Susan Desmond-Hellmann
speaker
362 appearances
1 recordings
1 series
first heard Apr 2025
last heard Apr 2025
Susan Desmond-Hellmann’s voice in public audio — every appearance, attributed to the second.
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Appearances
I'm happy to be here. I look forward to it.
I went to Catholic school for 12 years in Reno. I explain that when people wonder if I was at a casino for my childhood. And then I went to University of Nevada, both to undergrad and to medical school.
You know this with residencies. My dream residency was internal medicine at UCSF, my first pick. And I got my first pick and went to UCSF as an internal medicine resident.
1982.
If you read MMWR, that's 1981, was the first indication. In 1982, we knew that there was something happening, especially to gay men, but there was a sense it was homosexuals, hemophiliacs, and Haitians. Remember that?
Three H's. There was so much mystery still involved that I was and my colleagues were in a study to look at drying our blood to see if we had been infected.
Pneumocystis. Pneumocystis cariniae pneumonia was the number one diagnosis. So that's what you saw in the hospital that brought patients to attention.
Oh, it was a disease that immunosuppressed patients could get very rarely. Most clinicians had never seen it before. What was also clear is that there were many other infections that were not as obvious or life-threatening as pneumocystis was when we saw it right away. What was interesting from an outpatient perspective was capsic sarcoma.
Kaposi's sarcoma is a really unusual purple-colored tumor, very visible externally. It caused nodules. In patients with HIV infection, it also caused internal organ involvement, and patients would cough up blood or they would vomit blood. But what was really sad and difficult is the combination of cachexia and Kaposi's sarcoma meant that everybody knew you had AIDS. He sort of wore it.
And what was interesting for me was that this old-fashioned Kaposi's sarcoma was fundamentally different than what we were seeing. We also saw non-Hodgkin's lymphoma in numbers much smaller than Kaposi's sarcoma. But Kaposi's sarcoma was a very big problem in San Francisco. It was very common in gay men, and it was common in the population we saw.
I think it's probably a reflection of my own personality and my own wish to be a physician, that my memories of those days are much more about sadness, about my patients and about people my age dying or being pretty clear they were going to die.
I mean, a story that brings it to life is many patients started selling their life insurance because they were sure they wouldn't live long enough and they wanted the money now. And then when the antiretroviral therapy came along, they wished they hadn't, which is a good thing to have. But I was just really sad. There were fears about the residents and about contagion.
But in San Francisco, there was such a wish to help the patients and such a good spirit about playing a role in helping that we all persevered. But the first patients I took care of in the hospital, I remember very well in 1982, we were a gown, gloved, masked, had a cap on. It was like we were going into an operating room.
Absolutely.
I did a chief residency at the university hospital. And I think that was the first that I knew I really liked managing. I really liked interacting with people and helping people succeed. So I did that for a year and then went into my oncology fellowship after that year.
Oh, to this day, I love oncology. If you love medicine, and I do, and you love patients, and I do, it's the combination of, you get to call on your compassion gene and your nerdy science gene. And when I was in Reno, at the Reno VA, I had an attending, Stephen Hall, and he was the oncologist who was teaching me about medicine, third year medical student.
And I loved everything about how he showed up. I loved his compassion. I loved his intellect. And after that, I had in my mind this bug about I wanted to be like him.
That's really well said. I love that.
Let me talk about breast cancer. That's a cancer that is such a good example. The common therapy that was used, cytoxan, methotrexate, 5-FU, were very old, decades old. There were no new chemotherapy drugs. Hadn't been in a while. The field was stifled, I would say, in terms of medical oncology. There wasn't a lot going on. I was really interested in cancer epidemiology.
That was something to me that asking the question, why did people get cancer and couldn't we do something about it, seemed really important to me. I wanted in the second year of my fellowship to study the relationship between hepatitis B and hepatocellular carcinoma and to understand that better and to think about the viral link
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