“Community Care, Reagan-Era Altruism, and the United States’ First AIDS Ward”
When: Saturday, April 30 @ 3:30 PM
Where: Ballroom 4, Minneapolis Marriot Center City
The talk I will be giving at AAHM 2016 is derived from the second chapter of my dissertation, “A Caring Disease”: Nursing and Patient Advocacy on the United States’ First AIDS Ward, 1983-1985.
As the AIDS crisis unfolded in the early 1980’s, San Francisco General Hospital—which housed 5B, the country’s first AIDS Ward—became a de facto extension of the city’s gay community. While the influx of gay patients and visitors made some SFGH staff members uncomfortable, 5B’s founder recognized that developing this relationship would only improve the quality of his patients’ experience on the unit. He sought out the support of individuals and organizations operating outside the purview of the San Francisco Department of Public Health, and, in many cases, outside the medical establishment completely. The integration of “non-experts” and community-based groups onto the ward destabilized the structures of knowledge and authority on which the nursing profession was (and is) built, but also significantly improved the quality of patient care, saving 5B a tremendous amount in operating costs.
Using the ward’s official records, oral histories, and local and national media coverage, this presentation highlights three different ways the nursing staff integrated “the outside world” onto the ward: the 5B volunteer program, The Shanti Project, and Rita Rocket’s Brunch Bunch. I demonstrate that the nurses’ use of (largely) unpaid labor was one of three major internal contradictions that characterized the unit. Second, because they were politically motivated, these volunteer efforts were dependent on the demographic composition of the ward. Most volunteers worked on 5B as a show of support for the queer community—and disappeared over time, as the patient population became less white, less gay, and less male. Finally, I demonstrate that, while intended as a repudiation of an uncaring federal government, the radical volunteerism that structured ward 5B unintentionally lent support to a community care model being advanced by its political opponents: at this same time, the Reagan administration was calling for altruism to take the place of government services. The tensions and inconsistencies between 5B’s politics and praxis demonstrate that the shared ideology of the nurses who built the country’s first AIDS ward, if crucial to building the ward into a vibrant community space, also made it a space of curious exclusions.
KEY WORDS: AIDS, Community, Nursing
CME LEARNING OBJECTIVES:
- Promote tolerance for ambiguity of theories, the nature of evidence, and the evaluation of appropriate patient care, research, and education
- Recognize the dynamic interrelationship between medicine and society through history
- Acquire a historically nuanced understanding of the organization of the U.S. healthcare system, and of other national health care systems
“The Six Million Dollar Scholar” is the personal blog of Andrea Milne, a Ph.D. candidate in modern U.S. History at the University of California, Irvine. To get the story behind the blog’s name, click here.