Lisa W. Yingling looks the picture of good health. She smiles broadly and often, and pokes fun at AIDS, the disease that is threatening her life.
"Even my husband is totally optimistic," she said. "He says I look well, so I must be well."
Five years ago, with the tiny prick of a needle, this 36-year-old Carroll County nurse went from care giver to carrier of deadly HIV. Now an AIDS patient retired on disability, Ms. Yingling is telling her story to anyone willing to listen. Her husband, who is not infected, supports her efforts, she said.
She seeks compassion for AIDS patients and awareness of the disease that kills one American every 15 minutes.
"I am your next-door neighbor and I have AIDS," Ms. Yingling told a roomful of Carroll Hospice volunteers Tuesday. "I am not the norm for the disease by any means. I had it for four years and didn't even know. You must consider that everyone you see has AIDS and take precautions."
The Manchester resident knows that as a heterosexual married woman who has not used drugs, she doesn't match "everyone's stereotype" for AIDS.
Ms. Yingling contracted the human immunodeficiency virus, ,X which causes acquired immune deficiency syndrome, while she was working on the surgical unit at a Baltimore County hospital. Someone carelessly left a bloody needle in a patient's bed, she said, and it pricked her gloved hand.
She took the recommended blood test for the virus and it came back negative. But she left the hospital in 1990, shortly after the incident, and she said neither she nor the hospital followed up with a second test.
Now, it is standard procedure at most hospitals for anyone exposed to the virus to be tested within 24 hours and retested several times for the next year.
"For four years, I walked around with the virus and never knew it," she told about 40 health care workers at the hospice training session.
"We must all be careful. We really don't know who is infected. This part of my story is important. It should make you consider that everyone in this room [may have] AIDS."
She incurred a second needle stick while she was nursing in a pediatric AIDS unit in Baltimore last year. Again, she was tested for the virus.
"It was just a baseline test, so I figured it would be negative," she said. "It takes at least eight weeks for the virus to show."
But her test immediately came back positive; she was already carrying the virus.
Ms. Yingling said she knew she had no other risk factors and soon realized that she had been infected by the first needle stick. When she recalled how she got a severe case of mononucleosis shortly after the first incident, her doctors became convinced. "Doctors figured I had been positive since ++ the original incident," she said.
In the 13 years that the national Centers for Disease Control and Prevention has collected statistics, it lists 42 documented cases and 88 possible cases of AIDS-infected health care workers who contracted the disease through their work. Nationally, 10,122 health care workers have been identified as having AIDS, the CDC says.
"Needle sticks are frequent, and gloves can't protect you," said Ms. Yingling.
When she volunteered to speak at the hospice training session, she called it her "coming-out party."
"It took me almost a year to talk about it," she said. "Now, I won't stop talking about it."
She told the care givers there to take precautions when handling blood or body fluids. She asked them to add an extra measure of kindness to their nursing skills.
"This disease is not easy to catch," she said. "You can only contract it from contact with body fluids. You can't get it from kissing or hugging."
Immediately after learning her diagnosis last year, Ms. Yingling said, she went to the Carroll County Health Department for help. She said the caseworkers were kind but they offered little solace.
"You can't even get numbers of [AIDS] patients here" in Carroll County, she said. "Probably, most go to Baltimore for treatment."
She had hoped officials at the Health Department could put her in touch with other patients.
"I wanted to talk to someone who was [HIV] positive," she said. "I asked them to give my phone number to other patients. They refused."
She said she has found many AIDS patients on the Internet and has placed her name on computer bulletin boards.
The virus has affected her eyesight and left her with a kind of tunnel vision that prevents her from driving a car. Her doctors do not expect her vision to improve.
Ms. Yingling can no longer work, but has health insurance through her husband's state job. She also was recently diagnosed as having HIV-related encephalopathy, an opportunistic infection associated with AIDS. She garnered a few laughs at the training session when she said, "If you can say encephalopathy, you can't be too sick."
Her illness also disrupts her ability to concentrate. At the training session, she frequently referred to notes to quote statistics from the CDC, which in 1993 named HIV the leading cause of death among people age 25 to 44.
"I know how everyone hates statistics, but one-fifth of all known cases in the U.S. happened in 1994," she said. "That means we are not doing enough to educate people about a disease people don't like to talk about."
In telling her story, Ms. Yingling has cast herself as an activist who's helping to erase the stigma that surrounds the disease. Her own plight generates sympathy; others with AIDS, particularly gay men and intravenous drug users, are not so fortunate, she said.
"We don't condemn people with colon cancer for eating the wrong foods," she said. "Why put labels on AIDS patients? It's not anybody's fault. Let's just concentrate on getting rid of the disease."
Ms. Yingling admits to being "a little uncomfortable" living with AIDS in Carroll County.
"Yes, I am worried what people will think," she said, "but I don't have anything to lose. I have to do something and I can't be afraid to talk about it. Everybody with this disease is dying."
She says her mother, Patricia Silberman, is her rock and staunch ally. When Ms. Silberman learned of her daughter's illness, she ,, retired from her law practice and joined the battle.
"We have no time to do anything but fight," said Ms. Silberman. "Both of us have learned so much. You can't beat your breast and ask, 'Why me?' You have to get to work and fight. You have to learn to manage your own case."
Kathleen A. Bair, director of volunteer services at Carroll Hospice, thanked Ms. Yingling for her courage in giving her talk and for "removing some myths about AIDS."
"It happens to real people right here in Carroll County," said Ms. Bair. "We sometimes think we are insulated and that it can't happen here."
Carroll Hospice, which opened in 1986 to administer to the terminally ill, has had 15 AIDS patients.
"That is [a] regrettable number and not a good average," said Ms. Bair. "Obviously, there are many more [AIDS] patients in the county than those referred to us."
That, said Ms. Yingling, is another sign of the AIDS stigma. She said that when she has told people about her illness, she has encountered two reactions.
"People are either totally accepting or they won't come near you," she said. "You never know how someone will react when you tell them you have AIDS.
"At first, I only told three people -- my husband, my mother and my best friend since childhood. I lost my best friend."
After the training session, the participants lined up to shake Ms. Yingling's hand and offer words of encouragement. Many wrapped her in strong hugs.
"I always wanted to be a nurse," she said. "Despite what has happened, I would do it all over again. And I would still work with AIDS patients."