Learning Medicine through the Closet Door

The year was 1986. I was on my first rotation as a third-year medical student. It was 7 p.m. on my first night on-call. I had picked up my patient for the night: a 35-year-old woman with a long history of type 1 diabetes who had suffered many of the ravages of that disease. As I leaned over Harrison's Principles of Internal Medicine in the team room trying to figure out what else to write in my admission note, the intern received a call about an admission coming from an outside hospital. The patient was a 42-year-old gay man who presented to a community hospital with a headache and stiff neck. A spinal tap revealed fungal meningitis, which, at that time, was very unusual. The community hospital was transferring the patient to the university hospital where I was in training.

When the intern got off the phone, he turned to the two other medical students on our team to fill them in. All three of his medical students were male, so the intern felt free to use graphic and derogatory language to describe the patient, his sexual orientation, and the sexual activities that would most likely have led to his HIV infection. I sat in the corner of the room with my eyes fixed on my textbook, feeling my face grow warm and staring at the blur of black and white on …