In plague time, physicians learn firsthand the scale of an epidemic’s tragedy and horror. Less than ten years ago, I walked into the room of James, a young man my age who had a disease researchers were just beginning to call AIDS. Although AIDS appeared to be an infectious disease, the organisms that caused the disease and their method of spreading were still unknown.

I wondered if I might catch AIDS from James; I knew if I did I would die, for it was obvious that whatever caused James’s disease was one of the most virulent organisms I had ever read about or encountered. James’s system of defense against infection was being destroyed. He suffered from weight loss, fever, chronic diarrhea, and multiple infections.

Despite aggressive treatment, James died. Halfway through his hospitalization, when another terminally ill patient with AIDS was admitted to the ward, and then another, it was obvious that AIDS was more than a syndrome. It was a plague, a deadly epidemic disease. I went home every night like an ancient plague doctor, looking in the mirror with wonder because I had somehow escaped the pestilence.

This first encounter with AIDS forced me to make some difficult choices. They are choices we will each soon have to make, because AIDS is no longer confined to a case here or there; AIDS is an epidemic. The choices are really as old as plague itself. They are the choices of the ancient plague doctor and the enraged and baffled medieval citizenry. When finally confronted by plague, we can each choose to desert, to persecute, or to care.

Desertion

In the plague times of the Middle Ages, many Christians—including physicians and clergy—deserted the cities and their poor and dying inhabitants. And in ...

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