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The placebo effect


Boston -- WHITE HOUSE doctors are concerned that George and Barbara Bush have Graves' disease.

The Secret Service was dispatched to find how much iodine and lithium is in the drinking water at the White House, Bush's residences in Kennebunkport, Me., and Camp David, Md., and his former vice- presidential home at the Naval Observatory.

"Prudence," said presidential spokesman Marlin Fitzwater, "dictates that all such possibilities be examined."

Graves' disease is an autoimmune disorder in which the body's natural defense systems attack themselves. It allows the thyroid gland to produce too much of the hormone that controls body metabolism. The disease recently gave Bush an irregular heartbeat.

Bush's doctors and most outside medical observers do not think there could be enough iodine and lithium in the Bushes' water to cause their thyroids to malfunction.

Dr. Basil Rapoport of the University of San Francisco was quoted as saying, "It's a wild-goose chase."

Given the same predicament and resources, we, too, would be testing our tap water. At the same time, Bush's diligent, long-shot search for medical evidence contrasts sharply with his unscientific paranoia on AIDS.

The day after the water testing was announced, the Bush administration put off a plan to let foreign travelers infected with HIV enter the United States. The prohibition against foreigners infected with HIV, the human immunodeficiency virus that causes AIDS, began in 1987.

The ban was inspired by Sen. Jesse (AIDS is spread by immorality) Helms, R-N.C. It was implemented without a shred of scientific proof to suggest that a traveler with HIV is a risk. AIDS is not transmitted by casual contact.

This puts the United States in the same phobic league as 17 other countries, including South Africa and Iraq, that ban infected travelers. The ban was so offensive that many AIDS activists and mainstream health organizations boycotted the international AIDS conference last year in San Francisco. Harvard University, host of next year's conference, has made noises about withdrawing if the policy is not changed.

Health and Human Services Secretary Louis W. Sullivan, more in touch with medical reality than Helms, proposed in January that the ban be dropped. The ban would have ended Saturday.

"This policy will bring us in line with best medical thinking, here and abroad," Sullivan said then.

The best medical thinking has thus far been no match for White House excuses. The administration has extended the ban 60 days. It now wonders if long-term visitors with HIV will tax the U.S. health-care system.

If taxing hospitals is the concern, then why not add heart disease and cancer to the list? Sullivan's office estimates that without the ban, perhaps 600 to 800 visitors infected with HIV will enter the United States each year and become permanent residents.

That is nothing compared to the one million U.S. citizens estimated to be infected. Formerly stereotyped as a disease of gay men, AIDS is spreading among women. Most have neither the income nor the health insurance for anti-AIDS drugs.

On average, white gay men live up to two years after diagnosis. On average, women with AIDS live up to six months after diagnosis.

That impending explosion is a much larger threat to our health-care system than foreign visitors.

Yet it is relatively ignored, because it means addressing overall conditions that weaken the resistance against risky behavior.

Instead, we divert ourselves on one-in-a-million AIDS tragedies involving blood transfusions or infected health-care workers.

For Graves' disease, Bush is on a search for bad water that most scientists say is futile. Marilyn Quayle, wife of Vice President Dan Quayle, said, "They're going to do many studies and, I think, relieve a lot of people's minds."

For travelers with HIV, no mountain of studies has caused Bush to relieve useless fears. He has ignored his own health secretary.

Prudence has not yet dictated a thorough examination, with answers based on common sense. All Bush has to show for his research is a scarlet letter.

Derrick Z. Jackson is a columnist for the Boston Globe.

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