Early in March of 1987, Dorothy and William Polikoff went to a health fair at the Veterans Administration regional medical center here. At a "Play Safe" booth, she remembers, "They were giving out condoms. They gave Bill a condom and he laughed and said, 'I've been married for 40 years.' "
They did take home brochures urging that anyone at high risk for AIDS contact the county Health Department for testing. As they read, their uneasiness grew. Three years before, Bill had been given blood transfusions during bypass surgery; in June of 1986, after Dorothy had come down with hepatitis B, he had been discovered to be the hepatitis carrier.
For months afterward, the Polikoffs, certain that the donated blood had been infected with the hepatitis virus, had grown increasingly apprehensive as they read about transmission of AIDS through transfusions. Since September of 1986, they had been asking to be tested for the AIDS virus at the San Diego VA Hospital but, Dorothy said, three doctors there "told us there was nothing to worry about . . . it was not necessary." By February, Bill had developed a lump under one arm, was having night sweats and intermittent high fevers.
After that, they decided on their own to get the tests, through San Diego County. On April 2, four days after celebrating their wedding anniversary with their four children in Denver, the Polikoffs got the news: Both of them had the antibodies for HTLV-III (now called HIV or Human Immunodeficiency Virus), which causes acquired immune deficiency syndrome. The next day, a biopsy of Bill's armpit node showed invasion of the AIDS virus.
From that moment, Dorothy said, she began living "on tranquilizers and sleeping pills."
Death Ends His Fight
On Dec. 16, William Polikoff, 70, was buried with military honors at Fort Rosecrans National Cemetery on Point Loma. Although the final autopsy report is pending (an independent pathologist requested by the Polikoffs' attorney was brought in), Dorothy said she is convinced that her husband died of AIDS.
She is, by description of her attorney, Michael Orfield, "mad as hell." On her behalf, he has filed a wrongful-death suit against the UCSD Medical Center, where Polikoff's open-heart surgery was performed, and has submitted a claim against the Veterans Administration. Charging each with negligence, he is asking a total of $1 million in damages.
"It's not important to me to win the suit," she said. "It's important that doctors realize their responsibility, not just to Bill and me, but to mankind. They never should take blood from sick people. It could have been prevented, and they can save someone else the torment, the anguish."
Dorothy, 63, dabbed at her eyes and her voice broke: "He was a hell of a nice guy."
Now, she waits, wondering if, and when, she will develop AIDS.
Ill health had plagued Bill Polikoff for years. As an infantryman in World War II, he had survived the infamous six-day, 60-mile Bataan death march of April, 1942, in which an estimated 10,000 American and Filipino soldiers died.
A POW in the Pacific for almost 3 1/2 years, he received his honorable discharge from the Army in 1946. His discharge papers note that he was suffering from malnutrition, and that he had a "deranged" and atrophied right knee after being hit by a pick ax wielded by a Japanese guard; he had also had episodes of malaria, a tropical ulcer, pleurisy, scurvy, dengue fever and beriberi.
Later, a promising career as an engineer was derailed by health problems. At the time of his death, he was getting 100% disability pay from the service, plus Social Security. That income, though modest, allowed the Polikoffs to buy a tract house in San Diego. They had looked forward to the retirement years, to occasional short trips and other small indulgences.
"You'd of thought he'd used up his bad breaks," she said. But the bypass surgery, which had promised so much hope, was to evolve into a nightmare.
Putting Off Surgery
Bill had been fearful of his surgery, so much so that he had put it off for years, despite having suffered a heart attack in 1963, despite worsening angina pain. Finally he agreed, buoyed by doctors' projections of "10 good years" ahead.
Although Bill was an outpatient at the VA hospital, because of staff scheduling problems doctors there sent him to UCSD Medical Center for a catheterization that determined the need for immediate surgery. The sextuple bypass, performed at UCSD on Friday, Jan. 13, 1984, went smoothly and when he was discharged his physical condition was listed as "good."
His Medicare billing included a $45 item for three pints of blood.
He never really recovered from the bypass, Dorothy said. There were problems--a negative drug reaction, ulcerated lesions--necessitating lengthy rehospitalization. When home, he would venture out once or twice a week, for an hour or two, and return exhausted.
Dorothy, too, was feeling more and more debilitated. Then, in June of 1986, "I turned completely yellow overnight." The diagnosis, hepatitis B (or serum hepatitis) puzzled her and her doctors. The disease is transmitted by needle or by intimate sexual contact with a carrier. How had she gotten it?
Doctors tested Bill and their hunch was right: He was a carrier. Sometime during 1985 or 1986, after he and Dorothy had resumed sexual relations for a time, he apparently had infected her.
The Polikoffs figured there was only one way in which he could have been infected: via the donated blood during surgery. And they began to wonder--if that was a batch of bad blood, if the donor was a drug user perhaps, was it possible that donor also carried the HTLV-III (AIDS) virus?
By the time their nagging fear sent them to the county for testing last spring, Bill had developed some classic symptoms of AIDS. The county Health Department's finding that they both tested positive for the AIDS virus was confirmed at that time by backup tests at the VA hospital.
On Nov. 9, exactly a month before Bill's death, Orfield filed a suit in Superior Court in San Diego County, against the regents of the University of California and UCSD Medical Center. It alleges negligence and carelessness, contending that the defendants failed to comply with or require compliance with available standard screening procedures although in January of 1984 they had the ability to insist on testing of blood for "the viruses hepatitis B or HTLV-III."
It also asks compensation for Dorothy's "great mental, physical and nervous pain and suffering" as well as "profound shock and great emotional disturbance." Symptoms of AIDS or ARC (Aids Related Complex) may not show up for nine years or longer after exposure to the virus; scientists now believe that about 30% of those infected will develop AIDS within five years.
Eight months after testing positive for AIDS, after repeated hospitalizations, Bill died. He had endured bone marrow tests and spinal taps before ultrasound tests had pinpointed the cause of his pain as massive multiple stomach nodes. Even morphine could not totally dull that pain.
Dorothy cried as she talked about his last days, about the suffering, about how "his mind wandered and he imagined voices."
"I'm hurting. I'm deeply hurt," she said. "Who isn't when you lose someone you love? But not this way, not this way . . . it was not a peaceful death."
Bill was originally a plaintiff in the lawsuit. But, like Dorothy, what he wanted most to achieve was public awareness. A few weeks before he died, he told a hospital visitor, "It's too late for vengeance."
"He was not bitter," Dorothy said. "He had no animosity toward anyone." She is bitter sometimes, and she is angry. And frightened.
"Now I'm wearing the shoes," she said, "and walking in them."
The legal action on Dorothy Polikoff's behalf is proceeding even though the cause of death is unconfirmed. "He certainly was exposed to AIDS," attorney Orfield said. "We feel he had it. I'd be extremely surprised to find the cause of death was not related to AIDS."
According to the National Centers for Disease Control in Atlanta, screening for the HTLV-III virus was approved by the Food and Drug Administration in March, 1985, and within weeks was in widespread use by hospitals and blood banks. That was 14 months after Bill was given apparently tainted blood.
Nevertheless, Orfield said, "We know full well that AIDS as a national problem was coming on the scene in 1982. (Dr. Michael Gottlieb, then at UCLA, identified the virus in 1981.) We don't know if the system could have, or should have, moved faster."
But beyond that, Orfield said, "Certainly, they had the screening procedure in place for the hepatitis B virus. If that blood had been properly screened, certainly (Bill Polikoff) never would have gotten that blood. That blood should not have gone through."
Was it possible that Bill was carrying the hepatitis B virus at the time he entered UCSD Medical Center for open-heart surgery?
No, said Dorothy: "I'm positive Bill never had hepatitis B, never. My children would have had hepatitis B. I would have gotten it years ago."
Possible, Highly Improbable
According to Dr. Martin Finn of the Los Angeles County Department of Public Health, it is possible but highly improbable that hospital tests would not have included screening of a patient's blood for hepatitis B before open-heart surgery.
UCSD Medical Center has filed a response to the lawsuit denying responsibility but a spokeswoman said that, in view of the litigation, the hospital has no statement. She confirmed that the source of the blood given to Bill Polikoff was the San Diego Blood Bank. Orfield indicated he will bring legal action against the blood bank as well.
According to a blood bank spokeswoman, in January, 1984--at the time of Bill's surgery--all donors submitted to a questionnaire to determine if they had any known condition that would place them in a high-risk group for AIDS "and that was the best that we could do." Hepatitis B screening was done at that time on every donor's blood.
However, the screening is not failproof. According to Dr. Ira Shulman, director of the blood bank and transfusion services at L.A. County-USC Medical Center, there is no data but the risk today of getting hepatitis B is "probably significantly less than one in 2,000 or more transfusions," a risk that has been reduced since mid-1987 when the American Assn. of Blood Banks made a specific test for this type of hepatitis mandatory for accreditation. But in 1984, Shulman said, "It was possible for a low-level carrier to be negative with the regular hepatitis tests but still be potentially infectious."
The chances of contracting AIDS from donor blood are far lower. Finn said that a person receiving a blood transfusion today in Los Angeles County stands an estimated one chance in 38,000-40,000 of getting blood infected with the HTLV-III virus, higher than the national estimate of one in 60,000.
An amended claim, based on Bill Polikoff's death, has been filed against the Veterans Administration and, Orfield said, "We're waiting for them to tell us if they're going to honor the claim or deny it. We feel they're negligent." Under federal law, the VA must be given 180 days to respond before a lawsuit is filed.
The complaint against the VA alleges that "from September, 1986, to April, 1987 the claimant repeatedly requested to be tested for the HTLV-III virus" but was denied testing even though the hospital was aware of the dangers then inherent in transfusions.
No Comment From Hospital
A spokeswoman at the San Diego VA medical center, citing patient confidentiality and pending litigation, said the hospital could not comment on the case.
Orfield wants a total of $1 million in damages from all defendants. "We don't care where we get it," he said. "That's the money we're after."
Orfield said he views the suit primarily as a "public awareness" case. Dorothy Polikoff concurs. She also wants others to know that AIDS is a disease that afflicts old people as well as young. She wants people to lobby for more research money to fight AIDS. And she hopes that, with education, fear and persecution of AIDS victims will be replaced by "a little tenderness, a little love."
Dorothy Polikoff welcomes a visitor to her home and says, "Don't be afraid to touch my hand. I'm not going to give you AIDS." Don't be afraid to drink her tea, she begs. She smiles sadly and says, "Friends won't even talk to me on the phone."
She has discovered nodes under her arms, has lost quite a lot of weight and has been seeing floating black specks, possibly early signs of a detached retina. "That's what Bill started with last year, the same thing."
Occasionally she breaks down, then apologizes for getting "overly emotional." She has been seeing a psychiatrist, to help her deal with the stress. "He tells me to think of pleasant things. How long can you do that?"
She is certain, "Whatever Bill had, I have. It's just a matter of time."
Her eyes well with tears as she talks about Bill--"He cried. He said he was so sorry he gave me this. I'd give anything if we could undo it. But you can't." Then there is a flicker of anger--"They might have been able to save me. They knew how to test then for hepatitis B. They should have thrown that batch (of blood) out."
Prodding the Government
Still, Dorothy Polikoff wants it on the record that while she is taking legal action "to get the government to get off its rear" and make a real commitment to the fight against AIDS, she is in no way attacking her doctor, chief of staff Dr. Jacqueline Parthemore, and other doctors at the VA facility who have helped her and Bill: "I can't throw stones. They've been very kind and caring. They have tried. They're sorry. Their hands are tied, too."
On bad days, Dorothy says, "I don't think I can survive much longer. I have crazy thoughts," thoughts about suicide. She does not want to die the way Bill did.
She would like to do volunteer work but wonders, "Who would want to associate with me?" When casual acquaintances ask, Dorothy tells them that Bill died "of cancer."
What hurts most is that the fear has created a barrier between her and the people she loves. "My own sisters ask me not to kiss them, or my grandchildren. If this is the way people think, even people you love, there's nothing to wake up for."
There are support groups for gays with AIDS, but as a 63-year-old heterosexual woman , she wonders, "Where do I fit in? There are no senior citizens. It's uncomfortable, being with the young ones. I know there must be other victims like us. Who they are, I don't know. How do they cope? Who do they talk to?"
If only, she said, there were "a little more love, more caring, less fear. Someone to drop some cookies at the door and say, 'Hello.' "
She was hesitant about going public but, she says, "There's a killer loose. We have to get this killer before it destroys us all. There should be a public uproar. We must insist that AIDS is a top priority." Some have advised her not to tell anyone about having the virus, but she has decided that would be counterproductive. She has volunteered to be a participant in AIDS research--"If I can help someone, why not?"
Among other things, Dorothy Polikoff wants expanded education to combat fear and hysteria about AIDS, wants to see mandatory AIDS testing for sex offenders, wants every blood donor infected with the AIDS virus to be tracked down and identified. "They can backtrack, they can find out who these spreaders are," she says. "You don't just walk in and walk out. There's a record."
She does not want others to suffer. Reminiscing about her life with Bill, the man she met on an arranged date in New York 42 years ago and always admired for his "courage and determination," she says, "This is a hell of a way to spend these years . . . but other people are going to be faced with this, too. There should be some way of helping people like us. We didn't ask for this."
When identified as being infected with the AIDS virus, Dorothy Polikoff demanded that the county Health Department "find the one (the donor), and see who he associates with." She'll never forget the doctor's answer: "That man is probably dead now." It was only two years after Bill had been given the donor's blood.