There When AIDS Began: An Interview With Michael Gottlieb, M.D.
June 2, 2011
Nelson Vergel: Last, but not least: It's been 30 years. A few of us, like myself, have been positive for over 25 years; we are getting older. In your practice, are you seeing any aging-related issues that seem to be showing up a lot earlier in some of us who have been positive for a while, now that it's more of a manageable disease -- not for all of us, of course, but for some people who have access to treatment?
Michael Gottlieb: Well, you're very young at heart, I know. But in all seriousness: About 20 years ago, I said that my greatest wish was to be able to grow gray with my patients. And it looks like I'm getting it. Yes, there are some issues with HIV, such as earlier onset of coronary artery disease in some patients, osteoporosis related to both HIV and some medication --
Nelson Vergel: Maybe a little cognitive loss.
Michael Gottlieb: Potential cognitive dysfunction. There are some special problems associated with HIV and aging that we have to address aggressively. In my practice, we address blood pressure, smoking cessation and hyperlipidemias [high levels of fat in the blood] aggressively to try to keep our patients as healthy as possible, and we try to reduce the risk of other illnesses causing morbidity.
So the practice of HIV medicine these days is now very much like a general medical practice: not quite gerontology, but with many similarities. We're much more focused on the whole patient and not just the virus.
Nelson Vergel: And by the way, you don't look any older. Actually, you look a lot better. I'm looking at your picture with Elizabeth Taylor from the '80s, when you had a mustache and glasses, big glasses. You actually look better now, 10 years later.
Michael Gottlieb: Thank you, Nelson.
Nelson Vergel: So you may be grayer, but you still have some hair. You still look healthy.
Michael Gottlieb: And I'm not quitting. I'm still very much in the business.
Nelson Vergel: We really need people like you. Is there anything the community can do to support you and doctors like you who have been with us for so long? Sometimes, I don't think we say thank you enough.
Michael Gottlieb: I've had plenty of thanks. Early HIV doctors did what Dr. Paul Farmer calls "making common cause with the sick." We made common cause with our patients. In other words, we basically found ourselves in the early '80s kind of in the same boat as our patients: powerless. And we formed these coalitions of doctors and patients. And you and I still collaborate to move the agenda forward, both medically and politically. It's been just a very rewarding and positive experience for me to do that.
Nelson Vergel: You're one of the best doctor activists that I know. We need more activists from the medical community to support activists that are out there trying to make change happen.
Michael Gottlieb: Well, no. I think we need more activists like you. I think there's this sense, even among AIDS activists -- some AIDS activists, not you -- that we've come far enough, that we have what we want, we have medicine that is going to allow most people here to live a nearly normal life span.
But that's not enough. There are frontiers. There is a frontier for medication and pre-exposure prophylaxis. And there are social issues, like ADAP, that people really should be angrier about, and advocate for.
Nelson Vergel: Definitely. It is no time to be sitting down and assuming everything's OK, because it is not.
We really appreciate your taking a long time with us. Please just know that this community is behind you, supports you; and a lot of us have been following your work since day one. We're lucky to still have somebody like you advocating for better treatments and more access for people like me, living with HIV, both the newly diagnosed and the long-term survivors. Thank you so much for your time today.
Michael Gottlieb: Thank you so much, Nelson.
This transcript has been lightly edited for clarity.
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