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In Their Own Words: NIH Researchers Recall the Early Years of AIDS
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Harden: Yes. Whom were you working with? Were you working with epidemiologists or other scientists?

Quinn: King Holmes has a Ph.D. in epidemiology and an M.D. degree, and he was my tutor and mentor. He taught me the methodology. He assigned a statistician and a microbiologist to work with me, and basically I had a team. I also had a couple of physician's assistants assigned to me. So I was a fellow, yet I had this team of experts working with me. Then I had two junior faculty people also pitching in. One was a man named [Dr.] Larry Corey, whose name will come up later in your AIDS investigations, but Larry Corey was a virologist who had done some herpes work on the anal-rectal area, and he turned all his files over to me because he was moving on to other things. Another was a man named [Dr.] Walter Stamm, who is a famous chlamydiologist, and he helped me with the early description of the chlamydia intestinal infections. By July 1981, I had spent two full years working solely on the clinical epidemiology, microbiology, even to some degree the immunology of these infections in homosexual men.

Harden: But you were not calling this a new disease?

Quinn: No. We were reporting this as epidemics of intestinal infections in gay men, and our early papers reflect that. What are the anal-rectal infections in gay men? Gay men engage in anal-rectal sex, oral-anal sex, and they get contaminated with these fecal organisms, organisms from the intestinal bowel.

When my first report, a sentinel report–although it came out a couple of years later because you know how you have to massage data–came out in the New England Journal of Medicine, it was on the chlamydia outbreak in these men. It was followed up by a report on the outbreak of herpes in the anal-rectal area. Then I finally pulled everything together, the whole potpourri of infections, and we put it in as a single paper, “The Polymicrobial Etiology.” That was also in the the New England Journal of Medicine, and it came out right at the beginning of the AIDS epidemic.

We have not gotten to AIDS yet, but I could be described at that point, having finished all my training, as a person with some immunology training, laboratory training, interest in parasitic tropical diseases, who was now an expert in sexually transmitted diseases among gay men. So that is how I was...

Harden: Poised.

Quinn: Poised, ready for AIDS. I was in the Public Health Service during all this, and then they transferred me. I had finished the training.

Hannaway: You were transferred back to the East Coast?

Quinn: That is right. That is how I ended up back here.

Harden: I want to go over this very carefully. The Public Health Service brought you back here and you were in the Baltimore Marine Hospital. But–let me run through what I know, and then you can flesh it out for me–at some point you hooked up with the Johns Hopkins University.

Quinn: Yes.

Harden: I want you to tell me first about the administrative arrangement for you here at Hopkins, because there are not many people who are paid by the NIH who are working at a university. I would like to know about that. But also, at some point, you start to see these patients as having an immunological problem rather than just having the infections.

Hannaway: Having a range of infections?

Harden: Right. I am wondering if it is because they simply had not gotten to that point when you were seeing them in Seattle.

Quinn: Right.

Harden: Or what was happening? I want you to describe it to me. That is a long question.

Quinn: It is, but that is where I am headed.

Harden: Okay.

Quinn: What happened and how I ended up with Hopkins is an interesting story. When I was finishing up my training, the PHS said, “You have to move.” They said, “We have three hospitals you can consider to work in. We need someone at Staten Island, we need someone in Baltimore, and we need someone...” I think it was a place south of Houston.

Harden: Galveston?

Quinn: Galveston. Thank you. I looked at the possibilities. I did not look at Galveston. I was not interested in going down there at the time, nor was my family, so I looked at Staten Island. Being from New York, that made sense. And I looked at Baltimore. The Baltimore Public Health Service Hospital was affiliated with Johns Hopkins. In teaching, patients would go back and forth, residents went back and forth. It was a teaching hospital. So I decided that it would be very nice to be able to be affiliated with Johns Hopkins and be in the PHS hospital.

Interestingly, they did not have a chief of infectious diseases until the end of 1980, the beginning of 1981. That was [Dr.] John Bartlett, who was recruited from Boston, and he became the chief of infectious diseases at Hopkins. So he had just arrived, and he was a single faculty person. He was the division at that time. There was no one else. All of a sudden, here came this new trainee, just finishing training and looking for a position, and I would be paid by the Public Health Service, so it was very nice. He interviewed me, and his interest was in intestinal infections, but it was not the same as mine. It was in C. difficile, a different organism, causing antibiotic-associated colitis. But he thought that my intestinal background meshed with his in terms of our research interests, so he said, “I will offer you a faculty position here at Hopkins as assistant professor.”

So I joined the PHS hospital, and I became chief of infectious diseases there. Two months later the hospital was sold by the government and it became a private institution. There was a major RIF, reduction in force, by Ronald Reagan, president at the time. I was in that RIF. I was relieved of all my obligations of payback for the training that they had given me if I wanted to, and I could leave the PHS.

However, I got a phone call from [Dr. Kenneth] Ken Sell and [Dr. Richard] Dick Krause at the time, and also from Lou Miller and [Dr. William] Bill Paul. The four of them evidently saw my name on the RIF list. The PHS had said to the NIH and to the CDC–I do not know why this occurred–“If you folks want to pick up one or two people for your individual institutes, you are welcome to do that. These people are all being freed of their obligations, and you can just pick them up.” So I got the phone call, and Ken Sell had me down to the NIH with [Dr. Michael] Mike Frank, who also was there, Dick Krause, and so forth. Whether it was the beginning of the AIDS epidemic that made me of some interest to them or whatever, I cannot say because...

Harden: Can you provide the date of this meeting for me?

Quinn: I know it was either in August or September that this was happening.

Hannaway: Of 1981?

Quinn: Of 1981. So the first report was out that there was this thing going on in gay men. They did not come right out and say, “Tom, we want you because you have expertise in working with these gay men.” Although the very first time I worked with Dr. Krause, he actually said, “We need more people like you because you have training to address this particular issue. We have to get more people like you. Where are they?” I said, “To be honest, hardly anyone is being trained in sexually transmitted diseases, never mind being trained in diseases that are common among gay men.” And he replied, “Well, we need people like that.” When I met him, that was the message that got passed along.

When I met with them–that is, Ken Sell, Mike Frank, and so forth–they said, “We’re picking you up. We know you from your time working here at NIH on parasitic diseases. Lou Miller gave you a good word, [Dr.] Frank Neva knew you, he gives you a good word. What do you want to do?” I said, “I really want to keep on with my research in sexually transmitted diseases, but I am not sure Bethesda is the best place for that.” They said, “What are you thinking?” I said, “I was just getting my research going in Baltimore at the sexually transmitted disease clinics. I could study chlamydia there, and there are gay men that we could follow as well in terms of what is going on with this new little outbreak,” which barely had a name at the time. They thought about it and they said, “Yes, but we want you here doing some research.” So Mike Frank, who had done this clearance of red cells before, said, “Do you want to get back into that, labeling red cells, but doing it in people this time?” He said, “It might be interesting if you did some of that on these people who are getting this unusual disease, this AIDS.” So I was getting tugged a little bit as to what was I going to do at this point, and where.

In between I had a little free time–well, time to make these decisions–and the Fogarty International Center asked if I could help them edit a couple of books that would stem from symposiums over the next three years, one on eradication of measles, one on eradication of polio, and one on eradication of yaws, was it feasible, how far are we from achieving eradication?

Actually, I met some famous people during that period. [Dr. Solomon] Sol Crookman was there; I met [Dr. Samuel] Sam Katz; and I worked very closely with these people in the big battle over the Salk versus the Sabin vaccine. I had to edit their papers. I had to get them to work together. This was all happening during this sort of decision-making process.

But then something happened that led to why I am here at Hopkins, and I will explain it. Then we will come to AIDS, where I interface there. The NIH at that time had a clinical training program in infectious diseases that was suffering. They did not have enough patients for the fellows to be trained on. To get board-certified, you really need a fairly intensive clinical exposure. I got board-certified in infectious diseases by going out to Seattle and taking care of patients. But the fellows that stayed at the NIH to get their training were not finding enough patients, and the training program was coming into question, which meant loss of board certification for the institute. So Ken Sell, Dick Krause, Mike Frank, and [Dr.] Jack Bennett, who oversaw that, got together and they said, “There is this new person, Tom Quinn, who has this joint appointment at Hopkins. We have occasionally been rotating fellows to Hopkins to get some extra training. He wants to work on STDs in Baltimore. Why don’t we set up a situation with Hopkins where we will assign one of our scientists there for a two-year period, and he will set up the training program so that our fellows, whenever they want, can go there and get experience in taking care of patients for a month, two months, three months, whatever they want to do. And Tom can see if he wants to keep his research program going.” So they asked me if I would do that, and I said, “Well, I still live in Baltimore, and that would beat this commute every day. I will still come to the NIH once or twice a week and meet with Mike Frank,” because I was starting those experiments with him about the clearance of the red cells and so forth inside the gay men with this unusual disease.

At the end of two years, the program was working well here at Hopkins. The NIH was happy with it because all their fellows were getting trained; they got their re-accreditation. I was happy. I was starting to get some good research done. I was still commuting to Bethesda periodically, so I was keeping in touch with everyone. We all decided that we should extend the program, and it has been extended ever since, so here I am.

I am still in the Public Health Service. [Dr.]Tony Fauci is my boss. I was transferred into his laboratory as I did more and more AIDS work. That happened in 1985. I report to him all the time, and I provide an epidemiologic expertise for the basic bench research that they carry out, and we interface on a regular basis on that. As I developed my area and my interest in international AIDS, I was given my own section on international AIDS, although I am not allowed to staff it much with NIH people because I am off campus. There were certain restrictions I had to abide by as Tony and the powers-that-be were not ready with a whole big laboratory, like the Rocky Mountain Laboratory. They did not want another laboratory like the one that was out in Hawaii. The Rocky Mountain Laboratory was already big enough, so they did not want another one in Baltimore at the time. But they could justify having one or two people here, and so they gave me a technician. I have an NIH-funded technician and I have my own intramural budget. I interface with the extramural people here, and we will get into how that is beneficial further on in the interview.

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