AS A FREQUENT visitor to medical clinics, I think it's safe to say that few can match the despair and detachment found in the waiting room of the Moore Clinic at Johns Hopkins Hospital's AIDS outpatient program.
Those who frequent the clinic, like myself, have some of the most complicated cases of HIV infection in the area. Many patients are there to participate in clinical trials of drugs.
In the Moore Clinic's waiting room, there is a deadly silence -- as, ironically, it's silence that permits the disease to spread throughout the world. Typically, four or five patients sit fidgeting, sometimes accompanied by a loved one but often alone, waiting for a report from a doctor who could bring good news but more often doesn't.
There are usually more men than women, but all races and ethnic groups are represented.
On a recent visit I met Wanda, 32. She doesn't appear to be sick. Wanda, diagnosed with the virus in 1989, has been coming to the Moore Clinic for a year. Her husband, who died from AIDS last November, referred Wanda to the clinic when she came down with PCP pneumonia.
"I still go through that emotional thing," she said. "To have my husband die from the disease so soon after we discovered how " thoroughly our lives were entwined with each other. We were sick for a very long time and didn't know it."
Wanda took AZT for about two months before doctors switched her to another drug that's believed to help ward off symptoms of AIDS. Both caused severe reactions in her and had to be discontinued. "I don't take the artificial medicine, but I do take the spiritual medicine offered here at the clinic."
When questioned, Wanda went on to explain, in her profoundly abstract way of explaining things, that she gets a lot of help from just coming to the Moore Clinic.
"Sometimes I get so lonely. The doctors and nurses, though, respond quickly to my phone calls, whether I'm feeling ill or not."
I, too, express my feelings to the Moore Clinic staff. A lot of times mine are feelings of frustration over the drug-trials process. After being poked with so many needles and ingesting so many drugs that you leave feeling sicker and weaker than before, I get angry and paranoid about the trials.
One person at the Moore Clinic who often hears my frustration is Eileen Wiggins, who works for an organization that recruits volunteers for drug trials. Although she knows many patients view her with suspicion, she continues because she feels she's on a mission -- to help find a cure for AIDS.
She also helps people with AIDS get treatment that can help them live longer, more productive lives.
"Sometimes when you wait until you are sick before you see doctor, you don't get to return home. You leave the hospital and go straight to the grave. In clinical trials, we treat and teach against that," she said.
"We are the front line for primary care. We don't just test drugs on people. We do everything within our power to make sure the drug is safe and we make sure the doctors are aware of a patient's need for things like a flu shot, transfusions, dermatology, psychological help and nutrition. We teach the patient to be vigilant about such needs as well. Many times the patient develops needs that would not have been necessary if cared for earlier."
Perhaps Wanda put it all in perspective when she said: "I associate with a more positive crowd now. The staff at the Moore Clinic is part of that crowd. I can come for my check-up, or I can come here simply because I want to feel safe. It does something good for you when you see people fighting so hard to destroy a deadly disease that blocks their path. This thing wounds the spirit, too, you know."
H.B. Johnson Jr., a playwright and poet, writes occasionally on living with AIDS.