AIDS: For the Lack of a Cure, a Curriculum of Understanding

Acquired immune deficiency syndrome, AIDS, is now reported in 123 nations; in the United States about one in every 150 people carries the viral agent. The calamity of AIDS can be taken as a metaphor, though limited, of a society gone wrong.

The disease is most often transmitted from one person to another in the course of activities not discussed in genteel drawing rooms. Ascribing the spread of AIDS to “sexual excess” and “drug abuse” conjures Dantean images--that the virus, among the tiniest and least complex of all living things, has developed through diabolic mutational changes.

This health catastrophe comes at an awkward moment when the American people already question their values and when our institutions of learning are held to be turning out an increasingly less educated and less interested work force. Prof. Allan Bloom’s best-seller, “The Closing of the American Mind,” carries a subtitle: “How Higher Education Has Failed Democracy and Impoverished the Souls of Today’s Students.”

Lacking a cure for AIDS, society must offer education, not only by public pronouncement but in classrooms. Those with AIDS or those at high risk of AIDS suffer prejudice; they are feared by some people who find living itself precarious, while others conduct themselves with a “bravado” that could be fatal. AIDS has afflicted a society already short on humanism, open-handedness and optimism. Attempts to slug it out with the offending microbe are not abetted by pre-existing social ills. Such concerns impelled me to offer the first university-level undergraduate AIDS course, with its two important aims:

* To address the fact that AIDS is caused by a virus, not by moral failure or societal collapse. The proper response to AIDS is compassion coupled with an understanding of the disease itself. We wanted to foster the idea of a cohesive and humane society.

* To describe how AIDS tests the institutions upon which our society rests. The economy, the political system, science, the legal Establishment, the media and our moral-ethical-philosophical postures must respond to the disease. Those responses, mumbled or shrieked, easily accepted or highly controversial, must be put in order if the nation is to manage AIDS. South Africa has begun the deportation of migrant workers suffering from AIDS; in the United States and in other nations, legislation to create a mechanism for quarantining or sequestering AIDS patients has been debated. Scholars have suggested that how a society deals with the threat of AIDS describes the extent to which that society has the right to call itself civilized.

AIDS, then, is woven into the tapestry of modern society; in the course of explaining that tapestry, a teacher realizes that AIDS may bring about changes of historic proportions. Democracy obliges its educational system to prepare students to become informed citizens, to join their voices to the public debate animated by AIDS. Who shall direct just what resources of manpower and money to the problem of AIDS? Even more basic, who shall formulate a national policy on AIDS? The educational challenge, then, is to enlighten the individual and the societal, or public, responses to AIDS.

The course at UCLA, AIDS: The Modern Plague, was offered from January to March of this year; it was open to all students, to be taken for credit but without grade. Student interest was high; although class meetings were scheduled from 5 to 6:30 p.m., about 540 undergraduates enrolled and perhaps as many as 2,000 were turned away.

The first few lectures emphasized biology--the exquisite simplicity of the AIDS virus and how it manages to victimize the most complicated of organisms. We reminded students of nature’s unity, describing the basic biology of the virus and of human beings, presenting the rules governing all living things and pointing out that AIDS is a natural, rather than supernatural, event.

Later lectures demonstrated that AIDS is knowable; it can be scientifically described and explained. AIDS became less frightening and, jumping one more hurdle, students began to realize that perhaps AIDS could be managed, if not yet cured. In that context, it was relatively easy to persuade them that the consequences of acting on bad advice, on vacuous myth, or in ignorance could lead to final illness.

We next presented clinical notes on patients themselves and on public-health issues. These lectures, delivered by scientists, by doctors dealing with AIDS patients and by public health professionals--all appropriately “white-jacketed”--needed to be counterbalanced by personal portraits.

We invited a panel of very different people: a homosexual, a heterosexual, a prostitute and a conservative argued their contrasting views. Then came a class meeting where two persons with AIDS told their own stories of living with illness. They spoke of discomfort, of hope and of the importance of people who care. They described their insistence on fully experiencing life and nature, however short or long the time ahead. Their courage, their willingness to dream and their humor were special case-histories of success. Success is something with which students today can easily relate. At the end, the persons with AIDS received a standing, and very emotional, ovation. Compassion can be taught; it grows out of understanding.

In contrast to lower back pain, AIDS is a health matter of major international concern. One student confessed being “numbed by AIDS.” The course referred to it as a plague, defined as a widespread, contagious, fatal and incurable disease. The stage was set to explore how a plague is responsible for historic societal change. Government, for example, often faces crises that can be managed with a “quick fix”--say, a tax change or a new traffic light--with hardly a murmur of debate. But there is no quick fix for AIDS and stormy governmental wrangles have yet to produce a policy to guide the $1-billion federal allocation made this year.

AIDS turns back medical practice by 100 years, to days when doctors offered “care and dignity” to patients they could not cure. Deplorably, only 46% of physicians in a recent California survey said that they were willing to treat AIDS patients. Medieval societies were terrified by the inability of royal and clerical leaders to defeat bubonic plague; worse, the leaders themselves were often stricken. Parallels are obvious and the notion of a “modern Renaissance” to follow the current plague becomes relevant.

I’d like to think that education helped form a bond between our students and the troubled, confused people who had perished 600 years ago. Epidemics remind us of the common human destiny of man. We read selections from “Moby Dick.” Students said that Chaucer and Dante held new meaning for them. To complete the message, guest lecturers included a lawyer, a philosopher and a newsman; they discussed the ways that AIDS affects all parts of our society and how it has become a significant component of the human condition.

My sense that humankind occupies a central position in the scheme of things--a lesson learned from biology Prof. John Preer of Indiana University--and my feeling for the pertinence of history suggest seeing the present epidemic with guarded optimism. For we have conquered such physical ills as Black Death and “the pox.” Man-made degradations such as child labor and indentured servitude are long gone, too. Education helped then; broad-based, academically oriented courses on AIDS can help now.