A Human Touch
Some of the Stars of a New Documentary, 5B—Cliff Morrison, Alison Moed, Guy Vanderberg, Harry Breaux and Others—Tell A&U’s Hank Trout How Something as Simple as Compassion Improved the Lives of People with AIDS
Photographed Exclusively for A&U by Michael Kerner Photography
The last time I was in Ward 5B at San Francisco General Hospital, I was there to visit my friend Lon. He and I had met a couple years earlier through our mutual love of wrestling. Lon was barely recognizable when I entered his room. His powerful barrel-chested body had shrunk. His collar bones stuck out, his cheeks were hollowed out, his eyes were sunken back into his head. He heard me come in and gave me a half-smile, the most he could muster. Lon couldn’t speak much because it hurt and it also depleted his scant energy and the little oxygen he could get into his lungs. I read to him, told him what was going on with mutual friends, and tried to engage him as much as possible.
Before I left his room, I reached down and touched his hand. He flinched and jerked his hand away from me—simply being touched was too painful for him. I left his room shortly afterward, doubtful that I would ever see him alive again.
San Francisco General Hospital’s Ward 5B was the first-in-the-world hospital ward dedicated to caring for AIDS patients. Built in 1983 in response to the rapidly growing number of patients with AIDS, the care practices developed in Ward 5B, practices based in humanity, compassion and holistic well-being, quickly became the international standard for HIV/AIDS care. Physicians, nurses, and others came to San Francisco from around the world to study the care practices at 5B. In the twenty years that Ward 5B existed, the ward’s courageous nurses, doctors, and staff treated thousands of AIDS patients with compassion and selflessness, without fear, despite horrible, crushing odds.
Commemorating the incredible work of the nurses, doctors, and staff of Ward 5B who took extraordinary actions to comfort, protect, and care for their patients, award-winning filmmakers Dan Krauss and Paul Haggis have made an inspirational documentary, 5B. The twice Academy Award-nominated Krauss said in a prepared statement, “I was a ten-year-old boy living in a suburb of San Francisco when the events in this film took place. Like many, I had no inkling of the courageous battles being fought in the name of compassion and care just a short distance away…. The opportunity to share this little-known episode of history now—thirty-five years later—is an extraordinary honor.” He and Haggis have crafted an extraordinary documentary. Krauss spent years researching the Ward and interviewing many of the nurses and patients, and others, in 5B, enabling them to tell the story of 5B in their own, eloquent, often gut-wrenching words.
“I was always so proud of the staff who always conducted themselves as true caring professionals. The Shanti Counseling staff were phenomenal and provided so much support for patients, their ‘families’ and us as the staff. We supported each other and it felt wonderful! There was a common bond and commitment and it bound us all together.”—Cliff Morrison
Cliff Morrison became SFGH’s hospital AIDS Coordinator in 1982, consulting with nurses, doctors and other staff and coordinating AIDS patients’ care. He told A&U that with the crush of new AIDS patients at SFGH, there had already been discussions about setting up a specialized AIDS care ward, but those discussions had been held “for all the wrong reasons, i.e. to separate, isolate and protect other patients and staff. I did not want to participate in anything like that.” Instead, as the number of patients continued to balloon, Cliff started thinking about setting up an AIDS ward for the right reasons, “to centralize care, increase the quality of care by having staff that wanted to care for the patients and have an environment of inclusion and participation by patients in their own care.” Considering the fear that surrounded HIV/AIDS at the time, this was a revolutionary concept.
Revolutionary, indeed. In those earliest years of the epidemic, because of the ignorance and stigma that surrounded HIV/AIDS, most hospital care for HIV patients—when it could be gotten at all, with doctors and nurses refusing even to touch HIV patients, let alone treat them—was practically medieval. Practitioners dressing in protective gear that looked like scary NASA rejects; nurses and orderlies refusing to change the patients’ bed linens; nurses insisting on wearing two or three pairs of protective gloves before inserting an I.V. or drawing blood; patients shoved unnecessarily into cold, lonely biohazard isolation rooms; orderlies leaving trays of food outside the patients’ doors, to get cold and useless; staff refusing to let any non-immediate family members visit, which often kept friends and lovers away from patients’ bedsides. Patients often were treated worse than lepers.
That was not the kind of “care” that Cliff envisioned for HIV/AIDS patients; not the kind of care he wanted to give.
Surprisingly, when Cliff began talking about a unit as he envisioned it, “There was a lot of positive response from patients, their family, friends, significant others and some staff.” He sought out input from staff whom he had identified as good care providers. Although the SFGH administration was hesitant about the unit and although some nurses and other staff were indifferent to the idea or ignored it altogether, patients and their families were supportive right away, and the patients themselves became Cliff’s primary consultants in setting up the unit.
A small number of nurses were extremely eager to work in the ward. Cliff recruited the twelve nurses he needed to staff the unit from within SFGH staff, and a couple came from outside agencies. Of course, given the times, there was a lot of negativity around the Ward. Many of the nurses reported being harassed and even receiving death threats. Cliff himself was threatened—“[you’ll] never be able to work anywhere else again, etc.” — but he was never threatened with physical harm. He advised staff “to have proper support and protection and if in their gut they felt they were in danger to contact law enforcement immediately. Some staff always had escorts and some did carry some sort of protection.” All because they worked with AIDS patients.
Also threatened was entertainer Rita Rockett. For years, Rita and her friends visited AIDS patients at SFGH and performed for them. They also brought food and goodies to share with the patients. After a while, her Sunday brunches in the Ward became a regular feature of patient care. Rita and friends tap-danced their way into many hearts in those days.
“We had the opportunity there to create together a model of care for AIDS patients that crossed disciplines to provide acceptance, inclusion of loved ones, advocacy, education, and state-of-the-art care, as well as coordination with community resources to ensure planning so that patients would have follow-up and support when discharged. 5B/5A truly was a labor of love. I was proud to be a nurse there and always will be.”—Alison Moed
Alison Moed was Nurse Manager of the Ward. Asked about staffing problems, Alison told A&U, “I found indeed that there were more nurses eager to work on the unit than I had positions to fill. Even though they might have been committed to a regular position on another unit within the hospital, they would sign on as per diem staff.” Although most of the staff who volunteered were straight, “there was definitely a strong and stated motivation on the part of gay and lesbian staff to take care of their own, as patients with HIV infection were often isolated, ignored and subjected to undue infection control precautions that created further isolation.” Fortuitously, Alison never received any of the threats that other nurses received; she was aware of the threats, but “I personally did not feel externally threatened.”
At a time when most AIDS care involved nurses doubling up on their protective gloves, patients being put unnecessarily into isolation units, doctors in protective garb that resembled space suits, caregivers wearing masks and goggles, and many healthcare givers refusing even to touch their AIDS patients, Ward 5B took an entirely different approach. No more space suits, no more isolation rooms. Many of the nurses even eschewed wearing gloves when bathing or changing a patient or even when drawing blood or inserting an I.V. Staff were convinced that this “human touch” was essential to the compassionate care they were giving. “I am particularly proud of the whole ‘touch’ phenomenon,” Cliff told A&U. “From the beginning, it set the stage for everything, acceptance, caring, contact, etc.”
Given the demographics of San Francisco and the huge number of patients who passed through Ward 5B, it was almost inevitable that nurses there would find themselves treating a friend, a neighbor. Alison reported having treated only one friend in her years there—“my friend Merry E. Because I knew she was getting sicker and that hospitalization was inevitable, it was actually a relief that when she needed inpatient care, we were there for her. Though I was a nurse manager at that point and not caring for her directly, it soothed me to know that she was receiving care from loving hands.” Since Cliff is himself a gay man, it was perhaps to be expected that he would know several patients before they became patients. “Almost from the beginning, I knew many of the patients and took care of many friends, and colleagues, on the unit. Including several very close friends who were treated and died on the unit. It was extremely challenging and difficult.” Alison added that there were also “patients I had grown to know and care for after repeated hospitalizations were admitted to the unit to die, it was my honor to care for them. Was this difficult? Yes, it was a heartbreak but at the same time very important to know that we could ensure an environment of peace, acceptance and good care,” a sentiment that Cliff echoed.
“Everyone can do something [about AIDS]. Nurses, doctors, social workers, volunteers, family members, loved ones. We can’t wait for a leader, a policy, or for the perfect presidential candidate. We know what to do. It is right in front of us. All we have to do is get started. To start doing. To talk to each other. To keep learning and getting better at it.”—Guy Vandenberg
Guy Vandenberg, a nurse who worked on the unit after it moved to Ward 5A, recalled that caring for men whom he knew outside the hospital was “a common occurrence.” This was difficult, he admitted, but “it was actually easier when I started working at 5A, because from the mid-to-late-1990s (with the onset of ART) we started seeing people get better.” Guy remembered that “The most difficult time for me, however, came when my husband Steve got sick with AIDS in 1998 and almost died of Immune Reconstitution Inflammatory Syndrome in 1999.” Steve was on Ward 5A for months, much of that time in a coma from inflammation and swelling of his brain. “At some point,” Guy said, “he was started on steroids, and he started recovering almost instantly. It took another year for him to learn how to walk and talk again, but he made a full recovery. Had he not been at Ward 5A,… I am sure he would not be alive today.”
One thing that set Ward 5B apart from the rest of SFGH was the Ward’s compassionate visitation policies. Like many hospitals, SFGH’s visitation policy limited visits to family members only. But not 5B. Recognizing the extraordinary emotional needs of the patients, the Ward opened visitation to friends, partners, any anyone who wanted to visit. Activist and long-term AIDS survivor Harry Breaux says in the film, “It didn’t matter if you were family or not. If you wanted to get in to visit someone, you got in!” Although Harry was never hospitalized in Ward 5B, he has high praise for the staff and caregivers there. After Harry moved back to San Francisco, in late 1981-1982, “A friend called and left a message on my answering machine that a friend had died in General of a strange disease. It prompted me to sign up and take the Shanti Volunteer Training for emotional support.” In addition to taking care of his ill roommate, Harry took on two clients at 5B. Both clients eventually, inevitably, died. Undeterred, Harry has continued his volunteer work with valiant dedication.
Among the testimony that the filmmakers captured in “5B” are remarks from Mary Magee, a former Ward 5B nurse who, together with her union, Service Employees International Union (SEIU), fought for safer-needle legislation to ensure the safety of healthcare workers by reducing the occupational transmission of bloodborne illnesses. Former news reporter and CBS-SF news anchor Hank Plante, recipient of the George Foster Peabody Award for journalism and multiple Emmy Awards, recalls the frustration and incredible sadness of covering the AIDS epidemic, especially in the early years, and has high praise for the service provided at Ward 5B. Guy Vandenburg, a native of Amsterdam, moved to San Francisco in 1985 and began working at a hospice. He decided to change careers and went to nursing school. Afterward, he got more deeply involved in hospice and received many patients from Ward 5B. He still works as a nurse in the outpatient unit at SFGH. Harry Breaux’s partner and fellow activist George Kelly recalls the anger and chaos and frustrations of the time and adds his voice to the chorus of praise for Ward 5B.
As AIDS became more manageable and not necessarily a death sentence, Ward 5B was closed in 2003 and its functions absorbed into an oncology unit in the hospital. “I was very happy when care began to become integrated around the hospital.”
Kudos for a job well done.
Asked if he had mixed emotions about the closing of Ward 5B, Guy Vandenberg said, “When it closed, I felt a sense of loss. I still work at SFGH but now at the outpatient HIV Clinic (Ward 86), and I often visit our patients who are in the hospital. I am always happy when I see that so much of the things that were considered revolutionary in the 1980s and 1990s are now standard practice. Patients and their loved ones are much more involved in their care plans.
“At the same time,” Guy continued, “it is undeniable that something was lost. The culture of 5B /5A was unique. There was a tight bond. There were parties, there was Rita Rocket and her Brunch Bunch, there was a lot of celebration of life amid all of the illness and death. There was a sense that we were in this together, and an awareness that we may not always have the support of other healthcare professionals, or middle management, but that we had an obligation to see it through.”
The documentary screened at the 2019 Cannes Film Festival, where it was awarded the Grand Prix. After showing in theaters around the country, it is now available on video-on-demand. I first watched the documentary at the Castro Theatre here in San Francisco in June. I’d be shocked if there were even one dry eye in the theater. Although it is an emotional roller coaster, bittersweet and candid, 5B is an absolutely essential addition to AIDS history as well as LGBTQ history and certainly required viewing for anyone who wants to understand part of what the earliest days of the AIDS epidemic were like and the courageous women and men who responded to them. Bring tissues.
After I left Lon’s room, I leaned up against the wall near his door and began quietly sobbing. A male nurse approached me and put his hand consolingly on my shoulder.
“He isn’t going to make it, is he?” I asked.
“None of them do,” he sadly replied.
Thank you to a great team!
Makeup: Mikal Sky, mikalsky.com
Lighting assistant: Coda McCaffrey
Production assistants: Anthony Fennell and Kenneth Berard
Special thanks to SF Catalyst.
For more information about the photographer, visit: kernercreative.com.
For more info about the film, visit: www.5bfilm.com.
Hank Trout, Senior Editor, edited Drummer, Malebox, and Folsom magazines in the early 1980s. A long-term survivor of HIV/AIDS (diagnosed in 1989), he is a forty-year resident of San Francisco, where he lives with his husband Rick. Follow him on Twitter @HankTroutWriter.