>first recalcitrant patient. <v Speaker>You're gonna try and take me into isolation. <v Speaker>I would have to get a court order to place you in isolation. <v Speaker>Yes. <v Speaker>Would you oppose or support that request for a court order if <v Speaker>the facts are as you describe it? <v Speaker>I think we all recognize that in any public health crisis, there is a need to deal

<v Speaker>with that occasional and they are very occasional recalcitrant. <v Speaker>And as long as it is being done in a way that that Christopher has <v Speaker>a right to defend himself and that the state has to go before a judge and prove <v Speaker>that this is necessary. And this is indeed the very last resort <v Speaker>and the only means at their disposal to deal with this issue, then I think it's very hard <v Speaker>to argue against it. What one can argue against is a broad quarantine or isolation power <v Speaker>that that does not go through all the various hoops that should be necessary <v Speaker>before you deprive someone of their individual liberty. <v Speaker>Although the court is smiling at the moment, the brow was <v Speaker>very furrowed. 30 seconds ago. <v Speaker>You've got the health officer. <v Speaker>You've got community groups coming in <v Speaker>and you've got Christopher Porter, who says, I thought this was a free country. <v Speaker>They want to put me into custody.

<v Speaker>He wants to put me in jail. He calls it isolation. <v Speaker>Well, it would depend upon the authority under which he was acting. <v Speaker>If he is exercising what we call police powers, <v Speaker>which permits him to protect the public health <v Speaker>and the authority which confers <v Speaker>the regulation or a law which confers upon him the authority to do what he is doing. <v Speaker>If that has been promulgated was due regard for <v Speaker>the the public health concerns, isn't it? <v Speaker>This authority unconstitutional in a free society? <v Speaker>No, no. <v Speaker>The the powers conferred upon the <v Speaker>state to protect the health and welfare of the <v Speaker>citizen is known as the police power. <v Speaker>And that may be exercised in a reasonable fashion. <v Speaker>Christopher Porter has come out of isolation.

<v Speaker>He has finally gotten the message from various people. <v Speaker>Promises follow safe sex. <v Speaker>I'm lying in bed one night watching television <v Speaker>news. <v Speaker>Spencer brings me a report <v Speaker>about some research being done on a <v Speaker>by Dr. Krim. <v Speaker>Something called a compound K for kripp, <v Speaker>and it appears that some of the early <v Speaker>results show it's stopping the virus. <v Speaker>So I call up Dr. KREM. <v Speaker>Doctor, could you get some of that compound K over here?

<v Speaker>I'm an AIDS victim. <v Speaker>No. <v Speaker>Of course, the first thing that has to be done with a compound like this is <v Speaker>to establish and convincingly that it is indeed effective against <v Speaker>the virus in the laboratory. <v Speaker>First of all, test tubes in animals and heard on it. <v Speaker>I heard on the news tonight that this may stop the virus. <v Speaker>Yes. In that case, do it in animals. <v Speaker>Then the next step is to try whether it is effective in human being. <v Speaker>Well, here I am. OK. <v Speaker>So there there there is an agency that regulates the use of <v Speaker>new drugs in human beings, and that's the Food and Drug Administration. <v Speaker>And it requires a certain amount of information on the drug before allowing <v Speaker>its experimental use in human beings. <v Speaker>May I call you back in a week? Will I be able to get it? <v Speaker>I know it takes longer than that. Few months, maybe a few weeks sometime. <v Speaker>Maybe a few weeks. Yes, I'm dying.

<v Speaker>Well, that unfortunately takes some time. <v Speaker>Mr. Deputy Commissioner, why can't I have come <v Speaker>home? <v Speaker>I'm twenty five. <v Speaker>I'm dying. Do you want to have the last days of your life? <v Speaker>Be more it could take more suffering <v Speaker>to, in fact, contain fewer days, fewer hours, fewer bill ability of <v Speaker>consciousness, of an access to the loved ones of you you <v Speaker>share life with. Now you want just the drug that we give you to to to <v Speaker>cause you harm. <v Speaker>What if it gave more meaning to mail it to my death, to my disease, that if I could feel <v Speaker>even if I died a few weeks sooner by participating in this trial of this drug, <v Speaker>I will have contributed some valuable wild knowledge that could have saved other people's <v Speaker>lives rather than lying in a hospital an extra month and contributing nothing. <v Speaker>I don't agree. I don't just agree with it. I think if we can we can expand the <v Speaker>availability or access to experimental drugs that would be appropriate.

<v Speaker>We have to do so always balancing the the possibility that we will be <v Speaker>doing harm. <v Speaker>Let me assume that risk stop being so damn paternalistic. <v Speaker>We're not being paternalistic in this sense. If we galloped into this some of these <v Speaker>studies, we can tell very quickly a matter of weeks, literally, if the toxicity is a <v Speaker>problem, certainly a matter of months, it's going to be a problem for us to <v Speaker>put you on a drug that's gonna be highly toxic. <v Speaker>It may be promising in other ways, but we'll be highly could be highly toxic to you. <v Speaker>It's not fair to you as well. <v Speaker>But about eight weeks later, he's back in. <v Speaker>Second. <v Speaker>What's my prognosis? Dr. Landsman Very poor, <v Speaker>very poor. <v Speaker>It's getting close, isn't getting close. <v Speaker>How close? <v Speaker>Well, again, you can't predict that with with certainty, but probably one would say six

<v Speaker>months or less expensive. <v Speaker>Highly expensive. How expensive? <v Speaker>Well, estimates are anywhere from 50 to a hundred and forty thousand dollars <v Speaker>overall. <v Speaker>Care for a person from the time of onset of disease to the time of <v Speaker>the time of death in two years time. <v Speaker>Between 70 and 80 percent of the beds in metropolises hospitals <v Speaker>will be occupied by terminal AIDS patients. <v Speaker>Well, in Metropolis, we have taken the position that <v Speaker>there will be acute care for every AIDS <v Speaker>patient. All of our hospitals, municipal and <v Speaker>voluntary, participate. And we estimate that when <v Speaker>Metropolis grows to be a city of 7 1/2 million, the expenditure will be <v Speaker>one hundred and fifty million dollars of <v Speaker>all funds. City, state and federal that we will be

<v Speaker>applying to an estimated AIDS population at that time <v Speaker>of about five or six thousand in just Metropolis. <v Speaker>So we don't think that you have to choose <v Speaker>or must choose between providing the best <v Speaker>medical care for someone who is in acute condition as opposed <v Speaker>to saying we will provide little or no care and we'll take the money and we'll put <v Speaker>it in to research. <v Edward Koch>The reason we think that both are doable is uh that the dollars involved <v Edward Koch>are not so astronomical. <v Arthur Miller>General Koop? <v C. Everett Koop>I think that many times people are critical of uh how little they know <v C. Everett Koop>about AIDS, not realizing how much we know about AIDS in a very <v C. Everett Koop>short time, considering how long we've known about AIDS. <v C. Everett Koop>Uh we've had uh whooping cough with us forever. <v C. Everett Koop>We know much more about AIDS than we do with whooping cough. <v C. Everett Koop>We don't know as much as we'd like to do. <v C. Everett Koop>And therefore, when someone says, what do you know?

<v C. Everett Koop>And we put in a but or an if or an apparently they think we're <v C. Everett Koop>hedging. Uh I really think that the response of the private sector <v C. Everett Koop>and of academia and of the government researchers toward all aspects <v C. Everett Koop>of AIDS has been rather phenomenal for the very short period of time that we've been in <v C. Everett Koop>and ?inaudible?. <v Fred W. Friendly>The tragedy of AIDS poses a tough test for us all. <v Fred W. Friendly>How we manage with AIDS without a cure depends most <v Fred W. Friendly>of all on education, the knowledge of what AIDS is, and what <v Fred W. Friendly>it isn't, and how we can stop it. <v Fred W. Friendly>Next week, we look at medicine and the complicated miracle of birth <v Fred W. Friendly>in a program called Technology Rocks the Cradle. <v Fred W. Friendly>[music plays] <v Narrator 1>Videotapes of the program are available right to Columbia University Seminars

<v Narrator 1>on Media and Society, Graduate School of Journalism, New York, New York <v Narrator 1>1 0 0 2 7. <v Narrator 1>Columbia University Seminars on Media and Society is solely responsible <v Narrator 1>for the content of this program. <v Narrator 2>Funding for this series has been provided by Equicor. <v Narrator 2>Equitable Health Corporation of America, which believes that only by confronting <v Narrator 2>today's health care challenges can we assure tomorrow's miracles. <v Narrator 2>[PBS theme plays]