At John Peter Smith Hospital in Ft. Worth, Texas, Patti Wetzel is known as the “AIDS Doctor.”
The nickname originated three years ago, when as a 29-year-old resident in family medicine, she helped develop the first in-patient AIDS clinic in the Dallas-Ft. Worth area.
“When I finished my residency, I chose to work exclusively with patients with HIV,” says Wetzel, who subsequently was appointed the hospital’s first director of HIV services.
Before she accepted the new position, Wetzel wondered about the emotional stress from working with 500 HIV patients, people with one of several viruses that cause AIDS. After discussing the pros and cons with her husband, she took the job, primarily because she was appalled at the medical treatment AIDS patients were receiving.
“Doctors would stand at the door of a patient’s room, afraid to get any closer,” Wetzel says. “As doctors, we learn all of this technical stuff, but we’re not being equipped with the social skills necessary to treat people our own age who are on death’s doorstep.”
After only three months on the job, her decision turned tragic. On Sept. 14, 1991, after drawing blood from a person with AIDS, Wetzel was accidently stuck with a contaminated needle.
“Your first thought is `God, how could I have been so stupid?’ ” Wetzel says. “Then there is this sudden surge of fear and frustration.”
But Wetzel maintained hope. According to Centers for Disease Control and Prevention statistics, she had a 1-in-300 chance of contracting the disease.
“All of my co-workers had had needle sticks,” Wetzel says. “The odds were on my side. I was certain things would be fine.”
Things looked better after her initial test came back negative. But standard procedure was for her to repeat the test every three months for a year.
“The next three months were really tough,” says Wetzel, who began experiencing symptoms of HIV infection. But she says, “I convinced myself I was just being paranoid.”
Wetzel’s second test was in December. Her husband, Sirous Partovi, an emergency-room physician at the hospital, was out of town skiing with his brother on the Friday Wetzel gave blood. Using a confidential number assigned to her sample, Wetzel called the hospital’s lab that evening and asked for her test results. The technician, who didn’t realize the blood was Wetzel’s, merely said, “It’s not back yet.”
“I knew what that phrase meant,” says Wetzel.
What it meant was that the blood had tested positive for the HIV antibody. The first screening for HIV, known as the Elisa test, is simple, inexpensive and takes only a few minutes to perform. What her reply meant was that the lab had sent out the sample for the more expensive and reliable Western Blot test used to confirm the positive result. It meant Wetzel probably had the disease.
“This poor lab tech, she couldn’t figure out why I was hysterical on the phone,” Wetzel said. “I just wanted to believe, with any shred of hope, that it wasn’t real.”
Two days later the results were confirmed and Wetzel learned that she had become, according to the CDC, the 29th verified case of a medical worker infected on the job. She couldn’t deny it anymore. “I think, in the back of my mind, I knew it would be positive. I was just coping by hoping it would be something else.”
Then came the hundreds of “if only’s.” If only she had become a musician, as she had planned while in high school at Interlochen Arts Academy in Michigan. If only she had taken up medicine at some clinic in a blighted urban area, as she had promised herself at Northwestern University Medical School in 1988. If only she had not taken the patient’s blood that day.
Yet Wetzel thinks she made the right decisions. As an honors college student and biochemistry research assistant at the University of Chicago in 1982, she knew she wanted to be a doctor.
“I was one of only a few people at the U. of C. who actually said I wanted to be a doctor. There were 300 people in organic chemistry, and only two of us wanted to be doctors.”
After medical school, she realized that working with individuals infected with HIV “was the most gratifying work” of all her training. “It was only when I was forced to deal with HIV as a physician that I learned how to be a good doctor.”
Dealing with her own HIV status took much longer for Wetzel to get used to. For weeks, especially during the ensuing Christmas holiday, she vacillated between numbness and grief. She doesn’t remember much from that period except that she and her husband cried a lot.
Shortly after New Year’s Day, she and her husband went to her parents’ home in Wells, Minn. It was in the tiny farming community where she began her life that Wetzel was able to envision her future.
No sooner had Wetzel walked in the door before her mother knew that something was wrong.
“It’s uncanny the sort of sense moms have,” says Wetzel. “I was so nervous I just wanted to blurt it out. Almost immediately, I sat them down and told them. That was really the toughest part of it all.”
Her parents initially thought that because Wetzel was HIV-infected, she “would be dead tomorrow.” But as the conversation progressed, her parents saw she was still the “same goofy, crazy person” they brought up, and that HIV wasn’t a death certificate. Instead, the family began planning how to spend more time together, and that weekend the four arranged a vacation in Texas.
The homecoming proved cathartic. Wetzel came to believe that “you can’t keep beating yourself into the ground with `if only.’ ” Now she claims everything happened for a reason.
“I started thinking about why this had happened to me, and it became clear that it had to be for a higher purpose.”
After her two-week hiatus, Wetzel returned to work, a decision that was reported in the local papers. She had stopped working at the inpatient clinic but decided to continue with outpatient services until recently. “For me, I couldn’t deal with the death and dying every day. I just couldn’t do it. I knew I had to get away from that situation.”
Both she and her husband regularly talk to a therapist, separately and together. They struggled for a long time to regain their intimacy, a struggle that she believes never will end.
“People think that if you have HIV, you don’t have a need for intimacy, that your need for intimacy goes away,” she says. “My husband and I now feel closer than we ever have. I just feel so lucky to have him. A lot of people in the same situation-married only a year and a half-would have just walked.”
Today, she still calls herself the “AIDS Doctor,” but the name carries a different connotation. It symbolizes her campaign to raise awareness, especially among physicians, that AIDS also is a women’s disease. Her experiences as the “AIDS Doctor” and as a woman with HIV have shown her that the stereotypes about AIDS, that it affects mainly intravenous drug users and homosexual men, are working against women.
“Risk stratification allows people to shun the disease. Too many doctors say they don’t have AIDS patients in their practices. If that were true, there would hardly be a practice in this country with an AIDS victim,” says Wetzel. “I’ve taken to my particular soapbox on that issue-health-care providers are insulating themselves and women are not being diagnosed until they are on death’s doorstep.”
Women currently have the fastest-growing transmission rate, a fact that too few people recognize, Wetzel says.
AIDS is the fifth-leading cause of death for women between 25 and 44 years, according to Wetzel, and the CDC estimates that 1 million Americans are infected, 12 percent of them women.
Wetzel wants more physicians to watch, warn, test and talk to women about AIDS. She says women have four to 10 encounters each year with health-care providers, and these are opportunities to identify infected patients.
“When a woman has recurring yeast infections, most doctors recognize that it could signal diabetes and run the appropriate tests. They should also be recommending an AIDS test,” says Wetzel.
That’s one of the points Wetzel made recently to a group of doctors in Chicago. She gives two to 12 talks a week, coast to coast, to various of organizations. She recently spoke at an Air Force base and at a clinic for American Indians in Oklahoma, at a high school and at a town meeting in Virginia and before a group of insurance executives in Colorado.
In 1992 then-presidential candidate Bill Clinton named her one of 53 Faces of Hope, people he designated as “symbols of humanity.” She attended the president’s inauguration and spoke with him for 20 minutes about AIDS.
“The thing I really wish for is what we already have-the means to get out there and prevent people from contracting the disease,” she says. “I just wish we were doing a better job.”
