A Doctor’s Journey through the AIDS Crisis
Ross A. Slotten, MD
University of Chicago Press
Reviewed by Hank Trout
In 1992, a commissioner on the Chicago Board of Health “informed me that no one had signed more death certificates in Chicago than I had,” Ross A. Slotten, MD, writes in his new memoir, Plague Years: A Doctor’s Journey through the AIDS Crisis.
That grim statistic sank into some dark hole of my consciousness during the day, surfacing at the most vulnerable moments, in the middle of the night, when sleeplessness unknitted the tightly woven sleeve of care.
Trained as a family physician, a “birth-to-death” caregiver, Slotten finished his residency in 1984, just three years after the first reports of what became known as AIDS. Although he was not an infectious disease specialist, his unique position as a gay man treating primarily other gay men in a large urban setting led Slotten to become one of the early pioneers of HIV/AIDS treatment, beloved by patients, revered by other experts. Since the events in his memoir occur before the advent of HAART in 1996, nearly all of Slotten’s HIV/AIDS patients died the kind of horrible death many of us have witnessed, leading Slotten to refer to himself as “a grim reaper gripping a stethoscope instead of a scythe.”
Plague Years is unique among the other doctors’ memoirs of the AIDS crisis that I’ve read in that Slotten freely discusses the psychological and emotional effects on himself of his practice. At one point in 1991, during the peak of AIDS deaths in the U.S., Slotten examines his perceived callousness when a young doctor telephones him early in the morning to tell him that another of his patients has died. “Although I feigned surprise,” he writes, “I couldn’t feign sorrow. Another death from AIDS—by now so commonplace for me that a week without a death was an anomaly.” He frets about the effect of his career on his personal relationships, especially after one partner abruptly leaves him after twenty-four years together. And although he greatly admires the activists of ACT UP and other groups, he laments that he cannot join in. “I couldn’t be a doctor caring for hundreds of HIV-infected patients and an activist protesting in the streets or lobbying politicians….I had to choose my battles. Treating patients was my greatest strength.”
The concluding chapters of Slotten’s memoir occur after the 1996 advent of the HAART “cocktail” (the AZT-Norvir-Crixivan combination so many of us began taking). As his patients begin living with HIV instead of dying with AIDS, Slotten describes with affection and compassion the “Lazarus effect” on patients who earlier were close to death. He describes his sense of relief as his practice comes to resemble a typical family physician’s practice and not primarily an AIDS practice. He writes, “If I never see another patient with full-blown AIDS again… I’ll have absolutely no regrets.”
Plague Years is a thoroughly enjoyable, plainspoken, well written, unique glimpse into the life of a prominent in-the-field physician who has cared for HIV/AIDS patients since the very beginning of the pandemic. Slotten writes honestly, lovingly, movingly, about some of his patients and his relationship with them, from the unique perspective of a young gay doctor treating young but dying gay men. His memoir is a valuable and most welcome contribution to HIV/AIDS history.
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.