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e mid eighties when passing out condoms would have been a radical act to ease up slightly on myself it s true that i hadn t yet really had sex myself so the gesture would have been a complicated one but then the next panel reminded me that next year 1992 was the year that aids became the biggest cause of death for young men in the united states and in 1992 it only seemed like it was going to get worse 1991 2010 i ve been somehow involved in aids work almost all of those years with a few small breaks for parts of my medical training more than half the epidemic in fact now about two thirds of it minus the very worst years next year will be 20 years out of 30 i don t know what to say about that exactly i could have stopped in 1997 since from 1991 to 1996 i said i would stop doing aids work and start doing something else when the crisis is over and when i said crisis i meant the kind of mass death that ended in san francisco with highly active antiretroviral therapy but i didn t stop though most of my friends who were also there for the crisis did i m still not sure why i didn t go do something else for a brief moment in 1997 i almost went to work for an ad agency but i got another aids job instead and i was relieved and knew i d made the right choice during a year in a lab i found that i was depressed until i started volunteering for a needle exchange program no one i was super close to died or even got sick there wasn t some big cathartic event other than living in san francisco in the early 1990s that kept me going i just kept thinking about aids because i kept thinking about aids even though there would have been a lot of other alternative paths for me in which i probably could have done greater good for a greater number of people so it s not like i m claiming a moral high ground i m just observing the persistence of a theme it is what it is given that i have kept doing this work kept connecting myself to this epidemic i m glad i got out in the drizzle and walked not for my hospital and only partly because of the aids action committee since the money raised was raised whether or not i walked and they probably could have given my tote bag to encourage one of their nutrition clients to go to the farmer s market or something mainly i was glad to walk because those little clusters of families with their team t shirts deserve to have lots of people around them when they gather together to remember someone now gone it also gave me a couple of hours to think about how long this epidemic has kept pulling me back towards it for reasons i don t entirely understand if you want to give some money to the aids action committee they re good people i know them personally because they re getting food and other services for one of my patients who s really sick and a few years ago they got me down to the statehouse to help lobby for their successful effort to decriminalize syringes and make clean needles available in pharmacies in our state they do a lot of other great stuff too here s the link to my aids walk fundraising page and thanks so much to that small but sweet group of friends and family who donated it means a lot to me it s true that because of your donations i qualified for a tote bag but more importantly my patient will get some food and trust me he needs it posted by joe wright at 2 12 pm 5 comments labels aids aids walk boston personal saturday may 15 2010 stop obama s misguided global aids policy photo kaytee riek whose other photos of this recent demo can be found at kayteeriek com president obama is making big mistakes on global aids click to read south african aids activist zackie achmat explaining why see also takeanumber org new york times zackie achmat in new york may 13 2010 posted by joe wright at 12 00 pm 0 comments labels aids aids activism economics goals of care healthcare justice obama sunday april 25 2010 1996 protease inhibitors were confusing for my zine i wrote this although my life changed in other ways shortly afterwards and somehow that also meant that i stopped publishing my zine those were in the days before blogs children in the days of photocopiers when self published writers had to go to the leather tongue video store and drop off five copies of the zine for the magazine rack in hopes that there might be only two when they returned a month later not long after this i ended up going to work for an hiv vaccine research group which restored my sense of urgency it also stalled the question of doctor or account planner see previous 1996 post then i learned immunology did some needle exchange and with much more excitement and no inertia i decided to become a doctor october 14 1996 at my job at an hiv prevention agency in san francisco another person has quit everyone seems disspirited and low to some extent that s because of the particular politics of the agency personnel absences departures events personality changes etc but i ve been wondering on my return whether there s something deeper the advent of the new drug treatments and the incredible promise of the protease inhibitors may have subliminally actually depressed people the idea that we are an important lifesaving effort is slowly losing focus if people are staying alive with hiv then we are disease prevention specialists not the first line of defense in a community under siege in itself that would be great news but unfortunately no one knows for sure what the truth is how many people will really benefit from the protease inhibitors the most optimistic school of thought has it that the protease inhibitors if used for somewhere around the range of three years might be able to help some people s immune systems to entirely eliminate hiv from the body in other words that in a couple of years we might have a partial cure blossoming in front of our eyes others are more skeptical and uncertain about the longterm prospects of the new drugs if this group of people is more correct we will only see people with aids die a couple of years later than they would have before so we can t yet cheer the end of an era on the other hand the urgent language of our previous era is fading and cracking under the dim light of future prospects we are left with no sure knowledge of our role no clear sense of how important our work will be and no overtly stated acknowledgement that things have changed i am beginning to suspect that inertia is the result posted by joe wright at 1 26 am 0 comments labels community organizing epidemic phase hiv hiv prevention protease inhibitors urgency zines saturday april 24 2010 1996 what color was my parachute i was looking through old files for something else and found this since you re reading this blog you know what finally happened math was hard but i stopped letting that stop me i bought an algebra book re learned algebra and trigonometry took science classes went to medical school apparently what color is your parachute knew what it was talking about maybe also i had kind of forgotten how into rem i was back then whenever someone asks me what i m up to these days i say oh trying to figure out what i m doing with my life then they chuckle heh heh they ve been there but were they ever really as desperate as i am now because i ve turned not once but twice to what color is your parachute it s maybe the most famous self help book ever so i must be in bad shape right the concept of the book is that if you follow its instructions you ll not only find just some job but you ll figure out exactly what your ideal job is and then get it i m a product of the culture that this book helped to create it was first published a year after i was born maybe that s why i hold on to the belief that it is actually possible to find an ideal job a true calling even outside of lottery winner a while ago i was housesitting in a house so beautiful that i went out and bought twenty lottery tickets so maybe i could buy a house just like it at least one of the beautiful house s owners had read an early edition of what color is your parachute which they still had laying around marked up with notes so after my lottery tickets yielded no results i sluffed my way through a few of the book s career exercises i came up with a plan which was a pretty good plan except that it depended on some people who didn t agree with it after that i managed to ignore my career woes for a while actually i was sort of ignoring my career period my new boss the smarty pants bastard eventually sat me down and told me that i d better start shaping up which reminded me oh yeah i still hadn t figured out what i was doing with my life so back to parachute this time i started in on informational interviews a series of what do you dos and how do you like its yielded a great deal of interesting information not least of which was that if you sit people down and ask them about themselves some of them don t really want you to leave maybe ever a couple of people told me i should be a doctor sounded cool but difficult i m like that talking barbie math is hard plan b was a little more accessible account planner at an ad firm until i realized that having plan a as be a doctor and plan b as be an account planner was a little too much like talking barbie i still really hadn t figured it out so back to the book i started doing all the exercises not just the few i didn t find depressing while i was writing a list of everything that i had ever learned i was listening to an rem song and it occured to me that part of what bothers me most about submitting to the indignity of this kind of exercise is the overwhelming sense that most of my heroes never really did this when rem were a bunch of students in athens ga they just started playing music because they loved playing music and then they started putting out singles and albums and videos until they became the huge phenomenon they are today i just can t see that there would have been any career self help books in the process from when i was fifteen to when i was twenty four or so i had a calling i wanted to be a movie director and i wanted to make frequent interview appearances in oversized magazines and late night talk shows but let s not speak of those mistaken notions now let s focus on the future i need a new plan i know that what color is your parachute should help me find some reasonably satisfying direction but i yearn for something more a new calling a new certainty that what i want is what i will be best at and enjoy the most and give the most to the world by doing and also that it will be infinitely glamourous and make me famous and loved the problem is that this book this parachute is designed to move you away from obvious answers and convince you that for instance everything you like about being a movie director is actually fulfilled by being a freeway engineer the idea is obvious answers aren t always the best answers sometimes you d actually be happier designing freeways or selling plastics but in the direction of obvious answers also lies the allure of glamour of what everyone wants or thinks they want diving with sincerity into a career self help book is a sure sign that you re giving up glamour an important step no doubt but also inevitably a sort of depressing one this isn t going to be about your calling the moment in athens georgia where everyone realized you really had something this is about settling down and going to work posted by joe wright at 11 58 pm 1 comments labels advertising autobiography jobs personal pre med older posts home subscribe to posts atom subscribe to hemodynamics joe wright md hemodynamics is a blog i worked on mostly as a medical resident i keep it up for historical interest only still i would keep the same description and disclaimer this is a blog about the social world of medicine and sometimes about other things that interest me it is not a good place to seek medical advice none of it should be read as medical advice this blog is no longer being updated blog archive 2010 21 october 1 hiatus august 1 june 2 may 1 april 5 march 6 february 2 january 3 2009 23 december 2 november 3 october 2 september 1 august 1 july 2 june 3 may 3 march 3 february 2 january 1 2008 38 december 3 november 6 october 7 august 8 july 1 may 5 april 6 march 1 january 1 2007 52 december 1 november 2 october 3 september 2 august 1 july 7 june 9 may 12 april 12 march 3 member perspective confidentiality disclosure reliability courtesy medbloggercode com medbloggercode com gandhi looking at leprosy causing mycobacteria 1940 the tactics of the diagnosed a brief history of the people with aids self empowerment movement act up oral history project association of cancer online resources denver principles the founding manifesto of aids activism by and for people with aids disability rights and independent living movement oral histories and other historical resources from uc berkeley e patients gnp global network of people living with hiv aids metastatic cancer list serv michael berube neurodiversity many links all emphasizing social acceptance of the neurological spectrum ragged edge online remembering the importance of the 504 sit in for disability rights treatment action campaign what i ve learned from e patients an md learns from the braintalk forum voices of the diagnosed a chronic dose acid reflux regurgitated ramblings of a canadian sober poz ex hooker turned aids activist ballastexistenz not being able to speak is not the same as not having anything to say duncan cross international carnival of pozitivities last chance texaco chris used to write a blog called methed up now he s driven to a new stretch of the road of recovery leroy siever s my cancer blog on npr org sick girl speaks first demonstration led by people with aids 1983 health policy the pump handle public health politics and policy of hiv aids blog by grad students post docs in tx ca ma aids action committee boston blog treatment action campaign march cape town 2003 from the treatment action campaign health work emergiblog the life and times of an er nurse head nurse paging dr jess another p care medicine intern running a hospital ceo of beth israel deaconess boston geek doctor cio of beth israel deaconess street watch notes of a paramedic becoming a doctor anastamosis a medical student s personal blog emergence medicine from the trenches dr njbmd s advice to med students oldpremeds national society of non traditional pre medical and medical students the yale doc yale med student health care quality improving medicine s industrial processes ahrq s guide to health care quality for patients atul gawande s gawande com institute of medicine crossing the quality chasm projects general health related links boston globe s white coat notes boston area medical community news medical grand rounds weekly round up of health related blogs everythinghealth dr toni brayer s updates and explanations on medical news reference dermatology image atlas health map global disease alert mapping sy...