Linda Durand says the fear she sees in her AIDS patients today is worse than the anxieties she witnessed in Vietnam, where, as a 26-year-old nurse, she cared for GIs with gaping wounds in their bodies.
"The anxiety is so intense, I've never seen anything like it in my 20 years of nursing," said Durand, 43, who helped start a consulting clinic for acquired immune deficiency syndrome victims last December.
"The enemy was identified in Vietnam. You can't see this. It's a virus, and it affects you sexually. It's made people look at their morality and past sexual behavior and what they're going to do in the future. It puts a lot of doubts in a lot of people's minds."
The toughest part of running the clinic, she said, is seeing the babies, the 19-year-olds and the homeless dying.
Team Sees Patients
"It tears you apart," said Durand, a single parent of a 5-year-old son, Andy, whose framed photos in her office inspire her to keep going.
At the clinic, a team including doctors, psychiatrists and drug therapists sees adults and children each session, then makes recommendations to their physicians on their care. The clinic covers the whole spectrum of the disease, including patients who test positive for exposure to the AIDS virus or who have AIDS-related complex.
The clinic also works closely with Rhode Island Project AIDS, a nonprofit organization of concerned citizens that runs a telephone hot line and tries to help AIDS victims with problems.
The clinic had been operating one day a month. Last month, recognizing the always-increasing number of AIDS patients, it extended operations to once a week.
"The need is so great," Durand said.
Runs a Support Group
Beyond the clinic, Durand has run a support group every Tuesday for two years where people with AIDS or who carry its antibodies can come by to talk.
"Sometimes we don't talk about AIDS at all, just their experiences during the week or how they're feeling about some particular problem," she said. "Or we may talk about being positive for (exposure to) the virus. Helping them maintain control over their lives is one of the biggest issues we deal with."
It is seeing babies with AIDS, most often the children of addicts who use needles to inject drugs, that can leave her choked with emotion, Durand said.
"You feel like crying when you see them, helpless, a listless 2-year-old baby who's supposed to be tearing up my office and he's just lying there."
Durand met with one mother, a drug addict, just after she had been told that her child had contracted AIDS in the womb.
"She didn't know what to say. She was crying. She was blaming herself. I was feeling angry. I felt sorry for her. I felt sorry for the baby. All these feelings are going around in your head. You just can't knock them out at 4 o'clock."
Durand went to Vietnam in 1970 and served a year. "I just couldn't understand the war and what was happening," she said, "so I thought I'd go over and find out for myself."
She watched men 18 to 25 die every day.
"I think the thing that impressed me most was the gutsy GIs. They had so much fire in them," she said. "I saw incredibly devastating injuries. Some were lethal injuries and they were still alive, like 90% burns all over your body, and they'd still be talking and you knew they weren't going to make it."
Began AIDS Clinic
Durand returned in February, 1971, and was discharged from the Army six months later. In subsequent years, she worked in Veterans Administration hospitals and earned a master's degree in nursing from the University of Rhode Island. She joined the staff of Rhode Island Hospital five years ago as a nurse practitioner in the medical primary care unit.
She started the AIDS clinic with her boss, Dr. Tom Wachtel, director of the hospital's medical clinic, to speed care for victims and to help them with other problems such as intravenous drug use.
"The gay community and the IV drug community have been the biggest populations affected (by AIDS)," she said. "They're the underdogs. Right now, it's very fashionable to get on the AIDS bandwagon. In 1983 it wasn't. People were approaching patients like Russian astronauts and I think that initially I did too, because I didn't know what was happening."
Durand said many AIDS patients seemed afraid to seek treatment while others were ignored.
"It struck me very deeply that the patients were so needy," she said, recalling one she described as a street person.
No Place to Go
"He would sit in the lobby here during the day because he had no place to go. He had no conception of what was going to happen to him. I'd try and broach the subject about dying and he would just start talking about something else. He was never ready to hear it."
The patients she sees are mostly 20 to 30 years old. Like the soldiers of Vietnam, they are in their prime.
"A 19-year-old boy told me, 'Well, I've lived a good life,' " she said.
For Durand, such cases are the realities of AIDS. Vietnam was worlds away and often seemingly unreal to many.
"Your flight home was called a flight back to the world," Durand recalled. "It was like people didn't think Vietnam was part of the world. It was something different. We were there. We were existing. We were doing things, but it wasn't really part of life.
"But this is different. This is a part of life."