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Harden: What about any effects on your personal life? I believe that your wife has been involved with AIDS as well.
Henderson: That is right.
Harden: Do you have children?
Henderson: We have children.
Harden: How old are they now?
Henderson: We have two sons, one is 19 and one is 16, and one daughter, soon to be 6.
Harden: We have heard from some people, especially those who had teenagers, that in 1985-1986, when the hysteria about AIDS was at its peak, that they felt some pressure. Their kids did not want their friends to know that their parents worked on AIDS.
Henderson: That is fascinating, because it is my impression that my kids liked it that I worked on AIDS. They asked me to come to their schools to talk about the disease. Because I talked about risk, that provided a reasonable approach for teenagers. At one time I had much of the information that people really wanted to hear and I think I learned over time to be able to present the information in a way that both scientific and lay audiences could relate to it. So I went to both my kids' schools and to church and talked to the church groups, and I have done a lot of community service presentations. To my knowledge, my children never ever expressed any reservations about that.
Now, they were younger then, but they were perfectly happy in having me do that, I mean as happy as a kid ever is to have his parents show up and be doing something like that. At some level they are sort of proud of you and at some level they really wish you were someone else's father. I do not think I felt inhibited about that at all.
Harden: I also recall that Dr. Fauci told us at one point that he and his wife had decided that this was what their life was going to be dedicated to. It sort of took over their lives. I just wondered if you and your wife had had similar personal discussions of this kind of thing?
Henderson: I think there were times that the frustrations of it, the sort of bad news, when bad news surfaced, took away more time. But, as is the case with Dr. Fauci's wife, my wife is a nurse and actually worked with him for a while, when she was his special assistant for AIDS. So she was very knowledgeable about the disease. I think it was a pain in the neck sometimes, when we ended up here on the weekends or had to come in and those times when really bad pieces of news surfaced. When we had our infection, for example, we went systematically to every department, to every shift, talking about what it meant and making certain that people had a chance to talk about it because it was one of us. That took a huge investment of time, but I felt it was just part of the job. This is not a 9:00 to 5:00 job, so I do not think I ever felt it. It changed the course of my career, but it did not change the course of my personal life. But periodically it was oppressive.
Harden: Did you worry about becoming infected yourself or about your wife’s possibly being infected?
Henderson: Not too much. I tried to be both sensible and careful. During this time, I also worked as a moonlighter at one of the community hospitals and took care of lots of HIV-infected patients. I did not worry too much about it, I think, in part, because I understood the risks pretty well and knew the risks I was taking.
Hannaway: As far as your personal career, I wonder if you would comment on the effect of AIDS on the infectious diseases field. You obviously have reflected on the field of infectious diseases. I remember when I was on the faculty at Hopkins in History of Medicine and I went to a Medical School Council meeting. The Council had a representative from every department, and the man from infectious diseases came running in and he was all excited–this is very early on in the 1980s–about this new problem. He was excited because of the research possibilities and so forth. But he was also excited because infectious diseases was going to gain more status in the medical hierarchy. Would you comment?
Henderson: Infectious diseases physicians do not routinely perform procedures such as bronchoscopy or endoscopy. The only "scope" for infectious diseases physicians is the microscope (and you really can’t bill for its use!). We do not catheterize anybody, or squirt dye into anything; in great measure, infectious diseases is an intellectual subspecialty, and it is a little dusty for some people. But a higher profile certainly has resulted from the HIV epidemic. I think under Dr. Fauci's leadership, the National Institute of Allergy and Infectious Diseases has really blossomed in this epidemic by doing wonderful work and he has led them unbelievably well through that time.
Rodrigues: I noticed this morning in the paper that the CDC finally seems to have a reasonable budget proposal for funding for their infectious disease surveillance system.
Henderson: Right. The article I read, it must have been the New York Times or one of the other big papers–I cannot remember where I saw it–quoted [Dr. James] Hughes, who was one of the people that I sat with developing those first guidelines at the CDC. He is now the director of the Center for Infectious Diseases in the CDC. He came from the Hospital Infections Branch, did HIV, and then has stepped up there. In effect, we have kind of gotten gray together.
Harden: We are hoping to go to Atlanta to talk with [Dr. James] Jim Curran. The CDC does not have such a program of interviewing people about their contributions to AIDS research. Dr. Curran has moved to Emory University now.
Henderson: Yes. He is the dean of the School of Public Health. He is a terrific guy. He has a wonderful sense of humor and he will be a great interview for you.
Harden: He seems to have been in the middle of everything. Everybody talks about having run into him.
Henderson: He was the lightning rod for AIDS and HIV infection at the CDC. He and [Dr.] Harold Jaffe. Harold Jaffe is the other person you might want to speak with at CDC.
Harden: People have talked about AIDS turning into a “normal” disease instead of being something that people do not understand. We have now lived with it for over a decade and we are dealing with it as we deal with most diseases. Do you want to speculate on the future course of AIDS? Is it a harbinger for other emerging infections, and for what is coming in the world of infectious diseases?
Henderson: The major problem, I think, that we are dealing with poorly currently has to do more with how we are managing the infectious diseases that we already think we know how to manage. The problem of antibiotic resistance is going to be a huge hurdle. There was a wonderful paper in Science about two years ago that said that we were entering the post-antibiotic era, and I think that is significant. Vancomycin resistance in enterococci is a harbinger of things to come, and if that glycopeptide resistance finds it way into Staphylococcus aureus, we will have retreated successfully to 1950. We will be back to where hospitals may have to close, operating theaters may have to close, despite all of our intelligence and all that we have learned.
AIDS is slowly–even though I thought it would never happen– being better accepted in society. From my own view, the biggest problem will be to control the epidemic in Africa. The dimensions of the epidemic on the African continent are horrific, at best.
Initially, everything that one might imagine that was horrible seemed to be associated with this disease and really, I think, that is what polarized people. It has taken a long time for it to be accepted, and it still is not accepted perfectly in society.
Harden: Thank you so much for talking with us, Dr. Henderson.
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