Knowing he had AIDS, I'd go to Dr. Almaraz today


I KNEW Rudy Almaraz, the Johns Hopkins surgeon who died of AIDS. I knew him not as a patient, not as a colleague, but as a friend's rescuer.

It started one afternoon when a young unmarried friend, terrified by a lump in her breast, came to my office in tears. She had been living with the implicit dread of cancer for more than a week. A general surgeon had recommended a mastectomy. Frightened, she hurriedly consulted a preeminent surgical oncologist who had just told her he would have to remove her right breast. Distraught, she stopped by to share her panic.

Not so fast, I thought. There must be something else to do, someone else to see. She was, after all, only 30 years old, hardly old enough to disfigure her body, damage her self-image and disrupt her intimate life without more research, without at least considering alternatives.

I remembered a specialist who had been mentioned by a neighbor of mine who is also a physician. The specialist's name was Rudolph Almaraz. I looked up his private office number, dialed, and he answered his own phone. I related the story of youth and fear, prior diagnoses and urgency, and asked if he could schedule a time to see my friend. He told me to bring her right over. It was 5:30 p.m.

We went; he came out and shook hands, his back very straight, his thick curly hair piled above an extremely handsome, wide-eyed, smiling face. Then he and my friend went into his office. For 90 minutes, until well past 7 p.m., I waited outside. For 90 minutes he comforted and reassured her.

Surgery was scheduled, and a tiny chunk of breast was removed. Then the breast was neatly and invisibly sewn together. He asked if, for support, she would like names of others who had had similar bouts with breast cancer. Later, after a series of follow-up visits, he asked if he could refer her to future patients who might want someone to share the terrifying confrontation with cancer. Her experience would be particularly valuable for other young patients, he said.

When Blue Cross paid only 40 percent of the bill, Almaraz waived the balance. He was the only doctor she saw who did so.

Some months later, my office was moved into his building, one floor above his suite. I would see him in the lobby and in the elevator. He was always courteous, approachable, smiling. We'd exchange small pleasantries . . . the heating, the cooling, the parking. There was gossip that he was treating patients with national celebrity, and he'd confirm it with obvious relish. When my physician-neighbor who had referred me to him got married, Almaraz and I rejoiced together.

He was a complex person who "lived his life in private departments," my recovered young friend said when news of his death became public. Now she feels "sad and complicated" about the moral implications of the doctor's decisions to continue serving his patients and then to leave his practice without notifying them of his illness. Part of the anger many are expressing, she thinks, is directed more at the terrifying illness of cancer than at the physician. After all, there is no one else to blame.

If Alvaraz were alive today, even if I knew what I now know, he would still be my physician if I thought I had trouble. There would an element of the unknown, though I believe my chances of contracting AIDS would be minimal. What I would know, though, would be his superb expertise, sensitivity and dedication.

My friend's story was repeated about 1,800 times. That's how I prefer to remember Almaraz rather than to defame him -- when he isn't here to defend himself -- for choices made in his private torment.

Ghita Levine writes from Baltimore.


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