San Francisco: Pioneering AIDS Hospital Ward Celebrates First 20 Years

When the world's first AIDS ward opened in San Francisco General Hospital two decades ago, many people thought it was a bad idea. Dr. Mervyn Silverman, director of the San Francisco Department of Public Health at the time, opposed its opening, fearing it would stigmatize patients and become a lonely place of no return. "Fortunately, I was proven completely wrong," said Silverman.

From the moment it opened to widespread publicity, San Francisco's AIDS Ward 5B -- and then the larger Ward 5A, where the unit moved in 1986 -- became both a national symbol of the disease's toll and a global model of compassionate care. "From the day it opened, it took on a life of its own. We knew we were on to something," said Cliff Morrison, clinical coordinator of the unit until 1986. According to Morrison, dealing with an unprecedented disease provided the opportunity to do things differently. At the core of Ward 5A/B was the idea that patients, rather than just doctors and nurses, have a role in planning their care.

Until the AIDS ward opened, explained Morrison, it was common practice for hospitals to exclude all but spouses and next-of-kin from visiting critically ill patients. "Gay partners were not recognized as such," he recalled. "We redefined what a 'family' was." The ward soon became a focus of the epidemic in the gay community, giving life to ideas such as the "community consortium," which pooled public and private clinics to test new drugs.

While UCSF doctors-in-training would come in for a one-month rotation, nurses remained the heart and soul of the ward. "We were the constants," said Steve Keith, one of the original staff nurses, who retired last October and serves as unofficial historian of the unit.

To date, the hospital has recorded 21,500 stays in 5A and 5B. When the epidemic peaked in 1994, the hospital began to treat cancer patients, who have medical issues similar to those of AIDS patients, in the ward. Today, only one patient in three being treated in 5A is an HIV/AIDS patient.

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