I’ll Tell No Lies
Physician and TV producer Neal Baer gets real about HIV in drama
by Larry Buhl

Photographed Exclusively for A&U by Sean Black

In 1996, AIDS went from a death sentence to a manageable disease—for many—when the first highly active antiretroviral therapy (HAART) was introduced. Also in 1996 a recurring character on a hit TV drama “came out” as HIV-positive and, in a first, was living with the disease, not dying from it.

Jeanie Boulet, played by Gloria Reuben, was introduced toward the end of season one as a physician assistant and budding love interest of Dr. Peter Benton, played by Eriq La Salle. The writers and producers of ER quickly saw new paths for her character to take. Those paths required her to have HIV.

ER writer/producer Neal Baer told me that being a physician helped drive his interest in exploring Jeanie Boulet as a fully rounded person who happened to be living with the virus.

“I think [HIV] helped tell more stories more deeply about her character. You want to deal with the complexities of the disease and I think we did that.”

More than twenty years later, Jeanie Boulet remains one of a tiny number of regular characters in American TV history with HIV but not on death’s door.

Baer, who is also a doctor, recalled that in 1996 there hadn’t been a major character on primetime TV who was living and healthy with HIV.

Jeanie Boulet evolved as treatment was evolving, Baer said. “I went to medical school from ’91 to ’96 and was able to see the profound change in treatment options for patients. The Lazarus effect was real.”

Baer was a fourth-year medical student at Harvard when childhood friend John Wells sent him a movie script Michael Crichton wrote in 1969. Wells was attached to adapt the script and create a TV pilot that would become the series ER.

“When I read [Crichton’s] script I thought it was like my life, except that it was outdated in its details,” Baer said. Wells asked him to supply notes and then come to L.A. for several months to break stories. After two seasons Baer was bumped up to co-producer and stayed on for four more seasons, using his experience behind the stethoscope to get the medical issues right, and using his passion for social issues to push the envelope on HIV awareness.

Changing hearts and minds
A long-running megahit like ER can be, and was, a powerful conduit for educating and informing the public, with key issues and messages embedded in the scenes. From how a character contracted HIV, to how an employment case is handled, to how nurses treat spilled blood, every issue had to be considered for accuracy and social impact, Baer said.
For four seasons the Jeanie Boulet storyline exposed millions of primetime viewers to issues people with HIV faced and are still facing. Through several storylines, Boulet faced dating while positive and adopting a child with pediatric AIDS. A plot point about getting HIV-infected blood on the skin educated a fearful public about how the virus is transmitted and how it isn’t.

But Boulet wasn’t just put there to be the “HIV character.” Her issues around HIV were woven carefully into storylines, so the writers could gently shift viewers’ prejudices and misconceptions.

One episode from the third season, “Ask Me No Questions, I’ll Tell You No Lies,” involves privacy issues about Boulet’s HIV status as a healthcare provider after another doctor views her file. The storyline played out over several episodes.

Giving HIV to a heterosexual, African American female character was groundbreaking because it dispelled the notion that HIV/AIDS was something only for white, gay men. Just as significant was the fact HIV didn’t define the character. Jeanie Boulet returned to the show years later, in 2008, still living a healthy, if still complicated, life with HIV.
“[Gloria] portrayed Boulet with honesty and with dignity and that’s what we wanted,” Baer said. “Back in 1996 people had lots of apprehension (about HIV/AIDS) and were misinformed. They believed it could be contracted by ways that we knew weren’t true, through daily interactions. Through Jeanie Boulet the show was able to challenge the status quo.”

Boulet’s relationship with her husband, Al, and their ultimate divorce, attacked several misconceptions about HIV transmission as part of her story arc. In one episode Al, who was HIV-positive, came into the ER with a construction injury and he bled on his best friend. The medical staff was compelled to tell the best friend to get tested for HIV, even though transmission was unlikely.

“When they end up at a bar later that night, Al and his friend get into a fight, and Al’s friend asks, ‘Did you get it in the vein or in the booty?’ That line was quite bold for the time, and I don’t even know we could say that now,” Baer recalls. “That epitomizes the anger he had toward Al and the stereotyping and viciousness.”

Baer laments that the show didn’t get everything right. The writers decided that Al Boulet’s character contracted HIV from sex with a woman, instead of more common ways, such as IV drug use or having unprotected sex with a man. Viewers noticed this misstep and they let Baer and the other producers know.

“It wasn’t the way men in the U.S. contracted HIV,” Baer told me. “Bottom line, we didn’t want to say Al was gay. I don’t think that would be an issue if we did it today. I was in the closet then too, so I knew what it was like.”

There’s evidence that Americans really can boost their medical knowledge through TV. In 2000, the Kaiser Family Foundation (KFF) released a survey charting how much ER viewers learned about the human papilloma virus (HPV) just from watching the show. In one scene nurse Carol Hathaway counseled a teenager and explained that unprotected sex could transmit HPV and HPV could lead to cervical cancer. The scene was about a minute long. KFF sampled regular ER viewers one week before, one week after, and six weeks after the episode. The proportion of viewers who said they had heard of HPV nearly doubled in the week after the episode aired, from twenty-four to forty-seven percent of regular viewers. The number who could correctly define HPV and who were aware of its link to cervical cancer tripled.

Baer left ER after the seventh season and in 2001 he was hired as executive producer and showrunner for Law & Order: Special Victims Unit. On that show he tackled more issues about HIV, including criminalization and whether parents should get their children tested for HIV. In a 2008 episode, “Retro,” the show put actor Martin Mull on the stand, portraying a homeopathic doctor who deterred patients with HIV from taking antiviral medications.

Unlike ER, Law and Order: SVU did explore the issue of men “on the downlow.” It was no coincidence that in an episode titled “Lowdown” Baer hired the actor who’d played Al Boulet, Michael Beach, to portray a sports agent who contracted HIV from sex with a man and subsequently infected his wife.

“This episode was my mea culpa for Al Boulet on ER,” Baer said. “I wanted to finally address the issue honestly.”

ER script page from “Ask Me No Questions, I’ll Tell You No Lies” Season 3, Ep 9. Teleplay by Barbara Hall, Story by Neal Baer & Lydia Woodward. Courtesy of the Writers Guild Foundation Library

HIV/AIDS goes back into the closet
In some ways the characters of Gloria and Al Boulet represented a high water mark for using drama to enlighten the public about HIV. Despite the now-cancelled Looking, and How to Get Away With Murder, there have been no recent primetime series with major characters who are HIV-positive.

Baer told me that TV could be doing a lot more today to share the reality of HIV/AIDS now.

“The statistics tell a tragic story that hasn’t been told well on TV. That is, only thirty percent of those with HIV are fully treated with their viral load suppressed. And that it’s a disease still striking young people and men and women of color.”

Baer adds that HIV stigma in the gay community could be addressed on TV. “If you go on the dating apps you will find people looking for someone who’s ‘clean’ and other pejorative terms and that shows there is still a lot of misinformation about HIV.”

It’s possible Baer will explore some of those issues on an upcoming show. 20th Century Fox recently purchased a medical drama Baer created, The Beast, for the 2017–2018 season.
More than one way to save lives

Though he’s best known for his writing and producing credits, Neal Baer never left medicine. Baer never considered medicine and television an either/or thing. Before he went to med school, he had been a directing fellow at the American Film Institute. One of his first jobs in the business was to write and direct an afterschool special on STD transmission, “Private Affairs.”

In reading his bio, one is likely to respond by wondering how he’s had the time for everything. Baer actually finished medical school while on staff of ER, studying on hiatuses and on weekends. He completed his medical internship and residency at Children’s Hospital in the late nineties during breaks in filming ER.

Baer doesn’t see patients now, but he does maintain an academic appointment at the UCLA School of Public Health, where he works on obesity prevention and HIV prevention.
And Baer’s commitment to telling HIV/AIDS stories goes beyond the boundaries of the U.S.

As a member of Venice Arts, Baer has been instrumental in an initiative to provide training in filmmaking and photography for kids from low-income homes in Los Angeles. That initiative was extended to Mozambique and South Africa, where mothers with HIV or AIDS and AIDS orphans were given cameras to document their lives. Some of those photos ended up in a documentary film, Home is Where You Find It, made by seventeen-year-old Alcides Soares, whose parents died of AIDS.

As with his work on TV, the documentaries in Africa integrate information into moving stories without being didactic.

“As a writer I try to tell the best story I can,” Baer said. “So you don’t put the brakes on and have a character say, point one, point two. You integrate important information and statistics as naturally as they would come up in a conversation.”

Larry Buhl is a radio news reporter, screenwriter, and novelist living in Los Angeles. Follow him on Twitter @LarryBuhl. He interviewed Jenna Ortega for the May cover story.