| In the Moore Clinic
with Wesla and Gloria
By Anne Bennett Swingle
Photography by Keith Weller
In January 1984, Frank Polk and John Bartlett set aside one half day a week to take care of a small group of gay men with AIDS. At that time, AIDS was still in its infancy. “There still was no blood test,” recalls Bartlett, chief of infectious diseases. “We were pretty sure it was a virus, but we didn’t know what the virus was, and we weren’t sure how it was transmitted.”
To find out how it spread, Polk, an epidemiologist, had designed a protocol, the Multicenter AIDS Protocol Study, or MACS, the first big epidemiological study of AIDS. To treat and study the first handful of enrolled patients, he and Bartlett set up shop in one small room within the Moore Clinic.
Polk died of a brain tumor in 1988, but the tiny clinic grew right along with the epidemic. Today, the Moore Clinic is the centerpiece of the Johns Hopkins AIDS Service, the largest program for HIV care in Maryland, one that last year alone served nearly 3,200 unique patients. In this one central location on Carnegie 3, patients can receive practically all their primary and specialty care. Each one has his or her own doctor and nurse. Each has access to specialists from seven different services, such as psychiatry, gynecology and dermatology, who come to the clinic every week. Phlebotomists are on site, a social worker is available for every clinic visit, and a variety of support and education groups are ongoing. Because the clinic has long conducted research into HIV infection, patients have always had access to the latest medications.
Two Moore Clinic employees, Wesla Zeller and Gloria Jones, have been on the front lines of the epidemic from the start. They were at Moore even before AIDS in the early 1970s, when the clinic treated chronic and hereditary diseases. They were there when the first cases came in, when the first death occurred. The inextricably linked “Wesla and Gloria,” as they are always called, were witnesses to patients’ fear and determination, as well as the stigmatization they endured in those grim days before the treatment revolution transformed AIDS into a chronic disease.
Wesla is clinic coordinator. She mans the phones and takes care of the front. Gloria, senior patient service coordinator, presides over the waiting room from her desk, first from the right. Over the years, they have come to know thousands of patients (Moore had 20,000 visits last year alone) and helped set the clinic’s warm, family-like tone. People talk today about “service excellence,” but these two have never needed any slogans to remind them that patients come first. Today, with the threat of emerging infectious diseases such as SARS looming large, Wesla’s and Gloria’s unhesitating concern for patients in the first years of the AIDS pandemic could very well be a model for us all.
As the Moore Clinic prepares to mark its 20th anniversary, Dome spent a morning with Wesla and Gloria as they talked about the clinic today and reminisced about the way things were when it all began.
Gloria: Dr. Polk only expected 10 patients. But it mushroomed, and it’s taken over the whole clinic now.
Wesla: We went from one session, to two, to three. Then we had an all-morning session, every morning. Then we started having clinic all day.
G: It was a death sentence back then. Our first patient was dead in three months. There was one patient we thought died, I don’t know how many times. Each time we saw her, we thought it would be the last time, but she just kept popping up. I don’t think we really believed she was dead when she was dead. And look at the length of time patients live now! We probably have patients who have been with us for 10, 15 years.
W: Our family and friends, when they realized where we were working, they were frightened. They kind of backed away a little bit. I think our families have become accustomed to what we do at work. Since we’re still alive.
G: If you tell somebody you’re comfortable with it, more than likely they’re going to develop the same attitude.
W: And it doesn’t even come up any more.
G: That was because people weren’t educated about HIV.
W: I’ll never forget when an ambulance crew brought a patient in, and one of the attendants was all covered up from head to toe. Someone told him not to come back. They even called the ambulance company and told them not to send him back.
G: Or those times when we were short-staffed. They’d bring someone down from the floor, and we had a couple of nurses who refused to work with patients. But Dr. Polk made us feel comfortable.
W: I’ll never forget that time when we needed to do that blood transfusion, and Dr. Polk just came right out and said, They don’t want us upstairs. And we looked at one another and we said, Well, we’ll have to do it here. And he even said, You don’t mind? And we said, Well, it needs to be done; where else are you going to do it?
G: We had dealt with a lot of transplant patients who had hepatitis, and we were familiar with being cautious about how to handle specimens. At that time, we were handling serum. We actually were.
W: We would have to label blood. I’ll never forget that one time the lid popped off and it went all over everywhere.
G: We’ve known a lot of these patients for years. They’re kind of like friends. It’s awful when they die. I always have a hard time connecting names with patients, and I think that’s because I don’t want to know their names. I’d rather think they just dropped out of clinic, even though that wouldn’t be true.
G: It’s a different environment, this clinic. We know all these people. We hear what’s going on with them. They tell us stuff they don’t tell the doctors half the time.
W: They’re open. They don’t care where they’re sitting, in a doctor’s office or in the hallway. They just say it.
G: Lots of times, patients will say, You’re the reason I keep coming back, the reason I keep taking care of myself. I look forward to your smile and saying ‘hi’ to me.
W: Lots of the patients come up just to talk to each other. One patient wants to come up here whether he has an appointment or not. He tries to get us to lie to his mother and tell her he has an appointment.
G: He calls almost every day. We’ve had other patients like that. We know we’re their only support system. The families have disowned them. That was really hard for patients. They were just afraid to tell their families. And I think that’s probably still true today because it is still not accepted.
W: When they miss an appointment and call, I tell them: I know where you live.
W: We’ve got some that go back out on the street. And they’re honest with you. They won’t lie about it.
G: You just let them know you’re glad they’re back. Nobody knows if they will ever be in that situation themselves. You don’t know what kind of events you’ll have in your life, where you become overwhelmed. You shouldn’t be judgmental.
W: Because but for the grace of God, there go I.
G: We have people who fly back and forth from different states and countries to visit the clinic.
W: They say that from the front desk on back to the physician, their treatments aren’t as good [where they live] as what we give here. In some places patients are even told to lay the [hospital] plate down. Or [staff] wipes the things off with alcohol swabs. Which we don’t do here. We grab their plate and we go on. We’ve always taken the plates, we’ve done that from the beginning.
G: It’s still that fear.
W: Our clinic is very personal.
G: Everybody knows everybody. Everybody here works really hard. And everybody here works toward helping the patients.
W: That’s our goal. Some of our patients have met their husbands here. They got married.
G: They bring kids with them, and we get to know them from before they have kids.
W: One patient always asks if he can come home and cook for me.
G: ‘R’s’ daughter is going to college, and we’ve known her since she was a baby. You know, eventually they’re going to tear this building down, and it’s going to be a hard time. I wouldn’t want to work anyplace else but here. We’ll be here until the building is gone. We both say that all the time. We’ll be here forever.
W: I always tell them: You can throw me out ... but I’ll be back tomorrow.